Alaska’s first “Housing First” project Karluk Manor

Harm Reduction Approach: A Housing First project, Karluk Manor addresses housing for chronically homeless alcoholics in Anchorage, allowing people to move directly into housing from the streets without the precondition of treatment acceptance. Photo provided by Maryellen Tuttell.

Harm Reduction Approach: A Housing First project, Karluk Manor addresses housing for chronically homeless alcoholics in Anchorage, allowing people to move directly into housing from the streets without the precondition of treatment acceptance. Photo provided by Maryellen Tuttell.

by Maryellen Tuttell, AICP, Anchorage, Alaska

After a heartbreaking 12-month period where 20 homeless individuals died outdoors, Anchorage is making strides in addressing its homeless population.

Background

At any given time in Anchorage, approximately 1,700 people are homeless. Of these individuals, 300 to 400 are chronic homeless inebriates—people who have been on the streets from five to more than 20 years and who suffer from chronic alcoholism, Post Traumatic Stress Disorder, or other severe mental health problems. The needs of this population are so complex that a full continuum of services must be provided to ensure that each need is addressed.

In the late 2000s, the number of deaths of homeless people in Anchorage seemed to be growing dramatically. A seemingly constant stream of stories hit the local newspaper about homeless people being found dead outdoors in truly heart-breaking conditions. The Anchorage Daily News published a map showing the location of 20 outdoor deaths of homeless individuals in a 12-month period.

The public was moved by the stories and the mayor had established a Homeless Leadership Team of community organization leaders to work with the Department of Health and Human Services to work on this issue. However, moving a project forward to help address the issue remained an uphill battle.

Defining the problem

In 2009, Anchorage’s Community Service Patrol and Transfer Station – commonly known as the “sleep off” center – dealt with 3,528 individuals. Due to multiple intakes per individual, it conducted 24,127 intakes. The 50 most frequent users accounted for 4,947 visits, each averaging 114 visits in 2009. Nearly all habitual users were homeless.

These top 50 homeless individuals were suffering from extremely severe alcohol dependencies. These individuals also represented the most difficult cases – most suffering from years of alcoholism, as well as multiple medical and mental health issues. The top 50 used over 21 percent (approximately $308,710) of the 2009 operating budget for the center, even though these individuals represented just 1 percent of the total number of clients. In addition to this disproportionate fiscal impact, these habitual center users accounted for a multitude of emergency room visits, (each at a cost of $1,500 and up) impacting taxpayer-funded emergency services and the criminal justice systems.

Despite extensive histories of childhood trauma, traumatic brain injury, Fetal Alcohol Spectrum Disorders, chronic unemployment, severe health concerns, mental illness and substance abuse and dependence, individuals who are homeless are very resilient and do respond positively to a strength-based approach. Repeated unsuccessful participation in traditional programs such as abstinence-based or mandated treatment and high rejection rates of these programs by chronically homeless individuals with alcohol problems suggested that less conventional approaches such as Housing First were needed.

Housing First project

In 2010, Rural Alaska Community Action Program, Inc.1 (RurAL CAP) began development of a Housing First project to address housing for chronically homeless alcoholics in Anchorage. Housing First is a new approach towards ending chronic homelessness where people are provided rapid access to low-cost apartments, with vital medical, mental health and other support services available on site.

Housing First programs take a harm reduction approach rather than mandating abstinence. This has proven to be a more humane, successful and cost-effective method than paying for these same individuals to cycle in and out of the emergency room, the sobering center, or jail.

RurAL CAP’s program targeted the most vulnerable population of homeless and allowed people to move directly into housing from the streets without the precondition of treatment acceptance. A study by the Journal of the American Medical Association documented a decrease in alcohol consumption associated with the length of time that chronically homeless alcoholics were in housing, as well as a decrease in the costs of health and emergency services provided to them.

Overcoming opposition: Nearby landowners vocally opposed the selection of a former motel, pictured to the left, for the project. So RurAL CAP designed the project to minimize the potential for adverse effects on adjacent properties. Photo provided by Maryellen Tuttell.

Overcoming opposition: Nearby landowners vocally opposed the selection of a former motel, pictured to the left, for the project. So RurAL CAP designed the project to minimize the potential for adverse effects on adjacent properties. Photo provided by Maryellen Tuttell.

Hard won achievement

In 2010, RurAL CAP acquired the Red Roof Inn near downtown Anchorage intending to develop a facility for over 40 residents. The site was called Karluk Manor, as it sat at the corner of Karluk and 5th Avenue.

Although Karluk Manor was recommended by the Mayor’s Homeless Leadership Team as one of the top priorities for addressing the issue of chronic homeless alcoholics, the reaction of the community surrounding the proposed site was dramatic. When RurAL CAP decided on the Red Roof Inn site, the local community council and nearby landowners vocally opposed the project, creating signs reading “NO RED NOSE INN” and posting these throughout the area.

The community had some valid concerns about the program and the site. The site selected for Karluk Manor was located in an area that has had a number of other social service facilities or LULUs (Locally Unwanted Land Uses) and community members felt they were unfairly burdened with this type of land use. However, the site was ideally located in an area with good transit service and close to services needed by the target population.

RurAL CAP worked hard to overcome the community opposition. They met regularly with the community council and developed and incorporated measures to address their concerns into the project. RurAL CAP also developed a coalition of social service providers and other concerned groups to help communicate to the public the importance of this project. Assembly and community council members were taken to visit a Housing First facility in Seattle to see a Housing First project in action. Finally, RurAL CAP made themselves available to media inquiries and was able to educate the media regarding the issues resulting in fair and balanced media coverage.

RurAL CAP also designed the project to minimize the potential for adverse effects on adjacent properties through design of the program and facility (fencing, site monitoring and management, meals on site, transportation services for residents, conduct rules for residents). RurAL CAP joined the community council and attended all community council meetings to be available and responsive to community concerns.

Dining area in Karluk Manor. Photo  by Maryellen Tuttell, AICP.

Dining area in Karluk Manor. Photo  by Maryellen Tuttell, AICP.

Lasting impact

Anchorage continues to have a substantial population of chronically homeless alcoholics. This project has made a difference though – it targeted those individuals that had the highest usage of emergency or police services and gave them a place to call home.

Although too soon to fully evaluate the effects of the project (a three-year assessment is underway by the Circumpolar Health Group at the University of Alaska Anchorage), some residents have decreased their alcohol consumption and some residents with mental and physical diseases that were untreated are now on medication for the first time. Although residents have continued to drink and some have succumbed to their disease and died at the facility, they died in their own “home” and not on the streets and alleys of Anchorage.

Today, Karluk Manor is a 46-unit housing residence serving the chronically homeless population in Anchorage. Recognizing its success, the Alaska Chapter of the American Planning Association honored Karluk Manor with its Hard-Won Victory Award in November 2012.


Maryellen Tuttell, AICP, is Past President of the Alaska Chapter of the American Planning Association and serves on The Western Planner Editorial Board. She manages Planning and Environmental Services for DOWL HKM, a multi-disciplinary consulting firm in the Western U.S., headquartered in Anchorage.


Endnotes

  1. RurAL CAP is a private, statewide, non-profit organization working to improve the quality of life for low-income Alaskans. RurAL CAP has programs in child development, community development, planning and construction, and supportive housing.

Published in the July/August 2016 Issue

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