Faces of the Unknown, Part 2: Coupling programs, support to fight homelessness in Cambridge

Originally published July 11, 2014 in the Cambridge Chronicle.

Lucky, 18, who do not wish to give his last name, draws on a hand-rolled cigarette in the Cambridge Common outside Harvard Square. He said he was kicked out of his South Carolina home when he was 15 and has been homeless for the last year and a half. Wicked Local Staff Photo/David Gordon

Lucky, 18, who do not wish to give his last name, draws on a hand-rolled cigarette in the Cambridge Common outside Harvard Square. He said he was kicked out of his South Carolina home when he was 15 and has been homeless for the last year and a half. Wicked Local Staff Photo/David Gordon

Editor’s note: This is the second story in a three-part series examining homelessness in Cambridge. Read part 1 here

Linda is tired. She started “ripping and running” (stealing) when she was 19. That was 30 years ago.

She’s 48 now and says she can’t keep it up any longer. Too many nights spent in an empty hallway, hair unkempt, clothes soiled.

“I’d be on the streets for days on end, not showering, not sleeping,” she said. “I hate living like that. I deserve better. It sucks. …I’m just grateful I have a roof over my head and a warm room to sleep in, and I’m not in a hallway waking up early with no shower.”

At the time the Chronicle interviewed Linda, she was staying at the CASPAR shelter on Albany Street, one of two “wet shelters” in the state that allow people to stay the night even if they’re drunk or on drugs. A year ago, Linda enrolled in a substance abuse program at CASPAR called Access. She stayed in it for seven months and even graduated. But, as soon as she got out, she went right back to the streets.

She was in jail within the month.

That was March 2013. Seven months later, in September, Linda got out and came right back to CASPAR because she said she has nowhere else to go.

“I have nothing,” Linda said. “It gets harder and harder every time I go (to jail). But I want to live clean and sober. I want a life. I’m going to be 50 years old soon and shame on me. It’s like, enough already.”

Linda can’t go back to Access because the program was grant-funded and wasn’t renewed. Although there are several addiction recovery programs in the city, Mark McGovern, director of Healthcare for the Homeless — a program of the Cambridge Health Alliance that operates a drop-in clinic out of the Salvation Army building in Central Square, said detox beds have disappeared.

“We used to have 60 detox beds in Cambridge, now we have zero,” McGovern said. “We have people asking for detox and there are no beds. It’s one of the biggest missing pieces.”

Before the U.S. Department of Housing and Urban Development (HUD) implemented its Housing First model, people experiencing homelessness would first have to stay in an emergency shelter, get sober and/or receive mental health counseling, and demonstrate that they can stay in a transitional housing program before moving on to permanent housing. Funding was geared towards emergency shelters, detox programs and other supportive services. Around 2007, the Housing First model flipped that mentality, said Ellen Semonoff, assistant city manager for human services in Cambridge.

“The idea was, in fact, to expect someone — while they’re homeless and living in a shelter — to actually effectively deal with their issues is ineffective,” Semonoff said. “So it’s just better to get them housed, and they’ll have a better chance of addressing their mental health or addiction issues.”

Several studies have shown success in this model: both in terms of cost-savings for taxpayers since a small portion of chronically homeless people take up the majority of ambulance, police, emergency room, and incarceration services; and in terms of keeping people housed who were previously homeless. A study of Housing First participants published in 2009 in the Journal of the American Medical Association found a 53 percent reduction in the total costs of housing homeless people as opposed to providing emergency shelters. Monthly costs were reduced from an average of $4,066 to an average of $1,492.

The programs work best when coupled with robust support, Semonoff said. But, success, when defined as a formerly homeless person remaining permanently housed, doesn’t always come on the first try. Those who work with people who are experiencing chronic homelessness know to tailor their definition of what success is, even when that definition is not the same one recognized by the federal government.

That’d be fine, except that after the passage of the Homeless Emergency Assistance and Rapid Transition to Housing (H.E.A.R.T.H.) Act of 2009, Semonoff said funding for homeless services became increasingly tied to demonstrable outcomes related to housing.

CASPAR program director, Odessa Deffenbaugh, used the example of therapy offered at the shelter.

“Our therapist is out there helping people reduce someone’s mental health symptoms and helping them lengthen their periods of sobriety, but there’s no outcome measure that we can report back and say, ‘Look, we’re doing these things and that’s actually really important,'” Deffenbaugh said. “It would be great to have resources for evaluating other kinds of outcomes because I think it’s very limiting when the only measure of success is finding permanent housing.”

That’s a challenge for shelters like CASPAR, Deffenbaugh said, especially as the population who use the shelter’s services changes. More women are finding themselves at CASPAR’s door, Deffenbaugh said, as are people arriving with opiate-related addictions, as opposed to the mostly alcoholic men who filled the shelter in years past.

At the time of the Chronicle’s interview with Linda, she was in a suboxone program, a replacement therapy for people recovering from opiate addictions, and she said it was helping. Her boyfriend was in the program as well, and he encouraged her to keep going to meetings and not to shoplift, another one of her vices.

“My boyfriend would feel insulted if I shoplifted. He says he’ll buy it for me,” Linda said. “He’s a big support for me. He’s clean. If not nothing, I have him.”

She had been calling the Somerville Homeless Coalition every day in order to stay on the waitlist for one of four beds. If she secured a spot, she’d be able to set aside 50 percent of her income in a savings bank and with the help of the shelter’s case managers, she’d be able to apply for housing. She had been going to addiction recovery meetings as well, she said.

“That’s my goal, to get there and get myself on track,” Linda said. “Once I’m on track, I can stay on track.”

Of the roughly $3.8 million the city received from HUD last year, Semonoff said the vast majority goes towards housing programs. (Non-profit organizations actually apply to the city for those funds, and only a small portion goes towards funding for city-run programs, Semonoff said.) None of that funding goes directly towards operating shelters, she said.

“So, it is the funding that pays for the rent for someone to be housed,” Semonoff said. “It’s a huge change in the shifting of funding over time along with HUD’s belief that the way to manage or end homelessness is actually through housing.”

The problem in Cambridge is that it’s hard to find affordable housing. Mark Alston-Follansbee, director of the Somerville Homeless Coalition, said residents of the shelter face steep barriers in the search for housing. Criminal records and bad references from landlords top the list, he said. Less than half, or 45 percent, of the people in the shelter were able to move onto housing, Alston-Follansbee said.

For Linda, her best shot was to wait for a subsidy to come through. It could take months, or a year, or more. This time though, Linda said she’s not going to give up on herself as easily as she has in the past.

“I just want to be dependable,” Linda said. “I give up on myself so easily all the time, but now I’ve been getting things done. Everything is falling into place, little by slow. Little by slow.”



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