A broken neck was an unwelcome intrusion that threatened to shatter William’s life plan. Living in Everett with his wife and children, he was four years into a manufacturing apprenticeship that offered the likelihood of solid, rewarding work in the future. But an on-the-job accident changed the trajectory of his life.

William, whose last name is being withheld to protect his privacy, was unable to work as he recovered from his spinal cord injury. As the bills piled up, so did the tension in his home. William and his wife eventually divorced, and William moved out.

“It was a tough one,” William said of the split. “I pretty much lost everything I ever worked for.”

Without a home of his own, William moved from one friend’s house to another, sleeping on their couches. Over time, the generosity of his hosts wore thin and William moved into a tent. He remained homeless for the next 12 years, estranged from his children and struggling unsuccessfully to gain back some of his lost pride. 

“I was so ashamed,” William said. “I had always been able to work.”

The stress of living on the streets took its toll on William. After more than a decade of living outside, he suffered a massive heart attack that sent him to the emergency room and plunged him deeper into a spiral of desperation. 

The cycle of chronic homelessness

William is one of an estimated 3,500 adults in King County who are classified as chronically homeless by 2018 federal Department of Housing and Urban Development tallies. These include people who are unable to secure permanent housing due to physical disabilities, medical issues, mental health crises or substance abuse problems. They rotate through emergency rooms, hospitals and rehabilitation centers, only to be eventually released back onto the streets.

Without a landing point, the chronically homeless revert to living in crisis mode. Tasks such as interviewing for a job, cooking healthy meals and managing medications take a back seat to more immediate survival needs. Unlike other homeless populations whose plights may be episodic or temporary, the chronically homeless repeatedly cycle in and out of housing, sometimes for decades. 

While this recurring cycle takes a toll on the people experiencing it, it also is financially taxing on the communities that serve them. People who are experiencing homelessness are far more likely than the general population to have chronic medical illnesses and complications from these illnesses because of lack of medical treatment, according to a study published in the American Journal of Public Health. Researchers studied 29 people – each formerly homeless – who found permanent housing through Plymouth Housing, a Seattle nonprofit dedicated to housing the city’s chronically homeless population. The public’s cost of serving these people decreased by a total of $1.8 million, or an average of $62,000 per person, during their first 12 months living at Plymouth, the study found.

“We believe in housing first,” said Paul Lambos, Plymouth Housing’s executive director. “When people are dealing with medical issues, substance abuse issues and mental health issues, there’s no way they can get help while living on the streets.”

When Plymouth Housing recently announced the launch of its $75 million capital campaign, it was seeded by grants of $5 million from each of three prominent area healthcare companies. These companies, including Premera Blue Cross, have been vocal about the connection between homelessness and healthcare. Their contributions to the larger capital campaign will help fund the development of four new properties and further Plymouth Housing’s mission of eliminating homelessness and addressing its causes by providing supportive, permanent housing options.

Building better lives

Plymouth Housing was founded in 1980 by Plymouth Church, a downtown Seattle church that often found the city’s homeless population sleeping on its doorstep. Its congregants started providing shelter, eventually forming a nonprofit agency. Today, Plymouth Housing owns 14 apartment buildings in and around downtown Seattle, each offering between 70 and 100 housing units. Collectively, the properties serve more than 1,000 individuals. 

In addition to providing permanent housing, Plymouth Housing also works with the City of Seattle, King County, the Veterans Administration and a range of medical institutions, all of which refer patients to the nonprofit. Case workers and on-site nursing staff help residents with the transition from the street to living inside. They work with healthcare providers to ensure residents are up to date on their medications, and, where appropriate, reconnect them with medical and mental health services offered through the VA. 

The four new properties under development include one at the corner of South King Street and Rainier Avenue South (currently under construction); a senior-focused housing tower soon to break ground on donated Sound Transit property on First Hill; a complex on property on lower Queen Anne Hill that was transferred to Plymouth Housing by the City of Seattle at no cost, and a redevelopment project on First Hill in partnership with St. Francis House. The four projects will add 500 new apartments for single adults experiencing chronic homelessness.

Seattle is struggling with an unprecedented surge in its population of chronically homeless individuals, so the addition of permanent, supportive housing is timely. 

“It’s quicker growth than we usually do, but this crisis is growing,” Lambos said, “and we really want to do something about it.”

A history of reaching out

The Premera gift (Swedish Health Services and Providence St. Joseph Health also gifted $5 million each to Plymouth) is the largest single gift ever from the not-for-profit health insurance company and underscores the company’s dedication to addressing homelessness and its underlying contributing causes in the region. 

Premera Blue Cross views homelessness with a holistic lens, with the belief that prevention – rather than intervention – has the biggest potential to affect change. The Premera Social Impact Program, launched in 2017, is aimed at supporting behavioral health issues, particularly in underserved communities. Premera Social Impact financially supports 26 evidence-based programs and pilot projects – of which Plymouth Housing is one – with the potential for meaningful impact in Washington state and Alaska. In 2018, the program awarded more than $9.5 million in grants and sponsorships across the two states where it operates.

“One of the most significant impacts in getting people’s physical and mental health stabilized is putting a roof over their heads,” said Paul Hollie, leader of Premera Social Impact. “We feel Plymouth Housing has a long-range plan and strategy to make a real difference in this area.”

Getting back to living

William’s heart attack may be what ultimately saved his life. He received emergency treatment at Harborview Medical Center, where staff connected him with Plymouth Housing. Shortly after he was discharged, he moved into a Plymouth Housing apartment, ending more than a decade of homelessness.

Now that William has a permanent, long-term place to live, he can stop worrying about a leaky tent and his next meal. He has a refrigerator where he can keep his insulin, a stove where he can cook healthy meals, and a warm bed instead of a thin sleeping bag. His building has an on-site health clinic, so he can schedule preventative care appointments before an illness or infection gets out of control.

With a roof over his head, Williams is able to tend to his basic needs. He can start focusing on less-immediate but equally important issues such as dental care, personal relationships and employment.

“We’re taking folks living in a constant state of emergency and bringing them into a home,” said Amanda Vail, Plymouth Housing’s senior communications and development manager, “and allowing them to resume a normal pace of life.”