Cost of Homelessness Webinar

Hear from Dr. Thomas Chalmers McLaughlin as he researches homelessness and reveals its impact on society.


Male Speaker: Hi, well first of all I want to thank all of you for attending. Um and I’m excited to share some of the latest research that I’ve been working on that relates to Homelessness and kind of cost and effect of this Homelessness. But I want to start out quickly by — well let’s go on our next slide please, Mary.
I want to start out quickly to just give some provisional kind of definitions here so that we’re all in the same page on what we’re talking about. And I think — If you think of homelessness, when you think of the kind of policy implications of how it works. It really kind of falls into two major categories here. We have uh two major kinds of debates um that are going on. And so we’re just gonna spend a little time kind of laying the work there, the foundation that relates to that. So I think the debate breaks down into two categories. One is called the do nothing concept which is basically as you see here the policy makers, social researchers and others believe that if you cut social service funding that actually it has the effect of motivating people who have received social services to actually move on to be more self sufficient. And, let’s see the next slide please. And I’ve given a kind of a couple of examples here of what I consider to be some working examples in the field of people kind of advocates to the do nothing approach. It’s interesting, there’s a lot of data that’s coming out immediately on kind of both sides of the debate but now last week we had staff from the [inaudible] Bureau that shows that the nation has seem to have the largest jump in the number of people in poverty, one in seven Americans now live in poverty, it’s the largest increase in the last 51 years and then kind of related to that today that was the Forbes Fortune 400 Richest People in the United States. And if you look at the data from that it actually shows that folks got a 8 percent raise in probably the worst economic times since 1930s. But as we look through this do nothing advocates, the do nothing advocates actually believe that the current system where we live in has the ability kind of support people without the use of social support systems. Um next slide please.

So, what is it that they actually need? It actually needs — do nothing is a concept that actually means that the government can actually improve people’s lives by reducing entitlements. There’s a provisional kind of part of this argument is that people who are on social services um the longer that they are in the social service network, the less likely they are to actually get motivated to go and um look for work, improve their lives, change their family situation. Um and a larger kind of component to this is I just want to call your attention to this is the second bullet point here. The people who lose social service benefits will access indigenous social services support to the community. The do nothing argument really bases its position on the fact that there are these indigenous social services support systems in the community. They could be religious organizations; it could be the Salvation Army, um other kinds of systems that will kind of step up to fill in the emergency needs of people that once the government funding has been cut.

So, let’s move on to the next slide and look at what is the do something concept suggests here. Uh let’s go to the next one if we could, please. Okay, so do something advocates would argue that um there is a group of folks and for the most part of the system itself needs to be arranged in such a way that it provides a complete, continuum of those services for people and through this continuum services which includes the mental health, substance abuse and um case management component on one end of the continuum and what I would say is the jail, police, social service kind of stuff on the, er, sorry, jail, police, emergency room stuff and the other on the continuum that having that system in place provides people with basic safety net of support. Um and we’ve got a couple of quotes here of some authors that I would suggest that are good, kind of advocates so to speak for the do something um concept. Okay, next slide please. Do something really means, it’s just creating this system of social services. And the system of social services allows for the safety net. But it also allows people to know that they have a basic level of support and with that um basic level of support they can achieve different things. They can kind of have a basic quality of life and that will allow them to access educational opportunities, maybe workforce development, if they have a mental illness or some substance abuse problems also it allows them to have access to those types of services so they can be kind of addressing them in their [inaudible] while at the same time look for work or maintain important thin connections.

Okay, next slide please. Okay so we can start off here. I just want to talk briefly about uh before we get in to the kind of research data. Um what is the um social services structure really look like? And the social service structure is — as I’m defining it here, you’ll notice that it’s um it is in this continuum. Kind of trying to break them out in such a way that you have the most severe, so to speak for the social service things which I were I think most service’s heavy components like mental health, primary healthcare, um disability assistance, case management. Um and then as you move down the line so to speak, you get to what I call the emergency service. Emergency services are such as that emergency room, emergency in-patient, psychiatric, ambulance, uh emergency shelters and pantries, um soup kitchens, uh and then kind of further down the emergency system is law enforcement and the jail. Um for the most part, the soup kitchen, emergency shelter, perhaps ambulance, definitely the law enforcement and jail are not usually included in the social service structure but it’s important to keep them in there for um analysis because if you do nothing and people don’t necessarily access the indigenous um social service support then the police and the jails and the emergency rooms become the de facto social workers, medical care facilities and things like that. So, to do any kind of an analysis to find out if doing nothing and people will actually step up and take care of themselves really works, we need to make sure that we account for and capture data from these emergency services.

Okay, next slide please. Okay, so before we actually get to the data, I think it’s important to just kind of review who actually pays for this stuff. Um because before we can really look at some of the relationships here, we need to know where the money comes from. So, for the most part you’ll notice on the left hand side of your screen we have categories that normally are paid for by a kind of a county or a states and federal funds. This works in general. It’s uh pretty good here. In other parts of the country it’s a little bit different which we’ll talk about it in a minute. But you’ll notice it on the left hand side of your screen you have eight categories mental health, primary care, housing assistance, work force development, disability assistance, and case management and other supports. And then on the right hand side of the screen you’ll notice that these are services that for the most part in general, across the country are paid for not necessarily by state and federal funding. And in some cases there is some state federal funding that’s kind of makes them but it’s not the lion’s share of who’s paying for that. So charity care covers emergency room. That is for people who don’t have insurance are in here, the ability to pay. Same thing with emergency psychiatric in-patient services, who puts a danger to themselves or others, um you know that’s not paid for usually by the state. It’s usually paid for by the hospital or another funding source. Uh ambulance services usually comes from county or local tax structures, same thing with emergency shelters, soup kitchens and most definitely the law enforcement and the jail. When we talk about the jail, we’re actually talking about the county jail systems. Not where they’re sending to stay for a longer period of time of six or seven months or longer than that. But the county jail system where people are just staying there for short amounts of time. Um, and it just — to kind of talk about this a little bit more and the effects, the way it works in general is feds pay a lion’s share of this services on the right hand of your screen. The first two, three I guess I would say mental health, primary care and housing assistance comes through the Medic Aid program. Each state calls it a little bit something different. In main it’s called Main Care. In your state it probably has another nick name attached to it but it’s basically, its Medicare system and how Medicare work is to, for every dollar that’s spent on mental health services or primary health care, the federal government reimburses the state two thirds of that. So if you think about it, for $1.00 spent, $00.66 of it comes from the feds. The other $00.33 is covered by the state government.

Okay, next slide. Um so to think about this as I kind of start about that, we wanted to look at what is the cost of doing nothing and does doing nothing actually costs more than doing something? So that is if you do nothing as the theory suggests, people will just access in business community supports, then it’s actually cheaper, right? And furthermore, it’s also cheaper if you based on the do nothing theory if you cut states and federal funding, then you’re actually saving money in the long run. So what we really want to look at is in this usual questions is does that actually cost doing nothing actually cost more or cost less I should say. But I kind of spun the question a little differently here because I want to explore some of this data pieces with you as we talked, as I showed you in continuum there to look at what’s the emergency costs systems here. And so that really gets to the third bullet point here on what are some of the assumptions in the do nothing strategy. Um and I added that one in and it wasn’t part of the research that we looked at but I think it shows up in our conclusions and recommendations and it may be helpful to you as you kind of think forward how some of the stuff have been working in the community.
So okay, next slide please. Okay, so how do we do it? So basically what we did is we worked on Marty Birds, where Marty Birds is the corporation for supportive housing. She actually playing here several studies based on looking at the cost of homelessness and really what it is is truly by taking the time to kind of break down and fair it out exactly how much it cost for someone to kind of live in the community. So if you think about your own life, so if you if you um get up in the morning, you have breakfast at home, what does that cost you? That’s $4.50 but on your way to work you would stop for a cup of coffee and let’s say you go to Starbucks and that’s another $4.00 and you’re going to eat or you run into you know some other — you live in the area. The country has I do or its notes [inaudible] there’s a portion of the cost that goes to supporting the streets and look like. So my work or Marty’s work is really about kind of mapping out what are all those costs of how your lives are touched by different systems. And so, one of the things that we wanted to look at here is you’ll notice is you decided to take folks who were on main care and then really find out how much do they actually cost the system itself. So as we go back and think about a research questions, the question is it is actually cheaper with funding is people really don’t receive entitlements than the state, federal government saving money. Then actually translate into cheaper cost after they lose their Medic Aid. So it makes sense, so what we did is we actually went through and we got detailed records on individuals when they came in the service, if they went for medical health treatment and they cost $42.60 and I would give the daily treatment the amount of that cost, uh if they went to the hospital, if they went to receive a primary care position and they prescribe some medication. I would get the data of the prescription and the cost for the medications provided, is there arrest by the police, I know what and get the police amount of time that they spent on that and the cost for that. We know the cost for jail night, the cost for shelter stay. So, we know kind of all these kind of costs based on people’s lives. So what we did is we took 10 folks and we kind of tracked them over a two-year time frame just to see what do we know about their lives, how was it changed.

So, next slide please. Okay, so we selected five women and five men and this was kind of built up for a larger study that I’ve been working on, looking at the overall cost of homelessness. Um the five women and the five men that we selected and the criteria for being in the sample was that they have been receiving Medic Aid, as called here. Um and other social services between 2006 and 2007 and if they lost their covers between August of 07 and July of 08. And um furthermore, that they agreed to be contacted monthly for a five minute kind of follow up interview to find out how things are working in your life. So why do we choose people that were just on medic aid and other social services? Well frankly because it was easier for us to collect data. We had access to the medic aid records um for folks so we knew we could get detailed records. With Medic Aid works it’s like a full in terms plans that covers everything from health insurance to mental health, to substance abuse, to housing in some cases. So it allowed us to get access to all these records so we could look up before which is the data set we’re getting here in July 06 to July of 07 and then the after, after they’ve lost their services. Did they in fact kind of just be absorbed into the community and have no kind of contact with the social service structure. What was their some other kind of fall.

So, okay, next slide please. Okay, so what do we know? Well we know, just some basic kind of demographic steps here. Um we actually went through each of this but it’s a pretty good distribution I think. Um the, one of the critiques of course is the size is so small, if we had more time and money we probably could, you know, maybe a hundred people and find out if this stuff actually goes, uh it continues in the same kind of trends. Some initial things here, I just want to share with you is that there is a number of these folks to receive medic aid for over a long time. So we have a number of folks in here that have been receiving it for five years or more. And um the longest continuous period of implement is 24 months. This isn’t necessarily something that just occurs within this population area but a little bit in the work that we do in the social work is that people have very sporadic employment histories um which creates challenges for anyone wanting to kind of advance in a career because they can necessarily have long periods of employment when they get enough skill to move up to management level or another type of work.

So okay, next slide please. Okay, so here’s some basic stuff of what we know. So we have on the right hand side. This is the cost associated with folks when they were on Medic Aid and then after they lost medic aid services. So I would just give you a minute to look through this but you’ll notice that you got ten categories on the right hand side and ten categories on the left hand side. And we’re gonna go through it and look at some of these in a few minutes here but just to call your attention to — look at mental health, there’s an increase after they left, after they were discharged from Medic Aid. Prescription drugs went up and ambulance, police, jail nights um and emergency visits, all show an increase. So stick a few minutes to look at the — a few seconds here. Okay, can we go ahead and move on to. Okay, so what I did is I basically just took the numbers, took the average as you saw there and went back to our original question as you know does doing nothing save money? And I’ve kind of given you the ten categories here but if you’ll look, you’ll notice that if you have taken the average, you’ll notice that it actually cost above $24, 000 more to do nothing than it is to provide people with the services, the heath care, and the mental health and any other kind of conformance. Um the more important thing I think here, and this is what we are seeing in Main and I think this is true on other parts of the country based on some reports on the National and Homelessness and some other things is that there’s actually been a cost shift. And the shift is gone away from state and federal funding or programs that are funded by the state in federal dollars. And the burden has rested on local tax dollars. So if you don’t see categories where you see increases here in mental health care, that’s mostly psychiatric episodes, increases on psychiatric episodes, um emergency room visits, as I said people lose insurance covers and stuff like that, if they are sick they needed to go somewhere for the medical health, for their health care needs or their chronic needs. But the other ones, the ambulance, police, contact, jail night, I would just invite you as you think about this and if you have some time is go and get some data from your local police department or county jails um between 2007 and 2010. And see if they have seen an increase in their calls for service or increase in the amount of people [inaudible] in jail. Those sources as I’ve said are paid for by the local taxes which could be anything from property tax to local income tax or charity care which is something that’s funded by either donations or legit organizations or other kind of [inaudible].

Okay, next slide please. Okay, I just want to share with you uh just really kind of the participants that are in the data set here. As I told you, there were, this actually comes from a larger project that we were working on. So, we have a good number of folks in here but this participant in this case here, um when I met her she was a mother, a young mother, she lives in an apartment with her boyfriend, and on the left here was a criteria of what we talked about. And then a year later, a little more than a year later, after she had lost access to Medic aid um there was a change in her condition here. Um, no, that’s not all, she say that she lost her health insurance and her other entitlement programs that led to her having a child removed by the Department of Health services or the you know her psychiatric episode directly related to the fact that she lost her insurance but there’s definitely a change in her life. And it’s definitely, she definitely be compensated from when we first met.

Okay, next slide please. Um here’s another person that has a mental illness. Also was doing fairly well. I mean he was working full time, um has his own apartment, [inaudible] community had some um community supports, people checking in on him to see how he’s doing, um mom and dad checked in on him weekly. He told me at the time in our initial interview, this is just a bit of a substance abuse problem and then — um we jump forward uh update here. We noticed that because he lost his entitlement, he lost his access to housing and mental health support; he lost a place where he’s living. He’s actually living with his sister now. And he uses the shelter as a place to kind of go and hang out when it gets too much from this instance in the system, where he still holds his job but since we first met he has been arrested and he has spent a couple of nights in jail, it’s been seven nights in jail at that time. So he’s doing okay I guess, but he’s different in terms of his quality of life I would say as I believe when he was on Main Care, Medic Aid than where he is now.

Okay, next slide please. Okay, just kind of look through this one here. You’ll notice that this person was with the family members, um has a part time job, a bit of a criminal history, um had some issues reported of a substance abuse, and definitely has some chronic health issues um and that was in September 2007. And in January of 2009 as you notice, there’s been, I would say a significant kind of change in her life and most importantly I think are the first, second, and fourth bullets. Um in the fourth one because she has chronic health issues, it seems to be translating it to other kind of health issues. I really kind of sticking with her I think and she’s gone from kind of living in the park with a family and a partner to being homeless and living in the shelter. Um and again it is not directly attributable toward change in her entitlements but it does in fact show that there is something that’s going on here.

Okay, next slide please. Right, so this is the last one. I just wanted to give you a kind of profile of what somebody looks like. I think the August of 2007. I think he was doing okay. You know he got some kind of mental health and a substance of use problem but he has a big connection to his mental health condition, he was depressed and saved his life. He has a bit of a history of violence and but he has been working, doing a research for us for a long time. It seems we get at that. Fast forward to February of 2009, um we see now that for the most part, uh most of those ports that you see on the right hand side, I’m sorry, on the left hand side have been eroded and he’s now kind of I would say really on the mercy of, this mercy services that we have in place here.
So, okay, next slide please. Okay, so just to kind of wrap this up and then I’ll take some of your questions here. I think that really things that emerges from the research here is that these issues of indigenous support that people have. I think indigenous support — indigenous support is really more related to what support system does that the people have for themselves. So the indigenous community support system only works if the individuals already have connections to family friends, co-workers or a work history or a full housing history. So I think without that do nothing, well it’s basically a rug, a pull off from underneath you. Folks are automatically at the mercy of whatever system’s left here. Um and then the last bullet, I just want to mention here is that I think it’s really interesting that the data that suggests that it’s clear that as Main’s care and the federal system and the state systems lose their funding or lose funding kind of tightens up and social entitlements um decrease, that people don’t just go away. They actually continue to use social service systems but that social service system becomes an emergency system of the police and the emergency rooms, the ambulances and things like that. And I think we see an increase here in these types of calls for service and emergency systems in the jails and the police departments and the local shelters. And it’s my understanding from the other data we’ve gotten around the country that that is also the case. Okay, we’ll have to take any questions you have.

Female Speaker: Thanks so much for your time and I will be reading them to you so that you could respond.

Male speaker: Okay.

Female Speaker: First question is from Deborah. She said, if law enforcement is included in the social services, why did they not [inaudible] and education to social work?

Male Speaker: Yeah, um why? Well I guess it’s a good question. I think, why don’t we pay more attention to it in the field and I think we, you know like, I don’t know, this is a good question. I think we talked about it, we — I know in my classes that I teach it comes up a lot. It’s almost like a, the two systems work with each other. Kind of hand in hand, um you know the law enforcement side there’s kind of a what they would call the — my colleagues would say aid factors; they’re not social workers or anything. So when they signed up for the job that they kind of want to do and on the social work side they say well I didn’t sign up to be the agent of social control but at the end of the day I think both sides would agree that they do updates of each other’s job. And you know it’s a good question and if you think there’s a lot of an opportunity for some collaboration there.

Female Speaker: Next question is from Laura. She asked are the costs per individual?

Male Speaker: Um the cost, the data I collected was on, was per individual. But as I reported here, that was an aggregate of everybody.

Female Speaker: Okay. Next question is Rebecca. She said, what is your opinion on the inventory birth control for those receiving the system?

Male Speaker: No, I don’t — I would say that um there is a larger policy on the HPSE question for the, I think that great dialogues and debates but we don’t — Um when I was in school no one told me that you have to do the following things in order to do this. Or when I get my paycheck nobody tells me hey you can’t buy alcohol with this or you only make $20,000 a year therefore you can’t have more than you know six kids. Nobody tells me that so I’m not sure that it’s appropriate for us as you know policy makers and to say look at you. If you get uh, if you get support for your children you have to be on birth control and you can’t have anymore.

Female Speaker: Okay. Next question is what is your stand on drug testing for receiving benefits?

Male speaker: I think, again I don’t think I would say that it’s a bad thing. Um you know in my background as [inaudible] enforcement and social works so I don’t think drug testing really works well. And again, you know we don’t, no one tells me when I get a check at the end of the week how I can spend my money and um you know if you get a property tax rebate or any other kind of that stuff. No one says you can get, you can’t have these property tax rebate if you abuse alcohol and drugs. I don’t, and I know I’m kind of mixing up as much of it but I don’t think it’s the government’s role to tell people what they can and cannot do to receive certain benefits.

Female Speaker: Okay, next question. It’s from Daniel. He said, do you have an interest in a larger goal for this project beyond the 10 individuals studied?

Male Speaker: yeah actually we do but um we’ve been in contact with some folks at the housing and urban development and it was kind of what we call the research will shot the proposal around but we weren’t tough economic country. You know there’s not a lot of money to do this. It takes a lot of time and a lot of works, a lot of follow ups and stuff like that. So, but I have this small data set. It’s connected to a larger one as I’ve mentioned and I think over time we’ll get some funding and some opportunities that really expand it.

Female Speaker: Okay, next question. From Caroline, she said, when a person with mental illness is arrested, is the jail equipped to handle them? What do they do for them?

Male speaker: yeah, good question. Not, I mean no. The county jail system is not equipped to handle it. Um somebody comes in and they’re suicidal, there’s an emergency crisis system which is um run by the state which will come in and do some kind of an assessment. But if they say yup, sure enough they’re suicidal. Uh at least from here there’s only a certain number of beds where they can go to and most of the time those are forwarded as a waiting list. So the jail is kind of stuck watching them in observation rooms but they are definitely not equipped to handle um folks who have um mental illness at all.

Female Speaker: Next question is, I have this subject, circumstances improve in the following year. If so how?

Male Speaker: They um, in sense, this time the last kind of cut um some people’s lives have improved and I think one of the things and I’m not sure what the real reason for this is and more research is done but I think as people move from kind of this temporary position to some type of disability, they are deemed to be disabled. That seems to kind of improve their lives.

Female Speaker: Next question is, can you explain more about what happened next after the research is done. Were they get presented and how do they get presented? Who takes it up after that?

Male Speaker: yeah, that’s always a good question. You know I– we’ve written articles, they’ve been published from, done some presentations of different locations in the U.S. and internationally. Um so we’re doing our best to really disseminate the findings from this and from the other cost studies that we’ve done. Uh but the true challenge I think is just probably with the question you’re asking here is, you know this needs to become a pulse here, a political advocacy strategy and I think you know that’s the great thing about this and in the field of social work is can be then, can we hand it off to the policy advocates in the social work role to mention advocacy rope strategy around this.

Female Speaker: The next question’s from Kenneth and it’s a follow up one of the biggest questions and she said, so it’s not the government’s role to tell to how to spend their allotment check even if substance abuse is part of the reason for their need?

Male Speaker: Yeah, I don’t, I personally don’t feel it is. I mean, I think there are, this is way outside of my practice area but I think there are treatment methods, um my colleagues would know about that include not necessarily that you have to be, you really have to completely quit drinking before you can engage in recovery. So I think there are methods that we could do that. I just don’t think, I would be interested in seeing what research exists as well myself to look it up. Um what research exists that says mandated programs, mandated um programs that require people to be clean and sober or alcohol free if what the long term impacts those are if they actually do change the trajectory of people’s lives.

Female Speaker: Next question is what is the average level of education that refer to crisis event?

Male Speaker: Yeah, so you’ll notice that I talked a little bit about that but the average level was less than a high school education. Um and I think as we think about that, just in the National data, that’s pretty normal. Main has actually a pretty high education level. But in the study that we’re talking about here we have half of those are high school grads and the rest are not. So five, five are high school graduates and the rest are high school to be.

Female Speaker: The next question is from Elise. She said you said that doing nothing costs more, what do we as social workers do when nothing is done?

Male Speaker: When nothing is done, so I think you know that’s kind of respect to the other questions. I think that this is the challenge for us as a field and as practitioners is to really take this up and use this kind of confront with contradictionist as one of my colleagues would say. So, look and you know tell the policy makers and the funders. Look you say that this is gonna save money but here’s what we know from some research and it’s not just, and there’s other research out there as well. The stuff from Marty Bird and some other things that show that it doesn’t save money and it actually cost more money. So I think we, that’s the challenge um for all of us as social workers. We just kind of take this message forward and the policy makers know the reason of cost savings here. It actually is gonna cost you more money in the end.

Female Speaker: Okay, next question from Tiani and she says how do we begin community conversation to understanding the intensity of this social problem?

Male Speaker: yes, that’s the next paper I’m working on and I think we need to, first of all as a group, um we need to establish like common themes and because I think one of the challenges on our field is that you know a social worker’s start talking. We live and breathe kind of helping people every day and then when we start talking about mental illness or treatment from their illness we get into the folds of how it works and it just becomes a you know, dizzying array of alphabets that no one really has the ability to understand. So I think we as a field, specifically on social works needs to come up with a common themes that people know which is what I was a kind of working towards here when I was provisionally defining doing something and doing nothing. But I think we need to come up with just mental illness and then define it as people who have a diagnosis or substance abuse, people who have are actively using substances or homelessness. Meaning they don’t have a permanent place to stay. So that means we can provisionally come up with common themes, then we are talking to other people, we don’t have to explain the kind of in their definition what that is. We just say look, if you don’t provide mental house services, it’s actually gonna cost you more because the cops are gonna do it. And that’s very simplistic but people would already understand the definition and then we can get to the next level of that conversation.

Female Speaker: Next question is, did anything surprise you while doing the study?

Male Speaker: Um, you know I was really surprised and I continue to be surprised by the resiliency of people um it just, you know the kind of ravages of poverty and the violence that comes with being impoverished and how people actually make it in their day to day lives. How do they actually just, you know live in survival. I’m very impressed that people’s resiliency and I know just reflecting on some of the conversations like one person just saying that you know they only see their kids once a month and it’s usually like in a public element or in a public park or where it was but how hurting that was they had that time in the society. They were family has become fragments because of the problems they’ve had.

Female Speaker: Next question. Do you have diversion programs in Main to give people a choice between treatment for substance abuse or domestic violence instead of jail time?

Male Speaker: Um diversion programs. So we have uh we do have diversion programs for both but I’m not sure if we have them for — we have them for both discriminately not connected together. So if you have a substance abuse problem and you’re say a batter in the domestic violence thing, I’m not sure that there will be something that fits for that category where one which said, or one of those categories would actually fit for both.

Female Speaker: Okay. I think that’s it for our questions this evening. So um thank you so much Tom for presenting and I’d like everyone who’d been able to join us. Actually we have one more question, it just came in. Okay, so do you think there should be a time limit on how long someone can receive the system and main care when there’s no visibility involved? Example, some of you is actively using drugs and receiving benefits.

Male speaker: Um so you’re saying like should there be a time limit for someone who has a substance abuse problem, a time limit on how long they can receive food stamps or main care?

Female Speaker: Right.

Male Speaker: Okay, well. So the thing in food stamps is for the most part, that’s not just supporting one person. I think if you look at SNAP, which is what food stamps is called now, if you look at SNAP benefits now that it’s actually supporting families. So if the, let’s say the main person comes in and applies for food stamps has a significant substance abuse problem um cutting off food stamps so that person actually cuts it off to their entire family. And I think to a lesser extent there also may occur with Medic Aid and Medicare. So, by the other piece of it is the, I think the data is pretty clear on someone who is actively using substances and he’s engaged in a meaningful treatment for substance abuse. That there is, you know, that having not access to main care that covers the cost for their substance abuse treatment does actually help reduce this episodes of substance abuse and stuff like that. So I guess that’s a long way around of answering your question.

Female Speaker: Actually there’s a couple more question coming so if we go, have some time um, the next question’s from Jules he says, would that higher incident of negative result after loss of care for any specific racial group, gender or other factor for which there was no control?

Male Speaker: That’s a really great question but there is, I think the women, again remember it’s five and five, the women do fair a bit better with the indigenous of social support systems than the men did. Men are typically following what’s called non categorical or non-cats. And I think they are pretty precarious any way on the benefits and so they’re –when they lose that there’s a deeper slide but a more important question is there, the sample does not have much diversity in it. Actually it has no diversity in it and that’s mostly because of the demographic of where we live here. I mean the larger sample size that we have is actually more representatives of the state’s population but through most part here where 97.4% I think are Caucasian.

Female Speaker: Okay. And the next question is how much do you think lack of education fits in the puzzle?

Male Speaker: Yeah, you know that’s really [inaudible]. I think that’s the piece that like several other studies that I’m working on now and that one always comes up. Um you know I think what we know, at least from the work that we’ve been doing is that that you know the more education you have, the greater opportunities it provides you. It is absolutely true and I think if you have a high school education or less, um the job opportunities that are available to you are — prevent all kinds of challenges. So, not the least of which is you know, you’re not gonna make a lot of money but secondly I think from another study I’m looking at that relates to tenant free position and that food stamp thing is that if you work and say if you have less than a high school education and you’re waking up to make a job and make a minimum wage and you have two kids at home and you’re a single mom, um the chances of you getting a job from during the day, Monday to Friday, say nine to five are pretty slim. Most of the work we’re finding from the other survey’s is irregular work hours, nights, weekends um and so I mean just the opportunity to work a nine to five schedule or a schedule where you have weekends and time off with the family I think is a huge factor that relates to education that maybe sometimes is missed one and people think it is a greater income. It’s also greater convenience for college education and everything.

Female Speaker: Thank you so much. I think we have gotten all. Um did you want to add anything additional um you know before we close?

Male Speaker: I just want to thank everyone for participating. I think one of the great things for me at least as a researcher and kind of um in the social work field is that we have the ability to kind of pull from multiple fields here. And you’ll notice that you know that I talked a bit about you know economics and history and social policy and some of the other things that are kind of more traditional kind of social work things. I know it came up in classes in a the day when some of the students were very excited because it gives them an opportunity to like pull and collaborate and be then different disciplines that kind of change people’s lives. So, yup thank you all very much. I appreciate it.

Female Speaker: Thank you so much and thank you for coming every one and keep your eyes out for upcoming webinars on our research series. And if you have any specific questions that weren’t answered, you do contact your woman at Viber. Thanks again.

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