Doors for the homeless
DECADES OF experience with homelessness in Massachusetts have given advocates and policymakers a good idea of what works and what doesn't.
What succeeds is a package: help with housing, education, jobs, overdue bills --and with personal demons, from drug habits to crushing financial debt. The best way to deliver this help is through a web of partnerships that stretch across communities.
What hurts is the state's chronic shortage of affordable housing. But communities are still finding ways to cope.
In Worcester, the Central Massachusetts Housing Alliance is trying to put itself out of business by addressing the root causes of homelessness. Families who go to the alliance find two pools of help: what the agency offers and what Worcester as a community offers.
Prevention is stressed. This means people get help negotiating with landlords, navigating housing court, or paying security deposits. Elderly owners of vacant apartments get loans so they can renovate units and rent them to needy families. Elderly residents in their own homes get help with repairs so they can stay in them. Contractors do the work, and homeowners pay only for the materials.
''We stay accountable to families," says Grace Carmark, the alliance's executive director. She says the group relies on a strong network to fill the gap between incomes and housing costs.
Churches raise money. Businesses pitch in. Rotman's, the furniture company, backs the alliance's furniture bank, helping move items from donors' homes into warehouses and on to needy people. Businesses support the alliance's annual walk against homelessness, which this year raised $85,000. The walk keeps people aware of the problem and confident that there are solutions.
At Worcester's Family Health Center, homeless patients get medical treatment and social services. The mix works because it's less stigmatizing to seek help in a healthcare setting, says Dr. Linda Weinreb, the program's medical director and a professor at the University of Massachusetts Medical School.
One brutally common problem: More than 90 percent of homeless mothers have been victims of violence, Weinreb says. These families move frequently. They have high rates of chronic illness. And many mothers suffer from depression, which can harm their own and their children's ability to thrive.
Staffers at the health center help parents become well enough to manage the demands and stresses of poverty, because emotional and physical health makes it easier for mothers to buffer their children against economic instability. Trauma recovery is a priority. Teams help with housing, school issues, and transportation. Staffers focus on families' strengths where they find them: in parents' love for their children or their efforts to get their child good healthcare.
''People change when they succeed," Weinreb says, so strengthening families helps ensure that the benefits of healthcare will stick.
In Worcester, homeless single adults can find health care and housing help at the Community Healthlink program, where there's a ''no wrong door policy." Clients who come in for help with anything get access to everything, including mental and physical health services, detox programs, and housing help.
''No one is developing low-income housing for this population," says Larry Gottlieb, Healthlink's vice president of homeless and detox services, referring to disabled clients who live on Supplemental Security Income and may have only $7,200 in annual income, considerably less than the federal poverty level of $9,570. So, in addition to healthcare, the program uses money from the US Department of Housing and Urban Development to help people find housing and pay their rent. Healthlink does outreach in shelters, and once people are housed, there are continuing support services that help people remain stable. Gottlieb says 75 to 80 percent of clients who get help with housing stay in their homes for a year -- a benchmark that is an indicator of likely long-term stability.
This kind of effort works only when people in the community are willing to come to the table. In Worcester they are. That's the conclusion of a recent report on prevention from the Boston Foundation and the Center for Social Policy at the University of Massachusetts in Boston, which also notes that ''even those politicians who could not easily be considered liberal have shown themselves to be ever-present in the battle against homelessness in Worcester."
As a smaller city, Worcester has an easier time pooling resources. By contrast, Boston has neighborhood success stories of helping the homeless. But Mayor Menino is asking his senior staff to create ''a citywide chorus of advocacy, effective outreach, and case management," according to Jim Greene, head of the city's Emergency Shelter Commission.
At the state level, meanwhile, Lieutenant Governor Kerry Healey and the state's commissioners of welfare, housing, and mental health all deserve credit for pursuing better ways to prevent and end homelessness.
Missing are more state and federally funded vouchers, the subsidies that help people pay rent. These vouchers let people get a foot in the door of high-priced housing markets. Having the stability of a home is a key step toward gaining financial independence.
Massachusetts should boost prevention. The state's Residential Assistance for Families in Transition program, or RAFT, which helps families pay back rent and overdue utilities, recently got a boost, growing from $2 million to $5 million, a vital improvement. The RAFT program should expand further to cover homeless individuals. Stopping homelessness before it happens is cheaper than addressing it afterwards, and it works. The efforts identify people who probably also need long-term help climbing the workforce ladder so they can forgo public aid -- permanently.
People may always face or fall into homelessness. But communities could do a better, faster job of helping them.
