By Whitney Isenhower
Carlotta Mauney was homeless for nine years and used drugs for 12, primarily crack cocaine.
“It was tough, but while I was out there, most of the time my attitude was, ‘This is what I deserve; I don’t deserve anything better,’” she said.
But eventually, she got fed up.
“One day, it just came to me. I said, ‘You know what? I remember when I was better than this.’”
So in 2008, she went through a drug-addiction program at a Charlotte women’s shelter.
“I’ve been clean now six years and about six months,” Mauney said last fall.
Despite cleaning up, she was still homeless. Shelters don’t offer permanent housing, and she said the longest she could stay was usually six months, though sometimes it could be extended.
“After I left the women’s shelter, I was staying with my daughter for a while,” Mauney said. “Things didn’t work out too good in that situation, so I was back out on the street again.”
In February 2012, she finally found her own apartment, in a building called Moore Place, where some of the formerly most vulnerable homeless individuals in Charlotte now live.
And researchers tracking the program at Moore Place say not only does it provide stable housing and a restoration of people’s dignity, it saves county and state dollars.
Back on her feet
Moore Place sits at the intersection of North College and North Tryon streets, in a spot that could be described as “desolate,” near the railroad tracks, tucked between the gleaming uptown skyscrapers and the Amtrak station.
But Moore Place is a cheerful, large, yellow-and-beige building. The roof is red, and residents can sit outside talking on benches under a covered area outside the entrance. Trimmed, bright grass extends from the building’s sides, with short bushes next to the outdoor walls.
Mauney was one of the first 10 people to move into Moore Place when it opened more than three years ago.
Once there, she met with a psychiatrist. She was able to get medications for high blood pressure and mental health disorders.
Then, in January 2014, she reconnected with her father before he passed away.
“We talked a lot, and he was proud of me. So at least I did something right before he left,” she said. “He used to worry about me so much; he would tell me that all the time.”
Mauney received a scholarship for a peer-support certification, which she completed, and was looking to find related work.
Housing first
For years, the script for social service workers or clergy working with homeless people was, “Get cleaned up, then we’ll get you a place to live.”
But what drives Moore Place flips that logic on its head. The managers at the complex use a “housing-first” model: Find people who are homeless a home before worrying about anything else. There are no requirements to prove you’re sober or mentally well or have a source of income.
The idea is that once someone has housing, he or she has the foundation to get well and find financial support. Without income, it can be difficult to find a home. And without a home, it can be difficult to have the stability needed to get sober, get cleaned up, find a job, achieve adequate income.
“You don’t require people to succeed in services in order to keep their housing,” said Lori Thomas, who teaches social work at UNC-Charlotte.
Caroline Chambre, Moore Place’s director, arrived in April 2010 after working with Common Ground in New York City, which also uses a housing-first model.
Chambre said this model aims to break the cycle in which chronically homelessness individuals can find themselves.
“If you think about being homeless, and you think about sleeping on a park bench or sleeping under a bridge, or, you know, sleeping on the street, even staying in the shelter,” she said, “it’s that much harder to get out of homelessness on your own if you have a severe and persistent mental illness, or if you have a severe and persistent mental illness and a substance abuse disorder, or you’ve got the trifecta of those three things and a chronic health condition.”
Barriers for these people, Chambre said, are that much higher than for most people.
Low barrier
Moore Place uses a “low-barrier housing” approach for homeless individuals by first focusing on one key thing: “Let’s give you what you need most, which is housing,” said Chambre.
Once that’s addressed, the model works to keep people out of homelessness.
Staff at Moore Place take a holistic approach. The apartment building has an onsite health room, a staff nurse and a psychiatrist who comes in two days a week. The organization also connects tenants with a primary care physician.
Chambre said there are still challenges in linking tenants to specialist medical care, such as an ophthalmologist or dentist. Most tenants have Medicaid, and she noted that few dentists take it.
Nonetheless, residents get healthier. According to a study performed by academics from UNC-Charlotte, by the second year 34 study participants were receiving Medicaid to cover health expenses and care, up from 17 at the study’s baseline.
But more extraordinary, said Thomas, who performed the study, was the decrease in medical resources.
In the year before moving into Moore Place, she said, the facility’s residents had 571 emergency department visits.
“One person alone had 125 visits in one year,” Thomas said.
In the first year after moving into Moore Place, the number of ED visits dropped to 124 for the 61 people she was able to track through medical records.
And if people were eventually admitted to the hospital, the average number of days in a hospital bed fell from 7.6 days per admission to 1.6 days. Per resident, medical bills fell from $7,336 to $1,863.
“We looked at what the hospitals were billed as well, and the bills were $1.8 million less,” she said.
Getting the keys
Those who want to get into Moore Place must apply, and the building only takes individuals, not families.
The permanent supportive-housing model Moore Place uses is typically for single people, and most chronically homeless individuals tend to be single. Chambre noted her team counted maybe six chronically homeless families out of 200 people when doing an initial analysis for the project.
Tenants sign a lease and are responsible for putting 30 percent of their monthly income, if they have it, toward rent. The Charlotte Housing Authority also provides a rental subsidy for all 85 efficiency apartments.
Moore Place aims to add 35 more units by the end of 2015.
Chambre said Moore Place received 83 percent of original construction costs from private funds and 17 percent from public funds. The program itself is run with about 90 percent public funds and subsidies and 10 percent private funds.
The Charlotte-based Duke Endowment provided funds to establish the health room and health support and conduct a study of the project.
Thomas said models such as Moore Place’s have become more prevalent in the past 10 to 15 years.
“It’s going to be much more based on providing permanent housing,” she said.
In addition to being provided with safe, stable, supportive, permanent housing, Mauney has found that people can be kind.
“It’s good to know that people who are more fortunate than you are don’t mind giving a helping hand to somebody who’s down on their luck,” she said.
“Because when I was out there on the street, I never would have thought that. I never could see that happening to somebody like me.”
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