A Team Approach

Nearly 2,200 people experience homelessness every day in Austin. (Photo by Jana Birchum)

After three consecutive years of decline, Austin has begun to see an increase in homelessness rates. Advocates attribute this to exploding population growth and an increase in cost of living that's made the city unaffordable for many people.

To get ahead of the problem, the Austin Police Department, along with the Down­town Austin Alliance and other partners, have launched a pilot program to change how the city deals with its growing homeless population. Implemented last month, the Homeless Outreach Street Team (HOST) program is aimed at proactively connecting homeless people to housing, social, and medical services in order to divert them from jail or emergency rooms.

"What we've been doing for a long time hasn't worked," said Bill Brice, vice president of operations at the DAA. "We have to do something new."

HOST is a multidisciplinary collaboration between APD, DAA, Austin/Travis County Emergency Medical Services, Austin Travis County Integral Care (ATCIC), and the city of Austin's Innovation Office, all of which have dedicated staff members to the program. During the week, the team walks around Downtown and West Campus – from I-35 to Lamar and Cesar Chavez to 29th – and interacts with the homeless, serving as "a conduit" between people and services, Brice said. While existing resources currently fund HOST, the goal is for the city to formally adopt the initiative into its budget this October so that HOST becomes a full-scale program.

Similar teams launched in Houston and San Antonio inspired Austin's HOST program, which has been in the works for a year. A handful of other states, including California and Florida, have implemented their own versions of the broader outreach initiative – each with their own acronyms. There are over 25 teams in place across the United States.

So far, HOST has approached 141 people in Austin within the first two weeks of its launch on June 1, according to Brice. Of those 141 people, about 70 had their needs addressed by the team, such as obtaining a government ID, buying a bus pass, being driven to a doctor's appointment, or getting medication. Another 22 were enrolled in Coordinated Assessment – the Ending Com­munity Homelessness Coalition's (ECHO) housing-needs evaluation process – 15 of whom were placed into housing or shelter, Brice said. "The statistics are starting to show that the team works," he said. "Hope­fully HOST will be able to demonstrate its effect in getting people out of crisis."

In Austin, nearly 2,200 people experience homelessness on any given day, according to the preliminary results of this year's Point-in-Time survey conducted by ECHO. That's a 20% increase from the 2015 count, which found 1,832 people living on the streets and in shelters. But these statistics are somewhat misleading, said Darilynn Cardona-Beiler, associate director of ATCIC's Adult Behavioral Health Services. The Point-in-Time numbers, she said, are only a snapshot of homelessness on a single day, not of how many people are homeless throughout the year.

Instead, homeless service providers estimate that more than 5,000 homeless people live in the city, Cardona-Beiler told the Chronicle. Last year, more than 7,000 people were living on the streets and in cars, parks, and shelters, according to ECHO's annual count. About 22% of those people were chronically homeless. "There are many more homeless than you can count in one night," she said.

It's not lost on Brice or others involved in HOST that Downtown property owners and businesses are perceived as anti-homeless. Often times, the response to homelessness is to call the police, which has led to homeless people being forcibly removed from the streets, ticketed, or thrown in jail. "What we're trying to do is get ahead of that," Brice said.

Mayor Pro Tem Kathie Tovo, who represents District 9 – much of which falls in HOST's coverage area – said the program has been met with "enthusiasm" for its proactive approach. But Tovo said she has also heard concerns that the HOST team may be just another enforcement tactic. And given Downtown's problematic history, that's not surprising. So she wants to assure her constituents that APD shares the view that homelessness shouldn't be treated as a crime or enforcement action. "Being homeless is not against the law," Tovo said.

HOST also has broader implications for Austin taxpayers. According to ECHO, the average public cost when a homeless person goes to the emergency room is $1,400 per visit, while EMS transport can run $876 per ride (over 62% of homeless people reported having been to the ER in the last six months). An inpatient hospital stay, meanwhile, can cost $4,800 per day.

That's a hefty price for the city to shoulder. And advocates say a program like HOST can dramatically reduce the public's financial burden by connecting homeless people to critical services that keep them off the streets and on stable ground and thus putting a stop to the cycle of jail, shelters, and hospitals.

That could mean the difference between the city spending $600 a day or $116 a day, said the city of Austin's Chief Innovation Officer Kerry O'Connor. "We're interrupting the revolving door," she said.

The APD will evaluate the initiative after 90 days from launch. The assessment will allow the agencies to identify critical service gaps, as well as parse HOST's effectiveness as they seek to expand the initiative. How the program expands, though, depends on what's financially and logistically feasible, Brice said.

While the feedback so far has been positive, Brice does recognize that there's some trepidation among homeless service providers. Particularly because, he said, cash- and resource-strapped organizations worry they'll become overwhelmed by an influx of new clients. To address those concerns, the agencies behind HOST have launched weekly sessions facilitated by O'Connor between the team and Downtown providers – including Front Steps, Caritas of Austin, Trinity Center, and Salvation Army – to discuss challenges, achievements, and service gaps.

More importantly, the meetings allow the groups to discuss homeless people who have used each provider, but haven't fully engaged in services, said Mitchell Gibbs, executive director of Front Steps. "We've got some folks we know are falling through the cracks," he said. "It's a wonderful opportunity to be able to come together to address individuals."

The trepidation remains, though. Car­do­na-Beiler admitted that reassigning two staff members to HOST has stressed ATCIC's resources. Remaining employees now have to handle work overseen by the agency's HOST members in addition to their own caseload, she said. This means ATCIC has to cover more ground with less staff.

That strengthens the case for getting HOST into the fall city budget, advocates say. New monies will allow the program to function effectively without siphoning off existing resources and breaking down productivity, even if slightly. But if that doesn't come to pass, Tovo said she will work diligently to identify financing streams.

"I'm going to advocate hard for the program," she said, "and find that money in the budget to continue what is really a critical community need."