Anchorage Daily News

The deaths of four street people outdoors during May, and the swelling numbers of homeless in Anchorage, tell us as a city we're not doing enough for those who live harsh, self-destructive lives in the woods. One approach that might help is "housing first." The concept, advanced here two years ago by Melinda Freemon, director of Anchorage services for the Rural Alaska Community Action Program, has since been taking hold across the country.

The idea is this: You provide permanent housing for chronic alcoholics to get them off the street. You let them keep drinking if they have to, demanding only that they meet with a caseworker and not cause trouble where they live.

This has been proven to cut the costs of caring for chronic alcoholics, and let them live healthier lives.

In April, the Journal of the American Medical Association published a study of what happened when Seattle put 95 chronically homeless people with the worst alcohol problems in permanent housing downtown.

It compared costs such as emergency room fees, Medicaid charges, charges for community service patrols, detox services and jail time, for the year before and after the people were housed. The costs dropped from $8 million in the prior year to about $4 million -- and the clients got housing where they had none before. The people gradually cut back their drinking, too.

RurAL CAP in Anchorage is in the third year running a modest version of housing first, with 14 people in scattered apartments -- not all in one building. "It totally works here, too," said Freemon.

Drinking is allowed, as long as the behavior that goes with it is acceptable. "We're constantly coaching them -- you're going to lose your house if we get another complaint. Sometimes people have to be housed four times to modify their behavior enough to be housed."

Freemon thinks there are at least 150 people among Anchorage's chronic homeless who would benefit from Housing First. RurAL CAP applies for whatever funds become available, but since the program saves money, there ought to be a way to translate the savings into more permanent housing units. In Washington state, $20 fees for real estate transactions go into a housing trust, said Freemon. That's something Alaska could look at, too.

There's one big downside to housing first: Nobody wants an apartment house filled with drinking alcoholics living on their own as a neighbor. Yet locating an apartment house near existing shelters and camps would just put the residents back in the dysfunctional life.

It's a problem, but not an insurmountable one, Freemon says. So far, RurAL CAP has sidestepped the issue by distributing housing first residents in scattered units.

The growth of homelessness in Anchorage is disturbing. Housing first is a successful system that should be expanded to take care of more street people with serious alcohol problems.

BOTTOM LINE: Anchorage should find permanent housing for more street alcoholics. It's cheaper and helps them live healthier lives.

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