As managed care and increasing health care costs continue to squeeze hospitals’ bottom lines, the institutions charged with maintaining the safety net of our health care industry are beginning to show signs of wear. Nonfunded mandates, an increase in the number of uninsured, and crowded emergency rooms are only part of the problem facing our nation’s emergency departments as they struggle to find balance between costs and quality of care. While additional funding may be one answer, an argument for improved delivery of social services is also presented.