I. The Price of Living on the Street
Based on 2014 data, there are approximately 580,000 homeless people in the United States. Jurisdictions that have embraced the Housing First model have helped drive down national totals in recent years. But even areas that have pursued reform are up against the national affordable housing crisis. Housing First is based on the premise that overall costs of providing for the homeless can be reduced if individual housing is provided.
1. Nearly 1/3 of All Homeless Live in Just 10 Cities
New York City 67,810
Los Angeles (city and county) 34,393
Las Vegas/Clark County 9,417
Seattle/King County 8,949
San Diego (city and county) 8,506
Washington, DC 7,748
San Jose/Santa Clara ( city and county) 7,567
Denver 6,621
San Francisco 6,408
Chicago 6,287
2. Cost of Multiple Arrests
Osceola County, Florida tracked 37 homeless people arrested 1,250 times over 10 years for 61,896 days of incarceration. Here's what they cost: Booking costs - $130,000 + Jail costs - $4,951,680 + Mental-health care in jail - $1,336,225 = $6,417,905.
3. Denver's Housing First Savings
Denver saved $17,858 per person over 2 years in the following costs alone: the largest savings came in impatient care, followed closely by detox costs, then came emergency room costs, followed by outpatient costs and, finally, incarceration costs.
4. Homelessness Down Since 2007 But Gains Not Uniform
Homelessness up 29% in New York but down 18% in California.
5. A Person on LA's Skid Row Costs Nearly 5 Times as Much as One in Housing First
A homeless person on the street costs $2,897/month, versus $605/month in supportive housing. Homeless costs on the street are composed of: welfare services, jail, private hospitals, public hospitals and clinics, and paramedics. Public hospitals and clinics comprise the largest single cost. (Sources: Mother Jones, March/April 2015; motherjones.com/homeless)
II. The Grim State of the Rehab Industry
1. Needed Alcohol Treatment
18.7 million Americans needed alcohol treatment in 2010 and only 1.7 million received it.
2. Reason Addicts Give for Not Getting Help
45.5% Can't afford it/inadequate health coverage
24.5% Not ready to stop using
9.0% Don't know where to go
8.0% No transportation/inconvenience
6.6% Worried about their job.
3. Too Few Clinics
There are 14,148 addiction treatment facilities in America. Very few include impatient services.
81% Outpatient
26% Residential
6% Hospital impatient
4. High Prices
Private insurers covered only 15% of the costs of alcohol addiction treatment. While it's possible to get free treatment at charities like the Salvation Army, a month of residential care can cost as little as $1,800 at a government subsidized center and up to $60,000 at the kind of facility that helps celebrities like Lindsay Lohan.
5. Poor Oversight
* 20 states require either no degree or only a high school diploma to become a certified addiction counselor.
* Only 10 states require residential treatment programs to have a physician on staff.
* Only 8 states require the same of outpatient treatment programs.
* Only 21 states require the tracking of patient outcomes.
6. Cost to Society
* Alcohol addiction costs $250 billion each year.
* 1 percent ($28 billion) of total health care costs in 2010 went to treating drug and alcohol addiction.
* For every dollar federal and state governments spent, 95.6 cents went to pay for the consequences of substance use; only 1.9 cents were spent on any type of prevention or treatment. (Sources: National Center on Addiction and Substance Abuse, Columbia University; Substance Abuse and Mental Health Services Administration; Centers for Disease Control and Prevention)
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