The Absolute Cost of Homelessness - Calgary Drop-In & Rehab ...

A DI Discussion Paper1

2The Absolute Cost of HomelessnessWith 50 years experience in servinghomeless and low income Calgarians,the Calgary Drop-In & Rehab Centre(DI) has a historical perspective and theprerequisite empirical data that evidencesthe real benefits and costs of supportingchronically homeless Calgarians. Using theinformation from our database, a rich andcomprehensive record of individual clienthistories, our evidence confirms that thecost to support one chronically homelessindividual in Calgary is almost half thesuggested costs put forward in otherresearch.the cost of homelessness reaches beyond the bottom lineThere is a cost to homelessness.Just as there is a cost, social andmoral, to family abuse; addictions;poverty; foster care and any other provisionof social services to people inneed. When we as a collectivevoice allow myths to overridethe facts, we undermine theefforts of those working hardto make a difference in the lifeof someone on the street.A fundamental flaw inpresenting the cost as$100,000 for all homelessindividuals is that thecomplexity of homelessnessand its impact on the individual is lost inthe data that reflects an aggregate cost forall homeless Calgarians. As an example,the figure of $100,000 is based on the top18 most frequent emergency service users“Our evidence confirmsthat the cost to supportone chronicallyhomeless individual inCalgary is almost halfthe suggested costsput forward in otherresearch.”The Calgary Homeless Foundation’s(CHF) Report to Community 2009, “TheHomeless Among Us”, states, “It costs$100,000 a year in social services tosupport one homeless person. There arethousands of them in Calgary.” (p.8) InHomeless exercise their write tospeak 1 , Tim Barber, a self-describedveteran of homelessness, attempting toenlighten Calgarians with a new perspectiveon homelessness, states, “Over $100,000per year is spent on every homeless personin Alberta.” His comment further cementsthe collective opinion that every homelessindividual is a significant cost on tax-payersand public purses.reported in the CHF’s Report on the Costof Homelessness in Calgary, publishedJanuary 28, 2008. Applying these coststo every homeless Calgarian creates a biasthat supports the view thatwe are turning our backson those who need us. 2 Thecorrelative view would be tosuggest that every Calgarian isa frequent emergency serviceuser with, for example, annualunpaid emergency servicefees of $25,191 3 . Suggestingevery homeless individualcosts $100,000 burdens eachindividual with a social andmoral cost where their valuein our communities is preceded by the costto support them – a cost that is not reflectiveof the individual, but rather, of the sector asa whole.The Absolute Cost of Homelessness

3bottom line costs varyTo determine the true cost of supportinga chronically homeless client at the DI,(those with the highest no. of stays in 2009– day and night sleep which includes HarmReduction) we undertook an analysis of thefrequency of stay and emergency serviceinteractions of the top 50 users at the DI.Within our top 50 chronically homelessclients, there were 27 EMS calls and 9 CPScalls (total) during 2009. The calls wereattributable to 15 individuals in our top 50users.Figure 1 provides an overview of theestimated costs of supporting one homelessindividual according to the CHF and thebreakdown of actual number of calls forEmergency Services support by the top 50users of the DI.Figure 1:CHF Cost FactorsCHF Cost Structure for Annual Cost of ChronicHomeless individual per year 4 :DI Top 50No. of Calls for Top 50 Chronic Homeless Individualsin 2009 at the DI:EMS Attendance:FIRE Attendance:CPS Arrest/Attendance:Unpaid EMSUnpaid FIREUnpaid CPS$ 276/call$ 276/call$ 84/call$ 8,397/person$ 8,397/person$ 8,397/personTotal EMS Calls: 27Total CPS: 9No. of Clients(those from whom calls are attributed)EMS Calls 9CPS Calls 6Hospital Stay$ 1,000/dayCalgary Remand CentreEmergency shelter$ 109/day$ 40/nightTOTAL Clients of Top 50who required EmergencyServices15DI Annual Cost for One IndividualShelter, Food, & Programs $ 13,140A DI Discussion Paper

4According to the CHF report, an additional$25,191.00 covers unpaid fees for EMS, CPSand Fire. Social services costs, per person,not including unpaid fees, are $10,513.80+ $14,600.00 (365 nights in a shelter @$40/night) hospital and Calgary RemandCentre stays totalling $15,761.72. It canbe assumed, therefore, from the numbersprovided in the Cost of HomelessnessReport, that it costs $61,156.48 to supportthis individual annually, with an additional$33,876.60 attributable to other factors toreach $100,000.Of the 15 clients responsible for the27 EMS calls, 10 are attributable toone individual with a non-alcohol or drugrelated seizure disorder. This individualhad difficulty obtaining appropriatemedication in 2009. All of the individual’scalls were EMS related. Over the course ofhis ten years utilizing the DI’s services offand on (he stayed at other shelters for acumulative period of two and a half years)this person had 24 EMS calls and no loggedCPS interactions. During his presence at theDI he has been noted as intoxicated threetimes. None of these incidences requiredCPS assistance.the ACTUAL cost of homelessnessAn examination of the actual costs,however, based on the DI’s records,indicates it costs substantially lessthan this to support a chronically homelessindividual such as this gentleman. In2009, the government of Alberta fundedeach shelter night at the DI for $28.00 --$12.00 less per night than the figure quotedin the Homeless Among Us which statesthat “Government pays a shelter $40 a dayto give someone a mat on the floor and ameal, which is $1,200 a month.” (p15) and,$20 less per night than the $48 used todetermine shelter costs in Report on theCost of Homelessness, (Exhibit A-1, p4.)Using the cost of $275.69 per EMS and Firecall 5 , this would account for $5,513.80 forEMS/FIRE support for this one individual.The individual had a total of 5 nights not atthe DI in 2009 which can be attributed to astay in hospital at an additional $1,000 pernight for a total of $5,000 6 . In total, basedon the numbers provided in the CHF’sReport on the Cost of Homelessness in theCity of Calgary, his Emergency Servicescosts for 2009 were $10,513.80.The Absolute Cost of Homelessness

5In actual fact, the DI’s average daily costper client is $36 of which $28.00 isfunded by the provincial governmentper bed. The DI raises an additional $8.00/day attributable to auxiliary services suchas clothing, counselling, life-skills training,courses, etc. It cost the DI an average of$1,080 per month, or $12,960.00 to supportthis individual for a year.Figure 2 shows the cost comparison forChronic Homelessness, based on theReport on the Cost of Homelessness versusthe actual costs of one individual with themost EMS calls in 2009 at the DI. Includingan assumed unpaid fees as determined bythe report, this individual’s actual costs for2009 were $40,267.80 -- 360 nights at theDI, five nights in hospital, 10 EMS calls andno police interactions.Figure 2:Cost of most frequent user of EMS at the DIAnnual Cost/Chronic HomelessAnnual Cost/Chronic client (Top 50 - highest userCalgary Homeless Foundation (CHF)of services + 10 EMS calls and 5 days in hospital)Calgary Drop-In & Rehab Centre (DI)$100,000.00 $40,267.80Projected Cost Factors:Actual Cost Factors:Calgary Drop-In & RehabCalgary Drop-In & Rehab$40/day x 365 $ 17,520.00 $36/day x 360 $12,960.00(CHF Report - $48/day/person from Province)(Actual $28/day/person from Province)Emergency SupportEmergency SupportAvg. 4 calls/person @ $275.69/call10 calls @ $275.69/call*EMS $ 1,102.76 EMS $ 1,102.76FIRE $ 1,102.76 FIRE $ 1,102.76POLICEPOLICEAvg. 3.3 calls/person @ $84/call No calls in 2009CPS $ 278.04 CPS $ 0.00Unpaid EMS $ 8,397.00/person **Unpaid EMS $ 8,397.00/personUnpaid FIRE $ 8,397.00/person Unpaid Fire $ 8,397.00/personUnpaid CPS $ 8,397.00/person Unpaid CPS $ 0.00HospitalHospitalAvg. Stay 12.2 days $ 12,200.00/stay* Stay 5 days $ 5,000.00Calgary Remand CentreCalgary Remand Centre$108.72/day$108.72/dayAvg. stay 34.6 days $ 3,761.72 Avg. Stay 0 days $ 0.00Sub Total $ 61,156.48 ACTUAL COST $40,267.80PLUS -- OTHER(particulars not known) $ 33,876.60TOTAL $100,000.00*Fire does not attend every call at the DI**Has AB Health Care Card. Not Known if bills paid.*Average length of hospital stay for a chronicallyhomeless individual is 12.2 days. (CHF report)A DI Discussion Paper

6many chronically homeless neveruse emergency servicesNot all chronically homelessindividuals are users of emergencyservices. As an example, Jack*a 52-year-old chronic alcoholic has beenusing the DI services since 2001. His onlyrecorded CPS interaction was in 2006 whenCPS dropped him off at the DI. He has noknown EMS or Alberta Health Servicesinteractions. As such, his total cost to theDI in 2009 was $13,140 (365 x $36/night).Given his long-term homeless status,however, he would be labeled chronic andthus, he would be deemed to cost socialservices $100,000 per year.Figure 3:Cost comparison of one chronically homeless client at the DI with noEMS or CPS interactionsAnnual Cost/Chronic HomelessAnnual Cost/Chronic client (Top 50 Users - noCalgary Homeless Foundation (CHF)known EMS or CPS interactions)Calgary Drop-In & Rehab Centre (DI)$100,000.00 $13,140.00Projected Cost Factors:Actual Cost Factors:Calgary Drop-In & RehabCalgary Drop-In & Rehab$40/day x 365 $ 14,600.00 $36/day x 365 $13,140.00(Est - $40/day/person from Province -- The(Actual $28/day/person from Province)Homeless Among Us)Emergency SupportEmergency SupportAvg. 4 calls/person @ 275.69/call0 @ $275.69/callEMS $ 1,102.76 EMS $ 0.00FIRE $ 1,102.76 FIRE $ 0.00POLICEPOLICEAvg. 3.3 calls/person @ $84.00/call No calls in 2009CPS $ 278.04 CPS $ 0.00Unpaid EMS $ 8,397.00/person Unpaid EMS $ 0.00Unpaid FIRE $ 8,397.00/person Unpaid FIRE $ 0.00Unpaid CPS $ 8,397.00/person Unpaid CPS $ 0.00Hospital Avg. Stay 12.2 days $ 12,200.00/stay Hospital Stay 5 days $ 0.00Calgary Remand CentreCalgary Remand Centre$108.72/day$108.72/dayAvg stay 34.6 days $ 3,761.72 Avg. stay 0 days $ 0.00Sub Total $ 58,236.28 ACTUAL TOTAL $13,140.00PLUS -- OTHER(particulars not known) $ 41,763.72 *Has AB Health Care Card. Not known if bills areTOTAL $100,000.00paid.In suggesting that every homeless Calgariancosts the system, and therefore the taxpayer,$100,000 per year to support, we perpetuatethe idea that every homeless citizen is a highuser of our social services, through frequentinteractions with Emergency Services,Health Care, the judicial system and othersocial service agencies. Attributing remandcentre costs, judicial costs and policeservices to every chronically homelessindividual suggests that every homelessindividual is inherently criminal.The Absolute Cost of Homelessness

7According to the CHF, homelessness ringsup an annual cost to taxpayers of $4.25billion 7 . The Homeless Among Us alsostates, “Supportive housing can be morecost effective than an array of emergencyservices. The average annual cost perperson were $66,000 to $120,000 forinstitutional responses (prison, detentionand psychiatric hospitals) and $13,000 to$42,000 for emergency shelters, but only$13,000 to $18,000 for supportive andtransitional housing and $5,000 to $8,000for affordable housing without supports.”(p15)homelessness costs less at the DIIn 2009, with an annual budget of $21million the DI provided services toover 12,000 individuals, 89% of whomstayed less than three weeks at the DI.For $13,140 per person, we provided eachperson the opportunity to be safe and tofind the resources they needed to continueback to the homes where they belonged.Providing individuals a safe and caringenvironment where they are treated withdignity and respect and where they canfind essential resources is critical for thepeople we serve. It is not about managinghomelessness. It’s about ensuring everyoneis safe, has a place to belong and a way toget back home. And for some, staying inour community longer than society deemsappropriate, is a reality of their experiencein homelessness.Nobody ever dreamt of becominghomeless. And yet, when they findthemselves in that place of NoFixed Address, having a welcoming shelterto come to, finding a place where they canbelong, is the only thing that keeps them safefrom the cold, hard reality of the street.At the DI, we do not manage homelessness.We manage our resources and ensure thatwe extract maximum value from everydollar the government, communities,organizations, corporations and individualsentrusts in our agency. We ensure that withthe resources we are provided, we maximizeour value in the lives of the people we serveand minimize our impact upon our sisteragencies and organizations such as CPS,EMS and the health care system.More than managing the business ofproviding for individuals who are homeless,however, we care for people. We delivereffective and respectful service to peoplein need. We accept people where they’reat, and hold a place for them until they findtheir courage to say, “Here’s where I wantto go. Can you help me?”A DI Discussion Paper

8the Power of MythsThe costs of serving homelessindividuals should never takeprecedence over the moral andsocial imperative of providing personsexperiencing social distress includinghomelessness, impaired mental and physicalhealth, and any other social ailment,appropriate support and service. When welet myth take precedent over fact we devaluethe people experiencing the very conditionwe are attempting to ‘solve’ with our plansto end the homelessness in their lives. “Theaverage annual cost of system usage, suchas hospitals, corrections and shelters, by ahomeless person in Calgary is estimated tobe approximately $100,000. And the moralcost of allowing our fellow citizens to sufferis simply too much to bear. We can solvethis problem.” states The Homeless AmongUs (p. 5).Homelessness is not the problem. It is asymptom of what is wrong in an individual’slife. It is an outcome of weaknesses in thesocial fabric of our families, communitiesand society. It is a result of governmentpolicies that, while formulated with goodintent, ended up hurting those on themargins of our society.We cannot solve the ‘problem’ ofhomelessness. We can recognize thatto end it, we must awaken in the peopleexperiencing it the realization that theydeserve more, they can do more to changetheir role in our society. We can’t do thatholding onto myths that keep people miredin the belief – the only time we ‘see’ themis when we add up the burden of their costin our communities. We can do it when wefocus on providing care that honours theindividual and gives them room and spaceto grow into claiming their place as valuedmembers of our communities, no matter iftheir address is a shelter or a home of theirown within our neighbourhoods.References Cited1http://comcul.ucalgary.ca/news/homeless-exercisetheir-write-speakThe University of Calgary, Communicationand Culture.2The Homeless Among Us. Calgary Homeless FoundationReport to Community 2009. p73Report on the Cost of Homelessness in the City of Calgary,RSM Richter & Associates Inc. 20084Calgary Homeless Foundation Report on the Cost ofHomelessness in the City of Calgary RSM Richter & AssociatesInc. Business Valuations & Litigation SupportCalgary, January 28, 20085Report on the Cost of Homelessness in the City of Calgary,RSM Richter & Associates Inc. 20086Ibid.7The Homeless Among Us. Calgary Homeless FoundationReport to Community 2009, p158Ibid. p5*To protect individual privacy pseudonyms are used throughoutthis document. Some details have been changed.Calgary Drop-In & Rehab Centre Society423 - 4th Avenue S.E., Calgary, AB T2G 0C8discussionpapers@thedi.caThe Absolute Cost of Homelessness