Even in Compassionate Boston, Homelessness Tests Civic Patience

BOSTON —  In a city noted for compassion toward the homeless, the deaths came as an affront.

“How could it happen here?” anguished Erik Payne Butler, president of New England’s largest homeless program, the Pine Street Inn, after six homeless people froze to death in the space of a few uncommonly mild weeks.

The deaths in November and December of five men and a woman served as a reminder that here and across the country, the homeless population is both increasing and changing. The mayor’s annual Dec. 1 census of the homeless showed that in a year the figure grew 5%, to 5,272.

For the first time, a significant number of young people are moving directly from foster care to the streets, and the census revealed more immigrants and ex-inmates. The mentally ill continued to account for a large portion of the population here, as elsewhere, but a shortage of affordable housing and a tightening of welfare regulations also are producing an increase in families on the streets.

Boston Trends Borne Out

The homeless do not make for an easy head count, but experts say the Boston trends are borne out across the country. The U.S. Conference of Mayors recently surveyed 30 major cities and found that 72% experienced an increase in homelessness last year. Fifty-four percent said the length of time people remained homeless had increased during the last year.

What’s more, the growth in homelessness has been accompanied in many cities by impatience about the seeming intractability of the issue, according to social service agencies. Although Boston is known for its humane outreach efforts, some cities have turned to near-draconian measures.

San Francisco--with an estimated homeless population of 16,000, twice the number of 10 years ago--has joined the ranks of cities that stage police sweeps to remove homeless people from the streets. This earned San Francisco a place among the country’s top five “mean streets” for the homeless--along with Atlanta, Tucson, Chicago and New York City--in a report issued this month by the National Law Center on Homelessness and Poverty in Washington.

No agency keeps precise tabs on the number of homeless people who die each year on the nation’s streets. But the death this month in Boston of a seventh homeless man who perished when his makeshift trailer shelter caught fire sent officials here into further despair. By contrast, only two people died on Boston’s streets in the previous year.

Bob Erlenbusch, executive director of the Los Angeles Coalition to End Hunger and Homelessness, said the county coroner’s office makes it difficult to track homeless deaths.

A recent statistical analysis by the nonprofit Shelter Partnerships confirmed the widely used “mid-range” figure of 70,000 people on any given night who are homeless in L.A. County, Erlenbusch continued. An informational pamphlet to aid homeless people was printed last year in nine languages, he said, including Armenian. Like Boston’s, Erlenbusch said the homeless population of Los Angeles increased about 5% last year.

With their unkempt appearance and antisocial demeanor, homeless substance abusers such as Kelly, Charles and Wayne--occupying a park bench within yards of Boston’s famous Faneuil Hall--disturb most people and offend many others. A strong national economy has done nothing to promote sympathy for the homeless either.

Even in a community that views homelessness more as a public health concern than a police problem, “people get tired of hearing about it,” said Dr. Jim O’Connell, a physician who since 1985 has headed Boston’s Health Care for the Homeless.

“I’m just a doctor looking at this thing,” he said. “But when you pick apart this homelessness issue, it’s not really a population but kind of a prism through which the light of society gets shone: the elderly, the immigrants, substance abusers, the mentally ill, young people, those trapped in the welfare system.

“But when I say that, people say, ‘Oh my God, we’ll never be able to change all that.’ It seems so vast, and there’s no sound bite that captures this problem.”

The six deaths by freezing jolted a network of providers that has been hailed by the U.S. Department of Housing and Urban Development as a national model. Police and business interests collaborate with city officials and nonprofit groups. O’Connell’s free clinic specializes in health problems of the homeless, such as tuberculosis and gangrene infections.

“We have a collective objective to have a bed for every homeless person in the city,” Butler said. With the recent addition of 500 “overflow” beds at Pine Street, a landmark structure, that goal has been attained. A series of halfway houses and other centers devoted to the homeless spreads throughout the city.

Still, as many as 250 people per winter night sleep outdoors, mainly in the downtown business district that bustles by day but grows empty at night. Like most who live on the streets, the six who died were substance abusers, lulled apparently by unseasonable days that lingered through Christmas. All six were familiar to outreach workers who patrol the streets by van and on foot, night and day.

“We do the ABCs: ‘Everyone OK? Anything you need? What’s going on?’ ” said Paul Janvier, a counselor with Pine Street’s Neighbor program. Janvier and Linda Curnane, a nurse, canvass the city by foot, checking in nooks and crannies, on park benches, in alleys.

Deaths Have Made Them Vigilant

The deaths have made them especially vigilant. Early one recent morning, they searched for Kelly and Charles by the waterfront in a park between an expensive hotel and a row of trendy apartments. At the Fleet Center arena, they stopped to chat with Maurice, a Vietnam veteran with Nick Nolte looks who is often delusional.

“Nice to see you,” Janvier told Maurice.

“You’re late,” Maurice replied. “I’ve been waiting for you.”

Maurice declined an offer of coffee and assured the team: “I’m doing all right. I’m glad you’re thinking about me.”

Curnane and Janvier were on their way to Government Center when they finally spotted Kelly and Charles on the bench with Wayne. Wayne was high, Charles was hugging himself to stay warm and Kelly was joking that she might try selling a pocketful of condoms that counselors from Pine Street’s night van had given her.

“It’s too cold for sex,” she said.

Soon the park bench trio was wearing new chartreuse hats and heavy socks supplied by local merchants. Concerned about Charles’ badly weathered skin, Curnane dug further into her backpack and found a tube of moisturizer. She made a note that Kelly needed new pants, size 8. An alcoholic since she was 13, 29-year-old Kelly confided she had been so cold the night before she thought she, too, might freeze to death. She fell asleep crying, Kelly said.

Her uncle owns a popular restaurant a few blocks away and regularly urges his niece to “go home.” Out of the question, said Kelly: “I like freedom.”

In the tradition of Pine Street, a facility started by activist priests in 1969, Curnane and Janvier are careful to refer to the men and women they meet on the streets not as clients, or patients, but as guests.

“We try to instill in our guests that it is possible to move on and that they deserve it,” Curnane said. “A lot of them don’t think they deserve it.”

Julia Child Is Program Mentor

Provided they are not packing a weapon, a bottle or drug paraphernalia, those who do find their way to Pine Street or a satellite shelter are offered substance abuse counseling, detox, health care, housing referrals and advice on job training. Julia Child is a mentor to a new on-site program that prepares some guests for food-industry work.

But the first order of the day--or night, since that is when homeless shelters kick into action--is a foot wash. Reasoning that the feet of a homeless person are in some ways the gates to the soul, Pine Street staffers bathe the feet of their guests.

The philosophy of his $12-million operation, Butler said, is: “In order to become homeless, you have to lose a lot of stuff--in many cases, including any form of ID. We are in the reconnecting business: reconnecting to employment, housing, health and some sense of being able to live in connection--in relationships--with other human beings.”

After the sixth death was reported on Christmas Eve, Mayor Tom Menino called a meeting of police, city officials and shelter providers and issued an emergency $80,000 authorization to fund a second van to bring supplies and health services to the homeless. “We are very frustrated with the increased number of homeless in the city of Boston and by the recent tragedies,” he said.

His concerns are mirrored around the country, said Julie Wolch, a geography and urban planning professor at USC. Thanks largely to federal welfare reform efforts, “cities are increasingly being left holding the bag. And they don’t have the resources to cope with the scale of the problem in terms of providing the whole service system.”

Dr. Jim, as his patients and colleagues refer to O’Connell, said he aims for a hands-on approach at Health Care for the Homeless. All his patients have his beeper number and often call him at strange hours. He encourages sick street people to come to his clinic; if not, he is back with his health van each Monday night to treat them in the street.

O’Connell said he agonizes about national indifference to homelessness. And yet “it’s just been such a difficult problem. No matter what policy changes we make, it just keeps coming back.”