Sarah Watts was staying out at Anchorage’s Centennial Campground when last month’s heavy rains began, drenching seemingly every tent, blanket and sleeping bag on site.
Already, she’d been having difficult time with the outdoor accommodations.
“In my situation, I’m a high-risk pregnancy, and it was hard to sleep. You couldn’t get an air mattress to stay inflated,” said Watts, who is due in November.
Watts, 43, also suffers from health complications that require equally complicated treatments: She uses a blender to liquefy the nutrients and vitamins she has to take, she requires regular blood transfusions, and her unexpected pregnancy meant getting herself to regular maternal health appointments. It was hard to impossible to manage all that while camping at Centennial, and the negative impacts on her health were compounding.
“It was a life-and-death matter to get out of there,” Watts said.
Mercifully, help arrived.
Watts was one of the extremely vulnerable Centennial residents identified by volunteers and workers for a spot in the new shelter, called Complex Care and run by Catholic Social Services. Since June, the former Sockeye Inn on the northern edge of Midtown Anchorage has been repurposed to serve as a homeless shelter geared specifically for people with health and mobility issues.
For years, advocates pointed to a dire need for homeless shelter facilities tailored to the elderly, medically fragile and disabled, who need extra support navigating daily life and tend to get drastically sicker living on the streets.
Watts, like nearly all of the Complex Care shelter’s 83 residents, has a room of her own. A bed. A refrigerator to store food. She shares a clean hall bathroom with others on the floor. Case workers from Catholic Social Services are constantly on hand to help her and others navigate benefits programs and get her to medical appointments. There’s a place to plug her blender in.
“Just being able to sleep at night ‘cause you’re safe, you know a bear’s not gonna come,” Watts said. “You’re not worried about every day wasting away your money because you’re having to buy little things. You’re able to actually have actual groceries. This whole setup actually makes a huge difference. As opposed to the tent: You had to get super creative.”
Proponents of innovative homelessness strategies say Complex Care is a model of what the city ought to be focused on: relatively small shelters spread across different neighborhoods in the city, each focused on a specific demographic of the broader homeless population. Rather than a mass-care site with hundreds of people dealing with a wide range of needs, Catholic Social Services and others say there need to be shelters tailored to women and families, young people and advanced health needs, among others.
Serving a population with acute needs
The COVID-19 pandemic scrambled many of Anchorage’s longstanding systems for handling homeless residents. Almost instantly, business as usual changed. Overnight shelters shrank their number of daily clients to reduce viral transmission risks. Vacant hotel rooms were repurposed. A mass-care site was installed in Sullivan Arena, which at times over the last two years slept upwards of 500 people a night.
It was in that context that a group of social service providers, organizations and funders began a years-long conversation on pieces missing from the city’s homeless system, resulting in the Complex Care shelter, which opened at the beginning of June.
The shelter is designed to house a significant chunk of the city’s overall homeless population — specifically, those with serious, chronic ailments and mobility issues. Since the start of the pandemic, the Brother Francis Shelter in downtown Anchorage was repurposed from a low-barrier walk-up shelter, as it had operated for decades, to one focused exclusively on that medically fragile group. Complex Care was envisioned to carry on that same work permanently.
Its opening in June constituted a major success for social service providers, achieving a substantial piece of Anchorage’s comprehensive approach to homelessness. In past years, opening an 83-bed facility funded with a mix of public and private dollars would have yielded a big press conference and public accolades. But that milestone happened to coincide with the closure of Sullivan Arena and the chaotic start of the open-air Centennial Campground as the city’s de-facto primary option for unhoused people to go, which has almost totally eclipsed it in public discussions of homelessness this summer.
Catholic Social Services, which runs Complex Care, moved dozens of clients who’d been staying at Brother Francis over to the new facility, where it expects people will stay around six to eight months before heading on to permanent housing or assisted living facilities.
“It really was never meant to be a medical facility,” Robin Dempsey, Catholic Social Services’ executive director, said of the new facility. “It’s really meant to be a shelter where we can provide a higher level of service to people with those needs.”
Ship Creek Community Assets, a nonprofit entity created to purchase the property, negotiated the sale with the previous building owner earlier this year. Calista Corp., Chugach Alaska, Doyon, the Municipality of Anchorage, Providence Health and Services, the Rasmuson Foundation and Weidner Apartment Homes kicked in $4.8 million to buy the building, according to Chris Schutte, a private consultant who helped funding partners with the due-diligence process and previously worked as the city’s director of economic and community development under Mayor Ethan Berkowitz’s administration.
The shelter costs Catholic Social Services around $4 million a year to run, paid for through a combination of federal, state and municipal dollars.
“We’re getting a substantial amount of money from the alcohol tax,” Dempsey said.
The rooms are modest, with small beds, a few cupboards and drawers, and large windows that look out over busy street traffic, a pawn shop, bar, laundromat and an axe-throwing business. The washing and drying machines on site are all free. Three meals a day are brought over by a food-service delivery company and there are a few small communal kitchen areas where people can gather to eat.
A lot of what the operating budget buys is staff: Eight employees and a program director are on hand during the day, a much lower client-to-staff ratio than most shelters maintain. They help clients when they need something, check bags at the front for banned alcohol and drugs and check in on people. Case managers are available around the clock, helping people navigate what can be a lengthy, convoluted process to get connected with social services, benefits, employment and other sources of stability that can get them into a better situation.
In the roughly two months since Complex Care opened, already three or four people have moved on to permanent housing.
“The homeless population in general is getting older, and health care is a real issue for people who are homeless, those two issues go hand in hand. So we find a lot of people experiencing homelessness have chronic health issues,” Dempsey said.
Escaping ‘the vicious cycle’
Complex Care opened just as the city was upending the homeless response system anew, closing its mass-care site and directing people across town to a campground with minimal staff, resources or planning.
“For the first time in 40 years, Anchorage doesn’t have a low barrier walk-up shelter,” Dempsey wrote in Catholic Social Services’ summer newsletter. “Closing the Sullivan Arena without another option has left our city in crisis.”
It certainly looked like a crisis to Watts while she was at Centennial. She’d been living on the streets, in shelters and in her car since serious health problems emerged two years ago, forcing her to stop working. Being homeless is terrible for a person’s health because of what Watts called “the vicious cycle.”
“You’re already sick and you’re not able to get the proper medical care. Everything goes hand-in-hand, from your diet to your sleep to being able to get to your medical appointments,” Watts said. “You can’t get better.”
Instead, easily treatable wounds worsen. Medications disappear and go unfilled. Restorative sleep is impossible. Ailments snowball until there’s an emergency so dire, people go to the ER. Though Watts tries not to speak badly about any of the shelters she’s been to, she bristled when mentioning the Sullivan — where, as she was recovering from a surgical procedure, using the bathroom facilities caused a staph infection in her wound, she said, sending her back to hospital once more.
For her, the Complex Care shelter has been an enormous improvement.
“You’re on a road to recovery, as opposed to in that vicious cycle of getting sick over and over again, and then your health potentially worsening,” Watts said. With the help of staff at the shelter, Watts was able to start making and keeping appointments for regular preventative care. “I’m not going to the emergency room every visit.”
The accommodations at Centennial were far less than at even an overburdened, repurposed facility like the Sullivan. While plenty of people staying there were familiar with outdoor camping and physically capable of taking care of themselves, others she saw couldn’t handle needs as basic as washing in the shower facilities.
“There were a lot of seniors and people with medical needs. How do you get to the bathroom when you barely can walk? And get out of your tent? And trying to get any type of wheelchair — you can’t get that in a port-a-potty,” Watts said.
In the early part of July, Catholic Social Services and other organizations scrambled to ameliorate some of the suffering and chaos at the Centennial Campground. Though they’d already filled most of the beds brought online with the opening of Complex Care, they still had some left, and knew there’d be a dire need for them.
A small group of former employees from 99 Plus 1 who were laid off when the Sullivan shut down took it upon themselves to show up at Centennial, and they began identifying people for whom navigating the campground was not possible. They knew who would best benefit from the services at Complex Care when its program director, Jessie Talivaa, had bed spaces available.
“It had rained really hard that day out there. And that’s when I was getting a whole bunch of phone calls,” Talivaa said.
Watts was one of the people on his list of ideal candidates to move into Complex Care. Even though it was a Saturday, technically his day off, Talivaa went to the campground to look for her.
One of the challenges for service providers with the Centennial site is locating people they know are staying there, particularly when wet weather drives everyone inside their tents. Reaching people by phone is tricky, too — there are few places for the campers to charge devices. Once they did connect, Watts was able to drive herself to the shelter from the other side of town.
“It’s new,” Dempsey said of the Complex Care shelter. Funding is secure for three years as everyone assesses how well it works.
“I think that there’s a need to prove the need,” Dempsey said. “I don’t think we’re gonna have any trouble proving the need.”