Because of John

Posted on May 8, 2012

This blog was written by Georgi Fisher, case manager for HomeLink, a program of Virginia Supportive Housing.

For as long as I’ve worked in social work, I’ve had a difficult time grasping the idea of “housing readiness.” The idea behind housing readiness is that a person who is homeless should first conquer his or her demons and prove that they are ready for and, have in turn, earned the right to housing. While most homeless programs have operated off of this philosophy, this premise is one that homeless service providers have wrestled with for years. I’m not sure about you, but no one ever made me prove my ability to cook, clean, never make poor decisions, pay bills on time, and be the overall picture of perfection before they allowed me to have a roof over my head . If they had, I’m more than sure that I would never have been granted access to an apartment during my 20’s and probably never would have been given a house in my 30’s.

Virginia Supportive Housing subscribes to the “housing first” model, which focuses on bringing people directly from the street and into their own apartment. In this model there is not a period of transition from the street to a shelter, from a shelter to a transitional program, and from a transitional program to an apartment where a person has to earn their right to permanent housing. Here, the primary focus is to put an individual into permanent, stable housing right away. And this is where my role at Virginia Supportive Housing comes in. My name is Georgi and I was hired to work as a case manager for a brand new program within Virginia Supportive Housing called HomeLink. The HomeLink Program is one that was started to identify and house those most at risk of dying on the street. Since I first began to work with this program, many people have asked me why we put people into housing without asking them to clean up their credit, get a job, stop using drugs, follow directions, or otherwise be perfect. In the beginning it was difficult to answer this question, other than by just saying “because it’s right.” And then I met John.

John was one of my first client’s in the HomeLink Program and our first meeting was in the downtown Social Services building. I walked into the room and was met by a frail younger man wearing a heavy army coat and a hat that was pulled down over his eyes. The distinct odor of days without access to a shower and alcohol met me as I pulled a chair next to him. I introduced myself and John, without saying a word, slowly looked me up and down with a skeptical look on his face. He then said, “You and I aren’t going to get along.”  Trying not to look taken aback, I smiled and said that was ok. The conversation didn’t necessarily go well from there. John was skeptical about my program and the fact that I was offering him housing with no strings attached. Several times during the first meeting he got up to walk away and I gently coaxed him back into the chair to talk with me. After an hour passed, we wrapped up our conversation and I asked John if he would want to go look at an apartment. He again looked at me with a bit of shock and skepticism, but advised that he did want to look at an apartment and we agreed to meet the next morning at a corner he liked to hang out at downtown.

The next day arrived and I pulled up to the corner to find my new client even more frail than the day before. His thin body was no longer wrapped in a heavy coat and the skeletal outline of his body was shocking. John seemed a bit more relaxed and opened up to tell me more about his history. He explained that he had been on the street for nine years and that he had been battling addiction. He also disclosed that, because of his addiction, he had burned many bridges with people in his life and that he had made the decision to separate from friends and family in an effort to protect them from further hurt. The shame was glaringly evident as he spoke quietly in the car next to me, head down and gaze pointed at the floor board of our van. After looking at an apartment, we set a date for John to move in just a couple of weeks away. He was quiet, but excited, and still a bit skeptical.

As I was driving him back to the place where he would spend his days, he disclosed that he had been feeling quite ill for weeks but did not want to go to the hospital. John, I knew, had AIDS and had, many times in the past, battled serious illness as a result of being on the street and not accessing proper nutrition or medical care. I offered to take him to the hospital to be looked at but he declined, saying that he did not like hospitals. I gave him my card and told him to call me if he changed his mind. Several days passed and John continued to decline to go to the hospital. Then, one night, right before I was leaving the office, I received a phone call from him saying that he would go. I immediately drove to pick him up but as we reached the hospital he, again, changed his mind. I offered to buy him a Frosty from Wendy’s and sit with him in the Emergency Room while he was evaluated. Looking surprised, he agreed and there we sat for hours, waiting for him to be seen. There were many strange looks as people walked by and saw me, dressed in my work clothes and John, dressed in his dirty army coat and stocking cap, sharing dinner and conversation together.

I imagine that John knew, in his heart, that if he went to the hospital he might never get to come back home. He had battled with severe pain and nausea for weeks but never wanted to go to the hospital because of fear of the unknown, denial, and, on a deep level, fear about how people would treat him knowing that he was homeless, an alcoholic, and HIV positive. John was admitted into the hospital that evening and, for the next two months, he remained there. Battling sepsis, an infection in the blood, and meningitis, John lay weak and in pain in his hospital bed. Every day I, or one of the two social workers on my team, would go and sit with John. We would talk about the weather, about his day, about his illness, about his hopes to go to his new apartment, and, toward the end, about the many joys and many regrets that he had about his life. 

Always with gratitude, John began to open up about his life. He shared about his long-term relationship with a young woman and the three beautiful children that had come out of that relationship. He shared about how he and his partner battled addiction, he to alcohol and her to heroin, and how their youngest son was born addicted to drugs. He shared the guilt that he and his partner fought with daily about his son’s exposure to drugs. John then shared that their baby boy passed away at just 31 days old due to birth defects caused by his partner’s substance abuse. He spoke about the deep rift that his son’s death had left in his family and how, a few months after the baby’s death, his partner had left him a note apologizing for harming their son and explaining her deep sadness. He found that note and his partner after she killed herself. He described the panic, the despair and the anger that he felt, now being alone with two children. It was there, he explained, that his addiction took a dramatic turn and there that he began to lose touch with the world.

Several weeks after our first meeting, I found myself sitting in John’s hospice room, gently washing and shaving him with another social worker from my team. John was unconscious, now in a coma state, but it was a final act to bring dignity to a man who so many had looked past or given up on. We played Teddy Pendergrass, his favorite musician, on a CD player next to his bed, changed him into a clean gown, and tucked him into fresh linens. For many people, these steps would be carried out by family members enjoying the last moments with their loved one. But for many other people, these moments wouldn’t be shared with anyone. For our clients, their last moments would have been alone, under a bridge or in an abandoned building, without care or comfort and, most likely, without ever being identified after their death.

Having the pleasure and privilege of being John’s social worker taught me quite a bit about life and its value. More importantly, John finally gave me an ability to answer the question that so many had asked me regarding the housing first model – why? Now, I can easily say “because of John.” Without a housing first model, John would have never been identified for intensive case management and would have, most likely, continued to refuse care and treatment. And, though John was never able to move into his apartment, he died surrounded by people who loved and cared for him.

John’s death could have been prevented. With early identification and intensive case management, John could have received necessary treatment and follow up that would have ultimately saved his life. That is why we believe in and practice a housing first model. I now carry a case load of individual’s who are struggling with AIDS, advanced cancer, heart disease, acute kidney failure, mental health and substance abuse, among a host of other medical and psychological diagnoses. Since I started working with HomeLink four months ago, I have buried two clients and am actively preparing for the death of a third. I realize, with every new person that I meet, that the investment in a housing first model will eventually move from providing compassionate end of life care to providing important interventional care that will allow for our client’s survival and reestablishment into the world.

So, housing first is about ensuring survival, practicing compassion, and realizing our own imperfections. Jesse Jackson once said, “Never look down on another person unless you are helping them up.” Every day I know that, when I offer my hand, I am helping another person up.

A Race Worth Winning

Posted on March 20, 2012

This blog was written by VSH’s volunteer resources manager, Alison Jones-Nassar.

This past weekend, I was reminded again of how breathtakingly beautiful our nation’s capital is. I was in Washington on Friday and Saturday (along with 40,000 other runners) to participate in an annual half-marathon event, and the city was awash in the colors and smells of spring.

Between the beautiful monuments, historic stone buildings, meticulously-tended outdoor spaces, upscale shops, and affluent residences, no one can deny that Washington is indeed a lovely city. At least on the surface. In stark contrast to its majestic exterior, however, is a dark underside of homelessness. In fact, according to the NAEH’s State of Homelessness in America report released in January 2012, the rate of homelessness for Metro Washington exceeds the national rate (24 homeless individuals per 10,000 in D.C. compared to a national rate of 21 homeless individuals per 10,000) and is almost three times the rate in Richmond (9 homeless individuals per 10,000).  Moreover, while the homeless population decreased nationally, it increased in the District of Columbia.

In past years, it was not at all uncommon to see homeless people sleeping on benches and huddled on sidewalks along various points of the race course, especially in some of the downtown areas and working-class neighborhoods east of the Capitol. It has always caused me some measure of discomfort to run past them as if they were just another feature of the scenery, and frankly, I did not look forward to seeing this again over the weekend.

But this year, strangely, I did not see a single homeless person. Although I hoped for an optimistic explanation (“Breaking News: D.C. Solves Homelessness!”), I suspected a less cheerful reality. No doubt the race organizers considered the negative PR of exposing 40,000 out-of-town visitors to the “unsightliness” of homelessness and “sanitized” the area accordingly with a beefed-up police presence. One problematic consequence of the Occupy Movement has been that more and more urban areas choose to “deal with” their homeless problems by sweeping homeless individuals out of sight and passing laws that criminalize their visibility. It seems that the easy short-term quick-fix options are almost always selected over the harder long-term solutions, even though “easy” comes at a heavy price – both financially and in human costs.

So I had to conclude that the race organizers had consciously and callously prioritized my need to run guilt-free through a sterilized landscape…at the expense of the hundreds of individuals for whom homelessness is an ongoing nightmare. I felt a little discouraged about all this as I headed back down 95. Now more than ever, research is telling us that we know how to end homelessness, especially the most persistent form: chronic homelessness. Consider this excerpt from page 13 of the above-mentioned 2012 State of Homelessness Report:

Another notable decrease was the 3 percent decline in chronic homelessness. This decrease is consistent with a trend that began in 2007….A primary reason for the downward trend in chronic homelessness is the increasing use of permanent supportive housing, an intervention shown to be effective and cost effective in ending chronic homelessness.

But then I stopped to get coffee in Garrisonville and a Washington Post headline caught my eye: “Home At Last, For Good: District Opens New Permanent Housing Complex for Women on the Streets At Least a Year.”  For us at Virginia Supportive Housing, the article chronicles a familiar story – and a hopeful one.

Speaking about D.C.’s growing dynamic of chronic homelessness, Human Services administrator Fred Swan says, “We wanted something more sustainable….The long-stayers just kept coming back, and it was a cycle that needed to be broken.” The article continues: “With that in mind, officials implemented a ‘housing first’ model, focused on offering long-term sustainable housing first and then treating health or social issues – a concept that has been used nationwide.” The article concludes with a quote from one of the featured tenants, Gail Faulkner: “You see these,” she said, dangling the silver apartment keys next to her face. “Nobody can take them away.”

So while no American city – Richmond and Washington D.C. included – has succeeded in solving homelessness (yet), there is good news on the horizon, and that good news, for Gail Faulkner and so many of the people served by VSH, is permanent supportive housing. Study after study concludes that increased availability of and access to permanent supportive housing will be absolutely critical to our efforts to reduce and end homelessness once and for all.

I don’t know how many years I will continue running the D.C. half-marathon, but I like to think that one day in the not-too-distant future, the absence of homeless individuals will not be because we chased them into the shadows….it will be because there aren’t any. By taking slow deliberate steps in the right direction, we can win this race.

Hopeful, Optimistic….But Also Impatient

Posted on February 15, 2012

Three nights ago, the temperature plunged down into the teens and the wind chill factor was even colder than that. Most of us passed the night in the warmth of our heated homes. But according to Homeward’s most recent Point in Time Count, almost 1000 people in our very own community did not have a home in which to sleep that night and more than 100 were forced to sleep outside in public parks, on fire escapes, and in encampments by the river.

Statewide, more than 9,000 Virginians experienced homelessness that night according to estimates by Virginia’s Department of Housing and Community Development.  Can you imagine sleeping outdoors in that kind of cold? The truly sad part is that we know how to fix homelessness and a solution is within our reach. It’s called permanent supportive housing.

“Permanent supportive housing works,” states John Dearie, board member with the Virginia Coalition to End Homelessness, in his recent RTD op/ed piece. “Eighty-five to 100 percent of the tenants in…Virginia’s PSH programs have not returned to homelessness. The National Alliance to End Homelessness recently identified the emergence of PSH programs as the single most important factor in reducing chronic homelessness in America in recent years.”

Even more important, according to Dearie, is the fact that the permanent supportive housing model delivers dramatic savings to the community. “A 2010 analysis of Virginia Supportive Housing’s A Place to Start initiative showed that the program had dramatically reduced this hopeless and costly cycle [of chronic homelessness], saving the local community $320,000.”

This is really good news because it means that political consensus is possible. At a time when politicians can’t even agree on the color of the sky, Democrats and Republicans are joining forces to support legislation that paves the way for policy amendments, funding, and eventually, new PSH developments.

Dearie goes on to say, “Much more work remains to be done. According to VCEH, another 7,000 PSH units are needed to end homelessness in Virginia. That’s a daunting number, but it can be achieved. And Virginia has already made impressive progress.”

At Virginia Supportive Housing, we are hopeful and optimistic…but we are also impatient.

Hopeful because we know that permanent supportive housing is what solves homelessness and we work toward that solution each and every day.

Optimistic because advocacy for this evidence-based model is slowly but surely growing, both across the state and across the nation.

Impatient because, for the people who are sleeping outside in frigid weather, that solution can’t happen soon enough.

To read John Dearie’s complete op/ed piece, click here.

To read what the National Alliance to End Homelessness has to say about permanent supportive housing, click here.

To find out more about the work of Virginia Supportive Housing, click here.
To support VSH, click here.

Work Harder, Look Deeper

Posted on February 8, 2012

This blog was written by VSH’s volunteer resources manager, Alison Jones-Nassar.

If you saw this individual standing on a street corner, you might be tempted to avert your eyes and hurry past him, maybe even cross the street to avoid him.

We all tend to do that when we encounter people who appear dishevelled or dirty or just somehow….different. Unpredictable situations make most of us uncomfortable, and we don’t like to feel awkward or stupid, much less threatened.

But as this powerful Tribute to Robert Wood demonstrates, we sometimes ignore the people in our community who seem to exist “on the margins of society” at our own expense and end up missing out on a rare opportunity to be enriched.  

The gentleman pictured here was well-known to the citizens of Kent, Ohio. For many years, he accessed the town’s social services and regularly participated in the hot meals program. In this loving tribute, published on the occasion of Mr. Wood’s death from unspecified causes, Kent Social Services Manager Christie Anderson notes that “perhaps eccentric people are incarnations of God, for they challenge us to look deeper for their divinity….some people, more than others, require us to work harder at extending grace to them because they evoke fear in us.”

Anderson goes on to say, “This is the lesson that I have taken from knowing Robert Wood. He taught me, and others in the Kent community, that we mustn’t be quick to judge another human being. When we take the deliberate steps to set aside our fears of people perceived as different, a world of discovery opens for us. Mutual understanding begins when we lower our defenses and encounter our common humanity.”

Reading this, I was reminded of an encounter I had last week. One of our A Place To Start clients (I’ll call him Kenneth) had expressed an interest in serving as an office volunteer, and last week he gave several hours of his time to help with our move to the new headquarters.

Kenneth is a full-grown man about my age and taller than me. His gaze can sometimes appear unfocused and every time I see him, he seems sweaty and slightly agitated. I remember thinking that his facial expressions seem somehow child-like. Consequently, I felt rather awkward and unsure of how to interact with him. I had to be sure he would perform the tasks he was there to do (dismantle old manuals, carry trash out to the dumpster, shred documents), but at the same time I didn’t want to make assumptions or come across as condescending. 

“Kenneth, you doing okay? Kenneth, how’s it going?” My questions pertained to the work at hand, so I was surprised when, after a trip to the dumpster at the back of our building, he gave me the broadest grin and declared, “Boy, it is such a beautiful day outside, isn’t it?” In fact, I had been too preoccupied with all my to-do lists to notice the weather. With complete sincerity, he went on: “Ahh, it’s just gorgeous, and the breeze feels so nice! It’s a perfect day for a nice long walk!”

A few minutes later, we carried a load of boxes out to the trash together and Kenneth suddenly rushed toward the dumpster. “Oh no, look at that beautiful plant that someone threw out! That’s a little piece of paradise right there!” At that moment, I looked at Kenneth and saw what he truly had to offer for the very first time.

Tom Allen, in his February 5 Faith and Values column, urges us to move beyond competition and the judgment that we all engage in as we compare ourselves and our accomplishments (or failures) to everyone around us. “There’s something very liberating about accepting, and trying to live, the fact that we’re all brothers and sisters, children of God. It frees me to want, and to work for, what’s best for others in my life. It frees me to celebrate their successes, and to love them without jealousy. Most of all, it frees me from the constant strain of having to be ahead of them. I can just be with them, and we can travel together. What a huge relief.”

We tend to dismiss the Kenneths and the Robert Woods of the world because they don’t conform to our standards of what is “normal” and “acceptable” and “successful” and “beautiful.” Kenneth in particular, with his experience of chronic homelessness and his mental illness, can barely manage a few simple responsibilities without close supervision. What could he possibly teach any of us?

Later that day, as I left the office – and every day since – I have made a point of looking up at the sky and the trees and noticing the feeling of the sun and wind on my skin. “You’re right, Kenneth, it’s actually a really nice day.”

If we are only willing to look a little deeper and work a little harder, we will be rewarded with priceless gifts. It is definitely worth the effort.

For One Volunteer, Homelessness Hits Close To Home!

Posted on October 5, 2011

Last Friday, Capital One hosted a picnic for VSH clients and staff, and thirty-seven Cap One associates supported this great event. One volunteer, Tracy, shared this story about her personal experience with homelessness:

“My father had been searching for his father, my grandfather Jack, for over 40 years.  A few years ago, we found out that he was homeless and had been living on the streets of San Diego for 30+ years.  

“We found out that, in 1949, he received a dishonorable discharge from the military. We also found out that he had been involved in some criminal activity after his discharge. All of this alienated him from his family and eventually led to his homelessness. After searching for so many years, my father didn’t care so much about any of that. He just really wanted to get him off the streets.  Even though we didn’t know him very well, we still had our own special bond with him and really wanted to help him! 

“Despite everything we were able to find out about Jack’s situation, it proved extremely difficult to locate him. We were able to establish that he was consistently using a certain shelter in downtown San Diego, and we called several times and spoke to a priest who said he would give him our information.  We were also able to contact his case manager and she has been wonderful trying to piece things together for us. 

“My grandfather knew that we were looking for him, but no matter what we did we couldn’t get through to him. At one point, my dad even drove out to California to see if he could make contact, but he didn’t succeed. The case manager told us that my grandfather was sick and needed medication but wasn’t willing to take the help that was being offered to him. He was becoming sicker and sicker but continually refused to be hospitalized.

“On the evening of March 16, I was at home doing some additional searches and I found out that Jack had passed away on 2/19/2011. He passed away in the hospital after being found near death on the street by a Good Samaritan. Unfortunately he was alone!   

“As a family we were very disappointed that we were not able to reconnect with my grandfather before he passed, and very sad that he died without family. As I have gone through this whole search process, I have come to realize that there are an amazing number of people on the streets who are in a similar situation. My prayer is that homeless people will get the assistance they need before it’s too late. At the picnic, I was reminded again that what Virginia Supportive Housing does is so important. No one deserves to spend their last days like my grandfather, sick, alone, and homeless.”

Unfortunately, Tracy is right. There are more than 100,000 chronically homeless individuals sleeping on the streets of America on any given night. Their ages, backgrounds, and experiences may differ, but one thing unites them all. Their medical vulnerability and chronic homelessness makes them three to four times more likely to die prematurely in circumstances we wouldn’t wish upon anyone. 

Like Tracy, we at Virginia Supportive Housing strongly believe that no one deserves to live on the streets, struggling with illness and cut off from loved ones. That’s why we work hard every single day to provide permanent housing and support services for these individuals, so that their health needs can be addressed, their lives can be repaired, and their hope can be restored.

For Tracy’s grandfather, Jack, it’s too late. But for so many others, we CAN make a difference.

To help VSH win the Amazing Raise Challenge, click here!

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