[Hpn] Housing the Homeless; KnowledgePlex; 12/21/2007

Morgan W. Brown morganbrown@gmail.com
Tue, 25 Dec 2007 17:44:17 -0500


-------Forwarded fyi-------

--------------------------------------------------------

KnowledgePlex
Housing the Homeless
http://www.knowledgeplex.org/news/1232841.html

Neugeboren, Jay. Jay Neugeboren is the author of fourteen books of
fiction and nonfiction. His novel 1940 will appear in April 2008.
 Commonweal
 December 21, 2007



ABSTRACT

In New York City, halfway into Mayor Michael Bloomberg's vaunted
five-year plan to reduce the homeless population by two-thirds, the
number of homeless families is at an all-time high, with more than
ninety-five hundred families using the shelter system every night.
Pathways can do this because renting individual apartments at
fair-market value while having an off-site team that provides the
intensive clinical services is less expensive than operating (or
building) facilities for the homeless that require staff to be present
on a twenty-four-hour basis-as happens in shelters, community
residences, and other supervised housing programs.

FULL TEXT

A PROGRAM THAT WORKS

For the past dozen years, Pathways to Housing, a New York City
nonprofit organization, has been helping to reduce the problem of
chronic homelessness by a radical strategy: giving homes to people
with histories of mental illness. Most of Pathways clients also have
substance-abuse problems. These are the very people most housing
programs do not consider eligible even to apply for housing.

On any given night, somewhere between eight hundred thousand and a
million Americans are homeless. Across the United States, many cities,
despite the repeated heralding of plans "to end homelessness,"
struggle merely to keep the situation from worsening. In New York
City, halfway into Mayor Michael Bloomberg's vaunted five-year plan to
reduce the homeless population by two-thirds, the number of homeless
families is at an all-time high, with more than ninety-five hundred
families using the shelter system every night. Over the past year,
there has been a 23-percent rise in the number of families entering
the system, and an 11-percent decline in those moving into permanent
housing. With Congress's Joint Economic Committee now predicting 2
million foreclosures on subprime mortgages by the end of 2008, one
must wonder: What will happen when the housing needs of these
displaced families put added pressure on the rental market and city
shelters?

In New York City, families are not "automatically admitted" to
shelters when they seek help, and last summer only 50 percent of the
families that applied for assistance qualified for help. But in the
Pathways program, you don't have to "qualify" for assistance-all you
have to be is homeless. Pathways takes the most vulnerable individuals
among New York's homeless, gives them immediate access to apartments
of their own, and-something city programs do not dogives them choices
in the selection of their apartments.

The program-which would provide a useful model for any community
struggling to reduce homelessness-works remarkably well. Over a
ten-year period, the housing-retention rate for those individuals New
York City deemed worthy of housing was below 50 percent. (The
housing-retention rate is measured as a percentage of individuals who
remain stably housed for two or more years.) The housing rate for
Pathways' clients during this same period was 88 percent.

Pathways moves people who are both homeless and mentally ill into
places of their own, straight from the streets. Then it wraps various
services around them, providing a multidisciplinary clinical team,
available seven days a week, twenty-four hours a day, to provide those
services.

To provide these men and women with their own furnished apartments
(clients choose their own furniture) and extensive support services
costs, on average, 20 percent less per year than the cost of living in
a shelter. Pathways can do this because renting individual apartments
at fair-market value while having an off-site team that provides the
intensive clinical services is less expensive than operating (or
building) facilities for the homeless that require staff to be present
on a twenty-four-hour basis-as happens in shelters, community
residences, and other supervised housing programs. Pathways now serves
more than five hundred people in New York City, all living in their
own apartments, many with part- or fulltime jobs. More than 120
children live in these apartments with their families.

But Pathways does more than provide homeless people and their families
with homes: it gives them the resources and services-and, most
important, the hope-they need to return to the world as productive
citizens. It offers psychiatric services, nursing outreach,
prescription and medication management, rehabilitation and counseling
opportunities, communal activities, and job placement. (One client who
lived in subway tunnels for more than a dozen years now lives in his
own handsomely decorated apartment and is the Pathways director of
transportation.) It does this primarily through eight Assertive
Community Treatment (ACT) teams, each of which serves approximately
seventy clients. Each ACT team is staffed by a registered nurse and by
certified social workers, peer counselors, and other specialists.
Program-wide, Pathways also provides additional services through a
psychiatrist, employment counselors, family therapists, and
substance-abuse specialists. It has a housing department that locates,
acquires, maintains, and renovates apartments around the city, while
also dealing with client-landlord problems and legal issues.

Pathways is funded primarily by federal, state, and local grants, but
it has also begun raising money privately to pay for services the
government will not pay for. Thus, thanks to a generous grant,
Pathways has been employing family therapists to work with mothers,
fathers, and children who face problems not unlike those most families
face, though their problems are made more intense because of their
histories of homelessness and mental illness. And Pathways is also
raising money that will pay for services needed to help parents
reconnect with children the courts have taken from them.

In most programs that deal with homelessness, people must qualify for
the right to get into shelters (or out of shelters), or into group
residences or apartments. They must be clean and sober, drug-free,
taking their meds, prove they are entitled to the (usually) inadequate
housing they are offered, and must do so by jumping through elaborate,
arbitrary, and patronizing hoops. And, the Puritan ethic being forever
at work, a client falling off the wagon or going into detox or jail
invariably faces the loss of his or her housing. Not so with Pathways.
It will hold apartments for its clients' return.

As Sam Tsemberis, the program's founder and director, says:

Pathways serves clients because they fall off the wagon. That's what
addiction means. We anticipate that people will relapse-it's part of
the recovery process, and the advantage of this harm-reduction
approach is that people are not evicted and homeless again simply
because they've relapsed. They remain housed, and so can continue to
work on curing their addiction or improving their mental health. What
we do, that is, is to separate housing from treatment-thus, if you
relapse, you're still housed. There's treatment for addiction and for
mental illness-and there's housing for homelessness.

"I was in Pathways for a dozen years before I began to straighten
out," Jimmy L. recently told me.

I was on heroin and coke, crack and pot, and I was a problem to
everybody, and most of all, to myself. But then, three years ago, I
began to get it together. I'm off drugs and booze now, I've begun to
have a relationship with my daughter again, I'm working, and I have a
decent life I'm proud of. But it hasn't been easy and I don't know
where I'd be if Pathways hadn't stuck by me when nobody else would.

Jimmy, an articulate, soft-spoken man in his mid-forties-a man I might
have taken for a school guidance counselor or manager of an upscale
retail store if I hadn't known his story-has only one fear now: "What
happens if I wake up and Pathways is gone?" What people like him need,
he says, is pretty simple and, most of the time, unavailable: "We need
kindness, respect, and-first and last-a roof over our heads."

Sam Tsemberis founded Pathways fifteen years ago, and for a dozen
years it was the only Housing First program in the country. But in the
past four years, as studies have continued to demonstrate that
Pathways actually works (especially for those who have been
chronically homeless) and that it is less costly than traditional
programs, others have begun to imitate it. Forty Housing First
programs are now in various stages of formation and operation around
the country.

Perhaps, then, if and when our cities and our governments begin to
operate on the principle Pathways operates on-that housing is the
fundamental need, a right one does not have to qualify for-things will
begin to change for the better. For how can anyone have a decent life
without first having a home?

--------------------------------------------------------

**In accordance with Title 17 U.S.C. section 107, this material is
distributed without charge or profit to those who have expressed a
prior interest in receiving this type of information for non-profit
research and educational purposes only.**

--------------------------------------------------------

-------End of forward-------