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Is Utah still a model for solving chronic homelessness?

Editor’s note: This is the second in a three-day series on homelessness, the issues that are keeping people living on the streets of Salt Lake City, and what can be done to help.

SALT LAKE CITY Bare, frostbitten toes on size 14 feet stand out in a crowd. These ones are scabrous and peeling, whitish and bluish with one entirely black and clearly gangrenous. They belong to a lanky African-American man nicknamed Preach, who on a balmy spring day is sunning himself on the sidewalk next to the Catholic Community Service center on Rio Grande Street. Next to Preach is a brilliant purple pair of brand new size 16 basketball shoes, large enough to fit over his swollen feet, a gift from his brother who just got out of jail. He ll put them on, he says, when he has some socks.

Is Utah Still A Model For Solving Chronic Homelessness?

“Preach” sits on the sidewalk outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. Preach was wearing shoes too tight which caused sores and for him to go without shoes in the cold which led to bad frostbite on his toes. | Nicole Boliaux, Deseret News

Preach knows he needs treatment fast, and he knows he can find it at the Fourth Street Clinic[1], a free site a few blocks up the road. Badgered by a friend, he grudgingly agrees to have his toes looked at. He doesn’t trust doctors, he says. Preach is one of about 200 people sprawled on the sidewalks and milling in the streets on this early spring day, just north of the Rio Grande Depot between the Road Home emergency shelter, where many sleep, and Catholic Community Services, where they often eat.

He s been on the street now for 18 months, he says. He lived with his mom, who had an apartment and had been receiving disability, before she died of an opioid overdose. His mom’s multiple painkillers were legally prescribed, he says, and he festers with resentment toward the medical profession for her death. A stroll around the large block where Preach eats and sleeps is a walking tour of the issues Salt Lake City wrestles with as it fights against homelessness from health problems to mental illness and addiction. It s also ground zero for the battles raging now throughout Salt Lake County, as the city pushes to shutter the massive 1,000-plus bed Road Home emergency shelter and build smaller, dispersed facilities to replace it. The policy shift has set off a firestorm among citizens whose neighborhoods are earmarked for the new homeless resource centers.

Is Utah Still A Model For Solving Chronic Homelessness?

“Preach” sits on the sidewalk outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” with Criss in Salt Lake City on Wednesday, March 8, 2017. | Eric Schulzke, Deseret News

The furor over homelessness is also causing whiplash among some Utah residents, who remember that just two years ago the national media heralded Utah’s achievement in “winning the war on chronic homelessness.” Now, state, county and local officials are dealing with the bitter battles over shelter locations and whether it will make any difference, even as problems continue to spiral around the Road Home neighborhood. How did the conversation change so dramatically so fast? Is Utah, in fact, a model for addressing homelessness or is it a mess?

Part of the explanation lies in understanding the difference between chronic and nonchronic homelessness. At the same time, a mounting drug crisis has put more people on the street people whose addictions make them harder to help with housing programs.

Sources of confusion

According to The Daily Show With Jon Stewart, Preach shouldn t be on Salt Lake City’s streets at all. In 2015, the popular news satire show breathlessly announced[2] that Utah had nearly solved chronic homelessness simply by giving the homeless homes.

Is Utah Still A Model For Solving Chronic Homelessness?

“Preach” sits on the sidewalk outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” with Criss in Salt Lake City on Wednesday, March 8, 2017. | Eric Schulzke, Deseret News

The reporter, Hasan Minhaj, ambled through Salt Lake City, unsuccessfully seeking homeless people. Have you seen any homeless? he asked pedestrians in the business district. Where did you hide them? he asked Lloyd Pendleton, then director of Utah s Homeless Task Force. Pendleton answered that 10 years earlier Utah started placing the chronically homeless in apartments, using a philosophy known as Housing First. We have reduced our chronic homeless population by 72 percent since 2005, he told The Daily Show. Later that year, Gordon Walker, director of Utah s Division of Community and Housing, told the Deseret News[3] that the state s chronic homeless numbers had been cut by 91 percent over the previous decade, from 1,932 in 2005 to just 178 in 2015.

The 91 percent figure took hold, appearing in coverage touting Utah as a proven model for solving chronic homelessness in the Washington Post[4], NBC News[5], and L.A. Times[6]. It was a stunning achievement, if true. But it was not quite what it seemed. First, while most news accounts did mention that chronically homeless people are a small subset of the overall homeless population, headlines fed confusion on this point in the public mind, said Tamera Kohler, director of the state’s Community Services Office for the Utah Department of Workforce Services.

The definitions matter, and are legally fixed by federal law. The nonchronically homeless are those on the street for brief periods, and they don’t have a formal disability. The nonchronic group, experts say, include up to 85 percent of those who sleep in emergency shelters over the course of a year. These clients often end up couch surfing with friends and family before ultimately finding stable housing. The chronically homeless, in contrast, is a much smaller group. To qualify as “chronic,” clients must be homeless for an entire year or have been homeless for at least four periods over the past three years which together total 365 days. They must also have a diagnosed disability, for which serious mental illness or disabling drug addition both qualify. The chronically homeless make up 22 percent of the overall homeless population nationwide, and does account for the vast majority of the costs in crisis services.

The second point of confusion that caught Utah off guard was that homelessness was a moving target. It did not sit still and wait to be solved: it mutated, shifted and grew, both nationwide and locally. Despite a recovering economy, the total number of individuals who had contact with the state’s network of homeless services rose in recent years, from 12,241 in 2014 to 13,614 in 2016. The Road Home reported that in 2016, its emergency shelters served more than 8,000 unique individuals, and it is on pace to top 9,000 this year more than double the pre-recession annual count from 2004 through 2007.

Is Utah Still A Model For Solving Chronic Homelessness?

Homeless members of Salt Lake wait outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. | Nicole Boliaux, Deseret News

Finally, there was confusion about how the chronically homeless were counted and categorized, leading to disputes over how much Utah had actually accomplished. Kohler places some blame for the 2015 confusion on federal agencies that changed definitions and methods of counting the homeless during the previous decade.

Once a year on a night in January, the state does a comprehensive homelessness census, the Point in Time Count, required by federal law. This involves counting by hand the number of people on streets and in shelters throughout the state

But this count is as much an art as a science, and, as Kohler notes, definitions shift over time. But some of the confusion was also errors made by Utah officials. As much as 85 percent of Utah’s touted reductions in chronic homelessness in Utah may have been due to changes in how the homeless were counted, according to Kevin Corinth, an economist at the American Enterprise Institute. Prior to 2009, Corinth says, Utah mistakenly counted clients in transitional housing (semipermanent housing for up to two years) as chronically homeless. This inflated Utah s chronic homeless numbers. When the mistake was corrected in 2010, the correction created an illusion of sudden and dramatic progress. Kohler says she fears that focusing on the disputed claims from 2015 obscures the larger point. We ve taken 900 people who fit the strict definition of chronically homeless, she said, and put them into permanent housing.

And all disputes notwithstanding, Utah’s Housing First strategy does seem to be having an impact on the chronic homeless population. The state s chronic rate is now among the lowest in the country: In 2016, just 6 percent of Utah s homeless population were deemed chronic, compared to 22 percent nationwide[7].

Housing First

But a stroll north from the Rio Grande Depot drives home how many chronic or near-chronic people are still on the streets. There s Preach, of course, with his frostbite and gangrene. In addition to distrusting doctors, he is wary of authority figures. This seems to stem from beatings he said his father gave him when he was a young child.

The adults in my family didn t do anything about it,” he says. “They just turned their eye. People will be blind to things they don t want to see. The worst thing I could ever see is a little child getting hurt. He puts on sunglasses to hide his tears. Sitting next to him is Karren Cardenas, on the street now for seven years, not having seen or heard from her father or her six children in that time. Addicted to heroin, depressed and openly suicidal, she alludes to sexual assault she suffered on the street.

Is Utah Still A Model For Solving Chronic Homelessness?

Criss, left, comforts Karren Cardenas, 45, right, outside the Catholic Community Services 200 S and 500 W next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. Karren has lived on the street for seven years and hasn’t seen her father or her six children in years. She suffers from nerve damage, high blood pressure and PTSD.| Nicole Boliaux, Deseret News

Today, the street as a whole looks dirty, crowded and uncomfortable, but not particularly dangerous. It’s lunchtime, and an earnest young couple with a large plastic bag is passing out McDonald’s hamburgers. A trio of shiny SUVs pulls up and a line forms as home-school moms and kids set up slow cookers and begin ladling out soup into paper bowls. In the middle of the street, a bulky man with bushy dark hair and a curly beard does slow squats, contemplating the asphalt. It s not clear whether he is stoned, mentally ill, or both. But at this rate, he s not getting any soup.

Is Utah Still A Model For Solving Chronic Homelessness?

Karren Cardenas, 45, right, cries while thinking of her last Christmas outside the Catholic Community Services(200 S. and 500 W.) next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. Karren has lived on the street for seven years and hasn’t seen her father or her six children in years. She suffers from nerve damage, high blood pressure and PTSD.| Nicole Boliaux, Deseret News

On the corner, across from The Gateway shopping district, two Taser-armed security guards from the Road Home help a nearly catatonic woman with wildly dilated eyes to her feet. She stumbles out into the street in a stupor. For decades, homeless experts viewed these problems as insoluable. But there is a proven solution to hard-core, chronic homelessness, argues Sam Tsemberis, the godfather of the Housing First movement: simply help people into homes.

Tsemberis, who pioneered the new approach in the early 1990s in New York City, says he has mixed feelings about Utah s 15 minutes of Housing First fame. He likes that the coverage sparked a national dialogue about solutions to homelessness. The downside, he said, was that Utah s experience was not exactly as advertised. The traditional model for homeless support, Tsemberis said, is called Continuum of Care. In that model, service providers offer shelter but require that clients be sober or under psychiatric care before they are given a permanent home. This often leaves clients on the street, Tsemberis said, bouncing in and out of rehab or psychiatric treatment, constantly returning to old friends and addiction triggers or falling off their meds. If offered a home instead, Tsemberis argued, even the toughest cases also achieve surprising stability. In 2004, he led a controlled study in New York City that found that 80 percent of seriously mentally ill homeless clients who received apartments retained them for at least two years, which ran sharply counter to the underlying assumption of the Continuum of Care model.

Is Utah Still A Model For Solving Chronic Homelessness?

CJ shows bed bug eggs on a watch outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called on “The Block,” in Salt Lake City on Wednesday, March 8, 2017. CJ and many other homeless people say that the Road home has a bad bed bug problem along with mold and unsanitary conditions. | Nicole Boliaux, Deseret News

There is no empirical support for the practice of requiring individuals to participate in psychiatric treatment or attain sobriety before being housed, Tsemberis and his co-authors concluded.

Once people are housed and stable, Housing First advocates say, the program costs very little, particularly when it focuses on the toughest cases, including those most likely to use ambulances or emergency rooms or have encounters with the police. In 2002, a rigorous Housing First in New York City study by researchers at the University of Pennsylvania found giving severely mentally ill an apartment saved local hospitals and agencies $16,282 per year in estimated crisis health and legal costs, costing a net of just $995 per person per year with housing costs included. An even larger and equally careful study by the federal government in Canada, also focused on the severely mentally ill, found similar savings.

Black or white

Around the bend from Rio Grande Street, a few dozen young men mill around with no apparent purpose. But their purpose soon becomes clear. A visitor walking through this crowd is accosted three times in 20 yards by men who ask, “You need black or white?” He shakes his head, unsure of the question. Finally, the third man helpfully explains. “Drugs, man!”

Black is heroin and white is crack cocaine, said Salt Lake police Sgt. Brandon Shearer. They are sold in “balloons,” tiny bits of plastic wrap twisted at the end, and users will often buy one of each and inject them together, known as “speedballing.”

This is Salt Lake’s open air drug market, located on the street corner by the city’s largest homeless shelter. Police round-up dealers weekly, Shearer said, but its clear the they don’t consider getting arrested much of a threat. Nearly everyone in Rio Grande homeless nexus has some sort of drug problem, said Dennis Kelsch, homeless services director for Salt Lake s Catholic Community Services, a major force in the city s homeless services scene. And for the addicted, Kelsch notes, there are no shortage of triggers here.

The problem is getting worse, Kelsch said. The clientele is younger, and the drugs are harder. As recently as six years ago, he says, most of the people on these streets were over 50 and alcoholic. Today, the clientele has shifted decades younger, he says, and opioids dominate.

These are young people,” Kelsch said.

Is Utah Still A Model For Solving Chronic Homelessness?

Criss, left, cleans the area around where she stays outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. Chris, originally from Ohio, has been exited from the Road Home until March 12 and has relapsed since being removed from the shelter. | Nicole Boliaux, Deseret News

A 2008 survey[8] of 25 cities by the U.S. Conference of Mayors asked 25 cities for their top three causes of homelessness. Substance abuse topped the list at 68 percent as the primary cause of homelessness for single individuals. And surveys of homeless people have found that about two-thirds of homeless people report that drugs or alcohol played a major role in their displacement. Tsemberis says the best estimates are that between 50 percent and 80 percent of the chronically homeless nationwide are out there at least in part due to serious substance abuse issues. And many of those, he says, are dual diagnosis, addicts who also suffer from mental illness, with the drugs often a form of self-medication. Serious substance abuse problems are tougher than mental illness for Housing First to address, Tsemberis said. Most of the 15 percent to 20 percent of clients who wash out of his Housing First programs are serious addicts.

The problem is that they mostly use with others, Tsemberis said. The in and out of frequent guests quickly becomes a lease violation. Some guests won’t leave. Apartments are lost. After several cycles of this, it becomes clear the person needs a harm reduction program in a secure building where someone else is in charge of the front door.”

Near the corner of 200 South and 500 West, within a stone s throw of the open drug market, is the home of the Salt Lake Police Department s Community Connections Center, opened last summer. According to Lana Dalton, the center’s manager, there is a nexus between Utah s sharply rising housing costs and the opioid addiction epidemic. As housing prices rise, she said, addictions, low-paying jobs and expensive apartments don t mix.

They end up using what funds they have for what they feel they really need, she said, which will be the drugs. A Community Connections staffer bursts into the lobby, alerting a pair of police officers that a client needs help. A tall African-American man is walking quickly across the street, past the Road Home, and around the corner. The man is off his meds, unstable, and might harm himself. A pair of crisis support police officers rush out to take him to the hospital.

Is Utah Still A Model For Solving Chronic Homelessness?

Criss, left, folds and reorganizes clothes outside the Catholic Community Services (200 S. and 500 W.) next to the Road Home, called “The Block,” in Salt Lake City on Wednesday, March 8, 2017. Chris, originally from Ohio, has been exited from the Road Home until March 12 and has relapsed since being removed from the shelter.| Nicole Boliaux, Deseret News

Looking to the future

The misunderstood publicity wave and miscounted numbers of 2015 came and went, with lingering confusion and sheepishness. But Utah s policymakers at all levels still see themselves on the cutting edge of homeless policy. State and local officials are moving aggressively to streamline homeless services. In a few dizzying weeks in February and March, state, county and local officials served, volleyed and slammed proposals for multiple smaller, dispersed facilities to replace the current center on Rio Grande. Their efforts have met with an outcry about a lack of transparency in decision-making from citizens whose neighborhoods would be affected. Lost in the disputes, Utah s homelessness policy stakeholders fear, are the truly innovative programs behind the headlines.

With chronic homelessness now well below national levels, Utah is poised to expand the reach of its Housing First philosophy. The new program, called Homes Not Jails, targets the persistently homeless, or those who spent at least 90 but fewer than 365 days homeless in the past year.

These are people not yet in the chronic category but are in clear danger of slipping into that group through health, addiction or mental crises. The Homes Not Jails pilot will be operated by the Road Home, initially targeting 315 individuals. These clients will receive help in finding and paying for housing, along with medical care and counseling. In addition to helping those at greatest risk, the program aims to free up space for those who only need temporary help the vast majority of clients.

Eighty percent of our clients have one episode and never need the shelter again, Minkevitch said. But day in and day out, pressure for space in the shelters stems from the 20 percent of clients with the most persistent problems. We literally have an 80/20 problem, Minkevitch said. Homes Not Jails will use a Pay for Success model, meaning private investors will put up the money and only get paid if results are shown. Clients will get assistance in housing, along with intensive case management, behavioral treatment and employment counseling.

A third party of researchers will then validate the results, and only if specific goals are met for reduced arrests, improved employment wages, and service hours worked by participants will investors be paid. Because the agencies and nonprofit providers will now be working together with investors and researchers, Minkevitch said, We ll be able to see what works and doesn t. We can innovate and tweak, and when we find what works, we ll be able to scale up. No one is promising a silver bullet this time.

I hope it changes the paradigm, Salt Lake County Mayor Ben McAdams recently told the Deseret News. We now have a system that was built in the 1980s to find people who are homeless and suffering and give them a meal and a bed. What I want is not just to alleviate suffering, but to put them on a path to greater stability and self-reliance.

How to help in Salt Lake County:

The Road Home[9]

(801) 359-4142

www.theroadhome.org[10]

A nonprofit social services agency that provides emergency shelter, case management and emergency services to help the homeless transition back into the community.

The Fourth Street Clinic[11]

(801) 364-0058

www.fourthstreetclinic.org[12]

A medical clinic primarily serving homeless Utahns and offers primary care, dental care, and behavioral health care.

Volunteers of America[13]

www.voaut.org[15]

A human services nonprofit that provides affordable housing and substance abuse treatment for the low-income and homeless.

Crossroads Urban Center[16]

(801) 364-7765

www.crossroadsurbancenter.org[17]

A grass-roots nonprofit organization that runs an emergency food pantry and thrift store to assist underserved Utahns.

Utah Food Bank[18]

(801) 978-2452

www.utahfoodbank.org[19]

A nonprofit that distributes food across all 29 counties in the state with direct service programs to children and seniors.

United Way of Salt Lake[20]

(801) 736-8929

www.uw.org[21]

The world s largest privately funded charitable organization.

The Other Side Academy

www.theothersideacademy.com[23]

A free two-year school where students learn vocational, pro-social and life skills. Available to men and women involved in the criminal justice system, the homeless, substance abusers and others.

The Inn Between

801-410-8314

www.theinnbetweenslc.org

A refuge where Utah’s homeless men and women can die with dignity and receive professional hospice services.

Catholic Community Services

A social service agency that runs the St. Vincent de Paul Dining Hall and Weigand Homeless Resource Center, a day shelter for homeless individuals.

801-977-9119

www.ccsutah.org

References

  1. ^ Fourth Street Clinic (fourthstreetclinic.org)
  2. ^ breathlessly announced (www.cc.com)
  3. ^ told the Deseret News (www.deseretnews.com)
  4. ^ Washington Post (www.washingtonpost.com)
  5. ^ NBC News (www.nbcnews.com)
  6. ^ L.A. Times (www.latimes.com)
  7. ^ 22 percent nationwide (www.hudexchange.info)
  8. ^ A 2008 survey (www.abtassociates.com)
  9. ^ The Road Home (www.google.com)
  10. ^ www.theroadhome.org (www.theroadhome.org)
  11. ^ The Fourth Street Clinic (www.google.com)
  12. ^ www.fourthstreetclinic.org (www.fourthstreetclinic.org)
  13. ^ Volunteers of America (www.voaut.org)
  14. ^

Dying homeless in Salt Lake City

SALT LAKE CITY A woman leaving the bank shortly before 11 a.m. was one of the first to notice him. He was sitting on a concrete bench near One Utah Center, wearing a black sweatshirt and a dirty baseball hat, fingers curled, slumped over. Word spread quickly after that. Two police officers stationed semi-permanently across the street answered her call. Then word traveled to the men and women who called Main Street their home, the ones who slept on the same sidewalks and shared their food and drugs with him. The news made its way to a security guard who had befriended him, then to his stunned family.

Dying Homeless In Salt Lake City

Justin Huggard shortly before his death in 2016. | Photo courtesy Aimee Rolfe

Then and only then did the news land like a thud in the home of Aimee Rolfe. That Justin s life had been wasted was clear to everybody, but most of all to 44-year-old Rolfe, a garrulous woman from Heber City who had been Justin s best friend for nearly 30 years. Justin was a felon and an addict who drank vodka out of the bottle.

Dying Homeless In Salt Lake City

A young Justin Huggard (middle) at around 3 years old with two cousins on their grandfather’s snowmobile in Kamas. | Courtesy of Sadie Erickson

He had spent most of the last four years of his life homeless in downtown Salt Lake, scraping money together to feed his addiction before he fed himself. He was small and scraggly, the sort of person you pass by on the street without noticing. He was also loved.

And so, because he had meant everything to her, Rolfe bundled into her car one Wednesday during the first snowstorm of the season, drove 50 miles to the mortuary to retrieve his ashes, strapped the gray plastic box to the passenger seat of her car and placed an old photograph of him on top. To nobody in particular, she announced that it was time to bring Justin home.

Dying homeless

Each year, between 70 and 100 homeless people die in Salt Lake City. They are the legacy of a social safety net with gaping holes that has left the criminal justice system to catch the people, like Justin, who fall through the cracks.

Not that Salt Lake is unique. In every city, in every state, people are dying on the streets. Last year, 44 homeless men and women died in New Orleans. In Sacramento, a coalition of homeless advocates counted 81. Denver counted 171. Orange County recorded more than 200. New York City counted 239.

Many of these counts are conducted unofficially by volunteers who triangulate between multiple agencies to locate and identify the dead. In Justin s case, he was missed. In fact, without the intervention of a friendly security guard, word of his death may never have gotten back to Justin s family. And nobody would have known this:

That Justin Lee Huggard, who was 38 when he died, was born in Park City to a girl who was 14 years and four months old.

Dying Homeless In Salt Lake City

Justin Huggard, about 18 years old, with his cousin at his grandparents’ house in Kamas where the family would spend summers together. | Courtesy of Sadie Erickson

That he grew up in Keetley, a mining town that was flooded by the waters of the Jordanelle Reservoir in 1995, before moving to Heber City. That he always seemed to get beaten by the men his mother loved. Sometimes he showed up at his grandmother s house black and blue with crib marks on his face or belt marks on his back. That he started drinking and using drugs at a young age, sometimes with his parents.

That he died on the streets of downtown Salt Lake City with a dollar to his name.

That despite it all, friends say Justin was good. Rolfe, who is effusive with a crackly laugh, met Justin at Pizza Hut when he was 12 or 13 and she was 17 or 18. It was a version of Heber City still untouched by the development burgeoning in Park City. One stoplight and a lively nightlife. Jimmy. Jennifer. Aimee. Justin. The four of them would set up their lawn chairs right in the middle of the road in the summer and holler at friends who drove past. After Christmas, they would gather around bonfires of Christmas trees and wrapping paper.

Life in the trailer court was close-knit. Justin s grandmother lived two minutes from his aunt. Rolfe lived just down the way. Justin’s mom came home less and less frequently until it was mostly his grandmother and aunt who were raising him. At night they roamed the mountains with radios playing hide and seek. On Sundays they took a friend’s purple Chevy Blazer and drove as far east on Highway 35 as they dared, up through the pass and clear to Tabiona, and when they stopped, Justin would jump out and grab fistfuls of wildflowers and hand them to Rolfe. They fell into drugs and alcohol at different times; he mostly alcohol and some heroin, Rolfe four years of meth.

Dying Homeless In Salt Lake City

Aimee Rolfe talks about her friend, Justin Huggard, while holding a box that contains his ashes at her home in Heber City on Thursday, March 30, 2017. Huggard was homeless when he died on a sidewalk in Salt Lake City in 2016. | Spenser Heaps, Deseret News

She kicked the habit faster than he did, moved into her own home in Heber at age 22, gave birth to her son Zach, then her daughter Liberty. She found work cleaning houses in Park City mansions, homes with elevators and two or three kitchens.

She fed Justin on Sundays and stuffed leftovers into Tupperware to set him up for the week. He frequented a bar called The Other End, where he and his mom were a daring pool team they were unbeaten for two years and the bar made them pool sticks with their nicknames

The Brat for his mom, because she was a troublemaker.

Rat Boy for Justin, because he was small but had big ears. He had work, sometimes at a recycling company, but it was low-paying, not enough to get him back on his own feet, and his addiction got in the way.

Strange as it sounds, more than anything, he loved to help people. He had a habit of shoveling snow from his aunt and Rolfe s driveway before she rose at 7 a.m. to send the kids to school.

He d help the neighbors with anything, said his cousin Amber Salgado. If he saw somebody packing groceries, he d go help them with their groceries. Or if he d see like an elderly person trying to get into their house, he d help them up the stairs. And I m sure he was the same way on the streets.

He would have been content with a wife and some kids, but he was shy around women. He loved kids and wouldn’t drink when he baby-sat Zach and Liberty. Justin, Rolfe thought, wanted everything he couldn t have. Tragedies found Justin. His mother was the first to die, age 41, from pneumonia.

His grandmother died five years later. The news sent him spiraling, deepening his depression and adding to his loneliness. Shortly afterward, Justin moved to downtown Salt Lake City and became homeless.

Whenever he got depressed, whenever he got lonely, he turned to his bottle, Salgado said. And Justin was always depressed and he was always lonely. Justin would get back on his feet for a few months at a time, but it never lasted. Last year, he was hospitalized for about a month with pneumonia. Shortly after being discharged, he went to Rolfe s house to tell her that he was going back to Salt Lake City. That there was no reason for him to stay in Heber anymore.

Rolfe stuffed six pairs of socks, a first-aid bag and her favorite hoodie into his arms. Her teenage son gave him a knife. He didn t need any of it, but it made Rolfe feel better.

I knew it was the last time I d ever see him, Rolfe said. I just knew in my heart.

A kind security guard

Scott Camara, a 45-year-old former security guard at One Utah Center, said there was something different about Justin. A scruffy guy with missing teeth, he came up to Camara on one of his first shifts at the security company three years ago just wanting to chat.

In fact, Camara said, he was probably one of the only ones there that never asked for anything.

Dying Homeless In Salt Lake City

Scott Camara poses for a photo outside his parents’ home, where he currently lives, in Provo on Monday, April 10, 2017. Camara befriended Justin Huggard while working as a security guard in downtown Salt Lake City. | Spenser Heaps, Deseret News

Camara, a stocky man who wears his hair in a short mohawk, struck up a friendship with Justin. Whenever Camara came out for his break on his 12-hour weekend shifts, Justin would meet him. They bonded over a shared sense of humor and a love of fishing. Often, Camara would let Justin call his aunt on his phone. Sometimes, Justin would cry. Last summer, after Justin had gotten back on his feet, Camara drove from his house in Provo to Heber City to pick him up to go fishing on one of his days off.

Justin opened the door, stunned. He couldn t believe that I actually followed through, Camara said. They drove to Deer Creek, where it rained and they didn t catch any fish. But against the backdrop of the Wasatch Mountains, they talked and talked.

Justin was lonely and depressed, the type of guy who didn t feel like he deserved anything. He talked often about how much he missed his mom and grandmother. He drank, heavily. He was always trying to quit, but he would fall victim to terrible withdrawals, including seizures. It became hard for him to communicate or carry on a conversation. He didn t know how to function. More than once, Justin gave away food and money to other homeless people. What was hard for me, too, is they wouldn t appreciate it, Camara said. They didn t appreciate it at all.”

There was something else that drew Camara to Justin an intermittent drug problem that he d had since he was 18.

His was more out in the open, Camara said. Mine was always hid.

Camara had always held down a job. He had successfully raised two kids. And he d kept a roof over their heads for their entire lives. But after three years of working in downtown Salt Lake City, where people would use drugs right in front of God and everyone out there, Camara found himself struggling against dark thoughts. Camara saw what happened to Justin and others like him, and it frightened him. He begged his supervisor to transfer him. Although most people don’t think of it that way, research increasingly supports the definition of addiction as a brain disease[1]. Repeated use of alcohol desensitizes the reward circuits of the brain, making it harder for people like Justin to get joy out of normal events a good conversation with a friend or a beautiful sunset. Addiction erodes brain regions involved in decision-making and self-control. Early exposure, family history and poor social support increase vulnerability.

Nine months ago, Camara entered rehab. He s been clean since and stopped smoking as well.

Dying Homeless In Salt Lake City

Scott Camara poses for a photo outside his parents’ home, where he currently lives, in Provo on Monday, April 10, 2017. Camara befriended Justin Huggard while working as a security guard in downtown Salt Lake City. | Spenser Heaps, Deseret News

The last he heard, Justin had gotten back on his feet, moved back in with his aunt, and cleared up his outstanding warrants. Then, in October, Camara spotted Justin at the Rock N Ribs festival at the Gallivan Center. Justin was happy to see him but looked thinner than ever and weak. His wife and kids gave Justin some food and they listened to the music together. Justin told them he was depressed and dying. He’d said those words before. He looked upset when they had to leave.

He just gave up after that, Camara said. I just don t think he had any more fight in him at all.

Finding him

When he wasn t doing right oh, heck, I got on him.”

That s Colleen Swasey, the woman who found Justin. A 61-year-old woman from Taylorsville, she arrives at work on Main Street every day at 6:30 a.m. and always looks for the homeless people who make that block their home. Just to make sure they re there, Swasey said. Then I go down there and give them a lecture.

Swasey is opinionated, almost harsh. Eight years working on Main Street has made her cynical. She used to dispense cigarettes and change. Now she dispenses advice.

These guys like to be homeless, most of them do, she said. Apply for food stamps, they get food stamps. They apply for disability, they get disability. And then they get all that money to spend on stuff they don t need.

Justin said, ‘All I have to pay for is alcohol, everything else is free for me.’ And it is. Homeless advocates say this is a common misconception. But they do struggle sometimes to separate the people who want to change from those who simply aren t ready.

On any given night in the U.S., more than half a million people are homeless. Of those, about 2,800 on any one night call Utah home. Five percent are unaccompanied youth. Twelve percent are veterans. And 35 percent are people in families with children, according to the U.S. Department of Housing and Urban Development. Many of them are older today, half of America s homeless are 50 or older.

One in five have a serious mental illness and a similar percentage have a chronic substance abuse disorder. The problem is complex and multilayered.

Swasey said that many homeless people she knew choose to take their chances on the sidewalk, even in the cold, rather than risk the theft and violence that run rampant both inside and outside The Road Home shelter. She tried to encourage Justin to go back to Heber City. You did it before, she would tell him, you can do it again.

Dying Homeless In Salt Lake City

Justin Huggard, 34, in Heber, before he died. | Courtesy of Aimee Rolfe

When she saw Justin doing Spice, a synthetic marijuana, with his friends, she hounded him. She scolded. She looked it up on the internet and told Justin that it would make his brain bleed. She had seen too many deaths over the years.

There was the Indian girl three years ago whose nose wouldn t quit bleeding and legs swelled until they looked like balloons. The paramedics took her but said there was nothing they could do. There was Bruce, who Swasey caught drinking hairspray. He died shortly after leaving the hospital. There was Nate, the Vietnam veteran who jumped off of the parking garage behind Carl s Jr. last year. It was a Saturday.

This and more in eight years working here. Why, oh why, would Justin want to come back?

“This is where all my friends are,” Justin would reply.

“This was home for him, Swasey said. He d been here so long that it d become home.”

The bishop

Brad Baird is in his office on the 21st floor of One Utah Center, trying to explain. Baird, 62, spent nearly 38 years commuting from his home in Heber City to his job in downtown Salt Lake, first as a real estate director for a natural gas company and then for 13 years as an executive with the Economic Development Corporation of Utah.

As an LDS bishop, Baird worked with many people in his ward who struggled with addiction and employment. Baird had taken a liking to Justin, who was gentle and polite, and tried to help him with counseling and jobs.

Dying Homeless In Salt Lake City

Brad Baird sits on the bench where he last saw Justin Huggard in Salt Lake City on Thursday, April 6, 2017. | Spenser Heaps, Deseret News

Once, when he needed an extra hand on the tree farm he runs in Heber, he hired Justin for a few days. But the work wasn t constant and Justin had his demons, particularly alcohol.

He was a good worker, Baird said. I always felt like he had so much potential if anyone would give him a chance. For a while, it seemed like Justin was pulling things together. He was attending church every week and had even gotten a job as a housekeeper at a hotel in Park City the first full-time job he d ever had where he could be independent. Then the hotel did a background check on its employees and found a past felony conviction for drug use. He was fired.

That just devastated him, Baird said.

After Justin became homeless, Baird would see him downtown and occasionally buy him lunch. You ve got more in you than what you re showing, he d tell him. You ve got great capacity to do good things. By then the petty charges had begun to pile up.

October 9, 2012: Disturbing the peace. Dismissed. June 20, 2013: Use of roadway by a pedestrian. Dismissed.

March 4, 2013: Trespassing. Three days in jail and a $100 fine. April 18, 2014: Open container. Dismissed. Jan. 18, 2015: Theft of services (UTA). Four days in jail.

Jan. 2, 2016: Justin s last interaction with the system. He was charged with disorderly conduct and intoxication. A judge fined him $370. Ten months later, he was dead.

Dying Homeless In Salt Lake City

Brad Baird sits on the bench where he last saw Justin Huggard in Salt Lake City on Thursday, April 6, 2017. | Spenser Heaps, Deseret News

I feel like I had an opportunity and missed it, Baird said, quietly. He had seen Justin a week before and thought about taking him to lunch. Months later, Baird watched the news coverage of a town hall in Draper with a heavy heart. Mayor Troy Walker had volunteered Draper to host one of the homeless resource centers that the city wanted to spread out across the county, but residents shouted him down and booed a homeless man.

Baird sees both sides very clearly. He empathizes with residents who are concerned legitimately so with having a shelter like The Road Home in their community, around their children, near their homes. But I think most of the people in that meeting if they knew a Justin, if they had a Justin in their family, would not be afraid, Baird said.

The last day

It was nearly noon on Nov. 4 when police rolled Justin over and saw his face, purple and blue. It had been cold that night, and Justin s cause of death was ruled to be exposure/pneumonia. But those who saw him right before he died, like Swasey, said he had been using Spice.

Because the medical examiner s office doesn t usually screen for Spice, it s still unclear exactly what happened. The news trickled onto Facebook, where old acquaintances circulated the rumor that Justin had overdosed on heroin, and Rolfe spent several days angrily responding. Maybe it didn t matter how he died to the rest of the world. But it mattered to her.

Dying Homeless In Salt Lake City

Boxes store the unclaimed ashes of poor and indigent deceased at Carver Mortuary Services in Salt Lake City on Tuesday, April 04, 2017. | Spenser Heaps, Deseret News

Because the family couldn’t afford to pay for a funeral, Justin s body went to the county, which has been paying for “indigent burials” of the poor and homeless since the county was founded in the 1800s. That means the last one to handle their bodies is someone like Shane Westmoreland, the mortician and manager of Carver Mortuary Services.

In one of the back rooms of the building, which sits in an industrial part of town, a curtain of ugly brown paisley shields the forgotten from the gaze of the sun and the glare of the public. Little plastic boxes are stacked neatly on three mismatched tables, each affixed with a label that spells out the deceased s name and gives them a number. Abigail Oden #4653

Johanna Gurule #4419

George Chavez #4301

Gilbert Tanaka #909

Dennis Ogdin #628

The mortuary does more than 100 cremations a month, of which about 30 are so-called “indigents” people whose families do not have enough money to afford a burial, or those who have no family and friends at all. The county pays the mortuary half of what it usually charges.

Dying Homeless In Salt Lake City

Boxes store the unclaimed ashes of poor and indigent individuals at Carver Mortuary Services in Salt Lake City on Tuesday, April 4, 2017. | Spenser Heaps, Deseret News

Westmoreland opens a box to demonstrate how they affix a tag to each set of remains so they can identify the deceased. He pulls out a bag of ashes. Just carbon, he says. Every once in a while, someone comes to scoop up all the veterans. The rest wait under Westmoreland’s watchful eye. Technically, the mortuary is allowed to get rid of the remains after 90 days. But as long as there is room on the shelves, “We’ll keep them for as long as we can,” Westmoreland said.

Justin was Number 3440. Rolfe felt conflicted as she accepted his remains.

“We knew he was dead,” she said. “There was no question. But getting that box right there was reality.”

To the outside world, Justin’s death came and went like a raindrop in an ocean. The men and women who knew Justin on the streets made a memorial for him out of a wrinkled piece of cardboard and offered pieces of fruit and chicken. Someone wrote on the cardboard:

Dying Homeless In Salt Lake City

A makeshift memorial created by homeless friends of Justin Huggard.| Photo courtesy Colleen Swasey

Always Remembered

Never Forgotten

Justin

A five-sentence story went out in the newspaper saying that police were investigating the death of what was thought to be a transient at 235 S. Main St. Somehow the cadre of homeless advocates at the Fourth Street Clinic who volunteer every year for the same grim duty compiling the list of homeless men and women who died the previous year missed him.

Monte Hanks, the client services director at the clinic, counted 92 homeless people who died last year, including five veterans. For whatever reason, the police forgot to tell him about Justin. On a busy Thursday morning, nearly at the end of what had been a long and frustrating week, Hanks sighed. God almighty, he said. I think we started doing this in 06, 07. The 69-year-old Vietnam veteran struggled with substance abuse and anger issues after returning to civilian life. It took the death of his father at age 64 to put him on the path back to living, as Hanks puts it.

In the decade since Hanks has been recording the deaths of homeless people in Salt Lake City, he’s seen the same rotating cast of complications every year: Drug overdose. Alcoholism. Heart failure. Suicide. Cancer. Car accidents. Murder. Now a number of stakeholders, from politicians who want to fix the problem to developers who want to tear the Road Home down to advocates who have fought for the homeless for years, are jumping in. Salt Lake County Sheriff Jim Winder floated a plan to create a homeless campsite that was criticized by the ACLU of Utah.

Salt Lake County Mayor Ben McAdams fought a bitter battle to locate a homeless shelter in South Salt Lake, a move that many advocates questioned because it would put the homeless farther away from transportation and other services. The Downtown Alliance announced a program that would discourage people from giving panhandlers money. If it were up to Hanks, he would push for what he says is a dire need for more medical detox facilities and mental health services. He says the homeless need a medically supervised place to recuperate a time-out from whatever problems you had on the streets and then innovative housing like the Other Side Academy that focuses on work ethic, integrity and responsibility.

People go, Oh, it s just the homeless, Hanks said. Well, that s crap. Almost every family out there has got a story like this.

On Dec. 13, homeless advocates and clinic employees gathered at Pioneer Park to honor the 92 homeless who had died that year. A DJ played music. Longtime homeless advocate Pamela Atkinson gave a speech. The attendees spoke a prayer:

Let me be a little kinder,

Let me be a little blinder

To the faults of those about me,

Let me praise a little more.

Four days later, after temperatures dipped to 21 degrees, the sun rose on the body[2] of another homeless man.

A final trip

Rolfe made her way carefully back to Heber City through the storm, fielding phone calls from Justin s worried aunt, Christine Huggard. As she climbed the stairs to Huggard s house, holding Justin s ashes in her arms, she grasped at the empty feeling in her chest. In the kitchen, the two women put the box on the counter and gaped at it. Justin, she thought, what are we going to do with you now?

The children roamed about, approaching the box with curiosity. What do you mean Justin s in that box? asked 10-year-old Devin, one of Justin s aunt s grandsons. Nine years ago, they had all gone tubing on the Provo River, and Rolfe crashed into a tree and fell into the water.

Struggling to surface, Rolfe realized that a cord connected to a cooler had wrapped around her neck and was strangling her, holding her beneath the powerful current.

Dying Homeless In Salt Lake City

Aimee Rolfe talks about her friend, Justin Huggard, at her home in Heber City on Thursday, March 30, 2017. Huggard was homeless when he died on a sidewalk in Salt Lake City in 2016. At the table is a gray box containing Huggard’s ashes, a pair of photos of Huggard, and a single dollar bill that was in his wallet when he died. | Spenser Heaps, Deseret News

Suddenly, Justin was there, next to her, cutting the rope with a knife, pulling her out of the water. Rolfe’s neck was raw and red, her legs like hamburger from beating against the rocks. Afterward, they walked along the railroad tracks by the river while he sang to her: “Lollipop, lollipop

Rolfe told everybody who would listen that he saved her life.

No, I didn t, Justin would say.

Yeah, you did. You know you saved my life.

I m a simple man, Aimee, he d laugh.

It would have been better, Rolfe sometimes thinks, if they could have afforded to bury Justin. Next to his mom and grandmother in Heber Cemetery. Not like this, a box and a Ziploc bag of his last possessions: a wallet, a packet of rolling tobacco, a piece of paper with her phone number scrawled on it. Police records later showed that Justin had died wearing Aimee s sweatshirt. She didn t get it back. Where to put him to rest? It preoccupied her thoughts, crowded out any sense of closure over his death.

Four months had passed, and still she wasn t sure where to scatter him.

We re just going to fling him, Rolfe jokes. Maybe they would sprinkle them in the Jordanelle, near Keetley, or in the Provo River, where he saved her life. His cousin wanted some of the ashes. Maybe she would save some for a tattoo. On a damp Thursday afternoon, Rolfe stepped outside to smoke a cigarette, walking to the place where the sidewalk ends and the gravel driveway starts. The last place she saw Justin.

Dying Homeless In Salt Lake City

Aimee Rolfe talks about her friend, Justin Huggard, at her home in Heber City on Thursday, March 30, 2017. Huggard was homeless when he died on a sidewalk in Salt Lake City in 2016. At the table is a gray box containing Huggard’s ashes, a pair of photos of Huggard, and a single dollar bill that was in his wallet when he died. | Spenser Heaps, Deseret News

She tried to talk him out of leaving. She pleaded.

He just told me that there was no reason for him to stay here anymore. That he wanted to go back there,” Rolfe said. She wondered how many people had walked past him downtown. She wondered whether the people who found him had carried his body gently, carefully, as she would have, or whether they didn t care.

If only they had known him as the 13-year-old kid being raised by his grandmother, she thought. If only they had known how devastated he was after she died. If only they knew about how he would play kick the can with neighborhood kids as the sun set against the Wasatch Mountains, and the time he had fallen into a hole and twisted his ankle and limped around wailing Oh, my cankle! Owie! Owie! to make the children laugh. They would have liked him, she thought. They would have understood. Her mom poked her head out of the door. It was time to go. They had to take Zach downtown.

I think I might put some of Justin in the flower beds, Rolfe yelled. What do you think?

She turned away as she laughed, wiping tears from her cheeks.

She would wait. It was still too cold, too dreary. They need to wait for a day with sunshine and balloons and hot dogs and beer. It had to be the right time. The right place.

She wanted to get it just right to find a home for Justin. It had to be perfect. He deserved it.

Editor’s note: This is the first in a three-day series on understanding those who are homeless and searching for ways to help.

How to help in Salt Lake County:

The Road Home[3]

(801) 359-4142

www.theroadhome.org[4]

A nonprofit social services agency that provides emergency shelter, case management and emergency services to help the homeless transition back into the community.

The Fourth Street Clinic[5]

(801) 364-0058

www.fourthstreetclinic.org[6]

A medical clinic primarily serving homeless Utahns and offers primary care, dental care, and behavioral health care.

Volunteers of America[7]

www.voaut.org[9]

A human services nonprofit that provides affordable housing and substance abuse treatment for the low-income and homeless.

Crossroads Urban Center[10]

(801) 364-7765

www.crossroadsurbancenter.org[11]

A grass-roots nonprofit organization that runs an emergency food pantry and thrift store to assist underserved Utahns.

Utah Food Bank[12]

(801) 978-2452

www.utahfoodbank.org[13]

A nonprofit that distributes food across all 29 counties in the state with direct service programs to children and seniors.

United Way of Salt Lake[14]

(801) 736-8929

www.uw.org[15]

The world s largest privately funded charitable organization.

The Other Side Academy

www.theothersideacademy.com[17]

A free two-year school where students learn vocational, pro-social and life skills. Available to men and women involved in the criminal justice system, the homeless, substance abusers and others.

The Inn Between

801-410-8314

www.theinnbetweenslc.org

A refuge where Utah’s homeless men and women can die with dignity and receive professional hospice services.

Catholic Community Services

A social service agency that runs the St. Vincent de Paul Dining Hall and Weigand Homeless Resource Center, a day shelter for homeless individuals.

801-977-9119

www.ccsutah.org

References

  1. ^ brain disease (www.nejm.org)
  2. ^ body (www.deseretnews.com)
  3. ^ The Road Home (www.google.com)
  4. ^ www.theroadhome.org (www.theroadhome.org)
  5. ^ The Fourth Street Clinic (www.google.com)
  6. ^ www.fourthstreetclinic.org (www.fourthstreetclinic.org)
  7. ^ Volunteers of America (www.voaut.org)
  8. ^

Amnesty for refugees from Ebola-affected countries expires next month

T

housands of immigrants allowed entry to the US[1] to escape from West Africa s recent Ebola outbreak now face deportation, as the program that allowed them residence is ending. An estimated 5,900 immigrants from Guinea, Liberia, and Sierra Leone arrived in the US under the Temporary Protected Status (TPS)[2] program between 2014 and 2016. However the US Citizenship and Immigration Services confirmed this week that the program will expire May 21. The widespread transmission of Ebola virus in the three countries that led to the designations has ended, the agency said in a statement. The last new cases of Ebola in West Africa emerged in 2016. Today the World Health Organization is focusing on recovery efforts in the countries affected, including an experimental Ebola vaccine. [3][4]

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Lawrence Beah is one of those who came to the US under the TPS program. Beah and his family left Sierra Leone in 2014 during the Ebola outbreak. He sent his mother, sister, and other relatives to Mauritania. But before he could join them, Mauritania issued a travel ban on immigrants from Ebola-affected countries. Beah then traveled alone to the US, arriving just as the Department of Homeland Security established TPS, allowing people from Ebola-affected countries to remain in the US and legally work. Now Beah works as a security guard in New York.

Amnesty For Refugees From Ebola-affected Countries Expires Next Month

Read More

With the end of an immigration program comes Ebola fears for West Africans in the US

Beah fears he will have to leave the US.

Mauritania will not let me in, Beah said, noting that country s recent wave of crime and terrorism[5]. He would have to return alone to Sierra Leone. I cannot get a job there, he said. More generally, Beah said, he feels less safe as an immigrant in America these days, although he he hasn t heard of any deportations of people with TPS documentation. Because I see people getting deported in other cases, he said, I cannot sleep, and I am afraid to go out anywhere. Immigrants and their advocates had hoped that TPS, which had been extended twice, could be extended again, perhaps indefinitely.

Beah and other West Africans are talking to immigration attorneys, hoping they can get green cards or asylum. But most of them don t qualify [to stay in the US] under any other category, especially now, said Amaha Kassa, executive director of African Communities Together, an immigrant advocacy organization in New York.

Advocates argue that the secondary effects of the Ebola epidemic remain a threat to the economies and health of affected countries like Sierra Leone. Many of the 11,000 people who died during the 2014-2016 Ebola outbreak were health care[6] workers, which has devastated the health care infrastructures of Sierra Leone, Guinea, and Liberia.

The damage from epidemics will take years to fix, said Kassa. The number of health care providers plummeted during these epidemics. There is also the loss of foreign investment in those countries, and there have been effects on the food supply and widespread malnutrition.

References

  1. ^ allowed entry to the US (www.statnews.com)
  2. ^ Temporary Protected Status (TPS) (www.uscis.gov)
  3. ^ emerged in 2016 (www.who.int)
  4. ^ recovery efforts (www.who.int)
  5. ^ crime and terrorism (travel.state.gov)
  6. ^ health care (www.who.int)
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