What’s the best way to treat homeless alcoholics? Give them a place to live with a concierge who runs out and buys them beer or vodka every time they teeter towards the brink of sobriety? Most people would not call that a great idea. Except for Bevan Dufty, and his colleagues, who think it is. Dufty is a former San Francisco Supervisor, and is now Director of HOPE (Housing Opportunity, Partnerships and Engagement) for the City and County of San Francisco.
That means a lot of people pay attention to what he thinks. Like San Francisco Mayor Ed Lee, and a number of San Francisco officials, including Joyce Crum, director of housing and homeless programs for the Human Services Agency, Barbara Garcia, Director of the Department of Public Health, and Henry Alvarez, former head of the Housing Authority.
Dufty, not surprisingly, thinks San Francisco should open its own wethouse, ASAP. Since 2010, Dufty has led three field trips of San Francisco politicans and policy wonks to a Seattle facility called 1811 Eastlake. It’s a homeless shelter that houses 75 homeless alcoholics, who get city housing, complete with the services of a building staff who make booze runs to the local liquor store, bringing back beer, wine, and hard liquor.
If you’re one of the 75 residents, what’s the catch? There isn’t one. Almost all homeless shelters have a strict no alcohol policy. At 1811, it’s exactly the opposite. Residents are free to drink as much as they like, 24/7. There’s no curfew. Alcohol abuse meetings are offered, but attendance is voluntary. The only requirement is that residents are required to spend 30 percent of their income — if they had any — on rent and social services.
Of course, the staff of Downtown Emergency Services Center in Seattle who manage this program are completely enthused about it. They claim that the wethouse program has saved taxpayers millions of dollars because residents gradually drink less and take fewer trips to the public hospital’s emergency room. They’re also more likely to accept treatment for their addictions once they’re off the streets. How gradual is gradual? On average, the residents of 1811 Eastlake consumed 20 drinks a day when they were on the streets. After a year in the wet house, they had cut down to 12 drinks a day.
Does this really save money? It may. At least, a study published in the American Journal of Public Health says so. According to the study, before joining the wethouse, a group of 95 homeless alcoholics cost Seattle $8.2 million in medical bills, policing, detox and incarceration, for an average of $4,066 per month. After six months, they were costing the city an average of $1,492 a month. After 12 months, the cost was down to $958 per person per month.
When you add in the cost for room, board, Old Overholt, and concierge service, the study claims the cost per person averaged $2,449 per person per month. It’s hard to find many current performance measures from 1811, but there are some unsettling stories from 1811’s early days: In one nine-month span in 2006, there were 148 responses by the Seattle Fire Department, all for medical assistance. Typically, the calls occur because one of the residents is trying to go dry and runs into the kind of detox shakes that can lead to seizures. Six residents died during that same nine-month period.
So is this an idea that should spread to every major city? Or should it go to the museum of failed science projects?
It’s hard to argue with the compassion that advocates have for these homeless folks, and it’s good to be open-minded in looking for creative solutions. I’ll agree with the current sentiment that alcoholism is not a character flaw, but a disease that should be treated. But like most liberal programs, I’m left with the uneasy feeling that this one is based on some very fuzzy math. Partly because I’ve read a number of pro-wethouse stories in a variety of papers, and none of their numbers come out on my calculator they way they do in these stories.
There’s something else that feels out of whack with this program. Maybe it’s the 393 years of American history since the first Pilgrims landed at Plymouth Rock without a wethouse waiting to welcome them. Maybe it’s the fact that my alcoholic uncle, who went on three-week binges until one of them killed him in the sixties, always paid for his own drinks and his own disease. Or maybe it’s the fact we live in a culture where liberal governments of all sizes, from federal to local, feel they can wrap us in a bubble where no personal responsibility will ever touch us.
What are your thoughts?