Tag: Salvation Army

Homeless Authority Struggles to Find Severe Weather Shelter Providers After Key Contractor Bows Out

Image via Compass Housing

By Erica C. Barnett

As temperatures plunged during the first severe weather event of 2023,  the King County Regional Homelessness Authority had just one emergency severe weather shelter available for adults without children in Seattle—an overnight shelter in the lobby of City Hall with a capacity of up to 45 people. This represents a loss of more than half the city’s emergency winter shelter capacity from last year.

The Compass Housing Alliance, which provided 60 beds during previous weather emergencies, did not seek to renew its contract with KCRHA for 2023. According to Compass director Mary Steele, the frequent shelter activations did a number on Compass’ staff and its building in Pioneer Square, where it runs a year-round men’s shelter and a day center.

“During 2022, Compass was activated for overnight or 24 hour shelter more than 50 times in the 4th quarter,” Steele said. “We could not sustain that level of wear and tear on the staff and building.”

In December, the authority put out a request for proposals (RFP) for emergency winter shelter providers that could provide a safe place for both families with children and single adults. According to a KCRHA spokeswoman, only one qualified agency applied: The Salvation Army, which has historically run emergency shelters during severe weather and wildfire smoke events at City Hall and Seattle Center.

The award document for the Salvation Army contract, worth a little over than $200,000, notes that the KCRHA used an alternative procurement process for the emergency shelter contract due to “the low number of applications received for this REP, and the proposer’s inability to serve both single adults and families with children.”

A spokeswoman for the Salvation Army, Marta Coursey, told PubliCola the KCRHA also authorized the nonprofit “to provide shelter to families with children via a hotel voucher system.”

The KCRHA’s draft Five-Year Plan, which the agency is required to produce by the interlocal agreement that established it, includes “improve severe weather response system performance” among its high-level priorities. Currently, there are still very few emergency severe weather shelters open to all people, including adults without children, in any part of the county. The KCRHA took over responsibility for Seattle’s short-term emergency shelters from the city last year.

The authority has struggled to find providers willing to provide severe-weather shelter on an as-needed basis, even before its contract with Compass expired. As PubliCola reported in December—a time when the Compass Center shelter was still available—the KCRHA used a home care provider with no homeless shelter experience to staff the shelter at City Hall. According the KCRHA agency spokesperson, 17 adults stayed at City Hall on January 28, and 33 slept there on January 29. The KCRHA currently plans to keep the shelter open through February 2, according to its website.

As Seattle Reopens, the City Faces Tough Questions About Its Response to Homelessness

The crisis of homelessness, which exists alongside and intersects with the issue of police violence and the tendency by government to insert cops into situations where their presence exacerbates tensions or just isn’t needed, has fallen below the fold over the past few weeks, but the crisis continues.

Last week, the county and city held the second monthly meeting of the new county-run regional homelessness authority, which is supposed to take over the duties of the city’s Homelessness Strategy and Investment division by the end of the year. Although they mostly just discussed the process for selecting a firm to come up with a list of candidates for “CEO” of the authority (“CEO” being the universal new term for public servants employed by the government, apparently), there were tensions over whether the input of the “lived experience” members of the authority’s governing board—all of them people of color—was being taken seriously.

Here’s a roundup of some other homelessness-related news that has slipped below the radar in the past few weeks.

• The city’s Navigation Team, which the mayor’s office told me made “15 obstruction removals” before encampment removals were partially suspended in mid-March, actually removed more than 60 encampments designated as “obstructions” or “hazards” during this period—a fourfold increase over what the city claimed. This dramatic discrepancy was first reported by writer Guy Oron on Twitter. In April, I requested the same information Oron received through his press release; the city notified me that the records were available last week, but has not yet produced them, despite the fact that I paid for them three days ago and have followed up with two emails without any response.

HSD did not respond by press time to questions, sent early Monday, about the difference between the numbers the city gave me back in March and the actual number of “obstruction” removals. When official numbers have proved to be inaccurate in the past, the department has generally responded by saying that their early numbers were “preliminary” and should be taken with a grain of salt.

The Navigation Team, which the mayor’s office told me made “15 obstruction removals” before encampment removals were partially suspended in mid-March, actually removed more than 60 encampments designated as “obstructions” or “hazards” during this period—a fourfold increase over what the city claimed

It’s important to note that there would be no discrepancy between the numbers HSD initially pushed out and the actual numbers if HSD hadn’t chosen to push out the narrative that they had slowed down encampment removals in response to the pandemic in the first place. By claiming that the Navigation Team had only removed 15 encampments in March, HSD was trying to promote the narrative that they had dramatically reduced the number of sweeps they conducted in the early weeks of the pandemic before suspending them completely on March 17. As the agency put it on March 17: “Since the beginning of March and in response to the COVID-19 outbreak, the Navigation Team has primarily focused on conducting outreach. … Since March 2, there have been limited Navigation Team removals.”

Even accepting that the original number of 15 was preliminary, the actual number of removals was not “limited” in comparison with the Navigation Team’s track record during previous months. Extrapolated out to cover the month of March, 60 removals between March 2 and March 15 represents a higher rate of removals than what the Navigation Team reported in its most recent quarterly report—120 per month, versus just 101 per month in the last three months of last year. (For obstruction and hazard removals only, March was on track for 114 removals against an actual average of 97.) In other words, not only did the Navigation Team not slow down encampment sweeps in early March, it appears to have accelerated them.

Under Mayor Jenny Durkan, the Navigation Team has shifted to doing “obstruction” removals almost exclusively; these do not require advance notice, outreach, or offers of shelter or services.

Support The C Is for Crank
During this unprecedented time of crisis, your support for truly independent journalism is more critical than ever before. The C Is for Crank is a one-person operation supported entirely by contributions from readers like you.

Your $5, $10, and $20 monthly donations allow me to do this work as my full-time job. Every supporter who maintains or increases their contribution during this difficult time helps to ensure that I can keep covering the issues that matter to you, with empathy, relentlessness, and depth.

If you don’t wish to become a monthly contributor, you can always make a one-time donation via PayPal, Venmo (Erica-Barnett-7) or by mailing your contribution to P.O. Box 14328, Seattle, WA 98104. Thank you for reading, and supporting, The C Is for Crank.

• Another narrative that both HSD and the mayor’s office have pushed is that the Navigation Team has had an extraordinarily high shelter “enrollment” rate since the COVID-19 epidemic began. According to several separate posts on HSD’s website, “Preliminary data shows approximately 70% of all referrals the Navigation Team has made citywide since mid-April arrived and enrolled at these new shelter resources.”

This success rate, which deputy mayor Casey Sixkiller also touted during a tense city council meeting about legislation that would have reined in the Navigation Team’s powers, is the inverse of the team’s usual enrollment rate, which is less than 30 percent. This rate only reflects the percentage of people who “accept” offers of shelter and then follow through; those who aren’t interested are not counted in these percentages.

HSD acknowledges that the high enrollment rate is related to the fact that people living at the Commons encampment were offered guaranteed spots in highly desirable new enhanced shelter beds or spots in tiny house villages reserved specifically for the Navigation Team. The city has created fewer than 100 new shelter beds during the COVID crisis, and those are now full. When I asked HSD what the “preliminary data” have to say about the shelter enrollment rate from sweeps that took place after the city announced its 70 percent success rate, a spokesman said HSD couldn’t provide preliminary data for those removals because people at those encampments were referred to available shelter beds all over than town, rather than funneled into brand-new beds created for that purpose, making them harder to track in real time.

Fair enough. Or it would be, if HSD and the mayor’s office hadn’t repeatedly brought up the 70 percent rate specifically as evidence that the Navigation Team works and should not have its power to sweep encampments during the pandemic restricted by law in any way.

The Salvation Army, another shelter provider whose guests have been redistributed to temporary sites like Fisher Pavilion to maintain social distancing between emergency-shelter cots, has relocated 28 veterans from its William Booth Center to a Holiday Inn in South Lake Union through a partnership with the Veterans Administration

• One reason you’re reading about referrals to shelter, rather than temporary housing such as rooms in hotels, is that the city has been extremely reluctant to provide hotel vouchers for people living in encampments—to the point that dozens of hotel rooms are currently paid for but sitting empty because the city has repeatedly declined to approve people living in tents during the pandemic for the program.

Asked why the city has continued to put people into mass shelters, where COVID is more likely to spread, instead of hotels as King County has done, a spokeswoman for the mayor’s office responded, “Through the City’s contracts, 318 unique individuals have been supported at various hotels, including the Red Lion in Renton. The initial costs are estimated to be $764,670 and are ongoing. These individuals were formerly staying at programs operated by DESC and Catholic Community Services.” I reported on the county’s efforts to move shelter residents into these hotels last month.

• The Salvation Army, another shelter provider whose guests have been redistributed to temporary sites like Fisher Pavilion to maintain social distancing between emergency-shelter cots, has relocated 28 veterans from its William Booth Center to a Holiday Inn in South Lake Union through a partnership with the Veterans Administration, both the Salvation Army and the VA have confirmed. The relocation, according to a VA spokesperson, was possible through a CARES Act provision that allows agencies like the Salvation Army to ask for a higher per diem for certain veteran clients, which has provided enough funding to put them in a hotel instead of bunk beds. Salvation Army spokeswoman Lora Marini Baker says the move is temporary, but there is no current end date for the arrangement.

• Finally, check this space for an update on the future of shelters in Seattle. During the pandemic, cities and states across the country turned to hotel rooms as a safer alternative to congregate shelter, giving people experiencing homelessness a rare opportunity to experience privacy, security, and an actual bed, and to escape the hectic chaos of a typical shelter. As cities open back up, they face a choice: Whether to reopen mass shelters, which are often traumatizing and dehumanizing, or find a way to provide some of the dignity and privacy of hotels to people without permanent homes.

In Seattle, where the city is already beginning to add people to shelters that were “de-intensified” to reduce COVID transmission, the city seems poised to return to the previous system, with the possible exception of the Downtown Emergency Service Center’s downtown shelter. I’ll be reporting more on this subject soon, so stay tuned.

State Buys Central District Nursing Home for Hospital Relief, City Hall Shelter Clients Still Sleeping Inches Apart, and More COVID News

1. The Washington Department of Social and Health Services has purchased the former Paramount Rehabilitation and Nursing Home in Seattle’s Central District to serve as a hospital for people without COVID-19, at a cost of $13.5 million, The C Is for Crank has learned. The 165-bed nursing home closed down last month, after an analysis by the US Department of Health and Human Services called it one of the worst-performing nursing homes in the country.

Chris Wright, a spokesman for the state COVID Joint Information Center, said the goal of the purchase is “to free up beds in hospitals during the crisis by finding patients who are currently in hospitals, but could receive the same level of care in this nursing home.” He says the state is “trying to find a contractor to run the facility and hope to open by the end of April.” The facility will create about 100 job openings, for nurses, food service workers, maintenance workers, and supervisors, Wright says.

2. As homeless shelters run by the Downtown Emergency Service Center, Salvation Army, and other nonprofit groups “de-intensified” their existing shelters by moving some clients to new locations, people are still sleeping inches apart at the nighttime-only shelter at City Hall, which is run by the Salvation Army’s William Booth Center. Staffing is apparently an issue; expanding the shelter to the red-glass lobby on Fourth Avenue (as has been discussed) or moving some shelter clients elsewhere would require additional Salvation Army employees or other staff.

A spokesman for the city’s Emergency Operations Center said that “Many shelter operators, including the operator at the City Hall shelters, are facing staffing capacity constraints that make it challenging to split operations between multiple sites quickly. City staff have been stepping in to help staff shelters to meet this need, and we are working with the service provider to identify solutions.” A spokeswoman for the Salvation Army said the group had nothing new to announce about the shelter.

The basic shelter at City Hall consists of 75 mats on the floor inside the Fifth Avenue lobby, which is open daily from 7pm until 7 in the morning.

Support The C Is for Crank
During this unprecedented time of crisis, your support for truly independent journalism is more critical than ever before.

The C Is for Crank is a one-person operation supported entirely by contributions from readers like you. Your $5, $10, and $20 monthly donations allow me to do this work as my full-time job. Every supporter who maintains or increases their contribution during this difficult time helps to ensure that I can keep covering the issues that matter to you, with empathy, relentlessness, and depth.

If you don’t wish to become a monthly contributor, you can always make a one-time donation via PayPal, Venmo (Erica-Barnett-7) or by mailing your contribution to P.O. Box 14328, Seattle, WA 98104. Thank you for reading, and supporting, The C Is for Crank.

3. Staff at the city’s Human Services, Parks, and Seattle Center departments are being reassigned to front-line positions working in some of the new shelter spaces that have been opened for residents at  as part of the city’s response to the COVID-19 epidemic, and distributing food through HSD’s division of Youth and Family Empowerment. These reassignments apply not just to the approximately 70 workers who have been specially trained to work in shelters, but also to other staffers who will be reassigned as part of the departments’ Continuity of Operations Plans (COOPs), which shut down certain city facilities and functions while defining others as “mission essential.”

It’s unclear what, if any, long-term plan exists for city employees who would ordinarily be reassigned to front-line jobs but are in a high-risk group for COVID exposure. The mayor’s order authorizes departments to provide “full or partial compensation” to these workers, but the city did not provide any specific details about what that will look like, or whether some employees may eventually have to be furloughed until front-line services can open again.

4. Governor Jay Inslee confirmed on Saturday that the state is using prison labor to make hospital gowns during the COVID crisis. According to the Washington Department of Corrections, the gowns are being produced by inmates at the Coyote Ridge medium-security prison in Franklin County. Inslee said Saturday that the prisoners were “very eager for this job, and we’re eager for their success in this regard.” Prisoners in Washington State make a fraction of the state minimum wage.

Prison reform advocates across the country, including in Washington State, have argued that state prison systems should release many incarcerated people to protect their health during the COVID crisis. Inslee said Saturday that “we have a commitment … to keeping these incarcerated individuals as safe as humanly possible” during the pandemic.

5. The Seattle City Council adopted a nonbinding resolution this afternoon asking Gov. Inslee to use his emergency powers to implement a moratorium on all residential and commercial rent and mortgage payments in the state, and to forgive any debt accumulated by renters and property owners after the COVID crisis has passed. The resolution, which also calls on the federal government to enact a similar policy nationwide, passed unanimously, though not without a bit of incredulous guffawing from council member Debora Juarez, who (along with her colleague Alex Pedersen) seemed skeptical about the idea of effectively canceling all rent and mortgage payments for the indefinite future.

“So you’re saying that a commercial [landlord] that owns 20-plus units, or apartments, who also has a mortgage to pay … that we are lobbying for them as well, under this administration and to our governor, that they too don’t have to pay their mortgage to the bank?” Juarez asked.

“That’s right,” the resolution’s sponsor, council member Tammy Morales, responded.

Pedersen expressed doubt about the legality of preemptively forgiving all rent and mortgage debt, and seemed to question whether renters would really need the help. “I’m concerned that [if] people are getting other relief, why would we want to then suspend the payments that are due when they’re getting relief from other angles?” he said. On the other hand, Pedersen said, “I have received lots of emails from constituents who are expressing their major concern and fear and pain that they’re suffering during this crisis, so I wish we had more time to think this through.”

Homelessness and Addiction, Part 2: Why Don’t They Take What They Can Get?

Last month, Seattle Times columnist Danny Westneat wrote a column that struck a chord with many Seattle residents, particularly those already inclined to believe that people choose to be homeless and addicted to drugs or alcohol. It struck a chord with me, too, although not for the same (or probably the intended) reasons. In the column, Westneat marveled that just a few blocks from the Jungle—the dangerous, massive, unpoliced encampment that stretches along the west side of Beacon Hill—there is a “shelter” that has empty beds every night. (The “shelter” is not actually a shelter, but a long-term Christian rehabilitation center run by the Salvation Army).

“Some shelter beds go empty—even right next to Seattle’s Jungle encampment,” Westneat’s headline roared. “How can this be?,” Westneat wondered. “How can a homeless rehab center next to the city’s most notorious encampment have 10 to 30 empty beds?” Why would anyone in their right mind turn down a “free 60-day stay” in a warm place with food and running water for the dangerous, cold, risky life on offer in a no-man’s land like the Jungle?

This story is an attempt to explain part of how that can be, starting with the difficulties homeless people face on the path toward treatment for drug and alcohol addiction, and  ending with the overburdened shelter system itself, including the Salvation Army rehab center. The questions behind the surface Westneat scratches—with more than 400 homeless people living around a freeway overpass nearby, how on earth could these beds be empty?—are deeper and more difficult to answer than such glib incredulity implies. They include: Who “deserves” government-funded services? Why do some people decline services, including treatment? And what obligation do we have to people who can’t or won’t get help but still, because they are people, need a place to lay their heads?

On Monday, I reported on some of the barriers homeless people who are addicted to drugs face to getting “in the system” of treatment and recovery. (In that piece, I used the term “addict,” which is common in treatment and recovery programs but which some in the homeless advocacy community prefer to avoid because it can be “othering” and reinforce the stigma around drug addiction. When appropriate, I will use the terms “drug and alcohol abusers” and “drug and alcohol dependency,” but I feel the terms addict and addiction are useful because they acknowledge explicitly that drug dependency is a disease, not a lifestyle choice. )

Today, I’ll report on two different approaches to helping homeless people recover from addiction and get into shelter and more permanent housing. The first, espoused by the Salvation Army and presented by Westneat as a no-brainer option for all addicted people experiencing homelessness, is what I’ll call the “high-barrier” approach–requiring clients to commit up front to certain behaviors, including sobriety, and a program of recovery that may include church attendance, Bible study, and unpaid work. The second is the “low-barrier” approach; this model includes shelter and housing for people who are actively using drugs or alcohol as well as related harm-reduction programs such as  safe injection sites. High-barrier entry points are controversial because they exclude people who are unable or unwilling to meet the requirements, and privilege those who are ready or desperate enough to totally overhaul their lives; low-barrier services are controversial because they allow people to continue behavior that is illegal or that some wish to eradicate, like abusing drugs and alcohol and related nuisance crimes.

arc-rosetteIn his column, Westneat glorified the high-barrier approach while conveniently glossing over the height of that barrier. The closest he came was a breezy, “Now some of this may be because the Salvation Army has rules you have to follow”–as if “rules” like sobriety, a schedule that is dictated for you minute by minute, and mandatory work are simple bumps in the road to a normal, healthy, productive existence.

Part of the problem with thinking this way is that it fails to acknowledge the reasons people “choose” to be addicted to drugs and living on the streets. When your underlying thesis is that people who won’t enter a program are just stubborn or don’t want help, it’s easy to ignore the fact that the help the Salvation Army offers at its Adult Rehabilitation Centers is a six-month residential program that requires Bible study, church attendance, and the willingness to work a full-time job for no pay beyond room, board, and a small stipend for incidentals from the Salvation Army commissary.

Timothy Rockey, the compact, intense Southerner who runs Seattle’s Adult Rehabilitation Center,  strongly believes that people who want to recover need to take personal responsibility for their actions, and he dismisses many aspects of harm reduction—like providing trash and sewer service in the Jungle–as destructive. “My idea of enabling is something that prevents someone from being able to make choices. I believe God gave us free will, and anything that violate’s someone’s free will is enabling,” Rockey says.

“Simply because something’s a disease doesn’t mean we don’t have to be accountable for how we deal with the disease,” he continues. “Whether it was triggered by trauma or because of life choices, it should be treated the same way.” Rockey likens the disease of addiction to diabetes—even though it’s not your fault, you have to take insulin every day, eat right, and “have discipline” to keep it under control.

At the ARC, that discipline takes the form of a rigid daily schedule that begins before sunrise with a shower, breakfast, and a “brief devotional” at 6:30, followed by a full work day in the residence itself, the office, or a Salvation Army warehouse. After dinner, which has a dress code, the residents go to Bible study or 12-step meetings. The goal of all this regimentation, Rockey says, is to retrain people used to the chaos of the streets to function in a society that has schedules and rules.

The program is explicitly Christian. As the center’s website notes, “Each program participant is provided with a clean and healthy living environment, good food, work therapy, leisure time activities, group and individual counseling, spiritual direction, and resources to develop life skills and a personal relationship with God as provided by Jesus Christ.”

“Yeah, we’re a church,” Rockey says of the Salvation Army and its private rehab center. “The Supreme Court says we can discriminate on that. It’s fine if you’re not religious, but you are required to participate. I was an atheist for many years but I went to weddings in churches, I went to funerals in churches, and it didn’t hurt me to be exposed to other religions.”

But, Gale points out, the faith-based nature of the program does alienate many who have had negative experiences with organized religion, or who simply don’t adhere to the Christian principles on which the Salvation Army program hangs. “That Christian-based model doesn’t work for everybody,” Gale says, describing a REACH client who felt unable to participate in his own Native American spiritual practices at the ARC and dropped out of the program. “In the native community, there are people who may have been Alaska natives with experiences in orphanages who may not feel comfortable participating in a system that is run by a Christian organization,” she says.

Moreover, Gale points out, the Salvation Army doesn’t offer medical detox, because it isn’t a medical facility; as I reported Monday, there are only about three dozen detox beds to serve all the low-income addicts in King County, and detox is often critically necessary to keep people from dying during severe withdrawal.

Mark Putnam, head of All Home, the King County organization dedicated to reducing homelessness and making it “brief, one-time, and rare” (in its previous incarnation, All Home was known as the King County Committee to End Homelessness), says treatment centers like the Salvation Army represent “the complete opposite of best practice” for getting people off drugs or alcohol and off the streets, because they apply a one-size-fits-all approach to a very diverse population of potential clients.

“It’s the opposite of a client-centered approach, which asks, what does the client need?” Putnam says. “Sure, there’s a whole segment of our county and society that says, ‘screw what they want and what their preferences are—if they don’t like what we’re giving them, let’s put them in jail.’ But that’s not how you make progress on homelessness. Actually, you need to lower the bar—first get people into housing, then address all the other issues. When you have a program like that that isn’t full, that should tell you they’re doing something wrong.” The model Putnam is describing is called Housing First, and is based on the notion that giving people experiencing homelessness a roof over their heads makes solving root-cause problems like addiction much easier than trying to do it the other way around.

Brad Finegood, director of King County Public Health’s behavioral health and recovery division, says that in the absence of a comprehensive, funded plan to house the  county’s homeless population, the best way to get homeless people who are addicted to drugs or alcohol into treatment is to meet them where they are, and sometimes, that means places like the Jungle. King County sends outreach teams like REACH out into the many homeless encampments around the city, to do welfare checks, see what people need and if they’re relatively safe, and whether they need medical attention.

King County’s Brad Finegood

“If I’m a provider and I go out to the Jungle and I say, ‘We want you go come to our treatment agency,’ and they thumb their nose at that, it can’t be an all or nothing thing. We have to be able to say, ‘Cool, you’re not ready for it—what about this type of service? Can I get you some medical help while while you’re out  here? We have to try to start engaging people where they’re at and, when they’re ready to  come out of the cold, to have those resources  available.”

Rockey, it turns out, kind of agrees with this—except that in his ideal world, people from the Jungle would have to leave their encampments to access those resources. “Putting centers in the city forces people to come to us and get access to help, and we can start a relationship,” he says. People who want to go to the Jungle to help people there, he says, are saying, essentially, “let’s keep it in the Jungle where we don’t have to see it. Let’s make it possible for people in the Jungle to commit violent acts. They don’t talk about that. They don’t talk about people living in filth that is absolutely disgusting. Giving toilets and water to someone in the Jungle meets an end, but it doesn’t solve the problem.”

Housing isn’t the only resource in short supply across King County. As with detox beds, residential treatment beds and even slots in outpatient programs are hard to come by, and the moment of clarity when an addict decides they’re willing and ready to change can slam shut as soon as the desire for the next hit outweighs the desire to get better.

In another sharp departure from the tough-love approach embraced by Rockey Finegood and Putnam espouse not just access to traditional treatment but harm reduction—making drug users and alcohol abusers safer while they continue to use. This includes novel approaches such as the safe-injection site Seattle is currently considering (and which I’ll cover in more detail in the future), as well as low-barrier shelters that don’t require sobriety but do provide access to medical care and other services.

And it includes so-called medication management, using drugs like methadone and suboxone to tamp down the urge to use by replacing heroin and other opiods with less-dangerous (but also addictive) substitutes.

“Medication assisted treatment is one of the most studied, evidence-based, proven, effective ways of treating opiate addiction,” Finegood says. “I’ve known people who’ve been on methadone for 20 years and they’ll swear it’s the main thing that’s keeping them from using heroin ever again and able to go to work every day and be a good parent.”

Rockey opposes medication management, which he sees as just another form of dependency. Rockey and the Salvation Army are hardly alone in this assessment; many recovery programs don’t consider you clean and sober if you’re dependent on suboxone or methadone, which are addictive narcotics that can be just as hard to kick as heroin.

“The people I know who try substitutes for heroin end up kicking those by going back to heroin,” Rockey says. “With suboxone, we’re not treating the root cause of the problem. Same with poverty. We have to address root causes. If simply housing is what you’re offering, that is not enough. … To me, providing dope fiends dope or providing dope fiends a needle exchange—that’s just enabling,” Rockey says.

Many clients, Rockey acknowledges, aren’t ready or willing to stick with such a rigid program, and therein lies the real answer to Westneat’s question: Why on earth does this center have empty beds? It has empty beds because a highly regimented system is not what works for everyone, and because some people aren’t ready to stop using.

The questions that answer raises, however—about what to do with people for whom treatment doesn’t work, about how to provide enough treatment beds so that they’re available when people are ready for help, about how to help people who are still using and may never stop—are the ones governments and service providers are still struggling to answer, even as the population of people who are homeless and addicted in Seattle grows.

I’ll be exploring those questions more in the coming weeks and months. Stay tuned. And if you like the work I’m doing here, please consider becoming a monthly supporter of The C Is for Crank by signing up at Patreon.