Time to Heal
Personal stories from the Chicago
Housing and Health Partnership
and the National Housing and
Health Study Project
In 2003 and 2004, two housing initiatives were launched in the
Chicago region: Chicago Housing and Health Partnership and
the National Housing and Health Study (H&H) Project. Each
was designed to foster greater coordination among housing and
service providers and to better address the complex needs of
individuals facing poverty, homelessness, chronic medical
issues, mental illness and/or long-term substance use.
The Chicago Housing and Health Partnership (CHHP) is a
‘hospital to housing’collaboration of 14 citywide health care
and housing providers designed to improve continuity of care
and outcomes for homeless individuals suffering from chronic
medical illnesses, including HIV/AIDS. CHHP is the first effort of
its kind in the nation to model a“housing first/harm-reduction”
approach in serving the complex needs of this population.
To date, CHHP has created 230 service-enriched permanent
housing units for homeless individuals with chronic illness,
including approximately 110 units for people living with HIV/AIDS.
Four years ago, Chicago, Baltimore and Los Angeles were
selected as sites for the National Housing and Health Study
Project (H&H). A joint effort of the U.S. Department of Housing
and Urban Development (HUD) and the Centers for Disease
Control and Prevention (CDC), H&H aimed to measure the riskreduction and health outcomes of providing housing to homeless or unstably housed people with HIV. As part of this study,
H&H provided 105 new rental subsidy vouchers in Chicago for
scattered-site housing units for homeless people with HIV/AIDS.
With time and place to heal, what became of those who
participated in CHHP and H&H? The pages that follow
highlight six stories of hope. All names have been changed
to respect the privacy of the individuals.
Darrell
Before he hit rock bottom, Darrell
worked from time to time as a day
laborer. He arrived at Interfaith
House, a shelter that provides
short-term housing for injured or ill
homeless people, in January 2004
after being referred from John
Stroger Hospital by the Chicago
Housing and Health Partnership
(CHHP).
Darrell, 57, remained at Interfaith
House for a month. His medical
diagnoses included congestive heart
failure, a nodule on his lung, and a
work-related hand injury. He had
been homeless for three years,
occasionally staying at one of three
places: with his sister on the city’s
South Side, at the Franciscan
Outreach Shelter, or the Pacific
Garden Mission.
Finding understanding
He had no source of income when he arrived at Interfaith House. As a recovering alcoholic, Darrell
had a 36-year history of alcohol abuse – at one time consuming as many as two 40-ounce bottles
of beer a day.
“When I realized that I could no longer work or pay for a place to live I contemplated taking all
my medicine at one time,” Darrell recalled.“Instead CHHP helped me get to Interfaith House.
The counselors there were understanding and helped me get to where I could get Social Security
and re-housed.”
Darrell received complete assessments from his CHHP case manager, the health services staff,
the Interfaith House substance abuse counselor and a mental health professional from Mt. Sinai
Hospital Medical Center.
During a substance abuse assessment Darrell reported that he had not had a drink since
2003. He worked with his CHHP case manager to discuss housing options and was referred
to housing at Chicago Christian Industrial League, after he was medically stable.
Maintaining sobriety and stable housing
Darrell’s CHHP case manager not only encouraged him to follow a proscribed medical recovery
plan, but assisted him in preparing an application for Social Security disability income and food
stamps. The case manager also reminded him to follow up with a court date that had been pending
since 2002 as well as a previously filed workers compensation claim. On his path to recovery, Darrell
successfully quit smoking.
“Being able to ask
for help when I
needed it was a big
step for me.”
After four months at the Chicago Christian Industrial League, Darrell was able to move
into another CHHP housing project, Mercy Lakefront’s Major Jenkins Apartments, through
the assistance of his CHHP case manager. Today, Darrell remains medically stable and still
receives medical services through John Stroger Hospital. He meets with his CHHP case
manager once or twice a month.
Darrell does not practice total abstinence from alcohol, his drug of choice. But his case
manager reports that,“He has an occasional drink while watching a ball game but his
drinking is under control. He is resolute that his drinking will be kept under wraps.”
The most important services CHHP offered Darrell were interim housing, supportive housing, medical care and recuperation, case management, and assistance in receiving Social Security benefits.
Indeed, Darrell is the best advertisement that CHHP could ask for, according to his case manager.
Those kind words are returned by Darrell who praises CHHP for helping him get back on his feet.
“Being able to ask for help when I needed it was a big step for me,” he said.“I always thought I had
to be in control. Then you get sick and you find out you’re not in control. You need other people.”
AIDS Foundation of Chicago
2
Susie
Her health has increased dramatically
and she feels happier
Susie, a 28-year-old white female,
was homeless for nearly two years
before being accepted into the
National Housing and Health Study
Project (H&H). The mother of two
was diagnosed with HIV in August
2000, suffers from depression and
has a history of being in domestic
violence situations.
Susie lost her last apartment due
to an abusive situation with her
boyfriend. During her homeless
period, she stayed in domestic
violence shelters, bus depots, parks,
abandoned buildings, and with
family members. For part of that
period, Susie was pregnant with
her second child.
Prior to receiving the H&H housing
voucher, Susie resided in a supportive
housing program for homeless
people. She has held her own
apartment leases in the past as well
as steady jobs.
Treated with dignity
Susie heard about H&H through her Ryan White case manager. Upon receiving the voucher
she moved into an apartment in February 2005. Although she was worried that her credit
history would interfere with obtaining an apartment, her H&H intensive case manager was
able to secure a unit for her based on a professional relationship with the landlord.
Susie has had to adjust to being in a new setting and to the rules and guidelines of being
in an apartment again. But she felt she was treated with dignity and respect by her case
manager and the agency staff during the entire process.
Of Susie’s two children, her 8-year old son is living with his biological father and her 3-year
old daughter was taken into custody by the Illinois Department of Children and Family
Services (DCFS) and remains in foster care.
Future goals
Susie is currently working with DCFS to regain custody of her daughter, but realizes it is a long
and challenging process.
She tries, however, to not to let the situation get the best of her. She is in school to obtain her
GED and she is learning about computers.
At one point, Susie began a maid service with some friends but was unable to keep it up.
he is still actively looking for work.
In the meantime, she volunteers, her health has increased dramatically and she feels happier.
Her future goal is to become a pharmacy technician.
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Time to Heal Personal Stories
Cynthia
Without CHHP, Cynthia would
undoubtedly be on the street again…
For Cynthia, life is a series of
struggles that started in childhood.
The 44-year-old had attended but
did not complete grade school and
long ago lost contact with her
family and two grown children.
She abuses alcohol and crack
cocaine, which she has used
sporadically for 20 years.
Psychiatric complications from
the substance abuse include
blackouts, depression, and psychotic
symptoms. Cynthia had been
incarcerated for felony possession
of a controlled substance and has
never been employed or had a
steady source of income.
As a CHHP participant, Cynthia
arrived at Interfaith House, a shelter
that provides short-term housing for
injured or ill homeless people, on
June 2004 and was placed into a
housing unit three months later.
Lived in a park
Referred by the Chicago Housing and Health Partnership (CHHP) from Mt. Sinai Hospital and
Franciscan Outreach, Cynthia’s medical diagnoses included HIV/AIDS and previous treatment
for tuberculosis. She had lived in a nursing home for six months but was asked to leave after being
denied funding. In the three months following her discharge from the nursing home, she stayed
in a park, hospitals or at Franciscan Outreach.
At Interfaith House, Cynthia received complete assessments from her CHHP case manager, the health
services team, a CADC substance abuse counselor, and a mental health professional. The substance
abuse counselor referred Cynthia to outpatient treatment, 12-step Alcoholics Anonymous and
Narcotics Anonymous meetings, and established a schedule of weekly progress evaluation sessions.
The CHHP case manager encouraged Cynthia to follow her medical recovery plan, work with the
agency’s art therapist, and meet with the substance abuse counselor. The case manager also helped
Cynthia prepare an application for Supplemental Security Income (SSI) benefits and food stamps and
assisted her with obtaining identification which had been lost or stolen.
Housing, recovery, relapses, but still housed…
After her placement in a CHHP permanent housing unit, Cynthia remained clean for six months but then
tested positive for drug use. By the fall of 2006, Cynthia was actively using crack cocaine again. She went
into treatment from November 2006 to January 2007.
Cynthia stayed clean for a few weeks following rehab, and then relapsed again. During her“clean”time,
Cynthia was enrolled in a GED class and participated in a job training program that paid a small salary.
Unfortunately, access to money seemed to act as a trigger for her to buy drugs.
Today, Cynthia still has no income. She did, however, receive presumptive SSI benefits for a time but
her disability application was eventually denied. Cynthia has retained her CHHP housing with a private
landlord although she has violated her lease by having unauthorized people live with her.
One of the more challenging aspects of Cynthia’s drug use is that she does not keep her medical
appointments as regularly as she should nor takes her medications as prescribed. Her CHHP case
manager has encouraged Cynthia’s attendance at 12-step meetings and counseling with a recovery
specialist, advice which she occasionally follows.
The most important services that CHHP offered Cynthia was interim and permanent housing, medical
care and stabilization of health status, behavioral health and substance abuse services, case management,
and assistance in applying for SSI benefits.
Without CHHP, Cynthia would undoubtedly be on the street again, without any medical care
and deeply mired in drug abuse.
AIDS Foundation of Chicago
4
Charlie
Charlie feels he can live a long and healthy life
Charlie, 41, is an African-American
male who was diagnosed with
HIV/AIDS in April 2003. He had
worked as a mental health counselor
for several years and maintained his
own apartment for 15 years.
But due to AIDS-related illnesses
that lead to long periods of sick
leave, he lost his job. Soon, Charlie
could not keep up with his bills or
pay rent.
He was evicted.
Charlie began receiving case
management services from the
Illinois Department of Human
Services Division of Rehabilitation
Services (DRS) program in August
of 2003 due to the toll his medical
condition took on his ability to
function. He ended up moving into
his brother’s home, having no means
to live on his own.
Charlie began receiving Social
Security disability income payments
of about $1,000 a month, but his
medical bills ate much of that up.
As his capacity to take care of
himself improved, he switched
from a DRS case management
to a Ryan White case manager.
Room for Charlie
Still he couldn’t work and, as a result, was unable to move out of his brother’s home.
Charlie’s living arrangement necessitated major changes for his brother, who had a
family of his own. Two of his brother’s children, who had had their own rooms, were
forced to squeeze into one in order to make room for Charlie.
The situation proved stressful on Charlie. The lack of independence, the sense
of being a burden, and his difficult financial situation, all led to Charlie’s depression
and depleted self-esteem.
Charlie heard of the National Housing and Health Study Project (H&H) around this
time. Since he qualified for the Project, he applied for the study through his case
manager and received a housing voucher.
Charlie has been stably housed in his own apartment unit for three years as
of December 2007.
Living independently
Initially, issues of debt and bad credit would have discouraged Charlie from applying
for his own apartment. But with help, guidance, and advocacy from his H&H housing
advocate, he was able to secure an apartment early on in the study. His advocate
examined the apartment before the move-in date to make sure that it was in good
condition and had heat and running water.
Charlie has lived independently and said he feels like he is working towards a
better life. His focus has been on obtaining an online degree and he has begun
to work various part-time jobs.
Charlie feels he can live a long and healthy life, be independent and take
care of himself financially due to the stability made possible through the
subsidized housing.
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Time to Heal Personal Stories
Mary
Mary is receiving services and has
a web of people who care about her
Following eviction for failure to
pay rent due to health problems,
Mary began living in an office
from which she conducted a
clerical business. At 79, she had no
identification, Social Security card
or birth certificate. She had been
homeless for two years.
Mary arrived at Interfaith House,
a shelter that provides short-term
housing for injured or ill homeless
people, in November 2004 and
was discharged ten weeks later to
permanent housing.
Her medical diagnoses included
hypertension, chronic anemia,
and colonic polyposis. She had been
referred to Interfaith House by
the Chicago Housing and Health
Partnership (CHHP) from John
Stroger Hospital. At Interfaith
House Mary received complete
assessments from a CHHP case
manager as well as health and
behavioral health services staff.
Solid work ethic
Cheerful and positive, Mary was well-liked by other residents. They were sensitive to her
fragility and“adopted”her as a grandmother. The role was a natural fit for a woman who
dispensed sage advice and expressed concern about the state of the world and the demise
of a solid work ethic.
Throughout her stay at Interfaith House, Mary pressed for opportunities to get back to her
office to keep current on clerical projects. She didn’t want to let her clients down.
The CHHP case manager assisted Mary in preparing an application for Social Security
disability income benefits. It proved an extraordinarily difficult task: They first had to obtain
her birth certificate from Iowa, circa 1928. Mary had lived under at least three different
aliases ––her birth name, a married name, and a final name change ––all without benefit
of any legal proceedings. This in turn complicated efforts to obtain a Social Security card and
other identification which had been lost or stolen.
Removing isolation
Since her discharge from Interfaith House, Mary has had surgery for a hernia and a blockage
in her colon. She has difficulty breathing due to emphysema and was placed on oxygen.
A home health aide visits twice a week to assist with grocery shopping and laundry.
She also is tended to in her apartment by a visiting nurse and a physical therapist.
Mary’s health status has been up and down recently after she fell on a city bus and broke
several ribs. Her CHHP case manager reports that like many frail elderly, she is lonely.
She has no family and few friends.
To ease Mary’s isolation, her case manager reached out to Little Friends of the Elderly and
the organization now sends a volunteer companion to Mary’s home on a regular basis.
The most important services that CHHP offered Mary were interim housing, placement into
permanent housing with Housing Opportunities for Women, medical care, stabilization of
health status, case management, and assistance in obtaining Social Security benefits.
Although she continues to have health problems, Mary has a home and is receiving needed
services and has a web of people who care about her.
AIDS Foundation of Chicago
6
Mark
Mark occasionally stayed at
shelters and ate out of soup kitchens
Mark, 50, is an AfricanAmerican male who was
diagnosed with HIV in January
1990. He has been stably
housed with a voucher from
the National Housing and
Health Study Project (H&H)
since January 2005.
Mark receives $604 in monthly
Supplemental Security Income
benefits. When he was using
drugs, Mark could neither
secure employment nor keep an
apartment. And when he did
work, his income often went to
buying drugs instead of paying
bills. He has abstained from
drugs since 1999.
Nomadic period
Before the H&H study, Mark lived with a host of family members and friends at various times.
He would live with anyone he could – a sister, cousin, mother or friend – and stay as long as
he could before exhausting that resource and moving on to the next family member or friend.
During this nomadic period, Mark occasionally stayed at shelters and ate out of soup kitchens.
In 2002, a car accident led to a stay in the hospital and a nursing home. To this day, Mark is
still unable to stand for long periods of time. Before his acceptance into the H&H study, Mark
lived with his sister who was about to lose her place. Mark had never held his own lease.
He had difficulty maintaining a medication schedule while moving around and often
missed dosages.
His case manager referred him to the H&H study. Upon receiving the voucher he was
assigned a housing advocate. When initially attempting to secure an apartment he disclosed
his HIV status to the first five potential landlords and was turned down by all of them.
On his next attempt, Mark kept his status confidential and signed a lease. He has
maintained this apartment for almost three years. Some of the challenges he faced,
however, were learning to budget and to pay his bills on time. With help from his H&H
housing advocate, he eventually developed these skills.
New beginnings
The biggest reward to having stable housing is the improvement of his relationships with
family. Mark has an adult son whom he sees on a regular basis now, and his father is
able to visit him in one place.
Mark’s family also stays in touch more frequently through visits, phone calls and letters and
cards. Mark is considering going back to school or entering a job-training program to boost
his income.
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Time to Heal Personal Stories
Founded in 1985 by community activists and physicians,
the AIDS Foundation of Chicago is a local and national
leader in the fight against HIV/AIDS. We collaborate with
community organizations to develop and improve
HIV/AIDS services; fund and coordinate prevention,
care, and advocacy projects; and champion effective,
compassionate HIV/AIDS policy.
411 South Wells, Suite 300 | Chicago, Illinois 60607
(312) 922-2322 | Fax (312) 922-2916
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