Sunday, August 02, 2009

Total spent on homeless "frequent fliers" better spent oustide of jail

An excellent story by Kim Horner at the Dallas News tallies up the cost of dealing with the homeless in Dallas County, which comes to $73 million annually in publiic and private dollars, half of it for less than 1,000 "frequent fliers." Here's how it begins:
Dallas County taxpayers spend about $50 million a year sheltering, treating and jailing the homeless.

Perhaps half of that is for the 600 to 1,000 toughest cases – many of whom visit emergency rooms, psychiatric hospitals, jails so often they're called "frequent fliers." These very ill people repeatedly cycle through a massive, uncoordinated system of local, state, federal and private institutions at alarming speed and alarming cost. And despite the millions being spent, many of these chronically homeless people remain in shelters and cardboard boxes.

"What do we get? They're still homeless," said Mike Rawlings, who serves as Dallas' homeless czar. "Somebody would be fired in the business world if they got those results."

The $50 million figure was arrived at by totaling the annual expenses of more than a dozen local taxpayer-funded agencies. It is a conservative figure because some agencies do not track how much they spend on the homeless. And it does not include at least $23 million in private funds spent locally caring for the homeless.

Some of the costs to taxpayers are predictable: the police officers who get the homeless off the street, and the places that house them and treat their mental and physical illnesses. But there are plenty of other expenses: for ambulance runs, removing trash from homeless camps, even staffing for the city's drunk tank.

Dallas officials are working to end this costly cycle by shifting money into housing that would come with services to help people remain stable. But there's a major shortage locally of this type of housing.

"Texas is called a bootstrap state. But we're probably costing ourselves a lot of money by insisting on that bootstrap approach," said Dr. Ron Anderson, president and CEO of the Parkland Health & Hospital System. Parkland Memorial Hospital spent about $15.6 million providing health care to homeless people in 2008.
The full story is worth a read. Good stuff, though perhaps I especially appreciated it because it provides ammunition for my own position about how best to manage this troublesome, high-cost population, which is a problem in every big city.

For the truly chronic homeless (and as the article notes, the government knows who they are: Dallas police have a list of them), it makes a lot more sense to pay for semi-permanent housing, long-term aid and programming. The alternative is the current "ricochet" effect described in the article where homeless people bounce back and forth between different government systems racking up massive, often needless expenses.

Think about it this way: If between 600 and 1,000 homeless people account for half the total homeless costs, Dallasites are already spending $36.5 million per year on this population, which amounts to somewhere between $36,500 and $60,000. That's a middle class salary - enough to pay their rent, groceries, meds, and caseworkers to check in on them and help them manage their affairs. Plus their healthcare costs can be absorbed much less expensively if its performed oustide of the emergency room.

It's a lot of work to tally up the costs from all those different agencies, and as Horner says, $73 million is probably a conservative estimate for what's being spent in Dallas. Looking at the cost issue from 30,000 feet, as this article attempts to do, it's evident all that money could be spent on this small, identifiable handful of people more wisely and effectively.


Soronel Haetir said...

My question would be along these lines:

Say you did set up some sort of housing arrangement for this trouble population. Given that it would almost certainly involve government of some sort, what are the chances it would come with rules these folks would be able to follow?

I've seen reports from other cities, the most chronic population is made up of folks who just aren't capable for the most part of conforming their behavior to what society expects. And given the side effects of many of the medications used to treat these conditions I can understand why people would rather suffer with their problems than the cure.

Gritsforbreakfast said...

Soronel, you raise a good question that's perhaps easier answered than you might think. Since many of these folks are in and out of the justice system, the way to easily impose rules is through an enhanced community supervision system - perhaps a specialized probation caseload operating through a mental heath court.

Right now probation is weak, has access to few problem-solving resources, and the only alternative is usually revocation and jail. I'm suggesting we strengthen alternatives to incarceration, especially community supervision, using more of a case management vs. a law-enforcement approach, since we're cycling them all through the justice system anyway.

That's not to say, btw, that homelessness or mental illness should ONLY be treated as criminal justice problems, and I think there need to be more outpatient beds and support resources available through community providers - both government and nonprofit - on the front end BEFORE people get into trouble. In those settings the issues are more difficult. But when we're talking about the frequent fliers in and out of the jail, it's easy to figure out how to impose rules on them.

Perhaps we can agree that the problem of nonconformist behavior, to use your terminology, is exacerbated when people must steal to eat (or drink, for that matter) and don't have a roof over their heads. By contrast, if they have a home to go to, at least the government usually knows where to find them when they go off their meds. That's always step one, then ideally you can do competency restoration outpatient and further relieve stress on the forensic mental health side.

Soronel Haetir said...

I don't see it being that simple. I believe in freedom enough that I would rather give people the choice of jail and being medication free. I do not like involuntary competency restoration, even in felony cases.

Anonymous said...

I agree that the problem of homelessness is a problem of freedom as well as money.

If $30,000 to $60,000 is being spent annually on an identifiable number of folks, then I also agree that there is a great deal of wasted money that could be better spent.

Resources should be available to this population when they want it and on their terms. That alone would save a bundle since folks that want to rejoin mainstream society could have a hand up. The only requirement for folks that cannot function the way we want them to is that they should not present a real threat to public safety.

Anonymous said...

Spending the money on housing, meds, case managers, and programming will decrease but not stop the other costs - - emergency room, police involvement, etc. Also, putting them on specialized supervision will only work for those who can (or will) follow the rules. I agree with the plan, but people should realize that it will not be a cure-all.

Anonymous said...


Check out Haven for Hope in San Antonio - a trendsetter in the US where several agencies work together in one location to take in not only the homeless but those arrested on minor non-violent charges. They work their way out literally - I mean paying jobs and are assisted in getting jobs and housing. It is a terrific idea.
Also Chicago has a beautiful environmentally based homeless several story center for their citizens. There are logical solutions. Good luck.

Charlie O said...

What, Texas actually spend money to HELP people. C'mon you can't be serious. Unfortunately, most Texans have the same attitude as Soronel. Either they "want" to be homeless or it's their own fault, so screw'em. Or it hopeless to help anyone, so why bother trying.

Anonymous said...

I think you confuse Texans with politicians.

I applaud those Texas police officers who demonstrate compassion for their fellow man, it’s highly likely that a few of them may (be) Texans.

I feel the Homeless appointee, Mr. Rawlings is searching for answers and that in and of itself shows that at least someone in government cares enough to give consideration to alternatives. It is of course his job to do something, or there would be no need for a “Homeless Czar” but rarely does that mean much these days when it’s a government job.

For those who have actually been elected to office, and apparently felt the need to appoint someone to do the governing for them in Dallas, and for the rest of the noble people who choose to enter “public service” by attaining political office, Texas or otherwise; I would consider a requirement by law that they open a Webster’s Dictionary and read the definition of the word inconsiderate, until they can, at will, repeat it verbatim.

In-kən-‘sid-(ə-)rət 1: not adequately considered : ILL ADVISED 2: HEEDLESS, THOUGHTLESS b: careless of the (rights) or feelings of others

Then perhaps they too will seek out alternatives to incarceration, and put the Texan taxpayer to whom they serve at the forefront of their actions, and their money to much better use in the fields of health care and education, where it may actually (be) well spent.

Anonymous said...

I would only support forced medication for felons.

Meanwhile, we can afford to lock these guys up. We need targeted enforcement. Focus more police resources on getting these guys locked up for long periods of time.

Anonymous said...

I stand embarrassingly corrected Charlie O, unmistakably 08:02PM is an advocate of locking up the mentally ill, and has no disposition other than screw’em.

There’s no way to be certain but it’s very possible that he may be the only one, unless of course 08:02PM is a politician.

If he is Tar, Feathers, a wooden rail, and a trip out of town come to mind, then (if) he is a Texan, the city 08:02 PM calls home could hold its head up high once again.

Anonymous said...


Goodluck with the tar and feathers or the wooden rail, you liberals tend to have difficulty with physical exertion.

The question is whether these community services are really a good investment. I tend to think they are just a waste. What does the data say? We should look into it.

Anonymous said...

I would prefer not to be labeled liberal unless of course that’s the Republican Party’s new twist for its own constituents, since politicians tend to play shell games with their opinion sometimes its difficult to tell. I do not advocate big government or high taxes. Nor do I advocate allowing tax dollars to be spent for the purpose of serving government.

I do think our government is in shambles due to political blunder on both sides, so I care not for politicians. I’m fairly certain that doesn’t make me the Lone Ranger. In fact that puts me square on the side of the majority when you poll the nation’s approval ratings of our leadership in the last regime, and this “new change” regime that threatens the very freedom our country stands for.

You suggest this subject should bear scrutiny, insinuating that tax dollars would probably be wasted. You reference whether or not it would be investment worthy, I assume because we prefer our investments to have a positive return.

The people in question are “homeless” and mentally ill. The criminal justice system puts them through a revolving door in part because they are “mentally ill”. To prove someone knowingly and willingly committed a crime you must establish that the person has the capacity to determine lawful behavior. Our current investment gives us a negative return. Your approach would be to create new law, I guess discriminating against the mentally ill. Your investment plan would no doubt set up mental health hospitals within our penal system at astronomical costs that could for all practical purposes by your own statement be perpetual.

The cost for care could be shouldered by both tax dollars and private funds that are readily available for a “worthy cause”.

Our jails are currently packed beyond capacity and our Federal Courts are going to mandate releasing more criminal defendants from our local jails, criminal defendants that are not mentally ill!

If thoughtful insight isn’t given to address jail overcrowding, the release of criminal defendants, which is happening now for non-violent offenders, is going to increase regardless of what they are accused. So the statement, “we can afford to lock these guys up” is tantamount to putting your head in the sand, unless you think we should print some more money to pay for it.

I want real criminals in jail. I would like to think that breaking into my car has more consequences than the same revolving door. Non-violent offenders who I guess (steal politely), and drive lethal weapons under the influence are exempt from the old fashion rehabilitation that takes place when parents say “this is your first and only get out of jail opportunity, next time you will stay there”; the government has taken their input and the very real consequences they represent completely out of the picture, they do not need their help to get out of jail. Hooray, a free for all.

Our government already spends more tax dollars than anyone can ever begin to put a number on through current “community services” that operate directly within our criminal justice system. The government run program exists by in large to fight a war on drugs that has not only given us a negative return, but in fact compounds the problem of theft, violence and drugs beyond belief. They place our national security at great risk and enhance the black market’s strong hold on our citizens.

You advocate spending even more, to place even more people in jail that shouldn’t be there.

“Who’s robbing this train Jessie?”

Anonymous said...


Read the article carefully. It suggests that half of the $50 million dollar tab is caused by 600 to 1000 tough cases.

Now, if 800 people are causing $25 million in expenses, that's about 31 thousand per person. And that doesn't even consider the cost of the crimes committed by these individuals.

We know it costs about $22 thousand to lock up an average inmate for a year. If we can lock up a mentally ill inmate for 31 thousand a year, I'd say its a good investment. Heck, even if it was higher than 31 thousand it still might be worth it because they wouldn't be committing their crimes in the free world.