Seattle Visit, Downtown Emergency Service Center

The second part of our visit to Seattle, Washington was with Bill Hobson, Executive Director for the Downtown Emergency Service Center. Bill Hobson—whom media articles inevitably describe as “crusty”—had dinner with us Thursday evening where he held forth for more than hour about homelessness, housing homeless people and what the DESC does.

Bill Hobson is a Texan by birth, and although he’s been running DESC in Seattle for the past twenty-five years, you can still here the twang in his conversation. Hobson is also a fascinating talker by turns brilliant, quirky, and down to earth. DESC is unusual for an organization working with homeless people because it runs both a shelter and permanent supportive housing, and does it very well.

DESC’s best know project is 1811 Eastlake.

The development is unique because it took the seventy-five most expensive homeless people in Seattle and put them in housing. These are the people that are chronic alcoholics, frequent visitors to the emergency room, people that consume the time of the police, the EMS and the jail.

The development has especially attracted attention for its cost savings. Here’s a summary (prepared by DESC) of the findings of an article in the Journal of the American Medical Association, “Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol
Problems” (Vol. 301 No. 13, April 1, 2009) :

· DESC’s 1811 Eastlake saved taxpayers more
than $4 million dollars over the first year of
operation. Annual average costs per person while
homeless, the year before moving in, were
$86,062. By comparison, it costs $13,440 per
person per year to administer the housing
program.
· Median costs for the research participants in the
year prior to being housed were $4,066 per
person per month in publicly-funded services
such as jail, detox center use, hospital-based
medical services, alcohol and drug programs and
emergency medical services. The monthly median
costs dropped to $1,492 and $958 after six and
12 months in housing, respectively.
· During the first six months, even after considering
the cost of administering housing for the 95
residents in this Housing First program, the study
reported an average cost-savings of 53 percent --
nearly $2,500 per month per person in health
and social services, compared to the costs of a
wait-list control group of 39 homeless people.
· Alcohol use by Housing First participants
decreased by about one-third. The median
number of drinks for participants dropped steadily
from 15.7 per day prior to move-in to 14, 12.5
and 10.6 per day at 6, 9 and 12 months in
housing.

Hobson is an unqualified advocate for serving the most difficult homeless people. In his mind, anyone who tries to serve homeless people and does less than that is simply shirking their duty. Hobson is a rabble rouser, not afraid of legal or political battles. In fact, while I wouldn’t say that he seeks them out, I have a feeling that he enjoys them once they’ve started.

Hobson also has an unremittingly realistic view of the people he serves. He was delighted and surprised by the reduction in the average number of drinks per resident at 1811 Eastlake from 15.7 to 10.6 per day.

Let me repeat that fact: Reducing the number of drinks per resident per day to 10.6 is a great victory.

I can’t imagine trying to get the people of Dallas to support projects like 1811 Eastlake. Selling even projects with mixed populations serving less severely impacted homeless people has been a hard slog—and we’ve often failed.

Hobson would say that we’ve set our sights too low. He may be right.