Chronic homelessness & the

cost

of doing nothing

Can we save money by

doing the right thing?

Who supports The Way Home Campaign?

3,700 concerned citizens and 57 local and national organizations

Agenda
Welcome and introduction, Whitney Parnell, Capitol Hill Group Ministries

Background on chronic homelessness, Kurt Runge, Miriams Kitchen

Remarks from Co-sponsors

Keynote speaker, Waldon Adams, PSH Resident and Advocacy Fellow, Miriams Kitchen
Panelist presentations

Solutions to chronic homelessness, Christy Respress, Pathways to Housing and Adam

Rocap, Miriams Kitchen
Q and A
Reception with light lunch
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What is chronic homelessness?

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

Jeff used to live under a bridge in Foggy Bottom

In Feb 2014, he moved into his own place.

Who is chronically homeless?

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
Donald was homeless for 15 years. Much of that time was spent outside at
Union Station before getting housing 5 years ago.

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.

Ending chronic homelessness is possible

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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The cost of chronic homelessness in D.C.

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.

Methodology

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The cost of chronic homelessness in D.C.

It is estimated that in just one years time, DCs 828 most
vulnerable chronically homeless individuals:

4,702
E.R. visits

2,346

2,544

2,154

1,696

Police
interactions

Ambulance
rides

Inpatient
stays

used a
crisis hotline

Emergency services totaling

$19 million a year

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*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.

Of the 828 most vulnerable chronically homeless individuals, the

top 50% of highest utilizers incur even greater costs:
Inpatient/Emergency
Department Services

Ambulance
Services
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

Behavioral
Health Services
3.1 short-term mental
health visits across the year
amounting to $2,516 in
Medicaid costs

Incarceration &
Police Costs

Annualized Costs:
Average of $40,843
per individual

3.4 police interactions amounting to

$615 to the police system

PSH only cost $22,500 a year and drastically reduces the use
of emergency services.

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*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.

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.
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Total Visits vs. Unique Patients by Month (thru Jan 31, 2015)
550

Total Volume of Patients

450

Monthly Volume

350

250

150

50

-50

Discharge Diagnosis

Volume by Hour of Day

120
104
98

100
87

85

Volume of Visits

80

71

66

61

60

40

68

51

49
40

37 39

37
30

44
36

90

47 48 49
41

27 29

20

0
0 1 2 3 4 5 6 7 8 9 1011121314151617181920212223
Hour of Day

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

Human Cost
Chronically Homeless
Medical Diagnosis

x 7 Years

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
Room Visit)

333

66,726

Inpatient

$59,709

Total

$126,436

Human Cost
Chronically Homeless 5+ years
Medical Diagnosis

COPD Chronic Obstructive Pulmonary Disease

Alcohol dependence w/ Seizures
Bipolar Disorder
History of Suicide Attempts

Inpatient Vs.
Outpatient

Visits

Total Cost

Outpatient
(Emergency
Department
Visit)

200

$24,364

Inpatient

18

$ 88,981

Total

$ 113,345

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

Ending chronic homelessness IS possible

With Housing First,

anyone
Insert picture here

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can be successfully housed

Ending chronic homelessness IS possible

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)
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North Capitol Commons, PSH for veterans

Ending chronic homelessness IS possible

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

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Ending chronic homelessness IS possible

Its urgent
We know what works
We cant afford to do nothing

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