Homelessness is like a black hole, Debbie* said, and she's afraid that one day she's going to disappear into it: "Some people, this is their way of life. I get scared that I'm going to get sucked into this vortex of homelessness."
Since she became homeless in January, Debbie has lived in three shelters. The latest is Catherine's Place in Hartford, Conn., a women's transitional housing shelter run by the Roman Catholic order Sisters of Mercy. Debbie, a nurse, said until she became homeless, she expected to work into her 70s and then volunteer after she retired: "That may be the nurse in me, having the need to be doing. . . . I really have a strong belief in giving back to the community."
Getting people back into the community is one of the goals of Access to Recovery (ATR), a $600 million federal voucher program that grants certain states vouchers for anti-addiction services. If you could put ATR's mission on a bumper sticker it would read, "People renewing their life in the community," said Thomas Kirk, Commissioner for Connecticut's Department of Mental Health and Addiction Services (DMHAS): helping people find a place to live, work to do, and a place in the community.
When it comes to having a place to live, ATR reports, 22 percent of ATR clients with unstable housing say they've gained stable housing by their discharge from the program. When it comes to having work to do, 29 percent of the unemployed clients report employment after their discharge. When it comes to a place in the community, 59 percent of the clients who said they were socially disconnected report some kind of social connection-a self-help group or someone reliable in times of crisis. Of those once involved in the criminal justice system, 84 percent reported no involvement at discharge. Of those addicted, 71 percent were free from substance use.
ATR allows clients with substance-abuse problems to choose recovery-support services from the provider of their choice: a secular program or a program like Catherine's Place. Kirk said choice is key to ATR because it gives a message: "You're the one that's going to manage your recovery."
If a client comes to a faith-based housing provider in Connecticut, for instance, the provider first has to determine the person's ATR eligibility. (In Connecticut, the person has to have a substance-abuse addiction and must be involved in either corrections or the child welfare system.) Then the provider has to give the client a choice of different housing providers. If the client chooses the faith-based group's services, the group then submits a claim to ATR for the housing.
Or a probation officer might work with a newly released client to develop a plan for post-prison life, identifying what the client needs to mesh with the community again. This might include affordable housing, transportation, resumé help, clothes for a job interview, or even a haircut. In each instance, the client can develop his own plan and use vouchers for his own provider.
The percentage of ATR dollars going to faith-based organizations has climbed each year, from 24 percent in June 2006 to 31 percent in March 2007. Connecticut especially relies on faith-based organizations: 27 of its 67 service providers are faith-based, and 7,000 of its 16,000 clients choose faith-based programs.
Connecticut has been building its relationship with faith-based providers for a decade now. When Kirk was Deputy Commissioner, he learned about a Baptist minister-Marcus McKinney-who trained priests in pastoral counseling for a hospital. The government invested in McKinney's program, and Kirk attended faith conferences to learn more about faith-based service providers.
After 9/11, Connecticut turned to McKinney and others to help victims' families. So when ATR came along, Kirk said it was natural to partner with faith-based providers, not just in identifying the services they could provide, but also in listening to what they had to say. Kirk said he wanted recovery support to be culturally responsive to the importance of spiritual community, especially among minority groups like African-Americans and Latinos. Where do you go to be accepted again, find a support system and make new friends who can help you hold to new habits? Kirk said many go back to what they knew from their youth: faith.
The grants came with regulations, however, and implementing them proved difficult for both the DMHAS and faith-based providers. Each provider had to undergo a certification process, answering questions about its experience, governance, and official qualifications of its spiritual leaders. The state must know detailed records on the providers' grievance procedures and billing practices, and providers had to file progress notes and claims for the services they provided. The faith-based providers have to submit their curriculum if they use one, but the state doesn't dictate what they teach; it only determines that they're qualified to teach it.
McKinney, now ATR's coordinator for faith-based programs, said many faith-based organizations are new and loosely structured, and some were reluctant to change their way of operating. But McKinney said he believes ATR has helped faith-based groups build a solid structure and learn how to sustain themselves once their ATR grant runs out.
Mercy Housing and Shelter-the organization that runs Catherine's Place-received ATR money in the first phase of the grant, but now it has turned to other revenue sources. Working together has benefited both faith-based organizations and traditional agencies, McKinney said: Faith-based providers are making new connections, and traditional agencies are rethinking their stereotypes of faith-based organizations.
McKinney said faith-based providers are well-equipped to handle people's mistakes and lapses back into addiction because they "understand redemption and work with you on your recovery, and not place judgment or penalize you because that is part of the healing process." Kirk said if you look at the names of the faith-based providers they were funding, just the names themselves are more hopeful: "It sounded like a group that could help you as opposed to a bureaucratic addiction treatment program. . . . They reflected renewal."
When it comes to disappearing into the black hole of homelessness, Debbie says she sometimes feels helpless since a lot depends on "the competency and efficiency of the people in the government programs." But she says Catherine's Place is different from the other places she's stayed, even though the stated purpose and structure were the same.
At the other shelters, the residents were a better resource than the staff when trying to find medical help, clothing, counseling, and job help. "It's haphazard and it's potluck at best," Debbie said. At Catherine's Place, "There's greater sincerity here and actual concerted effort made to help the clients." Right now, the staff is trying to help Debbie get the prescriptions she needs. They cost $4,000 a month so she is going without two of the dozen she usually takes, including the anti-depressant she has taken for 15 years.
According to Catherine's Place rules, she must either volunteer or work. Because of her medical conditions, she can no longer work as a nurse so she volunteers at a telephone support program for recovering addicts. Sometimes she works as a greeter at the parish that helps with Catherine's Place. She said it restores some of her self-respect and makes her feel useful: "You're treated with respect here."
Her eyes filled up with tears-partly because she still lacked her anti-depressants but partly out of gratitude, she said. "When you become homeless your self-respect takes such a dive. The staff here helped give me my dignity back just with the way they conduct themselves and with how they treat me day to day. . . . I wish I'd fallen here first instead of somewhere else."
*Name changed to protect confidentiality