Hospital-led partnership helps homeless overcome alcoholism
More than a decade ago, people walking around Sacramento’s downtown business area were accustomed to seeing unconscious figures passed out on sidewalks.
Paramedics often would gather up inebriated people and bring them to Sutter Medical Center’s emergency department (ED). Or police would respond to a business owner’s complaints and haul them off to jail. But they soon would be back on the streets, potentially harming themselves or others.
“Was it a police problem or a medical problem?” is how Dion Dwyer, a director with the Downtown Sacramento Partnership neighborhood revitalization organization, summed up the city’s response to chronic homelessness and alcohol abuse. “We were treating the immediate symptoms but not the actual disease. The hospital came to the community and said, ‘There needs to be a better way of addressing the needs of this population.’”
The environment changed for the better after Sutter Medical Center reached out nine years ago to downtown businesses, non-profit organizations, and government and law enforcement agencies to form the Serial Inebriate Program (SIP). The partnership has made impressive strides in cleaning up the lives of dozens of men and women who suffered from severe alcoholism, and the city’s downtown area.
“These people often have more than a drinking problem,” said Holly Harper, Sutter Medical Center’s community benefits manager. “They are plagued by mental health issues and other co-morbidities. We needed to address the whole health stability model, and to find the partners who excel at that.”
People who have been taken to the Sacramento County Jail, admitted to local EDs or a detox program at least 25 times within 12 months are eligible for SIP, which is a court-ordered, 90-day treatment program. Clients receive alcohol addiction counseling and are offered housing through Sacramento Self-Help Housing, one of the partners in the collaborative. They also are connected with primary and mental health services to help address long-term medical needs.
The model of care is called “harm reduction.” Sobriety is not required before entering the program, says Harper. “The point is to get them off the street without them hitting their heads on the ground and coming back to the emergency department or returning to jail,” she said.
“We try to wean them off the old lifestyle and moderate that excessive drinking,” added Dwyer, who is SIP’s director. “We’ve seen some great success.”
Patients in SIP housing attend substance abuse, nutrition and mental health classes. Dwyer says about 80% of those who complete the program do not return to the downtown area. “We want to stabilize and create a dignity in their lives that they could never have on the streets,” he says.
The partnership also employs “navigators” to reach out to homeless people in the downtown area. They build trust and link the homeless to services. “It’s another tool in our toolbox for connecting with these people,” says Kelly Brenk, the hospital’s coordinator for community benefit.
According to the Sacramento Police Department, the number of people arrested for drunkenness in the downtown area dropped from more than 1,100 in 2004 to less than 150 six years later. Sacramento has saved more than $38,000 in arrest-related and ED costs for each of the more than 170 men and women who have completed the program.
Sutter Medical Center contributes $50,000 a year to the Downtown Sacramento Partnership to support SIP. Dwyer credits the hospital’s leadership in making the program a success. “Sutter knew early on how important the housing component was in dealing with chronic homelessness and alcoholism, and in bringing together all the players who could come up with an alternative model for treating this disease,” he said.
Asked what advice he has for others seeking to achieve similar goals, Dwyer says: “Keep it simple. Communicate, collaborate, come together and leave your egos at the door.”
Watch Sutter Medical Center’s video about SIP. Tune in here.