Tag: homelessness levy

Addiction, Election 2017, labor, legislature, Mayor Murray, Morning Crank, race

Morning Crank: That Really Interferes With Making Progress

1. One element of Mayor Ed Murray’s proposed $275 million homelessness levy that didn’t get mentioned at his press conference earlier this month—perhaps because it involves a significant concession to labor—is that it helps pay for higher wages for the caseworkers and counselors who will be integral to the success of the outreach and treatment elements of the proposal. (The Service Employees International Union 1199 advocated for the inclusion of higher wages in the levy.) Those workers include public health nurses and mental health and substance abuse counselors who will evaluate and treat formerly homeless people who seek services through the city’s navigation teams and at the proposed new 24-hour shelters; outreach workers who talk to people living in encampments during encampment sweeps; case managers who get people connected with rental assistance in the form of new temporary housing vouchers funded through the levy; and the people who staff the new 24-hour shelters and permanent supportive housing. Turnover in those positions is notoriously high, in large part because many people who take those jobs burn out or leave Seattle because they can’t afford to live here, and because high-quality clinical workers and case managers tend to leave for better-paying jobs in the private sector.

The exact cost of raising wages for these positions is unclear, since the increase would also apply to existing contracts.  The initiative itself alludes to the wage increases just once, in this blink-and-you-missed-it line: “The Director of Finance and Administrative Services shall make appropriate allowances for (1) the higher costs of high-quality programs staffed with clinical or social service professionals and paraprofessionals and (2) a reasonable wage differential in organizations where employee wages have increased or will increase as a result of the City’s minimum wage.”  A more detailed program-by-program breakdown for the initiative indicates that public health nurses and mental health counselors will be paid $45 an hour; therapists in the pilot “Journey of Hope” residential treatment program will be paid $35 an hour; substance abuse counselors and caseworkers will be paid $25 an hour; and outreach workers will be paid $22 an hour. Previously, according to SEIU, some of those workers were making as little as the $15-an-hour minimum.

Downtown Emergency Service Center director Daniel Malone argues that agencies like his need to be able to pay higher wages to attract and retain high-skilled workers. “Some of the client services that we’re able to deliver are highly dependent on establishing a trusting relationship with a person who has had, quite often, bad experiences with treatment or social services, and when somebody’s case manager is changing all the time, that really interferes with making progress with them. You needs staff who are skilled at working with and providing help to people who sometimes have challenging behaviors, and you can’t have a workforce that is always principally comprised of people who are basically brand new and just learning.”

2. State Senator Mark Miloscia—perhaps best known to readers of this blog as the Republican who proposed two bills that would ban Seattle from allowing homeless encampments and safe injection sites, respectively—met with teenagers from the immigrant rights group OneAmerica outside the Senate chamber in Olympia the other day, and things did not go smoothly.

According to the version of events I heard from a source in Olympia, Miloscia “grilled” the students (including one young woman wearing a headscarf) about whether they were “Catholic or Christian,” then engaged them in an animated argument over race and religion.

I talked to Miloscia this week, and here’s his version of the story. He says he was approached by a group of kids who “peppered” him with questions, and that one of them, a person of color,  “said ‘I can only be represented by somebody who looks like me.” Miloscia (who is white) claims he used religion merely as another example of how a person could feel represented by someone who doesn’t share their race—then asked whether the teenagers were “Christian, or Catholics. I said, ‘You can be represented based on religion, not just skin color.'”

Miloscia says he noticed the young woman who looked Muslim, and thought about using her religion as an example, but didn’t want to “put her on the spot. I was going to say she could be represented by a white Muslim or an Asian Muslim, not just a black Muslim.” He said the group then discussed two versions of a statewide voting rights act—one that would give citizens the right to sue if their city’s voting system disenfranchises minority voters, and another, proposed by Miloscia, that would not. “They impressed me with their knowledge of what’s in both bills,” Miloscia says. OneAmerica didn’t want to comment on the record about the exchange, but it’s probably safe to say the admiration wasn’t mutual.

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Addiction, Drugs, Election 2017, Health, Mayor Murray, Morning Crank

Morning Crank: A New Line of Business

1. When Mayor Ed Murray announced his $275 million homelessness ballot measure last week, he noted several times that the measure included “5,000 new treatment slots” for homeless people struggling with addiction, accounting for about $20 million over the five-year life of the levy. If the image that pops into your mind is beds in a residential treatment facility like the Betty Ford Center, think again: The treatment in the levy proposal consists primarily of programs that expand access to buprenorphine, also known as Suboxone—a prescription opioid that reduces cravings in people who are addicted to heroin and other opioids—and “housing with intensive outpatient substance use disorder treatment,” also focused on expanding buprenorphine distribution.

Suboxone is a drug that allows people who are severely addicted to heroin or other opiates to stabilize on a less-harmful opioid drug under the supervision of a medical professional, without having to go to a clinic to receive medication every day, as methadone patients do. Increasingly, health departments and addiction experts are recommending long-term buprenorphine use for people with severe addictions, because it reduces cravings for street drugs like heroin that can lead to overdoses and dangerous lifestyle choices. (Suboxone itself has been shown to be addictive). However, no prescription alone can address the many factors that lead a person to start abusing drugs in the first place, such as trauma, abuse, depression, mental illness, and despair. And buprenorphine doesn’t address addictions to non-opiate substances at all, including alcohol addiction, which kills about 88,000 people each year (compared to about 33,000 deaths from opioid abuse) and is endemic among people experiencing homelessness.

Curious about the precise breakdown of those 5,000 “treatment slots,” I asked the levy campaign for more detailed information. Here’s the breakdown they provided. Of the 5,000 slots over five years, 3,600 would consist of expanded access to buprenorphine, through new clinics, transportation to and from buprenorphine providers, and a new access point for people seeking treatment to find a provider in their area. That accounts for about $1.6 million of the approximately $4 million in new annual spending.

Another $540,000 a year would subsidize rent for about 300 formerly homeless people in “Oxford-style” sober housing—self-managed houses where people with substance use disorders live together in a sober, supportive environment. It’s unclear at this point what measures the city would take to monitor the quality of the sober housing it subsidizes, but Kaushik says the city will take steps to ensure the providers are legitimate.

The remainder—about $2 million—would pay for two programs: A low-barrier, residential inpatient treatment center serving 16 people a year, and an intensive outpatient program, with case management, serving about 300 formerly homeless people who would receive housing subsidies from the city. (The treatment would not be located in or tied to the housing itself).

When I asked about the relatively small amount of money for treatment in his levy proposal last week, Murray pointed out that treatment was “a new line of business” for the city and is typically funded by King County. Given that millions of people seeking treatment are likely to lose health care coverage under Trump’s health care “reform,” the city might need to get used to being in the treatment business.

2. Another question that nagged me about the mayor’s levy proposal had to do with the “landlord liaison” program that will be funded through the levy. I wondered if the city still needed a program to match landlords with tenants just coming out of homelessness, given that the city now has a law banning housing discrimination based on a tenant’s source of income.  (A tenant paying with one of the short-term rent vouchers funded by the levy, for example, could not be turned away because he had a voucher). City council member Sally Bagshaw, perhaps the most vocal elected proponent of the program, told me the landlord liaison program would go much further than helping renters get access to housing; it would also provide landlords with a financial “backstop” by promising to pay for any damages tenants cause, to provide case management, and to respond quickly to emergencies or landlord concerns.

“Let’s say we put Bob in [a unit], and we know Bob has some bipolar issues. If he’s stabilized, he’s fine’ if he goes off his meds, he’s not,” Bagshaw says. “Let’s pretend, for the sake of argument, that Bob does trash the place. We will have an insurance pool and we will say to the landlord, when Bob leaves, if he has trashed the place, if he puts his hand through a wall or puts a stick of dynamite down the toilet, we will come in and pay to fix the place back up.” Bagshaw says the goal of the program would be to identify 1,000 units around the city whose landlords would agree to participate in the program.