Four Walls and a Bed

A HUGE TASK, 50 TIMES OVER

Project 50 Doesn't Demand That Skid Row's Hardest Get Clean or Get
Mental Help. It Just Gives Them the Keys.

First of Four Parts

The searchers carved skid row into quadrants and advanced in small
groups, aiming flashlights into the cold.

They moved between nylon tents and cardboard lean-tos in the Toy
District, where junkies had stripped the streetlights and left whole
blocks in darkness. They roused the human bundles scattered around
the tumbledown hotels and freshly painted lofts on Main Street,
wasted faces blinking into their flashlights.

They looked in the eastern section called the Bottoms, around the big
missions and flea traps, and around the neighborhood's forbidding
eastern edge, a zone of industrial warehouses and razor wire known as
the Low Bottoms, where even now, hours before daylight, the crack
trade was brisk.

The searchers, a couple dozen volunteers and Los Angeles County
workers, had orders: Interview everyone living on these streets. Find
out how long they've been homeless. Ask about their addictions, their
mental and physical health.

Carrie Bach, a 54-year-old nurse with the Public Health Department,
was leading one of the teams, a scarf around her neck and a
walkie-talkie in her mittens. As her department's homelessness
coordinator, she knew skid row better than most. But she felt nervous
and a little naive. She had never glimpsed the Boschian tableau that
materialized after the warehouses bolted their doors, after the
corrugated-metal gates rolled down over the church fronts, cheap-toy
outlets and fake-flower shops.

She hadn't seen the pavement scattered with bodies, the spectral
shapes swaying against the cinder-block walls, the mounds of garbage
screeching with rats. For some searchers, it was too much. They
handed back their clipboards and went home.

The canvass marked the beginning of a two-year, $3.6-million plan,
launched by county Supervisor Zev Yaroslavsky, to find the 50 people
likeliest to die on skid row's streets - the hardest of the hard
cases - and house them however possible.

Scuttling decades of settled wisdom, Project 50 would not demand that
they quit drugs or stop drinking. Nor would they be required to seek
psychiatric help.

Rather than allow the homeless to grind endlessly through the
machinery of missions, lockups and hospitals, why not just give them
an apartment key? Rather than force them into treatment programs, why
not settle them in a room and offer all the help they'd take?

This method, called "housing first," was meant to do more than save
lives. The hard-core homeless cost taxpayers hugely in emergency
services, and studies showed that putting them in apartments, with
access to doctors and counselors, slashed those costs. If it worked
on Los Angeles' skid row, that infamous 50-square-block netherworld
sometimes called the nation's "ground zero for homelessness," it bore
promise of redefining homeless policy everywhere.

As Bach searched the streets that night in December 2007, she found
two worn-looking women huddled against a wall and tried in her
polite, persistent way to interview them. Suddenly an angry man
wearing too much jewelry was standing threateningly in her face.
Later, someone explained: their pimp.

For Bach, who would soon be named the project director, much of the
next year would echo that encounter: a struggle to decipher a world
not her own. She was a grandmother who carried a Bible in her Buick
and worked the soundboard of her Presbyterian church. She talked to
God in traffic and asked forgiveness when she cursed.

She had narrowly avoided homelessness herself. Her first marriage had
ended in destitution, leaving her living in a borrowed cabin in the
woods near Big Bear, where she sewed clothes for her three girls and
warmed their bedsheets with a skillet on cold nights. She was
remarried now, to a sweet, burly man who suffered from manic-
depression and took his pills religiously.

She knew she would now confront extremes of despair and uncertainty
far beyond her own experience. Over nine nights, she and the other
volunteers found 471 people living on the grid bounded by Main Street
and Central Avenue, 3rd and 7th streets, which encompassed all but a
deserted sliver of skid row. Of that number, 350 people answered
detailed questions about their health, habits and psychiatric history.

The list was soon ready, the names studied and boiled down to the 50
worst cases. Many had some combination of addiction, mental illness,
chronic disease, advanced age and more than six months on the streets.

Six months: That was the directive from the county chief executive's
office. Find everyone on the list and get them housed in six months.
In mid-January, the Project 50 team fanned out to the streets and
alleys, soup kitchens and missions, clinics and storefront churches.

"Whatever it takes" would be the motto, speed the watchword.

The rooms weren't much, just cell-size efficiencies in a cluster of
refurbished downtown flophouses. A bed, a sink, a dresser, tile
floor, and windows that overlooked dirty courtyards. Shared kitchens
and bathrooms. Halls redolent of cleaning chemicals. Lobbies with
vending machines and mounted televisions.

Maurice Lewis, No. 36 on the list, got the first key.

Lewis, who frequented the Los Angeles Mission, was easily found. He
had a glowering stare and big shoulders hunched in bulky clothes. He
had been homeless for about a year off and on, he explained, drifting
around downtown, sleeping on buses. He was 54 but looked a good decade older.

He'd spent years "drinkin' and druggin'," he said, and heard voices
in his head. He displayed an expired merchant marine license and
mumbled about getting back to the sea.

The terms of Project 50 were explained to him: We have a room for
you, your very own. You don't have to see a shrink. You don't have to
attend substance abuse counseling. All that's required is that 30% of
your income - in Lewis' case, a $221 monthly general relief check
from the county - go toward rent.

Lewis seemed wary of the eager-faced people ushering him to the
Senator Hotel on Main Street. He opened the door and surveyed the
featureless 10-by-15-foot room. The third-floor window overlooked the
street's round-the-clock drug transactions.

His wariness turned to anger when he learned the lock hadn't been
changed since the last tenant moved out, which meant, he was
convinced, that the person might return any time; he'd be easy prey,
confined within four strange walls. He handed back the key and headed
to the streets, where he felt safer.

The lock was quickly changed, a fresh key offered. And in the last
week of January 2008, as Lewis moved in, Bach's team could count its
first tentative victory.

The following week, Bobby Livingston, No. 1 on the list, moved in a
floor below Lewis. He was 64, with schizophrenia, asthma, a crack
habit and a love of brawling. He had survived on skid row for 37
years, longer than anyone else they'd found, and if anyone tested the
program's premise, Bach thought, it would be Livingston. Whether he
was capable of changing much - whether he had any desire to change -
was anyone's guess.

Down the block, a week later, Cliff Butler, No. 46, moved into the
Sanborn Hotel. At 52, he was bipolar and industrious. He called
himself the Polish Man, financing his $150-a-day cocaine habit by
shining big rigs. "This ain't a bunch of mental midgets. Even the
mentally ill have developed a con or hustle," said Butler, speaking
as much about himself as the other clients.

In late February came Paul Sigler, No. 49, who had a familiar
combination of afflictions - manic-depression and crack addiction -
but presented a puzzle. He was 44, with striking light-blue eyes, one
of skid row's few white men. "I used to be a millionaire," he
repeated as he settled into the Senator.

It sounded like the delusion of someone eager to distance himself
from the wretched cases around him, but Bach - who thought she heard
the remote echo of privilege in his speech - refused to draw
conclusions about him. It was impossible to tell who was telling the
truth down here.

In early April they found No. 5, Wanda Hammond, who was huddled on
the pavement half-clothed, where she had been prey to sexual attacks.
She was 49, mentally ill and known as a "strawberry," a woman who
traded sex for a fix.

Only after she'd found the rock cocaine and pinch of heroin in her
blankets, only after she'd shambled down the street to buy the pipe
and hypodermic to deliver the double blast, did she reluctantly climb
into a car with outreach workers.

At the detox center in Long Beach, nurses found her back crawling
with scabies and turned her away. Back on skid row, Bach snapped on
gloves, smeared permethrin ointment on the infection, then raced to
the detox center before it closed. This time, the nurse objected
because Bach hadn't applied the ointment head to toe as protocol
required. When Bach made it clear that she was ready to stand there
and argue all night, the nurse admitted Hammond.

Two weeks later, Hammond walked into Project 50 headquarters,
smiling, and Bach greeted her with a hug and a bouquet of flowers.
Hammond moved into the Senator that day.

In May the outreach team found Cathy McFee, No. 3, a hollow-cheeked
transsexual with hoop earrings, tight black curls plastered to her
scalp with Vaseline and a floral-print dress draped awkwardly on a
square 5-foot-3 frame.

"If I get my hands on my check, I don't care what anybody say, I'm
gonna go astray," McFee, 62, told Bach as they rode to the Social
Security office. "No matter what I say, please..."

"Money is my - what do you call it?" McFee said.

"Achilles' heel?" Bach said.

"Money makes me want it. I gotta get that urge off me that's in my brain."

McFee sat uncomfortably in the back of the car. Doctors had removed a
malignant tumor from her leg the year before, but the wound never
healed. She was ashamed to sleep in shelters because people recoiled
from the smell, which she tried to mask with 99-cent cologne. Now and
then, someone would decide it was time to call her an ambulance. In
the last year, she'd racked up 15 emergency room days and 26
inpatient hospital days, a taxpayer tab of about $90,000.

She had four children somewhere, but during eight years on L.A.'s
streets she'd mislaid their photos, along with her anti-depression
pills. Twice, she'd been shot for stealing other people's drugs.

For McFee, the day was proving exhausting - in and out of the car,
government counters, housing forms, welfare forms, ID forms: There
were countless pieces of paperwork needed to bring a ghost off the
streets. Bach shepherded her through a gantlet that McFee knew would
defeat her completely if she had to face it alone.

It was time for the interview at the Sanborn Hotel, her prospective
new home. "Are you sober?" asked building manager Bryant Caver. "Do
you use drugs now?"

"I ain't done nothing in quite a while," she said vaguely. "I'm
trying to save my life. If I mess with that, I'm killing myself."

"What if the music's loud next door and you need to sleep?"

"I put cotton in my ears."

After the interview, she sank back into the car and sighed wearily.
There was still another trip, still more paperwork, this time at the
city Housing Authority. "Oh, God," she said.

She got her room the next day. She found a used DVD player and some
bootleg movies. "You either gonna be in here getting messed up, or
you got something to entertain you," she said.

Psychological triggers were everywhere. Walking down the hall, she
said, she could hear lighters clicking behind the doors and could
smell crack vapor seeping out.

To Bach, what distinguished McFee from other addicts she met - what
made her seem a more hopeful case - was her frank admission of her
helplessness before her cravings. When the beginning of the month
arrived, a frantic McFee cashed her welfare check and thrust an
envelope of cash at Bach, pleading: Please take it.

Bach apologized. Rules were rules. She couldn't take a client's
money, and the program didn't have funds to hire an agency to manage
it. With a helpless feeling, she watched the small figure hobble away
to find the dope man.

Just a few months into the program, questions were becoming
inescapable: Was it possible to keep people under a roof, even if
their addictions and mental illness remained untreated? Did "housing
first" imply a promise to give more than shelter - to nudge at least
some people back into the world, to family, to independence?

Was "whatever it takes" even close to enough?