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Recasting Homelessness As Life Or Death

Susan Campbell

January 24, 2010

At 6 a.m. this past Thursday, the usual gang of advocates for the homeless was out beneath Hartford's bridges looking for people too drunk, tired or mentally ill to come inside.

It was cold enough to make even a dedicated volunteer think twice about getting out of a heated car to tromp under the bridges. Imagine the pain of spending the night outside, says Brian Baker of South Park Inn, a frequent bridge-crawler.

The volunteers don't complain. Their prey is, for the most part, the chronically homeless. Since the governor opened an overflow shelter on Lafayette Street (which has, Baker says grandly, carpeted floors), the number of people who suffer outside a population that is almost entirely male has shrunk from a high of 30 to 11 last week, and eight the week before that.

And that's progress.

Sarah Gallagher, executive director of Journey Home, a nonprofit organization charged with implementing Hartford's regional 10-year plan to end homelessness, wants to use that face-to-face interaction. Later this week, Gallagher and other advocates will meet to talk about instituting something called a vulnerability survey, where volunteers survey each homeless person in shelters and on the street. The most vulnerable those at most risk of dying unhoused get housing.

Based on research by people like Dr. Jim O'Connell of Boston Healthcare for the Homeless Program, the index identifies people by looking at how often a person has visited a hospital recently, the age of the person, general health (the possibility of cirrhosis, end-stage renal disease, and effects of the cold such as frostbite). Volunteers also ask about HIV/AIDS and psychiatric conditions.

Something about talking about life and death gets wheels turning, and information gained from the index has resulted in vulnerable people being housed nationwide, said Becky Kanis, of Common Ground, which trains people to use the index.

"We are accurately reframing homelessness in life-or-death terms," Kanis said. "We're not being histrionic. This is based on solid and reputable research."

The organization is especially interested in Hartford, said Sharon Gowen, who works for Common Ground in Connecticut. The city could be a laboratory for similar-size cities anxious to deal with their homeless population.

"There are far more cities like Hartford than there are like New York or Los Angeles," Gowen said. "There are homeless people in small cities, particularly small cities that have an aging housing stock, where people who worked in factories don't have jobs anymore."

Kanis said that by using the index, Washington, D.C., housed 300 vulnerable people in three weeks. In New Orleans, some 150 people sleeping under a bridge were housed in two weeks. Portland, Santa Monica, and Brooklyn all report similar success.

"What you learn when you do the indexing is that there are people who are homeless with a 'comma-but,'" Gowen said. "They are homeless, comma but if we could just get Section 8 housing; or they are homeless, comma but if we could get them to the VA."

Homeless advocates tend to know their own clients intimately, but the information is not shared universally, Gallagher said, nor are individuals' medical records collected uniformly.

The beauty of Hartford, she said, is that the homeless population is small compared with other cities that have used the index. It's manageable. It's fixable.

"We're hoping it's a new way to think about homeless," Gallagher said. "We can solve this."

Reprinted with permission of the Hartford Courant. To view other stories on this topic, search the Hartford Courant Archives at http://www.courant.com/archives.
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