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New National Approach Focuses on Chronically Homeless

http://www.pbs.org/newshour/bb/social_issues/jan-june07/homeless_04-27.html

New National Approach Focuses on Chronically Homeless

People who have been homeless for at least a year or have been homeless multiple times within a few years present a unique challenge. The NewsHour reports on a new national approach to homelessness that seeks to address this group.

OUTREACH VOLUNTEER: What do you think?

MARY FREEMAN, Subsidized Housing Recipient: Oh, my gosh. It looks good, though.

LEE HOCHBERG, NewsHour Correspondent: She was happy about her free haircut, but Mary Freeman was elated about the new housing she won that day. At an outreach event to the homeless at the Portland Coliseum, she was one of 50 who drew lucky bracelets that put them at the head of the line for government-subsidized housing.

Freeman had roamed Portland's streets for six months, high on methamphetamine, and had her daughter declared a ward of the state.

MARY FREEMAN: I can't believe it. I mean, I just -- I can't even express my joy. I have no words for it. I'm so thankful to God. I'll never, ever lose this bracelet.

OUTREACH VOLUNTEER: When was the last time that you had your own home of your own, like your own single home?

MARY FREEMAN: It was about two years ago.

LEE HOCHBERG: Portland and several other cities launched an experimental strategy three years ago to put the most troubled of the nation's 750,000 homeless into permanent housing, rather than a shelter, to see if that makes it easier for them to stabilize their lives. Early data suggests it does.

Portland Housing Commissioner Erik Sten.

ERIK STEN, Portland Housing Commissioner: What we found is that you really can't solve your problems very easily until you have permanent housing. The key thing we're finding is it makes them more functional.

LEE HOCHBERG: The number of homeless in Miami dropped 30 percent last year with the new approach. In Dallas and San Francisco, 28 percent. Nine hundred of Portland's homeless are off the street.

ERIK STEN: They are safer. The city is safer. There's a perception that the city is more hospitable, because you don't have people you're stepping over sleeping on the streets to nearly the same degree.

LEE HOCHBERG: The program eliminates the longtime requirement that the homeless be clean and sober to qualify for housing. Its main target is the nation's 75,000 chronic homeless, who have so many daunting issues.

CINDI GRIES, Subsidized Housing Seeker: I'm manic-depressive and schizoaffective. I have heart problems. I have COPD. I have to have breathing treatment every four hours because I can't breathe.

LEE HOCHBERG: Cindi Gries showed up at the coliseum, also suffering from HIV and substance abuse. She'd lost her housing in South Dakota and was now in Portland with partner Parthina Kincaid, their 4-year-old son, and two dogs, all living in her car.

CINDI GRIES: When you're on HIV meds, you have to take them at the same time every day. And if you even go an hour behind...

CINDI GRIES' PARTNER: You're messed up.

CINDI GRIES: ... you're messed up. So I have to have them, and they have to be refrigerated. Otherwise they melt. We really have to be in housing. I can't be outside. I have to take a breathing treatment every four hours.

Philip Mangano
Philip Mangano
Interagency Council on Homelessness
Housing itself is therapeutic. So instead of the person using the emergency room of the hospital at $1,000 a night as kind of a respite unit from the streets or a shelter from the street, that person is using the emergency room much less frequently.

The cost of chronic homelessness


LEE HOCHBERG: Complex cases like this, left to struggle on the street, can be extremely costly. Doctors at the University of California, San Diego, and the San Diego Police Department studied 15 chronic homeless and found, in a year and a half, the government spent an average of $200,000 per person in treatment, law enforcement, jail and court costs, hospital visits.

PHILIP MANGANO, Interagency Council on Homelessness: The other finding of the study was, at the end of that 18 months, those 15 people were in the same condition and same situation as before. They were still on the same street corners and the same doorways.

LEE HOCHBERG: The Bush administration's point man on homelessness, Philip Mangano, says housing these people not only helped stabilize them but actually costs government less.

Portland found, for example, that even with the cost of housing 1,000 of its homeless, its overall expenditures on the homeless dropped by 35 percent as arrests of its homeless fell 47 percent, and emergency room visits at hospitals declined. Four hospitals actually contributed $300,000 for housing so their discharged patients have somewhere else to go.

PHILIP MANGANO: Housing itself is therapeutic. So instead of the person using the emergency room of the hospital at $1,000 a night as kind of a respite unit from the streets or a shelter from the street, that person is using the emergency room much less frequently.

LEE HOCHBERG: Portland couldn't find permanent housing for the Gries family that night, but an AIDS advocacy group put them into temporary housing, watching to see if that might help.

The city did find a place for Shannon Woodward, seven months pregnant, who said she'd been to emergency rooms four times a month for the nine months she'd been on the street. With young daughters Carly and Kimberly, and 4-year-old son Kenny, she had hit the street to escape domestic abuse.

OUTREACH VOLUNTEER: ... to pull the pieces back...

SHANNON WOODWARD, Subsidized Housing Recipient: I tried to hard. I wanted to work.

OUTREACH VOLUNTEER: You're taking a lot of really good steps. You're taking -- are you OK? You're taking a lot of good steps. You should be really proud of what you're doing.

LEE HOCHBERG: Woodward's family got a hotel for the night, with hopes a subsidized apartment later might help them towards self-sufficiency.

Bill Hobson
Bill Hobson
Downtown Emergency Service Center
These are people with extreme, acute trouble in their life. They spent years getting there. They're not going to get better overnight. But they are going to be alive, and they're not going to be costing us as much money as they are now.

An experiment in Seattle


LEE HOCHBERG: Perhaps the most ambitious experiment is 150 miles up the road in Seattle, at a facility called 1811 Eastlake.

RODNEY LITTLEBEAR, Subsidized Housing Recipient: I'm Chief Medical Ed, and this is my co-host. He's a good knucklehead.

SUBSIDIZED HOUSING RECIPIENT: He's the number-one clown, though.

RODNEY LITTLEBEAR: Yes, OK.

LEE HOCHBERG: Seventy-five of Seattle's most desperate street inebriates moved into this brand-new, $11 million, government-funded building last year. To ease their transition, drinking is allowed in the building.

RODNEY LITTLEBEAR: Well, at least I'm not sleeping underneath that bridge no more, because it's cold out there.

SUBSIDIZED HOUSING RECIPIENT: Out in the rain.

RODNEY LITTLEBEAR: I get to smoke in my room and, you know, drink to my heart's content and, you know, when I pass out, I just dive on the bed, you know, and go to sleep, you know, just rest in peace.

LEE HOCHBERG: There's no data yet on the project's cost-effectiveness, but tenants at a similar project in Minneapolis reduced their use of detox facilities, and jail bookings declined.

1811 Director Bill Hobson.

BILL HOBSON, Downtown Emergency Service Center: These are people with extreme, acute trouble in their life. They spent years getting there. They're not going to get better overnight. But they are going to be alive, and they're not going to be costing us as much money as they are now.

BRUCE RAMSEY, Seattle Times: It's morally objectionable to essentially enable the lifestyle of a street drunk, even if it saves money.

LEE HOCHBERG: Critics, like the Seattle Times newspaper, have lambasted the project. Editorialist Bruce Ramsey.

BRUCE RAMSEY: We didn't object as an editorial board to some housing for street people. We objected to the idea that they would not have to be sober.

And to essentially build them a new apartment house is putting them ahead of the line of other people who might need housing or other services. It just seemed like you're rewarding the wrong people. I'm kind of skeptical that you reform people by changing their physical environment.

Cindi Gries
Cindi Gries
Housing Recipient
We've been in the Vantil Motel. We've been in the Val-U Inn. We've been to the Sandy Motel, and we couldn't stay living there, because I couldn't -- I have to have a fan or air conditioning all the time or I can't breathe.

No guarantees with some housing


LEE HOCHBERG: And yet, there are four of these deeply troubled 75 who have taken jobs since entering the project. Kenny Warnock is working at a car wash.

But now you're keeping a job.

KENNY WARNOCK, Subsidized Housing Recipient: Yup.

LEE HOCHBERG: Still drinking?

KENNY WARNOCK: Yes, but not very much, not nearly as much as I was. I used to have to -- I had to make sure that I drank enough to where, like on a really cold night, when you stayed at the sobering center, the lower your alcohol level, the earlier in the morning you're going to get booted out.

I mean, I've been booted out of there at 3:00 in the morning, when it's 28 degrees out. So you want to make sure, when it's really cold out, that you're good and ripped, you know? I don't have to do that anymore.

LEE HOCHBERG: Still, housing doesn't guarantee the road back. In Portland, we followed some of the newly housed for several months after their intake. We found Cindi Gries and her family three months later in temporary housing in a small hotel, and very unhappy.

CINDI GRIES: Here, I don't feel safe at all.

CINDI GRIES' PARTNER: Nope.

CINDI GRIES: But we've been in the Prestigien. We've been in the Siesta Motel. We've been in the Vantil Motel. We've been in the Val-U Inn. We've been to the Sandy Motel, and we couldn't stay living there, because I couldn't -- I have to have a fan or air conditioning all the time or I can't breathe. There was no air conditioning, no fan, no telephone, no TV, no nothing. Just...

LEE HOCHBERG: Kincaid said she had given up her job after being harassed for being a lesbian. And unable to establish a permanent address, she said, she'd been unable to enroll in school to get her GED.

So you're no better able to support yourselves now than you were when we met you months ago?

CINDI GRIES' PARTNER: Nope.

CINDI GRIES: Not until we get into subsidized housing, hopefully.

LEE HOCHBERG: The city hoped a permanent apartment would open in a few weeks. But while waiting for that, funding for their temporary housing ran out, and the family ended up again living in their car.

Mary Freeman
Mary Freeman
Housing Recipient
I could never have done what I did if I didn't have a home and a safe environment. And just the security of having four walls and a roof over your head that you can call home, that really does help.

The federal government's role


LEE HOCHBERG: Commissioner Sten says housing inventory is a problem.

ERIK STEN: We're going to hit the wall here on the amount of housing that's available. We can't make hundreds-of-people-a-year gains forever without running out of housing.

LEE HOCHBERG: And he says, while the federal government has helped subsidize rent, it recently failed to renew a key grant that funded health care for the homeless in 11 cities.

ERIK STEN: Disability payments, housing subsidies, and Medicaid are all being gutted by this administration, so once we get these folks off the street, where's the backend support that's going to be necessary?

LEE HOCHBERG: Mangano says the federal government continues to fund the services the chronically homeless really need. Mary Freeman, for example, is drug- and alcohol-free after months of government-funded rehab. Her hair has grown back, and she's got her daughter back in her new subsidized apartment.

MARY FREEMAN: I'm just elated. And I feel safe. And I feel very thankful. We're miracles we're here, definitely.

LEE HOCHBERG: She's taken a job as a nurse.

MARY FREEMAN: I could never have done what I did if I didn't have a home and a safe environment. And just the security of having four walls and a roof over your head that you can call home, that really does help.

LEE HOCHBERG: And there's a new family member in Shannon Woodward's new subsidized, three-bedroom apartment. She says she's seeing pediatricians now, not emergency rooms.

SHANNON WOODWARD: Well, we've been there once since then, December. My son had a little accident, so we went to the emergency room, but we would go there anyway for that. So it's nice. I don't have to do all that anymore.

LEE HOCHBERG: And she's taking steps to become self-sufficient.

SHANNON WOODWARD: I'm going to go to college. I'm signed up for college. I'm going to go to be a drug and alcohol counselor, get my degree for doing that. So I'm excited. You know, if we didn't have a home, I wouldn't even be thinking about college. I would be thinking about where we were going to stay the night.

LEE HOCHBERG: And the Gries family got their permanent housing in October. They now have three dogs, two cats, and a bird, and plan to adopt another child. Kincaid recently landed a job cleaning a bank, so they can contribute some toward their rent payment. Gries says she's having an easier time controlling her medical condition.

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