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Chronic homelessness has a high human and financial cost. Ending chronic homelessness saves lives and resources that could be better spent ending chronic homelessness. Learn more about the true cost of chronic homelessness in this presentation from The Way Home campaign.
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Chronic homelessness & the
cost of doing nothing
Can we save money by doing the right thing?
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Who supports The Way Home Campaign?
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3,700 concerned citizens and 57 local and national organizations
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Agenda
• Welcome and introduction, Whitney Parnell, Capitol Hill Group Ministries
• Background on chronic homelessness, Kurt Runge, Miriam’s Kitchen
• Remarks from Co-sponsors
• Keynote speaker, Waldon Adams, PSH Resident and Advocacy Fellow, Miriam’s Kitchen
• Panelist presentations
• Solutions to chronic homelessness, Christy Respress, Pathways to Housing and Adam
Rocap, Miriam’s Kitchen
• Q and A
• Reception with light lunch
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Chronic homelessness - an individual or family who has been homeless for a year or more, or at least four times in the past three years and has at least one – and sometimes many - disabling conditions
On a given night in the District, there are approximately 1,800 individuals and 130 families who are chronically homeless
What is chronic homelessness?
Jeff used to live under a bridge in Foggy Bottom In Feb 2014, he moved into his own place.
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Donald was homeless for 15 years. Much of that time was spent outside at
Union Station before getting housing 5 years ago.
Nationally • Majority “single" adults • 75% male • 25% female •High rates of mental illness (60%) and/or substance abuse (80%) • High rates of chronic and life threatening conditions such as hypertension, asthma, HIV/AIDS, liver disease
Who is chronically homeless?
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Ending chronic homelessness is urgent
People who experience chronic homelessness die 4-9 times younger than the general population.
The average age of someone who is chronically homeless is in the 50s and average life expectancy is 61, compared to the U.S. average of 79.
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Ending chronic homelessness is possible
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The cost of chronic homelessness in D.C.
A Coordinated Entry System (CES) launches in D.C.
Image Courtesy of Chris Ko – Home for Good LA
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Over 3,350 assessments have been completed from Fall 2013 through February 2015.
Assessments from coordinated entry tell us the frequency of emergency services:
The cost of chronic homelessness in D.C.
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Methodology
The cost of chronic homelessness in D.C.
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It is estimated that in just one year’s time, DC’s 828 most vulnerable chronically homeless individuals:
The cost of chronic homelessness in D.C.
4,702 2,346 2,544 2,154 1,696 E.R. visits Police Ambulance Inpatient used a interactions rides stays crisis hotline
Emergency services totaling
$19 million a year
*Cost estimates are likely an underrepresentation of the true cost of chronic homelessness,
because they are based on self-reported data and do not capture all cost drivers.
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Of the 828 most vulnerable chronically homeless individuals, the top 50% of highest utilizers incur even greater costs:
3.1 short-term mental
health visits across the year
amounting to $2,516 in
Medicaid costs
3.4 police interactions amounting to
$615 to the police system
5.1 ambulance ride for 10 miles
amounting to $2,515 in costs to
Medicaid
8.7 visits to the ED amounting to $7,470
and 5 inpatient admissions amounting to
$27,727 to DC Medicaid
Ambulance
Services
Behavioral
Health Services Incarceration &
Police Costs
Inpatient/Emergency
Department Services
Annualized Costs:
Average of $40,843
per individual
PSH only cost $22,500 a year and drastically reduces the use of emergency services.
*Cost estimates are likely an underrepresentation of the true cost of chronic homelessness,
because they are based on self-reported data and do not capture all cost drivers.
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The cost of chronic homelessness in D.C.
Ricky
Took the ambulance 134 times to the hospital
Had four inpatient hospital stays
Used mental health crisis services 12 times
This represents $208,908 in medical costs alone.
PSH only cost $22,500 a year and drastically reduces the use of other emergency services.
-50
50
150
250
350
450
550
Mo
nth
ly V
olu
me
Total Visits vs. Unique Patients by Month (thru Jan 31, 2015)
Total Volume of Patients
87
61
49
40
30
37
27 29
37 39
51
36
44 47 48 49
71 68
41
66
85
98
90
104
0
20
40
60
80
100
120
0 1 2 3 4 5 6 7 8 9 1011121314151617181920212223
Vo
lum
e o
f V
isits
Hour of Day
Volume by Hour of Day Discharge Diagnosis
In 18 Months 57 patients each accumulated at least 36 visits to the
Emergency Department to qualify as a Super User Patient
Collectively during the 18 month period, these 57 patients totaled 2277 visits to
the Emergency Department
The total cost for the Emergency Department Visits =
$600,530
Inpatient Vs.
Outpatient
Visits Total Cost
Outpatient
(Emergency
Room Visit)
333 66,726
Inpatient 8 $59,709
Total $126,436
Human Cost
•Chronically Homeless x 7 Years
•Medical Diagnosis
• Traumatic Brain Injury
• Type II Diabetes
• Osteomyelitis and ulcer of toe
• Right Leg DVT
• Scabies
• Alcohol use vs. Abuse
Inpatient Vs.
Outpatient
Visits Total Cost
Outpatient
(Emergency
Department
Visit)
200 $24,364
Inpatient 18 $ 88,981
Total $ 113,345
Human Cost
•Chronically Homeless 5+ years
•Medical Diagnosis
• COPD – Chronic Obstructive Pulmonary Disease
• Alcohol dependence w/ Seizures
• Bipolar Disorder
• History of Suicide Attempts
• Is a Healthcare Intervention
• Will reduce Healthcare Cost
• Will result in better Healthcare Outcomes
• Will prevent fatalities
• Will enhance the overall effectiveness of
the Healthcare system
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Ending chronic homelessness IS possible
With Housing First,
anyone can be successfully housed
Insert picture here
Ending chronic homelessness IS possible
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Solutions - Housing
Permanent Supportive Housing
Rapid Re-housing
Flow Housing
The Housing must be:
targeted to the right people (Coordinated entry)
with few barriers (Housing First)
North Capitol Commons, PSH for veterans
Ending chronic homelessness IS possible
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How do we reach that goal?
Invest new resources in housing solutions
Use the resources we have better. Turnover and new construction need to be targeted
appropriately and Housing First. Pairing behavioral health services to housing.
Leverage new resources Medicaid Pay for Success
Ending chronic homelessness IS possible
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It’s urgent
We know what works
We can’t afford to do nothing