BRATTLEBORO — A person experiencing homelessness in the United States typically has to jump through a series of hoops before finding safe and secure housing.
Although the sequence varies by community, most of the time it looks like this, according to Pathways Community Relations Manager Patrick Gallagher:
“Find a shelter with space available, meet the shelter's behavior requirements, make an appointment with a case manager, get to that appointment, fill out a bunch of forms to prove [you] are, in fact, homeless, qualify for transitional housing, hold down a job to qualify for transitional housing, stay off alcohol and drugs, take the drugs the doctor says you must take, deal with those drugs' side effects,” he said.
“And then - maybe, someday - move in to permanent housing,” Gallagher said - all while dealing with the trauma of finding a safe, warm, and dry place to sleep, to spend the days, to keep one's belongings, and to use the bathroom.
It's not like anyone just hands out apartment keys to people who are homeless.
Except when they do.
That's how it happens with the Housing First model used by Pathways, a statewide nonprofit organization offering housing and mental-health support to Vermonters struggling with homelessness and major life challenges.
With Housing First, rental housing is given to people in need and is accompanied by services throughout the entire process, which continues even after housing is secured.
In the Brattleboro stop of Pathways' “Crossing Paths” tour around the state, Hilary Melton, the organization's founder and executive director, recounted how she learned about Housing First.
Melton said she knew from childhood that she wanted “as an adult, to help people,” and early on in her career, she worked in the outreach van for Boston's Pine Street Inn homeless shelter.
“It was scary and sad,” she said.
Later, while living in New York City, she met Sam Tsemberis, who brought the Housing First model to the city. The program was developed in Los Angeles in the late 1980s by Tanya Tull, then a young social worker who noticed a marked increase in the number of families with children who were homeless.
Tsemberis “rented 10 apartments. Then we went out on the street and handed out the keys,” Melton said, recalling how the two helped the residents move their belongings into their new homes. In one instance, “we rolled their shopping cart with all of their stuff right into the apartment,” she said.
When Melton started Pathways in Burlington in 2010, “it was the first rural application of a Housing First model,” she said.
A human right, without strings
In a follow-up conversation with Gallagher, he told The Commons that within a few years, the organization opened offices in Washington, Franklin, Addison, Windham, and Windsor counties. Brattleboro's was established in 2012.
“We kind of grew quickly,” because the need is there, said Gallagher, who noted that the “standard, old-school model of dealing with homelessness is making people prove they're able to maintain housing.”
“We're often asked if people are ready for housing. We believe housing is a human right,” he said.
The requirements of the old housing model often dictate that a person stop using drugs while also demanding they take drugs - as long as they're psychopharmaceuticals prescribed by a doctor.
“We never tell someone they have to take their meds or not take certain types of drugs,” said Gallagher. Instead, Pathways staff members talk to clients about harm-reduction strategies.
When asked if he has noticed any specific challenges unique to Windham County, Gallagher said Pathways staff members here interact with more clients who have a history of opiate use.
“The population we're serving down there has struggled with that, maybe more than in other communities,” he said.
Working with property owners
To find homes for its service users, Pathways' housing team works directly with landlords - an estimated 50 of them in Windham County.
“We find housing like most people do - we often look on Craigslist,” said Gallagher.
“Some landlords reach out to us because they want to do the right thing” and rent to people most in need, he noted.
Once the initial contact is made, Pathways staff builds relationships with property owners and acts as a liaison between them and clients, Gallagher said.
“They're taking a chance on someone” who, due to periods of homelessness, has an inconsistent housing history and may need extra support in navigating the landlord-renter relationship, he explained.
“We work with them. We don't just walk away,” once the client has a home, he said.
Gallagher also said the organization operates on the “scatter-sites” model.
“We're not just housing people in one building, to segregate them. They deserve to be part of the community,” he said.
Choice, not coercion
Gallagher said Pathways would like to open additional Housing First offices to serve more of the state where they identify a need, such as in Rutland and Bennington, “but we're held back by funding restraints through the state Legislature,” he said.
In addition to helping people find homes, Pathways provides a case manager and a variety of supports, including drug and alcohol counseling, employment support, psychiatry, and nursing care.
But, Gallagher noted, the program leaves it up to individuals which services they use.
“All of our programs are by choice. Not coerced. We find that works,” Melton said.
“It's client-driven,” he said. “We sit down with them in the beginning [of the relationship] and write up a service plan, which is a series of goals,” such as finding work, or minimizing or ending alcohol or drug use.
That plan can evolve, Gallagher said, and it often does as a person's life stabilizes because of access to a safe and secure place to live. With that stability often comes the realization that the drugs and alcohol are causing harm.
Sometimes the plan is no plan, and goals are not a requirement for housing, Gallagher said.
Pathways wants to keep the barrier to housing as low as possible. The one mandate: a client must meet with a case manager due to subsidy requirements, but that meeting can take many forms, including a simple check-in.
Other services, other possibilities
In addition to operating Housing First programs throughout the state, Pathways also runs a community center in Burlington's Old North End, where guests can come for free wireless internet, meals, coffee, a hot shower, employment services, weekly classes, meetings, or just to relax.
Gallagher told The Commons that he and other staff members have received many requests to open a similar center in Brattleboro.
Pathways' Supportive Services for Veteran Families provides short-term, intensive case-management to help participants with permanent housing and its related costs, legal services, and assistance accessing Veterans Administration benefits.
For Vermonters facing overwhelming life experiences, Pathways operates Soteria, a Burlington respite house “for the prevention of hospitalization for individuals experiencing a distressing extreme state, commonly referred to as psychosis,” says the organization's website, and the Vermont Support Line, a free, anonymous phone line (1-833-VT-TALKS) for people who need someone to talk to. Both are staffed by peers.
“Lived experience” is a major component of Pathways. According to information the organization provided, of its 86 statewide staff members, 78 percent have experienced mental-health challenges, and almost half have experienced homelessness.
At the Crossing Paths session, Calvin Moen, a member of the Pathways board of directors and a former staff member, talked about what drew him to the organization: shared values, especially harm reduction and peer support.
“I have always had that perspective on the importance of stable housing,” he said, and that began during childhood, when his family had periods of housing insecurity.
As an adult, he saw the benefit of harm reduction and peer support through negative experiences with the psychiatric system and through work in peer-to-peer support networks.
A money-saving approach
Pathways receives most of its funding - 61 percent - through state contracts. Money from federal contracts and Medicaid reimbursement make up 34 percent, and the remaining 5 percent comes from donations.
More than three-quarters of the nonprofit's expenditures goes toward programs; operations and administrative costs take up 18 percent.
Gallagher described Pathways' programs as cost-effective, and noted the model “saves [taxpayers'] money on incarcerations and hotel costs” by giving people a permanent home.
According to Pathways figures for 2017, the average daily cost for a psychiatric hospital stay is $1,500; incarceration in a correctional facility costs $135 per day.
The Housing First program costs $42 per day per person.
Melton told the Crossing Paths attendees that in the last year, the support line took about 6,000 calls, and the organization helped approximately 100 homeless veteran households. In 2017, it assisted 283 people in its Housing First program.
“Maybe you know some of the people behind those numbers,” she said.
“A lot of our people have gone through long-term traumatic situations,” Gallagher said. “We look to serve those populations who are sort of falling through the cracks - they've been in and out of transitional housing, psychiatric wards, residential hotels. We're trying to stop that,” he added.
“I don't know if we're going to see an end to trauma, poverty, and addiction in our lifetime,” said Melton, “but I know we can end homelessness.”