"There are so many people this could help," says Sister Joan, "but a lot of pieces have to fall into place."
One of the Sisters of Charity of St. Augustine, Sister Joan, along with several others on her project committee, has spent the past three years transforming the broken-down, empty building across the street from St. Vincent Charity Hospital into a nice place to live. In a couple of weeks, it'll be open for business as Joseph's Home, a transitional housing facility that will provide home health care to patients who have no home.
Referred by social workers in hospitals and shelters, these patients will recuperate here from the flu, cancer, and almost anything in between. Sister Joan says Joseph's Home won't take terminally ill patients, and she'll send those in need of detoxification to the hospital first. Once admitted, residents can stay for up to six months, cared for by a staff of 10, including a registered nurse, a licensed social worker, and a live-in home monitor.
"We're not keeping with a first-come, first-serve basis," Sister Joan explains. "It's for those in the greatest need." And for the first few months, she'll be taking only men. "I thought, let's try with one sex until we get ourselves settled," she explains, noting that the city already has several shelters exclusively for women.
She expected to get mostly asthmatics and diabetics and people with broken bones. But the waiting list has already grown to six people -- two of them recovering from chemotherapy and radiation, another HIV-positive.
The concept of a recuperating home for the homeless is still a little experimental: Sister Joan knows of only three other homes like it in the country, none of them in Northeast Ohio. Until recent years, hospital charity care absorbed the necessity for a place like Joseph's Home. Hospitals kept and looked after their homeless patients until they recovered fully. As Brian Davis, director of the Northeast Ohio Coalition for the Homeless, points out, "Why release the person onto the street when they have no place to recover? They're just going to be back in the hospital. That's not cost-effective, and it's not humane." But under the HMO system's strict rules about patients' lengths of stay, hospitals are now forced to release homeless patients with only a handful of medicine and an admonishment to stay in bed -- which most of them cannot obey, since the shelters are closed during the day.
"This is an increasing problem that no one has confronted in our community," says Davis. "We have heard stories for years of ambulances showing up at the shelter to drop people off. Even the simplest thing, like a broken leg, for a homeless person is a serious, serious problem."
Social workers at the city's hospitals agree. Already eagerly gathering lists of the patients they hope to send to Sister Joan, they only wish Joseph's Home were bigger.
Mark Lehman, director of social work at MetroHealth -- where, he says, about 15 percent of the patients are homeless -- estimates that he'll refer two to five people a month to Joseph's Home. "For us it has become a nightmare, how to treat homeless people after they're out of the hospital," he says. "We've always patched together what we could, but Joseph's Home is a quite needed resource in the community. I hope they get more room."
Sister Joan laughs. "Everybody has told me, "Oh, Sister Joan, you're going to be filled before you turn around!'" she says. "But I just want to learn first, see if it does well before we talk about expanding." She also wants Joseph's Home to feel like a real home, not an institution. So each resident will have a lot of space -- a small private bedroom and several wide common areas.
Rita Mott, head of social work at Lutheran Hospital, says Joseph's Home could help 8 or 10 homeless patients she knows who keep coming back with recurring health problems. She worries more, though, about the patients she sees only once. One homeless man, she remembers, was treated for a broken jaw and then released. "The surgeon had said there's no way he can be out on the streets," she says. But since he didn't need hospital care, she couldn't keep him. "Hopefully he did OK. I didn't see him again. Somebody like that really needs a place that's going to be clean and safe."
Sister Joan hopes Joseph's Home will be more than clean and safe. She hopes it will change people's lives. "We're taking a holistic approach to recovery," she says, explaining that the desire to change is something she'll require of incoming residents. As they recuperate, residents will be learning life skills and job skills to help them get off the streets. Volunteer tutors will coach them through the gaps in their education, and they will take classes next door at Cuyahoga Community College. When the residents are stronger, Joseph's Home will help them find jobs and apartments, and teach them to save their money. "We want to help the person become a well-balanced individual," Sister Joan says. "That's what people need to live happily in society."
She expects many residents with a history of drugs and alcohol. Rosary Hall, St. Vincent's drug and alcohol treatment program, will offer a weekly Alcoholics Anonymous meeting, and the staff will help residents through their 12-step programs. "This is what transitional housing does," she says. "It says, "Take this person from homelessness to self-sufficiency.'"
"It's good that they'll try to break the cycle of homelessness," says Lehman. "Hopefully they'll get people back into the community and out of the shelters. That's nice -- it's not just a quick fix and you're out the door."
Even before it opens, Joseph's Home has been a huge undertaking. The renovations alone cost $400,000, half of which was covered by a grant from the Department of Housing and Urban Development. HUD will also pay for all services to the patients and about two-thirds of the operating budget -- $1,029,651 in all. The rest of the project will be funded by the CSA St. Vincent Charity Ministries Corporation, an organization that raises money for new ministries and health-care work in the neighborhood.
All that stands between Sister Joan and opening day at Joseph's Home now is the undelivered elevator she's been expecting for a month. Besides that, she says, she and her inexperienced but enthusiastic staff are "ready to go." Gazing around at the Salvation Army, CCC, and St. Vincent's, which encircle Joseph's Home, she says, "Look at this. It's a perfect place here. I'm a strong Christian believer. I see this and say, "Well, this is God's hand.'"