Reaching into a void
Monday, December 06, 2004
- Organization: San Francisco Chronicle
Reaching into a void
For mayor's team of street crusaders, getting the chronically homeless into housing requires patience as they battle their addictions -- and persistence if they relapse
Part Two: Connecting with the neediest.
An August heat wave had turned the usual foul mood even fouler on the sidewalks of Jones Street in the Tenderloin.
Ricky Smith lay on his back alongside a shopping cart overflowing with grubby blankets and jeans, snoring in the late morning sun. At his side slept tiny Leslie "Jill" May. Sweat streamed across her wrinkled face and into her open, toothless mouth. Across the street, four other homeless regulars argued loudly over a broken crack pipe.
A white van pulled up next to Smith and May. Out stepped Ben Amyes, one of 12 counselors working in San Francisco Mayor Gavin Newsom's new outreach effort to move the chronically homeless off the street and into housing and social service programs.
"Wake up, sleepyheads!" Amyes called cheerily, bending down to nudge the pair. He tapped them both again. No response.
Amyes had made an appointment with the pair the day before to meet them here at this time, 11 a.m., to talk about getting into drug rehab -- and they'd clearly forgotten. Just as hundreds of other hard-core homeless people had forgotten similar appointments with Amyes before this. And hundreds more will in the future.
Seven months ago, Newsom started the street outreach team as the centerpiece of the city's plan to solve homelessness in San Francisco -- a crisis, the mayor declared in his State of the City speech in October, that had "replaced the Golden Gate Bridge and the cable car as one of the city's most defining symbols." With just a dozen outreach workers versus an estimated 3,000 chronically homeless people, the word daunting only begins to describe the challenge.
Catch them in lucid moments, and most of the chronically homeless say they want help -- but actually getting them to take advantage of the offer is slow, hard, frustrating. Amyes and his co-workers say they prefer not to dwell on the toughness of the task but on the one-day-at-a-time patience it requires. And on those moments when they can connect with their "clients" -- broken people like Smith and May.
On that morning in August, 47-year-old May stirred beneath her blanket. "Mmmm, why's it so hot? Where's Ricky? I feel sick," she mumbled in a rush of words that clipped off abruptly as she opened her eyes and saw she had company in the form of Amyes and his outreach co-worker Dorothy James.
Smith, 51, woke, rolled to his side and groaned. "Where's our methadone?" he snarled.
The smile on Amyes face grew wider. "Tomorrow," he said brightly. "We're taking you in for a full doctor screening first, then the next day you get your first dose (of methadone). This is going to work. You are going to get clean, off heroin. You're going to get off this street!"
May stared blankly.
Smith nodded almost imperceptibly and slowly got to his feet.
James handed over two raspberry Nutri-Grain bars. "Take care," she said, getting no response.
As the outreach workers climbed back into their van, May ducked under her blanket, fiddled with a syringe and lit her crack pipe. Smith ambled a few paces over to the wall of the Hotel Layne -- a tourist enclave on this strip of Jones Street, one of the Tenderloin's seamier stretches -- unzipped and urinated against the golden stucco.
Leaning in the doorway 10 feet away, Hotel Layne manager Randy Patel watched Smith without moving, then stared at May. His face was weary with resignation. He snorted in disgust and walked inside.
Amyes happened upon Smith, a former pimp, and May, the last of his once- large stable of prostitutes, within a few weeks of the May 11 launch of the outreach team.
The couple were spending their nights on cardboard scraps under threadbare blankets on Jones Street, in front of liquor stores and cheap eateries. Smith, a lean, good-looking man with an easy grin, hustled crack rocks to make a few dollars each day for heroin and food. May was a weathered beauty wasted as thin as a starving child. Her face was deeply lined from years of sleeping outside. She turned occasional tricks in cars or hourly flophouse rooms to pull in a few more bucks, and her legs were so damaged from exposure and infections from dirty syringes that she could only shuffle.
When May and Smith weren't hurting from drug withdrawal, they were engaging, even erudite, sharing food and advice with anyone who wanted to talk.
But when they were strung out -- as they usually were when Amyes found them -- they were the horror of the block.
It wasn't always that way for either of them.
"I was raised in a good, churchgoing home," Smith said one day in mid- July as he sat on the sidewalk, his head clear after shooting heroin that morning. "The only reason I'm out here is because I f -- my life up myself."
Smith's father was a carpenter in San Francisco, and his mother ran a strict house with their six children, he said. Most went to college, and Smith's younger brother Ron became a supervisor at San Francisco General Hospital. Their cousin, Victor Willis, was a music star -- the macho "cop" character in the campy, 1970s pop group Village People who co-wrote many of their hits, including "YMCA."
Smith said he always wanted to follow in his cousin's footsteps but grew impatient, dropped out of high school and discovered the quick cash of hustling drugs.
In the early 1970s, under pressure from his family, Smith went straight and ran his own men's clothing store for a couple of years, Smith and his brother said. But then he discovered the easy bucks he could make pimping. By the late 1970s, he was known as "Slick Rick," drove a Corvette and ran 25 prostitutes -- including May, whom he met in "the business."
May said her mother was a drunk, and when May was 12, she found her mother dead on the kitchen floor from alcohol poisoning. The girl was then raised in Idaho by her father, who she said raped and impregnated her at 16. After a miscarriage, May ran away, became a prostitute and wandered the Northwest for two years before landing in the Bay Area in 1976. She and Smith hooked up that year for heroin, cocaine, the sex trade and companionship -- and along the way, though they never married, May became the pimp's "woman" more than just his worker. They had three children together.
But throughout the 1980s, they got arrested too often and got too hooked on dope, and Smith slowly lost all of his other hookers. The two finally tumbled to the street, broke, in the early 1990s -- they're not exactly sure when -- having exhausted the patience of their families. They struggled in and out of bottom-end housing with their children either in tow or staying with relatives until 1995, when the kids went to live full time with Smith's brother Ron, who has raised them.
Low-level busts for drugs and prostitution have dogged the couple ever since, almost all resulting in court orders to enter rehabilitation programs that they never attended.
Their world after hitting the skids in the early '90s became two blocks of the Tenderloin on Jones Street, between Geary and Ellis streets. Just three blocks from Union Square, it hosts a dreary collection of rock-bottom hotels, quick-stop markets and low-budget restaurants, with a few fancy tourist shops and pensions scattered in between. It also is home to about 30 hard-core homeless people drawn to the neighborhood by easy access to dope dealers and a plethora of poverty-relief agencies, including the busy soup kitchens and health clinics at St. Anthony Foundation and Glide Memorial Church. The group spends its days roaming, sitting, sleeping on the cement and playing out its dysfunctions in public.
"Sixty years I worked around here, and until this past 10 years, it was never this bad," said Carl Mooney, who ran a nearby barbershop until he retired last year and who was visiting colleagues at the Haircut Place on Jones. "It's the drugs. It's disgusting what they do. No respect for themselves or anything else. You can't walk 15 feet without stepping on one."
When Amyes, accompanied by outreach team leader David Nakanishi, first encountered Smith and May on June 1, they didn't exactly hit it off.
The outreach workers were walking north on Jones Street and nudged each other as they spied the pair lying next to a parking meter with several street pals. A syringe was in the dirt next to Smith, several in the group were smoking crack, and May, addled by dope, was trying to shout at another homeless woman for bumping into her.
"Hey there," Amyes said as he walked up to the couple. May stopped yelling and stared. "You know, I can get you under a roof if you give me a chance," the outreach worker told her.
"Like hell you will!" May mumbled.
"I mean it!" Amyes shot back, adding with a grin: "I'm not out here for the view!"
May scowled and limped away, swearing under her breath.
Smith lay on a blanket on the sidewalk and watched the exchange with a frown. He stuck up his hand and shook his head when Amyes turned to speak to him.
"We'll be back," Amyes called out over his shoulder as he walked away. Halfway down the block, he looked back to see the two erupt into an argument. One of May's regular customers had come by offering $20 for oral sex, but Smith wanted her to stay and guard their shopping cart while he bought crack.
"This will take awhile," Amyes sighed. "I've got to get something to offer them, or they'll never listen."
Smith and May had no idea how lucky they were just to get the outreach team's attention. There's no way everyone who needs it can get help -- and the team knows this.
Since its inception last spring, the outreach workers have logged 4,950 contacts with hard-core street people. And out of all the spent shoe leather and attempts at persuasion that represents, they've gotten 40 people (34 through Care Not Cash) into supportive housing with on-site social services, 60 into shelters or temporary rooms, 30 into drug rehab and hooked up dozens more with emergency medical services. That's considered pretty good progress by experts, considering most of the time street counselors in big cities are just told to get lost.
One day in mid-July on Jones Street, during another trip to find Smith and May, Amyes surveyed the block, shaking his head. Of the 20 hard-core homeless on the sidewalk that day, he could point to a half-dozen his team never has time to approach. Another half-dozen of those he saw get visited once a month at best.
"We have to concentrate on the ones who are willing to give us a shot," Amyes said. "Like Ricky and Jill (Smith and May). All we can do is move one step at a time. You make a presence. You let them know you've got something to offer. You don't give up.
"One of the hardest things for me, doing this, is realizing that some of these people will be dead," Amyes added quietly, watching two men start to scream and throw blankets at each other. "No matter how hard I try."
Amyes reckoned he had two priorities with Smith and May: housing and drug rehab. To him, it didn't matter which came first. Under Newsom, the city now has adopted the nationally proven model of "housing first" -- getting junkies indoors whether they're clean or not, so the addiction can be treated in a calmer setting.
To make room for the Smiths and Mays of the world, Newsom ordered up 200 new treatment slots for methadone, in which addicts get once-a-day doses of the liquid drug that substitutes for heroin and erases the craving for the narcotic. Amyes knew he could get his couple into two of those spots.
But getting them to claim them was no easy trick.
For months, every time the street counselors left Smith and May, peer pressure tugged at them. "I've seen these counselor people come and go, and they never follow through," one homeless friend told them. "They're just out to bust you with the cops," another said. "You can't leave your homies out here," a third said. The couple were confused and scared.
Amyes and his co-worker James tried to visit at least once every week, sometimes finding Smith and May, sometimes not. Each time, it was a little chat time mixed with handouts of food or a blanket. Finally, it sank in that the counselors were serious.
"I want so bad to get clean, so bad to get off this damn street, so bad to have something good happen to me," May whispered one afternoon in mid-July after Amyes had left. She lay on her blanket, arm over her head to ward off the sun.
"Jill, shut up about that crap! Nobody cares about us!" Smith barked, punching her shoulder. Neither had shot heroin yet that day, and they felt nauseous and irritable, which is why they again told Amyes to buzz off that morning.
The pair glared at each other, then one after the other ducked under a blanket and smoked down a rock of crack apiece.
"I am so sorry, baby, so sorry, I was mean just then," Smith said, face aglow from his high. "You know I love you." A tear squeezed from May's right eye, and she nodded silently.
The outreach began to pay off in late July. By late August, the outreach team had signed up Smith for his first-ever welfare check and put him on the waiting list for a residential hotel room. On Sept. 22, the couple -- for the first time -- went jointly to the Westside methadone clinic on Pierce and Ellis streets with Amyes and James.
They saw the long line and walked out.
Later that afternoon, however, the street counselors drove by Jones Street again, cajoled the couple into the van and took them back. This time, Smith and May took the methadone. They've been "dosing" every day since then.
As he bedded down that first night after starting treatment, Smith took the heroin syringe he had in his pocket, rolled it in a paper bag and dumped it in a trash can -- unused. The next day, he called his cousin, the former Village People singer Willis, and told him that he was on his way back to stability.
"I'd love to see Ricky and Jill get their act together again," Willis, who lives in San Francisco but sees Smith so seldom he didn't know where he was sleeping, said in a later interview. "Jill used to be so beautiful -- a real killer. You wouldn't know it today, but boy, was she a looker."
Patel, the manager of the Hotel Layne, said he couldn't believe his eyes when he saw the couple heading off in an outreach van for rehab.
"It's like seeing the cavalry come in, it really is," said Patel, who just oversaw a $1 million upgrade that turned his marble-floored, 45-room establishment into a showpiece, though he still has to keep his prices down because of the wretched dramas that unfold on his sidewalk every day.
"In the old days, back in the early 1990s, the massage parlors and hookers were the problem we all complained about -- but now we don't even notice that," Patel said. "It's all about the homeless."
He clasped his hands as if in prayer, gazing out his window to marvel at Smith's and May's shopping cart sitting mostly empty at the sidewalk while the two were away at the clinic.
"It would be so wonderful to learn that every one of these people -- all the Rickys and Jills -- got inside somewhere, got cleaned up," he said wistfully. "But after all these years, I won't believe it until I see it."
With the couple's heroin craving under control and Smith already on a waiting list for a room, the next problem for Amyes to solve was finding housing for May. Given the tight supply and the overwhelming demand, the outreach team has only a handful of rooms available each month, and under governmental funding rules, it can't place unmarried couples like Smith and May together -- so two open spots were needed.
The answer came on Sept. 24, when one of eight rooms allotted to the outreach team for housing chronically homeless people on a month-to-month basis became vacant. When the opening was announced at an outreach team meeting, Amyes slammed his hand on the table and yelled, "Jill! We've got to give this to Jill!" The half-dozen counselors gathered around cheered.
A few hours later, Amyes walked up to May as she stood on Jones. "Sweetie, I got a room for you," he said.
May burst into tears.
Smith had been in jail for two days, busted by the area patrol cops for having a syringe on him (he said it was just "left over"). So he wasn't around to celebrate when May carried her bag of clothes and an 8-inch, black-and- white TV into the Bristol Hotel on Mason near Eddy Street. The next week, though, Smith was discharged straight to the street, and as soon as he showed up in the Tenderloin looking for May, the outreach team drove him to his own room at the Marilyn Hotel several blocks away.
Just as quickly, however, it became clear that getting a room didn't mean leaving Jones Street behind.
May and Smith still went back every day to score the occasional crack rock, to hang out or to panhandle. But they were inside, their stuff was no longer clogging the sidewalk, and they were working on beating their addictions, dosing on methadone daily. Smith went diligently to work twice a week cleaning city buses as part of his welfare program.
They dressed cleaner, their gazes were clearer, and they talked more coherently. And there was an attitude change.
For May, the transformation blossomed the day she moved into her hotel room -- and rushed back to Jones Street around midnight to spread the good news.
"OK, OK, I'm glad for you," mumbled one of her street buddies, 55-year- old Wayne Brown, picking at the grimy arm of the wheelchair he lives and sleeps in because of a back injury. "I just wish those outreach guys would talk to me."
May leaned against a wall and lit a cigarette. She patted Brown on the shoulder and turned away.
"Dorothy and Ben (James and Amyes) have been putting up with our crap for months, and they still hung in there," she said, eyes shining. "All the disappointments, all the trouble. Why did they do it? But now! I'm happy."
She stared back at Brown, who began nodding off in his chair for the night.
"Just one day before I die, I'm going to see the Statue of Liberty," May said softly. "I'm going to get on a Greyhound bus, see the country. Go to school, get a job. I want to do normal things."
She watched the traffic whizzing by, and then suddenly, her chest heaved in a sob. She pressed her palms to her eyes.
"Is it too late for me and Ricky?" she said, crying. "I never had my head clear enough to look at myself, and now here I am."
On Oct. 29 -- about a month after she moved in -- May was evicted from her hotel for missing two key appointments to sign up for welfare that would pay for a permanent residential room. She shrugged when Amyes told her she had to vacate the place, grabbed her bag of clothes and promptly moved it into Smith's room.
"I'll make it to that appointment sometime real soon, I know I will," May said that afternoon as she stood at her usual spot on Jones Street. "I'll find friends to sleep with until then. It'll work out. This isn't over."
A week later, Smith, too, was tossed out of his room -- for letting May sleep there.
"We sure as hell live an exciting life," Smith said with a regretful chuckle. "I would give anything for it to be dull -- if I could go back and change it to dull all the way through, I'd even do that."
May fumed on the sidewalk beside him. "They give us hope, then they drop us!" she sputtered. "Do they care?"
Amyes was upbeat about it all. He called the evictions merely "a hiccup in the big picture."
"Now that they're off heroin, we have to work on what's underneath -- and that means getting Jill to make it to appointments and Ricky to learn the rules better," he said. "They can do this. Jill has to show us she can walk the walk, that she can put in a little effort of her own to meet us halfway, and Ricky just needs to go that extra yard."
He gave a tired little laugh.
"Hey, that's what this is all about, isn't it?" Amyes said. "Two steps forward, one step back."
San Francisco Mayor Gavin Newsom built his campaign on reforming the city's homeless services. When he entered office in January, the city had the nation's worst hard-core homeless problem -- with at least 3,000 people panhandling, sleeping, drinking and shooting drugs on the street every day. Reporter Kevin Fagan and photographer Brant Ward have tracked the city's progress under Newsom since his Jan. 8 inauguration.
Sunday: San Francisco is moving hundreds of people into housing and treatment programs but still has a long way to go.
Today: The painstaking, day-to-day struggles of San Francisco's new homeless outreach team.
Tuesday: Inside the new housing programs San Francisco is counting on to help solve its homeless crisis.
Sunday's installment can be read online at sfgate.com
E-mail Kevin Fagan at firstname.lastname@example.org.
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