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Public Housing for Homeless Alcoholics Saves Money

Removing sobriety requirements cut expenditures in half, study found

TUESDAY, March 31 (HealthDay News) -- Providing housing to homeless alcoholics, regardless of their sobriety status, reduces health-care use and costs, U.S. researchers report.

They evaluated a type of program called Housing First (HF), which removes the usual housing for homeless requirements of sobriety and mandatory attendance to alcohol treatment programs. The study included 95 housed participants and 39 others on a waiting list.

In the year before the study, the 95 housed participants had median (midpoint) costs of $4,066 per month per person for services and legal costs such as shelter and sobering-center use, hospital-based medical services, publicly funded alcohol and drug detoxification and treatment, emergency medical services, Medicaid-funded services, jail bookings and days in jail. The total cost for all 95 participants over one year was $8,175,922.

After entering the HF program, the per person costs per month declined to $1,492 after six months and $958 after one year. The total cost for all 95 participants for one year was $4,094,291, a reduction of more than $4 million.

Compared with those on the waiting list, the participants in the HF program incurred 53 percent less costs over six months and also had a 2 percent decrease per month in daily drinking.

The study appears in the April 1 issue of the Journal of the American Medical Association.

Mary E. Latimer, of the University of Washington in Seattle, and colleagues wrote that "the current study adds to the body of literature in support of HF. Reductions in health care and criminal justice system use and costs and alcohol consumption support expansion and replication of this low-threshold approach. Repeated unsuccessful participation in traditional programs such as abstinence-based or mandated treatment, and high rejection rates of these programs by chronically homeless individuals with alcohol problems, suggests that less conventional approaches such as HF are also needed."

"Findings suggest that permanent, rather than temporary, housing may be necessary to fully realize these cost savings because benefits continued to accrue the longer these individuals were housed. Findings support strategies to retain these individuals in housing, including offering on-site medical and mental health services, supportive case managers, and minimal rules and regulations pertaining to their housing," the study authors concluded.

More information

There's more on the causes and treatment of alcoholism at the U.S. National Institutes of Health.

-- Robert Preidt

SOURCE: Journal of the American Medical Association, news release, March 31, 2009

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