It’s a hopeless economic proposition to prove or debunk.
That the $15 million spent in 2011, to house and support 1,789 formerly homeless Edmontonians within an umbrella of complementary social programs coordinated by The Edmonton Homeless Commission, is money well spent.
The idea of this column was to look at the cost/benefit ratio of that $15 million not through compassionate eyes (for who can argue with any social program that relieves the misery, loneliness, mental and physical pain of those reduced to having no place to call home) but through practical eyes.
In the third year of its 10 year mandate from city hall to end homelessness in Edmonton, the Homeless Commission announced last week that, over three years, 1,789 individuals who were once homeless are now housed.
The “cost avoidance” argument can be easily proved. – before and after arguments are shut-and-dried. The newly housed, with the right social supports, do cost much less for emergency room use, ambulances, incarceration and hospital stays.
But what of the bigger picture?
Does that impressive figure of 1,789 individuals off the streets mean the police, paramedics and emergency docs can shift more time and resources to our collective betterment? How much?
Does it mean ambulance response times are dropping because of fewer medical emergencies in the inner city?
Does it mean we’ll be tended to more quickly in hospital emergency rooms compared to three years ago when more homeless ended up in the hospital?
Does it mean downtown sidewalks are less scary because of fewer derelicts and panhandlers?
Nobody seems to know.
The factors at play are too numerous: As the population grows, newly homeless arrive from out-of-town. City residents still move from housed to homeless. The Hope Mission – the city’s biggest shelter - still took in an average 499 individuals per evening in 2010, the last year for which statistics are available, compared to 496 per evening in 2009. If police response times are shortening, is it the result of fewer calls, or more police? What about the tightening rental market?
Plus there’s the inherent contradiction of all social services – for every program governments cut in the name of cost containment, the social agencies (with the best of intentions) can propose 10 more to address compelling social issues.
And, pardon my cynicism, all social agencies want to be seen as doing a good job and will present their statistics accordingly.
The emergency doctors working at the Royal Alex Hospital honestly don’t know if the newly-housed help their situation. The statistics from Alberta Health Services, they suggest, aren’t precise enough (yet) to define the homeless other than the designation of “no fixed address”. But the docs certainly aren’t seeing a drop in overall case loads.
The paramedics? The union says response times are marginally better than the last red-alert crisis, but how much of that was due to more ambulances on the street compared to a drop in calls from the homeless?
Nor will the downtown beat police hazard a guess.
Homeless Commission executive director Jay Freeman is far too sensible to suggest money is actually being saved, or resources measurably redeployed, at any collective social level.
But he’s comfortable with this notion of “cost avoidance”.
Despite the Hope Mission statistics above, the commission reports an overall 23% drop in shelter use between 2008 and 2010. Does this result in a 23% drop in their costs? Of course not, but shelters are now starting to look beyond the mere provision of a sleeping mat, he says, to think about prevention for their clients.
The commission’s statistics suggest the homeless spend an average 28 days per year in hospital (outside of mental institutions). But, once housed, their client hospital use has dropped to 9.3 days a year.
There’s similar comparisons for drops in jail time, court costs, mental hospital stays, once the homeless are housed.
In conclusion, the commission says, once housed and given necessary social supports, the societal costs of the formerly homeless individual drops from $100,000 to $35,000 a year, an “avoidance” cost saving of $65,000.
Is it true? Who knows?
Are the actual number of homeless on Edmonton streets dropping? We won’t know for sure until October, when the every-other-year homeless snapshot is taken. Everybody was excited in 2010, when the reasonably accurate count dropped by 668 people, from 3,079 in 2008 to 2,421 in 2010.
The only reality I’ll fully subscribe to in this debate comes from a doctor friend, who spends part of his time working in community health clinics in the inner city.
“All I know,” he says, “is that some of my patients are now in better shape when they come to see me. They’re now washing themselves, taking their medications, their blood pressure is stabilizing, their diets are improving, their acute issues aren’t as bad. They’re not coming in full of cuts and bruises from being robbed or beaten up. And it’s because they have a roof over their heads and assistance when they need it.”