When CityBeat tagged along with Travis Larson and his street-outreach team last June, theyd just received a $332,000 grant from the United Way. The money was to go toward getting some of the areas most difficult-to-reach homeless people off the street and into rooms at the Metro Hotel, located in East Village, where theyd then work with a case manager to get their lives on track.
Larson, a project manager for the nonprofit Alpha Project, admits now that he might have been a little overly optimistic about the programs success.
I think that at the inception of this program, we were really starry-eyed and just were, like, were hoping for 100-percent committal, he said. People are going to come in and really change their lives.
In the last year, hes had to learn to be OK with the fact that some people, as he put it, never really leave the streetand the failure rate, hes found, is roughly 25 percent.
But the reality is, you should feel pretty good about changing the lives of 75 percent, he said.
The Metros been an unofficial pilot program for a new initiative that the United Ways rolling out this week. Called Project 25, the program seeks to move 25 hard-core homeless people off the street and into housing thats coupled with services.
Were picking individuals who are costing the taxpayers the most money, said Brian Maienschein, the United Ways commissioner of the regional Plan to End Chronic Homelessness. Thats the critical component of this because I believe its going to show that its a lot more expensive to do nothing than to do something.
To do this, the United Ways working with local police, hospitals and emergency-medical services to come up with a list of 100 people whove proven the most costly when it comes to ER visits, ambulance trips, hospital stays, jail time and calls to police. Once the lists drawn up, the challenge will be to find the top 25 users of these services and convince them to join the program.
Its been shown that homeless individuals who are offered housing and services accept it, overwhelmingly, Maienschein said. Are there going to be instances where its going to be difficult? Sure. Thats one of the more difficult parts about this project.
San Diegos Project 25 is being introduced in the wake of a series of articles in The Los Angeles Times in which L.A. Countys skid-row-targeted Project 50which sought to house at least 50 chronically homeless peoplewas laid bare. While the stories showed the programs successesroughly 80 percent of participants have remained off the street since Project 50 started in 2008it also showed the often-challenging reality of the housing first or whatever it takes approach thats become the model for many homeless-services providers. Housing first says that permanent shelter is a necessary precursor to helping a person deal with issues like addiction and mental illness, even if it means that the person might take some time to address those issues. One photograph that ran in the newspaper, for instance, showed a woman guzzling a bottle of liquor in her apartment, prompting L.A. County Supervisor Mike Antonovich to criticize the program as warehousing without healing.
Joel Roberts, CEO of L.A.-based People Assisting the Homeless (PATH), whose organization has been selected to operate San Diegos proposed permanent homeless facility, described the debate raised by the L.A. Times series as ripping a bandage off a fresh wound.
People feel that if youre going to provide housing, you should provide housing for people who are working for it, Roberts said. And [housing first] is saying, No, were looking for the people who are most needy and helping them access housing. Traditionally, homeless-services programs came with rulesfollow the rules and work your way up from a shelter to more stable housing. Get caught with drugs or alcohol or miss a curfew and youre out of the program. The product of this approach is a chronically homeless population thats hard to help, said Rosemary Johnston, program director with the Interfaith Shelter Network.
Many of them have flunked out of traditional shelter programs either through their own fault or just because of the nature of their disabilities, she said. Theyre not capable of living in a large-scale shelter environment and following a lot of rules and that kind of thing. Its just overwhelming for them, and they choose the street as a better alternative.
Johnston said its challenging to get the public to understand the need for a housing-first approach.
I spoke to a group maybe 18 months ago about the concept of permanent supportive housing and how there are minimal rules, really, and theres no requirement that you stop drinking or using drugs as long as you behave yourself and dont become a problem. And, boy, did that register a negative reaction, she said. People dont want to hear that, and they dont want to fund it, but its also true that over time, if people are in stable housing, they are more willing and able to look at these kind of issues and think, Ive just been told by my doctor that my liver is on the way to never-never land if I dont stop drinking yesterday. And once they can think clearly because theyre getting better nutrition and a decent nights sleep and a stable living arrangement, they are, I think, more likely to begin to address those issues.
The Alpha Projects Larson estimates that the Metros 60 beds have saved roughly $600,000 in emergency-room visits, law-enforcement costs and other medical expenses in the first yearand thats a conservative estimate, he said.
I really think its probably higher than that. It could be right around $800,000, taking into consideration everything.
Since being appointed the United Ways commissioner in January 2009, Maienschein, a Republican former San Diego City Council member, has been reframing the discussion about homelessness to be more about cost-savings than compassionbecause the compassion tack hasnt really worked.
At a time of declining budgets, he said, they cant argue about the data.
His hope is to generate enough funding to keep Project 25 going for three years. So far, the United Way has committed $1.7 million.
Most programs, theyre one-year programs, so at the end of a year, all these people would be on their ownsee you later,he said. The service provider whos awarded the contract to handle case management for Project 25 will have to have a discharge plan for program participants, Maienschein said.
When asked how hed deal with a program that might not show results immediately, Maienschein said the focus should be on the long-term.
I think the key word is immediately, he said. That is, among other things, what has made this population so difficult in the past, and perhaps why some havent wanted to work with them. But I believe that with the services and the case management component, the vast majority will eventually have very significant improvement. It wont be immediate in all casesalthough it will in manybut it will over time. Then these individuals have an improved quality of life, and they cost taxpayers far less money.