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Shawn Vestal: ‘Homeless Island’ should not to be confused with Rhode Island’s approach to homelessness

May 5, 2019

Perhaps you’ve heard recently of the “genius” of Rhode Island’s approach to homelessness.

If so, you probably haven’t learned what you think you have.

Because Rhode Island does not lock up homeless addicts indefinitely and force them to complete drug treatment – as you could be forgiven for thinking it does, if you watched and believed the “Seattle is Dying” report by KOMO-TV.

No, what Rhode Island does, more than any other state in the country, is offer voluntary drug treatment to everyone who enters the corrections system. The state applies a program that combines the use of the medications such as methadone with therapy and other components. It’s called medication-assisted therapy, and it’s done all over the country. We even do a bit of it here in the Washington prison system, though not enough.

In 2016, Rhode Island dramatically expanded its spending on MAT, starting a new $2 million program. The feds chipped in $1.5 million more this year to expand the program’s post-release supervision.

The program has had truly remarkable success in reducing opioid overdoses. While there are surely some benefits for those in that population who are, or have been, homeless, the program has not ever been sold as a solution for homelessness, at least not that I can find in reading countless media stories about the program and information about MAT that comes from Brown University, which participates in the program.

Meanwhile, homeless advocates in that state are calling for more of what we have in spades here in Washington – more permanent housing and other alternatives to the shelter system.

MAT for every single inmate who wants it is probably a great idea. But the people who think that’s what they saw in “Seattle is Dying” might underestimate the cost of such an expansion in Washington, as well as the inaptness of comparing our state to that one.

Our population is more than seven times larger than Rhode Island’s. Our state corrections system includes 13 prisons, spread around the state; that doesn’t include county jails, which deal with the bulk of the kinds of crimes that can be associated with some homeless populations.

Rhode Island’s system consists of seven facilities in a single location, and the state does not have county jails.

Rhode Island spends the third-most per inmate of any state corrections system in the country, at more than $58,000 in 2015, according to a national analysis by the Vera Institute of Justice. Washington spent roughly $37,000 per inmate in that year.

The depth of the Rhode Island delusion arising from “Seattle is Dying” is significant. Because I write about homelessness a lot, I hear from people who have opinions about homelessness. Many of them in recent weeks have shared that hour-long report with me, along with praise for the “solution” it offers.

That solution, the show strongly suggests, is based on the Rhode Island model. After mentioning the MAT program there, and interviewing inmates whose lives have most likely been saved by the treatment they received, KOMO reporter Eric Johnson shifted to his hypothetical proposal for a solution here, with the strong impression that it would mimic the Rhode Island model.

Johnson suggests creating an addiction prison on McNeil Island, complete with doctors and counselors and job trainers and the MAT program. In this fantasy, all other money spent on homelessness programs would be directed to Homeless Island.

Crucially, this proposal would jettison the voluntary nature of the Rhode Island experience. As Johnson says, “It would have to be a place where the patients couldn’t get up and leave if they wanted.”

I have been asking people who are impressed by this idea: How do we legally and constitutionally accomplish this? What is the mechanism by which we compel homeless addicts to a term of indefinite imprisonment? Will homeless drug addicts be given dramatically different sentences for crimes than other people who commit those same crimes? Will addiction itself be criminalized – and how will we then deal with addicts who do have a place to live?

What I hear back is usually this: How do they do it in Rhode Island?

They don’t.

They do not do anything remotely like that in Rhode Island. What they did in Rhode Island is straight out the liberal social-program playbook: They increased government spending on drug treatment for incarcerated people. They allow people the choice about whether to participate. They say this has resulted in a plummeting number of people dying from opioid ODs.

That doesn’t sound quite so appealing, I imagine, to those in love with the idea of Homeless Island. It doesn’t offer the promise and comfort for those who want simple solutions and are dying to be “tough” about it.

But at least it’s true.