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Housing First opens doors to humane solution

My View • Getting people off the streets is one step toward treatment, saving money

As public servants charged with making sound investments to solve our community's most critical housing issues, we make tough choices. Resources for creating affordable homes are shrinking, and we know the needs in our community are far greater than our capacity to meet those needs.

We welcome Peter Korn's recent articles on the city's approach to funding programs that help people experiencing homelessness move into permanent homes (see Life and death lottery, May 5, and Homeless and addicted: On the street or off?, May 12).

The city invests in a variety of housing to give people the stability they need to make significant changes in their lives. To better leverage our public investments, we work through local partners who offer programs that meet people where they are. What we've found out doing this work is that a 'one-size-fits-all' approach is rarely effective, especially in the hard, heartbreaking work of helping people cope with medical issues, addictions, and mental illness.

The 'Housing First' model provides homeless people a stable place to live, where they can address their addictions and other issues, away from the stresses and insecurities of living on the streets.

A stable place to live, coupled with case management support, is a cost-effective strategy to leverage existing resources - like primary health care - with housing. It's a proven and effective way for people to move from the streets towards stability.

People's health will improve if they have a place to live. There are hundreds of disabled people living on our streets with heart disease, late-stage cancer or diabetes and may have co-occurring mental illnesses and addictions.

The public cost of homelessness on our streets is steep. Last January, a very ill, chronic inebriate woman stumbled into one of Portland's emergency shelters. She had been admitted and released from a hospital emergency room that day after trying for a week to get into detox. When she began convulsing, staff dialed 9-1-1. Four firefighters arrived, who reported that they'd treated her earlier that day. Two emergency medical technicians arrived with a stretcher and took her again to the hospital, where she was released an hour later and sent by taxicab back to a shelter.

In one day, she racked up costs for a shelter bed, two calls involving two EMTs and four fire bureau personnel, two emergency room visits and a detox visit. Our community could have paid for detox plus six months housing in what was spent in one day for her to live on Portland's streets.

This scenario repeats daily in Portland, and presents opportunities for the city and our partners to solve expensive, morale-busting problems.

The Bud Clark Commons, which opened June 2, provides 130 safe and affordable dwellings for Portland's most vulnerable. It will also offer a new day resource center to connect people to housing and services, as well as a new location for an existing men's emergency shelter.

Other cities have faced similar scrutiny. Yet, business leaders and elected officials support them because they have been persuaded by the facts.

A Seattle study found that the cost of the average chronic inebriate cost taxpayers more than $100,000 a year in emergency room visits, jail time, police, prosecutor and public defender time as well as detox time.

If Bud Clark Commons can reduce residents' use of hospitals and such by just 25 percent (and we think we can do better than that), the building will have paid for itself in taxpayer savings within 10 years.

Here, in Portland, we will continue to combine what is humane with what makes financial sense to invest in best practices that work for our community.

Nick Fish is the city housing commissioner. Margaret VanVliet is director of Portland Housing Bureau.