Really there is a small but seriously problematic population of people in need of a high level of mental health care who I would guess are the primary perpetrators of public defecation + urination (schizophrenia, addiction/intoxication, etc.). The 1,320 homeless people needing the most aid required $106 million in emergency medical and mental health services in 2015. Putting this money to work institutionalizing these chronic cases seems like a sensible and responsible thing to do – and it isn't hard to pick these individuals out. Staff at the General know all the regulars.