WASHINGTON - On a cold January morning in 2001, Mel Martinez, then the new secretary of Housing and Urban Development, was headed to his office in his limo when he saw some homeless people huddled on the vents of the steam tunnels that heat federal buildings.
"Somebody ought to do something for them," Martinez said he told himself. "And it dawned on me at that moment that it was me."
So began the Bush administration's radical, liberal -- and successful -- national campaign against chronic homelessness.
"Housing first," it's called. That's to distinguish it from traditional programs that require longtime street people to undergo months of treatment and counseling before they're deemed "housing ready."
Instead, the Bush administration offers them rent-free apartments up front.
New residents, if they choose, can start turning their lives around with the help of substance-abuse counselors, social workers, nurse practitioners, part-time psychiatrists and employment counselors. However, residents are referred to as "consumers," and the choice is theirs.
The help is so good and the deal's so sweet that roughly four out of five chronically homeless Americans who get immediate housing stay off the streets for two years or longer, according to the program's evaluators. In Britain, which has used the approach for a decade, the so-called "rough sleeper" population declined by about two-thirds.
The "housing first" strategy gets much of the credit for a 30 percent decline in U.S. chronic homelessness from 2005 to 2007. The number fell from 176,000 to 124,000 people, according to the best available census of street people.
The chronically homeless, estimated to be between a fifth and a tenth of the total, are the hardest group of street people to help.
A chronically homeless person is someone with a disabling condition who has been continuously homeless for a year or more or for four or more episodes in three years.
If a "housing first" strategy seems absurdly generous to them, it's proved to be crazy like a fox for many of the more than 200 U.S. cities that have adopted the approach.
The earliest adapters, including Denver, Miami, New York, Philadelphia, San Francisco and Portland, Ore., found that the added cost of homes and support services for the chronically homeless wasn't burdensome.
In fact, it was largely or entirely offset by reduced demands on shelters, emergency rooms, mental hospitals, detox centers, jails and courts.
Instead of shuttling between them, chronically homeless people "are staying housed and starting to look for employment," said Nan Roman, the president of the National Alliance to End Homelessness, the leading advocates of the approach. "A lot are reconnecting with their families."
A profound life change
Just being off the street is healthy, said Sheila Crowley, the president of the National Low-Income Housing Coalition. "Even if they continue to drink, they're eating better, sleeping better and interacting with people better."
For the chronically homeless, the life change is sudden and profound.
"Today, God has seen fit to bless you," James Hamilton's counselor told him last month on a day that Hamilton began in a fusty bunk bed in a Washington homeless shelter.
By nightfall, Hamilton's permanent home was a quiet one-bedroom apartment in an iffy neighborhood in Southeast Washington, for which the city pays a HUD-subsidized $900 a month plus utilities.
It's furnished with a new $1,200 furniture set, including a green plush sofa, bureau and end tables. Also a new oak kitchen table and chairs, bed, linens and a $300 Target gift certificate for incidentals such as the microwave that's perched on a wastebasket.
Hamilton, a lean and chatty 51-year-old, hawks newspapers at a Washington subway station from 6 until 10 a.m. In the afternoons, he helps a clothing distributor make deliveries to fancy retailers.
In between, Hamilton spends a lot of time at Grace Episcopal Church in Georgetown, his spiritual home.
With its help, he's now enrolled in an educational lay-ministry course at Wesley Theological Seminary in Washington. He types his papers at a nearby public library.
He's also a recovering crack addict who tests positive for hepatitis C.
"This is the best chance I've ever had to make things work," said Hamilton.
To keep the apartment, he must:
* Meet with his counselor once a week.
* Abstain from substance abuse and smoking in his apartment.
* Start paying 30 percent of his income as rent "in a few months."
* Not let anyone else move in permanently.
For Hamilton, the apartment means that he can store his scattered possessions in a secure place. He can stock food securely, too. He's spared what he calls the "beefing" of other shelter dwellers and is free to watch his own choice of programs on the analog TV that his stepfather gave him.
Hamilton attends night events at Grace now. When he lived at Washington's Adams Place Shelter, he had to check in by 6:30 p.m. to keep his bed. He's also attending a more energized evening Narcotics Anonymous meeting than the one the shelter offered, he said.
In that regard, however, Hamilton's home, set amid older frame houses and small, rickety churches, has a threatening downside. Crack and PCP pushers are everywhere, he said: "You got God and the devil in the same place."
Spending rises
The "housing first" approach, originally intended for mental patients, may not work so well for substance abusers, who may need more structure and supervision, Roman suggested.
Critics also wonder whether more shouldn't be done for homeless families, especially newly homeless ones, and low-income families at risk of homelessness.
Those who favor the program say much of the credit goes to Martinez, who left HUD in 2003 to run for the Florida U.S. Senate seat that he now holds.
It was Martinez who got a pledge to end chronic homelessness in 10 years written into President Bush's first budget, said Roman, the head of the homeless alliance.
The cause received small but steady increases thereafter, thanks, others said, to Roman and to the bipartisan congressional support that her group nurtured.
Since fiscal year 2002, authorizations for HUD homeless programs have risen from $1.1 billion to a proposed $1.6 billion for fiscal year 2009. For all federal authorizations that help the homeless, including VA benefits, Social Security and Medicaid, the figure has risen from $2.9 billion to a proposed $5 billion.
PROGRAMS FOR HOMELESS IN TRIANGLE
Many people move to the Triangle because of all the talk about its being a great place to live.
"It is if you have a college degree," Thea Craft, who works with homeless people at Wake County Human Services, said of Raleigh's "best places" reputation. "But if you don't and you are working in a job that pays less than $14 an hour, ... it can be a pretty tough place to live."
Sometimes the newcomers wind up homeless, Craft said.
Federally funded programs under the "Housing First" umbrella have helped Raleigh and Durham move dozens of chronically homeless people directly into permanent apartments in scattered locations in both towns.
In addition to an immediate place to live, the "street homeless" receive services including substance-abuse counseling and life-skills training, Craft said.
The numbers are relatively small. Of the most recent Raleigh homeless count of 1,144 people, 109 are chronically homeless and 22 of those have homes through "Housing First" programs.
The program started in Raleigh with a $757,000 grant in 2005, Craft said.
In Durham, about 70 people have housing through the housing-first approach.
The program's funding is difficult to quantify because it comes from a variety of sources, said Terry Allebaugh, executive director of the nonprofit Housing for New Hope.
The program is more properly known as Housing First -- Housing Plus, Allebaugh said, because of the additional support it gives clients.
"It really looks at housing as a therapeutic intervention for chronically homeless people," he said.