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Story of Impact: Milestone Foundation HOME Team

by Mary Erin Casale
This case study is part of MANP’s Stories of Impact series highlighting the many ways Maine’s nonprofits are essential to a strong and healthy Maine.  

The ImpactMilestone logo

Individuals who experience substance use disorders and homelessness reside in many of communities. Often, these individuals are frequent users of expensive emergency services such as police, fire, and hospital emergency rooms rather than lower cost, more appropriate treatment and support services. The HOME (Homeless Outreach and Mobile Engagement) Team project of the Milestone Foundation seeks to address this issue by providing active regular outreach in downtown Portland.  In the past five years, these interventions have been successful at increasing the safety of the community while saving taxpayer dollars.

  • The team averages over 8,000 contacts per year, serving approximately 400 individuals.
  • An independent evaluation showed an estimated yearly savings of $250,000 to the City of Portland’s emergency medical system.
  • The program has reduced costs by nearly $1,000,000 since the program’s inception in 2010 and
  • The HOME Team provides a model of compassionate behavior for some of society’s most vulnerable and often ignored people.


The Story Behind the Impact

”Everyone should feel the bumps of that van, hear the gratefulness in the old men’s voices, smell sadness in the form of urine and alcohol, and see that you and I are merely one lost job, one pain prescription, and one bad set of cards away from that same situation.” – Paige LaPointe, Physician Assistant Student at University of New England

The mission of Milestone Foundation is “to provide the best quality services to empower individuals with substance use and behavioral health disorders  to attain stability, dignity, recovery, and an enhanced quality of life.” Regardless of past attempts of sobriety, the organization helps those dealing with chronic addiction and long-term alcoholism find safety, community and recovery. The HOME (Homeless Outreach and Mobile Engagement) Team, a collaborative undertaking between the City of Portland, Portland Downtown, the Milestone Foundation, and other community partners is one project that provides a direct service that has powerful economic and humanitarian impacts on the City of Portland.

Milestone VanIndividuals who experience substance use disorders and homelessness reside in many of communities. Often, these individuals are frequent users of expensive emergency services such as police, fire, and hospital emergency rooms rather than lower cost, more appropriate treatment and support services. Since 2010, from 12pm to 8pm, six days a week, a ten passenger van patrols the streets of Portland and provides outreach and community supports this population with care and compassion.

“The HOME Team really provides a unique service for people who society sometimes sees as no longer human,” said Executive Director, Bob Fowler. By identifying and forming trusting relationships with individuals, as well as responding to calls from business owners and police, the HOME Team’s daily presence helps reduce disruptive behaviors and saves the city thousands of dollars annually.

Modeled on successful programs in Burlington, Vermont and Cambridge, Massachusetts, the project costs $171,000 per year to operate. It is funded by a mix of federal grants, the City of Portland, foundation funding and contributions from Portland Downtown and Mercy Hospital. By diverting frequent users of hospital emergency rooms, police, and costly Medcu services into more appropriate treatment and support environments, an independent evaluation proved the program saved the city at least $250,000 annually. In addition to the cost savings, Milestone prides itself on the kindness and respect it uses in its interactions with individuals. Modeling compassionate behavior has the added benefit of inspiring others to do the same.

This unique program has earned the accolades of Portland’s City Manager,  Jon Jennings, who has called it one of the most vital programs in the city. During the 2016 budget cycle, Jennings broke with the city’s allocation committee for Community Development Block Grants to recommend an increase of funding for the program. The city council agreed with Jennings. Milestone will be able to run the service for seven days per week with the additional funding.

Milestone has engaged various partners from the community to participate. For the past three years, Milestone has worked with University of New England (UNE) and provided students an opportunity to learn about the particular health needs and issues of the homeless population. Milestone staff provides training and gives students an opportunity to shadow the HOME Team with ride-alongs. In return, twice per month students and faculty from an array of specialties host health clinics and provide services from blood pressure screenings to neuropathic foot checks. Milestone’s HOME Team has also teamed up with the Nursing School at the University of Southern Maine to implement the “nurse with a backpack” program.  This program – modeled after a similar program in Boston – involves student nurses and faculty members providing basic health outreach on the streets of Portland alongside the HOME Team.

Joe McNally

Joe McNally, Director of Community Outreach

The HOME Team partners with Portland Downtown and has become part of the emergency service delivery system for businesses. While its number one objective is to direct individuals to the appropriate recovery services, it also results in a more hospitable downtown for those who work and visit the area. Business owners were faced with issues of intoxicated individuals exhibiting disruptive behavior and driving away customers. Instead of calling the police, merchants now turn to the HOME Team.

Joe McNally, Director of Community Outreach, oversees the program: “Our number one goal is to keep people alive and to build the trust necessary to start putting lives back together.” McNally thinks it is imperative to raise consciousness about the nature of addiction as a chronic, relapsing brain disease. In particular, he hopes to educate more people the fact that someone with addiction experiences a relapse is not an indication that the person is failing or that recovery is failing. It is the terrible nature of the disease itself.

The HOME Team is an authentic and collaborative response to a problem that affects the entire community.  By addressing the needs of the individuals who need care, the high cost of emergency room visits and the concerns of local merchants, Milestone has created a program that has proved its effectiveness both financially and charitably.

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