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Downtown dilemma: Community working together to help 'chronic inebriate' population

Posted: November 25, 2011 - 1:05am
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Glory Hole Executive Director Mariya Lovishchuk, center, speaks out during a meeting held this fall at the Tlingit-Haida Regional Housing Authority to discuss homelessness and the growing numbers of chronic inebriates in Juneau.  Michael Penn/Juneau Empire
Michael Penn/Juneau Empire
Glory Hole Executive Director Mariya Lovishchuk, center, speaks out during a meeting held this fall at the Tlingit-Haida Regional Housing Authority to discuss homelessness and the growing numbers of chronic inebriates in Juneau.

It’s no secret downtown Juneau has become a hangout spot for somewhere between 15 and 30 homeless “chronic inebriates,” but what may be less well known is many community agencies, downtown businesses and the city are coming together to find a solution to this growing concern.

The Juneau Homeless Coalition, which has 25 voting members and about four non-voting members, is working on finding solutions to help this sector get off the streets and better coordinate services.

The coalition is also working to find a solution to the city’s homelessness situation. Some numbers are cited that indicate 500-600 people in Juneau are without a home — either living on the street, in a shelter or couch surfing between different friends’ and family members’ homes.

“The community knows there is an issue,” said Scott Ciambor, Juneau Economic Development Council affordable housing coordinator. “There is a lot of concern from downtown businesses to library staff to services. There are a lot of people who do not have resources.”

Who is most in need?

Ciambor said they are taking a look at the problems associated with public intoxication, public nuisances, health and safety and costs associated.

Seven of the coalition members went to a statewide coalition meeting last month to get a better idea of what other communities are doing to help homeless people who are struggling with alcoholism. The group came away with two ideas. The more immediate option is called a “vulnerability index.” Basically, service providers or members of the coalition will hit the streets and meet the people. They will document who they are, what level of service they would potentially need, and where they would mostly likely be found. This information would go into a binder and would rank people on who is most in need of services.

“It will set the criteria for who is the most vulnerable, who is most likely to die on the streets,” Ciambor said. “This was something that was developed by a doctor in Boston and used around the country. Anchorage recently completed their vulnerability survey in September.”

Ciambor said there is one common theme around this issue in Juneau.

“We already have enough services in this town,” he said. “You also have to think about the mentality of the service being provided. It’s very passive. If you come to our agency you’ll get services or you’ll get a referral. We have to be more active. That’s what the vulnerability index would do. ... They have to acknowledge they want to be a participant. It’s not like you’re going out and harassing them into it.”

A possible place to live

The second possibility will take more time to coordinate, but it involves housing. Ciambor said while there are a fair amount of services in Juneau, it lacks a housing component. What the coalition is looking at is called the “Housing First” model. Housing First models have been established in Anchorage and funding was approved this summer for a facility in Fairbanks. In Anchorage and Fairbanks, vacant hotels were or will be converted. Sitka also has a similar model.

“The concept is called harm reduction,” Ciambor said. “It’s targeting the homeless chronic inebriate population. Yes, they can drink in their room just like anybody who rents a room in the rest of the country. They will have access to programs that are available. It’s just removing a barrier and getting people into housing. The results have been phenomenal. There’s been a reduction in drinking almost immediately.”

Part of the problem is the cost of service without a Housing First model. Ciambor referenced a 2006 story from the New Yorker about a man called “Million Dollar Murray.” A man who was homeless and an alcoholic who probably rang up about $1 million worth of service costs in the 10 years he was on the streets. Just one person.

Rainforest Recovery Center’s Director Sandy Kohtz compiled costs for their top 10 recurring patients and for just August and September their visits cost $128,414. And that’s just services for Rainforest Recovery and low-end estimates of what emergency room visits cost. That doesn’t include costs associated with police interaction, Capital City Fire and Rescue response or any other service provider costs.

“In the last four to five months, four of our individuals that were chronic users,” Kohtz said. “Two we have gotten into long-term care. One of them moved with sober family members in some other town, into a supportive environment. The other one is now in treatment here.  What happens then is people move up in the list. Our No. 1 user, disappeared off the face of the Earth. We were able to get him to let us contact family. Which was a huge thing, which he never had. He alone cost $33,604, just for those two months.”

Kohtz also points out she doesn’t like people use the term “chronic inebriates” because it sets the belief that these people can’t ever get better. They can, she said.

“If you work in this field, if you start calling people that, then there’s no hope,” she said. “While alcoholism is a chronic illness and people die from it. Ultimately there is no cure.”

Ciambor said if you break the cycle of having emergency services constantly picking people up and sobering them up — typically briefly — and returning, the costs also immediately go down and people can get services that they need.

The organization is collecting data about full costs, and is hoping to have more gathered by its Dec. 15 meeting.

If you take a look at the 2001 McDowell report (contracted through the Advisory Board on Alcoholism and Drug Abuse, part of the Alaska Department of Health and Social Services) it shows millions of dollars spent on many aspects of alcohol and other drug abuse.

For example, there was a $319 million loss in productivity, $146 million spent on criminal justice and protective services, $123 million in health care, $21 million in traffic crashes and $4 million spent on public assistance in 1999.

The coalition has talked to case workers for communities with Housing First, and have found that alcohol consumption is reduced because people have a place of their own — they’re no longer consuming as much as possible as quickly as possible out of fear of someone stealing it from them. They’ve also heard feedback that by providing housing, this population tends to stay in their apartments instead of heading back out on the streets.

By using a Housing First model, it reduces the number of incidents that require emergency personnel, doesn’t force a person to stop drinking to simply have a warm place to sleep at night, and provides service options and personnel available to help them if they want it. There are still rules and requirements at Housing First facilities.

“There is a lot of work to do, but its nice to see some tools available,” Ciambor said. “You can sense the frustration in the community, especially in the downtown area. It’s been exacerbated by the fact that the Glory Hole changed their policy internally — making folks take a Breathalyzer before they can enter. It’s been good for the Glory Hole because it’s helped shape up that facility. Staff turnover is down. Kind of isolated this population that has no services available to them at all.”

That assessment of Glory Hole is true, for more details on what it’s doing to help mitigate the issues, see the related article.

What can be done now?

However all of the “solutions” being worked on are more long-term than immediate. Assembly member Karen Crane told the coalition she would also like to see work done on immediate options with winter here. Mariya Lovishchuk, Glory Hole director, said they have been stockpiling blankets and camping gear, but there is no legal place to camp in Juneau in winter.

Rainforest tends be full early in the evening, the Glory Hole has about seven people sleeping even on the floor in the winter and AWARE takes in any women and children the Glory Hole serves. Ciambor said the timeframe for a Housing First option can go quickly if everything goes well — but quickly means a year.

A Housing First model will take considerable work in Juneau. There really aren’t any vacant hotels lying about. So considerations would be where to build, unless there is another kind of facility available to be converted, who would own it and many other issues.

For more information on Housing First models, the vulnerability index or other related resources, visit bit.ly/sx0Gjl.

For more Housing First models and other supportive housing documentation, visit bit.ly/vczBBd.

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