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Joan Kloh is peeling potatoes in her one-bedroom apartment on El Cajon Boulevard. Chunks of celery and spices float over a pot roast she’s simmering in a slow cooker.
A framed picture of her 8-year-old granddaughter, Ruby, sits near the stove. Above her kitchen cabinets, Kloh, 52, has perched a handful of vases, a green glass bottle shaped like a Buddha and a trio of ceramic chef figurines, beaming their approval of Kloh’s growing dinner repertoire.
“I just like to collect what-nots,” she said. “It makes it feel more permanent.”
That sentiment’s not the only hint that Kloh’s place in this domestic dinnertime scene is precarious. As she cooks, she hobbles around in a walking cast. She broke her foot when a car ran over it, she said, after she’d been drinking.
When we met up, Kloh was one month, three days sober. It’s her latest coherent spell in the two years she’s been participating in Project 25, which launched with a $1.5 million United Way of San Diego grant and is run by St. Vincent de Paul Village, one of San Diego’s most prominent homeless services agencies.
Its goal is to persuade some of San Diego County’s most frequent users of emergency services to leave the streets. The second year of the three-year pilot program is coming to a close. At the end of its second year, it’s clearer than ever the effort is not as simple as opening a door and showing someone her new home.
“We thought we knew (the) homeless, but we have a group of people, as social service providers, we’d never met before,” said Kris Kuntz, a Project 25 staffer who collects and analyzes data on the program’s progress. “Success is a relative term.”
Indeed, the pace isn’t for the impatient.
This is Kloh’s second Project 25 apartment. After she’d moved into her first apartment, she went to jail last year for disorderly conduct. She moved in to her current place in August. She lives there now with her boyfriend, Renard Hall, and her guinea pig, Spice.
She speaks hopefully about the future, but looks ahead only a short distance. She hopes to remain sober tomorrow, and the next day.
The alternative looms.
“If I lose this apartment and go back to the streets, I’m going to die,” she said.
Project 25’s approach is often called “housing first.” Unlike some programs where participants must meet strict behavior and substance benchmarks before a client earns a chance at permanent housing, the permanent housing precedes the rest in this model — followed by the attempts to root out the causes of chronic homelessness.
The method has taken off in San Diego with a few different programs — Project 25, others connected to mentally ill adults and veterans and a couple of downtown-focused blitzes to house hundreds of vulnerable street-dwellers.
But the time windows on these pilot programs are starting to close. Project 25 has one more year under its United Way grant. Registry Week and Blitz Week, two downtown efforts, have housed more than 200 people in one-time blitzes.
Now, organizers are facing questions of how to sustain the people who’ve already been housed, and how to expand the programs.
“We don’t want anybody to fall into homelessness because we’ve stopped these programs, and these programs are working extremely well,” said Jennifer LeSar, a consultant whose development company organized the downtown campaigns.
But it’s time to institutionalize the approach, LeSar said.
“We’re not going to do another Blitz Week,” she said. “I think we’ve proven the point.”
Organizers are making their cases for continuing the often slow, sometimes exasperating work. Project 25 is collecting data on the millions of dollars saved by housing these frequent users of government and emergency services. And they’re planning to ask for money from hospitals, law enforcement, businesses — those that benefit when the individuals in these programs take fewer ambulance rides, have fewer encounters with police and use the emergency room less. They hope those entities might fill in the gap once United Way’s $1.5 million, three-year commitment runs out.
“We certainly don’t want to see this disappear and put the 35 people back on the street,” Shaina Gross, a United Way San Diego vice president, said. “That would defeat the purpose.”
‘Who Else Is Benefiting from This?’
To find the clients for Project 25, Executive Director Marc Stevenson, Kuntz and their team started with a list of frequent users compiled among hospitals, ambulance drivers, police officers and the like.
They had names and birthdates. No photos and, obviously, no addresses. The sleuthing took months.
In 2010, the 35 clients identified for Project 25 racked up bills at public systems of $4.3 million, according to data shared by a long list of hospitals, ambulances, governments and law enforcement agencies. Project 25 has built uncommonly open relationships with those agencies to track the data.
During the program’s second year last year, the same 35 people cost public services less than half as much — $2 million. After accounting for the money spent on supportive services and their housing subsidy, Project 25 says the program saved taxpayers $1.4 million in 2012.
And they hope the progress continues its upward trajectory: clients growing more stable, using less emergency services and requiring less intensive case management.
“The way the model is set up it’s more expensive in the beginning,” Gross said. “But we know with this population that they may never become fully self-sufficient.”
Watch Stevenson’s presentation on Project 25 at our recent homelessness event.
The savings is already a big part of the message the United Way hopes will make the case for implementing the program on a permanent basis when the pilot period winds down in a year.
“At some point we need to say who else is benefiting from this,” Gross said, “and how can we make a reasonable case for them reallocating some of those savings?”
It’s the natural progression of the original message that caught Brian Maienschein’s interest when he started Project 25 at the United Way: It is more expensive to do nothing.
Now a Republican state assemblyman, Maienschein took a job at the United Way after serving as a city councilman. Before that gig, he didn’t think about homelessness on a daily basis. But the experience of watching someone occupy a home for the first time in years made an impact.
“This has profoundly changed my life,” he said.
Jim Dunford, an emergency room doctor at UC San Diego Medical Center and an early researcher of the costs of frequent users, said the program’s impact is huge.
“People can’t afford not to do these things. Purely economically, the taxpayers’ savings are real. And so I don’t know how you can ignore that,” he said. “Now, who is the next person to say that they want to pay to sustain it? I don’t know.”
A Package of Housing and Services
Most of the “housing first” programs rely on two key components: a voucher for rent assistance, and a package of supportive services like mental health and substance abuse counseling, medical services and help living independently.
The housing piece is an unconventional twist on how government rent subsidies work in most cities. The regular waitlist for Section 8, the federal program where tenants pay 30 percent of their income in rent and the government kicks in the rest, is years long. But the San Diego Housing Commission persuaded the federal Housing and Urban Development Department to let the agency target vulnerable homeless people with Section 8 vouchers, even if those individuals weren’t in line.
The Housing Commission has allocated more than 225 vouchers to Project 25, Blitz and other programs. In many cases, the county government pitches in more money for mental health services for clients who are mentally ill and homeless. It funds those services, averaging $14,000 per client, with money from a state tax on millionaires passed in 2004.
Piedad Garcia, who runs adult mental health programs for the county, said a certain amount of funding can be counted on, “as long as there are millionaires.”
But she called for wider appreciation and funding for programs that proactively house people.
“It would be very ignorant of us to say, ‘Well we don’t have any more funding, we’re not going to continue this service,’” she said.
Meanwhile, traditional homeless service providers hope the focus on Project 25 and other “housing first” programs won’t supplant funding for the rest of the spectrum. Pat Leslie, a social work professor at Point Loma Nazarene University and longtime observer of homelessness services here, said the achievements of Project 25, and the veterans- and downtown-focused programs are exciting.
But she said cautioned that the chronically homeless don’t comprise the majority of San Diego’s homeless population, even if they use an outsize amount of public services.
“Guess what? Our responsibility as a community is for all kinds of homeless people, everywhere in our community,” she said. “If we target those resources to that group, who takes care of the rest?”
‘They Value You Like a Human Being’
Project 25’s effort is intense, and so is its target population.
Besides Stevenson and Kuntz, the Project 25 team includes two case managers, a nurse and a doctor. The team from St. Vincent’s manages 16 of the cases; the County of San Diego contracts with a private mental health service provider, Telecare, to cover the rest.
The project keeps a 24-hour emergency line open for clients and their landlords. All of the clients have Stevenson’s cell phone number, too. When I arrived to visit Kloh on Wednesday, Stevenson was there. He was on the phone with another client, suggesting the client call 9-1-1 if the situation on the other end of the line escalated.
Stevenson prepares his team for client relapses. Sometimes this is contrary to other St. Vincent’s policies, that caseworkers work with clients on safer ways to drink, or limits to drinking, rather than trying to shock themselves into abstinence immediately.
“Let’s work with what’s real,” he said he tells his team. “Let’s not come in with judgment.”
Kloh herself demonstrates the difficulty of a recovery after so many years battling addiction.
Her jail time was part of her tumultuous first year in Project 25 — the subject of a U-T San Diego story last year.
As her foot cast shows, it’s hard to teach a long-time chronic alcoholic and drug user new habits. She recently summoned the backbone to kick out friends from the street who saw her new home as a place for them to crash, too.
Inside her apartment, she lists off the meals she’s been cooking, like pork chops and meatballs infused with Rice-a-Roni. She tickles her guinea pig and gushes about the food she likes.
“Do you know this program brought my life back?” she said.
Project 25 staff members visited Kloh when she was in jail. They take her to appointments for ID cards, counseling and doctor’s check-ups. They sit for coffee, like Stevenson did the other night, and accept gestures of fledgling hospitality.
“They value you like a human being,” Kloh said.
Photos by Sam Hodgson
I’m Kelly Bennett, reporter for Voice of San Diego. You can reach me directly at firstname.lastname@example.org or 619.325.0531.