Study: Charlotte's Apartments for Homeless Save Money

By Mark Price for the  Charlotte Observer

The idea of building apartments to house Charlotte’s most troubled homeless men and women – including those with addictions and mental disabilities – was controversial, if not ridiculed, when first proposed by the Urban Ministry Center in 2009.

But a first-year impact report scheduled to be released Monday by UNC Charlotte shows the homeless apartment complex known as Moore Place has succeeded in fulfilling its many promises to the community, particularly in saving tax dollars.

The study, conducted by the university’s Department of Social Work, found Moore Place saved $1.8 million in its first year by drastically reducing the amount of time its tenants spent in emergency rooms (447 fewer visits) and admitted to hospitals (372 fewer days).

Statistics show tenants also stayed out of trouble more, with a 78 percent drop in arrests and 84 percent fewer days spent in jail.

The report is being released at a time when the city of Charlotte, Mecklenburg County and the Charlotte Housing Authority are offering incentives to encourage more permanent supportive housing projects for the chronically homeless.

Charlotte’s Neighborhood & Business Services department is pledging up to $1 million for development, and the county’s Community Support Services Department will provide up to $800,000 in supportive services.

Stacy Lowry, director of Community Support Services, says 10 proposals were submitted for review by the Feb. 28 deadline, suggesting Moore Place is just the start. The proposals are being reviewed, and results will be released by May.

Meanwhile, Moore Place is expanding from 85 to 120 units. The Charlotte City Council unanimously decided in November to help by contributing $1 million from the Housing Trust Fund. Urban Ministry officials say they have so far raised $3.5 million of the $4 million expansion cost.

Caroline Chambre, director of HousingWorks for Urban Ministry, said the UNCC report is proof that permanent supportive housing is worth the investment. Moore Place cost $6 million using a combination of government grants and private donations. That included the cost of the land in the Druid Hills community.

“You can’t argue with the statistics,” said Chambre. “This approach was controversial at one time because of the stereotype of who the homeless are, and we had to change that stereotype.”

It’s estimated there are more than 200 chronically homeless people in the county who qualify for the type of housing offered by Moore Place.

Moore Place operates on a premise that it’s cheaper and more compassionate for the community to permanently house the chronically homeless, who are often mentally or physically disabled and vulnerable to dying on the streets. Many are addicted, too, but the Moore Place approach is to admit them anyway, and encourage drug and alcohol rehabilitation.

Only 15 tenants have been asked to leave since the program opened for transgressions that included acts of violence toward fellow tenants.

Four people taken in by the project have died since it opened in 2012, including Charlotte’s most famous homeless man: William Larry Major, better known as “Chilly Willy.” He was struck by a car in 2012 after living nearly eight months at Moore Place.

“There were a lot of people that thought we’d be having to constantly give him a key to his apartment, because he’d be losing it,” Chambre said. “But he wore that key like a badge of honor and never lost it.”

It costs about $14,000 yearly per person to house the tenants of Moore Place, who are required to contribute 30 percent of their income toward rent. That income typically comes from disability or veterans benefits.

The rest of the operating money is provided by the Charlotte Housing Authority through rental assistance vouchers, as well as small grants and donations from individuals and churches.

Among the current tenants of Moore Place is Michael Byrd, 55, a native of New Jersey who moved to Charlotte in the mid-1970s for a job and has been homeless off and on since the 80s.

In the year before he moved into Moore Place, Byrd visited local emergency rooms 24 times for a variety of ailments, racking up $268,000 in medical bills. That fell to five emergency room visits during the year after he moved in, which cost about $9,600.

“When I was on the streets, my worst night was trying to sleep bundled up in an abandoned car when it was below freezing. It scared me,” recalled Byrd, who is disabled. “I’ve dumpster-dived behind a restaurant for food, too. It was not a good way to live.”

Moore Place has changed Byrd’s life to such a point that he is now dreaming of going fishing again, like he did as a boy.

UNCC assistant professor Lori Thomas, who directed the study of Moore Place, says one of the unexpected findings is that tenants there skew older than similar housing projects in other cities. Most are over 50; the oldest is 66.

Equally telling is the fact that half of them tested positive for post-traumatic stress disorder, which she guesses is connected to trauma or extreme acts of violence they were exposed to on the streets.

Thomas says the study will eventually include data on Moore Place’s second year of operation to show whether the numbers hold up. She is confident they will, given the success of similar programs around the country.

“For the longest time, we as a nation tried to manage homelessness instead of trying to end it,” said Thomas. “We as a community have got to focus on how to get them off the streets, rather than housing them in shelters … Permanent supportive housing works and saves money.”


Homeless Are Hesitant to Use Medi-Cal

By Lisa Renner via California Health Report

The expansion of Medi-Cal under the Affordable Care Act means that the homeless have more health care options this year than ever before.

Yet the handful of free homeless medical clinics in Modesto continue to see lines of patients eager to use their services. Some homeless people have trouble understanding the Medi-Cal enrollment process or providing the needed paperwork. Others would just rather be around other homeless people. Because of their hard life on the streets, they don’t always feel comfortable in more traditional settings.

As long as they earn no more than 138 percent of the poverty level ($15,860 for single adults, $32,500 for family of four), they qualify for Medi-Cal and can see any doctor who accepts the health coverage.

Richard Freitas, a homeless man who showed up for the free clinic at the Modesto Gospel Mission one evening for help with a wounded head, couldn’t give a good reason why he chose to go there rather than a doctor’s office. “I don’t know, I just don’t know,” he said, shaking his head.  He is enrolled with Medi-Cal and had a car that could take him to a doctor’s office.

Medi-Cal used to be open only to those under 21 or over 65 or people with disabilities or who were pregnant or met other requirements. An additional 2 million people are now eligible for Medi-Cal, according to the California Department of Health Care Services.

Despite the change, the Modesto Gospel Mission doesn’t expect to close its clinic soon. The homeless people it serves. depend on it.  “This is where they are,” said Dr. Jim Boozer, who volunteers at the mission’s clinic once a month. “They’re going to come anyway. While they’re here, they can get the care.”

The Modesto Gospel Mission, Modesto’s oldest homeless shelter founded in 1948, provides a place to sleep for up to 150 people a night. Two nights a week, volunteer doctors and nurses come on site to offer basic medical services.  They typically serve 20 patients in each three-hour session. Common ailments include infections, skin irritations and sinus problems. They can offer antibiotics, inhalers, ibuprofen and other basic remedies.

“It’s front-line Band-Aid medicine,” Boozer said. “We’re not trying to be anybody’s routine doctor.”

They encourage patients to sign up for Medi-Cal or the county’ Medically Indigent Adults program so that they can get follow-up treatment if needed from another physician.

Kevin Lopez, who came to the mission clinic for help with skin bumps, said he hopes to get on Medi-Cal soon. He has been homeless for a year since he lost his job in landscaping. “I have some mental problems,” he said. “It’s been hard to hold a job.”

But many homeless are not yet aware that they qualify for Medi-Cal.  Sandra Williams, health reform project lead for Stanislaus County, said the county has tried to get the word out by sending mailers to homeless with a mailing address.  County staff has also put up flyers and brochures at clinics and offices where homeless people go.

The Modesto Gospel Mission clinic tells patients about Medi-Cal but doesn’t help them sign up for the service on site. It’s a different story two miles away at the Golden Valley Health Center’s Corner of Hope Clinic, where there’s a big sign in the lobby, written in English and Spanish, saying “Uninsured? Ask about Medi-Cal and Covered California Enrollment Today.”  Another flyer alerts patients to an informational talk on the Affordable Care Act at a nearby church.

The clinic is run by paid staff and offers a range of medical services including behavioral health and dental.  Many patients are repeat visitors.

Juan Villa, Golden Valley’s homeless health care coordinator, said many of the homeless need extra help getting enrolled because they have cognitive disabilities. Others don’t have driver’s licenses, birth certificates or Social Security cards. The clinic will help reorder missing papers for patients that don’t have them. “We try to do as much work as we can for them,” Villa said. “My goal is every patient who comes through the door has an application pending.”

People find out about the clinic from other homeless, social service agencies and hospitals.  Homeless patient Gerald Saunders, who came to the clinic with a painful pelvis, said he learned about the clinic from his fiancé.

Though he and other homeless patients could visit other physician offices, they prefer Corner of Hope because of its concentration on homeless care. “They like to have a place of their own,” said Lisa Baladad, Golden Valley marketing coordinator.

The Salvation Army opened a medical clinic at its winter shelter in Modesto just last August and has only served a few dozen patients to date. The clinic only offers optometry and dental services now but has plans to offer women’s health services sometime this year.  Demand for all services is high. The clinic has a wait list with more than 100 names on it, said Carrie Ann Pimentel, the Salvation Army’s medical coordinator.

Pimentel said she often hears from shelter residents that they don’t have ID or paperwork necessary to sign up for Medi-Cal. “Either they’ve never had it or they had it and it was stolen, “she said.

If the Salvation Army didn’t have the clinic, some of its homeless clients might never get needed treatment.  Some won’t seek care unless a medical clinic is easily accessible.

Lauro Ramirez, a 65-year-old resident of the shelter, said he is grateful the Salvation Army provides the clinic. He recently visited the dentist to take care of an infected tooth. He couldn’t remember the last time he visited a dentist.  “Now I can eat better,” he said. “I feel much better.”

Homeless Czar Outlines Action Plan to Get People off Streets Philip Mangano Talks About Problems in Santa Barbara and Beyond - ~ Santa Barbara Independent

Philip Mangano Talks About Problems in Santa Barbara and Beyond

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Becky Kanis of 100k Homes on 60 Minutes. Hear her at the Homelessness Action Summit on February 24th at UCSB Campbell Hall.

Housing the homeless can save money

Giving apartments to the chronically homeless can save taxpayer dollars, advocates say

Advocates for the homeless say providing apartments to those who have been on the streets the longest and are at greatest medical risk can actually save taxpayers money.  Even if these people have not yet received treatment for substance abuse or alcohol problems, getting them off the streets often keeps them out of hospitals, where the cost for one night is more than a month's rent in many places.  

Anderson Cooper reports from Nashville, one of the cities that have joined the 100,000 Homes Campaign, for a 60 Minutes report to be broadcast Sunday, Feb. 9 at 7 p.m. ET/PT.

The 100,000 Homes Campaign is a national movement of cities and counties across the country that have adopted an innovative approach towards chronic homelessness by targeting the toughest cases,  "the hardest core of the hardest core, who also happen to be at the highest risk for dying on the streets," says  Becky Kanis,  director of the campaign, which was created by a nonprofit group called Community Solutions.

So far, the communities that have joined the campaign say they have housed more than 80,000 people nationwide.  Kanis says research shows these people spend less time in expensive emergency rooms and hospital beds when they have housing.  "We are paying more as taxpayers to walk past that person on the street and do nothing than we would be paying to just give them an apartment," she says.

 Kanis is referring to people like Robert McMurtry, who says he became homeless after losing his construction job and becoming ill. Until recently, a person in McMurtry's situation would often have to navigate a bureaucracy requiring job training or a treatment program before becoming eligible for permanent housing.  But because he had throat cancer, was HIV positive, and appeared to be at great medical risk, McMurtry was among the first to get his own fully-furnished apartment.  

Most of the apartments the homeless move into are in ordinary rental buildings. The rent is paid for mostly through federal housing subsidies that are available to veterans and to people with low income.  Private donations also play a role.

 60 Minutes visited McMurtry a few months later and found him making friends in his new building, even jogging in a nearby park.  Social workers visited him regularly to provide support and help him remain in housing.  A study by the University of Pennsylvania showed that 85 percent of homeless people in Philadelphia who were given housing and support were still in housing two years later and were unlikely to become homeless again.

 Not all of the people put in housing in Nashville fared as well as McMurtry.  One of the people 60 Minutes followed -- despite monitoring and support -- had to be  moved out of two different apartments because he became drunk and unruly.  Cases like this are what critics point to when they say limited housing resources are better spent on others, such as working-poor families or homeless kids.

Asked by Cooper whether it was fair to give an apartment to someone who  was being irresponsible and using drugs or alcohol, Kanis said,  "I don't think fairness is the right way to look at it...Having somebody on the street, fair or not fair, is costing us as a society, as taxpayers,  more than it would cost to have them in housing. " She tells Cooper, "I see it as giving them a second chance and most people, given that second chance, do something about those behaviors."

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The West Virginia Coalition on Ending Homelessness - Manifesto

“So what is it that you actually DO?” I get that question a lot. Almost as much as I get the question, “Oh “Zach Brown”? Like the band?” And boiling down what we do into an “elevator pitch” (being able to explain your organization in the time it takes to ride an elevator to your destination floor) can be a tall order. Honing in on our identity as an organization and deciding where time is best spent is an ongoing struggle and an ongoing work in progress. It’s a question of vision, management, funding, and the ability to remain flexible and realistic. It’s the ultimate exercise in “switching gears”.

As many of you are aware, we’re currently working with an epidemiologist from WVU, Dr. David Parker. Just the other day, he and I were discussing his presentation for our Annual Meeting, and we were specifically talking about the 100,000 Homes Campaign that we’re currently involved with, and how the campaign intersects with the research we’re doing with him. He took a quick spin around the 100K Homes website and said to me, “any organization that, upfront, has a “manifesto” is very cool”. That sort of stuck with me, mostly because I agree with it.

A lot of things get assumed about the WV Coalition to End Homelessness. Questions like “What is your end goal?” “What are you asking for?” “What are you doing?” come up quite a bit. We answer them as needed, in sort of a piecemeal fashion, but like any good stream of communication, it’s also important that we communicate that to the wider world. So, perhaps a “manifesto” can achieve a little bit of that. We’ll see how it goes.

Ending Homelessness: We’re not interested in managing homelessness, dancing around homelessness, pretending that we’re trying to end homelessness, or perpetuating services and mindsets that allow homelessness to continue. We’re not interested in the survival of our organization for the mere sake of its survival. We’re not interested in expanding our organization to be bigger, better, or larger just for the sake of doing so. Our goal is that our organization shouldn’t need to exist and we will behave accordingly. Our goal is that our children will see the idea of someone living on the street, in a car, in the woods, or under a bridge barbaric and unthinkable when they are adults. We’ll expand, change, and grow to meet the need. Nothing more.

Using Evidence: Washing your car with bottled water will indeed work. Your car will end up being clean. But evidence shows that it will take way longer and will be way more expensive. That’s how evidence works. There’s enough of a body of evidence out there showing that rapid re-housing, housing first, and diversion work, are less costly, and are more effective. Sure, you can find the odd study that tries to paint a different picture, but when looking at the breadth of evidence, what works and what doesn’t work becomes pretty clear. So, let’s do more of the stuff that works and stop doing stuff that doesn’t.

Collaboration: Success in ending homelessness is not about the individual organization. It’s about a system of housing and services, across programs and agencies that work together toward one end goal. Sentiments like “my clients”, “my community”, “my agency”, and “my plan” do nothing to build a system prepared to end homelessness. We’ve done this for a long time. It hasn’t worked. If it had worked, then I wouldn’t have a job and thus wouldn’t be writing this. We would have ended homelessness already. So, let’s inject some words into our discussion like “our problem”, “our clients”, “our goal”. Let’s collaborate across agencies and come up with community solutions. Look at it this way, if it still fails, we’re not any worse off than we already have been. If you are really dying for a competition, then let’s see which community can eliminate chronic, veteran, or family homelessness first.

Creating Solutions: It’s cool to disagree on things. Disagreement is communication, versus the sort of passive aggressive silence that embodies the antithesis of communication. But constant denial of factual information makes us all look a little goofy, honestly, and it’s not going to impede us from moving forward. We have no lack of stubborn people around the state (me included) and if we can all get fixed on one general goal (ending homelessness) we can fashion that stubbornness into a cruise missile of effectiveness. So, let’s go ahead and argue and debate, just as long as at the end of the conversation we arrive at a solution. Discussion, argument, re-assessment, and change works. That’s called “a feedback loop”. And we dig feedback loops in all things (other than music concerts, perhaps).

Changing: We have changed with the times and will continue to do so. Like anything that exists over time, we can’t remain static. We try things, learn new things, and rethink others. We respond to the environment, and to the needs that present themselves. It’s not always pretty and well organized, but being dynamic is not usually pretty and well organized. And we strive to be two things more than anything: dynamic and effective.

So, in the end, we are several things on any given day. And believe it or not, we really enjoy that. Particularly, we enjoy traversing the state, working with communities, and talking to people who are experiencing homelessness and the people who are trying to end it. But, we are ever changing and will be whatever ending homelessness and the prevalent evidence dictates we need to be until homelessness is a thing of the pas

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