Questions and answers about A Place to Start

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From Homeless To Home, With A Little Help



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• A Place to Start places homeless in housing

• Questions and answers about A Place to Start



"SOLOIST" EXPLORES SCHIZOPHRENIA IN HOMELESS

A new movie, "The Soloist," peeks into the world of this segment of the homeless population. The movie is based on a friendship between Los Angeles Times columnist Steve Lopez and Nathaniel Ayers, a homeless musician. Lopez met Ayers on Skid Row in Los Angeles, where Ayers wound up, having left the prestigious Juilliard School years earlier because of his struggle with schizophrenia.

Questions and answers about the program.

How much does A Place To Start cost?

The annual cost for each participant is estimated at $18,000 to 22,000, including rent and support services. That sounds like a lot until compared to the $40,000 to $50,000 in yearly costs typically spent on such individuals, said Katie VanArnam, director of housing access programs with Virginia Supportive Housing, the not-for-profit homeless-services provider overseeing A Place To Start.

Why does it typically cost $40,000 or $50,000 a year?

Ambulance services, hospital stays and jail incarcerations drive up the public's cost of caring for the mentally ill who are homeless, VanArnam said. One participant in A Place To Start made more than 70 visits to hospital emergency rooms during a three-year period of homelessness. The visits generally were for minor ailments. In A Place To Start, she has a primary-care physician and no longer makes trips to the emergency room.

Where does the money for A Place To Start come from?

Principal funding comes the U.S. Department of Housing and Urban Development (rental subsidies) and Medicaid (clinical costs). Richmond and Chesterfield County also contribute. Grants from The Community Foundation and the Virginia Department of Mental Health, Mental Retardation and Substance Abuse Services helped start the program, and contributions from numerous other sources, including Bon Secours of Richmond Health System and Richmond Behavioral Health Authority.

Participants contribute to the monthly rent with 30 percent of their income, which is typically derived from disability benefits. The rest comes from federal rental subsidies.

A part of the program that is not funded, however, is the transitional phase that provides motels for a few weeks or a few months as the homeless move from the street to permanent housing. Virginia Supportive Housing officials say that's a critical piece of the program, but it costs $90,000 a year and they cannot afford to keep it going without additional funding.

Who is eligible for A Place To Start?

Individuals must be "chronically homeless" - defined as being on the street or in a temporary shelter for a year or more continuously or four times or more in the past three years - and have a severe, persistent mental illness, VanArnam said.

What is the homeless population in the Richmond area?

During Homeward's "point-in-time" count in January, 1,150 people were homeless.

How many have mental-health problems?

In Homeward's survey, 59.6 percent reported having a mental-health problem sometime in their lifetime. Of those, 87.1 percent were currently being treated, and 90.3 percent were taking medication.

Where do A Place To Start participants live?

They live in housing scattered around the Richmond area in lease agreements with private landlords.

How many people are in the program?

Thirty-two are in permanent housing, and another 18 are in the transitional phase, receiving clinical services and awaiting permanent housing. Participants range from a few in their late teens who have recently aged out of foster care to those in their 60s who have been homeless for years.

Once they are in housing, are they left alone?

No. A support team that includes social workers, a psychiatrist and a nurse meets with them regularly and guides them through the labyrinth of applying for public aid such as food stamps; sometimes the most time-consuming part of the process is securing basic identifying credentials since the chronically homeless seldom have Social Security cards or birth certificates.

Team members begin meeting with the individuals from the moment they are referred to A Place To Start. Those first meetings might occur at park benches or wherever the homeless might be living and are critical in building trust since these individuals often view promises of assistance with skepticism, said VanArnam. - Bill Lohmann