Talking Health in the 406 � Ep 38 Homelessness, Housing, and Health
THIT406 United Way Final.mp3
Transcript
Trina Filan
Thank you for joining us for this episode of Talking Health in the Four Oh six, where we are one community under the Big Sky. I'm Trina Filan, a public health evaluator.
Margaret Mullins
And I'm Margaret Mullins. The social determinants of health program manager.
Trina Filan
We have with us today two great guests from the United Way of the Lewis and Clark area. Which serves Lewis and Clark, Broadwater and Jefferson counties. We might refer to this organization as U W l C A during this podcast. Because United Way of the Lewis and Clark area is a heck of a mouthful. We're going to talk today about how housing and public health intersect and why local interventions to address housing instability and homelessness can improve the health of whole communities. This is one of my personal passions. It's going to be a terrific conversation. Our guests are Emily McVeigh, executive director of the United Way of the Lewis and Clark area, and Jeff Buscher, Community impact coordinator. Welcome to you both.
Emily McVey
Thank you for having us.
Jeff Buscher
Thank you, Trina. Happy to be here.
Margaret Mullins
Housing in homelessness are major issues in many communities across Montana and the country. And housing is intimately related to health. According to. National Health care for the homeless council. People who are homeless have higher rates of illness and die on average, twelve years sooner than the general US population. Poor health is a major cause of homelessness. Homelessness creates new health problems and exacerbates existing ones. People experiencing homelessness have at least twice the rate of chronic disease than people who are housed, for instance, rates of diabetes are about nine percent for people who are housed, and about eighteen percent. People who are unhoused rates of high blood pressure are about twenty nine percent for people who are housed in about fifty percent for people who are unhoused and for our listeners, we'll make sure to put some links to some useful resources in the show notes.
Trina Filan
A key point here is that even if there is health care available to people experiencing homelessness or being unhoused, there's no amount of health care that can substitute for stable housing. It's an urgent need. And there is. Work to be done on this issue. Emily and. Can you each tell us about your roles at UWC? And how housing came to be is such an important focus for your.
Emily McVey
Work as the executive director. Job is to. Everything that happens at United Way. We are one of the United ways that has moved into Community impact work. And for us, that means housing and homelessness. Has become our priority. That has become our biggest project. We also do work in free tax clinics. We have a volunteer. We do a project called kids. And we. We help in a lot of other. We do lots and lots of projects, but really our biggest focus has become around the housing issues in our community. And so in that we do.
Speaker
And.
Emily McVey
Lot of different. We are the local continuum of care and we hold weekly case conferencing meetings. Which means we gather all of the case managers and other people in the community that work with clients that need housing, and we try to connect them to resources and to housing. Jeff helps with the showers program on. We've convened meetings, which we have done a really good job of taking the. Roughly seventeen meetings that were happening every month and condensing that down into a more reasonable number of meaningful meetings with the community stakeholders in the last year and really moving a lot of important projects down the road. Through the Community Health Improvement plan, action teams that Jeff started three years ago, we do a lot of work in housing that actually all started about seven years ago. With the team that was here at the United Way back then, which you were part of, Trina and back then they really jumped into that housing world and with the fuse project, the frequent users of systems engagement was one of the very first projects. And. That is still one of the projects we sit with today, and Saint Peter 's Health has taken that as their lead of that, and they, about two years ago hired the first case managers. The successor, seeing that that project is amazing and we could we could go into details about how that. Really focuses on the top users of emergency services. But showing that. By providing them with stabilized care, just changes the entire trajectory of a person 's life and. Really changes the. We spend money in the system of emergency services and housing and healthcare overall.
Speaker
Hi.
Trina Filan
I would love. Hear more about that as we. Eventually, we'd like to also have the fuse folks on for a discussion as well. Jeff, why don't you? Us. Your role. Why housing is integral to what you do?
Jeff Buscher
As Emily described, we not just Helena, Montana, but our country finds itself in a. It's out of a perfect storm of really not paying attention to the housing needs across our country. COVID pandemic did not help, but we have failed to keep pace. With the need for and, I feel like this is a belabored term, but I'll use the term affordable housing. And by that I mean. Homes that first time home buyers can. Homes that minimum wage earners might be able to afford. Folks who are. On vouchers or various? Subsidy programs can afford so that particular area of housing affordable housing. Is a significant gap. Let's just share an example and why we. Started the project when a person is given a voucher for housing folks who may be homeless, folks who may be disabled are awarded a voucher for approximately a thousand dollars a month through the federal government. Whether it's a supported housing voucher, a rapidly housing voucher. Their other section eight. Their number of voucher programs. But they're awarded those vouchers. And then? Told to go and find an affordable living space for eight, nine hundred a thousand dollars a month. That creates a significant challenge. Those vouchers are good for ninety to a hundred and twenty days, and often in that time folks are unsuccessful in finding a spot. Some of that is because. Landlords may be wary of voucher holders and past experience. And they may be set limits and say I'm sorry I don't. Don't rent to voucher holders. Things like that so. Homes in that price point, anywhere from or rentals. In that price point, from roughly eight hundred to eleven hundred dollars a month are are very difficult to find. So identifying that need led us to a. We'll talk more about the other thing I'll say from our experience this year. Last year 's. Count. Which is a annual count of our unsheltered population, revealed that we had approximately our exact count was a hundred and eighty one unsheltered individuals unhoused individuals in the Lewis. Clark area. And a lot of those. And my my. Hand experiences through the shower program. I would guess over the course of the last year we probably saw ten to fifteen people that came through the shower program. Who shared with us? This was their first time being unsheltered. They're from the area. They're not passing through. Their local but. This was a new experience for them. And so.
Emily McVey
Common fact that.
Jeff Buscher
High cost of housing leads to higher numbers of unsheltered individuals. That's just a general overview from the work that I do. The other thing that that I get to coordinating tweak is conversation with. Our case managers and social workers from across the community, and we're able to visit about specific cases, specific individuals and where they are on the continuum toward. Achieving successful housing and that work is it's hard when there aren't a lot of places to house people.
Speaker
Cool.
Trina Filan
You've brought up so many good points that we definitely want to touch on. Ask it a little bit later about the point in time. Survey I think it's really important for folks to know that a lot of the folks who are unhoused in our area. Are local people. These are folks who are our neighbors. They have long lives here in Helena, and that's the experience in a lot of places around Montana. Are our neighbors. So that's a lot of good stuff to. On. Thank you both very. Tell us a little bit about that showers program.
Jeff Buscher
Three years we started in November of twenty one, so twenty twenty one. Paul 's United Methodist Church. My the back story is that the pastor at the time the church building was built was a previous youth ministry. And he said when they built the building, he said, I want us to be able to have retreats here and I want us to be a place where we can hold a variety of of gatherings and they put in the lower level they have.
Speaker
Two.
Jeff Buscher
Men 's and women 's restrooms and at the back of those restrooms. Are three very nice shower stalls. And about three years ago, the missions person reached out to me, and we reached out to the folks at Good Samaritan and said we would like to work together to offer a shower program for unsheltered neighbors. And possibly do that weekly. So my role was to be the volunteer Coordinator and. The street outreach person at Good Samaritan was has been a helpful person to just be a contact for folks and and they help us publicize the showers and the Church of course made a huge. As you can imagine, thousands of gallons of water have gone through those showers over the years. I I can tell you real brief numbers and that is our first year, we had about four hundred showers and that's not individuals. That's. I'll come back to the individuals that. Second year, about seven hundred showers and this last year we were closer to twelve hundred showers on an average day we see about twenty to twenty five people in terms of numbers, our our first year was about fifty. A second year was about a hundred and twelve. And I think. This past year, we were over two hundred and twenty five different people utilizing the showers over the course of the year. And it's folks who are sleeping in their cars. It's folks who are on the streets. Sometimes it's folks who are lodging at God 's love. It's a. It's a wide variety of folks, and as I shared, sometimes it's folks who are newly evicted and. They're maybe living in their car or other places or even couch surfing with friends. But it's nice to just get out and get cleaned up, and sometimes we of course are able to do this for people who are preparing to go. An interview. They just need to be cleaned up and ready to go so that they can. Their best selves. It offers dignity and. We course try to. Treat them well and some other things that have happened over the course of this project is our good friends at the Rodney Street laundromat does washes our towels each week for us and the good folks at Vans grocery store. Provide a couple dozen Donuts for for the crowd each week, and so folks who've come alongside of us and help support that project, and it's just been a great. And besides providing that service, the other thing it does, it allows us to get to know these folks personally, learn about their needs and. On occasion, we're actually able to help help them with the various needs. I remember once a gentleman need a part for his car. I think the part was a hundred dollars and the volunteers at the shower said let's just cool. Money and get in. Part. And so we did that and. On another occasion. Someone had a camper that needed a small repair and one week we brought our tools and made. Small repair on that. So you just never know what people come up with in terms of needs. And sometimes we're able to meet them and sometimes we do a lot of referrals to folks like PureView ministries and Good Samaritan, so. It's it's just been a great, great project.
Margaret Mullins
Definitely, you know, ever since I've heard about the shower program, I have been so impressed by it. And what a beautiful example of when people and resources come together to fulfill a need. You might not be able to house that particular individual in that point in time. Like you said, it provides dignity. And it provides a resource that's really invaluable. It's a it's, it's. So thank you for for giving us some more information on that. So I'm really interested in hearing about your work because housing is intimately connected to social determinants of health. Which are those underlying social and economic conditions that influence people 's ability to be healthy? Housing connects to all parts of our lives, including economic stability, educational attainment and community development. I've often heard that a few different things need to be considered for housing to be adequate. Accessibility, stability, safety, quality and affordability. So Emily and Jeff, can you talk about what each of those mean? And how they impact housing, Emily? We start with.
Emily McVey
You. So when we look at finding housing for people, of course, the first thing we look at is affordability. You know, kind of for a person afford to pay the rent. One of the big things that we get stuck on is first month, last month deposits all the things that are required these days to get people just. Into an apartment or a house. It's very expensive to move, so you know, that's one of the first things we look at is affordability, the. You know the standard for a very long time has been somebody should be paying thirty percent of their wage to rent in utilities. That is just. I mean kind of out the window, right? It's just not even something we can look at because there is just nothing. There, that is. Within that. Range. Of affordability in our community or our state, really. And so we look at can we keep people within even fifty percent of their wage and you know, so that they're not paying more than half of. Their income toward rent, and that's that's even pushing it there we we talked to a lot of people who are paying seventy to ninety percent of their income toward rent, which I don't know how you make it through the month at that point. Do you? How do you pay for your medications? Do you pay? The rest of your bills but. Are making it. People are making it work. You know, so looking at affordability, that's one of our biggest first things, you know when. Look at. Who has become homeless in the last few years? We know that COVID obviously changed the world in a lot of ways, but it pushed. Lot of people out of. Because housing became so. Expensive, especially in Montana, Lewis and Clark County was had the fifth highest rental increase in the country between twenty one and twenty two. Because we were so stable for so long as a government community, things just didn't change. Rent was the same. And then all of a sudden, everything exploded. And what we saw was people on fixed incomes, especially senior citizens. Could no longer afford the increase in rent their vouchers. Longer worked on the apartments because fair market rent. And actually decreased during that time somehow, which none of us understood and still don't understand. We did finally. It is finally increased, but what we saw was the fair market rent rate at the federal level was going down. Rents were going. Vouchers weren't working in apartments and people were losing. There are places to live and they were on fixed incomes through Social Security. Or maybe a? Or maybe you know some combination of those things and what we saw in Montana was what they called the silver wave in shelters is the biggest increase in shelters with people over the age of fifty five and even over sixty five. And how do? Live in a shelter when you're over sixty five. Just can't even imagine. And you know, they saw those links of stay in shelters growing from, you know, what used to be a few days to three months to over a year. And so, you know, we just saw all of that really changing due to the affordability factor. You know, and so then people really started looking at, well, we'll just give up all the. Of those things. Maybe. Maybe the safety factor goes out the window. We look at something way further out. Town. If so, it's not accessible. Maybe we look at something that's not as. Maybe it's a month to month, and so all of the rest of. Started to. Waiver in their minds because we just needed something that was affordable. You know, we really started to see people kind of juggling all of the different things that you would normally consider. Just to keep. Over their. But you know. We really would like, you know, for people to be. To look. Us, you know, do you have a decent? Can you get to the place you need to live? Is it something? You're going to be able to stand because do you have kids? Do you want that kid to be able to go to the same school? Don't want them to have to bounce around. You want that long term lease? So you want. You know, you want to be able to stay in that home for a long period of time. Want that to be stable? Safety, obviously. You want running water and you want the roof to stay on the House. You want doors to close. You know all that kind of stuff, and especially when you're living in places that have vouchers, there's pretty strict rules. And so those things all have to. Happen.
Speaker
And.
Emily McVey
And they just went from. The old requirements to what's called inspire. And so those are all in the process of changing, which are all good, but a lot of like Jeff was saying, the landlords will say, oh, I don't want to take vouchers, but now they're saying I don't want to upgrade to the inspire requirements. Now they're not going to. Vouchers because of that. You know, we love to make sure places are safe, but if it if it's costing money and if it's causing heartache, we won't do that. So you know we. Of course, we want places to be safe, but it also creates struggles for people to get, you know, places that are affordable. With that, take vouchers because the landlords have to. They have to pay the price for that. There's no reimbursement for the landlord. S to make sure that they meet those requirements, which is unfortunate because it does sometimes cost a lot of money to make sure you're at that inspired capacity so.
Margaret Mullins
Thanks for that, Emily. Jeff, you have anything to add to that?
Jeff Buscher
Yeah, I'd like to focus on the stability piece of that question for folks who are housed or newly housed. This is a program that we are just getting off the ground. We've just assigned our first two or three customers or clients if you will, and. We call it home team. What we found. Is when folks are newly housed coming out of homelessness. And often, chronic homelessness and. They are moved into an apartment or a small home. They are. Used to living indoors and they're used to socializing with a group that moves outdoors and. There are certain things that will help them stay house. And that is simply learning to live indoors successfully. Example, if it is an apartment setting. Not playing your TV or your music so loud that it bothers the neighbors. Following the cleanliness rules, when the garbage goes out and often if you can imagine an unsheltered person often has to. Or do collect. Or even have a home. You may continue to do that, but but now you have a home and a safe place to keep things and helping make sure that home stays clean and and. By clean I mean. Safe and. Most kind of things. Simple things is what to put down the toilet and what not. Put down the. What goes in the garbage disposal? Umm, those kinds of things and the first few months of being newly housed are the most critical. And So what we've developed is right now it's a small. We've just trained four or five people, but we've trained some volunteers to pay attention and build a relationship with these newly housed folks. And check in on them once or twice. Week and just see. It's going. How are they doing? Do they have any questions? I think of the story of a gentleman who was fresh off the streets and was newly housing, apartment and of course, his best friends were other folks on the streets. He began to have one over to spend night on a cold night and then two. And then three, she then. And soon this gentleman was uninvited from his apartment because. Because of his kindness, because of his desire to help his friends. But it was not a rule that could be broken in that apartment facility. Just had too many guests and I were causing problems so. The home team, our model, is simply to walk with these people and their first three to six months of of being newly housed and helping them be a successful resident and a good neighbor and help them to plug into their new facility and. I stayed there for a long time, hopefully because if we can keep them house as one less person on the street, that we're looking for housing for, so, so that that's just one piece of the stability issue and one thing we ran into more toward the end of. And that was just a high number of evictions. And our good friends at Montana Legal Services provided a number of assistance encounters with folks who. But we saw this happen for a time period where folks were losing their COVID funds and. Then renters were, and I don't mean to put everybody in this category, because it wasn't all of them, but they were like they were suggesting we're going to, I'm going to be raising the rent and they were pricing people out and so. Our friends at Montana Legal Services and others tried to help people stay house. And uh. One thing I'll mention as we try to look the big picture in our community, there are some important positions that in some cities, like our friends in Missoula and Bozeman have positions that are paid like a housing navigator. Had that here in Helena. For a time, we currently do not have a housing navigator. One thing that we're working on right now is creating a position for a housing tenancy specialist who again would help people to find housing and stay housed. And then this home team that I described is kind of comes under the category of housing security. Staying house. Once you get house. So. So those three positions are positions that I'll just say this are our nonprofit community is providing those positions. And I think we can do better in our Community having some combination of government and nonprofit partnerships to help pave the way to make these positions more long term and offer greater. Stability to our local housing issues.
Margaret Mullins
Great. Thank you for. I appreciate the insights and affordability and stability that you really provided a lot more depth of information about the complexity of. What happens is obviously not just about getting people into housing, but what happens from that point forward. And and it is clearly complicated.
Trina Filan
Yeah, I was just going to say that. Seems like there's no. That's the greatest housing need in our area because each aspect. Has has urgency. Affordability, enough housing? Enough housing that is accessible and safe, housing that's available so that you don't have to live in. To, you know, drive in and and work each day. Is there something that really tops your your chart as the most urgent issue locally?
Jeff Buscher
I'll start by saying. One thing that I feel like we're doing well and that is the partnerships between our. Our mental health agencies are addiction services. The helping agencies. Purview and Saint. 'S health. Is the healthcare folks in our community? I feel like we're communicating well. But the biggest hurdle that. Face week in and week out is we discuss. Folks who are unhoused is. Where can they go? Where can they be? We have a handful of folks who are. What I describe as non compliant because when services are offered they are not interested in the services that are being offered. And for those folks who, in the back of my mind and thinking that we need some sort of low barrier group living facility that a person could feel somewhat independent but still. Be cared for because these folks are willing with medication. And mental health issues and things like that. And a model is called supportive housing, where the support they need is available. If they choose to take advantage of it. But it's not required. So that's why one of our projects has been a supportive housing project.
Trina Filan
Thanks. Emily, do you want to add anything to that?
Emily McVey
Yeah. I I really think that. What Jeff was talking about, the supportive housing it's it's the housing first model and that's what we've been working from for all the years that we've been working on housing projects. We really fight the battle that people argue that. Oh, so and. Needs to get sober before they get housing or so, and so needs to get well before they get housing or they need to do XYZ before we get them housing. They need to earn it and that, I mean, that has been proven over. Over that that is not. What works we need? Get a person housed before we can get. Well, that is really the model that has been proven to work all over the country all over the world. Because you can't really get a person well until they're stable in housing. And that is, I mean, we always talk about like, if you're going to get them treatment, how do you even know where to go find the person to take them to treatment if you don't know? Living. You you know. Where are they going to be? Tuesday, who knows? It's really hard to get a person stabilized if you if they don't have a place to live. That is the core of a person 's stability and so really being able to get a person housed and then work on the rest of the things that got them to. Place where they are unhoused in the first place. Is really where we need to start. We've talked to. About that all the time. And really try to fight that battle about how housing first is the most important thing. The supportive housing piece is important because you can't just also then throw them into housing and say good luck. You later. It's like what Jeff was saying is like the the mentorship piece. Because maybe they're not ready to just be housed. We don't know what they. They might need mental health treatment or chemical dependency treatment. They might just need some independent living skills. People come to us in all kinds of different places and we need to be able to support them through that for however long it takes. They're ready to be on their own. And then to move on to whatever next steps there, you know, so it's it's not just housing, it's that support piece as well. I think it's time for people to change their way of thinking that people don't need to earn something. It's. They get what they, you know, get the housing and then we support them through their whatever their needs are.
Trina Filan
And housing is the basis of preventative health care.
Margaret Mullins
What an amazing point to bring up. So. It's so fundamental to everything that you have this sort of, you know, chain and every link in that chain is is really critical. Just isolate those points and you all leave me really nicely. Into my next question, because you've both been alluding to it. I know you are involved in a really big housing project. I wonder if you could tell us a little bit more about your support of housing model.
Emily McVey
Well, it's all of the things we've. Talking about. Supportive housing has existed in Helena for a long time. A variety of ways. It's right now it calls scattered site and so it's people that live in different locations and use the services through Helen Housing Authority, many rivers, Whole Hills aware, you know, any of the different programs that exist. But that makes it hard to track because you don't know where people. What services they're using? There's a lot of turnover in this field, unfortunately, and what we're looking at doing is building. One site where all of that would exist. It's something that we've talked about for as long as I've been doing this work, as if we had one place where people could go and everything would happen all in one location so that people wouldn't have to figure out how to get to services because we don't have. Transportation for people. In Helena, Montana. You know, and if they don't want to use the services on site, they have a therapist that they love in town. Still. To figure out how to get them there so there's still options, but it means that people would have the ability to get. The support services that they need in the place where they live and have case management services having that, have that housing navigator or tenancy specialist. Services to you'll be able to say OK. Don't need to live in. Studio apartment. Maybe you move up into a bigger place when you're ready, but you know, just having those options so that when people move in that they start to get that stabilization and then moving into the next steps of their lives, but. Having somebody there to walk them through that and not expect them to be able to figure out all of that path on their own and you know, just really training up the community. Of providers. In working together through that model, and I think just, I think Helena works together really well right now and we've we can take it to the next level and make it that work through one, one location of of making just the services happen there. These there's a program in Missoula, one in Bozeman. They're currently building one in Great Falls and one in Hardin, and so we're we're seeing this pop up all over the state of Montana. There's three hundred. In other parts of the country, so we know this program works, we know they can be successful. It's a really cool program once they're up and running and they see huge amounts of success with people moving in and moving on with their lives in really successful ways. We're really excited to see this come to Helena because. We have seen a huge increase in in people becoming unsheltered and moving in their cars and campers, and we can, you know, we really need to increase the the amount of affordable housing and we need to support people. In getting there. You know, they stabilize and then get into that next step of housing.
Margaret Mullins
If there's something to add to that.
Jeff Buscher
Well, I would say that one of the hallmarks of the United Way in any community is that it identifies where gaps are and services and as. We have been doing this housing work for the past five or six years and even those that came before us. And the work that was done. The statistics we looked at made it very clear that as I spoke about before that that income gap, that low income housing was just a huge need. And for us to? Work to try to find a place where we could house folks affordably has been. A work for as long as Emily. I have been here. I don't believe look at so many buildings. You probably remember at one point we were looking at the Saint. The old hospital property. We're working with this hotel. And and let me just say that we're committed to doing this. We're going to make this happen even if we have to build our own location. If things go sideways or things don't work out on our current project, then. We'll find a way to make this happen because because of several things we've identified the need everybody. You know, it's been kind of fun the last couple of months in this office. To see how many people. I have come through the door or called us on the phone and said we wanna help. We wanna be a part of this because we know it's a significant need in our community. So that's been very affirming and we want to just be the lead agency. In making that happen in our community, so, so we will, we will continue, we will keep working on this whatever happens with the current project or wherever it leads us.
Margaret Mullins
Were most appreciative of that commitment to the cause for this project. I'm I'm curious. You mentioned you know these are these wrap around services and you mentioned case management, Emily. Can you? Tell me a few of the other wrap around services that would be provided in this scenario, at least as you picture it.
Emily McVey
Well, we're we're currently in the process of holding meetings with all the providers in the community. To see who would be interested in being on site and what I feel like is we actually are going to have to start narrowing it down because everybody is so excited about this project and. Really, we we can't have everybody there but. Would love. But it it that would be too big. Which is really, really awesome to have everybody so excited about this anywhere from mental health treatment to parenting classes. One of the things that I'm really excited to bring in and build up is an independent living training classes. And one of the things we hear from the people we work with on the streets and like we've talked about building that mentorship program is people don't. You know, they don't know how to cook or they don't know how to. Or they, you know, there's just some really basic life skills that they're missing or they. Knew at one point or they don't remember how to do or whatever the case is. When I was running group homes for teenagers, I would often get, you know, sixteen, seventeen year old kids in that had never learned those skills until we were teaching the kids those things before they turned eighteen, hopefully, and went out on their own. And there's just a lot of things that you think that kids learned before eighteen, and then you realize maybe they never did. And other adults. And we're we're at that point. We'll we'll build out. That kind of a program. So anything from financial literacy to cleaning your apartment to car maintenance? You know, whatever the community volunteers want to teach, we will have classes on site and teach, you know, maybe the residents will end up teaching each other. Because you do have people that are great chefs and they could come in and teach the class and you know, so we'll probably have a lot of that Co learning option as. As well it, it'll be fun to see how that plays out, but we'll have a curriculum and then we'll we'll let people play around with that a little bit as people come in with talents and interests. But definitely having certain things that. Will we will teach because their basic skills that they'll need to have. Especially things like once they move out of our. Program. How do you talk to your next? How do you work out issues that you might be having with your neighbors? What happens if? Might be late with your. You know, making sure that they have. Kinds of. Communication and coping skills that they might need in the next steps in their lives.
Margaret Mullins
What a great scenario to. Like a plethora of people and services to to sort of think about, including in that in that housing model. Pretty inspirational. I also just quickly want to. I think Jeff, you brought up or maybe it was Emily, the fuse program. Am familiar with it. It's an important part of this story and I'm wondering, how would this housing first supportive housing model fit with fuse?
Jeff Buscher
Fuse has been a part of the conversation as we seek a supportive housing location.
Speaker
You.
Jeff Buscher
One example comes immediately to mind is a partnership that Fuse currently has with local hotels because when unstable hous. Es surgery at. Peter 's or Pure View or somewhere? At they sometimes need a safe place to recover. That is not as expensive as a hospital room, so. One conversation we have had is possibly reserving a room or two for folks to who may be recovering. Who? Not that. That. Would have a I'm not sure we'll. Medical care right there on site. However, we have talked about. For example, PureView has a traveling healthcare van. Possibly that kind of supporting housing facility would possibly be a monthly or weekly stop for that. That kind of service so. Fuse also is very aware of. Folks who? Are frequent users of these systems and may also may know that, hey, we got this person a voucher. This might be an ideal client, so referrals from the fuse program could also be a significant kind of a pipeline if you will. Into into this kind of housing. What else would you add to that, Emily?
Emily McVey
We've talked about. Do we save rooms for few clients? They are some of the hardest people in the. To house. They have done a great job of making connections with landlords and and housing some of their clients over the last couple of years, but. You know, due to the affordability factor and. Just their histories. On paper, it does make it hard to house some of the fewest. And so we've talked about that with a lot of different groups like the VA has reached out. They they would love to work with us on. Having. Rooms for veterans and and kind of recreating what we lost when the Willis Cruise House closed and. We've talked about rooms for kids aging out of foster care and you know, so there's a variety of different groups that have reached out to say, would we be able to create a a wing or, you know, a certain set of rooms for these? This group of clients and have our case managers work with them and so we've definitely been in conversations with a few different groups about that kind of. Thing and and then they come with. Their own services, which is nice and creative. You know that's not specific to fuse. It's definitely something we've talked to a lot of groups about, but 'cause there's just some groups out there that are. Harder to house. They need a little bit more security and they need more. So it's, you know, that's just part of the conversation is do we do we save rooms or do we create pods or you know how do we make that work with? In a building without leaving people out, we don't want to create a place where we're not being inclusive, you know, not opening it up to the public either.
Jeff Buscher
I wanted to mention very quickly one other service we want to provide in a setting like that of support service. Would be and this is a changing. Here in Holland, we're getting used to our new friends at Maximus and that is just job skills. Job training and access to well to. Able to work in the workforce and may need help with resumes. Need help with interview skills and. Just what? What it means to be employed and what's realistic for them, if that's if that's a need so. One of the partners has has been job skills folks and and one thing as we're thinking through the logistics of this is I I refer to this person, but. The United way. Would probably have a staff person at the supporting housing facility who is what I call a service concierge, if you will. A person who gets to know the clients, gets to know the residents and then. Is able to match them with the the services they need, or at least offer them and. Know I'm. Foreseeing a day when we have a a menu of services, if you will, and folks can opt in and opt out. I'm seeing a day when there may be an A a meeting. It's on the property, things like that. So so managing that whole. A ray of services will be. As you can imagine. Our goal is successful residents who feel safe, fulfilled and able to better themselves. And move on with their lives.
Trina Filan
Thanks both of you for that. Excellent set of answers. It's a complex issue as we've been saying, there are lots of needs to fill. There are lots of. Different types of folks who are experiencing housing instability or who are unsheltered, and one of the ways. That. Is. Officially used. To try to count. Get a hold of how many people annually. Are living in unsheltered circumstances is the point in time survey. And you all are in charge of organizing that and United Way of the Lewis and Clark area has done that job for this area for a really long time. Maybe a decade and a half. And Jeff has really. Amplified.
Speaker
The.
Trina Filan
Performing of this this task so. Could you all talk about what? What is the point in time survey? When does it happen? What is it able to do and what doesn't it? Very well. And then we'll also. After you talk about that, we'll. A little bit about the continuum of care.
Jeff Buscher
Alright, the plate in time survey is called that and by the way, it is a HUD requirement. And they ask us to do our best as a community. And this happens across the country on the last Thursday of January. And people immediately ask why do they do it in the winter time? Wouldn't it? Easier to do it in the summer time. Answer is no. Because it's, as you can imagine at. In Helena, Montana, I. Am not sure all the Gulch is where people may be camping out and who are unhoused. So in the winter. Folks are generally finding warm places to be in the city, and it makes it a little easier for us to count them now. The point in time, as I mentioned, is the final Thursday. In January and this year, it's January. Thirtieth and. Over years past, we have gathered volunteers who have gone out and kind of justice looked in all the places where unsheltered neighbors sleep at night or stay or gather. And it's about a twenty to twenty five question interview. That these days can be done on your phone, on an iPad, and it takes about ten minutes. Usually when we find a person and they agree to take the survey, we try to thank them with a gift card or hat or gloves or. Whatever we can just to thank them for their participation. Obvious and it's not bragery, but obviously we want to encourage them to participate because the goal of the survey. Is to try to assess the number of unsheltered folks in your county in your area. So that and the reason HUD sponsors it, is based on those numbers. Federal dollars are directed toward that community. That assist with. The services provided, which we'll talk more about later, which is the continuum of care. But those funds rely on the number of unsheltered folks you have in your community. So we do our best to make those numbers as accurate as possible, but we. Often acknowledge that it's very difficult. Some folks are very independent, very private, and frankly don't want to be counted. Don't want to be that public about their situation. Frankly, they're embarrassed. They'd rather. Quietly go about their business. And so we know that the. Is an indicator. And. Last year was last year, the first year we did up to sleigh Emory. Or was it? Second year, last year, last year. The. Year that. Mentioned the initial way to do it was to send folks out. In pairs, let's try to find unsheltered folks what we started last year was offering free meals at places where folks gathered. For example, last year we were at our place. Were at God 's love. The Public Library and we also had a team kind of doing a tailgate at the Walmart parking. And in those four locations, we had two sets of volunteers. One set of volunteers were our. They were the folks who provided a hot meal. Hot coffee, hot chocolate, whatever. The meal chose to. And those end up being a safe communities, churches and religious groups. Volunteered and said. We'll provide the food that they 'd be. And so they did. That and the other set of volunteers were what I call counters. Where the folks who are trained to conduct the search. Early and at each of those locations where meals were being served and we promote this among our unsheltered neighbors and the word spreads. And so they gravitate toward these free meals. And then while they're enjoying their meal. Our counters sit down and interview them. Go through those twenty questions or whatever, and then offer them a thank you gift for their participation and and that method I was. I was a. Little nervous about using that different methodology. In terms of. How accurate would it? Would it affect our numbers? And as it turned out, our numbers? During those three years. Last year, the first time last year we had a hundred and eighty, one was our count. Mentioned and we're going to do that. This year. We're going to be in some different locations. We're going to be at God 's love. Going to be at. Paul 's church, where we do conduct a shower program. We're going to be at. Good Samaritan thrift store. And we're also trying new location out at East Helena, that East Helena United Methodist Church is they haven't made a final decision, but they seem to be very. About partnering with. To do this and which is helpful because. Helena has its own population that we may have been missing in previous counts. And by the way, I want you to know that we also count unsheltered folks. But we also. Folks who are sheltered temporarily and user folks who are in county. Detention center. Are these your folks? At the. These are folks who are in the family program at God 's Love. These are folks who are in possibly alcohol rehab facilities who, if they were not in those facilities, would be unsheltered. And that's what we call a sheltered count and our responsibility on that point in time night is the unsheltered folks. Also, we contact folks, sheriff and and schools folks out in Augusta. Wolf Creek. Lincoln, Folkestone. In Townsend, we try to get the word out as best we can. It's hard to go to all those places in one night, but the folks in those community know who are unsheltered neighbors are. So we try to collect that data as well. Emily, what else would you add to the Clinton time survey?
Emily McVey
So the one thing. Know is that this is a snapshot of what the reality of the unsheltered number is. What the experts say is you can usually assume that your real number is about ten percent of your population. In Helena, or the Lewis and Clark County. There's about seventy thousand people, so a real number is probably closer to seven hundred people. And if. Ask the people at the showers or the people down at our place. They would say that's pretty close. Accurate because they know who's out there in the Gulch is and who's down.
Jeff Buscher
At the parks and.
Emily McVey
They kinda know what's what in the unsheltered community, because what we don't see is. When we're out, you know when we're out on the streets, on point in time, night or what we do it in account. The transitional living facilities, or the shelters on those counts, we do not see the people living downt up in houses. Sleeping on people 's couches, the people living in. Somebody 's garage. We don't go knock on campers because that's not a safe idea. We don't knock on car windows and we know there is a lot of that happening in the Community and has. For years. And so there is a huge number of people that we miss in that count because. There are a lot of people living unsheltered in a very number of creative ways in the community. We do go drive through saw a variety of RV parks and places around town where we know that people are living in creative situations. And we just sort of count those places as like a unverified count. Those don't get counted in the official point in time, but we keep those numbers on our own count. So we'll count the campers and we'll count the. Cars. So we know there's another forty five or so of those things happening that we drove around that night and saw. The other thing you know, those people that are doubled up or couch surfing all of that, those are not counted even under HUD criteria. If you live in a camper that is connected to power and water that is not considered unsheltered according to HUD criteria. And so the school district keeps their own count, and they so they count those kids as unchilted according to the McKinney Bento. Staff and so they keep that count throughout the school year. And in Helena School District, they have about four hundred kids that they keep track of throughout the. Year. They consider unsheltered, even though they don't meet the HUD. So you know, we just we have a lot of different numbers that we look at throughout the year that may not be count. In that point in time count officially.
Trina Filan
Thank. I just want to double check something that you said, Emily. I my brain heard you say. We can expect ten percent of the population. But then the math was one percent. Did I miss something? You please clarify.
Speaker
Oh yeah, I might.
Emily McVey
Have done math wrong. When we talked to the people at the HUD. Offices on the national levels, they would say. You know, you can really think about ten percent a year population being unsheltered or in that creative living situation like the the couch surfing, the doubling up. And I I mean I. It has to. True, because when you look at the apartments coming online in our community, the studio apartments are twelve hundred dollars. Three bedrooms are upwards of twenty five hundred to three thousand dollars. More than mortgages of people that I know and I don't know how you get a one family unit into a place. That without. Extra people. I just don't know. I don't know how people aren't doing without doubling up in some capacity. And so that when you start looking at how people are living in more creative capacities, they they consider that. In some, you know, some way unsheltered, because you have some extra people living with you to be able to afford your. And so that, you know, they start looking at that as is that person, unsheltered. Otherwise if. Weren't living. With that family to help one or the other for the rent.
Trina Filan
Good clarification. And would you all be willing to chat just for a bit about the continuum of care and how you what that is, how you work within it and what it does for the state?
Emily McVey
Because Montana likes to be different. We're the only state in the country that has one continuum of care. States have a continuum of care per biggercity. Montana does one and then each larger community has. A smaller continuum of care, but we all answer back to the one larger continuum of care, and because it works that way, none of the smaller continuum of care is are funded. We all do that work. Through grants or? Through community fundraising and. So then we also all do it a little bit differently. And so actually the state is working on. Getting us all on the same page right now because it's been a little bit all over the place and not consistent. That's one of the efforts right now is for Montana to get all of the communities that have a continuum of care on the same page. Doing the same consistent work so that we're not all trying to figure out which path we're on. Nice. Because we all use what's called the homeless management information system. But we all use it a little bit different. And a little bit different capacities and it's a great system if you use it well. It is a way to keep track of people that are unhoused, even if they're bouncing around from town to town, like you said at the beginning. One of the things that we battle with. Uneducated community members, and they'll say, well, people shouldn't move to our community. They should just go back to where they came from while the majority of the unhoused people are from Helena or from Montana, we can see that they they maybe came from. Augusta or, you know, have a place where there's not a lot of. They maybe came to one of the bigger towns where there's services or a shelter, but the majority of the people in our community are from our community or the surrounding area. Maybe a smaller town around Montana. But they don't come from other states. It does happen, but it's they don't generally stay the end, so we can see that in that system, because that's a national system and they use it and we can see where people have been if they've been in other communities and shelters and things like that, we can. If they've been in a shelter. Or even in Oregon or wherever. So that's a nice thing to be able to see that a person has used services in other communities bounced around. We just don't see it very often. We do see people traveling through. We even see people from other. It just isn't that frequent and when we do see it, they are not staying very long. It's a very nice system to be able to have when a person gets into that system and says, oh, I see this person has actually been to all of the programs in town, but they're not actually connecting to a case manager. Let's let's get them connected to a person and get them consistent services because it doesn't look like we're doing them. Any justice, right? Because they're just kind of bouncing. Let's let's get this person some solid services.
Jeff Buscher
And the way that plays out. The week to week. Face of our continuing care, if you will, is what we call ACE conferencing each Wednesday we gather. Pre COVID it was always around the table but we now do a combination of zoom and around the table and we gather folks from mental health agencies. The hospitals, healthcare agencies. We have folks from the detention centre, Helena Housing Authority. Helena Indian alliance. And we have representation from at least one of the addiction services providers and we gather each Wednesday and my role is to go to that humanist database. The homeless Management information system. And. I pull. The names of folks who are in that system and who can pull their information by those who are last contacted you can. Information by those with the greatest. And then what we do with and by the way they sign off when they when they enroll in that system, they sign off on letting the information be shared in a confidential setting, so. We are not talking about people without their consent and. What we. Is we look at the folks on that list. And we talk about who is in contact. This person have a case manager. What kind of help do they need? And as I mentioned earlier, are they compliant? They respond to the assistance that's available. Or are they? Doing the best they can in their current condition and the. That they. And one thing I'll say, and I remind our team often and that is and this is a helpful thing for the public to know and an educator in Portland shared this statement. I I think it's true. And and that is that homelessness is not a choice as much as it is a lack of choices. And what we try to do in case conferencing is gather the resources in our community. Make them available as best we can with those who need those services, and so we go through that process each week and I'll say this roughly once to twice a month, we are able to celebrate as a group when someone does get housed, when we're able to hear. Someone. Was successfully housed or in some occasions they moved back to another location and found housing there. And it truly is. Something to celebrate when this person 's name may have come up several times. The last few. And they finally get housed so, so that process is challenging and it takes all of us. Because as we've been talking today, the complexities, there's no shortage of complexities of what it might take to get a person to a place where they can be successfully housed so that weekly conversation. Really helps. Hopefully keep our thumb on the nerve of where our greatest needs are in our community. And so that is where the rubber kind of hits the road, and this continuum of care. And that is meeting with the people who are working day in and day out with unsheltered population and trying to match. The availability of housing to the folks that. It most.
Emily McVey
And I'll just add. Real quick, as Jeff talked about people. Choosing their lifestyle and one of the things that people bring up all the time is that the people that are unhoused want to be unhoused, which isn't generally the case. Is like I said, a large number of unhoused people in our community and the state in the nation especially. Since COVID that number has jumped significantly due to the rise in housing costs. And you know, there are definitely people who choose. Be. There are definitely people who don't want to be a part of the system who choose to live a different lifestyle. But a story Jeff tells us probably just let him tell it. You know, there are people we work with who have been living this lifestyle for many years. Just honestly say I'm getting tooled for this and they. Choose a different path. And they realize, you know they are. No longer able to live unsheltered, and they come back to this group and they say I need to be housed. It's time to make a different choice. And yeah, they've been living that way for. Maybe up to thirty years or more. A long time, some of them, and then they realize it's time to to do something different. So yeah, maybe they've been doing that for a very long time. But a day comes when. They've made a different choice, and sometimes we've worked with people, you know, for a couple of years and we've pushed and we've tried and we've it's like we're working harder than you are. And and then one day the magic happens. So you know, yeah. Yes, there are people out there that are. That choice but. Is not very many of the people that are unsheltered that are making the choice to live unsheltered. That is a myth that is not true.
Jeff Buscher
Yeah, I was gonna add, Emily, because we do work with the statistics and we work. You know. Work with these agencies that number of folks who. If you will. Lifestyle are it's low, it's between five and seven percent. A very low number that are. Chronically unsheltered, and by choice. And as I as I described them, just noncompliant to services they would rather live this way. I'll even share a. Of one gentleman right now. Who? Has been around for a long time. Understands he has a serious addiction problem and in more lucid moments he and I have talked about would you go with me to a? An addiction services place and and at least have a conversation. And he indicated he would. When that day will be, I am not sure, but I'm ready and and so is the facility I've had that conversation to prepare them. Someday I will walk in with this gentleman and I hope we can help him because he has never. He has never been in any kind of treatment and he knows he has a problem, but he, like Emily, described the gentleman he knows. Those who's getting too old for this lifestyle and he wants he wants something better. And he wants to help the people around him as well. And he and I have talked about how he could help them so much better if he were in a better place himself.
Margaret Mullins
Thank you for that, Jeff. People being ready to accept help I know is a. Big factor in. All of this, Jeff discussed this a little bit with the reluctance of people to participate in the point in time survey. And that is around, I suspect, the stigma that comes with housing instability and homelessness. And I just would like both of your thoughts a bit about how that instability impacts the people. We know how the instability affects them, but that stigma mentally, physically, socially and even health wise, how it impedes their ability to find resources and to help keep them housed.
Jeff Buscher
We've seen that. Our small program of the showers is. Nice, you know. One of. Takeaways that we have learned is the value of just offering dignity to those who. Who may feel less than because of their unsheltered situation, and one of the things that when I talk at local churches or various groups, I talk about offering humanity to our friends who may be flying a sign. Smiling and waving. Maybe have some folks of prepare to go bag that they could hand somebody some water and some, you know, snack or something. I discourage folks from giving people. I I always tell people I can go into a whole different thing that I talk about toxic. Thirty and I suggest that people give their money to programs who are willing assistance, work that needs to be done, but all that to say folks are frankly get beat down by folks. You will get a job or you know who treat them unkindly. And so I talk often about. Smile, say hi. Strike a conversation. There's a certain level of loneliness to this lifestyle that. And Emily will talk more about this, but. There is this direct correlation you're talking about between health and unsheltered. Living is very real because some people may not have a mental health condition when they begin their unsheltered journey. But because of the difficulty of the. May end up. Third, mental health situation as a result of of that journey. And so as we've talked about the complexities, I think one of the greatest things we can do is just offer them the decency to offer any other individual. And help them understand, and I think we all need to remember that. There, by the grace of God, go out. I mean it's it's tough. My hope is that as a Community, we can come together and not only educate, but better organize ourselves to really find some effective solutions that will. Will offer them not only dignity, but if you will, a series of stepping stones that can move them from being unsheltered to securely housed.
Margaret Mullins
Thank you for that. Emily, do you have anything to add to that?
Emily McVey
Yeah. When? Have panels of people that we work with or people that were formerly unhoused they they talk in depth about. What it was like when they were living on the streets, that they literally feel invisible. People will walk by them and try so hard to not see them. And how lonely it makes them feel, but. And just how? They feel like they're not human and. It's just, it's so sad that you know, they they try everything they can do to be small when they go into places and not be seen and. Just the. Inhumane way that people treat them because they're unsheltered and. And it's just really, really sad. The and the way they talk about the way they feel when they're unhoused it's it's really tragic. So we talk about it, Jeff. Just just treat them like they're human. If if nothing else, just. Say hi and treat them like they're human.
Jeff Buscher
Counter.
Emily McVey
That's right.
Margaret Mullins
And there's, you know, hopefully podcasts and other informational resources like this can help people to understand a little bit more about the complexities that you're not making assumptions when you pass somebody on the street and. Just make you know, assuming certain things and and and moving on so quickly. Like you said, a smile and just some understanding around the situations that exist.
Jeff Buscher
One of the. Specific projects we did a couple years ago in cooperation with Plymouth Congregational Church was a a photo exhibit. Of ten. Or maybe it's ten of our unsheltered neighbors, and a photographer volunteered his time, and. The goal of that project was to really provide a glimpse, if you will, and bring some. Humanity to those folks who are unsheltered, we wrote. We wrote a short bio of of those folks, and their pictures were very friendly, very accommodating. And the goal of that was simply public education to. Folks know that. These are our neighbours. These are folks who? Have just come on some hard times, but they are our neighbors and they are not a threat. I.
Margaret Mullins
Am familiar with. That was a great project.
Trina Filan
Yeah, it's an exceptional project. Our last question is. Clearly it takes more than one person, one organization or one well oiled machine. To address. This very large and complex topic, and you've already mentioned a bunch of your regular collaborators. In your work, are there any other organizations that are really important to the partnership that it takes? To create. Safe, affordable, accessible, quality housing options and wrap around services. And is there a place people can go for a list of those organizations or for some of the resources in town?
Emily McVey
I think it takes everybody. I mean, literally all kinds of businesses, nonprofits, government agencies. When we started working on the Community Health improvement plan and we started having the action team meetings we had every, you know, a little bit of everybody. We have just individuals that are interested from the community. We have business owners, obviously you know people from the downtown area that are most affected. Lot of nonprofits, the service providers, people from the local government, state government. Well, all. Those different parties of people get involved in the conversation because they are all needed in the conversation to make things happen. We will often have people. Show up at a meeting. You. And they'll say, why haven't you? Or why don't you do and then? It's like starting over. We've we have tried to create a. What we've done. So please, you know, go to our website. Get caught up. And you know, here's all the places we've looked. Here's all the things we've done over the last few years, so we try to keep that. Information on our. Here's all of our collaborating partners. Our website is very busy. It there's a ton of information. It'll give you lists of all kinds of. Partners and housing information. But we try to do that because we don't want to have to rehash. At every meeting. But like I said at the beginning, we realized we were having seventeen housing meetings a month and in Helena. So we've we really looked at. We communicated with all of our partners and we said which ones can we combine, which ones can we put on hold? Can we get rid of? And we've downsized a lot of those meetings. So that we are spending more meaningful time getting things done. But when people get on our Facebook page or if they get on a news article and they comment and they have a complaint or if they have a misguided comment or if they're uneducated about something, my very. Thing is always come to a meeting. Come down to our office.
Trina Filan
Call me.
Emily McVey
We will have a conversation. I will tell you what's up. Like I have no problem ever talking to somebody about what we're doing. If you have a concern. If you don't agree with me. Let's talk about.
Speaker
It.
Emily McVey
Come to one of our meetings. Come and, you know, discuss your concerns with our community members. Everybody is more than welcome to have that conversation with people. We are open to any and all ideas. And we just want to get people housed in this community and we're we're definitely open to whatever kinds of things people want to bring to the table. So if if there's somebody that's interested that hasn't been a part of this conversation. Culinary way and we will figure out which meeting. Need to.
Jeff Buscher
Be at you know what an interesting dynamic of versus I mentioned before, one of our newly housed neighbours trying to help his friends who are unhoused still. And over the last couple of years. We've seen our unhoused neighbors in different ways take situation into their own hand, and they reach out to us as well and say we'd like to do this. We want to start. A campground or. Want to have this piece of property where we can? Live independently or and and they get very creative and. And I'm trying to. I need a little. I think I need some psychological training because I think it's a very natural process as a person become somewhat more stable and maybe gets housed or at least reaches. Level of. Of health and well-being that they do immediately want to reach out to their friends who are not as far down the path as they are and. I wish I had a dollar for every time I'd had a conversation with those people who come to me and say, how can we work together to fix this? And and I have to remind them that we didn't get here overnight and we're not going. Solve. Overnight, it's going to take time and it's going to take. People like you with the heart and a passion to help your neighbors. But it's also going to take. Policy changes the local governments going to take law enforcement education for law enforcement and and working together with the fuse program and teaching our even our own house neighbors. That the emergency room isn't the best place to warm. You know, there's other places so, so it takes all of us and. Again, sitting in this chair and being a part of this. Of care. We talked about gaps and why we're looking at supportive housing. One situation our friends in Bozeman face is all the cars people living in cars and campers on the streets. And I've often thought and and our friends in Missouri did. For a while. They had what was called a safe outdoor space. It was a kind of a campground that was had security around the clock, had kind of a. Community, if you will, but I've often thought. What if we had a campground? That was maybe it's fenced in a gated community, if you will, but some place for people to safely park, whether it's a camper or just a car or a truck. You know something that might be a a low cost facility, but maybe at the center of that is a A warming house with laundry facilities, maybe a kitchen and a place to gather. You know that it doesn't have to be a five million dollar facility. Know it could be something that simple but. And we learn those things by listening to our. One of the and I'm going to jump back. The showers. I'm sorry. I was at the showers this morning, so it's kind of front of my head about once a quarter. We do what we call big day at the showers where we have haircuts and piercings there. And we provide a lunch and. Always we include a listening session where we ask our unsheltered neighbors to give us some feedback. How awesome. What are your greatest? How can you as a community respond better? To your needs and and they are bluntly honest and they'll tell us what their real needs are. And I in fact. Think that idea of a campground came out? One of those conversations. So and you know. The complexities of that are, you know, that's not an easy list either, but it could be another answer to this, these challenges.
Margaret Mullins
Jeff and Emily, you have both been able to shine a light on the just incredibly great work that's happening in Helena and we see that there's a lot of cross sector collaboration needed to find these kind of lasting solutions. And yes, of course it does take time. We know also there's other organizations around the state working to improve health and and housing. We also know that our chronic disease programs here at the state have a role to play as well. I guess I'm wondering if there's anything else you'd like for people to know. As we wrap up this really great discussion today.
Jeff Buscher
Well, one. We didn't say in building that connection. Health and housing. And I've. A few statistics here, but just just to encapsulate it. A normal life expectancy and this may be twenty twenty three dated this statistic but. Average life expectancy for an American is seventy seven years old. And but for people who have experienced homelessness, it's only fifty years old. So that draws just a blatant connection between. The ability to be housed and secure and have all those things that housing provides and the connection to a person 's health. And I can give other numbers that unsheltered folks have higher numbers with, whether it's cirrhosis, HIV, asthma, hepatitis, all those things. Their numbers are. Significantly higher because of the nature of their living conditions and so. Just to bring it full circle, the connection between a person 's health and their ability to. Safely housed. Is so, so connected and they go back to Emily 's point. But that's why we focus on the housing first mob. We understand that from a foundation of being housed from a safe, secure place, a person can then pursue. Their health or mental health or addiction or whatever their needs might be. That's why the housing first model has been kind of harmonica, because it is a proven, successful way. Corpse these issues.
Emily McVey
We just held the longest night memorial service on the twenty first.
Jeff Buscher
We hold that every year on the winter soldiers.
Emily McVey
First of December. Which is the longest night of the year? The you know, the sun goes down about four thirty and you know, so really reflecting on that night when. Now people are unsheltered, and that's you know, that's about thirteen hours of. That night. And we remember the people in our community who passed away due to being unsheltered or the results of being unsheltered. And this year, we only had two names that we read. And so we really focused on knowing that the reasons that people pass away sometimes due to being unsheltered aren't necessarily while they're on the streets. Sometimes it's once they're housed and I always connected to. Like when people go to college and that first time they go home for Christmas break and they're sick that whole entire week because they finally have that stress let down and that body just is like finally they have a break and they're sick for that whole entire Christ. It's like that when you're unsheltered and you're you're constantly stressed. Your body 's on high alert and you finally get housed and your body does that stress let down and then. A lot of times we see those folks pass. Not very long after they become housed after being unsheltered for a long period of time, because their body doesn't react well to that stress let down. And all of the medical issues that they've been experiencing all those years really catch. To them.
Speaker
And.
Emily McVey
Like Jeff was reading off all of those different things and you're talking about diabetes at the beginning and lung disease is highly. Transferable and shelters and so many things that we know are true about being unsheltered and detached at the beginning, about. Mental health issues and chemical dependency issues and it's kind of that chicken and the egg argument are do people become unsheltered because of mental health issues or do they develop mental health issues once they're unsheltered? It's both. All things are true and same with chemical dependency issues you know. So we can't really say one or the other and people always say, well, everybody that's unsheltered is mentally ill. Or that's not true. It's generally true for the seen unsheltered people. And that's where you start looking at that high number of people that are living. Cars and campers and garages and those people are the unseen unsheltered. Those people don't necessarily have mental health issues, they're just unsheltered. For a variety of reasons. But people living on the streets. Are higher needs. They tend to have mental health and chemical dependency issues. But that's a very small number of the unsheltered. So when you really start digging into the data and start educating people around all of this, you start going well. What you believe to be true isn't necessarily true. The the number of people with mental health issues that are unsheltered is very is a lot smaller than you would think, but the medical issues are very, very high and. The people who. Actually passed away due to being unsheltered is significant, and when we read the names at the longest night, it doesn't even touch on what's real because we don't know. We don't know when the people become housed. And then and then they pass away. We don't necessarily know that. That even happened because they are housed in other sort of off our radar. And we don't necessarily find out till later sometimes. So you know, it's just a really unfortunate situation that happens that, you know, people get very sick and their body is just highly stressed and it causes PTSD and. You know, so we see a lot of really, really bad long term side effects from being unsheltered for people.
Margaret Mullins
Thanks for that, Emily. I do some work around housing and housing instability and I I just, I want to say to both of you. I've learned so many new things today. Just insights on what you understand and know from your long work in this area and I just want to thank you for that on behalf of myself and Trina, I think we've had a great discussion. Again, thank you from us and the crew behind the scenes and thank you also to. Both of you for working intently on developing. Comprehensive housing and care services for people that are experiencing housing instability and homelessness. If you'd like more information on what was discussed today, please visit our website at TalkingHealthinthe406.mt.gov, where there's links to the information that's been discussed. And if you haven't already, Please remember to rate, review, and subscribe to our podcast. And until next time, be healthy and be well.
Speaker
A.