Program developed in NYC seems to be working

By Larry Fisher-Hertz

For nearly two decades, Sam Tsemberis was a New York City social worker trying -- and largely failing -- to help the homeless.

He said he watched the men and women he worked with go in and out of drug treatment center.  He helped them enroll in other well-meaning and often costly programs – and then watched them drop out.

“I’m embarrassed to say, it took me years to figure out what the homeless needed,” Tsemberis said recently.

“They needed a place to live.”

Tsemberis quit his New York City job in 1992 and founded Pathways to Housing, a program that places the chronically homeless in apartments first, then enrolls them in programs to treat their drug addiction or mental illness.

Almost immediately, the program worked.  People who had not a had a place to live for years were dealing with their problems and staying in their apartments.  Studies consistently showed a retention rate of more than 80 percent – compared with 20 percent success rates for more traditional programs Tsemberis and other social workers in New York had tried.

Success helps growth

Pathways to Housing was so successful Tsemberis launched a similar program in Washington and agencies in other cities – including San Francisco, Phoenix, Chattanooga, Tenn., and Fort Lauderdale, Fla. – have replicated Tsemberis’ model with comparable results.

“I realized we had a successful program from year one,” Tsemberis said.  “This was people demonstrating that just because they were  mentally ill didn’t mean they didn’t know how to put their lives back together, if you gave them the chance.”

In 2002, news of Pathways success attracted the attention of one of the Bush administration’s top housing officials.

Philip Mangano, executive director of the United States Interagency Council on Homelessness, said he had seen the success rates being reported for Pathways.

He didn’t believe them.

“In this field, you learn to be a little cynical,” Mangano said this month.  “But I spent a couple days analyzing the date and asking hard questions about [Pathways’] outcomes.  Then I visited the people in their apartments.

“It was clear they weren’t putting the highest functioning people in the program to generate artificially good numbers for fund-raising purposes,” he said.  “What I discovered was Pathways works for the most disabled and the most vulnerable people on our streets.”

Having seen the results first-hand, Mangano said he has lobbied successfully for more federal money for programs like Pathways.

“In next year’s budget, the president has proposed an 8.5 percent increase in money to combat homelessness, including $200 million targeted to house folks who have been on the streets and long-term shelters,” Mangano said.

He said all studies he had seen had shown program such as Pathways not only keep the homeless off the streets, they do it for less money than any other approach.

“The cost is about $20,000 a year [per person].  That’s less than a shelter bed or a cell at Rikers Island, where many mentally ill homeless have been sent in recent years,” he said.

Mangano characterized the Pathways method as having “the genius of any successful enterprise”—giving people what they want.

“Sam paid attention to the wants of the consumer – in this case, the homeless,” he said.  “What the homeless want is a home.