Saturday, April 23, 2011

Policing the Homeless: Part 1. Understanding the Problem

On a cold fall night in 1997, in Green Bay’s Broadway neighborhood, a homeless man fell asleep on the steps of a church after drinking a bottle of vodka. A few hours later he was dead. An autopsy revealed that he died of asphyxia; choking on his own vomit. The death was ruled natural, the result of chronic alcoholism.
Research suggests that many homeless people suffer from mental illness, drug addiction and alcoholism.  These characteristics often result in behaviors that draw police attention and as a result, the homeless have a higher frequency of police contact than the general population. Their behavior is often self destructive and harmful to others. Herman Goldstein, author of Problem Oriented Policing observed, “The police at times are forced to use ordinances or criminal statutes, a process that is unkind to the homeless, distasteful to the police and inappropriate for the criminal justice system.” Since these behaviors are often related to substance abuse or mental illness, the criminal justice system is ill equipped to handle these problems.
It is important to note that people become homeless for a variety of reasons including economic hardship. This can include working families and children who have suffered economic loss through no fault of their own and, most likely, will not have any contact with the police. This blog focuses on those who are chronically homeless and whose behavior somehow merits police attention. Since the police are likely to have frequent contact with this demographic of the homeless population, part 2 of this blog will review best practices and suggest alternative strategies in policing the homeless.

How we got here

The U.S. Department of Housing and Urban Development defines a chronically homeless person as, “an unaccompanied disabled individual who has been continuously homeless for over one year. Factors that contribute to stereotypes about the homeless are behaviors such as sleeping on the streets, panhandling, disruptive and disorderly behavior, lack of personal hygiene, and defecation outdoors. Panhandlers can deter customers from patronizing local businesses. Because the homeless themselves are frequent victims of crime they tend to sleep in public places like parks during the daytime. Such behavior has a tendency to deter legitimate park usage and may result in complaints from the public.
Citizen concerns about the homeless can be fraught with stereotypes reinforced by the media and personal observations. One Green Bay resident who lives near a homeless shelter related this account in an email to city officials;
“The homeless alcoholics use containers so that they won't get stopped for public urination.  So, do not be naive and pick one up.  Several people I've talked with recently, since September, have noted an increase in the number of cans and bottles on the streets and in St. John's and Whitney Parks.  Being a draw for drunks doesn’t make me happy.” (Anonymous)
The message illustrates a perception many people have about the homeless and unfortunately the public may not differentiate between the mentally ill or substance abusers and a person who was displaced for economic reasons. The stigma of being labeled homeless seems to be closely associated with the stereotype of the New York’s squeegee men or as the Green Bay resident puts it, “homeless alcoholics”.

The Human Cost

Numerous studies confirm that a high percentage of people who suffer from mental illness and substance abuse are homeless. A 2007 survey conducted in Milwaukee revealed that 33% of the chronic homeless suffer from mental illness, 30% abuse drugs, and 30% abuse alcohol. In 2008, research conducted by the National Alliance for the Mentally Ill (NAMI) states, “44% of seriously mentally ill individuals had been arrested.”  According to the 2008 Annual Homeless Assessment Report to Congress, chronic substance abusers accounted for 36.5% of the overall homeless population and 26.3% were classified as severely mentally ill.
Author E. Fuller Torrey explains why the mentally ill and substance abusers are such a prevalent part of the homeless population in his book, The Insanity Offense. De-institutionalization of the mentally ill began in the 1950’s with the discovery that anti psychotic drugs could alleviate the symptoms of mental illness. Substandard conditions in mental hospitals added to the momentum and over the next three decades over 75% of those once institutionalized were released. With the emptying of mental hospitals came an increase in prison populations. A study in 81 cities revealed “a direct correlation between the reduction of public psychiatric beds and an increase of arrests rates, crime rates and homelessness among the mentally ill.”  
In what was perceived at the time to be a victory for civil rights dealt another devastating blow to the mentally ill. A 1972 court case, Lessard v. Schmidt, reversed the seven hundred year old legal principle of parens patriae, which established a government’s responsibility to protect people who are unable to protect themselves. The Lessard case defined stricter criteria for declaring a person a danger to themselves or others. Researchers argue that the criteria are unrealistic and so restrictive that it prevents those suffering from mental illness from receiving the care they so desperately need. The Lessard case set in motion a chain of events that some argue has resulted in countless deaths that would have otherwise been preventable, something Torrey calls, “The Consequences of Unconstrained Civil Liberties”. The Insanity Offense presents a number of case studies where people diagnosed with mental illness go on to commit murder because their mental illness went untreated. Torrey asserts this occurred because the patients did not meet the criteria of immediate danger, a standard defined in the Lessard case. He argues that the legal system has failed to protect the mentally ill and the victims of these violent acts. Researchers George Kelling and Catherine Coles support Torrey’s theory in their book, Fixing Broken Windows. Kelling and Coles describe a “catch 22 system” that provides temporary treatment and once the individual responds the treatment, they are no longer an “immediate threat” and are therefore released to repeat the cycle.
One aspect of mental illness, especially paranoid schizophrenia, is that those afflicted often do not view themselves as being sick or requiring treatment, a condition known as anosognosia. This may explain why so many individuals afflicted with mental illness fail to take prescribed medication. Those who do not feel the need to take medication are free to disregard medical advice until their behavior steps outside of social norms and may become, in some cases, violent or self destructive. These individuals find it difficult to function within the confines of social norms and as a result, many become homeless. Research and case studies in Massachusetts, New York and Philadelphia suggest those suffering from mental illness who do not take prescribed medication are more likely to become homeless.
Chronic alcoholism is another affliction which impacts homelessness and police resources. In 2009 the Green Bay Police Department took 300 people into protective custody due to incapacitation from alcohol. Of these 300 people, 25% were involved in three or more police contacts in one year where alcohol was a factor. Examples of these contacts were disorderly behavior, depositing human waste in public, panhandling and possessing open intoxicants in a park. One individual alone accounted for 28 police contacts. Another Green Bay study of people who had frequent alcohol related contacts with the police revealed 25% were homeless. The research revealed two important details, a small percentage of the population accounts for a disproportionate amount of police contacts and, chronic alcoholics were more likely to be homeless than those who were not alcohol dependent.
One example in Green Bay involved a chronic alcoholic known as “Rooster”, a homeless man known to local residents and business owners as the town drunk. Rooster averaged three police contacts per week for behaviors such as aggressive panhandling and public urination. Beginning in the 1980’s Rooster was taken into protective custody and committed to the Brown County Mental Health Center over 80 times. The cost of each visit was estimated at over $1,200, totaling over $96,000 in treatment with no apparent change in behavior. Despite efforts of local law enforcement to seek court ordered committal for Rooster, he continued to live on the street until he succumbed to medical complications resulting from alcoholism and died. Unfortunately, this situation is not unique to Green Bay. A Boston study revealed that 92% of street deaths involved people who were chronic alcoholics who chose not to stay at local shelters.
This is a serious problem that affects all communities, but what can be done about it? In part 2, Effective Strategies and Best Practices I will examine how police across the nation are coping with this universal problem and suggest strategies that may help with your local problem.

Friday, April 15, 2011

Alcohol Control and Innovative Strategies to Reduce Underage Access to Alcohol

How easy is it for a teenager to buy alcohol in your community? Communities across the nation struggle with this issue and some are more successful than others in preventing youth access to alcohol. In Green Bay compliance check results at the end of 2010 hovered around 75%. This month, after 3 months without compliance checks, our rate dropped to 33%. A 2010 survey of Green Bay area teens revealed that 70% of those had been arrested for an underage drinking offense admitted to driving after consuming alcohol.  Yes, it’s a serious problem and one we must get serious about solving. In this report I am going to talk mainly about off premise sales, primarily from convenience stores and liquor stores. I will continue the discussion of underage access to bars and night clubs in a future blog.

                The problem is not unique to Green Bay and as a result, interested people from across the nation meet annually to discuss and develop best practices. One organization in particular, the Responsible Retailers Forum (RR Forum) has done some excellent work in this area.  This April I attended the RR Forum’s annual meeting which was hosted by the State of Utah Alcohol Control Board in Park City. I have to say this is one of the most beautiful places I have ever seen. The mountains and the accommodations were indescribable! 

Under the leadership of Dr. Brad Krevor, the RR Forum has built an impressive collaboration of stakeholders that have some connection to the alcohol industry or its regulation. This group includes representatives from a variety of state and local regulatory agencies, producers, distributors, prevention specialists and community advocates. The RR Forum publishes useful documents which should help anyone in the alcohol industry to conduct their business in a way that meets local community standards and complies with state and local laws. Some of their most notable work is the creation of recommended practices for both on premise and off premise sales. These documents are free and downloadable from the Forum’s website www.rrforum.org . ("Responsible Retailing Forum")

Control States

Utah is one of 18 of what are referred to as control states. After prohibition the individual states were given the option to control the sale of alcohol and became known as “control states”. Alternatively states that leave the distribution of alcohol to private industry are referred to as “open states” like my home state of Wisconsin. In the control model, the state is the sole distributor of all alcoholic beverages. Utah’s Executive Director of alcohol control describes the situation as managed conflict. He points to the agency’s competing goals; on one hand, the state has a responsibility to promote moderation and discourage excessive alcohol use. One the other hand, revenue generated from the sale of alcohol is a significant source of tax relief for the citizens. Last year’s sales were $280 million, $30 million was spent on operating costs and $100 million was returned to the general fund (Kellen).

Utah, like many other control states use revenue to promote responsible drinking campaigns. One such campaign is called Parents Empowered. The state of Utah claims this has been one of the most effective campaigns to date, offering parents a number of tools to both educate their kids and gain the knowledge needed to prevent teen alcohol access ("Parents Empowered").

Green Bay’s Efforts to Reduce Underage Drinking

Compliance checks are still the most common way to determine if businesses are checking ID’s and declining sales to underage people.  A common tactic for police and alcohol regulators is to send an underage person into a licensed establishment to see if they can buy alcohol. Under our traditional approach, both the clerk and licensee were issued citations when a sale was made to our underage buyer. Despite these efforts, our compliance rates were miserably low and citations eroded trust with shop owners who genuinely wanted to comply. Clerks were either not checking ID’s or, they were ignoring the red vertical ID’s clearly labeled “UNDER 21”. Some were overriding the cash register when prompted for a date of birth to complete the sale. Most gave the excuse that they didn’t check the ID because it was busy.  One thing was clear; the weak spot was the clerk at the point of sale but since all we were doing was issuing citations, any opportunity to modify their behavior was lost. While it is true the clerks were making the mistake, managers were setting the stage for success or failure through their store policies and training. We did not study these factors but, if we had, we would have discovered that  training, signage and policies were deficient.

In 2010 we conducted a grant funded research project. One of our conclusions was that enforcement alone was an exercise in futility. Successful strategies in other communities involved a comprehensive approach and methods we had not previously tried. It became apparent that we needed to reward positive behavior and discourage negative behavior so; we adopted a new strategy modeled after something I saw at last year’s RR Forum meeting. Under the new strategy, “Red Card-Green Card,” the licensee received a red card if they failed the compliance check and a green card if they refused the sale. Licensees that are awarded with a green card are thanked and their positive behavior is reinforced. If the licensee failed the compliance check, they received a red card they were required to attend a licensing committee meeting to explain what steps they have taken to correct the problem. When we began the project, the manager was not cited as long as they attended the meeting. Initially we did not cite the clerk but interestingly, the store managers asked us to, explaining the clerk needed an incentive to follow their policies so, we did. We received a lot of positive feedback about the new strategy and by the end of 2010 our compliance rates had jumped from about 50% to 75%, still miserable but better. We knew that there was much room for improvement.

Successful Initiatives

As a police officer I am always looking for some “plug and play” strategies we can use back home. Here are just a few that I recommend.

Respect 21

Respect 21 is a program that involves the use of mystery shoppers to test employee’s compliance with store policy. The store manager sets a policy as to what age should trigger an ID check. Retailers welcome it because the mystery shoppers are of age so there is no risk of citation or sanctions against their license. The mystery shoppers give feedback to the store through the use of the red and green cards and also compile a report showing the overall compliance of all participants. Signage, ID books and other resources are made available to participating retailers. It a program with a documented record of success and is soon to be implemented in Green Bay. This program is sponsored by Miller-Coors and is usually administrated by the local distributor. ("Underage Drinking Prevention Programs")

I caught a CUB!

One such strategy employed by Utah’s Alcohol Control is called, “I Caught a CUB”. CUB stands for Covert Undercover Buyer. What makes the CUB strategy unique is that aside from the penalty, there is an incentive for clerks to check ID’s and decline the sale. If the clerk asks for ID and declines the sale the clerk receives a $50 reward. The store manager also receives the award for creating an environment for success. This combined with other initiatives has boosted Utah’s compliance rate to 96%! 


The Brown Jug Model

Another program which began with the support of a chain of liquor stores in Alaska is called the Brown Jug. The Brown Jug Model also creates an incentive for clerks to detect underage purchases and boasts similar success rates.
        Community Involvement - Brown Jug introduced legislation providing for a civil penalty against minors that illegally enter licensed premises, minors that solicit adults to purchase alcohol for them, and adults who order or receive an alcoholic beverage to provide to a minor. Minors that are liable for the $1,000 civil penalty are given an option to take a 2 day Prime for Life alcohol education class, a DUI victim impact class, and a sexual assault awareness class to waive $700 of the penalty. The reduced civil penalty of $300 is used to pay bonuses to employees for preventing minors from obtaining alcohol.”
The Brown Jug model has produced impressive results. Brown Jug employees have seized over 2,000 ID’s and passed 54 consecutive compliance checks ("Brown Jug Friendly Spirits").

Server Training in Wisconsin Needs Work

This issue easily justifies its own blog. Just a few basic points here. In order to obtain a license to serve alcohol in Wisconsin you need only attend a the 4 hour Wisconsin Responsible Server Class or for $16 you can take the course online. A family member took the course in 90 minutes and described it as “incredibly easy”. The online method is obviously more convenient but unfortunately there is no way to verify who is actually taking the online course. A colleague at the RR Forum related an instance where two individuals obtained their licenses through an online course and it was later learned that neither spoke English, proving that someone else had completed the online quiz for them. If we know that the weak spot in the system is the clerk, why is so little attention paid to training? I would describe this as a worst practice. ("ServingAlcohol.com")

Conclusion

Some of the best ideas in policing are either borrowed or modified from someone else. My goal in writing this blog was to share some of the best and most innovative strategies in dealing with an issue that is universal. The sale of alcohol to underage people is mainly an act of negligence and one that is highly preventable. Because it is a negligent act and not intentional one, the people whose behavior we are trying to modify respond better to incentives than punishment. That, in my opinion, is why the "I caught a CUB" program and the Brown Jug Model are so successful. While discussing these alternative strategies at the RR Forum meeting I heard this comment, “Why would you pay someone to do something they are legally required to do?” Answer: It works. At least it has in other communities so I am willing to give it a try.

I view every violation as a failure of both the seller and the regulator. Combined strategies that incorporate recommended practices outlined by the RR Forum’s research stand a better chance for success than random enforcement alone. Enforcement, an important component of compliance is but one of many tools at our disposal. Our success will be measured by lives saved, a reduction in human suffering and increased compliance rates, not by how many tickets we write.



Works Cited
"About the RR Forum." Responsible Retailing Forum. Responsible Retailing Forum, 2011. Web. 15 Apr 2011. <http://fcpr.fsu.edu/retail/index.html>.
"Eliminating Underage Drinking in Utah." Parents Empowered. Utah Department of Alcoholic Beverage Control , 2011. Web. 15 Apr 2011. <http://parentsempowered.org/>.
Kellen, Dennis. "Executive Director." DEPARTMENT OF ALCOHOLIC BEVERAGE CONTROL. State of Utah, 2011. Web. 15 Apr 2011. <http://abc.utah.gov/about/index.html>.
"Preventing Underage Access to Alcohol." Underage Drinking Prevention Programs. Miller Coors, 2011. Web. 15 Apr 2011. <http://www.greatbeergreatresponsibility.com/Alcohol-Responsibility/Retailers.aspx>.
"Responsible Retailing." Brown Jug Friendly Spirits. The Brown Jug, 2010. Web. 15 Apr 2011. <http://www.brownjugalaska.net/index.html>.
"Wisconsin Bartending License Course $16." ServingAlcohol.com. Serving Alcohol Inc., 2011. Web. 15 Apr 2011. <http://servingalcohol.com/wisconsin_bartending_license.html>.