By Sarah Owens and Michael Livingston
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| Touring future sobering space at 615 Commercial St NE, circa June 2018 |
As discussed here last June, this project is being "managed" by the City Manager's Office, and "led" by the Police Department.
Construction of the space that will hold the sobering center has not yet begun, and it's not clear whether funding to cover the projected construction costs ($508,000+) has been secured.
MWVCAA, which owns the building at 615 Commercial Street NE, has accepted a construction bid of $1,395,000 to complete Phase 2 renovations, which now include the sobering center build out. Originally, Phase 2 consisted of renovations to install showers, laundry, kitchen facilities and a sprinkler system, and the sobering center build out was to occur in Phase 3. The decision to combine the two phases not only saves construction costs, it puts additional pressure on the City to move forward with the project, whether or not it's sustainable. As of this writing, Phase 2 construction has not begun.
Also unclear is where the funds to operate the sobering program are going to come from. The City projects annual operating costs of $638,000, but Tim Murphy, CEO of Bridgeway Recovery Services, which will operate the program, said he thought that might be too low, based on conversations he had at the National Sobering Collaborative summit in San Diego. Regardless, commitments from the City ($200K), Marion County ($150K) and Salem Health ($100K for a limited time) fall short of what's needed just for the first couple of years, by about $200,000.
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| City Council 2018 Policy Agenda |
We asked the City staff assigned to the project, Courtney Knox Busch, for a breakdown or more information about the operating costs. She ignored the request, but did offer to come and talk to CANDO, presumably about the "one pager" she distributed at the PSCC meeting, the third published staff report on the sobering center project.
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| Courtney Knox Busch's one-pager |
The second staff report, issued in June to accompany a bare bones MOU with MWVCAA, stated that "to close the operating [funds] gap, the partners anticipate a grant from the local Coordinated Care Organization, Willamette Valley Community Health."
WVCH serves people covered under the Oregon Health Plan (Medicaid), which covers detoxification and treatment services, but not "sobering." The anticipated WVCH grant was not mentioned at the PSCC meeting, or in the City's one-pager, but WVCH isn't going to be around after 2019, anyway.
Let's face it, even if we are very optimistic, and assume that they can secure an additional $200,000/yr to operate the program, few donor agencies are willing to fund operations over the long term. Short term, yes. But not long term. That's why Salem Health hasn't committed long term. After all, it's law enforcement that stands to benefit, not Salem Hospital.
And what about the City? The City's 2018-2019 budget states that "there is not an offsetting revenue" for the sobering center, so it has to come out of working capital (General Fund). But the City has an increasingly concerning "structural imbalance between the proposed cost of General Fund services and anticipated revenues." In addition to the PERS rate escalations in FY 2020 and FY 2022, City Council just approved a collective bargaining agreement that will cost the City an additional $8M over the next three years. The City's either going to have to cut services or raise revenue, or both, in pretty short order. Under those circumstances, one has to ask whether or not the City's ongoing commitment of $200,000 is, you know, sustainable, especially when costs are only going to increase over the long term.
But might urban Renewal change the calculus? See "Urban Renewal to the Rescue."
Salem Hospital, which operates as a non-profit, has tens of millions of dollars in reserves which could be used for this important health initiative. Salem Hospital should be part of the group helping to make the future of this inititiative sustainable.
ReplyDeleteIt's important to understand that this is not a health initiative. This is a law enforcement initiative. That's why it started in the PSCC, why the PSCC gets updates, and why it’s led by Chief Moore with the strong support of Sheriff Myers. Salem Hospital is fulfilling its mission to provide emergency care for the indigent, for which it receives some remuneration, which is why it doesn't make fiscal sense for Salem Health to take on a substantial portion of the sobering center’s operating costs. Salem Health has other, mission-driven, plans for their reserves. There is no principled reason for Salem Health to subsidize a law enforcement initiative, and we shouldn’t want that, anyway. Let’s be clear, because, as William Stafford observed, “the darkness around us is deep”, the primary goal of the Salem sobering center is diversion from jail, just as it is the primary goal of the Santa Cruz sobering center, which Salem is using as a model. https://www.janussc.org/wp-content/uploads/2016/02/Sobering-Center-1000th-client.pdf
DeleteHRAP, as some have suggested, does not have the same sustainability concerns. HRAP for the most part employs a Housing First approach (the exceptions being for those who are just too vulnerable to live on their own, and for those with a history of violent crime), which has been proven over and over again to cost less than maintaining residents on the street (mostly in emergency services), not to mention improving the health of program participants and the community in general. CMS has made the connection between health and housing, and other systems are gradually doing the same.
ReplyDeleteResponding to a comment on Salem City Council FB page, Salem Health evidently does not agree that a sobering center is needed to "ensure ER resources get used appropriately."
ReplyDeleteThere is no question that sobering services are a less costly form of emergency service. But to whom? To say a sobering center is "sustainable if the City Council believes it's worth the cost", begs the question what factors and considerations would cause a reasonable person to think it is "worth the cost"? That analysis has never been done. The answer is assumed. And, as was pointed out at the PSCC when the sustainability question was raised (and not answered), Salem has had sobering services three times -- in the 70s, 80s and 90s. We don't know what they were, who provided them, or why they were discontinued. It is just foolish to proceed with such questions unanswered, but that appears to be what "the City Council" wants to do. That fact does not make the program sustainable.