Administrators at Boston Medical Center, which serves the neediest patients in the Boston area, have barred migrant families from sheltering in its emergency department, in some cases even sending them after-hours in Ubers to Logan Airport, according to five workers and a document reviewed by the Globe.
The new policy, implemented last week, requires emergency department employees to send migrants to a state-run welcome center or homeless shelter during business hours when they are open. It comes in response to the numbers of newly arrived migrants, some in need of medical attention. Many arrive at the hospital seeking shelter because other options are full.
If a family arrives at the BMC emergency room after business hours, the policy directs employees to order the family an Uber to wherever they stayed the previous night or to another address in Massachusetts where they would like to go.
The new policy is not sitting well with some BMC employees. A few dozen nurses, midwives, physicians, and other BMC staff protested the directive Tuesday on Boston Common, pleading with state officials to address the homelessness crisis.
They chanted into megaphones and held large posters that read “Right to Shelter Not to Floor,” a reference to the state’s 1983 “right-to-shelter” law, which obligates officials to immediately house eligible families.
“The reaction was one of indignation,” said Brynn Macaulay, an obstetrics nurse at the hospital, who often cares for pregnant immigrants arriving at the hospital. “How on earth could administrators expect us . . . who chose to work at BMC for this specific reason of taking care of vulnerable people, abide by a policy in which we are making them more vulnerable?”
The move by BMC is the latest sign of the strain on the state, which has grappled with an overwhelming need for more shelter space amid a surge of migrant and homeless families in recent months.
The policy states that if the family at the emergency department has no alternative address, staffers should order the family an Uber to Logan. The instructions do not say what BMC employees should tell families to do next after they are left at the airport arrivals drop-off zone.
It also states repeatedly that staying at BMC is not an option for the families — and that employees should not allow them to sit in the lobby space once they have been screened by hospital staff.
If the family refuses to leave, staff are instructed to call the on-call social worker and a public safety officer to assist. If the family continues to refuse, an off-shift nurse manager should decide next steps, according to the policy.
Macaulay, the BMC nurse, said the number of families arriving at BMC has sharply increased in the year-plus she’s worked at the hospital. They arrive hungry, sick, and often with small children in need of care. Some nights, it takes the entire shift to triage the groups of people in need.
“Often, it seems almost as if a bus has unloaded,” she said.
Her colleague Anissa E. Dickerson said she has seen an influx of new migrants and other homeless people arriving at BMC in recent months, including pregnant patients who slept on the street or on nearby porches, including during cold weeks in March.
“It’s not an appropriate housing situation for them to be in the lobby of a hospital or an airport,” said Dickerson, who has been a midwife at BMC for six years.
Two workers told the Globe that last Wednesday, more than 100 migrants arrived at BMC seeking shelter.
In the last week, multiple families were sent to the airport, a number of BMC employees said. In some of those cases, families were sent back from Logan to BMC, the employees said.
In an interview, BMC spokesperson Markeisha Marshall said the hospital has transported people to shelters or other places, based on “case by case” conversations with families.
She said they work to send people to the home of a family member, a church, or the last place they slept.
“In very small instances, some people have gone to the airport for a couple hours” before the state welcome centers open for the day, Marshall said.
In a letter to hospital staff Monday evening, BMC chief executive Alastair Bell said “given this situation, and after a number of difficult discussions with clinical and administrative leaders at BMC, late last week we began supporting families to seek alternative locations to shelter.”
“The past week has underscored that we cannot safely continue to serve as the front door of this escalating crisis,” he wrote.
Geralde Gabeau, head of the Immigrant Family Services Institute in Mattapan, said she had to call BMC on Monday after people were sent to the airport to sleep, a move she called “very troubling.”
A spokesperson for the Massachusetts Port Authority, which operates the airport, said, “Logan is not an appropriate place to house people.”
“We do not have the resources to care for or provide any human services,” Jennifer Mehigan, the spokesperson, said, noting that State Police contact local organizations and shelters when homeless people arrive at the airport.
The new arrivals to Massachusetts — many of whom are fleeing political strife, street violence, and economic collapse in their home countries — are turning up at places like BMC at all hours.
Massachusetts is a right-to-shelter state, meaning the government is obligated to provide care for some homeless families, including the migrants.
Boston, which is responsible for housing homeless individuals inside city limits, has seen the number of migrant families in need of shelter increase over the past few months. A spokesperson for the city acknowledged “a sustained strain” on hospitals, including BMC, due to the influx.
“We are continuing to support the state in their efforts to move families out of emergency departments into more stable housing options as soon as possible,” Ricardo Patrón, the spokesperson, said in a statement.
It’s difficult to quantify the number of migrants arriving, as the state does not count them separately from others seeking shelter. But the sheer number of arrivals has exhausted available shelter space statewide, with officials resorting to using empty dormitories and hotel rooms. As of Monday, there were 1,201 homeless families placed in hotel shelters alone. When Governor Maura Healey took office in January, there were 388.
The Healey administration has worked for months to address the crisis, including adding tens of millions to the emergency shelter system, as well as directing an infusion of money to local organizations helping migrants with case management and legal assistance.
The demand, however, continues to outpace supply.
A new shelter at Joint Base Cape Cod, which can hold up to 60 families, is already nearing capacity. And a brand-new central entry point for migrant and homeless families to receive resources located in Boston has been so overwhelmed it is already trying to hire more staff.
BMC is no exception to the influx, said Jeffrey Thielman, chief executive of the International Institute of New England.
“I understand that BMC is overwhelmed by people coming there with no place to stay,” said Thielman, who serves newly arrived migrants in Greater Boston. “However, sending them to Logan Airport isn’t a solution either. It speaks to an absence of good coordination between local authorities and private groups that serve people like this.”
Jessica Bartlett of the Globe staff contributed to this report.