Pine Street Inn shifts from beds to housing

Pushes for homes first, treatment later

There are things that Joe Meuse doesn’t remember. He can’t say when he first became homeless. He’s been told that over 18 months, he made 216 visits to hospital emergency rooms, but he says he can’t remember any of them.

What he can say for sure is how he became homeless.

“I started drinking. I mean I’m a serious alcoholic,” he says. “Once I start drinking I can’t stop. And I go right to the bottom real quick. And I don’t care about myself or anybody else.”

He remembers sleeping on a grate in Boston Common. And he remembers outreach workers coming by to offer help. But he didn’t want coffee or sandwiches; he wanted more alcohol. The worst feeling, he says, was sitting on that grate watching people with purpose in their lives go by.

* * *

In 1969, Pine Street Inn opened its doors to provide refuge for any guest seeking shelter, and it took in 200 men. Over the years, the organization added long rows of shelter beds to accommodate the growing numbers of homeless individuals.

“We all thought that people would come into shelter and that we would then say to them, ‘Well, would you like detox? Would you like mental health services?’ And then they’d get sober, get a job, and move out,” Lyndia Downie says. She’s been the president of Pine Street since 2000.

“That did happen for some people. But until we really looked at the data, we didn’t realize that it wasn’t happening for the people who were here 365 days a year.”

Social science calls these long-term residents of shelters the chronically homeless. Some spend months or years in shelter. Some sleep on grates or in parks or under bridges. They are men and women who go to emergency rooms for healthcare, driving up costs and getting treatment that can, as some advocates say, “wash off in the rain” if they continue to live on the streets.

In 1984, Pine Street took a small step into developing housing, placing 26 individuals into permanent homes in a building in Brookline. In the 1990s, Pine Street launched a two-step transitional shelter program: provide job training and placement assistance, then help people find permanent housing.

The goal was to help people become “housing ready,” which typically meant becoming sober. The approach worked, but not for people with crushing substance abuse problems, severe mental illness, or other significant emotional impairments.

“We weren’t willing to take people, even in our own housing, until they were ‘better’ and ‘stable,’” Downie says, explaining that Pine Street didn’t have the local support services that people would have needed. “In many ways, the system, not the person, was driving the agenda.”

By 2003, surrounded by the Boston area’s persistent and unmet need for affordable housing, Pine Street owned or operated 280 housing units. But what Pine Street still mostly offered every night were shelter beds, 715 of them.

The next year, Pine Street took a financial hit: a $3 million cut to its nearly $30 million budget on top of several years of level funding from the state. To manage and regroup, Pine Street commissioned two studies. One looked at the costs and benefits of the organization’s programs. The other analyzed how long newcomers were staying in shelter beds.

That second study replicated research done by University of Pennsylvania Professor Dennis Culhane in other cities and shattered a lot of Pine Street’s ideas about who was homeless and for how long.

As Culhane explained in a 2010 Washington Post article, “Long-term homelessness is relatively rare.” Of the 2 million people in the United States who were homeless in 2009, “on any given day, only about 112,000 people fit the federal definition of ‘chronic homelessness,’ which applies to those who have been continuously homeless for a year or more, or are experiencing at least their fourth episode of homelessness in three years.”

Only 5 percent were chronically homeless? Maybe nationally, but that couldn’t be true at Pine Street, Downie and her staff thought. They were certain that 50 percent or more of their guests fell into the chronic category.

But they were wrong. It turned out that over the course of a year, only a small group were heavy users of shelter: about 5 percent of guests were using 53 percent of the beds.

That finding would eventually push Pine Street down a new road.

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In the 1990s, Sam Tsemberis was working as a community health outreach worker in New York City offering help to homeless people. He discovered that what people wanted was homes first and treatment later. So he founded Pathways to Housing, a nonprofit organization that took the radical step of housing people who were not “housing ready.” It was an approach called housing first.

At the time, supervised apartments had been developed for the mentally ill, but as the New York Times reported in 1993, these apartments did not accept people with recent histories of drug use or those who had criminal records.

“They want people who have been substance free for six months or a year,” Tsemberis told the Times. “No one is like that on the streets.” Tsemberis kept count and found that housing first worked. The approach took people off the streets, and it was cheaper than paying for long stays in shelter. The policy was championed by the administration of President George W. Bush and held up as a national model.

But skeptics doubted that this approach could be successfully duplicated in other places. Among them was Pine Street’s Downie. But eventually Pine Street staff had a chance to go to New York and ask on a granular level: How do you do this?

In 2007, Pine Street launched a small housing first pilot program, leasing apartments for people who had been at Pine Street for a decade or more. If it didn’t work, Downie thought at the time, the participants could always come back to Pine Street.

A year in, about 86 percent of these Housing First pioneers were still housed.

“Not that everybody’s life was perfect,” Downie says. “But people were stable in a different way. And we were able to interface with people in a more consistent way.”

Pine Street was changing. The 280 housing units it had in 2003 grew to 513 units in 2009. During that same time, the historical heart of Pine Street’s mission shifted as it decreased its shelter beds from 715 to 691.

Staff and board members struggled with the transition, sorting out whether it would be fair, practical, or even wise to shift so decisively from shelter to housing. What if people couldn’t make it in permanent housing? What if demand for shelter beds spiked? And would a housing mission break with Pine Street’s long tradition of providing shelter?

After months of deliberation, Pine Street chose to increase housing and provide the support and services people would need to stay housed.

* * *

For Joe Meuse, who so clearly remembers sitting on that Boston Common grate, who was in and out of courtrooms, and who worked to earn money that he mostly spent on alcohol, Pine Street provided an apartment in Brookline and a chance to build a new life. Meuse, who doesn’t recall a lot of dates, does remember that September 10, 2010, was his sobriety day. The day before, in a final binge, he had “guzzled down a bottle of Listerine.”

Now, Meuse has reconnected with family and shows off photographs of relatives as well as the drawings and paintings on his wall that were made by his brother. Meuse takes care of a friend’s dogs, and he’s thinking of starting a dog walking business.

He recalls an Alcoholics Anonymous meeting where he was told that to save himself, he would have to practice altruism. But doing something for others and expecting nothing in return “made absolutely no sense to Joe Meuse,” he says of himself.

Now it makes sense to help other people. And now it makes sense to do better for himself.

* * *

“We got on board very early with this idea and have supported it extensively,” Paul Grogan, president and CEO of The Boston Foundation, says of Pine Street’s housing first work. “We hope it will be influential with other state and local players.”

In 2012, the foundation gave Pine Street a $225,000, three-year grant to support a “multi-year organizational change effort to shift from a focus from emergency shelter to a stronger emphasis on permanent supportive housing.”

“My dream is that Pine Street will be the Museum of Homelessness in Boston. That’s the 50-year plan,” Melinda Marble said. Marble had been at the Boston-based Barr Foundation, and was looking for models to address family homelessness, when Downie asked for help funding the 2004 studies of Pine Street.

But before Pine Street can help end chronic homelessness and become a museum, it faces key challenges. It needs funding that can be flexibly spent to provide housing and supportive services.

“The solution to homelessness is housing first,” Culhane, the University of Pennsylvania professor, says. He points to national declines in the number of homeless people and to the federal government’s recent success in addressing homelessness among veterans. There has been a 35 percent drop since 2009, thanks to a 400 percent increase in spending from $400 million to $1.6 billion. And since 2007, chronic homelessness has fallen from 180,000 to 85,000.

Culhane says ending chronic homelessness is “within reach in a five-year horizon, if we put enough new resources in.”

* * *

“We will never be able to thank the people in the neighborhood enough for their support and their help,” Downie said in October, standing under a tent outside 307 Bowdoin Street in Dorchester at the opening event of a new Pine Street housing development. City and state officials sat under the tent along with members of the Archdiocese and curious neighbors.

Formerly St. Peter’s convent, the building has been renovated into 31 studio apartments with high ceilings and large windows that open to let in the sounds of the street’s tall, rustling trees. The units are bright and new and full of chairs, tables, and beds donated by Bob’s Discount Furniture.

Ten years ago, all we heard about was shelter, Downie told the crowd. But that day she got to make a historic announcement.

“I am pleased to report that Pine Street Inn now has more men and women living in permanent housing than staying in our shelters.”

Meet the Author
On that day Pine Street had 670 shelter beds and 858 units of housing. The course for a new future was set. Pine Street Inn now predominantly fights homelessness with housing.

Alyssa Haywoode writes for Eye on Early Education, a blog of Strategies for Children, Inc.