A Growing Disconnect
We walk by people living on the street daily, thinking nothing of it. Maybe there’s a touch of guilt; you give a dollar, some water, or advice, but most times an offering is paid in pity rather than humanity. The views of, “Pull yourself up by your bootstraps,” and, “Get a job,” do little to help social advancement – often all they do is propagate the destructive rhetoric that people are homeless due to personal choice. In reality, more Americans live closer to the edge than are willing to acknowledge; only 48% of Americans have enough cash set aside to last three months (Kinish 2023). The subconscious fear of losing control pushes people to demonize those who have. A society with the unprecedented wealth of The United States should not have to be so concerned with homelessness, yet it is. But perhaps that is why so many upper-class Americans brush it aside. It was easy for them, so why is it not easy for everyone? This severed world view of many organizational leaders and policy makers has created an environment where solutions are effectively siloed, and collaborative efforts are logistically improbable. If we are to progress as a society, we must acknowledge and combat the lobotomized view we currently hold so that we can work together to introduce solutions based in equity and compassion.
A cognitively developed society resembles a high-functioning brain; the various parts quickly communicate with each other and contribute to the brain’s overall function despite being independent of each other. Conversely, a brain functioning below its capacity does not communicate well with itself – neurons fire slower, tasks take longer, memory is impaired, and critical thinking skills drastically decrease. Of course, homelessness support systems, like the brain, are infinitely more complex than the introductory and surface level sentences I’ve provided but thinking about it in this way serves as a baseline for thinking about the interconnectedness of the systemic issues plaguing the United States. It’s illogical to distill a social issue like homelessness to ‘poor personal choice’ or ‘drug use’, yet it’s also unfair to blame ‘the system at large’, or ‘capitalism’. The roots of chronic homelessness run deeper than it initially appears, and the symptoms which sprout from those roots have taken a considerable position in the American zeitgeist. Nobody wants to sleep on a park bench in the winter. Nobody wants to be a drug addict. Nobody wants to die alone in the street. Yet they do. But why? And what, if anything, can be done to help?
Government – Local and National
74% of Americans said that homelessness was a somewhat/very serious problem in their state in 2023. That study, conducted by the Bipartisan Policy Center (2023), surveyed 2,200 American adults about the severity of homelessness in their city, state, and country. Of that, 53% of respondents said that it should be ‘a top priority’, “…for the federal government to help ensure that everyone has access to a safe and affordable place to live.” 48% of that same group said that local governments should be doing ‘much more’ to reduce homelessness. It seems clear why so many people are concerned: the Department of Housing and Urban Development (HUD 2023) estimates that there are 653,104 people experiencing homelessness in the United States which is up from ~582,000 in 2022 and ~553,000 in 2017.
That’s not to say there have not been efforts to help the so-called ‘lower class’. As a response to the effects of the pandemic, the American Rescue Plan was signed into law on Mar. 11, 2021. The $1.9 trillion bill provided $130.2 billion to various governmental partners which would be distributed to city and state governments. Other organizations had been funded in the past, but they did not see much success. The United States Interagency Council on Homelessness (USICH) was authorized by Congress in 1987 but was shortly thereafter disbanded. It was reauthorized by the 2009 HEARTH Act, and it was the only federal agency tasked with ending homelessness until 2022. That was until the Biden-Harris administration unveiled their 2022 plan, ‘All In’, which is a collaborative effort between USICH and 19 other federal agencies. Then, they doubled down on Jan. 29, 2024, and the HUD announced $3.16bn in assistance for homelessness assistance for over 7,000 national projects. All In set the goal to reduce homelessness in the United States by 25% by the end of 2025 (USICH 2024), but, as has already been noted, it has not yet seen those results.
La Crosse County in Wisconsin has been struggling with homelessness for the past decade, and they are in the process of reorganizing their homelessness action plan, too. The problems they faced were only amplified during the pandemic. In 2019-20, the Coulee Collaborative to End Homelessness was created in La Crosse to work towards a ‘Functional Zero’. The initiative was extremely successful in the first two years – a 46% decrease, but then the COVID-19 pandemic sent shockwaves throughout all systems. The Institute for Community Alliances collects data from regional coalitions in the Midwest, and in 2022, there were 264 individuals homeless in the Coulee region during their point in time count. That number was down drastically to 136 in 2023, and it is poised to continue dropping (ICA 2024). It is important to note that point in time counts is not always the most reliable and the margin for error is rather high. La Crosse has been historically progressive with their policy, and the community is known for its generosity in donation and service. However, during their homelessness epidemic, there have been several tent cities and parks designated as encampments, and the issue did not seem to reflect the Institute for Community Alliances’ data or the history of La Crosse.
Mac Kiel is La Crosse’s City Council District 7 representative, and she has been working with at-risk populations for most of her career. She worked with kids at the Boys and Girls Club at Viterbo for 10 years, and she said, “I just kind of gravitated to the issue of homelessness in La Crosse.” She said that each city council member has their area of focus and described hers as, “…making sure that those at-risk have their voices heard.” Being a city council member, Kiel logically has more of a say on homeless policy and she is able to vote on proposals in the county.
One of the city council votes with a profound effect on those at-risk population was their striking down of a rezoning request by an organization called the REACH Center. REACH will be covered further in the coming sections, but simplified, REACH is a ‘homeless hub’ which offers walk in services. They had hoped to rezone to Traditional Neighborhood District zoning, which would have allowed them to add dental care and solar panels while improving accessibility. A supermajority vote of three-fourths was required to pass the rezoning because 20% of residents filed an objection against the city, but the first vote fell one vote short. Kiel argues her case, saying, “That not only affects the homeless population, but other very at-risk people.” In a display of politics, city council voted to remove housing owners’ ability to influence policy decisions through objection less than a month later, and the group will be attempting to retry the vote, only needing a simple majority for it to pass.
Governmental decisions regarding homelessness have reached the Supreme Court as well, in the case of Grants Pass v. Johnson. Here are the case facts. Grants Pass, a city in Oregon, has been dealing with a rather severe homeless problem for years; per capita, they have one of the largest homeless populations in the country. The city of 40,000 has 600 homeless, and there are no shelters for them to stay at. At the same time, Grants Pass instated city ordinances to punish people for sleeping outside, a decision many have viewed as unconstitutional. A group of the city’s homeless population formed a class action lawsuit against Grants Pass, citing their perceived breach of the Eighth Amendment right regarding cruel and unusual punishment. On June 28, 2024, the Supreme Court decided that Grants Pass was not violating the Eighth Amendment, justifying their punishment for public campers. The implications of criminalizing homelessness may be immense, creating a positive feedback loop where people are fined for being homeless, which leads to fines or jail time, which of course only adds more barriers to societal reentry (Vaughan 2024).
La Crosse is trying to avoid becoming comparable to Grants Pass, and they took another step forward in homelessness policy in early 2024, founding the ‘Pathways Home’ framework and setting the goal of having functionally zero unsheltered in La Crosse by 2029 (La Crosse County 2024). Kiel has strong faith in the plan, saying, “The shift in this Pathways Home plan that I’ve loved so much is that there will be… meetings of cross collaborations, so city, county and all of the nonprofits.” These cross-collaborative meetings align services within segments of homeless care and should ease the stress caused by years of independent solutions. Kiel continued, “There’s a lot of people that want to help fix this problem, but it’s so many different pockets [of people] doing it in so many different ways that coming together with a plan like this I feel like is going to be huge.” She claims, “It’s going to be more streamlined. It’s going to be more intentional… It’s less repetitive.”
As of August 2024, there has been little formal local government intervention, which Kiel says is because, “They’re still in the phase of building the list and planning what the actual needs are.” Once enough data is gathered, more informed decisions can hopefully be made on an individual or systemic basis. For example, if a single family is on the street, organizations can help them, but if half of the homeless population is families, organizations cannot help everyone, so more intentional support is needed for that group. Ideally, the data should be able to show where resources need to be allocated for the most efficient collaboration of groups involved.
Kiel is a proponent of ‘Housing First’ which is one of the founding principles of Pathways Home. She said a key to success is, “Getting them the housing [and] the rest will come.” That doesn’t mean that those who are formerly unsheltered should be expected to immediately succeed once housed: that would lead to more issues, like immediate eviction and, again, more barriers. Kiel elaborated, “We’re not asking you to get clean, have a job, do all of this while maintaining a house. We’re asking you just do this first and then we’ll support you.” Housing First has several supporters across sectors and parties, and 79% of people receiving housing first remained stably housed at the end of six months of the program (NLIHC 2024). But then the issue becomes funding; it’s hard to see homeless policy as a one-time investment per person, and because of that, funds are more spread out over time and are not adequate for sustained success. Systemically functioning policy is difficult, and many policymakers approach it from the lens of perfection-seeking. Kiel rebuts that position, saying, “When we’re building systems, it’s so easy to poke holes in [it]… [we make policy] for the 80-90% that it’s really going to help and impact.” She knows that every system has the potential for exploitation, but she says, “There’s still people that take advantage of the system, but we can’t build a system or policies based on that small percentage.” In most cases involving homelessness, any funding is good funding, and some policy is better than none. While the eventual goal in the city is functional zero – when homelessness is brief, rare, and shelters are below capacity (LA County 2024) – it is unlikely, if not impossible, to eliminate homelessness in every case. Kiel laments, “There’s really no solution that’s going to fix everything which is hard to grasp because it feels like that’s what we keep pulling for.”
She continued, “I understand that there’s lots of people with skepticism because they’ve been presented plans before that went nowhere.” Finding the right solution will be a collaborative effort, and it is now up to the community to rally together under one plan. “It’s hard because we all want the same thing… And that’s the hardest thing is trying to figure out a lens to talk to other people,” Kiel said. There are still several years left to determine the efficacy of the plan, but Kiel has high expectations, stressing, “I just have so much confidence that this plan is going to work, I am just worried about the community buy in.”
NGO Involvement
An essential factor in homeless care is the private philanthropic organizations that lead and develop collaboration on all levels. Nonprofits were 68.2% of all homeless organizations in 2012, eclipsing the public sector by 47.3%, and they take up the leading role in most action plans according to Valero & Jang (2016). Nationwide, Community Solutions is one of those organizations, and in 2010, they started the 100,000 Homes Campaign which, as the name suggests, was a project to provide 100,000 homeless people housing. The project was built around the housing first methodology, which was alluded to earlier and can be loosely defined as a homelessness solution which, “Provides unconditional and permanent housing as quickly as possible,” (Delancey 2022). This solution contrasts ‘treatment first’ which promotes treatment compliance on the street before housing is offered. Community Solutions has continued to work with the homeless population with their Built for Zero initiative, an initiative which now involves 105 communities.
The organizations serving homeless populations in La Crosse have become deeply involved in the populations they serve. Karla Hein is one of those organizational leaders, and she is the coordinator of the Catholic Charities Warming Center in La Crosse. The Warming Center is open from November 1 through April 30, and they housed over 300 people in the 2023-24 winter. Hein is a convicted felon – a fact she claims boosts her ‘street cred’ and improves her knowledge of systemic barriers. “I’m not proud of it, but guess what? I didn’t let it keep me down, because I’ve had the door slammed in my face,” Hein said. She told a story of when she was looking to be pardoned after 18 years of sobriety and social service and she needed to go to the County Clerk’s Office. “The second I said ‘felon’, the woman treated me like a piece of absolute garbage… [sometimes] I forget that this is what our guests go through every day.”
Hein described her personal low when she was an alcoholic and prepared to die at 30, a feeling she compared with what many of her guests go through. She said, “I think truly, if you ask our guests, I’d guess 90% of them feel the same way – that they’re just going to ride or die.” This ‘ride or die’ mentality is clearly impaired thinking, but it feels totally rational in the moment. Hein described many situations that can lead to many homeless individual’s struggles with paranoia, disillusion, and anger, saying, “Behind [those emotions] is the ten people calling you to move along, saying you’re not welcome here. You have no place to use the bathroom… Nobody wants you to use their facilities.” Witnessing those in a deep hole struggle is hard for Hein, but she understands it, saying, “For a lot of our guests, they either don’t think there’s better or they have convinced themselves that their okay with their situation… However, I understand that a when you’ve been told, ‘No, we won’t rent to you,’ 57 times, you have no money, you have no support system, and your best friend who’s out in the street just stole everything from you… that becomes pretty insurmountable.”
Hein mentioned compassion from several Warming Center employees as crucial to valid service, highlighting, “…people who see our clients and say I see you today… I see your potential… That’s the first thing that has to be seen.” Employees role at the Warming Center extends beyond employees seeing their clients as people – clients can see themselves in the employees. Many of the staff members are from traditionally underrepresented groups, as are many of their clients. Hein said that is a benefit to the Warming Center, saying, “Our guests need to come in and say, ‘I see me in the people working here.’ That’s huge.”
Hein described an interesting solution that an organization in Montana has been using to combat drug use with positive reinforcement and ‘contingency management’. A branch of treatment first, contingency management is being explored by more cities and organizations in the U.S. The Rimrock Foundation in Montana has been offering small, $5-$10, gift cards to their clients who provide clean urine tests. While it may sound impractical at first, there is research verifying its effectiveness. A study in Los Angeles found a 20.3% increase in negative methamphetamine tests for patients in the contingency management program (Blades et al. 2023) and the Veterans Health Administration has had 92% of their 88,000 urine tests come back clean for those in the same program (Cheng 2024). In Brown and DeFulio’s (2020) systematic review of contingency management, they found that while 26/27 studies decreased methamphetamine use, the cost of the programs is still not fully feasible. There is a $75 annual limit that the Department of Health and Human Services imposes per client for receiving grants, but the most effective programs had a cost closer to $600 over a 12-week period. There are also questions about the long-term effectiveness of contingency management – opponents argue that post-payment, grant recipients are likely to relapse and the social cost of temporary drug abstinence would not be worth it. Substantial long-term studies are yet to be published, but conceptually, contingency management seems scientifically backed and reasonable.
Hein has found ways to positively reinforce the Warming Center’s guests without the significant funding, saying, “For me personally, it’s tiny things… If someone cleans up their table after themselves, I’ll say, ‘That was really awesome.’” She went on to say, “[Our clients like when] people see that they’re making an effort and they’re getting an instant reward.” Instant rewards may be extremely effective as motivation for many experiencing homelessness because of the time dilation that the feel in the streets. Many would not expect time to feel different when a person is homeless, but Hein said, “Our guests will get 10-day bans for misbehavior… [and many] come back the next day.” That shortened ‘time horizon’ has a significant impact on how people operate, and it is a largely unnoticed, difficult to quantify barrier when working with homeless populations. Hein said, “’See you next Thursday at noon means nothing to our guests.” Van Doorn (2010) corroborates Hein’s claims, finding that when people become homeless, they are more apt to day-by-day living instead of planning for their future.
The Warming Shelter can house 34 people on an average night, but during days where nights fall below 15 degrees, they can house an excess population, up to 44 people. She went on to mention how the warming shelter will often take in people right from the jail or prison, saying, “It is also usually the toughest clients that we get because Salvation Army won’t take [sex offending] felons.” Despite not taking all clients, the Salvation Army is still quite active in La Crosse, offering services in shelter, food distribution and case management. Their shelter location has 64 beds, and on the north side of La Crosse they have a thrift store which helps fund the shelter.
Katlyn Becker works as a case manager with the Salvation Army, and she has a history in drug counselling. She is part of an integrated group that works in case management together called TNT, or Total Navigation Team. At TNT, different specialists from shelters, organizations, school districts, and the city come together to discuss solutions for people who come together for consultation. People afflicted with homelessness or homeless adjacent circumstances can walk in on a TNT Tuesday and receive case management from individual members of the group. Once the initial meeting is done and a line of communication is formed, members of TNT return to the group to discuss the best solutions for that person. Becker highlighted that the new methodology has been successful thus far in better addressing individual needs, saying, “In the past [before TNT] it was like, ‘okay, you’re number 238 on the list,’ versus now they look at barriers.”
TNT is hosted at REACH, the walk-in center for low income and homeless services that was previously mentioned. REACH is a collaborative effort between six local partners, and it was formed as part of La Crosse’s 2019-20 Coulee Collaborative to End Homelessness. Those partners – Catholic Charities, Couleecap, Independent Living Resources, New Horizons Shelter and Outreach Services, Salvation Army, and YWCA La Crosse – each offer a unique lens and set of skills which serve the purpose to, as their website says, “Provide a centralized ‘hub’ for those who are homeless, at risk of homelessness, or in other need of nonprofit services,” (REACH 2024). Some health care services are in the REACH Center too. Michael Fitzpatrick, another member of TNT, said, “It’s very moldable and it helps the people where they’re at to eliminate that huge fear of medical systems.”
Other health and ground level case management service providers have formed groups that address the issue with the people facing it. A Street Med Team and a Homeless Outreach Team both go out on Wednesday’s, and they have served hundreds of people in encampments over the past two years. The impact of these projects is being felt on a citywide scale, and councilwoman Kiel said she often brings her experiences there to city council discussions. She said, “Going out with the H.O.T. team has helped educate me a lot and them be able to educate everyone else on what’s actually happening out there.” She elaborated, “I’m big on stories, and how people’s stories can help inform others, because there’s a lot of misconceptions about the homeless.” The collaboration necessary for successful policy is seen clearly with nonprofits, especially on the ground level. Michael Fitzpatrick is one of the organizers of the H.O.T. and was an active homeless outreach specialist with Independent Living Resources (ILR). ILR’s foundational principle is that they work with and not for at-risk populations, a fundamental distinction from several other organizations. He said of the different organizations in La Crosse, “We’re all eyes and ears for each other which is the beautiful thing about outreach.” Fitzpatrick said, “One of the biggest parts of outreach is just building relationships… and building that trust.” To succeed, that trust must be formed between all groups, nonprofit to nonprofit, and nonprofit to homeless.
The success of the H.O.T has mirrored the approach Pathways Home is looking to take – collaboration on a grand scale, and they have successfully grown to where they can actively serve needs past boundaries. Fitzpatrick said, “Before COVID, there were only two outreach workers in the community, and they were really all on their own. Like they didn’t have people and didn’t have a crew.” Now, groups from several organizations come together every week to provide basic needs, case management, and health care to La Crosse’s homeless population.
Healthcare: Mental and Physical
A person experiencing chronic homelessness has a life expectancy of only 48 years, compared to the average American which is 76 years. So, why are they expected to live almost 30 years less than average? There are multiple reasons.
1. 38% of homeless people abuse alcohol and 26% abuse drugs (SAMHSA 2024).
2. Over 25% of homeless people have a serious mental illness, i.e., schizophrenia, bipolar disorder, major depression, and/or PTSD (Padgett 2020).
3. The consistent sleep insecurity of living on the streets or in shelters impacts daily function, productivity, etc., and it is directly correlated with heart disease, diabetes, and depression (Gonzalez & Tyminski 2020).
But, as we’ve said previously, simplifying those issues into bullet points is a disservice without proper context, so they must be analyzed through the lens of someone who has worked in homeless health care for almost 20 years.
Sandra ‘Sandy’ Brekke works in population health with the Gundersen Health System, and she is the former Executive Director at St. Clare Health Mission. She has seen firsthand the effects listed above and through her own research, she has developed a profound understanding of homelessness health care. “I started pulling a bunch of data across the system,” she said, “and I started seeing intersections between high utilizers of our emergency systems – high readmission rates – I kept running into people who were unhoused.” Morrison (2009) backed her claims, finding significantly higher mortality rates within the homeless population, including a “7-fold increase in risk of death from drugs compared with the general population.” Brekke realized, “So, if you take away everything else, gender, you know [other variables], homelessness itself is the independent risk factor.” While there are several other factors which play a role in the creation of homelessness, Brekke says homelessness itself is the cause behind many undesirable outcomes.
One of the most prevalent and most examined outcomes is drug abuse. As previously mentioned, the drug abuse rates amongst homeless populations are much higher than in stable situations. The H.O.T. often disposes of dirty needles, they provide Narcan to people on the streets, and they help people work towards sobriety. Interestingly, the road towards sobriety is often paved with positive social interactions. Venniro et al. (2018) examined the effects of drug use within a rat population, providing methamphetamine, food, and social rewards for pressing a lever. At the end of a trial period, they isolated the rats without methamphetamine for fifteen days to simulate withdrawal. Then, they brought the rats into different trials in two different experiments. Regardless of experiment, the rats would choose positive social interaction with other rats to the drug options. The scientists concluded that offering a social reward acted as a positive motivator in abstaining from drug use.
In La Crosse, Brekke and other health care providers have taken similar approaches, building trust within the community she serves. She said, “We’re super open with people who are struggling with substance use disorder, like to the extent that when fentanyl test strips came out, people brought their drugs to us and let us test their drugs with them…That takes trust.” Many would argue that providing test strips to drug users is incentivizing drug use, but it is more accurately categorized as ‘harm reduction’. Logically, since the drugs were already going to be used, it would only serve to benefit the user to know if they were safe or not. A further logical extension would be to setup safe injection sites (Peltz 2022), which have saved hundreds of lives, but is implementation of such facilities feasible with the current stigmatized view of drug use in the United States?
It would take a dramatic overhaul to our current thought systems, reframing drug abusers as victims instead of perpetrators. But as Michael Fitzpatrick argues, “Nobody would choose to go that deep into their addiction.” And as Brekke says, “It’s so rare that somebody that has been struggling with an addiction doesn’t also either have mental health or trauma issues with it.” She said, “I just talked to a guy yesterday who’s been three days sober, and my first question is, ‘What are your thoughts like?’ and it’s always a bad place. And you realized [their addiction] is an escape from pain.” Vilifying people and forcing complete abstinence immediately is not a viable solution. Brekke said, “[After treatment] they’re just going to continue because there is so much pain… Drugs are the symptom; what’s underneath?”
What has proven to work is harm reduction. The little steps. Fitzpatrick said, “If somebody went from smoking heroin to smoking weed, that’s incredible and that should be celebrated.” Yes, ideally there would be no drug use in a perfect society, but if drug use is going to happen and it can be safer, it should be. The National Harm Reduction Coalition (2024) promotes, believe it or not, harm reduction, saying that it is about, “Meeting people where they are, but not leaving them there.” Des Jarlais (2017) found that harm reduction through syringe exchange programs provide more humanitarian solutions while also lowering rates of bloodborne illness spread and overdose.
Brekke addressed sleep insecurity as another defining factor when accompanied with other struggles. She said, “We don’t think about lack of sleep. Nobody sleeps well in the shelter… These are the components of overall wellness that someone needs when they’re going into recovery.” Unfortunately, not everyone currently has access to all of the necessities, making it even harder to focus on sobriety, and by extension employment, societal integration, housing, etc. Being in the constant fog of sleeplessness makes the next steps hard to see, and people often end up living through survival instincts rather than through strategy. Brekke also argues for a housing first model, saying, “You’ve got to get them off the streets… I don’t know that I’ve ever worked with anybody who we’ve been able to help get sober on the streets and maintain sobriety.”
Housing Conflicts and Resolutions
73% of extremely low-income renters routinely spend more than half of their income on rent, posing the ever-looming threat of eviction (NLIHC 2023).
But at the same time, the housing market has never been as oversaturated and underpopulated as it is right now. There are approximately 15.1 million vacant houses in the United States in 2024, an astounding 10.5% of the total housing market (HR News 2024). Squatters’ rights now come into question because, well, if no one is using the space… after how long does private property become public? In New York, if a squatter has been living in a home for 30 days, they obtain tenant rights and cannot be removed without a court ordered eviction notice, which is perhaps a bit presumptuous. Squatters are then given the benefit of the doubt and are housed until their court order is served which is usually months later. Now, going around and squatting at different abandoned properties is not ethical to do, of course, but if 15.1 million homes are really vacant, how hard can it be to house 650,000 people?
The primary crisis response system used for homeless support is coordinated entry and the assessments help categorize needs on an individual level, but many times it is harder to find housing for people that the numbers suggest. Kiel described the struggle of finding low-income housing as a city, saying, “We don’t have the money as a city to do that on our own and yet a developer comes in and they also have to make money, right? We need more money from, and more support from, federal and state to funnel money to cities to be able to offer those things.” There was some bailout money from the American Rescue Plan in the form of $700,000 to rent La Crosse’s EconoLodge hotel for temporary housing.
During COVID, there was a program offered called ‘WERA’, or Wisconsin Emergency Rental Assistance. The program could pay a first month’s rent and security deposit for housing, and it could pay an additional 18 months of rent for individuals that qualified within specific income guidelines. Fitzpatrick said, “Everybody applied, same story, and then we’re out of funding… So, it had a really great purpose but there also wasn’t a lot of requirements around it.” Many hotels were also paid for with the funding, and Fitzpatrick said, “So, a lot of people shifted from being unsheltered into hotels, then what happened is the hotel owners caught wind, ‘Oh, I can put down whatever money I want.’” Ideally, though, hotels are a temporary step towards permanent housing, but there are several barriers limiting many homeless people from making the transition.
Given the spotty rental history of many unsheltered people, it makes financial sense why companies wouldn’t opt to rent their property to them. Fitzpatrick said, “It’s really difficult to find a place that’s affordable and also is willing to work with people.” La Crosse implemented a Landlord Mitigation Program to incentivize private investment in housing, meaning that landlords can receive up to $5,000 if a tenant damages the property or neglects payment, offering some insurance for renting to a higher incident-prone group. Many still avoid renting to people with lesser offenses. Fitzpatrick said, “I had somebody just denied for one of the housing authorities here and one of the reasons was criminal background, but the only criminal case they had, they had done a diversion agreement.” He recalls another story, “I had somebody who came to me with around 25 letters of recommendation, yet he was getting denied left and right.” There are also several other limitations posed by interaction with the justice system which prove cyclical, i.e., a person receives, say, a public intoxication charge, they go to jail for a day and forever alter their chances of finding housing. So, they stay homeless for longer and become more repressed, losing documentation, and falling victim to even more long term barriers of reentry.
Thankfully there are some locations willing to rent to the formerly homeless. One company that Fitzpatrick has helped house people in is Paramark Real Estate. He said, “They’re incredible and I’m really lucky to have the connection that I do with them over there.” He credits relationship building from all fronts as key to the success of his work, saying, “Building a relationship for me is not just with my clients but it’s also with property managers and rental companies.” Fitzpatrick hopes that there can be more investments into government-backed solutions, saying, “I’ve always said that I wish that tax credit housing would be something that our community really invests in, because it is an option. And we know that companies love tax breaks, right?” The La Crosse Housing Authority is one group that helps direct people to government-funded housing opportunities like these, and case managers help walk people through the programs. There is a mainstream housing voucher list, which operates like other programs such as Section 8; however, there is a limitation for funding recipients, barring everyone under 18 and over 61 from receiving services. Fitzpatrick said, “I had people that were 62 to 64 that could have benefited but they were unable to get in.”
Fitzpatrick also mentioned the friendships that people form on the street, and the negative effects that compassion may have, implying that people bring their friends into housing, even if for just a night. Fitzpatrick said, “If it’s 30 below and you know what it’s like out there, what are you doing?” Any compassionate person would bring their friends into their apartment, but that could potentially break a lease agreement and lead to eviction. Another hard part about maintaining housing for some is the continuation of care after housing. “As soon as somebody that experienced [homelessness/addiction], moves into housing, they take all of their problems and trauma with them,” Fitzpatrick said. Hein mentioned how difficult it is for many of The Warming Center’s guests to sustain housing at first, saying, “Our guests have these skill sets that we don’t have, but when they get into housing, they don’t know the basics; they haven’t had their own place.” She understands how much of an adjustment housing can be. She said, “There are people who are almost petrified, and once they get housing they don’t want to be there.”
But that doesn’t mean that it is futile to attempt housing if they believe that is the right next step. As has been repeatedly stated, finding housing before anything else is a viable approach for most, and the literature verifies those claims. Peng et al. (2020) found that Housing First programs perform significantly better than other approaches in addressing homeless needs. Their review of 26 studies found an 88% decrease in homelessness and a 41% increase in housing stability when compared to treatment first methods. Fitzpatrick said that everyone has the right to make their own decisions and that small improvements compound, “I always tell people, if you can give me 1% today, I’ll give 99%, and maybe tomorrow you’ll give me 2%.”
The People Beyond Our Characterization
There is no better source on homelessness than someone who is formerly homeless. Two La Crosse citizens were gracious enough to sit down for interviews – Cynthia and Jeremy. Cynthia had lived in Milwaukee before she lost her job. Then she became an alcoholic, and she moved to La Crosse in her car. Jeremy was wrongfully evicted, lost custody of his daughter for a year, and was outside in the winter. Both are now housed comfortably and soon; both will be living at Paramark.
Cynthia, or Cici as the likes to be called, became homeless after her job at a shelter in Milwaukee limited her hours during COVID. Cici said, “It all started from there, I couldn’t go to work, and they told me, ‘We’ll call you when we need you’, type of thing, and I’m wondering how I’m going to pay my rent.” Then, disaster struck when her first cousin, one she had worked with for over 20 years, overdosed on fentanyl. “Mentally, that’s when it came. I couldn’t sleep. I couldn’t eat. All I could do was drink and I lost my house,” Cynthia said. Working with the at-risk population herself, she found it darkly ironic that she would find herself in that situation, saying, “I would never in my life think I would be homeless because I’ve worked all my life.”
The rent payments caught up with her and she was evicted, and she turned to alcohol to cope. Cici said, “I owned my house for 22 years I never was a drinker in the first place.” And now, she was, so she packed her belongings into her car and drove from city to city, drinking away most nights and sleeping on people’s couches. When she reached out to her daughter, she turned away which sent Cici even further down her slide. She said, “I never would think my daughter would turn her back on me as much as I did for her.” She said, “That year when all of this happened, I actually lost my mind. I just had all kinds of things running through my head…I say it was just horrible. I really don’t mind talking about it [now] because all of the same people that I did this with are still doing the same thing.”
One of the first people she met in La Crosse was a woman named Miss Rossi. People in Cici’s life warned her about Miss Rossi by telling her how well they would get along – Rossi would drink every day. And they did get along well. Cici remembers, “I mean, fifths, we would drink, every day. Every single day.” One day, Rossi found out she had breast cancer, but she did not stop drinking. Cici reflected, “That made me feel bad. I had to say no: what am I doing?” So, she distanced herself, and a couple of weeks before Thanksgiving, Rossi died. Still wanting to feel connected to her friend, but in a healthier way, Cici found a plant that she named after her. She said, “It was just sitting outside in the rain and Miss Rossi loved the rain… She loved the rain.” The plant began to grow, and it has been with Cici since. She said, “And I say good morning, Miss Rossi, every morning to her.”
She eventually received a Section 8 voucher which meant she only has to pay 30% of her rent costs, and she moved into an apartment that now has a dozen or so plants. She recalls first moving into her apartment and meeting with Fitzpatrick for the first time, “I had nothing to sit on right away, so we sat on the floor.” Part of Cici’s success in her new housing was the relationships that she built with people from the outset. But being the only black woman in the whole building, she felt it may be tough initially to find people. She said, “It took a while for people to adjust… except for one lady. Her name is Miss Donna, and she lives down the hall, and when I met her, she said, ‘welcome home’.” She spoke highly of Miss Donna often during the interview, and emphasized, “Now we are best buddies… She’s been a wonderful friend from day one.”
Cici’s supporting cast has drastically improved in her current living situation, and she has worked into their community smoothly. “[Another friend] Mr. Hank and I did [last] Thanksgiving for everyone in the building, so whoever wanted to come, they could come. We had a good turn out.” She often thinks about how far she has come, saying, “I remember the time when I really couldn’t sit and have a conversation because I’d be crying and drunk.” But now, there is not the need to use alcohol to cope. She said, “I don’t have to drink, drink, drink, drink… It doesn’t bother me anymore.” She now ‘copes’ by speaking to others and praying. Cici said, “I also see a psychiatrist. She helps me, oh she has helped me a lot oh my goodness! And I’m starting therapy tomorrow. So, one day at a time.” She advises, “The best thing to do is reach out for help. You’ve got to have help.”
She is preparing to move into Paramark Real Estate’s affordable building where she’ll have more space to keep her belongings and bring her grandkids. She feels she has moved past the demons she had while enduring homelessness, saying, “Tomorrow might not be as good as today, but I don’t have to go and get three or four pints of vodka to make me feel better either. I just pray it out and hopefully things will be okay.” Once she was housed, the path to success was not perfectly smooth, but it eventually cleared for Cici and she was able to find herself again. “I’m just in my happy space in my happy place and I don’t want to ever be homeless again,” she said.
Jeremy is another formerly homeless La Crosse citizen who lost housing after an eviction charge that was dismissed in the months after he was evicted. He became unsheltered and slept in a graveyard for several months while he waited for new housing to open up. During this time, he sent his daughter to stay with her mother and he was forced to fend for himself on the street.
When he first met Michael, they both applied for over 50 housing applications, but he still had to wait to find housing. He said, “We waited, I was outside freezing in the cold.” He was unhoused for three months waiting for housing, and he eventually found his way into a motel. Jeremy did not hold back on his critique for some of the systems, using the analogy, “Don’t walk me down the street and get me down the road [only for when] I turn around when there’s a dead end, you’re gone.” He hopes for better support for all, saying, “Care is care, and a lot of people need help around here, but [supporting organizations] only extend it so far.” He stressed the point of continued case management and support, saying, “I can do work, do whatever, just don’t disappear.”
Many workers, looking to consolidate the population for easier care, told Jeremy to go to the tent city, but he was not in favor of that, opting to sleep in a cemetery instead. He said, “I’m not trying to go down there being homeless and catch a frickin’ addiction. Ain’t happening homie…That’s not where you get help. That’s where all hope is lost.” During this time, he was separated from his daughter who was in middle school at the time. She had to live with her mother, and her grades suffered for it. Jeremy recalled how during class registration; his daughter’s mother was so busy on the phone with her boyfriend that she ‘couldn’t’ take her. “So, like, being homeless was really, really hard because it’s the longest I’ve ever been away from my kid,” he said. Jeremy said, “She was able to come over a couple times, but it’s a hotel.” It was always meant to be temporary, and thankfully, it was.
After three months of working towards his goals with Fitzpatrick, a rental opened at Paramark. “As soon as we got in it all opened up and just went along smoothly,” Jeremy said. After Jeremy became settled at his new unit, his daughter could come see him more and she is now living with him again. Now 15, she is thriving in the classroom, and she went from missing a whole year of school to now being able to graduate early. Her growth past that year mirrors Jeremy’s, a fact he acknowledged by saying, “I think we kind of fed off of each other… It went from me having to ask her if she needs help to ‘How was your day at school?’ That’s it.”
Jeremy has been working at Paramark as the maintenance man, taking great pride in the upkeep and success of the building he calls home. He credits a significant amount of his work success to freedom within his support system. His boss, Jen, allows him to cover tasks on his own time and in his own way, but stresses that he can always ask her for help if necessary. He said, “[Michael] and Jen are probably two of my five most favorite people in my entire life, and they’ve only been in my life for a year and a half.” Jeremy’s work with Paramark has helped him establish a place in their company, and he has rethought his role as a worker. He remembered an occasion when an undercover officer approached him at work asking for his ID. Jeremy said no and was sharp with the officer, who went and talked to Jen. Jen sat Jeremy down to inform him about work professionality which made Jeremy reflect. He said, “I had to sit down and realize it’s not me representing me in this job, it’s me representing this company.”
There were struggles in adaptation to his new situation. He said, “The hardest part was the whole time management deal – trying to get a good schedule going.” But he’s been able to find a balanced schedule and is learning how to treat himself right. He said, “It got to the point where you have to set personal boundaries, which was a new word for me.” “Now I’m able to sit down and actually work on myself… I’m 42 years old and for once in my life actually I have something to strive for,” said Jeremy. When asked how his mental state current feels, he said, “[I’m] very content but focused on growing rather than being complacent.”
Progressing Past Pessimism
The systemic causes which enforce homelessness reflect the rotting internal structures that have made the United States a soft power powerhouse for generations. A country once united by compassion is now divided by class, and the extreme wealth disparity between rich and poor has made it nearly impossible for the multitude to rally around anything. When you’re constantly worrying about paying your bills, how can you help your recently evicted neighbor? When you see him on the street, can you afford to give him $10?
This is rather pessimistic rhetoric, and for some, combatting these wide-reaching systemic failures may seem futile. Government-led programs are doubted by many. “They’re just going to abuse services and end up back on the street,” one might argue. Even Fitzpatrick shares a hint of pessimism, saying, “I don’t know that there would ever be a situation where [a homeless] person would be able to prosper. I think in their own way they could but as far as financially they’re almost stuck.” While most people will never become wealthy after homelessness, going from ‘extreme poverty’ to ‘lower class’ should still be pursued to maintain and improve the health of the country and its people.
The complexity of each case of homelessness means more organizations need to be involved, making all-encompassing solutions difficult to attain through policy. Fitzpatrick said, “No blanket approach works for any population that has these sorts of barriers; it doesn’t work.” Barriers lead people into paths of continued dissolution, they become alienated from society, and society alienates them back. Brekke emphasizes the need for humanity in her work, saying, “I have learned more in my life from people out on the streets than anybody else. More about the humanity and the [human] condition. More about the broken systems in our country.”
While it may seem impossible to eradicate homelessness to many, active solutions should still be pursued; the most prosperous country ever should not have people overdosing in the street, unable to maintain a house. Brekke asked a seemingly simple question, “What if we don’t maintain people on homelessness [but] what if we end homelessness.” But the implications of being part of the ‘we’ runs deeper than it initially appears. The burden cannot fall on just the government, or the nonprofits, or the landlords, or the goodwill of strangers, it must belong to everyone, including the people suffering outside and the people reading this paper. ‘We’ collectively can change the current pessimistic circumstances because we all want what is best for ourselves and our culture. We can realign with the values which made America prosper and offer everyone a ‘seat at the table’, but we cannot do it until we understand how the table became so empty.
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