Helping Homeless Helps Bottom Line

By Leslie Linthicum
Albuquerque Journal
Sunday, February 20, 2011

Albuquerque’s homeless are sicker and more vulnerable than people who live on the streets in other cities. They have much higher rates of brain injuries, hepatitis C, mental health and substance abuse issues, and they are more likely to be victims of violent attacks.

The results of a survey of Albuquerque’s homeless released last week are disturbing, and they cry out for action. Why? Because men and women with heart disease, liver disease, kidney disease, cancer and asthma, people who are military veterans and senior citizens, shouldn’t have to sleep under bridges.

That’s the human side of the problem. There’s also a practical one: The cold, hard facts are that these are expensive people, and we’re all footing the bill.

The good news is that getting people off the streets and into permanent housing is not only the compassionate thing to do, but it might also be good for government’s bottom line.

Albuquerque Heading Home, a public/private partnership that originated in Albuquerque’s City Hall, has identified the 75 most vulnerable among those on the street to participate in a pilot project that will move them into apartments for at least a year.

Here’s who they are: Forty-nine men and 26 women. Average age, 53. Average time homeless, 20 years. Among the 75, they had 235 inpatient hospitalizations and made 564 emergency room visits last year. Total estimated annual cost for that care? Almost $1 million.

That million dollar drain on tax dollars doesn’t include the costs of emergency transport or tied-up police units or shelter services or incarceration, which send the price tag even higher.

Under the model that has been used in a number of other cities and will be tested here, the most vulnerable (and most expensive) are moved into a stable living situation and surrounded with support — substance abuse and employment counseling and cohesive, outpatient medical care.

Seventy-five people live a safer, healthier, fuller life, stay out of hospitals, ERs and jail, and their costs to government drop. In this age of budget deficits and calls for government to cut back its social service role, it’s rare to find an approach that’s as good for the bottom line as it is for the soul.

The lucky 75 will start being notified this week and should be inside with heat, beds, kitchens and bathrooms shortly.

In Albuquerque, according to Mayor Richard Berry, the project will cost around $500,000. How much will it save? Stay tuned. We’ll find out in a year.

There are lots of risks in this program and lots of unknowns. Dennis Plummer at Albuquerque Opportunity Center, an Albuquerque shelter, told me that making the transition to apartment living will be as challenging for some chronically homeless as being put out on the street would be for you or me.

The 75 will get lots of support, but they will also be under the microscope for the next year, with their health and social service costs especially scrutinized.

Robin Dozier Otten, the city’s director of family and community services, told me the program has minimal risks for government and social service agencies. The track record in other cities points to big savings, she said, and if at the end of the year the numbers don’t show a good bottom line, the city will end it.

In the week of bitter cold earlier this month, as survey teams were scouring the streets looking for the homeless, I talked to Ed Boucher, 26, who had been homeless for 2 1/2 years.

Boucher sat at a table inside the West Side shelter and answered “yes” to a number of questions on the vulnerability survey.

Where do you usually sleep? “Either outside or here. Mostly outside.”

How many times have you been to the emergency room in the past three months: “Once.”

How many times have you been hospitalized in the past year? “Five times.”

Heat exhaustion? Yes. Irregular heartbeat? Yes. Asthma? Yes. Treated for drug or alcohol abuse? Yes. Mental health issues? Yes.

Have you ever been taken to the hospital against your will for mental health issues? Yes.

Have you been the victim of violent attack since becoming homeless? Yes. In jail? Yes.

Boucher is an engaging guy with a nice Boston accent who spends his days looking for odd jobs, filling out employment applications, and finding shelter, food and help with his ADHD and bipolar disorder.

“I know I would not be in this situation if I could just get my feet on the ground and keep on level ground and not worry about where I’m going to sleep or worry about where my next meal is going to come from,” Boucher told me.

The mayor has explained Albuquerque Heading Home as a chance to stop managing homelessness and try to eliminate it. I like the idea of Albuquerque as a city where everyone has a chance to live on level ground.

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