A sobering issue

Erin Neff

Monday, April 10, 2000 | 11:07 a.m.

You see them ambling off balance in and around downtown with paper bags enveloping 40-ounce beer cans, or on a good day, a half-full bottle of whiskey.

To many, the Las Vegas Valley's public drunks are little more than an eyesore and the cause for an embarrassing explanation to children about why that man is staggering near the swings in the park.

As a nuisance, public drunks could be easily forgettable if not for the $7 million they drain from area hospitals each year and the precious bed spaces in emergency rooms they take up.

"When we have a chronic public inebriate in our emergency room, there's very little in the way of treatment we can give them," said Davette Shea, director of Emergency Trauma and Transport at University Medical Center. "They basically just need a safe place to sober up."

UMC can have as many as three drunks at any given time. Each will spend about 12 hours in the 42-bed emergency room, sobering up until their blood alcohol content is below the legal limit.

While UMC gets a majority of public drunks due to its proximity to downtown, the valley's hospitals have five inebriates in their emergency rooms at any given time, Shea said.

The high cost of treating such inebriates falls on valley hospitals due to sheer numbers. An estimated 4,000 drunks sober up at Westcare facilities each year. But when Westcare is full, police and ambulance crews who pick up drunks on the street bring them to hospitals.

Last year nine area hospitals treated 4,119 drunks in addition to the 4,000 treated at Westcare.

"The cost and rental of our rooms is much higher than that at Westcare," Shea said. "We could bill these people forever and never get our money."

Westcare Foundation President Richard Steinberg agrees that his facility can treat public drunks more efficiently.

"The one thing that we do know is that there really are cost savings to treating this as a system," said Steinberg, whose facility has 50 beds -- about half of which are funded.

Westcare treats 4,000 drunks a year for about $1 million. Hospitals treated the same number last year for more than $3 million. When the costs to ambulance, police and fire crews that are involved are added, the valley spends more than $7 million a year on the problem.

Why do the drunks require a $600 bed they can't afford in the emergency room?

"You can't just put them in chairs," Shea said. "They get sleepy, fall and then they are a true emergency room patient."

Increasing awareness about the issue is the first step toward finding a solution, according to Las Vegas City Councilman Larry Brown.

Brown asked Shea to give a presentation to the City Council recently in an effort to make more elected officials and citizens aware of the issue.

"This is important to everyone," Brown said. "You have the city's support in doing anything we can to raise the level of awareness."

One thing still needed, however, is money.

Las Vegas emergency service providers have been borrowing from a successful King County, Wash., program to deal with chronic inebriates. The King County model gives hope that implementing a system of care can alleviate high costs and free up much-needed emergency room resources.

"These are truly a subset of clients who are not suited for the emergency room," Shea said. "All we're doing is keeping them safe.

"Some of them are disruptive, but most of these people are simply inebriated," she added. "Medically, there's nothing else wrong."

In Seattle's King County, chronic drunks are picked up in unmarked vans by social service workers and taken to a "sobering shelter" where they are placed in touch with a network of housing, employment and service workers.

Funding for the system comes largely from taxes on alcohol sales. Ordinances also ban the sale of malt liquor and beer in large, single-use containers such as 40-ounce bottles.

Taxes on liquor sales in Clark County do go to support Westcare. But that type of tax is not levied on wine and beer here, in part because of the prevalent use of such spirits in casinos.

"Obviously there would be some opposition to that," Shea said.

Both Shea and Steinberg agree Clark County isn't far away from the King County model.

"There's a real need to have vans with workers not in uniform," Steinberg said. "That frees up law enforcement and paramedics enough to make a positive impact."

Steinberg estimates setting up a transportation system and funding additional beds at Westcare would cost more than $1 million.

Westcare gets its funding from federal and state grants, Clark County and private donations and is viewed by most emergency workers in the valley as the logical facility to treat chronic inebriates.

Hospital workers see some public inebriates so often they talk to them on a first-name basis, buy them lunch at McDonald's, occasionally donate shoes and give them rides to homeless shelters after they sober up.

One such inebriate, who gave his name only as Charlie, said he doesn't want to cause a drain on services.

"Look, I'm homeless and I choose to drink," Charlie said, the words fumbling from his mouth on a stream of Miller Genuine Draft vapors. "I don't want to go to no hospital and have them poking me and asking me questions. I just want to sleep it off."

Shea said chronic inebriates will become an increasing social issue as the population continues to grow.

"We prefer to be able to help them," she said. "But we only have so many emergency rooms, and there is a better way."

Erin Neff covers Las Vegas government for the Sun. She can be reached at (702) 259-4062 or 229-6436, or by e-mail at erin@lasvegassun.com.