Jo Ann Rebane: We need to know number of mentally ill homeless in Nevada County, and total cost to help them
May 21, 2018
Editor's note: This is the fourth and final article in a series of columns exploring sources of the statewide humanitarian problem of mental illness among homeless people, and its costs to cities and counties. See this story at TheUnion.com to read all four parts in the series.
Writing about homelessness in the Washington Times, Cato Institute senior fellow Doug Bandow cautions that "if the political authorities are to act, it should be because other institutions have failed to meet people's basic needs. Today, far more private than public programs serve the homeless."
Bandow sees the family, the church, other charities, local county initiatives, and lastly, federal programs which, in that order, should be responsible to care for the homeless and their problems. While I agree with much of Bandow's view, because helping mentally ill homeless people is such a complex and expensive endeavor, I see a major role for new state funding.
No local jurisdiction, especially rural counties, has the tax revenue to provide the comprehensive medical treatment, rehabilitation, housing, and individual support services the homeless mentally ill require.
Today the mentally ill homeless are not getting prompt evaluation and effective treatment. The public's safety is at risk. Current conservatorship programs are inadequate to protect the homeless mentally ill. They are not being protected from criminal acts on the street or in jail. The less restrictive setting — living in the woods or in a car — is inappropriate for the mentally ill. Their physical health is in jeopardy. The rights of the community for safety and quiet enjoyment are being put at risk, and local hospitals are likely carrying an unconscionable financial load.
It is time that cities and counties mount a full assault, and demand that Sacramento augment sporadic federal grants and provide reliable and adequate funding to implement comprehensive Homeless Management Information Systems in order to understand the magnitude of the cost the mentally ill homeless are to cities and counties in California.
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It is time that cities and counties mount a full assault and demand that Sacramento stop spending on projects like the bullet train with its ballooning $77 to $98 billion price tag. It's past time to modernize and reform the Lanterman-Petris-Short Act. It's past time to deregulate where necessary to provide incentives and the ability for willing private sector and nonprofit entities to care for the mentally ill homeless. It's past time to properly fund care and maintenance for mentally ill homeless people.
It is also time for Nevada County to implement a full and comprehensive data sharing Homeless Management Information System. That just a few of our public agencies and two or three private entities responsible for dealing with the mentally ill homeless collect incident data associated with the people they assist in this category is just a start.
I am certain that Sierra Nevada Memorial Hospital, as a nonprofit entity, knows exactly what its costs are to treat the mentally ill homeless and could report it. They are unwilling to release their experience to me, but hopefully the hospital would share its aggregate numbers and costs with the county if asked to participate in the Homeless Management Information System.
How, without solid numbers, can those charged with "handling" the mentally ill homeless design any program or evaluate any program's effectiveness if they don't know the scope of the problem or have any financial baseline costs that include all services, public and private?
Unlike Santa Clara Country, we don't have a Cisco Systems to donate $50 million over five years nor are we likely to raise our sales tax as Los Angeles did recently, both efforts to address homeless problems. Without a wealthy benefactor to privately underwrite implementation and training, we in Nevada County are stuck with a mandate, a good idea, and an inconsistent federal source of funding.
Why aren't our elected officials storming Sacramento demanding funding for rural counties to enable us to include all providers (jail, law enforcement, probation, fire, Crisis Stabilization Unit, ambulance, hospital, emergency department, local advocates, veterans administration, schools, feeding programs, etc.) in our Homeless Management Information System? It will take money to implement an expanded system, which includes all agencies which have contact with the homeless and homeless mentally ill and more money to train the personnel at all the data entry points. It will take some arm twisting and incentives to convince some service partners to participate in a comprehensive system. It will take exceptions to confidentiality regulations so that this vital, aggregate information can be assembled.
I believe the current situation of the mentally ill homeless is unknown and likely inhumane.
I believe the community wants to know the number of mentally ill homeless people in our county and the total cost to respond to, care for and deal with them.
I believe the community will want to know how the numbers and costs vary based on implementation of different programs and services. How else can the community determine what efforts alleviate the present humanitarian crisis?
It will take at least a couple of years to accumulate useful numbers and costs — now is the time to start.
Jo Ann Rebane is a member of The Union Editorial Board. Her views are her own and do not represent the views of The Union or its editorial board members. Contact her at firstname.lastname@example.org.