Housing First policy could save Missoula thousands on service costs accrued by homeless

A homeless man asks for money in downtown Missoula. The city has reported progress in its plan to end homelessness and is moving toward establishing a housing first model in the coming years. (Missoula Current file photo)

While the ethical and moral costs of homelessness on a community are well know, the financial impacts often get overlooked. Trips to the emergency room and visits before the judge add up, costing taxpayers tens of thousands of dollars.

Addressing members of the Missoula City Council and other community groups on Wednesday, Vanessa Fry of Boise State University said the homeless challenge has long been viewed as a social one, though several cities have taken a new approach by viewing the issue as one of fiscal prudence.

As a result, cities that have invested in a Housing First model have saved millions of dollars in service costs, benefiting taxpayers over time while giving the most vulnerable a new chance at life.

“We know the chronically homeless are some of the most vulnerable people in the community, and they’re using the vast majority of the resources we have available,” said Fry. “They’re costing our taxpayers quite a bit of money.”

Fry researched one homeless man in his 40s and the expenses he incurred during his chronic homelessness. Over six months, the man – who suffered both a mental illness and an addiction to alcohol – was transported by ambulance 11 times at a cost of $15,000.

He also made 13 visits to the hospital at a cost of $26,000 and interacted with the criminal justice system several times, including 14 arrests and 22 charges for a total cost of $3,000. During those six months, he also spent 95 days in jail.

“The direct cost the community was able to contribute to his homelessness and the issues around his homeless was $54,000,” said Fry. “This is just one person. Here in Missoula you have just under 50 people experiencing chronic homelessness. They cost money, too.”

The city of Boise identified around 100 people experiencing chronic homelessness, costing the community $1.3 million in a single year. But after an up front investment, the city has broken ground on a housing complex for the chronically homeless and expects to see significant savings down the road.

Fry said such savings have been identified in other city’s that have taken a Housing First model. Denver saw a 72-percent reduction in interactions with emergency medical care, saving $32,000 a year, while Seattle saw a 60-percent reduction and an annual savings of $37,000.

“It’s a new approach, and what you see is a lot of larger cities doing it first,” said Fry. “We in Boise are trying to figure out how that will work as we move forward. When we think about the savings and costs, it’s not a simple subtraction.”

The annual point in time survey completed last year counted 344 homeless individuals in Missoula, including 42 who identified as chronically homeless. Estimates suggest it costs more than $53,000 a year to deal with those individuals who place the greatest burden on local services.

Council member Julie Armstrong, who invited Fry to present her research on the issue – and who has taken the lead on the City Council in addressing homelessness – said the savings incurred by other cities could translate to Missoula if the community got behind the Housing First model.

“I’m pretty sure we can meet their basic needs for less than $53,000,” said Armstrong. “Because this has worked in other places, it’s worth exploring. I’m hoping people see the value of tackling this, and that it’s costly for all of us, especially the medical system and the courts. Everyone chipping in results in cost savings and benefits that accumulate over time.”

Fry described Housing First as permanent supportive housing that attempts to remove as many barriers as possible. Like many shelters, the Poverello Center in Missoula doesn’t accept those who’ve been drinking, leaving those hardest to serve with no option for shelter.

While some have referred to supportive housing as “wet housing,” it’s proven effective in other cities, regardless of its name. By providing shelter to those with addiction, it serves to meet their basic needs.

“The basic level of needs are shelter, water and a sense of belonging,” Fry said. “That’s what Housing First really tries to do. We can’t expect someone to address addiction without having a shelter. This is a philosophy and not everyone likes it, but it’s what our community (Boise) chose to do.”

Erin Pehan, director of Missoula’s Office on Housing and Community Development, said the city is in the early phases of looking at a similar model. As it stands, she said, Boise is about two years ahead in the process.

“We do know we have a core group of chronically homeless individuals who are high utilizes of our system – frequent utilizes of our hospitals, criminal justice and behavioral health systems who we’re not effectively serving right now,” said Pehan. “This is that double win of cost savings for the community and better outcomes for those who’ve experienced homelessness for decades.”

Pehan said the Housing First model dovetails well with the city’s own plan to end homelessness. It focuses in part on permanent supportive housing for chronically homeless individuals, particularly those struggling with substance abuse.

“It’s a key initiative in our plan and one we hoped we’d be further along with at this point in time,” Pehan said. “Permanent supportive housing is targeting the most difficult to serve individuals who have typically been on the street for a very long time.”