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"So much hardship, so much grace" is the title of The Plain Dealer story of the life of Juanita Serrano, who died on 5 March 2008, at the age of 77.  The Trustees and staff members of MHS extend their condolences to her family.

Ms Serrano was an intake worker for MHS homeless assistance programs in the mid 1990's. She brought to her work with homeless persons the same compassion, insight, and energy described in The Plain Dealer's story of her life. In that article, she is quoted as once saying "I get a lot of joy out of helping people. I like to give people hope, encouragement and support and let them know that someone cares."

Born in Puerto Rico, she moved to Miami with her husband and five sons in the 1950's. She gave birth to two more boys in Miami. After moving to Cleveland in 1964, her husband left her and their children. In addition to raising her sons, she became an effective community activist, creating a support group for single mothers, serving as a Trustee of several community organizations, and helping to found two HIspanic Catholic churches. MHS is honored that she chose to work with us.

Reference

Baranick, Alana. (2008, April 14). So much hardship, so much grace. Activist rose above circumstances to lead other single mothers. Cleveland, OH: The Plain Dealer, p. B8. (The title of the online version of the article is "Juanita Serrano: 'The voice of the community'.") Retrieve the article from Cleveland.com. (Articles are available without charge for a limited time.)

Read her death notice in The Plain Dealer.

"There is a nascent crisis building," says Professor Chris Barrett of Cornell University, in food assistance for vulnerable people in the U.S. The crisis is the result of a steep increase in the demand for food for people in need, plummeting supplies of surplus food, and rising food costs. The nation's housing and economic crises have led more people to seek food assistance, many for the first time in their lives. Supplies of surplus food have markedly dropped as the weaker U.S. dollar increases the demand for food exports from the U.S., and as larger amounts of corn are being diverted from feeding people to feeding automobiles and trucks that require alternative fuels. Food costs have risen because of the export-driven increase in demand, as well as the increase in the cost of fuels needed for food production, processing, distribution, and storage.

Charitable organizations that distribute food to hunger programs, such as the Cleveland Foodbank face an increased demand for increasingly scarce supplies of food. At the same time, MHS and other organizations that provide food for vulnerable people face rising client numbers and food costs in the face of cuts in funding.

The crisis in food assistance was reported in a story by Kris Maher in The Wall Street Journal of Thursday, 20 March 2008.

The article notes that "A big hit to food banks has come from cuts in fresh produce and canned food supplied through the U.S. Department of Agriculture's surplus-commodity program, designed to help farmers. Such donations dropped to $58 million worth of food last year from $242 million four years ago." At the same time, "demand is up more than 20% from a year ago," said Ross Fraser of America's Second Harvest, the nation's largest charitable hunger-relief organization.

The impact on MHS.

MHS has felt the impact of the food assistance crisis, as we provide meals for more than 2,000 homeless adults and children of our Emergency Shelter for Disabled Men, our Community Women's Shelter, and our SPOT Supportive Services program each year. Our annual costs for these meals rose from $127,272 in 2006, to $134,541 in 2007, an increase of 6%. Funding from some sources has remained stable from year to year, but the purchasing power of these funds declines inexorably from year to year in the absence of cost-of-living adjustments. Funding from other sources has declined because of eroding tax revenues going to local and state governments.

Reference

Maher, Kris (2008, March 20). A run on banks: Food charities feel the pinch. The Wall Street Journal, pp. A1 & A16. Retrieved 21 March 2008 from
http://online.wsj.com/article/SB120597773713950721.html   View a preview of the article.

We thank Donna Pfister (at right) of our fiscal services department, for swiftly retrieving the MHS food cost data presented here.

Columnist Regina Brett once more wrote of suicide in The Plain Dealer of Sunday, 9 March. Her cousin alerted her to a story of 13 February on cleveland.com:

"Cedar Road motorists, including children being driven to school, saw a body hanging from a tree near Legacy Village [a shopping center]. A white male apparently killed himself. One woman who saw the police cars, an ambulance and the body described the scene. It 'looked so lonely and sad.'"

"Within the hour, the online jokes started," writes Ms Brett, of the readers who wrote responses to the story. Then, she writes, "the blamers chimed in," calling the victim "selfish," and his suicidal act "mean-spirited."

Later, the victim's siblings responded, explaining "He was my tender-hearted brother who has been battling drug and alcohol demons all of his adult life." Another sibling wrote: "We know that your comments are based on ignorance, and truthfully pray that you can continue to live life without having such personal tragedy touch you. If you think this type of thing cannot happen to you, think again. This disease knows no boundaries and has no compassion."

"If you are thinking of killing yourself," writes Ms Brett, "call the Cuyahoga County Mobile Crisis Team at 216-623-6888 or the national suicide prevention lifeline at 1-800-273-8255. Depression can be fatal. It doesn't always have to be."

MHS has played a leading role in the Cuyahoga County Community Mental Health Board's Suicide Awareness Prevention campaign. The number of suicidal callers to the MHS Mobile Crisis Team increased since the public information campaign begain in February 2005. Click here to review preliminary data.

Reference

Brett, Regina (2008, March 9). Suicide: The end of a real disease. (The title of the online column is: Suicide is result of depression, not cowardice.) Cleveland, OH: The Plain Dealer, p. B1. Retrieve the article from Cleveland.com. (Articles are available without charge for a limited time.)

Of related interest, read about Regina Brett's columns of 16 and 18 March 2007.

The work of Joseph's Home to help homeless men "reshape their lives" through weekly art classes was reported in a story in The Plain Dealer of Sunday, 9 March 2008.

Joseph's Home is an 11-bed facility on Community College Avenue in Cleveland, Ohio, housing men with serious medical illnesses who had been homeless. Executive Director Georgette Jackson said "the program is part of an effort to incorporate art therapy and book club meetings into the normal regimen the men undertake as they try to reshape their lives."

"Our men normally have limited exposure to ways to express themselves," said Jackson.

William Denihan, Chief Executive Officer of the Cuyahoga County Community Mental Health Board, is an instructor for the art class. Denihan, at left in The Plain Dealer photograph above, talks with resident Anthony Jenkins about the use of background colors for an art project. "This class gives them confidence, and you can see it on their faces every time they finish a painting," said Denihan.

Jenkins, recovering from a broken hip and "battles with alcohol," said "Before I moved here, I was at a point where I just stopped caring. I'm trying to put the pieces back together now, and this class is helping me."

MHS salutes Mr. Jenkins, Joseph's Home, and Chief Denihan!

Reference

Donaldson, Stan (2008, March 9). Homeless man: 'I like this painting thing' Joseph's Home art classes help reshape lives. Cleveland, OH: The Plain Dealer, p. B3. Retrieve the article from Cleveland.com. (Articles are available without charge for a limited time.)

Related story: The Art of the Homeless, a story about an art exhibit featuring the works of 11 residents of the MHS Community Women’s Shelter. Click here to see the slideshow produced by The Plain Dealer, and to hear the artists tell their stories.

Quickly moving homeless people with disabling medical illnesses into housing with supportive services helps them, and saves communities money, according to results of a rigorous study conducted in Chicago. The study results are consistent with the principal claim of the "Housing First" service model that the best way to end homelessness is to make housing the first priority, then to provide individualized services that address the problems that had resulted in the person becoming homeless. The more traditional approach to ending homelessness is to work on recovery and self-sufficiency first, then obtain housing.

The study was reported in a story by Joe Barrett in The Wall Street Journal of Thursday, 6 March 2008.

Called the Chicago Housing for Health Partnership, or CHHP, the study recruited homeless people who had been admitted to any of three hospitals in Chicago. All participants had a chronic medical illness, such as HIV/AIDS, hypertension, or heart or liver problems, and some also had alcohol- or drug-use disorders or mental illnesses. Participants were randomly assigned to the "housing-first" group, or the "usual-care" group. The housing-first group were immediately offered housing, and provided with intensive services coordinated by a case manager. The usual-care group were provided with a broad range of services (e.g., shelter, healthcare, case management) from a variety of community providers. There were 201 in the housing-first group, and 206 in the usual-care group. Researchers collected data on every service (e.g., case management, emergency room, hospital admission, nursing home admission) received by individuals in both groups for an 18-month period.

Housing-First services cost significantly less.

At the end of the 18 months, 60% of those assigned to the housing-first group were living in an apartment or other permanent housing, compared with only 15% of those in the usual-care group. As shown in the Wall Street Journal chart below, the total cost of all services (including housing) provided to those in the housing-first group during the 18-month study period was about $1.3 million less than the cost of services provided to those in the usual-care group. For example, housing-first individuals spent 5,500 days in nursing homes, compared with more than 10,000 days for usual-care individuals. The savings in nursing home costs for the housing-first group was nearly $500,000.

The average annual total cost of care for a person in the usual-care group ($22,330) was $4,088 more than the cost for a person in the housing-first group ($18,242). Philip Mangano, who was appointed in 2002 to lead the U.S. Interagency Council on Homelessness, concluded that "The old status quo responses of ad hoc crisis intervention are more expensive."

Two Seattle studies also find savings with housing-first services.

Similar results were found in two studies of the Housing First initiative in Seattle, Washington. These studies examined costs of healthcare services (including emergency room, inpatient, and detoxification) in addition to jail services in 117 chronically homeless persons with mental illnesses, addictions, and physical disabilities who were provided with housing-first services at two permanent housing sites: "Plymouth on Stewart," and "1811 Eastlake." Total service costs for the year following enrollment in housing-first services were $3.2 million less than costs for the year prior to enrollment, when participants had been homeless. The table below shows outcomes from the Plymouth on Stewart site.

A controversy about alcohol consumption.

The news advisory notes that "there was much controversy over the fact that residents were allowed to consume alcohol in their homes at 1811. However, since moving in, 1811 residents have reported a one-third reduction in days spent drinking to intoxication, and researchers found an almost total elimination of the use of the sobering center by the building’s residents, a decline of more than 5,000 visits per year."

Housing First in Cuyahoga County.

Locally, the Housing First Initiative was created in November 2001, when the Sisters of Charity Foundation of Cleveland, the Enterprise Foundation, and the Cleveland and Cuyahoga County Office of Homeless Services convened 17 housing and service providers to develop a strategy to end long-term homelessness in Cuyahoga County. This Initiative was instrumental in the creation of the County's Housing First projects, including Emerald Commons, Downtown Superior Apartments, and Liberty Commons at St. Clair. In the autumn of 2008, MHS will open another Housing First program, Southpointe Commons, with its 82 permanent housing units.

References

Barrett, Joe (2008, March 6). Homeless study looks at "Housing First." Shifting policies to get chronically ill in homes may save lives, money. The Wall Street Journal, p. A10. Retrieved 7 March 2008 from http://online.wsj.com/article/SB120477350786615859.html   View a preview of the article.

Nickels, Gregory J. (2008, January 9). "Housing First" approach to homelessness brings hope to hard lives. Two studies show once-controversial projects are helping save lives and money. News advisory, City of Seattle, Washington, USA. Retrieved 10 March 2008 from http://www.ci.seattle.wa.us/news/detail.asp?ID=8078&Dept=40   Read the news advisory.

The efforts of MHS outreach workers to help Cuyahoga County conduct a census of homeless persons were featured in a story in The Plain Dealer of Thursday, 31 January 2008.

An annual, point-in-time count of homeless individuals in Cuyahoga County, Ohio, has been conducted by the Cleveland and Cuyahoga County Office of Homeless Services (OHS), since 2003. OHS Director Ruth Gillett, and Program Officer Rosemary Hozdic direct the annual survey, enlisting outreach workers from MHS and other local homeless assistance providers. Last year's count, taken on 28 January 2007, revealed a total of 2,185 homeless people in Cuyahoga County. Of those, 474 had a severe mental illness, and 1,140 had a chronic substance use disorder. The number of Cuyahoga County individuals who are homeless at any time during the year has been estimated at 21,811, of whom 8,070 are believe to have a severe mental illness.

Anthony Constantino and Reggie Williams of the MHS PATH homeless outreach program "made the rounds of bridges and vacant lots" to complete this year's count. Christine Couture, an Associate Director of Homeless Assistance Services at MHS told reporters that clients served by the PATH program "represent the roughly 17 percent of Cleveland's homeless with post-traumatic stress disorder, schizophrenia, major depression, psychosis, and other mental disorders."

Reference

Donaldson, S. & Albrecht, B. (2008, January 31). Local census seeks count, conditions of homeless. Cleveland, OH: The Plain Dealer, pp. B1 & B5. Retrieve the article from Cleveland.com. (Articles are available without charge for a limited time.)

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