Money to Burn and the Cost of the Homeless

Reprinted from SRQ Daily, Nov. 5, 2016

PBS – A report on the Homeless

It was a year ago this week that PBS came to Sarasota to report on the state of homelessness in our community. Since then, not much has changed. Unless you ask someone who sleeps on the streets. Aside from tougher ordinances that have been implemented by Sarasota County, the one issue that sticks out among others is their fear that they will be “Baker-Acted” into compliance.

On June 7, the Sarasota County Commission asked a question about the rising cost of “Baker and Marchman Act transportation and other utilization issues.” Health and Human Services convened service providers and stakeholders who could provide a clearer picture of the costs. I attended the first meeting. The numbers were staggering and the outlook was grim.

Representatives from all the area service providers such as: First Step, Coastal Behavioral Health Center, Doctors Hospital, Sarasota Memorial Hospital, Sarasota Police Department and the Sarasota County Sheriff’s Office were in attendance. The one issue that resonated among the participants was not being able to keep up with the numbers of people who are brought in under those classifications.

The Health and Human Services issued a report this week with results of their 6-month study. They noted that between October 1 and March 1, there were 2,320 individuals who were admitted into one or more of the behavioral health centers in Sarasota County. Of that number, 65 percent were identified as homeless.  Additionally, SCSO provided 57 percent of the Baker Acted transports and SPD transported 35 percent. For Marchman Act transport, SPD served 58 percent, compared to 38 percent of transports by SSO. The costs for the transport and care of these individuals for the 6-month period totaled $3.5 million.

Another noted cost was the 1,621 trips that were made by Ambitrans. The county has contracted with Ambitrans since 2002 to provide transport from one facility to another. And 80 percent of those trips for the homeless were considered secondary transports because they originated from the hospital to another behavioral facility for a total cost of $236,000.

The Baker Act and the Marchman Act

The Baker Act allows for an involuntary examination by a professional to give a psychological evaluation of a person who is considered a “harm to self, harm to others, or self-neglectful.” The Marchman Act is an involuntary examination for someone who “allegedly abusing substances like drugs or alcohol.” The general confinement of an individual under both acts is 72 hours.

Florida laws permit police officers to initiate Baker Act and Marchman Act commitments without having to observe the behavior of the individual. An observation reported by of credible person is enough to meet the requirement. Most of the crimes that are associated with these incidents are misdemeanors that are low level crimes associated with quality of life issues. It’s important to understand that if the individual did not commit a crime associated with the commitment, then they must freely consent to being admitted to the treatment facility or hospital. If not, then they have the right to leave at any time during the 72 hours. In that case, the opportunity for frequent trips back increases.

If there is no availability at any contracted treatment facilities, or there is a need for medical treatment, the individual will be taken to an area hospital. After medical treatment is received, they are placed under a “watch,” in a room where they will watch television and be fed three meals a day. No other services are provided except to make sure the individual does not try to harm themselves. After 72 hours, they are released. The hospitals are not equipped to do more.

If the individual is identified as combative, they end up at the county jail for the 72 hours. Again, no services are received.

It was not that long ago that a plan was laid out to build a homeless shelter with services to help the homeless get off the street. But a price tag of $9 million and the mere thought of people being admitted while intoxicated put some people into a tailspin.

Well, we obviously don’t need a shelter when taxpayers are willing to shell out $3.5 million in 6 months to do much less. And the hospitals don’t care if the homeless are intoxicated. Although in comparison, we could have the shelter paid for in less than 1.5 years. But let’s not be practical. Why fix something that is not broken?