Homelessness at minus 20 C - Is this not an Emergency?

On many a night shift I have witnessed the ambulance bringing in yet another intoxicated homeless person. Sadly, the vast majority are aboriginal as well. In the summer months, like in most ERs in the south, my goal is to rule out a serious medical emergency, treat any superficial injuries and come up with a disposition. This is challenging sometimes but mostly it is fairly obvious what to do. Some people end up sleeping it off in the RCMP drunk tank and the more sober ones either end up at one of the shelters in town or just walking out the door.

But what to do on a cold winter's night?

Often, the temperature around here in Yellowknife dips below - 20C. Some of the homeless sleep at the shelters, others have tents that are set up in some of the wooded areas around town. Unfortunately, some are banned from the shelters for inappropriate or violent behavior. Others still look for a warm place where ever they can (indoor bank machine rooms, unlocked doors, etc.).

Is there an ethical duty to provide a place for someone to stay who has no safe place to go? I would argue that there is. I am not sure though that this duty falls to the emergency department. The fact that waiting times are too long and bed availability is often a factor makes this a dilemma. I figure with no other options, it becomes our obligation to house these individuals until we identify another location.

So in a sense homelessness is a real emergency and not just a chronic (and therefore not an ER) problem. But is it not really everyone's problem? Shouldn't the hospital as a whole have a plan for providing a place to sleep for the homeless? Maybe we need to start by asking them!