City-county effort tackles chronic homelessness

Nearly $10 million in grants, programs
strengthen advocates' resolve
________________________________________________________
By JENNIFER ANDERSON - The Portland Tribune - Dec 2, 2003

Portland, OR - With each stroke of the ivories on one of
the world's finest pianos, John Prentice feels another
breath of hope.

A gifted classical pianist who idolizes composer Franz
Liszt, the 33-year-old Prentice focuses on what's most
important to him by playing at least an hour a day on any
piano he can get his hands on. He once owned his own
keyboards, but he sold them long ago to feed his drug and
alcohol addictions while living on the street.

He walks into a downtown piano shop and talks with the
director of sales, who seats him at the opulent $189,000
Bosendorfer 290, a model that's been played by members of
the Los Angeles Philharmonic.

He feels like royalty.

What a difference two months -- and a different kind of
treatment program offered by Central City Concern -- make.

In late September, Prentice nearly died in a Portland
emergency room after intentionally overdosing on
prescription sleep pills. He had been living in a city park
when he said he got depressed because someone stole his
sleeping bag.

"It's a feeling of serenity," Prentice says of being in
recovery after 25 years of addiction.

Prentice is symbolic of many of Portland's homeless people:
addicted to drugs and/or alcohol; cycling through jails,
emergency rooms and detoxification facilities; and without
housing because employment is fleeting in the midst of so
many problems.

In addition, many homeless are dual-diagnosed with
schizophrenia, bipolar disorder or another mental illness.
They often have no access to treatment.

It's that hardest-to-reach population that the city of
Portland and Multnomah County are trying to rescue through
a new, long-term strategy to end chronic homelessness.

The plan, unveiled in October, builds on a few of the local
programs deemed most successful over the years, including a
"housing first" strategy and two comprehensive peer mentor
programs that won't kick people out if they relapse.

City and county leaders are excited about the new phase of
the work, which utilizes $9.2 million in federal grants to
end homelessness, awarded to the city on Oct. 1.

The five-year, renewable grants will help provide intensive
case management and housing subsidies to 200 people
who are chronically homeless.

The city also received $625,000 in two other private
grants, which will help fund 400 new units of supportive
housing -- which includes readily accessible treatment
services -- in the next two years.

Ed Blackburn, director of health and recovery services at
Central City Concern, said the grants are a testament to
the work the local community has been doing with innovative
programs.

"Chronic homelessness has gotten a lot worse in a lot of
urban areas in the nation," said Blackburn, whose nonprofit
agency helps people with housing and addiction problems.

"In Multnomah County and the city of Portland, we have
demonstrated leadership in addressing homeless issues.
The federal agencies saw this."

City Commissioner Erik Sten, who oversees housing issues,
said the grants are a testament to the work the community
has done so far.

"It's a more formal version of what we're always trying to
do," he said of the plan. "In town here, there might be a
sense that we're not as focused as we should be, so this is
partly about reaching out and telling a story, and it's
also about trying to build some bigger partnerships."

The city has no estimate as to how much the program will
cost. But a related Blue Ribbon Committee on Housing
Resources -- a group of regional leaders -- is discussing
ways to better use existing affordable housing resources
within the city and county.

The costs of chronic homelessness

An estimated 3,500 people in Multnomah County and the city
are chronically homeless, 2,000 of whom are in hospitals,
jails, and mental health and detox facilities at any given
time.

Now that the winter months are here, waiting lists are
beginning to grow at shelters, and advocates continue to
work with limited resources.

"The stereotype is, people don't want to get off the
streets," said Rob Justus, executive director of Join, a
nonprofit agency that places people into housing. "We have
people who are knee-deep in their addiction, when we can't
do anything other than give you a blanket and put you on a
waiting list."

Homeless advocates said they hope that the city's new
outlook employs better strategies than some of the current
ways that city officials and police deal with the homeless
population.

"The premise is, if you harass people enough, interrupt
their lives, take them to jail, that's going to somehow
motivate them to seek services," Justus said.

"In my experience, it does just the opposite. They distrust
people more and distrust anyone associated with the system;
it pushes them to a place of being more desperate."

Portland Police Cmdr. Rosie Sizer of Central Precinct said
she, too, wishes there were housing and treatment services
for everyone. In the meantime, she has her officers arrest
people, some of whom happen to be homeless, for criminal
offenses.

"We get complaints about drug use within some of these
populations, about panhandling and an aggressive form of
panhandling," she said. "If you look at livability crimes,
we're fielding complaints about a lot of behaviors that are
illegal."

Sten's office is in the process of appointing two groups of
citizens to oversee the plan.

The Citizens Commission to End Homelessness, led by former
Citizens Crime Commission chairman Ray Mathis, will provide
oversight and hold partners in the plan accountable.

It will be made up of elected officials, business and
community leaders, and homeless and formerly homeless
people.

'Housing first' strategy works

The city's working title for the new plan is: "Not a
homeless plan, a plan to end homelessness."

One of the strategies it's banking on is continuing its
version of a national model called the "assertive community
treatment" program. Central City Concern has operated the
city's "community engagement program" since last July.

Two teams of peer mentors and experts in mental health,
addiction and other aspects of recovery work with referrals
from agencies as well as people they engage by finding them
on the street.

"Helping these people is like I'm helping myself," said
Robert Donaldson, a mentor and former addict who's been
clean and sober for nearly six years.

One morning, he visited 36-year-old Larry Zillyette, a
former commercial crab fisherman and longtime addict who
lived under the Broadway Bridge for a while and landed in
the hospital one day because he'd jumped into a truck to
chase a loose beer, he said.

More than a year later, Zillyette is cleaned up, living in
the Mark O. Hatfield Building on West Burnside, looking for
work and keeping busy with daily therapy groups,
acupuncture appointments and recovery meetings. His bipolar
disorder is stabilized, and for the first time in his 35
years, he said he sees some hope in his future.

It's successes like those that earned the city's community
engagement program a recent designation by the U.S.
Department of Health and Human Services as one of six
exemplary programs nationwide that serve mentally ill and
homeless people.

Cascadia Behavioral Healthcare, Multnomah County's primary
mental health provider, runs the county's version of the
national assertive community treatment program in a similar
fashion.

The other peer mentor program highlighted in the city plan
is called Individual Placement and Support Plus, which is
essentially the same thing as an assertive community
treatment program but also features a job component.

Outside In, a nonprofit agency that helps homeless youth,
will begin using the model for some of the older youths who
see more traditional job preparation programs as barriers,
said Director Kathy Oliver.

The city and county have documented successes with both the
assertive community treatment model and individual
placement programs. One study tracked 177 participants who
stuck with stable housing and treatment services during a
period of two to four years.

Over time, the study showed, the participants had a
significantly lower impact on public resources, saving
$601,500 in acute hospitalization, $135,000 in stays at the
state hospital, $49,714 in jail costs and $19,530 in
emergency room visits.

Other elements in the homeless plan include:

• Initiatives to prevent homelessness, such as providing
short-term rent assistance for families in crisis.

• A "housing first" model that has proved successful, both
on national and local levels. The nonprofit agency Join has
used the strategy exclusively since 1992.

Join places people -- many with physical, mental, substance
abuse or criminal justice problems -- in housing at an
average 92 percent retention rate a year later.

• Better discharge planning, which addresses housing,
service and income needs when someone is released from
jail, a hospital or foster care.

"If they have no home, they're probably out on the street,
either being a general nuisance or committing another
criminal act, and back in jail," said Sheriff Bernie
Giusto.

Advocates said the community engagement program works
because it deals with one issue at a time.

"If you're high all the time, you can overlook the
suffering" of being on the street, said Prentice, the
pianist. "Nothing is really achievable if you're in the
throes of addiction."

His life has been one rough journey, he said. He moved from
one city to another to try to escape his habits, teaching
private piano lessons, playing at retirement homes, even
attending the San Francisco Conservatory of Music for one
semester.

All the while, his addictions brought him down and made it
impossible for him to keep a roof over his head.

"I've been trying to rehab four times since 2001," he said.
"This is a different thing."

Portland Tribune source page: http://tinyurl.com/xhhq
________________________________________________________________
©THE HOMELESS NEWS - H.C. Covington, Editor http://tinyurl.com/2yg2


begin 666 spacer.gif
K1TE&.#EA`0`!`( ``````````"'Y! $`````+ `````!``$```("1 $`.P``
`
end