by Christina Hoag
Associated Press Writer
LOS ANGELES (AP)—After living two decades on the streets of Skid Row, Sheila Nichols was dying. Her body had withered to 61 pounds, ravaged by a heavy-duty crack cocaine addiction, hepatitis, HIV, and late-stage syphilis, when late one night a stranger offered her a sandwich and, just maybe, survival.
|AT DEATH’S DOOR—Sheila Nichols, 55, has her temperature checked by a nurse at a clinic in Los Angeles, July 19. After two decades living on the streets of Skid Row, Nichols was dying.
Two years later, the 55-year-old former computer analyst proudly shows off her tiny apartment, and wears bright red lipstick on her smile. “I’m not that person anymore,” said Nichols, now drug-free and weighing a more respectable 108. “I have the desire to live, I have hope.”
Nichols was rescued by a program targeting the 50 people most likely to die if they remained homeless. Dubbed Project 50, it marked a dramatic shift in homeless policy. Instead of funding temporary-fix shelters and apartments that typically house Skid Row’s highest-functioning residents, it focused housing, medical care and social services on the most down and out.
The concept initially raised eyebrows because the chronically homeless, who have spent at least a decade on the street suffering from severe mental illness, addiction and physical ailments, are generally considered hopeless.
After two years, 68 people have gone through Project 50 with 84 percent still housed through the program or alternatives like a nursing home or rediscovered family. Of the remaining 16 percent, six died of causes such as cancer and kidney failure and four went to jail. Six people walked out of the program, but four found their own housing. Two remain unaccounted for, possibly back on the street.
Getting nearly all participants off the streets has ignited hope that a solution is at hand for the roughly 20 percent of the homeless population considered chronic street dwellers.
“We have disproven the myth that chronically homeless persons can’t live in a housing unit,” said Los Angeles County Supervisor Zev Yaroslavsky, who championed the project and a $3 million one-time grant from the county to fund it.
The program will continue, financed by various county departments and federal subsidies. Costs are expected to decrease now that the system is in place, enabling the program to be expanded to 74 people, Yaroslavsky said.
The success of a pilot program in the nation’s capital of homelessness—about 50,000 people live on L.A. streets—has caught attention from Denver to Detroit. Neighboring cities are copying the model and the Department of Veterans Affairs is starting a similar project for chronically homeless vets in L.A.
Although it was expensive, proponents maintain it will pay for itself in the long run because it keeps the chronically homeless away from even more costly jails and hospitals. Participants also pay a small rent out of their Social Security income.
“It costs more to do nothing,” said Mike Alvidrez, executive director of the nonprofit Skid Row Housing Trust, which operates 1,000 apartments for the homeless including the Project 50 units in a new building.
In the year before entering the program, the Project 50 participants cost taxpayers a total of $756,000, according to a study by homeless advocacy group Common Ground, which developed the survey that identifies the people most in danger of dying on the street.
A portion of the program’s cost is the intensive treatment the chronically homeless require. Each participant is assigned a case manager, who shepherds them through psychiatric, medical, social and life skills services.
Some have taken issue with Project 50 because it does not require participants to enter rehab and participants are housed in the same neighborhood where drugs are readily available.
“I think it’s a mistake to concentrate this in Skid Row and not mandate an end to the behavior,” said Orlando Ward, public affairs director at the nearby Midnight Mission. “Are people really getting better? I’m taking a wait-and-see attitude.”
By offering housing, advocates hope to lure those who would never participate and then get them to enter addiction treatment. “That’s why we always say ‘housing first,’” Alvidrez said.
Nichols said she never wanted to get off crack until she got an apartment despite numerous stints in jail and court-ordered rehab. “Living like a human again” gave her the impetus to finally kick drugs, she said.
A native of Louisiana, Nichols was transferred to Los Angeles in the mid- ’80s for her job as computer analyst. Her downfall came when she met her husband, who introduced her to drugs, she said. Once she started smoking crack, she couldn’t stop, even when she lost her job, new car, house and spouse. She ended up on Skid Row, selling cocaine and prostituting to support her habit.
After 19 years on the street, it wasn’t easy to get her into housing. When an outreach worker approached her at 3 a.m. with a questionnaire and later an offer of an apartment and medical care, Nichols’ reaction was typical—she didn’t believe it. She hid when she saw workers returning, figuring they were trying to trap her.
During still another jail stint for drugs, Nichols signed up for the program, mainly for a promised gift card but also because she knew she was at the end of the line. She couldn’t swallow because of thrush through her mouth and throat. She suffered from chronic, severe diarrhea, had no muscle left that would take an injection and was nearly bald. Her body was caked with thick grime. All she wanted was another hit of crack.
Medical treatment, Social Security disability benefits, and an apartment helped build back her life. Still, it was hard to get used to living indoors. “I was claustrophobic for a long, long time,” she said. “I would still go on the streets. Now I spend most of my time in my apartment.”
She also attends prayer and Bible study groups and goes to Narcotics Anonymous meetings. Whenever she feels an urge to go back to her old habits, she looks at the raft of medicine bottles on her dresser and knows she has choices.
“I was at death’s door, but they saved my life and gave me my home back,” she said. “I’m pretty elated about it.”