Project 25 Helps San Diego Homeless Get Off Streets And Out Of Emergency Rooms
Thursday, February 20, 2014
Photo by Kenny Goldberg / KPBS
In his studio apartment in downtown San Diego, Douglas "Hutch" Hutchison feels secure.
He’s got his cigarettes, some beer and his tunes to keep him company.
After years of living on the streets, Hutch said this place is home.
“It’s nice. It’s nice and quiet. It’s not full of dope dealers, or, I can’t say hardcore alcoholics, ‘cause there’s a lot of them around. I oughta know, I am one," he admitted.
Hutch is 50 years old. He could pass for 70. He’s probably abused every drug known to man.
“When I quit doin’ drugs, I turned to beer. When I got tired of beer, I turned to vodka," he said. "And bang, that was the beginning of the end.”
Hutch’s brain is pretty fried. He has trouble remembering things. Like how many times he’s been to the hospital.
He said doctors could never figure out exactly what was wrong with him.
“But they all came to one conclusion," Hutch recalled. "Only thing they all agree was, they said, you might as well keep drinkin’, drink yourself to death, because you’re not going to live more than a year. Well, that’s two years ago, and I’m still here.”
Hutch was one of 36 homeless San Diegans originally selected for the program.
Each participant had averaged 41 visits to the ER annually, used ambulances on more than 20 occasions, and had been hospitalized more than ten times.
The annual cost per person amounted to $120,000.
Project 25 Director Marc Stevenson said these people just weren’t a good fit for other programs for the homeless.
“These are very severely impacted people. They have a lot of impairment, a lot of damage," he explained. "Many of them won’t experience the wonderfulness of life, even if they were to get completely sober and try to improve, because life has pretty much passed them by, and they’re impacted.”
The first thing Project 25 does is get a participant stable housing. The next is to assign them a case manager who helps coordinate all of the services they need, including health care.
“All of them, probably have a mental health condition, substance abuse issue, and at least two major physical health issues," Stevenson pointed out. "And if we didn’t get them the kind of preventive care it takes to keep them out of the emergency room, and out of that kind of perpetual crises, then we probably wouldn’t be able to maintain them in housing, either.”
That preventive care is provided at the medical clinic at St. Vincent de Paul Village, just down the street from where Hutch lives.
Medical Director David Folsom said Project 25 participants need a lot of medical and psychiatric care.
“A number of them have some really complex medical problems, that normally, were previously causing them to go to the emergency room all the time. We can manage most of those here. We don’t completely prevent hospital and emergency use, but we greatly reduce it," Dr. Folsom said.
That’s done in part by making sure people get to their medical appointments, and stay on their medication.
Since it started three years ago, Project 25 has greatly reduced the number of ambulance rides, ER visits and hospitalizations by its participants. Even though the program requires a lot of manpower and ongoing expenses, it’s saved taxpayers about $80,000 per participant per year.
UC San Diego Medical Center in Hillcrest is one hospital that’s benefitting from the reduction in visits from former frequent users.
ER physician Jim Dunford said Project 25 offers the right mix of wrap around services to help some of San Diego’s toughest cases.
“We’ve got this complex group of people, and just like our bone marrow transplant patients, they need complex solutions, they need complex teams," Dr. Dunford explained. "People shouldn't think of these people as different from anybody else. They just have a different disease."
Project 25’s Marc Stevenson said they’ve had to redefine what success means for individuals in the program.
For example, he said, Hutch no longer drinks every day.
“I mean, that’s a huge success for somebody," Stevenson said. "Is he completely sober? No. Is he viewed as a decent neighbor, is he viewed as a good tenant in his housing complex? Yes. Does he go to see his doctor? Yes, he does."
Hutch is just happy to have his own private space. He said it sure beats living on the corner of 10th and B.
“Basically, this is my castle, and I am the king,” Hutch said.
Project 25’s grant runs out this year. Officials say they’re looking for new funding.
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