Nearly a decade ago, Craig Johnson worked a construction job off and on that paid him nearly $1,200 a month. But in the 18 years he's lived in San Antonio — making one bad alcohol-fueled decision after another — the various government agencies that have supported him could have bought the 48-year-old homeless man a house with the money he has drained from their coffers.
A really nice house.
Johnson's addiction to alcohol, like that of many of the nation's homeless, took him from making money to costing society hundreds of thousands of dollars.
His troubles accelerated in 2002 when he emerged from prison with $100, a bus ticket and no place to go. From there, he quickly became part of a group known to experts as the chronically homeless — a group that, often beset by mental illness, substance abuse or both, has become one of the biggest burdens on the public purse.
Nationally and in San Antonio, medical, criminal, judicial and social service records for homeless populations are leading to the same two conclusions: that tens of millions of dollars are being spent each year on temporarily housing, adjudicating, jailing, hospitalizing and otherwise accommodating this troubled group; and that the people they are trying to help — especially the hard cases like Johnson — often find themselves in the same circumstances or worse.
Cities that have made an about-face in how they help the homeless have found that not only can a holistic approach produce better results than the fragmented, piecemeal tactics of the past, it can save taxpayer money.
San Diego, New York and Miami all have seen a decrease not only in the number of people living on the street but in the amount of money spent on things like emergency medical services and public hospitals because of programs that offer one-stop shopping for services and provide some kind of help with long-term housing.
By helping the chronically homeless confront multiple demons all at once through the Haven for Hope homeless services campus, San Antonio leaders want to put this city among those that can claim a decrease in the number of Craig Johnsons out there.
The campus planned for just west of downtown will boast an array of services: emergency and transitional shelter; dining services; job training and other employment opportunities; education for children and adults; medical and dental care; even housing for clients' pets.
Based on a loose accounting of costs through emergency medical services, emergency room encounters at University Health System and the Bexar County Jail, Haven for Hope officials estimate the center could save taxpayers a significant portion of the $40,676,475 they say is spent each year to help them in piecemeal fashion.
Stuck in jail, court
Since arriving in San Antonio in 1989 to work drywall jobs with a friend, Craig Johnson, a native Californian, has bounced in and out of the court system, detoxification facilities, emergency rooms, shelters and a handful of more stable places to live. In that time, he has spent 1.8 years, cumulatively, in Bexar County Jail, one year and seven months in state prison facilities and at least three weeks in University Hospital. And that's only what he can accurately recall.
His experiences demonstrate how the jails and courts have become turnstiles for many people living on the street.
For example, in fall 1999, after serving 21 days for criminal trespass, Johnson was released from Bexar County Jail on Nov. 6. By the end of that month, he had received 19 municipal tickets, almost all of them alcohol-related. He was back in jail Dec. 17 on more warrants, most stemming from his municipal violations.
Since coming into contact with municipal Judge Kimberly Kreider, who started the city's community court more than a year ago, Johnson will admit he has a little more hope about his sobriety and his future — and his Municipal Court record shows it.
Kreider has tried to change the way justice is administered to the down and out. A homeless person picked up for public intoxication no longer is held the requisite eight hours, released and possibly picked up again within hours. Kreider instead tries to develop a plan to help him or her get sober and functioning again.
That's not how it used to work, Johnson said. And he should know.
Municipal Court records for Johnson dating to 1999 show he had somewhere between 460 and 485 municipal violations, most of them alcohol-related.
A lot of his violations brought him misdemeanor tickets, which then led to warrants and eventually his arrest. Two of Johnson's crimes were violent — an assault and a robbery with bodily injury in two separate incidents more than 10 years ago.
City, county and state records also show Johnson:
Was arrested and booked into Bexar jail 78 times resulting in 657 days behind bars, usually for criminal trespass or obstructing a passageway. He said he often was drunk and passed out on private property. His total cost at the jail, minus any medical treatment he may have received, was $48,450.
Was held in the city's detention facility on Frio Street at least 185 times for public intoxication since late 1999, the earliest year computer records were kept for the city. Based on the $100 the city charges other municipalities to hold an individual, this cost the city at least $18,500.
Spent 558 days in state prison for burglary, costing the state nearly $90,000.
The total cost of incarcerating all nonviolent homeless offenders can't be calculated because Bexar County Jail does not track the homeless as a separate population. But Gilbert Gonzales, director of the Center for Health Care Services jail diversion program, estimated that if the jail population is about 4,000, between 450 and 550 of the inmates are homeless. At a base cost of $50 per day, that population has an annual cost of $8.2 million, based on 450 inmates per night.
Because this population is the least likely to have friends or family at the ready with bail, the homeless typically spend more time in jail on minor offenses. On one occasion in 1999, Johnson was arrested and booked for an outstanding warrant and obstructing a passageway. He cleared the warrant with one day in jail but served 28 days for the latter charge.
'A bad reaction'
The downtown hospitals naturally find themselves on the receiving end of the revolving door of homeless people. The poor and especially the homeless have to use emergency rooms to treat problems that otherwise might have been thwarted or quickly treated by a primary care physician. The hospitals treat various ailments, from the less serious hunger to the more acute problems that arise when people live on the street. Those include pneumonia, infected bug bites, communicable diseases or complications from chronic but manageable ailments like diabetes.
"I know there is a fellow they see frequently that basically just needs something to eat," Karen May, a spokeswoman for Baptist Health System, said about the downtown facility. "He knows if he complains about something and can get in, they will give him a voucher so he can go to the cafeteria to get some food. At least periodically, that happens."
Johnson only recalls a couple of instances where he required hospitalization. There was one time, he said, when he was drinking with a buddy who gave him some pills and Johnson "had a bad reaction."
"I fell down and scratched my face," he said. "The cops came and called EMS. So EMS came and I went to the hospital for about three days because I was shaking."
On another occasion, in 2006, Johnson said he was chasing a VIA bus while intoxicated and he slipped off the curb as the bus went by and it rolled over his foot. He fractured three toes and was bedridden for a little more than a month. Part of the time he spent in the hospital and the rest at SAMMinistries Shelter.
Johnson doesn't recall being treated at Downtown Baptist, but many people like him are. The Baptist Health System recorded $610,680 in care provided to homeless patients from July 2006 to June.
"I think that's kind of a minimum, because these are the patients who came in from the beginning and said, 'I don't have a way to pay for this, can I get charity care?'" said May. "We have millions of dollars in uncompensated care and some of those cases, of course, could be homeless."
Christus Santa Rosa and University Health systems have not put a dollar figure on caring for the homeless. Methodist Hospital System didn't respond to requests for information.
The Fire Department's Emergency Medical Services logged 916 transports of homeless people last fiscal year at a cost of $436,195.
'Not Pollyannas'
Johnson is a kind of worst-case scenario, though. And while he rang in 2007 sitting in a residential alcohol treatment program at the Patrician Movement, he hasn't stopped drinking entirely. At the same time, his municipal offenses have become fewer and further between.
For people like him, it's the state-funded detox facility, planned for the same area as the Haven for Hope, where local officials hope they can lengthen the time between sobriety and arrest and eventually end the cycle of tickets and arrests.
Haven for Hope Executive Director Robert Marbut Jr. describes the homeless population as a bell curve.
On one end of the curve are those experiencing a single incidence of homelessness, caused by an illness, job loss, domestic violence or some other unexpected calamity. Those people are the easiest to help because they need just a single boost, Marbut said.
It's the 45 percent in the middle, though, that other shelters have done their best work with. Those are the people who have experienced more than one episode of homelessness but are not yet considered chronically homeless.
Then there are those like Johnson, the chronically homeless, who will take the most work to get off the streets — and that's if they ever can.
"It doesn't work in all cases," Marbut said. "We're not Pollyannas. Even if they recycle, instead of it being on a daily basis, they're now maybe on a nine-month process."
Nationally, there are between 150,000 and 200,000 people considered chronically homeless, according to the National Alliance to End Homelessness. In San Antonio, where local officials conducted a "point in time" count of the homeless population in January, they estimate that roughly 10 percent of the 2,247 people counted fell into that category. The number may be low, however, because not everyone counted was interviewed.
Through the detox facility at Haven for Hope, chronic drunks will have the option of an intensive rehab program or jail. After the rehab program, the person can go into more programs and treatment at the same place.
The goal is less ambitious with this group, Marbut said, because the job is so much harder.
"If you can get someone who is getting arrested 100 times a year to where they are arrested only five times a year, that cuts cost significantly."
Morris Dees
Founder
