Victoria integrated outreach team's work paying off in a healthier street community
Four months in hospital.
That’s the average total length of time some of Victoria’s most vulnerable people spend in an acute-care bed over the course of one year.
The estimated cost to the health care system of that care: $97,000 per person.
This is only one of the costs associated with the standard approach to the homeless, mentally ill and addicted. A newer approach, however, is showing it can bring these numbers down significantly.
Five years since it launched, the Victoria Integrated Community Outreach Team has published its first set of data showing results over three years.
“It’s been so successful,” said Joe Power, manager of mental health and addictions with the Vancouver Island Health Authority, one of the team’s funders.
VICOT is an interdisciplinary team providing intensive, collaborative support to the region’s most street-entrenched population.
Last week its 2011 annual report was made public.
The numbers show that before being referred to VICOT, an average client spent a total of 121 days in an acute care bed over 12 months.
In the first year of support, that number dropped to an average of 35 days. In the second year, it dropped even further, to 11 days.
Multiplied over 65 clients – VICOT’s average caseload – the savings to the health-care system equals roughly $6 million per year.
“What this doesn’t capture is emergency room visits and ambulance rides – so (there are) significant savings, hence the justification for these teams,” Power said.
VICOT comprises a team of 12 people, including nurses, outreach workers, social workers, a probation officer, a police officer and a Ministry of Social Development assistance worker.
They share an office and meet daily to share information about clients.
In the first year, clients’ lives stabilize as they build a relationship with their team. In year two, they begin the rehabilitation process, Power said.
The annual report also presents data about police intervention.
Police calls related to VICOT clients dropped from 95 in the year before their acceptance into the program to 31 the following year.
The types of police calls also changed, said Trudy Chyzowski, VICOT team leader.
“I think sometimes we always think about police calls as being a negative encounter,” she said. “The one thing that has changed … is that some of the clients are seeing positive encounters with police – perhaps they’re calling in to report crimes.”
Despite its successes, VICOT faces some ongoing challenges.
Finding housing for clients is a constant struggle, Chyzowski said.
“Any change in individual’s lives is not going to be significant unless somebody has a roof over their head first and can create some stability in their lives,” she said. “Trying to change a drug addiction problem … when somebody is living on the street is near impossible.”
Another challenge is tracking.
To date there has been no comprehensive analysis of the costs and benefits of the program over time.
“We’re in the process of gathering the longitudinal, the evaluational data,” Power said. “Information and data gathering is always a challenge (with limited staff resources).”
For instance, the total cost of the 12-member team isn’t known, but elsewhere, similar teams have a budget of $1.4 million.
Also not tracked is client progress after graduating from VICOT’s support program.
“What we hope to find, and we expect to find, is that a certain subset of the clients will no longer need the services of the team at some point and will become productive members of society,” Power said.