Professional Documents
Culture Documents
24 months of operation
By
January 2013
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Overview
The HOME project in Portland is an ambitious collaborative venture between the City of
Portland, Preble Street, the Milestone Foundation, the University of New England, School of
Social Work and Opportunity Alliance to provide outreach and community supports to those
living on the streets who have chronic health and substance abuse problems. The project is based
divert frequent users of hospital emergency rooms and other health care systems away from these
systems in into more appropriate treatment and support environments, and to provide active
regular outreach in the downtown areas of each city. In most cases, these high end users present
This report continues the evaluation of the HOME team deployments, high
frequency user diversion strategies and inquiry into the number, frequency
and costs associated with high frequency user interactions with the Portland
This overview covers HOME team program operations during 24 months of team
As part of our ongoing analysis, we have selected 30 users of HOME Team services who
comprise 35 percent of all team encounters. This analysis of the high frequency users includes
an analysis of use of Medcu ambulance runs and encounters, police and emergency room
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services 12 months prior to HOME team deployments and comparing those contacts with current
Demographics
The HOME Team as had 9194 contacts during the first twelve months of operation. During the
second 12 months the team had 10395 contacts or 13 percent increase over the first 12 months of
operation. 12 months of operation. The team averages about 28 client contacts each day.
100.00% 92.30%93%
90.00%
80.00%
70.00%
60.00%
50.00% 2011
40.00% 2012
30.00%
20.00%
10.00% 4.10% 5%
1.00% 1% 0.70% 2%
0.00%
Initiated by HOME team members Concerned citizens
As with previous analysis the HOME team plays a proactive role in connecting with clients on
the street, 93 percent were initiated by HOME team members in 2012. This represents the
majority of the teams work. Slight increases were also observed in dispatch referrals. Business
and property owner referrals accounted for 2 percent of all encounters in 2012, or a total number
of 214 referrals in 2012. Referral sources and types have remained consistent during the
reporting period.
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Of note is the number of businesses who report being aware of the HOME team activities in the
target area. In a survey of business owners in the target area, 54 percent reported being aware of
the HOME team. Of those who reported being aware of the TEAM, 62 percent reported calling
the HOME team with a referral during the 2012 reporting period.
Encounters by month
1200
200
As the data suggests, the number of encounters by the HOME team have increased since
implementation in of the project in July 2010. With the exception of April 2012, HOME Team
encounters were averaging 10 percent higher than during the first 12 months of deployment. Not
surprisingly, HOME team encounters are higher during the summer months-May-September. Of
note from the period of July and August 2012, the City of Portland experienced a record number
of people seeking shelter at Oxford Street Shelter, these numbers are also reflected in the number
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of encountered by the HOME team. In July 2012, HOME team encounters increased 30 percent
from the same period in 2011. The date of encounter data also matches with the data on the
80.00%
68.50%
70.00%
60.00% 54.20%
50.00%
40.00%
29.80%
30.00% 24.80%
17.60% 2011
20.00% 11.60% 2012
10.00% 2.00% 2.00%
0.00%
As team deployments evolved over the course of the year there was a corresponding change in
the type of work which team members were doing. As the figure shows, team members are
working more with people who are disruptive and disoriented in 2012. As the data suggests,
there has been a significant increase in these two areas. Additionally, team members have also
worked with clients who have significant health issues. Data from July-June 2012 suggests
HOME team encounters for health related issues were 352 or about 3 percent of the encounters
for the 2012 reporting period. This seems to suggest that clients whom the HOME team is
working with have health related issues which are the main reason for the encounter.
Location
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The following is a breakdown of where HOME team members are encountering a majority of
their clients:
The data suggests a significant decrease in the number of encounters in the Longfellow square
area and an increase in the Waterfront area for the encounters by HOME team staff.
Additionally, the number of encounters in Monument square has decreased by nearly 50 percent
in 2012.
Transports
The data suggests that the HOME team transported 2366 clients, or about 99 percent of the
encounters, to the Milestone shelter. In contrast, MEDCU transported 15 cases, or less than .06
percent and the police transported 7 cases or less than .002. This represents a significant
decrease in MEDCU and Police transports during the 2012 reporting period. Prior to the HOME
Team, MEDCU was transporting 157 clients to the emergency room in 2010 and the police
reported 104 transports to emergency rooms in 2010. As suggested here, MEDCU transports for
2012 was 15 and police transports accounted for a total of 7 cases. This represents a 91 percent
decrease in MEDCU and Police transports for clients whom the HOME team has been working
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with. Instead of emergency room transports, a majority of these cases, 99 percent in the current
reporting period, were transported to Milestone by HOME team staff. This suggests a significant
cost savings to MEDCU and the Police in the time associated with the encounters and transports
HOME Team deployments have fluctuated between the hours of 1000-2000 over the course of
Average # contacts
30 28
26
25
20 18
15
11
10
5 4
0
1000-1200 hrs 1200-1400 hrs 1400-1600 hrs 1600-1800 hrs 1800-2000 hrs
As the table suggests, the most active time for HOME team contacts is between the hours of
1400 and 1600 and 1800-2000 hours. Contacts also cycle between summer and winter months.
During the summer months, HOME team contacts average 34 between May and September
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between the hours of 1800-2000. During the winter months, HOME team contacts between the
hours of 1400-1600 hours are higher between November and February, averaging nearly 30
contacts.
The data suggests that of the original 30 high frequency users of this service, whom accounted
for nearly 37 percent of all MEDCU, Police and HOME team encounters during 2010 and early
2011, the HOME team has engaged with them only 2131 times during the 2012 reporting period.
This is a 49 percent decrease in encounters with these high frequency users inception of the
program. Of the 30 high frequency users whom the HOME team has worked with, 4 have died
in the past 12 months, 4 are in recovery and 3 have moved out of the Portland area. Additionally,
4 have been housed in Portland and have not been part of the HOME Team deployments. Of the
11 clients who are in recovery, moved away or are currently housed, these cases accounted for
1103 encounters by HOME team members and 16 times by MEDCU and police in 2011. In
2012, the data suggests they were encountered only 88 times by HOME team members and 6
encounters by police. This is a significant reduction in team and police encounters. On balance,
as suggested above, HOME team encounters have increased which suggests team members are
working with a wider variety of clients during the 2012 reporting period.
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12 months of baseline data as compared with the first and second year team
deployments.
140
129
120 120
100
80
60
55
40
20
0
Ciminal Incidents of HOME team high frequency users between July 2009 and Dec 2009
The data suggests a decrease of 9 criminal incidents during the most recent reporting period,
however criminal incidents by the high frequency users is more than double from baseline.
120
114
100
80
75
66
60
40
20
0
CFS of HOME Team high frequency users between July 2009 - June 2010
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The data suggests CFS contacts of the 30 high frequency users suggests cases are nearly double
As noted earlier, 11 of the high frequency users have either been housed, moved away or are
deceased. As such, this last reporting period is data based on 19 remaining high frequency
users. Of the remaining 19 clients, 2 account for nearly 50 percent of police contacts during the
Cost savings
Based on the analysis of the reduction in the number of visits to the emergency rooms by the 30
highest users, as well as the reduction in MEDCU costs, it is estimated a cost savings to the
emergency medical system of $57,560 over the first 12 month period of deployments-(2010-
Of note is the cost savings associated with the 11 clients who have moved out of Portland, are
currently in housing or are in recovery. Based on the transport data, it appears all 11 of these
clients were homeless which suggests a savings to the emergency shelter system. Based on the
average number of bednights from these clients an average of 240 nights each, the cost savings
Summary
The data suggests HOME team deployments have not had the desired effect at decreasing police
calls for service or police interactions with high frequency users. While an initial reduction in
police encounters was observed in early 2010, the data suggests the frequency of contact with
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clients has increased in 2011 and 2012. On balance, based on two years of data on HOME Team
activities, police, Medcu and emergency room contacts, the HOME deployments provide an
important resource in addressing the changing nature of homelessness in Portland. With the
Portland Emergency Shelter system operating nearly 40 percent over capacity nearly every night,
With the increases in number of encounters which are not primarily for intoxication, the HOME
team has become part of the emergency service delivery system for businesses and community
members. It appears that, as a matter of course, the HOME team is called to work with clients
who may be presenting with other issues other than intoxication, e.g. disorientation, disruption.
All of this suggests the HOME team is playing an important role in outreach and engagement.
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