The City of Palliative Care
jayriverlong.github.io
jayriverlong.github.io
No doubt, chronic homelessness is a problem in San Francisco. And there's truth in this quote, from a fentanyl-addicted homeless person.
But I hesitate to base my entire view on the situation from a hot take of conversation with someone deep into drug abuse. They will feed the addiction first, and only then go on to address their other needs.
The article leaves me wanting to hear from people in recovery. Perhaps they are harder to find. Or perhaps (even more likely) I misread the article.
Nevertheless, I hang on to the real money quote:
The bitter joke of the story is that in San Francisco, the mother works full-time, drains her savings, but still can’t make ends meet and is forced to move away.
For example, a recent report on the SF homeless population flags 15% of them as having a traumatic brain injury.
You can spend as much as you want on other things, but those people need permanent, long-term medical care and nothing less is going to help.
Teachers. Churches. Fire departments. Emergency rooms of hospitals. Police officers... God bless them all. God, what the Berkeley Police officers had to deal with in the 1980s...
(Then everyone got AIDS and died during the earthquake and the fire.)
My wife was a teacher at a day program for adults with severe developmental disabilities. A shoestring budget, subsistence wages, hard work. The program had been started out of necessity by an indomitable mother with a son who needed 24-hour care. Her son had his 21st birthday, and there was no longer a place for him in the public schools.
It's a horrifically expensive situation all around.
It’s one of those things where once you remove it, resets listing it is really difficult and expensive.
No, that's $486M/6864 = $70,800 per homeless person per year. It's only after multiplying by the 9 years she lived in SF do you get $630k. It's a lot, and probably poorly spent, but probably only 10x what is reasonable.
As a society, even spending all this money, we are failing to help some of our most vulnerable citizens. It’s quite telling that conversations about social safety nets always become about money rather than reducing harm effectively.
This article sheds some light: https://missionlocal.org/2019/07/in-san-francisco-we-obsess-...
> the Department of Homelessness itself applies a multiplier of 2.89 to the PIT count to estimate how many individuals are homeless not just on one day but throughout the entire year.
Hard drug addiction can be seen as a terminal disease. The main cost to the city is truck rolls for EMT response. $100k/yr is much more than it costs to feed and house an individual in basic accommodations. The main cause of overdoses is purity/potency. Taken together, it seems like treating the situation as a public health problem with a palliative approach would save the city a lot of money as well as making life better for those trapped in it. Especially if SF could then turn around to the state and claim healthcare reimbursement for doing so.
Also, I cost more, on a per year basis, than the individual in the article, as I require an orphan drug and will for the rest of my life.
I am American but fortunately live abroad so I don’t have to put up with people writing BS narratives and stories that “link” arbitrary statistics together, which people with economics backgrounds tend to do. All in all, this is clickbait.
The solution to the “problem” in the article is houses, regardless of drug usage status.
We're talking chiefly people addicted to opiates, not someone affected by stimulant psychosis. They can handle homework just fine.
And even if that was the case, the cost would be lower than keeping these people in hotels and less damaging than sleeping rough.
And yes, it's actually very, very easy to do incredible amounts of damage to a place without much action. Don't clean it and leave trash rotting everywhere and cause an insect and vermin infestation. Throw literal shit on the walls, leave a clogged faucet on and forget about it and cause a lot of water damage everywhere along with a very bad mold problem, punch the walls in anger and leave huge holes in the drywall and broken windows. Rip off cabinet doors and use it as firewood because it's 'free firewood'. Fixing damage from bad behavior like that crosses into 6 figures very quickly.
And if your actively angry, you can do shit like pour concrete down the toliet and faucets and more.
These people need active management in a long term mental health facility, not just housing. The +%90 of invisible homeless that don't have a serious mental illness, brain damage and crippling drug addictions yes can be helped by housing. Most 'invisible' homeless people in that category get out within a year or two. I think what everyone is referencing when they are talking about homeless is the chronic visible ones yelling at a random tree.
I to tought that it was a branch of medicine dedicated to the relief of the suffering of those who are afflicted with a disease that will eventually kill them. But clearly you indicate that it's more than that so I would like to know.