Delivering on a promise of new hope

Everywhere Carrie Bach looked, there was cause for hope or its opposite. People were getting better and people were dying. They were inching toward trust and hiding in hypodermics. They were filling the air with prayer and fouling it with crack vapor. They were reclaiming a place in the human race and fleeing deeper into narcotic netherworlds. There were blackout drunks now lucid and blackout drunks still landing themselves in the emergency room.

In early 2009, the county’s push to house skid row’s 50 most hard-core homeless was entering its second year. Even as their fates remained precarious, clients were trying to learn the names of an ever-shifting staff. Almost all the original outreach workers, drug counselors and social workers were gone. They’d crumpled under the pressure or cycled back to their departments or found better-paying work.

Bach herself was quitting as director. From the start she’d known Project 50’s stakes: not just human lives and millions of dollars but also, perhaps, the fate of homelessness policy in Greater Los Angeles. But she’d come to feel isolated, a small and expendable player. Her judgment was questioned by colleagues and bosses: once when she led a reporter to a client’s room and the resulting article mentioned roaches, and again when she helped a client who had been arrested tap her welfare money while in jail.

The program, which gave apartments to homeless addicts with few conditions, had always been controversial, and if something should go wrong -- if someone in power found grounds to raise a clamor -- she feared she would be the scapegoat.

She’d fostered risky personal relationships with clients, going way beyond the job description. County bosses admired Bach’s zeal and knew that an unconventional program required a pliable playbook. But now they wondered whether her background as a public-health nurse had trained her to draw boundaries with mentally ill addicts.

“I’ve never been under such stress,” Bach said. “I don’t regret one moment of it. It was awesome. It’s just that it really did test me, and it showed my cracks.”

Among clients who had grown to love Bach, who got little explanation for her departure, the news hit hard. Maurice Lewis, the first one housed, summed up the feeling: “We were like her children.”

The new director, John Snibbe, a clinical psychologist with the county Mental Health Department, was everything Bach was not: guarded in speech, by-the-book, skilled in politics and bureaucracy. He would tighten procedures where Bach had left them loose. He would methodically screen people for federal benefits eligibility. He knew all about boundaries. There seemed small likelihood the clients would ever view themselves as his children.

Rotating back to a desk job in the Public Health Department, Bach found it hard to divorce herself entirely from the people to whom she’d devoted a year. Soon after leaving, she made plans to attend Project 50’s monthly birthday party for the clients. Then her phone rang. The new director’s secretary was on the line, sounding a little embarrassed, relaying word not to come. The clients needed to make a clean break.

*****

From the outset, a selling point of the two-year, $3.6-million program was the promise that it would largely pay for itself. Cathy McFee, a longtime addict with a festering abscess on her leg, provided a striking, if extreme, illustration.

During her last year on the streets, McFee had spent about 40 days in the hospital, costing taxpayers nearly $90,000. The year after Project 50 placed her in the Sanborn Hotel, with easy access to nurses, she visited the hospital just once, for a $940 tab.

“This has not cost us practically anything,” Zev Yaroslavsky told fellow L.A. County supervisors at a May 2009 board meeting, seeking their votes for a tenfold expansion of Project 50. “We know enough to know that this is working.”

But other supervisors balked at the expansion to 500. At a time of slashed programs and a bottomed-out economy, Supervisor Don Knabe asked, was it wise to spend heavily on the chronically homeless to “essentially provide them permanent housing for the rest of their lives?”

Since it began, the program has managed to shepherd 68 of the chronically homeless into apartments. Of the surviving 62, the county reports that 52 remain housed in one form or another. Some have transferred to nursing homes or been taken in by families.

All of the 39 who still live in Project 50 apartments are receiving medical help at the clinic next to the program’s headquarters. Thirty-seven are voluntarily getting treatment for mental disorders, 17 for substance abuse. Eight have been sober for more than six months. Of 50 identified on the county’s original list of skid row’s most vulnerable, 20 were never found, mostly because of a one-month delay early in the search for a transient and elusive population.

The project, which recently expanded to 74, continues with a combination of county, state and federal dollars. It remains controversial. Just Tuesday, pointing to participants who resisted treatment, Supervisor Michael D. Antonovich derided it as “warehousing without healing.”

But its imprint has been large. Common Ground, the New York-based nonprofit that provided the template for Project 50 with its work in Times Square, said L.A.’s skid row project has lent momentum to similar efforts in 43 communities, including Santa Monica, Van Nuys, Fort Worth, Atlanta, New Orleans and Washington, D.C.. Nearly 5,500 of the chronically homeless have been rescued from the streets as a result.

For 21/2 years, Project 50 has tested this question: Could society’s sickest and most damaged keep the keys to their own apartments? The laboratory: one infamous square mile in the shadow of downtown’s skyscrapers. The answer: With enough political will and enormous on-the-street effort, it works -- most of the time.

*****

For the clients, there were no tidy endings. Bobby Livingston, No. 1 on the county’s original list, held on to his room only a few months before drug charges sent him to County Jail, and eventually to state prison. Between these stints in lockup, when he dropped by the Project 50 office to pick up his Social Security checks, Bach asked if he was taking his schizophrenia medication.

He always claimed to enjoy the company of the voices in his head. Now he pounded his chest and said, “I like the way I am,” confirming what Bach had suspected all along. “We really did want it more than he did -- way more,” she said. “He never did want it.”

He was an exception. Two years into the program, many clients were emphatic that it had saved their lives. Wanda Hammond, No. 5, who had been found half-clothed on the street in a drug stupor, remained at the Senator Hotel and said she was going to a methadone clinic that helped her “cut down quite a bit on heroin.”

But sometimes she’d answer the door with wild eyes, her speech unintelligible. Other times she’d invite visitors in and sing for them, her voice a ragged alto. She dreamed of winning back the children the courts had taken from her. Two floors up, Maurice Lewis, No. 36, used a soup can to prop open the door of his little room and dreamed about the water. He’d passed his written test to reclaim his seaman’s license, he said, and was waiting for the Coast Guard to complete a background check.

Alcohol could make him surly. He bristled at the suggestion that he should quit drinking. “If I want to drink a beer, I’m gonna drink me one,” he said. He hoped to be on a ship soon. “Five more years, I can retire, if I live.”

On the same floor lived Paul Sigler, No. 49, the former entrepreneur who credited Project 50 with keeping him off crack cocaine for two years. He’d worn the paint off his cellphone, pressing it to his ear, trying to relaunch the advertising-sign business that had once made him rich. “All it takes is one big account and I’m back in the game again,” he said.

Memories of his old life still brought tears: how he used to sing the ABCs to his children and carry them across the swimming pool. He’d been sending e-mails to his ex-wife, begging to see them. She was remarried and said she wasn’t about to let Sigler, with all his guilt and drama, back into the lives of kids she insisted barely remembered him.

Reading the Bible, he identified closely with Job, whom he called “a multimillionaire way back in the olden days,” a man who clung to hope even after God stripped him of everything and then “got everything back double.”

Down the block at the Sanborn, Cathy McFee, No. 3, kept escaping into her pipe, her crack jags as predictable as the turn of a calendar leaf. On binges she’d bundle tight in her blankets, terrified of imaginary insects. But she paid her rent -- 30% of her benefits check -- before visiting the dope man, and made daily visits to the Project 50 clinic, where a nurse rubbed silver sulfadiazine cream on her abscessed leg and wrapped it in fresh gauze.

For decades she’d fled from place to place, hoping a new city would get her clean. It never did, but she was dreaming again. “In this building everything is on crack, even the bugs,” she said. “If I can get away from this building, it would solve a hellified problem.”

Cliff Butler, alias the Polish Man, No. 46, lived a few doors away. One day he emerged from his room, stooped and solitary, pushing his bicycle toward the elevator. His face was hidden behind shades, his body swallowed by a big green Army jacket.

“Your angry, hostile and threatening behavior can no longer be tolerated,” read a letter ejecting him from Project 50. He had launched into a frightening hour-long tirade at the clinic and left only after staffers threatened to call the police. He’d be allowed to keep his apartment -- his benefits would pay for it -- but he’d have to steer clear of the Project 50 office. “I got fired,” muttered Butler, a longtime crack cocaine addict. “That’s the realest thing I ever had in my life, and they took it away from me.”

As he headed to the front door, the building manager, Bryant Caver, spotted him. “We need to talk to you,” he said. Butler was four months and $1,000 behind on rent, in danger of eviction.

A young woman with the Skid Row Housing Trust introduced herself as his new caseworker. What did he need? Medical help? Dental? She was unfamiliar with the name he kept mumbling, Carrie Bach.

Butler hadn’t seen Bach in a year but thought about her every day. She’d begged him to stay away from the big rigs behind Central Avenue and all the quick, smokeable money he earned polishing them. He’d tried, and for a while he believed he just might save himself. But lately he’d been climbing on the trucks again.

To escape the conversation with the caseworker, Butler made an appointment with her and promised to keep it. Then he wheeled his bike to the sidewalk. He did not care to pay rent, he explained, and did not worry about being evicted. He had lived on the streets for decades; he could live there again.

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