Last week, we discharged another veteran to a homeless shelter.
He was medically fragile, recently stabilized after intensive care, and in no condition to recover on the street. The shelter required a 5:00 p.m. check-in. There was nowhere safe to store medications, no place to rest during the day, no stability. This is not an isolated incident. It is routine.
We work in post-acute and hospital discharge settings in Portland, including at Porthaven Post Acute, a skilled nursing facility that specializes in high-acuity care, dialysis patients, people with complex wounds, behavioral health needs, tracheostomies and veterans with PTSD and substance use disorders. Our role is to help people heal and transition safely. Increasingly, the system makes that impossible.
Patients are being discharged from hospitals and skilled nursing facilities directly into homelessness. Elders who should be focused on rehabilitation are navigating shelters. Veterans who served our country are leaving medical care with nowhere stable to go. Healthcare professionals are forced to participate in a process we know is unsafe because no viable alternatives are available.
What makes this especially troubling is that this is happening while Portland has a significant number of vacant housing units, particularly publicly subsidized housing intended to serve vulnerable residents. Recent reporting shows that nearly 1,900 publicly subsidized affordable housing units in Portland are currently vacant, the highest level in roughly a decade. In addition, Home Forward, the region’s public housing authority, has reported that approximately 14% of its units are sitting empty, more than double the city’s overall rental vacancy rate.
This is what is so infuriating about this moment: the housing exists. Taxpayers paid for it. These units were built specifically to serve people with limited income, disabilities and complex medical needs. And yet they sit empty while veterans and elderly people are discharged from medical care into shelters or the street.
We are told this is due to “market conditions,” “lease-up timelines,” or administrative barriers. But none of those explanations justify the outcome. If housing funded for the public good is left vacant while medically fragile people are homeless, then the system is not failing by accident. It is failing because of priorities. Veterans and elders should not be navigating eligibility mazes and waiting lists while empty units sit behind locked doors. This is not a housing shortage, it is a failure of urgency, coordination and accountability.
Beyond subsidized housing, Portland continues to see properties purchased and held vacant as financial assets, while people with urgent medical needs are told there is “nothing available.” If an individual or entity can afford to keep housing empty indefinitely during a housing and public health crisis, then our policies are misaligned with community needs.
This is where leadership matters.
Our mayor, governor and city council all have roles to play in addressing this contradiction by creating programs that bring vacant units online faster, setting accountability standards for publicly funded housing, and putting policies in place that discourage long-term vacancy while people are discharged into homelessness. Empty housing should not coexist with medical discharges to shelters without intervention.
Housing outcomes are the result of policy choices.
We, along with colleagues across health care and social services, have repeatedly reached out to elected officials in our district to request something very basic: a visit. Come see the reality on the ground. Meet the veterans and elders whose medical recovery is being undermined by housing gaps. We have received no response.
This silence matters.
City leadership plays a central role in setting housing priorities, approving funding and overseeing the systems intended to serve our most vulnerable residents. While no single office controls every lever, collective decisions and the absence of urgency shape whether people recover with dignity or fall through the cracks.
As health care professionals, we are repeatedly placed in the position of discharging homeless veterans and elderly Portlanders to shelters. We explain to families why their loved one, who just survived a medical crisis, has no safe place to go. We watch people do everything asked of them medically, only to be failed once they are deemed “stable enough” to leave care.
We would never accept a hospital discharging a patient into an unsafe environment. Yet we accept it every day when housing is treated as separate from health care.
It isn’t.
Housing is health care. Stability is health care. Dignity is health care.
Many of the people impacted by these decisions are constituents. They voted. They trusted that the city they built and served would not abandon them at their most vulnerable moment.
This is not a theoretical debate, it is a lived reality. We are asking city leaders to step into it: to visit our facilities, speak with veterans and elders and listen to the frontline workers who are holding this system together despite its failures.
Portland can do better but only if those with the power to shape policy are willing to look directly at the consequences of inaction.
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This article appears in January 14, 2026.