Room at the Inn

Why does a housing program for the chronically homeless have trouble using up its vouchers?

One day in the not-too-distant future, Sylvester Hudson wants to get a house cat. For now, Hudson is content with his recently acquired menagerie of stuffed animals. He has carefully arranged the furry critters—a rabbit, a raccoon, a teddy bear, and a dog—for display inside his sparsely furnished but tidy efficiency apartment in downtown Minneapolis. "They don't eat and they don't poop nowhere," Hudson cracks. He pauses and then adds a serious note: "I don't want to get a real pet until I can take care of myself."

At 56, Hudson has endured more than his share of struggles in recent years. A Vietnam War veteran, he suffers from post-traumatic stress disorder and says he has also been diagnosed with schizophrenia and bipolar disorder. Still, Hudson managed to lead a relatively stable life until four years ago when his relationship with a fiancée collapsed. As he tells the story, she slapped him, he reflexively struck her back and, just like that, everything went to hell. After spending a few days in jail on a domestic assault charge and then being served with a restraining order, he found himself unemployed, bereft of possessions, and on the street.

Since then, Hudson bounced around between Minneapolis and St. Paul. He tried to stay in shelters but was overwhelmed by the chaotic environment. "It just didn't work for me," he explains. "There would be human feces in the shower or there would be like 300 guys in one room, all of them snoring. You just couldn't get any sleep." So Hudson spent most of the intervening years trundling around the city with a stack of blankets, spending nights in whatever quiet corner he could find.

Home at last: Sylvester Hudson in his new apartment
Mike Mosedale
Home at last: Sylvester Hudson in his new apartment

His luck changed in August, when he met an outreach worker from People, Incorporated, a nonprofit organization that assists individuals with mental illness and other brain disorders. Under a new program launched last summer called "Housing First," the outreach worker told Hudson, he might qualify for a partially subsidized apartment. "At first I thought he was jiving me," Hudson recalls. "But I stuck with it and, what do you know, it all worked out." Hudson, who moved into his new place on December 28, now shells out 30 percent of his income—$311, he says—toward the rent. The remainder is paid through a grant from the Minnesota Housing Finance Agency.

The Housing First model, which originated under the auspices of the Pathways to Housing program in New York City in the mid-1990s, operates under the highly pragmatic principle that mentally ill homeless people are best served by getting them into apartments as quickly as possible. Under the Pathways approach, mental health and substance abuse problems are addressed after the need for housing is met. The basic humanity of the strategy is not its only appeal. Under Pathways, the money expended on rent subsidies and supportive services was quickly offset by dramatic savings realized from reduced use of emergency rooms, detox facilities, shelters, and the like. According to one study, mentally ill homeless people in New York who enrolled in Pathways consumed $22,000 in public resources annually; by contrast, those who didn't cost an average of $40,000 per year.

"The bottom line is, the way we've done things in the past cost a lot of money and didn't break the cycle," observes Hennepin County Commissioner Gail Dorfman, who was among the Minnesota officials wowed by the Pathways story after taking a trip to New York to observe the program firsthand. "Financially, it is the right thing to do because it makes sense for government to spend money with decent outcomes. It's also the right thing to do morally."

That sentiment is echoed across the homelessness advocacy community. And all this makes one statistic all the more surprising: Of the 50 housing vouchers that have been made available to the homeless Assertive Community Treatment team since last summer, only eight have been used. Currently, according to ACT team director Karen Anderson, three of those individuals have been expelled from their apartments. That leaves Sylvester Hudson and four others as the program's only current success stories. Meanwhile, the ACT team has a current client list of 26 people, the majority of whom are toughing out the winter in shelters or on the street.

Why the logjam? The answer is complicated, says Anderson. Some clients are highly distrustful of the system and, therefore, not compliant. Others have criminal records that make it difficult to find a landlord willing to rent to them. And then there is the considerable amount of paperwork and other bureaucratic hurdles that must be satisfied.

Kevin Turnquist, a psychiatrist with the Minnesota Department of Human Services who works with homeless people, says strict federal standards can make it difficult for people to establish that they are homeless. "Even if you can show that you were evicted from an apartment one year ago and have been basically living in the shelters ever since, you won't qualify if you spent any time in a hospital receiving treatment for your mental illness," Turnquist observes. "Time spent in hospitals, chemical dependency programs, or the workhouse is excluded when they calculate your period of homelessness."

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