Back to basics. Back to what we know works. That is my main takeaway from my interview with social worker Charlotte Tucker Sanders. I've had the privilege to work with her, first at Neighborcare's 45th Street Homeless Youth Clinic and then when I led the UW's Doorway Project. She said, "I feel like if we were to really think about this world which seems to be driven by money, and the costs and benefits. And if we were to really look at our system and not have it based on that (...) That if we keep people healthy, in the long run, we wouldn't be spending so much money on other issues related to unhealthy people. If we were to feed people, if we were to give people their basic needs, if we made sure that everyone had enough to live on, we probably wouldn't be so consumed with issues of violence, issues of homelessness (...) So I guess that would be my dream, that we would eventually recognize that meeting basic human needs, basic needs, would be good for everyone."

" 'The last thing you own when you're losing everything you own is probably your vehicle, so that becomes your home.' Jenn Adams knows this from six years living in her Seattle van starting in 2007. 'I've lived in three different vans and a doorway,' she said in a recent interview I had with her. She talked about her experience and current work as an advocate and peer outreach worker to vehicle residents in Seattle.

I had my own experience resorting to living in my car and in an abandoned shed for six months in my hometown of Richmond, Virginia, when I was a young adult. The topic of vehicle residency as a unique form of homelessness has long been of interest to me. I wanted to explore more of the nuances of vehicle residency from the perspective of a woman with a much longer experience than me and one based here in Seattle."

The above passages are from my new book, Way Home: Journeys Through Homelessness, in a chapter titled "Roll On." This chapter draws from my interview with Jenn Adams. Make sure to listen until the end for her powerful words, which literally left me speechless.

Anitra Freeman is a force of nature with an infectious laugh and a sense of humor. Freeman is a wise elder, a Raging Granny, a founding member of the Women in Black in Seattle, a housing/homelessness activist, a wife, and a computer wiz. Freeman also lives with a form of bipolar disorder and experienced homelessness in Seattle. She is now stably housed and continuously giving back to our community and working to make our city a safer, healthier place for everyone, including people without homes.

Her story is an inspiration. I have included my oral history interview here. I wrote a chapter of my Way Home book on Anitra Freeman. Freeman says, "I have often said that people have personal problems, of course, but personal problems don't cause homelessness. Personal problems don't dig the hole in the sidewalk; they just influence who is going to fall into it. It's systemic factors that create the hole."

Although only 1% of Seattle's population identifies as Indigenous, "hundreds of years of colonization, systemic racism, broken treaties, forced reservations, and more have resulted in native peoples making up a startling 15% of Seattle's homeless population," as well as 32% of people experiencing chronic homelessness (quote from the Chief Seattle website). Yet we have important Native-led organizations like the Chief Seattle Club coming up with innovative, culturally relevant health, housing, and social programs to reduce homelessness for our Indigenous community members.

Derrick Belgarde, who is Siletz and Chippewa-Cree, is the executive director of the Chief Seattle Club. He has lived experience of homelessness on the streets of Seattle. Leading the Chief Seattle Club through the COVID-19 pandemic and into its current expansion of services, including permanent supportive housing, Belgarde shared his insights and experiences with me. There's so much good stuff within this interview that I hope you listen to it in its entirety.

Focusing on the story of the police killing of the Indigenous woodcarver living in homelessness and in permanent supportive housing, John T. Williams, I wrote a chapter, "Displaced," in my forthcoming book Way Home: Journeys Through Homelessness. It was one of the more emotionally challenging chapters to write. In the chapter, I include content from my oral history interview with Derrick Belgarde. In addition, Belgarde graciously agreed to read, comment on, and suggest changes to the chapter. As a non-Native person, I wanted to honor the stories of people like Williams and Belgarde.

Dr. Simha Reddy is director of the Puget Sound VA Homeless Patient Aligned Care Team, where, for over the past ten years, he has done healthcare outreach and primary care with veterans experiencing or having experienced the trauma of homelessness in the Seattle area. In addition, he serves on the Implementation Board of King County's Regional Homelessness Authority and has served on the governing board of the long-running advocacy group, the Seattle/King County Coalition on Homelessness.

In early 2017, I had the pleasure of talking with Dr. Reddy about his work. At that time, he had been working on homeless veteran health care for five years. He said, "When I took my job, actually, that was the first time I learned of the VA's commitment to end homelessness. And I laughed because I thought it was ridiculous. After having seen what the VA has done, I think it is possible."

A significant reduction in veteran homelessness is one of the little-known (among the general public) successes in the US response to homelessness. Beginning in 2008, the Department of Veterans Affairs and the Department of Housing and Urban Development, with bipartisan support and funding from Congress, have reduced veteran homelessness by half while overall homelessness has risen. There was a recent slight increase in veteran homelessness caused by rising rents, especially in cities like Los Angeles. But even this increase was much smaller than for other groups of people experiencing homelessness. A recent New York Times article, "Decline in Veterans' Homelessness Spurs Hopes of a Broader Solution," by Jason DeParle (August 6, 2024), explains all of this well. What DeParle doesn't cover well in this article is the role of VA health care, especially community-based programs like that run by Dr. Reddy.

Housing without access to good trauma-informed primary care, including behavioral health care, will never work to reduce homelessness. VA Health provides access to comprehensive health care through its more than 13,000 hospitals and clinics nationwide. It is always imperfect, as with any healthcare system, but it is much better than the still fragmented, chaotic, and expensive US healthcare system for non-veterans. Housing First is the model of intervention used by the federal approach to reduce veteran homelessness. Housing First only works well if housing is combined with ongoing medical and social support services.

Towards the end of my conversation with Dr. Reddy he had this to say, "People sometimes have preconceptions of what a homeless person looks like, what a homeless veteran looks like. That's it's a drug-addicted, mentally ill, Vietnam-era veteran standing on a street corner with a sign. Maybe. But that person can get their life back together. I've seen that.

"But the other thing that has been remarkable to me is how close to the edge we all are. That the people I've cared for, all of them certainly, have been soldiers, sailors, veterans of all kinds, and have served their country, and have fallen on hard times at some point in their life by the time that I've seen them. But they have all been real estate agents, small business owners, cooks, priests, actually nurses, social workers.

"And what leads to homelessness is typically a crisis of some kind, and none of us are immune to a crisis. The loss of a family member. The loss of family through divorce, or something like that. A health issue. And those are the things I wish people could see; that we are so much closer to the edge than we think. But that if we live in a society where, if somebody falls over, there's somebody willing to help them stand back up, we are going to live in a better place. That is an investment in our people. And that's important."

The best part of my job is working alongside smart, dedicated, and compassionate people who make a positive impact on the lives of people experiencing homelessness. People like Hannah Glover. She is a health navigator at the Elizabeth Gregory Home, a day shelter for women and female-identified people in the University District (U District) of Seattle. Located in one of the few remaining churches in the recently upzoned U District, Elizabeth Gregory Home is a true sanctuary for people surviving homelessness. (For a recent Seattle Times article on changes in homelessness in the U District and the roles of upzoning, see "How-and why-life for unsheltered youth on The Ave has shifted," by Brendan Kiley.)

Think about the last time you tried to access health care, like making an appointment with a primary care provider, or for updating your vaccinations. Was it easy? If it was easy, you likely are housed, have ready access to the internet, and have a job providing decent health insurance. And you likely already have established care with a provider covered by your insurance. People who are experiencing homelessness have a much harder time with access to health care due to lack of (or confusion over) health care insurance, transportation to/from health care, lower levels of health literacy, and competing basic needs like finding shelter, food, and safety. In addition, as described in my interview with Hannah Glover, too often, a major barrier to care for people experiencing homelessness is a previous bad experience with health care. Experiences like negative stereotyping, judgmentalism, and all the 'isms' you can think of. Having a skilled health navigator available to people in community spaces they trust is essential.

When I provide basic health care onsite at the Elizabeth Gregory Home, Hannah Glover makes my work much more efficient and effective. The nursing students I have with me benefit from her experience and insights. We need more excellent health navigators in community settings, not just within hospitals.

Tim Harris, founder and longtime director (1994-2020) of Real Change, Seattle's "street paper" anti-poverty newspaper, talked with me about his life and work in 2015. Real Change turns 30 this year, with the first issue published on August 20, 1994. My purpose with this Skid Road oral history project and podcast is to highlight and celebrate the visionary people in Seattle who have impacted the landscape locally in terms of housing and homelessness. Tim Harris is one of these visionary leaders.

In April, I interviewed Seattle-based housing advocate and consultant Ginger Segel. I know a lot about health policy, especially as it relates to care for people experiencing homelessness. I do not know as much about housing policy as I would like to, so I was eager to hear her stories and perspectives.

Segel first spoke of how, as a student at Columbia University in NYC, she witnessed the role of the university in displacing low-income people in the expanding area around the university. When she moved to Seattle in the 1980s, she got involved in tenant's union organizing and in Operation Homestead. Operation Homestead's mission was to counter the harmful effects of the closing of Single Room Occupancy Hotels (SROs) happening throughout the country. The activists occupied emptied-out buildings so that homeless and other low-income people could live there.

Segel then worked for the Low Income Housing Institute (LIHI) on establishing the consumer-led housing building, the Aloha Inn, now renamed The Inn and run by Catholic Community Services. Currently, LIHI is a major player in the Seattle-area (and beyond) efforts to provide more affordable housing to people experiencing or at risk of experiencing homelessness. Segal and other advocates helped form the state Housing Trust Fund, which, since its formation in 1986, has provided over $2 billion in capital financing to affordable housing projects throughout Washington State.

Now working as a consultant on affordable housing projects throughout the state, Segel has seen first-hand some of the drawbacks of Housing First and permanent supportive housing, including through the newly established Apple Health and Homes Initiative. I was involved tangentially in the formation of this initiative and testified in its favor (when it was House Bill #1866) before the House Health Care and Wellness Committee of the Washington State Legislature. The Apple Health and Homes Initiative pairs healthcare and housing resources for permanent supportive housing for vulnerable (and high-needs) individuals. Segel points out that we need to examine the benefits and pitfalls of Housing First closely. Communities she works with sometimes say that they are forced to take people they cannot handle and that creates safety issues for other residents and staff members.

Segel stated, "Another problem in the advocacy community is we have said we're going to solve this (homelessness) too many time but we never could solve it because the economic forces were always much stronger than our strategies."