Strategy aims at the root causes
Administration’s campaign is liberal – and successful
Published Monday, Oct. 27, 2008
WASHINGTON-Ona cold January morning in 2001,Mel Martinez, who was then the new secretary of housing and urban development, was headed to his office in his limo when he saw some homeless people huddled on the vents of the steam tunnels that heat federal buildings.
"Somebody ought to do something for them," Martinez said he told himself. "And it dawned on me at that moment that it was me."
So began the Bush administration’s radical, liberal and successful national campaign against chronic homelessness. Sacramento – led by the incoming state Senate leader Darrell Steinberg, a former assemblyman – was among the first cities in the country to buy into the administration’s approach. Today, the concept is at the heart of the capital city’s 10-year plan to end chronic homelessness.
"Housing first," the federal program is called.That’s to distinguish it from traditional programs that require longtime street people to undergo months of treatment and counseling before they’re deemed "housing ready." Instead, the Bush administration offers them rent-free apartments up front.
New residents, if they choose,can start turning their lives around with the help of substance abuse counselors, social workers, nurse practitioners, part-time psychiatrists and employment counselors.
However, residents are referred to as "consumers," and the choice is theirs.
The help is so good and the deal’s so sweet that roughly four out of five chronically homeless Americans who get immediate housing stay off the streets for two years or longer, according to the program’s evaluators. In Britain, which has used the approach for a decade, the so-called "rough sleeper" population declined by about two-thirds.
The "housing first" strategy gets much of the credit for a 30 percent decline in U.S. chronic homelessness from 2005 to 2007. The number fell from 176,000 to 124,000 people, according to the best available census of street people.
The chronically homeless, estimated to be between a fifthanda10thofthe total, are the hardest group of street people to help. A chronically homeless person is someone with a disabling condition who’s been continuously homeless for a year or more or for four or more episodes in three years.
If a "housing first" strategy seems absurdly generous to them, it’s proved to be crazy like a fox for many of the more than 200 U.S. cities that have adopted the approach.
The earliest adapters, including Denver, Miami, New York, Philadelphia, Portland, Ore., and San Francisco, found that the added cost of homes and support services for the chronically homeless wasn’t burdensome. In fact, it was largely or entirely offset by reduced demands on shelters, emergency rooms, mental hospitals, detox centers, jails and courts.
Instead of shuttling between them, chronically homeless people "are staying housed and starting to look for employment,"said Nan Roman, president of the National Alliance to End Homelessness, the leading advocates of the approach. "A lot are reconnecting with their families."
Just being off the street is healthy, said Sheila Crowley, president of the National Low-Income Housing Coalition. "Even if they continue to drink, they’re eating better, sleeping better and interacting with people better."
For the chronically homeless, the life change is sudden and profound.
"Today, God has seen fit to bless you," James Hamilton’s counsel or told him last month on a day that Hamilton began in a fusty bunk bed in a Washington homeless shelter.
By nightfall,Hamilton’s permanent home was a quiet one-bedroom apartment in an iffy neighborhood in Southeast Washington, for which the city pays a HUD-subsidized $900 a month plus utilities.
It’s furnished with a new $1,200 furniture set, including a green plush sofa, bureau and end tables. Also a newoak kitchen table and chairs, bed, linens and a $300 Target gift certificate for incidentals such as the microwave that’s perched on a wastebasket.
Hamilton, a lean and chatty 51-year-old, hawks newspapers at a Washington subway station from 6 to 10a.m. In the afternoons, he helps a clothing distributor make deliveries to fancy retailers.
In between, Hamilton spends a lot of time at Grace Episcopal Church in Georgetown, his spiritual home.
With its help, he’s now enrolled in an educational lay ministry course at Wesley Theological Seminary in Washington. He types his papers at a near by public library. He’s also a recovering crack addict who tests positive for hepatitis C.
"This is the best chance I’ve ever had to make things work," said Hamilton, who, to keep the apartment, needs only to:
– Meet with his counselor once a week.
– Abstain from substance abuse and smoking in his apartment.
– Start paying 30 percent of his income as rent "in a few months."
– Not let anyone else move in permanently.
For Hamilton, the apartment means that he can store his scattered possessions in a secure place. He can stock food securely, too. He’s spared what he calls the "beefing" of other shelter dwellers and is free to watch his own choice of programs on the analog TV that his stepfather gave him. Hamilton attends night events at Grace now.When he lived at Washington’s Adams Place Shelter, he had to check in by 6:30 p.m. to keep his bed.
He’s also attending a more energized evening Narcotics Anonymous meeting than the one the shelter offered, he said.
In that regard, Hamilton’s home, set amid older frame houses and small, rickety churches, has a threatening downside, however. Crack and PCP pushers are everywhere, he said. "You got God and the devil in the same place."
The "housing first" approach, originally intended for mental patients, may not work so well for substance abusers, who, Roman suggested, may need more structure and supervision. Critics also wonder whether more shouldn’t be done for homeless families, especially newly homeless ones, and low-income families at risk of homelessness.
Even if all those arguments are right, it’s indisputable that the Bush administration has been a Good Samaritan to the least appealing of America’s homeless.
A lot of the credit goes to Martinez, who left HUD in 2003 to run for the Florida U.S. Senate seat that he now holds. It was Martinez who got a pledge to end chronic homelessness in 10 years written into President Bush’s first budget, said Roman, the head of the homeless alliance. The cause received small but steady increases thereafter, thanks, others said, to Roman and to the bipartisan congressional support that her group nurtured.
Since fiscal year 2002, authorizations for HUD homeless programs have risen from $1.1 billion to a proposed $1.6 billion for fiscal year 2009.For all federal authorizations that help the homeless, including VA benefits, Social Security and Medicaid, the figure has risen from $2.9 billion to a proposed $5 billion. Dr. Sam Tsemberis, a New York psychologist, also deserves credit.
In the early ’90s, he demonstrated that immediate access to housing worked for homeless people with psychiatric disturbances and substance abuse disorders. Tsemberis’ program, Pathways to Housing, is now the dominant national model for" housing first" programs. Dennis Culhane, a University of Pennsylvania social psychologist, helped the cause, too. In a series of long-term studies, Culhane established that while the chronic homeless were only 10 percent of all homeless people, they consumed about half of all the government services that the group used.