Housing-first saves lives later
Health authority transforms rundown hotel into
apartments for homeless people in Fairbanks, Alaska
With the territorial government currently planning to re-open a new facility in September, Yellowknifer decided to investigate some innovative measures which several cities across North America are taking to combat homelessness and addictions. This story is the second in a three-part series entitled Street Solutions. The last story of the series will appear next Wednesday.
Cody Punter
Northern News Services
Published Wednesday, July 2, 2014
SOMBA K'E/YELLOWKNIFE
In the winter of 2007-2008, seven people froze to death on the streets of Fairbanks, Alaska, six of whom had a chronic history of homelessness and alcohol abuse.
Ricky Blount takes a drink of whiskey while sitting in the trees in Griffin Park with his partner Dottie Pitts and a few others Wednesday afternoon, April 29, 2009. The park is a popular place, known as "Hamburger Hill" or "Hangover Hill," among
Fairbanks's homeless people. It is a place to take a nap or gather for a drink. - Eric Engman/News-Miner photo |
At the time, the city's only overnight shelter had a strict policy of not admitting clients who are intoxicated. According to Shirley Lee, an episcopal priest who was running church programs for the homeless at the time, at least two of the homeless people who died that winter had been turned away from the shelter before deciding to take their chances on the streets.
They were tragedies that could have been prevented, said Lee.
"It was just really heartbreaking to see that people didn't have a place to stay because they were drinking," she said.
In the wake of the tragedy, Lee rallied local church groups to team up with the Tanana Chiefs Conference (TCC) - a non-governmental organization that doubles as a health authority for the region's aboriginal population. Together, they planned to pressure the state government to fund an emergency shelter that would admit homeless people when they were drunk.
After extensive consultation with the Alaska Mental Health Trust Authority, it was agreed that rather than building a drop-in style emergency shelter, the government's money would be better spent on supporting a "housing-first model," where homeless people are provided with a place to live on a permanent basis.
"Permanent support housing is a place where these folks can live forever. The problem with developing a shelter is that then you have to figure out the next step," said Nancy Burke, senior program officer with the Alaska Mental
Health Trust Authority.
Housing-first models increasingly are being championed across North America as an alternative to short-term crisis-based approaches to solving homelessness.
Indeed, this past April the Canadian federal government completed At Home/Chez Soi - a $110 million, five-year housing-first pilot project spread across five cities (Vancouver, Winnipeg, Toronto, Montreal, and Moncton, N.B.)
The argument in favour of housing-first models over emergency shelters is twofold, according to Burke. On the one hand, they help reduce the strain on police and heath-care systems by providing stable housing for people who would otherwise be filling jails and emergency rooms.
But most importantly, they provide a permanent home for a portion of the population that is incapacitated because of their mental health and addictions issues.
"The whole premise of housing-first is that by providing a safe shelter first you let people get grounded and stable and then they can start addressing their other issues," added Lee.
Although the state's mental health authority was keen to fund a housing-first program, early estimates showed that building a new facility was expected to cost more than $9 million. Fortunately, a local business owner, who believed strongly in supporting the cause, offered to renovate a rundown, 102 room hotel free of charge before selling it to the TCC for $2.5 million worth of state-funded grants.
The hotel, which is located in the outskirts of the city's downtown, was originally considered too big to be dedicated to housing the homeless alone. So when the building was renovated, it was divided in two and given two separate entrances. Forty-seven of those rooms were reserved for housing-first. The remaining units were allocated for patients who travelled to Fairbanks from one of its 42 surrounding aboriginal communities in order to receive medical treatment.
According to Lee, who is now the director of the Tanana Chiefs Conference housing-first program in Fairbanks, the revenue paid through medicaid by medial travel patients is used to offset some of the costs of running the hotel.
The TCC officially opened the doors to its housing-first facility on May 7, 2012. Lee said street people who are admitted to housing-first Fairbanks must go through a rigorous interview process which includes consultations with local police and social workers.
As a cautionary measure, sex offenders and people with a history of extreme violence - i.e. murder or weapons offences - are automatically disqualified from being eligible for the program, she added.
Once admitted, each of the 47 people living in the residence is provided with their own self-contained bedroom, three meals a day and access to communal areas, including a living room, kitchen and garden, free of charge.
They also have access to a nurse who visits the facility twice a week and two full-time case managers who are there during the day from Monday to Friday. The consumption of alcohol is permitted on the premises.
"It's just as if you and I rented a place. We're free to do what we wish in the privacy of our own home," said Lee.
In exchange, tenants are asked to obey a code of conduct, which stipulates they will not create any disturbances within the community or at the residence.
"I'm not saying we're all sunshine and rainbows here, but we try and keep a respectable presence in the community," said Lee.
She said only a handful of people have been asked to leave the facility since it opened. Serious assaults against other tenants is the most common cause.
Darlene Christensen has been working with residents as a case manager at the facility since it opened.
She said most of them take great pride in the facility and they often volunteer to clean, cook or help with minor maintenance around the building.
| "She's the reason I'm sober. She's the reason I'm alive" |
"It is actually quite amazing. It's like an extended family," she said.
While tenants are not obligated to undertake treatment or get sober in order to become a housing-first tenant, Christensen works closely with anyone who wants help. As a professionally trained social worker, she said she assists them with anything from addictions and mental health counselling to searching for a job.
"Everybody comes in with lots of different problems and lots of things that they need to work through so we end up doing a lot of stuff," she said.
Through her efforts, Christensen has been able to help at least 12 tenants find work since the facility opened. Christensen and her co-workers have also helped approximately 20 per cent of residents quit drinking.
Jerry Joseph, who was one of the first people to move into the facility, considers himself lucky to be one of those people. Joseph said when he was first admitted to the program alcoholism had affected his health so badly that doctors gave him just five months to live. Today, he credits Christensen with saving his life.
"She's the reason I'm sober. She's the reason I'm alive," he said.
Joseph is originally from Tanana, a small village of 300 people 160 km outside of Fairbanks. Before he became homeless, he was an honours graduate with a university degree, a steady job, a wife and four children. However, the unexpected death of some of his siblings led him to turn to alcohol to cope with his grief.
Over time he became increasingly dependent on alcohol to the point where lost everything that was important to him. After trying unsuccessfully to move back home to his village, Joseph ended up on the streets of Fairbanks where he remained for nine years until housing-first came along.
"I couldn't deal with it I guess, everything just started crumbling," he said. "I fell apart."
Now that he has been sober for 18 months Joseph has completed some college courses, obtained his driver's licence and found a full-time job at a warehouse. Most importantly for Joseph, getting sober has allowed him to start reconnecting with his ex-wife and some of his children.
"I'm not the greatest success story because I have four kids, and I still talk to two of them," he said. "I'm just building those relationships right now."
In light of the progress that Joseph has made over the last year and a half, Christensen said she is in the process of helping him become the first person to move out of housing-first into a fully independent environment.
"We're just making a list of all the things he'll have to take care of outside of housing-first," she said.
While there is excitement at the prospect of Joseph moving on, Lee cautioned that the majority of residents will never be able to support themselves independently, even if they are able to quit drinking.
"Just because they're sober, doesn't mean their life skills or other relationships and such are magically improved," she said.
Even with homeless people staying in housing-first indefinitely, Lee said the program is still saving taxpayers a lot of money.
With annual operational costs of $1.1 million, it takes about $23,000 to support each housing-first tenant on an annual basis, she said.
Although TCC is still waiting on the results of a report based on the facility's first year of operation before evaluating the housing-first program, preliminary data reveals that tenants were costing the community more than three times that amount - an average of $76,000 each - in emergency services every year before they moved into the facility.
"Our primary goal was to save people's lives. But as a result of that we're also able to reduce the use of those services," said Lee.
Based on the success of the facility in Fairbanks, as well as that of a similar 46-room housing-first facility in Anchorage, Burke said the mental health authority is looking at setting up housing-first programs in smaller tribal communities throughout the state.
Although politicians at the state level are becoming increasingly supportive of housing-first models, Burke said the mental health authority faces an ongoing struggle to convince them that they're worth instituting in their own constituencies.
"You sort of run into a problem whenever you cite a specific project. Everybody loves the model - wants it to happen - but maybe not in my neighbourhood," she said.
With more than 300 people on the waiting list to get into housing-first Fairbanks, Lee said she would like to see the city's program expanded.
However, she said TCC is currently looking to extend the mental health authority's funding for the existing facility, which is up for renewal at the end of next year.
Lee said TCC is also fighting to get the state to provide social assistance payments for housing-first tenants in order to inject much-needed funding into the program.
Although Joseph is planning on moving onto a more independent life in the near future he hopes that at the very least, the existing facility will be around for a long time.
"If it's gone then Fairbanks has given up hope,"
Joseph said. "You can't give up hope on people."
