A PRAYER FOR THE CITY: Pathway To Hope

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deeneythumbnail.jpgBY JEFF DEENEY With the mercury starting to dip and the nights getting longer expect the Inquirer to drop their boilerplate homelessness story any day now. They’ve been reprinting this story annually, simply changing the date with each iteration, for as long as I can remember. You can set your watch by this story — it’s better than a department store full of fake pine trees and giant plastic candy canes for letting you know the holidays are almost here. You know, that story where an Inky reporter first gets Center City District CEO Paul Levy on the phone for a quote about people living on the parkway and how it negatively impacts the city’s tourism industry. Then said reporter makes another call to Sister Mary Scullion at Project Home who demands more resources for her agency. An editor will send a photog to snap a picture of some dude laying face down inside a cardboard box on Camac Street, then they’ll slap that puppy on B1 and go for beers.

Suffice it to say that the Inky’s coverage of Philadelphia’s homelessness problem hasn’t been winning the paper any awards over the years. However, there’s signs of change both at the Inquirer and within the homeless services industry in Philadelphia, as evidenced by the paper’s well timed highlight of industry giant Sam Tsemberis, head of New York’s Pathways to Housing, and his new venture here in town. The Inky finally tuned into the “housing first” movement earlier this year with a better-late-than-never three part series focusing on this new method of attacking the homelessness problem. What better possible opportunity for a follow up article on the movement than covering its founder’s establishment of a beachhead for his agency in West Philadelphia?

Tsemberis is credited with starting the housing first movement. A NYU Psychiatry Department professor, he was doing outreach in the 80s as a part of a mobile mental health team, engaging mentally ill men and women who were living on the streets. His team was continually frustrated by the fact that they had nowhere to refer people for a place to live. Those agencies that had housing resources required applicants to be clean and sober and stabilized on medication in order to access them. Tsemberis found that a lot of people living on the streets weren’t HomelessInquirer_1.jpgcapable of staying clean or maintaining a medication regimen, initially. His clients wound up back on the streets not long after joining these compliance-based housing programs, if they were allowed to join at all. Frustrated by the lack of suitable options,Tsemberis got into the housing industry. He started a harm reduction oriented housing program that took people directly off the streets and placed them in subsidized apartments with no requirements for sobriety or medication compliance.

It’s a controversial methodology, but one that fundamentally changed the way the homelessness problem is approached. Some housing first critics claimed that housing shouldn’t be a handout and others claimed that housing first programs are actually detrimental to severely compromised and vulnerable individuals who aren’t yet capable of living indoors. Tsemberis has always stressed that handouts in this case are actually cheaper; he’s found that the cost of housing a homeless individual for a year generally amounts to half the tax payer burden generated by the emergency rooms, detoxes, mental health crisis beds and jail cells that the homeless wind up occupying anyway as a consequence of the harsh conditions of street living. Tsemberis has also argued that the level of care in a well run housing first program is actually extremely high, utilizing what’s called an “Assertive Community Treatment Team.” ACT teams consist of a psychiatrist, nursing staff and social workers that are available on call 24 hours a day, 7 days a week.

Compared to a homeless shelter that is dangerous, dirty and in disrepair, that many homeless people would rather sleep in freezing temperatures than utilize, the housing first model is extremely attractive. Over the yearsTsemberis has claimed an 80% success rate; in that time crowded city shelter have produced little results beyond racking up a lot of costs and unhappy consumers.

The Inky article captures all of this more or less. Reporter Jennifer Lin seems to have been assigned coverage of the homelessness issue on an ongoing basis; it’s a beat the Inky should have had someone working a long time ago, and she’s steadily getting a grasp of what’s going on in the field. She points out thatTsemberis’s model is already being used in Philly by the mental health agency Horizon House, whose homeless services division has already housed 153 formerly homeless men and women. While not included in this story, it’s also worth noting that Resources for Human Development is currently developing a housing first program based onTsemberis’s model to be implemented among Camden’s heroin addicted homeless population. Tsemberis’s influence, while slow to take in Philadelphia at first, has come to steer the region’s homelessness policies.

It’s interesting that Tsemberis has decided to step into the Philadelphia’s homeless services industry with his program considering that his work was already being built upon here by Horizon House. Tsemberis , who I’ve met at homeless services conferences, is a looming industry giant whose work has been profiled in numerous major newspapers and magazines. He’s known to be incredibly brilliant and visionary in his approach to mental health services but can also be…a bit on the abrasive side. I’ve heard him characterized by others in the field as arrogant and difficult to work with. I wonder whether his presence in Philadelphia will be complementary to or competitive with Horizon House, who fought a hard fight to establish the housing first method as a viable option in a social services landscape populated with bloated, ineffectual programs.

There were consequences for Philadelphia’s initial resistance to housing first; as a result of institutional obstinacy, we fell behind other cities in positive outcomes. The numbers of homeless in Philly continued to swell under leaders like Project Home’s Mary Scullion while New York saw their population shrink under SamTsemberis . Philadelphia is halfway through the ten year period during which Mary Scullion’s high profile plan promised to end homelessness. Her boosters include JonBon Jovi , Bill Clinton and a veritable who’s who of local political wheels. And yet to my eyes, the agency getting the most results when it comes to getting people off the streets is Horizon House, and that’s as a result of implementingTsemberis’s model.

Let’s just say that Tsemberis’s arrival here may be met with grave concern in some social service circles.

I suppose, though, that the bottom line is this: Sam Tsemberis in Philly means less people living on the streets this winter. That’s a result we can all celebrate. So kudos to the Inquirer for their on-point coverage and welcome to Philadelphia, Pathways to Housing.

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