Dawn Galloway has been living in homeless shelters and tents since her landlord evicted her last September. But she says that, when she finally gets a new apartment, she’s not planning to host any parties or celebrations.
“I wanna be in a safe place,” she said. “Our place isn’t gonna have drugs or alcohol in it, period. … If you’re comin' over for supper, you’re comin’ over for supper and to watch a movie.”
At 44 years old, Galloway likes order. She keeps her hair brushed and clothes clean. Recently, before police made her take down her tent near the American River, it contained only a neatly made wood pallet bed and a few plastic storage bins.
Now, she’s at a shelter north of downtown Sacramento, waiting with fraying patience for permanent housing. And it could happen: She’s one of hundreds of homeless individuals enrolled in the city’s Pathways to Health and Home program, which aims to connect people to medical care and shelter.
But the Pathways program often hits a wall when it comes to finding housing, due to the city’s severe lack of affordable options.
Galloway is waiting for a Housing Choice voucher, formerly called Section 8, which will make her eligible for subsidized rent. “That piece is gonna really solidify everything,” she said. “I’m ready to go, as it’s called, inside.”
Pathways debuted in November 2017 with funding from the city of Sacramento and the major health systems, and there could be up to $64 million allocated for the four-year program, depending on a match from the federal government. There are similar federally funded pilot programs in 25 jurisdictions statewide, all under what’s referred to as the “whole person care” model.
California Gov. Gavin Newsom has shown enthusiasm for this approach to homelessness, mentioning it both in his January budget proposal and February’s State of the State address.
Of the approximately 1,000 people the Sacramento program has served since its launch, about half are in a shelter, a third are still living outdoors, and 19 percent are in transitional or permanent housing.
Emily Halcon, the city’s homeless services coordinator, says that’s because they can’t offer beds that don’t yet exist.
“The one thing [whole person care] can’t pay for is sticks and bricks,” she said. “We can’t pay somebody’s rent, we can’t build a shelter.”
Critics of the model say that’s a problem. Sacramento County intentionally didn’t apply for the federal waiver that funds whole person care, citing concerns that it “would result in waiting lists for services rather than actual services and housing.”
Despite these hurdles, Galloway says Pathways has been a lifesaver. She has numerous chronic health conditions — Ehlers-Danlos syndrome, multiple sclerosis and Lou Gehrig’s disease — and mental health challenges including post traumatic stress and bipolar disorders.
At her muddy homeless encampment she has to move around with a walker.
But since a staffer at a local hospital recommended her to Pathways last fall, she says she’s received consistent and vital help from her community health worker, Chandler Lavin. Together, they’ve enrolled in health insurance, arranged transportation to medical appointments and therapy, applied for disability assistance and started wading through the paperwork needed for the housing voucher.
And Lavin says that’s only step one.
“Even when people get their vouchers, it’s really difficult to find places to use them,” she said.
There’s a long waiting list, and landlords are often hesitant to take formerly homeless tenants — especially those who suffer from a mental illness or a substance abuse disorder.
“I always have to tell folks when they ask me, ‘How long until I’m housed?’ With that voucher, I always have to tell them ‘I really don’t know,’” Lavin said.
Jodi Nerell oversees workers like Chandler in her role with Sacramento Covered, the nonprofit that handles enrollment for Pathways. Just under half of the referrals come from law enforcement, fire and EMT personnel, while the other half come from hospitals, clinics and health groups.
She says that, even if the program doesn’t always help people immediately with their housing needs, it has the potential to slow the constant and costly cycle of homeless patients through emergency rooms by connecting them to more regular medical care and teaching them life skills.
“If they are struggling with an addiction that’s untreated, they’re not going to be that successful in housing, remembering to pay rent,” Nerell said.
On the flip side, health care doesn’t work if people don’t have a roof over their heads. Nerell gave the example of homeless diabetes patients who get prescriptions for insulin, but lack a cool place to store the drug.
Galloway says she manages her illnesses as best she can in the shelter setting. But she fears for her own safety and is distrustful of some of her male neighbors, which triggers PTSD and makes it hard to complete daily tasks. She sometimes swings between wired anxiety and sluggish depression. And she says mental health care is not always available when she needs it.
“Just trying to get those services is actually really a difficult piece, a very difficult piece,” she said. “For a lot of people out here, almost every single person I can think of, there is a mental health issue that’s severe.”
Sacramento Mayor Darrell Steinberg is trying to put more options in the pipeline. He supported a housing bond called “No Place Like Home,” designed to create new housing for people who need built-in mental health services and are experiencing or at risk for chronic homelessness. The governor recently called on Steinberg to lead a state commission on this type of housing.
In the meantime, Halcon says she wants to keep ramping up the Pathways program. The goal is to be serving 1,000 people at any given time. The city is inviting more organizations to become Pathways housing and medical providers this spring.
