The City and Borough of Juneau Assembly’s Human Resources Committee heard options and opinions on housing models for Juneau’s — and Southeast Alaska’s — chronic homeless inebriate population as it was updated on several aspects of the issue.
Chairwoman Ruth Danner invited Scott Ciambor, planner with the Alaska Mental Health Board and the Advisory Board on Alcoholism and Drug Abuse and co-chairman of the Juneau Homeless Coalition (JHC); Nancy Burke, program officer for the Alaska Mental Health Trust; Matt Felix, director of the National Council on Alcoholism; Dr. carolyn Brown and Juneau Police Chief Greg Browning to discuss defining the problems created by homeless chronic inebriates, but also more on the solutions available.
Ciambor updated the committee on what the JHC has been doing — working on getting a vulnerability index established, approved enrolling in the nationwide 100,000 Homes group (which has the rights to the index), and learning more about Housing First models.
It also got funding from the Trust for a position at the Glory Hole that will coordinate the index and gather other data.
Ciambor said the work being done is to put an emphasis on a continuum of care. Right now, Juneau has a lot of the pieces needed to handle the issue, however it needs a few more specific pieces to encompass the whole.
Ciambor said the last count — done last year — on the number of homeless people in Juneau is 562. He said they have been unable to get solid information on the number of them that are chronically inebriated, as the agencies involved aren’t used to tracking data on this sub-population. At any given time, however, they found that there are 10-45 people who fall into that category.
He said in a very conservative figure, the city, businesses and helping agencies spend about $1.4 million a year on the issue.
“The final result is we need to do more research,” Ciambor said.
While the JHC hasn’t settled on a specific housing model to support as a solution for Juneau, it has spent a fair amount of time looking at a Housing First model — something where homeless chronic inebriates can stay, pay rent, follow house rules and would be allowed the privacy of their own home (as in, no rules against drinking).
Burke gave an overview of those models in Anchorage and Fairbanks. The Anchorage facility is recently opened, while Fairbanks is in progress.
“Those people have severe addictions or several multiple disabling issues,” she said. “Juneau is well known around the state for being one of the best coordinated communities for social services programs. It gives you a really great start to start looking at the population.”
Burke said the Anchorage facility has had two deaths since it opened, however they don’t expect everyone to survive their afflictions just by being in the facility. Volunteer Alcoholics Anonymous and Narcotics Anonymous groups start up in these facilities and there are supportive staff members who are available to give residents access to recovery resources — should the resident choose to utilize them. Burke said the Trust is pleased that those people were able to die in their own homes, rather than on the street.
“We know that many people on the street have many complicated addiction and mental health issue,” Burke said. “One of the resources is active daily engagement — constantly engaging people to think through what’s happening in their lives to think through the next step. It really does make the most sense to see what type of service options would be most effective.”
Assembly Member Carlton Smith asked what she saw as Juneau’s next steps.
Burke said she would need to speak with the service providers first, but she felt the necessary pieces were in place to start looking at implementing a housing model. She said the only pieces really missing for that element are a housing site and which entity or person would apply.
Assembly Member Jesse Kiehl asked if there were any other options.
Burke said there are a lot of support services.
“When we think about people who have multiple disabling conditions, the services they can access are limited if an addiction is overlaying everything,” she said. “When we have this picture of someone with multiple conditions, the clinical goal is when the person can become detoxed from whatever they’re using and think through the layers of things that brought them to this place.”
Felix disagreed with the Housing First model, and instead supported a housing model that has a medical component.
He said there was a federal law passed in the 1970s that says public intoxication should be treated medically, not criminally as much as possible. Alaska was the third state to adopt that law.
“The models used to deal with this population in other states are basically medical models,” Felix said. “Yes, it is expensive to deal with these people medically. It’s the safest model to use.”
Felix said it’s also the most humane. With a Housing First model, it’s more of a social model. A “feel good” model that basically deals with the biggest issue of people dying out on the streets, but doesn’t actually treat the layers of what’s wrong.
“I would expect people die in a Housing First model,” he said. “If you don’t implement some kind of a medical support you’re going to have deaths. You don’t have to have deaths, I’m sorry, but you don’t have to.”
Felix praised Juneau, saying the community has risen to the occasion to address the problem.
“This particular population is a very, very fragile population,” he said. “I agree with the Coalition’s summation is the part that’s missing is the continuum of care. ... We’re lucky, I agree that we’re way, way ahead in this community because the Assembly has been so gracious over the years.”
Smith asked Felix what he saw as Juneau’s role in this issue since it is a regional hub. Felix said the city enjoys the benefits of being a regional hub, so it will also have to deal with the detriments of it as well.
Brown said one problem with the community is that so many organizations are “silo” focused — as in one organization will focus primarily on one social issue aspect. She said those groups don’t tend to branch out beyond their limited scopes.
Brown also supported Felix’s statement on “social model” housing. She said there needs to be an integration of both social and medical models or both will fail.
She posed three questions to the committee to work on finding an answer for, if they haven’t already done so:
• What do the chronic inebriates want? Would they use a housing model? Do they just want to be left alone?
• What do businesses really want? Do they just not want “those people” on their doorstep?
• What do the helping agencies really want?
• Contact reporter Sarah Day at 523-2279 or at firstname.lastname@example.org.