One of the best things about David Frankson’s new apartment is the drip coffee maker that sits by his sink.

He fires it up several times a day, brewing a full pot to start his day and usually a second one to end it.

He also loves being able to take a hot shower at the end of the day and the privacy that comes with having his own space.

These are things that Frankson has gone without for years. Frankson, 56, had been living on the streets of Victoria since Hurricane Harvey and lacked stable housing even before the storm.

But in October, Frankson got an apartment of his own through Gulf Bend Center’s Wellness Community. The apartment complex opened in 2015 and was designed to provide affordable apartments for adults with co-occurring mental and physical diagnoses.

Gulf Bend built the apartments as an early adopter of the housing-first philosophy some hospitals and health providers are now following.

For Gulf Bend’s wellness community, that philosophy means they want each of their 32 residents to find a way to “live well,” said Tiffany Seiler, the manager of the community.

For different people, that could mean “learning how to better manage their diabetes or learning how work is helpful to them or even just the basics of having shelter, not living on the streets and how much that improves their life,” Seiler said.

Searching for shelter

For about two years, Frankson was a long-term resident at Victoria’s Salvation Army shelter. He would work and contribute a portion of his wages to the shelter as well as help out around the kitchen and in the warehouse.

When Harvey made the shelter unlivable, Frankson started sleeping at a bus stop on Ben Jordan Street.

His life changed in 2018 when he ran into a familiar face at Christ’s Kitchen. Jodi Sandoval, Frankson’s former colleague at Ramsey’s Restaurant, recognized Frankson from across the room. Sandoval was at the soup kitchen to meet people as part of her new job with Be Well Victoria, and Frankson said she immediately invited him to be a part of the new group, which is working to address mental health and well-being in Victoria.

Since Sandoval re-entered Frankson’s life, she’s helped him navigate the complicated systems of finding a job, housing and medical care.

Frankson served in the Texas Army National Guard for five years in the 1980s. After that, he spent most of his adult life in Victoria, where he’s lived in various homes throughout the city. Sandoval helped Frankson figure out the confusing system of trying to get support as a veteran. When she realized Frankson was walking to all of his appointments throughout the city, she got her husband’s old bike fixed up for him to use. A Facebook friend of hers bought Frankson a new pair of shoes.

Sandoval also supported Frankson when he told her about the trauma he suffered as a young boy, when he said he was the victim of child abuse. He’s carried that pain with him throughout his life but said that it’s helpful to talk about difficult moments in his life with his friends.

Finding a home

Frankson’s chances of finding a home started to improve in September, when he got a job working at Greek Bros. downtown. He had jobs at Ramsey’s and, after that, at Hungry Jacks Thirsty. But when that restaurant closed after it was damaged by Harvey, Frankson was left without a job until he found a new opportunity at Greek Bros.

In October, things started to line up. Frankson had a paycheck and was looking for a place he could afford, which was when Sandoval approached Seiler, the wellness community manager, and asked her to meet with Frankson. Thanks to an unexpected vacancy in the apartment complex, there was an apartment ready for Frankson right away.

When Seiler handed him the keys to his very own apartment, Frankson said, he couldn’t believe it.

After about six weeks living in his new home, Frankson has settled into a new routine. He’s been able to unpack his belongings, most of which he stored at friends’ houses when he lived on the streets. The apartment has given him his own private space but also neighbors whom he has befriended, both things he lacked when he only had a bench for a bed.

The community has also provided Frankson with time to meet with a counselor every week to talk about his life, from what’s going well to some of the more painful things he’s endured.

“Others that are out there that don’t have any place to stay, I feel bad for them,” Frankson said. “If there was some way I could do something about that, I would. If I was rich, I’d build a big place or something for people to come off the streets, ‘cause I don’t wish nobody to be out in this cold.”

Housing first

Frankson’s dream to fund safe housing for anyone who needs it is an idea that more and more health systems are starting to adopt. A hospital in Denver is partnering with the city’s housing authority to renovate a building into affordable senior housing, with 15 apartments meant to help homeless patients transition after they are discharged from the hospital.

In Phoenix, the nation’s largest health insurer, United Health Group Inc., is trying a similar experiment. The company is using its own money to pay for housing and other services for about 60 formerly homeless people who have complicated medical issues.

The thinking behind such experiments is that for health systems in particular, providing those in need with safe and stable housing will allow them to address their medical needs promptly before they deteriorate and get more complex – and more expensive.

The long-term cost savings of experiments like these are still to be determined as different hospital systems, insurance companies and other service providers experiment with providing housing in addition to other services.

Gulf Bend’s leaders say they haven’t found a way to quantify what the wellness community saves law enforcement or hospitals in the long run, but they’re confident that it does save money.

The idea behind the wellness community originated years ago when Gulf Bend’s leaders started thinking about how they could better support people with mental illnesses. Advocacy work by journalist Pete Earley, who documented how his family has supported a son with bipolar disorder, made them think about how they could address an individual’s entire range of needs instead of just doling out a prescription, said Lane Johnson, Gulf Bend’s chief medical officer.

Around that time, Seiler, who was then a case manager at Gulf Bend, realized that some of the clients she was working with were living in substandard housing.

“I remember Tiffany saying, ‘We can do better than this,’” Johnson recalled.

Plans for the massive project came together quickly, and in 2015 the new community opened 32 apartments in a new complex in Victoria. The space was designed so every apartment opened onto a central courtyard so neighbors could socialize and barbecue together.

In more than four years since it opened, a few things about the community have changed. Although the community was initially designed for people diagnosed with mental illnesses, Seiler said they realized there was no reason they couldn’t also house individuals with intellectual or developmental disabilities who might also be getting services at Gulf Bend.

Similarly, Seiler had initially thought the wellness community would be transitional housing, where people could live for between 12 and 18 months before they found another apartment on their own. But as time went on, Seiler and her colleagues realized that totally independent living wouldn’t be a good fit for all of their residents. At the wellness community, staff members are available 24 hours a day in case of emergency or if someone needs help.

This flexibility means it’s a little harder to track the program’s success as not every resident is striving to live in their own apartment. But Seiler said the wellness community adapted so that success is defined by whatever an individual is hoping to achieve for themselves.

Since the community opened, 70% of the residents at the community have had “positive” outcomes, meaning they’ve either continued to live successfully at the wellness community, moved on to their own independent apartment or improved their lives in some other way. About 17% of the people maintained the same condition as when they moved into the wellness community, and for about 13% of the people, their situation got worse, according to Gulf Bend’s data.

All of these traits make the wellness community unusual. It provides both transitional and permanent housing. It serves people with traumatic brain injuries or who have been diagnosed with schizophrenia. It houses people who have been living on the streets and people who are transitioning from nursing facilities.

This freedom, Johnson and Seiler said, comes from a decision that Gulf Bend leaders made early on: They decided not to bill residents’ insurance companies for the care and support they were providing residents and to try to sustain the entire program through Gulf Bend’s operating budget.

“Gulf Bend categorically said no to that because then it becomes not the wellness community; it just becomes another facility,” they said.

But after four years, Johnson said it became clear that Gulf Bend’s budget alone would not be able to sustain the community. Now, leaders are turning to the Crossroads community and asking them to invest in Gulf Bend’s work.

What’s next

Frankson said he hopes to continue to share his story and maybe even write a book someday, so people can learn about what it’s like to live without shelter.

For Sandoval, helping Frankson find housing has showed her how difficult finding resources can be for those who don’t have any of their basic needs.

“I think that’s the biggest thing, is knowing that these systems aren’t set up for the people who need the services,” she said. “David really had to learn how to navigate a system, and I’m grateful that this was a good outcome, but unfortunately, that’s not happening for a lot of people. He’s just one.”

Ciara McCarthy covers public health for the Victoria Advocate as a Report for America corps member. You can reach her at cmccarthy@vicad.com or at 580-6597 or on Twitter at @mccarthy_ciara. To support local journalism at the Advocate through Report for America, go to VictoriaAdvocate.com/report.

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Health Reporter

Ciara McCarthy covers public health for the Advocate as a Report for America corps member. She reports on insurance, the cost of health care, local hospitals, and more. Questions, tips, or ideas? Contact: cmccarthy@vicad.com or call 361-580-6597.

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