Private organizations fill in the gaps left by the recession and dwindling government budgets

"If I was homeless tonight, I don't know if I'd be alive by morning, I don't have those skills," Anne McGhee, the Director of Residential Services at the Bethesda House of Schenectady, told Raw Story this morning. "All of us are two steps away from being homeless," Assistant Program Director Doreen Wright said, and Petra Lohmann added, "There's some crisis, and that's it -- we're all just two paychecks away from needing the services here."

Bethesda House employees and volunteers, who serve homeless and low- and no-income people in the upstate New York county, spend their days with a lot of people who society's been relatively content to ignore -- especially in a place like Schenectady (population 66,821), where homelessness and near-homelessness is far less visible than in urban areas. But the city acknowledges that homelessness is growing and they're almost entirely reliant on private organizations. The city estimated the population of homeless people in 2010 to be 1,815 in the city alone and that, to house them, they are truly reliant on Bethesda House.

But Bethesda House, which opened its doors in a church basement in March 1992 as a place for Schenectady's homeless and low- or no-income residents to just get off the streets for a few hours, does more than just house a portion of the city's homeless. They provide services for the people who most often end up homeless, 90 percent of which Program Director Danny Payne says have a mental illness, substance abuse or development disabilities, and most often a combination of the above. They help clients access social services, occasionally accompany them to doctor's appointments to advocate for their health, encourage them to get into treatment programs and fill in the gaps left by government services. Those gap-fillers include everything from their hygiene program -- which provides full sized personal hygiene products, which aren't covered by food stamps -- to a place to shower or do laundry, to a food pantry that opens at the end of the month to cover the gaps left by once-a-month food stamp programs, to even acting as a place for people to send and receive mail, faxes and phone calls, which are a necessity for job hunters.

"Yesterday," Payne said, "150 people came through our doors. And we were here to help every one of them."

Ed Falterman, the case manager for the Rep Payee program, has 62 clients who have been judged by a medical doctor to be incapable of managing their own funds. He helps them apply for social services -- including Social Security, food stamps and Medicare -- and then pays their bills, with a focus on maintaining a roof over their heads. Like many of Bethesda House's services, his program is "Housing First" focused, which means they take care of the immediate needs of many people to find a stable, safe place to live and then address their other issues, from food insecurity to mental illness to a lack of knowledge of how the job market works.

Ronya Bynum, the senior case manager, said that the biggest problem with the current system is that "immediate needs [like housing] aren't addressed," by the city's programs, so homeless people that qualify often end up sheltered in hotels, and those with children are immediately reported to Child Protective Services as a result of applying for benefits. But for a population that is "for a big part, undereducated and the majority of whom have literacy problems," just navigating the array of social services or getting help for their other problems is a overwhelming undertaking, which is where the staff of Bethesda House comes in.

That system frustrates even the experienced staff. To qualify for Bethesda House's HUD-supported beds, clients have to document four episodes of homelessness in the past three years and some sort of medical diagnosis. As McGhee said, "People that are homeless don't generally go to the Department of Social Services for assistance," and as executive director Kim Sheppard noted, "HUD audits case files every three years." Or, as Payne put it, "You see a person sleeping on the street and you think he's homeless, but HUD doesn't. And if you bring him home and let him sleep on your couch for a night, then HUD thinks he's found housing, even though it's not his house." And if Bethesda House doesn't abide by the federal government's rules, they risk losing their funding -- which, because private donations are dwindling as the economy continues to stagnate, are increasingly important

To make matters worse, even in a place like Schenectady, the subsidies paid out for qualifying homesless people are shockingly low: $419 a month if there's electric heat, $400 if there is gas heat, and $360 if heat and hot water included. McGhee said that Bethesda House is reimbursed $332 a month for the rooms they use to house the city's homeless. Bynum noted that "it takes months for landlords to get paid," by the Department of Social Services, and Lohmann noted that "many landlords won't deal with DSS anymore."

And then there's helping people access the services they need. Payne noted, "A lot of our people are dually diagnosed. They use substances to make them feel better because of their mental illness," and then "substance abuse [programs] don't want them because of their mental illness and mental health doesn't want them because of their substance abuse." Shepherd said, "The general public believes the people we serve are lazy and want to be in this situation and they're not." McGhee added, "The system is disjointed, it doesn't flow... it should be getting them housing and then get them the help they need, but it often doesn't."

To help clients deal with a system that forces them to wait and a society that too often treats them with disrespect, Bethesda House emphasizes client dignity in all their services. From their "consumer choice food pantry," which Wright said allows people with dietary preferences and restrictions to choose their food from the specified nutritional categories rather than sending them hold with food they can't eat, to the clothing donation room open on Wednesdays in which "everything has to be something we would wear," to the soup kitchen that feeds homestyle meals t0 80-150 guests a day, the programs are designed to give the city's neediest residents a sense of dignity that they often don't find elsewhere. "Some people look at the people who come to Bethesda House ans 'they," Wright said, "but they are 'we.'"

Payne said that, "on the streets, either you're a victim or a victimizers. Most of our clients are victims." Sheppard agreed, "There's so many people that abuse homeless people, beating them up, knowing when they get a [social services check] and targeting them after they cash it." They view their daytime programs as a way to get people in the door, provide them with some sense of security and help those they can reach start a process to get back on their feet.

One problem the staff often see is that, because of their illnesses, disabilities or lack of education, the clients' ongoing problems are previously ignored by the system. One client, Mary, went to the hospital with a serious kidney infection 4 times last Christmas season, only to be sent home with a series of misdiagnoses and ineffective medications until she collapsed of sepsis in the Bethesda House room she shares with her husband and nearly died. "If I'd still been on the street," she said, "I would be dead." Another man, Louis, went to the hospital sick on Thanksgiving several years ago and had open heart surgery the next day for problems his previous doctors ignored. Both appreciated the way the Bethesda House staff treated them -- especially Louis, who said, "Since they opened, I got 600 hugs, at least." He volunteers in the kitchen most days, helping cook, serve and clean up after the meals. Mary, too, used to volunteer, but had to cut back because of her illness and said, "I miss volunteering." John, another resident, told Raw Story, "This place is a blessing for people who want to get on their feet... I'm not taking this permanent here."

Estelle said she started coming three years ago for the clothes, but stayed for the women's group, which is facilitated by trained staff from Bethesda House, the YWCA and the Sexual Assault Support at Planned Parenthood. "We talk about domestic violence, and people support them, give information. We stick together as women." Dominica agreed, "They help you with things."

[Ed. note: The author of this piece volunteered a handful of times at Bethesda House in 1993 and 1994.]

[Ed note: This piece was corrected after publication.]