Number of Homeless Outreach Street Team (HOST) encounters with those persons experiencing homelessness resulting in potential diversions or system costs

Status

This Measure reflects the work performed by the City of Austin Homeless Outreach Street Team (HOST).  This multi-disciplinary team is made up of staff from Austin – Travis County Emergency Medical Services Department (ATCEMS), the Austin Police Department (APD), Downtown Austin Community Court (DACC), and the Local Mental Health and Intellectual and Developmental Disability Authority, Integral Care.  The team is comprised of community health paramedics, police officers, mental health professionals and case managers. The team proactively engages with persons experiencing homelessness out in the community and works to navigate them to services that address critical needs that contribute to homelessness. These needs include medical care, mental health care, case management and access to resources that can provide critical information and tools to obtain permanent housing.
HOST was implemented in 2017 and has made over 7,000 individual contacts.  Each year HOST continues to increase the number of homeless individual encounters with a goal of connecting these persons to available services and divert them form hospital emergency rooms, jail incarceration, or emergency mental health services.

Trending

The grey line in the chart shown left is the target for HOST encounters (contacts). The blue line reflects actual encounters performed in Austin.  HOST continues to serve an increased number of clients since 2017, although the total number of homeless individuals also continues to grow. A growing population of homeless individuals brings associated increases in costs associated with the healthcare system and criminal just systems.  This growth in homelessness has been somewhat mitigated by the City of Austin’s investment in the HOST program. 
Note: to see the underlying data for this chart, please select the "View Source Data" link to the left.

Additional Measure Insights

The estimated cost for a hospital emergency room visit ranges from $500 - $3000.  The estimated cost of pre-trial jail incarceration per day is $60. The average estimated costs of psychiatric hospitalization is $873 per day.  This range varies per condition and ranges from $726 - $1036. In 2017, - 2,388, 2018 – 3,289, and in 2019 – 1,688 for the first two quarters.  The City of Austin’s investments in in the HOST Program has reduced costs related to 55 diversions from emergency rooms for a potential savings in the range of $27,500 to $165,000, 12 jail diversions for a savings of $720 and 13 mental health facilities diversions with a cost savings ranging from $9,438 to $13,468.

Measure Details and Definition

1) Definition:  Number of unique persons served by the Homeless Outreach Street Team.  For the first quarter of FY20, HOST made 829 total encounters, 429 of these were unique encounters.  Within this population, there were 55 emergency room diversions, 12 jail diversions, and 13 psychiatric hospital single day diversions.  In the first quarter FY20, the estimated healthcare cost avoidance for diversions from emergency departments was estimated to be in the range of $27,500 to $165,000.  The estimated cost avoidance for diversions from jail for a single day incarceration was estimated to be $720.  The estimated mental health cost avoidance for diversions from psychiatric hospitals ranges from $9,438 to $13,468 related to the client’s condition and length of stay.
2) Calculation method: HOST captures the total number of persons experiencing homelessness contacts and the number of unique contacts.  Persons experiencing homelessness diversions are a subset of the unique client count.  
3) Data Collection Process:  Persons experiencing homelessness unique contacts and diversions are collected by HOST. 
4) Measure Target Calculation:  A projected target population is expected to grow annually as demonstrated by data collected over the past 3 years.  Diversions to emergency rooms, incarcerations, and emergency mental health facilities also would continue to increase in portion to total contacts thus increasing total costs associated with these interventions.
5) Frequency Measure is Reported: Quarterly (Fiscal Year)