WASHINGTON — On a cold January morning in 2001, Mel Martinez, who was then the new secretary of housing and urban development, was headed to his office in his limo when he saw some homeless people huddled on the vents of the steam tunnels that heat federal buildings.
"Somebody ought to do something for them," Martinez said he told himself. "And it dawned on me at that moment that it was me."
So began the Bush administration's radical, liberal — and successful — national campaign against chronic homelessness.
"Housing first," it's called. That's to distinguish it from traditional programs that require longtime street people to undergo months of treatment and counseling before they're deemed "housing ready." Instead, the Bush administration offers them rent-free apartments up front.
New residents, if they choose, can start turning their lives around with the help of substance abuse counselors, social workers, nurse practitioners, part-time psychiatrists and employment counselors. However, residents are referred to as "consumers," and the choice is theirs.
The help is so good and the deal's so sweet that roughly four out of five chronically homeless Americans who get immediate housing stay off the streets for two years or longer, according to the program's evaluators. In Britain, which has used the approach for a decade, the so-called "rough sleeper" population declined by about two-thirds.
The "housing first" strategy gets much of the credit for a 30 percent decline in U.S. chronic homelessness from 2005 to 2007. The number fell from 176,000 to 124,000 people, according to the best available census of street people.
The chronically homeless, estimated to be between a fifth and a tenth of the total, are the hardest group of street people to help. A chronically homeless person is someone with a disabling condition who's been continuously homeless for a year or more or for four or more episodes in three years.
If a "housing first" strategy seems absurdly generous to them, it's proved to be crazy like a fox for many of the more than 200 U.S. cities that have adopted the approach.
The earliest adapters, including Denver, Miami, New York, Philadelphia, Portland, Ore., and San Francisco, found that the added cost of homes and support services for the chronically homeless wasn't burdensome. In fact, it was largely or entirely offset by reduced demands on shelters, emergency rooms, mental hospitals, detox centers, jails and courts.
Instead of shuttling between them, chronically homeless people "are staying housed and starting to look for employment," said Nan Roman, the president of the National Alliance to End Homelessness, the leading advocates of the approach. "A lot are reconnecting with their families."
Just being off the street is healthy, said Sheila Crowley, the president of the National Low-Income Housing Coalition. "Even if they continue to drink, they're eating better, sleeping better and interacting with people better."
For the chronically homeless, the life change is sudden and profound.
"Today, God has seen fit to bless you," James Hamilton's counselor told him last month on a day that Hamilton began in a fusty bunk bed in a Washington homeless shelter.
By nightfall, Hamilton's permanent home was a quiet one-bedroom apartment in an iffy neighborhood in Southeast Washington, for which the city pays a HUD-subsidized $900 a month plus utilities.
It's furnished with a new $1,200 furniture set, including a green plush sofa, bureau and end tables. Also a new oak kitchen table and chairs, bed, linens and a $300 Target gift certificate for incidentals such as the microwave that's perched on a wastebasket.
Hamilton, a lean and chatty 51-year-old, hawks newspapers at a Washington subway station from 6 until 10 a.m. In the afternoons, he helps a clothing distributor make deliveries to fancy retailers.
In between, Hamilton spends a lot of time at Grace Episcopal Church in Georgetown, his spiritual home. With its help, he's now enrolled in an educational lay-ministry course at Wesley College Seminary in Washington. He types his papers at a nearby public library.
He's also a recovering crack addict who tests positive for hepatitis C.
"This is the best chance I've ever had to make things work," said Hamilton, who, to keep the apartment, needs only to:
For Hamilton, the apartment means that he can store his scattered possessions in a secure place. He can stock food securely, too. He's spared what he calls the "beefing" of other shelter dwellers and is free to watch his own choice of programs on the analog TV that his stepfather gave him.
Hamilton attends night events at Grace now. When he lived at Washington's Adams Place Shelter, he had to check in by 6:30 p.m. to keep his bed. He's also attending a more energized evening Narcotics Anonymous meeting than the one that the shelter offered, he said.
In that regard, Hamilton's home, set amid older frame houses and small, rickety churches, has a threatening downside, however. Crack and PCP pushers are everywhere, he said. "You got God and the devil in the same place."
The "housing first" approach, originally intended for mental patients, may not work so well for substance abusers, who, Roman suggested, may need more structure and supervision. Critics also wonder whether more shouldn't be done for homeless families, especially newly homeless ones, and low-income families at risk of homelessness.
Even if all those arguments are right, it's indisputable that the Bush administration has been a Good Samaritan to the least appealing of America's homeless.
A lot of the credit goes to Martinez, who left HUD in 2003 to run for the Florida U.S. Senate seat that he now holds. It was Martinez who got a pledge to end chronic homelessness in 10 years written into President Bush's first budget, said Roman, the head of the homeless alliance.
The cause received small but steady increases thereafter, thanks, others said, to Roman and to the bipartisan congressional support that her group nurtured.
Since fiscal year 2002, authorizations for HUD homeless programs have risen from $1.1 billion to a proposed $1.6 billion for fiscal year 2009. For all federal authorizations that help the homeless, including VA benefits, Social Security and Medicaid, the figure has risen from $2.9 billion to a proposed $5 billion.
Dr. Sam Tsemberis, a New York psychologist, also deserves credit. In the early `90s, he demonstrated that immediate access to housing worked for homeless people with psychiatric disturbances and substance abuse disorders. Tsemberis' program, Pathways to Housing, is now the dominant national model for "housing first" programs.
Dennis Culhane, a University of Pennsylvania social psychologist, helped the cause, too. In a series of long-term studies, Culhane established that while the chronic homeless were only 10 percent of all homeless people, they consumed about half of all the government services that the group used.
Phillip Mangano, a self-described "abolitionist" of homelessness, led them all. He'd founded and run an advocacy group called the Massachusetts Housing and Shelter Alliance for 12 years when Martinez recruited him. Mangano also was devoutly bipartisan, having pitched to both Democratic and Republican governors and lawmakers.
With Democrats, Mangano found that "If you went in with a couple of good stories on a snowy winter day, you could get some money." But in the Republican administrations of Massachusetts Govs. William Weld and Paul Cellucci, "stories didn't cut it," Mangano said. Their appointees would listen to the stories, he said, and then ask, "What are the numbers on that?"
So Mangano, now 60, a passionate and dapper former seminarian, melded Culhane's findings with Tsemberis' successes. Together, he said, they proved that housing the chronically homeless was both frugal governance and a moral good. The argument won a little money from Massachusetts' Republican governors to make the case, then more money when the strategy worked.
In Washington, Martinez wanted Mangano to head an obscure agency, dormant in President Clinton's second term, called the U.S. Interagency Council on Homelessness. Mangano turned it into a bully pulpit, ranging the country to press the nation's governors, mayors and county commissioners to adopt 10-year plans to end homelessness with a "housing first" approach.
Drafting the plans brought political leaders together with local businesspeople, clergy members, service providers and other advocates for street people, creating sturdy grass roots for Mangano's cause. Local support was key because the problem is local, and federal aid alone insufficient to solve it.
Mangano's initial goal was to get the 100 biggest U.S. cities committed by 2004 to ending chronic homelessness. He scored 127. Today, 350 cities and metropolitan areas have signed on, although many are still drafting plans.
The secret, former Gov. Cellucci said, is Mangano's conviction and tenacity, which Cellucci likened to a religious vocation.
How tenacious? In December 1999, after a homeless man named Jose Flores froze to death on Boston Common, Mangano led a march to the state Division of Health and Services office on nearby Beacon Hill. The marchers' demand: more money, immediately, for more homeless beds.
When the agency wouldn't yield, Mangano refused to leave. A vexed agency official threatened to call security.
"Please," Mangano begged. "Please do." Then he asked a homeless advocate in his group to call The Boston Globe and tell the paper why he was being thrown out.
The agency came through in a week, Mangano said.
"I'm proud of my association with that man," Martinez said.
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