Care Alliance Closes Buildings In Effort to Find Stable Funding

by Brian Davis

     This is a first person account of the struggle to keep two buildings that serve homeless people from closing. We usually have a reporter write these news type stories, but since the editor of the Grapevine was so intimately involved in attempting to keep these buildings open, it was decided to print a first person account of the situation. We extend the same offer to Care Alliance to put in an unedited account from their perspective of the situation with the two buildings on Payne Ave. in the next issue of the Homeless Grapevine. We will make that offer in writing to them.

Background on Care Alliance:

     Care Alliance was created by the Federation for Community Planning to coordinate services to homeless people without access to medical care. It was originally called Cleveland Health Care for the Homeless, and originally sent a health team to all the shelters on a regular basis to provide screenings and link individuals to needed health care services. Over the last four years the agency has broadened its mission to now include people living in public housing and people afflicted with virus that causes AIDS. They have expanded their budget significantly, but many social services providers in the community worry about their commitment to serving the medical needs of homeless people.

     In the mid 1990s, when millions of dollars began pouring into Cuyahoga County to battle homelessness from the Department of Housing and Urban Development, Care Alliance began expanding its mission in order to gain access to these funds. They constructed programs to serve women, women with children, and homeless people with a mental illness. A homeless person with a diagnosed severe mental illness actually does have access to health care because they are covered by Medicaid.

Care Alliance ventures into mental health services:

     Care Alliance constructed a safe haven concept in which homeless people (both men and women) with a mental illness could enter during the day and also have shelter available at night. This drop in service at first was actually only available by van, and there were never enough beds to accommodate the number of homeless people that used the facility as a drop in center. Many in the community were weary of the large number of mentally ill people in the same facility and the fact that women and men were under the same roof. The biggest problem with the safe haven was that Care Alliance was not a certified mental health agency, which would mean that they would have come under the scrutiny of the Mental Health Board locally. NEOCH raised this issue every year as problematic. The clients who used this facility seemed disconnected from the rest of the County mental health services. There was not the political will locally to exert any pressure on Care Alliance to make the needed changes to better serve homeless people.

Care Alliance also expands to serve women:

     Care Alliance also constructed a Women's Center to serve the medical and social service needs of homeless women and their children. They purchased and renovated a building locally at 2219 Payne Ave. to serve these women and put together a patchwork of social service providers to extend services to the 60 women who came to the facility every day. Care Alliance was determined to be in violation of their contract with HUD over the purchase of the 2219 Payne Ave. building. HUD found that the Federation for Community Planning used the donation of the building to Care Alliance as a local dollar match for a federal grant, and then later Care Alliance turned around and paid the Federation for Community Planning for the same building. Care Alliance was forced to pay HUD back for the cost of the building.

     Care Alliance also had a dispute with the other service providers who used the building, and for a period of time they parted company. This dispute led to the drop in services for women only being open for half of the day and then the women walking a few blocks down the street to another drop in center for the rest of the day. Officials of Cuyahoga County stepped in and negotiated a deal where the women would not have to leave the building and three different agencies would collaborate on providing drop in services-Care Alliance, Cornerstone Connections, and the YWCA. All received separate federal contracts to provide the services at 2219 Payne Ave.

     There was another small program called The Upstairs located on the second floor of the Women's Center, which featured dormitory style apartments for severely mentally ill women. This was permanent housing for these women and there was a social worker on site to provide support to the women. This program actually always had received very good reviews by the County Review team that looked at the program. The Upstairs program had actually received three years of funding in 2000, and thus was expected to continue in operation through 2004. It served 16 women who had become very stable and were found to be doing well in the review conducted by the County.

Care Alliance Buys a Second Building for the Mentally Ill:

     The safe haven program for the mentally ill was forced to move in 1999, and Care Alliance purchased and renovated an old union building at 2227 Payne Ave. to serve as the new home of the safe haven. Care Alliance began a giant capital fund development campaign to "create a social service campus on Payne Avenue." They received foundation support, government help including a $250,000 grant from HUD and a $94,000 grant from the Department of Health and Human Services, as well as funds from a number of corporations to purchase and renovate the building at 2227 Payne Ave. The new building at 2227 Payne Ave., next door to the Women's Center, was purchased and renovated with a mix of public and private donations for nearly $1.5 million. Care Alliance did save on some costs with the buildings next door to each other. They no longer had to transport by van the food from the Women's Center, which has a kitchen, to the safe haven. They could walk the food next door. They also did not have to provide a van service for the men and women who used the facility anymore since it was in the downtown area.

     The safe haven costs the federal government $554,089 every year to operate, and during the 1999 review the County found many problems with the program. These problems included client grievances and the fact that very few people were actually moving into something more stable. There was also administrative problems cited by the Review Team. This safe haven was very expensive to operate, but was not having much of an impact on moving people out of homelessness. There was acknowledgement by the Review Team that serving the severely mentally ill was difficult and posed a hardship for the agency. The County Review Team asked for changes in the program and extended one year of funding to the group.

The Programs Were Taken Away from Care Alliance:

     During the year 2000 review, The County Review Team consisting of members of government, foundation, business, homeless people, social service, and advocates again found problems with the operation of this program. The Coalition had received many complaints about the safe haven program from clients including terminations without cause and allegations of improper sexual contact between a client and staff. The grant was submitted to HUD for another year of funding despite the concern and after much debate. It was decided that Cuyahoga County would work with Care Alliance to find another social service provider (preferably one from the mental health community) to administer the safe haven. Care Alliance claimed that they informed the county in April 2000 that they would not be able to come up with the matching funds for this grant. There are no records to indicate that Care Alliance formally stated their desire to end this program in April of 2000.

     The Women's Center had the same problems, but the County Review Team felt that there was a higher degree or urgency for a new provider to supervise the program. The County team expressed concern in 1999, and recommended changes. In 2000, they heard a large number of complaints from clients including one that had a significant impact on the group. The Review Team was told of women who leave to go to the hospital and the Care Alliance staff throws all their stuff away. They told the other women that if any of them attempted to retrieve the woman who went to the hospital's items from the dumpster would be permanently banned from the program. There were many other problems including the reality that very few women were getting into permanent housing, which is the basis for the federal funding. Again, the County Review Team recommended submitting the grant to HUD, but finding a new provider to supervise the program.

     The other partners in the Women's Center were not interested in taking over the project, and so Catholic Charities decided to expand their existing services to homeless women by taking over operation of the drop in center. They also took over operation of the overnight shelter for women, and made plans for one facility that would offer both drop in and shelter services for women or women with children. To complicate matters, it was announced at the end of 2000 that HUD was not going to renew the Care Alliance grant for the Women's Center. The County has successfully appealed social service rejections by HUD in the past, but county officials have said that Care Alliance was not very helpful in filing an appeal. Because the program was going to go under the direction of another service provider, they had no interest in appealing their denial from HUD.

     Cuyahoga County officials worked out a deal that would allow Catholic Charities to take over the program on April 1, 2001 using the existing 2219 Payne Ave building. The Office of Homeless Services, the Cuyahoga County agency responsible for oversight of shelters, staff reported that "initially, Care Alliance indicated a willingness to do whatever would be helpful to follow through on a transition." On March 25 2001, OHS received notice from Care Alliance that on July 1, 2001 the safe haven had to vacate 2227 Payne Ave. and the women's program operated by Catholic Charities had to move out of 2219 Payne Ave. The memo sent by Ruth Gillett of OHS said, "Care Alliance has not indicated its plans for the use of this (2227 Payne Ave.) building."

Surprise! Surprise! Surprise!:

     Care Alliance applied to HUD for a change in purpose for the two buildings from serving homeless women and the other building serving homeless people with a mental illness to both buildings being used to serve homeless people with AIDS. This change in purpose was not discussed with County officials, the Coalition for the Homeless or the other big homeless service providers in the community. As of June 14, 2001, HUD had not decided if this change was acceptable, but Care Alliance went forward with evicting these two programs. It came to light in May that Care Alliance was also evicting the women in the Upstairs program. This came as a great surprise since that program had received three more years of funding and was under no threat by the County. Before anyone could mobilize opposition to kicking these women out of their apartments they were all gone. Care Alliance did offer one concession to Cuyahoga County after they raised concern over the closings. They would allow another entity to come into the building and provide services until June 30, 2002 but only at the safe haven at 2227 Payne Ave. They did not provide a lease to Mental Health Services to provide services in the building until the week of June 18, 2001 only two weeks before the program was slated to close.

     Mental Health Services claimed that they needed three months to transition into these buildings. They informed Care Alliance and Cuyahoga County of their time table in March, but never received word to go forward. This three months was to secure the funding, hire and train staff and find a new site for half of the residents. In order to assure quality of service, Mental Health Board rules prohibit more than 13 mentally ill people in one shelter facility. So MHS had to find space for the other 13 individuals who were sheltered at the safe haven to comply with the HUD contract.

All the Powerful Entities in Cleveland Could Not Stop the Closings

     Upon hearing of the closing of the buildings, NEOCH contacted all of Care Alliance's funders to enlist their support in keeping the building open. The Cleveland Foundation, Thomas White Foundation, Eaton Corporation, 1525 Foundation, HUD, HHS, Gund Foundation, United Way. A few of these organizations met with the Care Alliance board, but could not stop the buildings from closing. NEOCH contacted every local and federally elected official from Northeast Ohio to get them to intervene. From County Commissioners to U. S. Representatives to the Mayor and City Council and none were able to stop these buildings from closing. NEOCH contacted the media in order to get attention in the general public about this unacceptable situation. As of the last week in June, the two buildings were still scheduled to close, and no one had stepped in to stop this waste of a resource.

     HUD did send a letter to Care Alliance dated June 14 by Lana Vacha, the director of community planning, which said that their request to change the purpose of the buildings was under investigation, but they needed further information. Vacha's letter did say, "we also remain concerned about the potential displacement of current tenants, as well as your continued obligation under the Term of Commitment requirements." Vacha later in the letter said, "We recommend that Care Alliance cease any activity that is not yet approved by the grantor agency (HUD or Cuyahoga County) with regard to the current tenants or services provided at these sites." Since Care Alliance did not take their recommendation, we will have to wait to see what HUD does when they find that Care Alliance did not take their advice.

The NEOCH response to Care Alliance:

     NEOCH's Board felt that this was a tremendous waste of money to renovate buildings and then have them sit empty. NEOCH's Board also felt that this change in purpose for the buildings would not be in the best interest of homeless people. The thinking was that if homeless people with a mental illness and women had not received good services why would homeless people with AIDS receive any better services from Care Alliance. Based on previous experience, the NEOCH Board realized that it was very difficult to get neighborhoods to accept services and would take more than three months to find replacement facilities.

     NEOCH staff had worked with the AIDS community on a conference on AIDS and housing, and had seen that Cuyahoga County and the City of Cleveland had made a huge monetary commitments to fighting AIDS. We felt this change in purpose by Care Alliance was an attempt to go after this new pool of money that was made available locally. The NEOCH Board was so concerned about the clients at this building they offered to provide staff at these two buildings in the short term to keep them open while a transition was worked out. Cuyahoga County officials did not feel that this was a good idea. So as the building was scheduled to close, the plan was for the safe haven for the mentally ill to sit empty for the summer. The women at the women center would stay in their overnight shelter until 11 a.m. and then go to a drop in center for women and men called the Bishop Cosgrove Center. The Care Alliance Women's Center would sit empty until HUD decides if they could use it for the AIDS population.

     We did ask Care Alliance to comment for this article, and they refused. They sent this note: "Given our experiences with the Homeless Grapevine, we do not believe that the publication provides unbiased or fair coverage to homeless service providers in general, and to Care Alliance in particular, and therefore we chose not to participate in the Grapevine's article at this time.

Geri Chesler assisted with this report.

Copyright NEOCH and the Homeless Grapevine, Issue #48 -2001