Talking to Vernon, Doc, Gene and Minnie, the first thing you learn is that it's impossible to feel safe if you're homeless. Some homeless people are the “smartest and most honorable people in the world,” says Vernon, but then there are the crooks, other homeless folks who prey on people just trying to mind their own business.
Minnie's had her clothes and blankets stolen and, recently, her ID. Lacking identification, her application for general relief (a small monthly check and food stamps) was denied. She had already earmarked that money. “I would have gotten a [motel] room, taken a nice shower, slept in a nice bed.”
Her next sentence is mumbled, but it sounds like she says, “Just fool myself for one night.”
“I'll tell you what,” Vernon says to a reporter, “You come live with us, just for one night. You don't know when you're going to get stuck [with a knife]; on the street you don't know when you're going to get robbed.”
“His girlfriend got killed,” Minnie interjects, pointing to Doc, who's sitting next to her. Doc, frail with a gruff voice, seems vague on the details, other than that it happened on Dec. 1, in an alley about 100 yards from the police station. Minnie and Vernon, Doc and his girlfriend (also named Minnie) were sleeping in a group that night for protection. “It was cold as hell that night,” Gene remembers.
Doc is silent for awhile while Vernon, whose speech is impaired both by his lack of upper teeth and also because he's admittedly drunk, lectures on how taxpayers get bilked when the homeless are sent to jail. He doesn't care much for the police, he said, save for a couple of cops who seem to understand the homelessness predicament.
“You ain't got a damn home, where you going to drink?” he asks. “You depressed as hell, anyway.”
Doc interjects, “Sometimes you have to get intoxicated to go to sleep at night; you're cold.”
Gene has an on-again, off-again home, but the other three have been homeless long enough to qualify as chronic. Doc lost his job as a Navy dock worker shortly after Sept. 11. Minnie lost her job at the Marine Corps Air Station after she suffered two strokes. Unable to pay her bills, she turned her twin daughters over to their godmother and went homeless. Vernon is a Vietnam vet who gave up on sobriety a couple years ago. Gene, also a Vietnam vet, says he prefers living on the streets. He says his time in Vietnam changed how he sees the world.
The four often go to James Justus for help. Justus owns an auto-repair shop on Imperial Avenue in Sherman Heights and is a member of the Regional Task Force on the Homeless. Vernon can't say enough about Justus-“and it's not just because I'm sittin' in his place of business,” Vernon reminds the reporter. Justus knows their history well-as well as any social-services case worker would. He knows about Doc's girlfriend's murder. He's heard about Minnie's struggle to get her general-relief check. He remembers when Vernon was sober and had a car. He knows Doc once had a good job and a family.
Evangelist for the homeless
Philip Mangano believes that with cooperation from the right people, folks like Minnie, Vernon, Doc and Gene will be off the streets and in decent housing before the year 2015. Mangano, a Democrat from Massachusetts, is the point man for the Bush administration's ambitious plan to end chronic homelessness within the next decade.
A former manager for members of bands like Peter, Paul and Mary and Buffalo Springfield, Mangano says his life changed after watching the 1972 Franco Zeffirelli film Brother Sun, Sister Moon, about the life of St. Francis of Assisi, the Catholic patron saint of the poor. He gave up the rock-star life-on the Feast Day of St. Francis-and became a full-time volunteer in Boston's soup kitchens.
Over the next decade, Mangano climbed the social-service ladder to head the Massachusetts Housing and Shelter Alliance, a coalition of roughly 80 homeless-service providers. During that time, he watched Boston's homeless population grow. In a 2001 Boston Globe article, Mangano told a reporter that everything being done to combat homelessness was missing the mark-homelessness had become an institution, he said-an accepted norm rather than a “social evil.” The nationwide proliferation of soup kitchens, emergency shelters and day programs were merely acting as a Band-Aid on the problem. The focus, Mangano told the Globe, should be on the root cause of homelessness: the simple lack of housing.
In 2002, Mangano was tapped to head the federal Interagency Council on the Homeless (ICH) and, more importantly, oversee the Bush administration's 10-year Plan to End Chronic Homelessness. Since then, he's become more traveling evangelist than bureaucrat, hopping around the country, getting promises from at least 170 cities and counties that they'll draw up their own regional plans to end chronic homelessness. At inspired public meetings, he calls himself an “abolitionist,” name-drops Martin Luther King Jr. and Frederick Douglass and asks for an “amen” from his audience when he says something that resonates with them.
There is no federal mandate telling localities to come up with a 10-year plan; rather, it's an incentive-driven program: no plan and you're at the bottom of the list when HUD doles out federal funding for homeless services. Neither is there an overriding federal plan. Instead, the federal plan is to get everyone else to plan.
Local control in the planning process means each municipality must focus on what's worked for them and what hasn't. Mangano regularly takes representatives from other cities around the country with him to talk about their own innovative approaches to the problem. The San Diego Police Department's serial-inebriate program (SIP), which offers oft-arrested, homeless chronic alcoholics treatment instead of jail time, as well as the department's homeless outreach team, have both been lauded by Mangano as national models.
In the past year, Mangano has visited San Diego three times to meet with regional homeless service providers and political leaders and, since October, some of those same folks, along with business leaders, educators, city and county staff and law enforcement have been hammering out the details of San Diego's 10-year plan-a draft is due to be completed this month. Sharon Johnson, who heads the city of San Diego's homeless services department, said the group will submit the finished plan to the San Diego City Council and county Board of Supervisors for approval in June or July, and from there San Diego will join the roughly two-dozen other cities and counties that have completed plans.
Less scary vs. most vulnerable
The Bush plan focuses on just one subpopulation-the chronically homeless, defined as a single adult with some sort of disability (either mental or physical) who's been homeless for at least a year or episodically homeless at least three times in four years. It's estimated that the chronically homeless comprise only 10 percent (150,000 to 200,000 people) of the overall homeless population but, as some studies have argued, that 10 percent uses up 50 percent of resources that go to caring for the homeless-shelter beds, detox centers, law-enforcement services, psychiatric treatment, emergency medicine. San Diego's SIP program, in fact, began after a study found that 15 homeless chronic drinkers ran up $3 million in emergency-room visits over the course of a year. (In 10-Year Plan circles, the “San Diego 15” story has becomes a popular anecdote.) Now, roughly one-third of the homeless folks who enter the SIP program successfully complete it.
Nan Roman, executive director of the National Coalition to End Homelessness (NCEH), said the Bush plan is a modified version of a template her organization put together in 2000. Shortly after Bush was elected, NCEH representatives met with Housing and Urban Development Secretary Mel Martinez and Health and Human Services Secretary Tommy Thompson to talk about setting up a federal plan. The Bush administration, however, opted to go with something less comprehensive-ending chronic homelessness rather than homelessness in general.
“I don't criticize them for that,” said Roman. “Certainly we're interested in ending chronic homelessness, but we're interested in ending homelessness overall.”
Largely, homeless service providers agree that the chronic homeless are, by definition, an underserved population and a growing public-health risk. Not only is alcoholism, drug abuse and mental illness rampant among the chronically homeless, but so too are heart disease and diabetes. It's estimated there are between 1,300 and 1,500 chronically homeless in the San Diego region.
Chronically homeless people also tend to be vulnerable targets for theft, making them a public-safety concern as well, said San Diego Assistant Police Chief Bill Mayheu.
“For those who have SSI [disability] checks coming in, they call it Mother's Day-it's the first and 15th of the month. These guys get their checks, they cash them, they get a room for one night at one of the day hotels and then they have $600 in their pocket. They go down and buy a bottle, they get drunk, they get high, and then the suspects in that community take their money from them. It happens every single month,” he said.
Mayheu says an obvious solution to the problem is one that's been proposed for San Diego's plan. “Instead of giving that guy the check, if you make the payee one of the hotels downtown that's willing to take some of these people in, make them the payee and give them a room for $600 a month, then they always have a place to lay their head.”
Pat Leslie, who heads the Regional Continuum of Care Committee (RCCC), a group charged with securing homeless assistance money from HUD each year, points out that, historically, homeless service providers were encouraged to focus their services on people who were “less scary”-families with children, folks who were treatment compliant-the kind of people the community was willing to support.
“Well the folks with the good outcomes are not the people in the chronic population, by and large,” she said.
But, Leslie points out, focusing money and resources on one subpopulation potentially ignores other homeless subpopulations, such as families. Leslie said the RCCC is drawing up a regional “blueprint” to complement the 10-year plan that will include strategies for assisting populations not considered chronic. “There's such a national agenda for it,” she said of the Bush plan, “but we're not forgetting locally the other populations.”
Chris Megison, executive director of North County Solutions for Change, which recently built 32 units of temporary housing for economically displaced families, worries that because the people his organization serves don't meet the narrow definition of chronically homeless, Solutions for Change might be shut out from some federal grants.
“HUD's created a competitive environment,” Megison said. There's no shortage of solutions for helping homeless families, he pointed out. But it'll come down to whether his organization can get the funding to fuel those solutions. Megison said there are people currently working at the federal level, lobbying HUD to make sure funding priorities include homeless families.
Leslie agrees the definition of homelessness should be broadened. “I love Phil Mangano's language-that we're going to abolish another social evil,” she said, “but here's where I differ from him: When I think about Lincoln abolishing the social evil of slavery, which is the comparison that Mangano makes, I don't think Lincoln went out and said, ‘I want to abolish slavery but only for part of the population.' I think Lincoln said, ‘I want to abolish slavery as a social evil because it's not right.'”
Leslie said she's approached Mangano with this issue. He gives her two answers: “One is we have 10 percent of the population who's consuming 50 percent of the resources-you still have to prove that to me because I have numbers that say something different.” His most convincing argument, says Leslie, goes back to the fact that the chronically homeless are an underserved population. “I'm right there with him on that,” she said.
If Mangano's right, and it ends up that there is considerable savings from getting the chronically homeless off the street and into stable housing, Leslie just hopes there's a way to earmark that savings and redirect it to keep another group from slipping into homelessness.
A case manager on every corner
A federal plan to end homelessness isn't new. In 1994, the Clinton administration introduced its “Priority Home!” program. Clinton didn't have a Phil Mangano back then, and his plan got scant media attention when it was first launched. Clinton was, however, lauded by The New York Times for being the first president to recognize homelessness as “a large-scale problem.”
Beyond that, though, Clinton was up against an increasing lack of affordable housing and sky-rocketing rents. And, in the end, his program failed to make sure federal dollars going to local agencies were being spent on permanent, rather than temporary, solutions. In San Diego County, for example, in 2001, only 2 percent-roughly $750,000-of the $52.4 million allocated for homeless programs went to permanent housing while 11 percent, or just over $5 million, went to fund emergency shelters. (This past year, it came out about equal: $5 million went to permanent housing and $4.9 million to shelters.)
Mangano champions the so-called “housing first” approach to helping people off the street. The housing-first model suggests that a chronically homeless person will do best in an independent-living environment with minimal or as-needed supervision from a case manager.
The traditional model for getting a person off the street and into a more stable living environment is a step-by-step process known as the “continuum of care.” A person might start off in an emergency shelter, get on a waiting list for short-term housing and then move from short-term housing into something more long-term. So-called “wrap-around services” like psychiatric care, substance-abuse treatment and job training would follow that person as he moved into more stable housing.
St. Vincent de Paul operates the largest continuum-of-care program at a secure college-campus-type location in East Village. Ruth Bruland, a division director at St. Vincent's, calls the program “bridges to independence,” in which an individual moves to the next step only when he or she is ready. The homeless population, she said, exists on a bell curve. On one end are the people who were fine until something went wrong-they got laid off from work, for example-and with a little time in temporary housing, they'll likely be back on their feet. At the other end of the curve, though, is the chronically homeless person-“too much too fast and they can't handle it,” she said. It takes awhile for a person to shake the self-preservation mode street life requires and feel safe in a new environment.
And Bruland has a practical concern: “One of the things that puzzles me about the Housing First model is how the rent gets paid,” she points out. “We have far more people who could benefit from this service than we have people for whom we can afford to provide this service.”
Right now the San Diego region has only one nonprofit agency-The Association for Community Housing Solutions (TACHS)-dedicated to building and managing permanent supportive housing for homeless mentally ill folks.
Executive Director Kim Russell-Shaw said that of the 76 residents living in TACHS' three buildings, about half come in right off the street or straight from an emergency shelter. For those people, she said, the goal is to connect them with appropriate psychiatric treatment. The next step is to make sure they have a stable source of income, either through Social Security, disability or general relief (residents are expected to pay 30 percent of their rent, or about $225 a month). A case manager then helps the individual focus on goals such as education or employment that will lead to self-sufficiency. The ideal, she said, is to move tenants toward being self-supporting within two to four years, if possible. Right now the wait to get into a TACHS building is more than a year long, Russell-Shaw said, but the agency is working on a new 20-unit development in City Heights and hopes to site more housing throughout the county. Because TACHS fits the Housing First model, Russell-Shaw said they got slightly more money from HUD this year than the year before. TACHS also receives support from the city, state, private donors and a fund set up by local banks.
In doling out money for homeless assistance programs, HUD has adapted the point system it uses to favor housing-first programs that target chronically homeless. To get the maximum amount of points (and, the maximum amount of dollars), it's no longer about how many people an agency helps, but how many people an agency successfully helps. Successful is defined as keeping someone housed for at least six months.
Despite championing permanent supportive housing, HUD made available, nationwide, $1.2 billion in grants to cover not only the cost of adding more permanent housing, but also to pay for other homeless assistance services like job training, mental healthcare and outreach. To put that in context, San Francisco's 10-year plan, completed in July estimated that the city needs to come up with roughly $450 million to build the 3,000 units to house that city's chronically homeless.
NCEH's Roman says the Bush administration needs to look at factors that lead to homelessness, such as the lack of a national living wage and the shortage of affordable housing.
While a focus on prevention has been a key element in all 10-year plans, the Bush administration has given prevention short shrift, last year cutting into the Section 8 rental-assistance program, the waiting list for which is already up to three years. Next year's budget shows a slight increase in Section 8 funding, if only to keep pace with inflation, but it decreases funding for the Housing for People with AIDS (HOPWA) program. There's also planned cuts to housing for persons with disabilities and public housing in general.
Johnson said she's never counted on federal funding to solve the region's housing shortage. Who she is counting on is Dene Oliver, CEO of OliverMcMillan, the largest landholder in downtown San Diego. Oliver, who's worked with homeless service providers on housing projects, volunteered to head the 10-year plan process, and Johnson said there's hope he can tap into private-sector funds to supplement other money sources.
The county is also looking at an influx of money from Prop. 63, the November ballot initiative that added a 1-percent tax on individual income exceeding $1 million.
Johnson says the number of homeless in city of San Diego does appear to decline “in correlation to the number of homeless that are being placed in permanent supportive housing.
“I can't prove that,” she added, “but I think it's an easy rationale to reach.” San Diego's Regional Task Force on the Homeless keeps close count of the street population and Johnson said that after the city added 500 units of permanent supportive housing, she “saw an equal number leave the street.”
The most promising, workable element of San Diego's plan involves bringing in case managers to do outreach. Each case manager would have a designated area and would, ideally, get to know the homeless people who frequent that area. Johnson said they're hoping to be able to hire enough for a one-to-10 ratio. The money to do this would likely come from Prop. 63.
Case managers would let a person know when there's a bed available for them and, more importantly, help eligible folks get access to Social Security or disability benefits. A case manager, for instance, would have been able to help Minnie get her general-relief application processed and could find Vernon an appropriate day-treatment program to combat his alcoholism (he says he won't go into any residential treatment programs because that would mean leaving Minnie on her own).
Most service providers don't have the staff or open beds to do the kind of outreach Johnson believes is necessary to have an impact. The way the system works right now, it's largely up to the individual to seek help, and most don't.
At a recent planning meeting, Johnson was talking to a woman about the similarities between breast-cancer outreach and homeless outreach. Researchers found that “if a woman had a mammogram and it was questionable, if they only called her and said, ‘It's questionable,' but didn't follow up to get her back in, many women never came back again. But by making three phone calls and sending a postcard, they saw an increase... in people who came back for subsequent screening and treatment,” she said.
For now, the police department's homeless outreach team (HOT) provides the city's only consistent outreach effort. Sgt. Richard Schnell, who heads the HOT team, said the goal is to find the people most in need of help, establish a relationship with them and eventually get them into treatment programs. It can take five or more contacts to earn someone's trust, he said.
“They understand who we are, but it's difficult to get over that we're police, especially if they're mentally ill and a little paranoid.”
Schnell says his team will follow up until they get someone into treatment, but the goal is not for cops to be case managers.
Johnson said she frequently gets phone calls from parents looking for their adult homeless child. With a street-level case manager, she could put out the word that the parents of a particular person are looking for him. The plan is to have a sophisticated web-based network connecting the various homeless service providers.
“Not too long ago there was a 78-year-old father looking for his 52-year-old son,” she said. The father had a tip his son was in San Diego and contacted Johnson by e-mail. In this case, Johnson knew where the son was and was able to talk to him on the phone. He asked if he could dictate a reply to his father's e-mail. “He started out, ‘I'm so ashamed,'” Johnson recalled. “If you had a case manager, that could help that; who knows what kind of heartache could be ended.”
Last she heard, Johnson said, the man had reunited with his parents.