By Marc Fisher
Thursday, November 20, 2008

Until the past few weeks, Darian Holton and Catherine Bellamy were a big part of why medical care costs a fortune.

Holton, who was homeless for eight years, was the city's 911 king. He called for an ambulance 270 times last year, quite possibly a municipal record.

"They put you out of the shelters regardless of if it's hot, cold, raining, whatever," says Holton, 31. With nothing to do all day, "I went to the emergency room. It's warm. Certain hospitals, I could play the psychiatric card -- get admitted for a couple of days. At least, I could sit around for a couple of hours and watch television."

Nurses and ambulance drivers citywide know Bellamy, who until last month lived on the sidewalks near George Washington University. When she needed an indoor respite, she made her way to one of the District's emergency rooms.

" 'Here come Miss Bellamy,' they'd say -- they know me at every hospital," says Bellamy, 54. "I used the hospital as my relief. It was where I could get some warmth."

Christy Respress, director of programs at Pathways to Housing, a nonprofit agency that works to take homeless people off the streets, says Bellamy would "go in for four or five days, get discharged and go straight to the next hospital."

Bellamy hasn't been back in the hospital and Holton hasn't been calling for an ambulance since the District's Housing First program put them in apartments of their own this fall. They still have severe health problems, but now they have regular doctor visits and caseworkers who check whether they're taking their meds. More important, they're eating well and sleeping full nights for the first time in years.

Mayor Adrian Fenty's Housing First initiative has placed more than 385 of the city's 6,000 homeless men and women in subsidized apartments this year, making a noticeable dent in the population of panhandlers on downtown streets. It's expensive to rent all those apartments, and the nonprofit agencies that care for the formerly homeless don't come cheap, either.

But compare the cost of the new strategy -- about $67 a day for each homeless person who's given an apartment -- to the cost of a day in the ER ($3,085) or the mental hospital ($435) or the jail ($105), according to D.C. government statistics.

"This is one of the only good things to come out of the Bush years," says Tommy Wells, the D.C. Council member who is chairman of the human services committee. "Conservatives like it because it saves money, and it's far more humane than leaving people out on the street. And it goes straight to the issue of people seeing panhandlers on the street downtown."

So why did the council move last week to halt expansion of Housing First?

With the city facing a $130 million shortfall, council members sliced that much from Fenty's budget and froze an additional $46 million in planned spending, including about a third of the money that had been set aside to house about 400 more homeless people in the next six months.

Obviously, the sinking economy means politicians must make big cuts, and some of those cuts will hurt. But in a city that wastes tens of millions every year on grants to almost 200 community groups, some of which hardly account for their spending, the $19 million Housing First initiative seems like one that should be held harmless.

"We will find the dollars so we don't have to put anybody out on the street," says Clarence Carter, director of the D.C. Department of Human Services. "But we will not be able to put additional people into housing."

Bellamy, who was about 12 when her father died and her mother put her out of the house, says she drifted from the care of one addict to another through years of a heroin haze. After she kicked heroin, she ended up on the streets, using crack cocaine and serving time for assaults that she says resulted from her mental illness.

"I can't do it no more," she says. For the first time since the 1970s, she has a kitchen and a TV, a couch and a bunch of detective novels to read. "I'm going to be in this place till I'm gone." She's cooking now in her Northwest apartment -- chicken and rice, ribs and greens -- and she's saving some of her disability payments (30 percent of her income goes toward rent). She hopes to get a job; she was once a secretary for the D.C. Department of Corrections.

Holton, a jovial former football player at Anacostia High School who describes himself as "unpleasantly plump," ended up on the street after his grandfather died. Pulled off course by a brain tumor, seven surgeries and a rough case of depression, he lost all his possessions, including his football trophies, when an uncle he was living with was evicted.

On his own, with no income except his disability check, Holton drifted between shelters and hospitals. The 911 operators became his lifeline, forced to play long-distance parents for a young man desperate for a respite from the drug-ridden streets.

When Pathways counselors offered him an apartment in the Congress Park section of Southeast, Holton jumped. Now, in a living room empty except for a love seat and a chair, he dreams up new recipes and waits for his turn to watch the TV he shares with his next-door neighbor (the set is moved back and forth between the apartments every noon and midnight).

Holton suffers from swollen ankles, asthma, obesity, depression and a thyroid condition, but he's leaving 911 operators to real emergencies these days. "I got my place, and that's giving me a chance to eat right and sleep," he says, and he lets loose a hearty laugh. "I love this joint."Join me at noon today for "Potomac Confidential" at http://www.washingtonpost.com/liveonline.