The following is a script from "100,000 Homes" which aired on Feb. 9, 2014, and was rebroadcast on June 15, 2014. Anderson Cooper is the correspondent. Andy Court, producer.
Giving apartments to homeless people who've been on the streets for years before they've received treatment for drug or alcohol problems or mental illness may not sound like a wise idea. But that's what's being done in cities across America in an approach that targets those who've been homeless the longest and are believed to be at greatest risk of dying.
They're people who once might have been viewed as unreachable. But cities and counties affiliated with a movement known as the 100,000 Homes Campaign announced this past week that they had gotten more than 100,000 of these people off the streets and into permanent housing. We first told you about this initiative earlier this year. Local governments and non-profit groups do most of the work. The money comes mostly from existing federal programs and private donations, and there's evidence that this approach saves taxpayers' money.
If it sounds too good to be true, then take a look at what's been happening in Nashville, one of the cities that has joined the 100,000 Homes Campaign.
Ingrid McIntyre: You awake, buddy? [Ingrid knocks on door]
Ingrid McIntyre: Robert?
In a storage facility on the outskirts of Nashville, outreach worker Ingrid McIntyre introduced us to Robert McMurtry.
Ingrid McIntyre: Hey good morning. I want to introduce you to my friend Anderson.
Anderson Cooper: Hey I'm Anderson, how are you?
She'd come to ask him some questions about his health.
Ingrid McIntyre: How many times have you been to the Emergency Room in the past three months?
Robert McMurtry: Uh, twice.
Robert told Ingrid he had a lot of medical problems: HIV, hepatitis C, and throat cancer. He was getting treatment at Vanderbilt University Medical Center, but living in this storage locker without a toilet or running water. He bathed in a stream by the side of the road. He said he'd been homeless for three years.
Anderson Cooper: How old are you?
Robert McMurtry: I'm 48.
Anderson Cooper: Forty-eight? I'm 46, so we're two years apart.
Robert McMurtry: Uh-huh.
Anderson Cooper: It's nice to see someone else with gray hair.
He said he used to work in the construction business but fell on hard times after he lost his job and became ill. A friend took pity on him and allowed him to stay in this storage locker for the past three months.
Robert McMurtry: I never imagined I'd ever be homeless, 'cause I had-- I really worked really hard my whole life and it was just devastating really when it happened because I never imagined that I would be in this condition.
Ingrid McIntyre runs a nonprofit called Open Table Nashville, that's been working with the 100,000 Homes Campaign to survey the city's homeless - and identify those at greatest medical risk.
"I never imagined I'd ever be homeless, 'cause I had-- I really worked really hard my whole life and it was just devastating really when it happened because I never imagined that I would be in this condition."
Anderson Cooper: Do you think he's at high risk?
Ingrid McIntyre: I mean he's one of the most vulnerable people that I know.
Three days after interviewing Robert, she returned with an offer that was hard to believe.
Ingrid McIntyre: If you want to, I have an apartment for you tomorrow.
Robert McMurtry: Really?
Ingrid McIntyre: Do you want it?
Robert McMurtry: Yes. I do, really.
Ingrid McIntyre: Good.
The following day....
Robert McMurtry: Wow man....
Robert moved in to his very own apartment.
Robert McMurtry: This is great.
It's in a private building in downtown Nashville. He wouldn't have to bathe in that stream anymore. The apartment has one bathroom, one bedroom, and access to this rooftop pool.
Until fairly recently someone like Robert would have to jump through a series of bureaucratic hoops, and go through a treatment or job training program before getting permanent housing. The 100,000 Homes Campaign advocates using an approach first developed in New York in which the homeless are given housing first.
Becky Kanis: What we're really aiming for in this movement is that person that's been on the streets, many cases for decades-- who you walk past and you're like, "Oh, I can't even imagine this person being able to be in housing."
Anderson Cooper: The hardcore homeless.
Becky Kanis: The hardest core of the hardest core-- who also happen to be at the highest risk for dying on the streets.
Becky Kanis works for a group called Community Solutions, which created the 100,000 Homes Campaign. She says most of the 600,000 people who are homeless in the United States on any given night are on the streets for relatively short periods of time, usually less than a month. But it's the chronic cases, people homeless for more than a year, who Kanis says are most in need of help.
Becky Kanis: They're out of friends who will let them sleep on their couch. They're out of friends who will help them get a job. They've burned the bridges of the friends or they just didn't have 'em in the first place.
More than 60 percent of the chronically homeless have drug or alcohol addictions. Thirty percent suffer from severe mental illness. Kanis says many of these people have such serious medical problems, it costs taxpayers more to leave them on the street.
Anderson Cooper: How is it costing more?
Becky Kanis: The inability to tend to your basic healthcare needs, results in people on the streets ending up in emergency rooms and ending up in in-patient hospitalizations. And one night in the hospital is a whole month's rent on most places.
Anderson Cooper: So you're saying it's more expensive to allow a chronically homeless person to live on the streets than it is to actually subsidize an apartment for them?
Becky Kanis: Yes, we are paying more as taxpayers to walk past that person on the street and do nothing than we would be paying to just give them an apartment.
Becky Kanis began working for the 100,000 Homes Campaign after a career in the military. She's a West Point graduate and former Army officer who worked with the Special Operations Command.
Anderson Cooper: Do you think having a military background helps?
Becky Kanis: I absolutely think it does. It's boots on the ground intelligence that I think is one of the defining factors.
"Yes, we are paying more as taxpayers to walk past that person on the street and do nothing than we would be paying to just give them an apartment."
To get that boots on the ground intelligence the 100,000 Homes Campaign encourages teams of volunteers and outreach workers to spend three nights looking for and interviewing the homeless. Last year, in May, we joined the teams in Nashville as they headed out at three in the morning, searching in small patches of woods under highway overpasses and in caves where the homeless camp.
Will: Hey, sorry to wake you. My name's Will.
Those who agreed to answer a series of survey questions would get a free bus pass in return.
Will: How many times have you been to the Emergency Room in the past three months?
Homeless man: About five times.
The questions are mainly about their health ...
Volunteer : HIV or AIDS?
Volunteer: Liver disease? Cirrhosis?
Volunteer: History of stroke or heat exhaustion?
The information is used to decide who gets apartments first by giving priority to those at greatest risk of dying on the streets. And the risk is very real.
Homeless man singing: Rocky top you will always be....home to me.
On the steps of this church, a man froze to death last year, one of 52 homeless people who died in the city.
Not everything the homeless told the survey teams was accurate. We checked and found some discrepancies. But we were also surprised by the candor of some of the people we met. Ernest Thomas who has a prosthetic leg, says he once hoped to work in a pharmacy, but ruined his job prospects by getting involved with drugs and crime. He was on parole when we spoke.
Ernest Thomas: Look at me, man, I'm 39 years old. And I ain't got nothing. You know I'm sayin'? I don't even call my kids. You know, when I do call 'em, they be, like, "Dad how you doin'?" I gotta lie and fantasize. Oh, man, I'm straight.
Anderson Cooper: So how do you think you-- you ended up on the street?
Ernest Thomas: Honest with you, man, I can't tell you. I really don't know. I messed up. Somewhere, I messed up. Yeah.
Will Connelly is director of the city's Homelessness Commission. He is the person who decided Nashville should adopt the 100,000 Homes Campaign's approach. He'd already lined up a number of apartments for the people identified by the survey.
Anderson Cooper: And these are fully furnished apartments, ready to go that these people can just move into?
Will Connelly: Yeah. Yeah. Permanent housing, no strings attached really. As long as they abide by that lease agreement, it's-- it's theirs.
The apartments are paid for mostly by the federal government which gives rental assistance subsidies for veterans and people with low income. The homeless are expected to contribute 30 percent of whatever income they get from things like part time work, social security, or disability.
Some apartments - like Robert McMurtry's - were provided by civic-minded landlords willing to accept very little rent. Kirby Davis donated one percent of his units and has encouraged other building owners to do the same.
Anderson Cooper: And what's the push back you're getting?
Kirby Davis: That-- they might harass my other residents, what are my other residents gonna think? What kinda liability do we have?
Anderson Cooper: And-- and what do you say to that?
Kirby Davis: None of 'em got to where they are not taking risk. So how about taking a risk for somebody else?
Kirby Davis meeting with landlords: Why don't we go around the room and introduce ourselves?
No new tax dollars were required for Nashville's campaign to house the chronically homeless. A lot was achieved by getting people who don't normally work together - such as outreach workers and private landlords -- to focus on the city's most desperate residents.
Landlord: What I'll do is try two units and we'll start with that and give it a try.
To determine who should get apartments first, the homeless who were surveyed got ranked based on their medical risk factors. Robert McMurtry finished high on the list, but there were some in even worse shape.
Anderson Cooper: So who are some of the people you've identified?
Will Connelly: The most vulnerable is-- his name's Frank.
Frank is Frank Clements, who spent more than 30 years in prison for robbery and other crimes. For him and a friend, home was now this park bench.
Ingrid McIntyre: Where are you guys staying right now?
Frank Clements: Right here.
Ingrid McIntyre: Right here?
Jerry: Right here.
Ingrid McIntyre: Yeah
There was a bottle of mouthwash by his side, which is what alcoholics sometimes drink when they can't afford liquor. Frank was 66 years old and said he'd been treated for two types of cancer, pneumonia, and heart disease.
Ingrid McIntyre: How many times have you been to the emergency room in the past three months?
Frank Clements: About three times.
Four days after he answered those questions, he was walking into his new apartment...
Outreach worker: This is your new home!
Frank Clements: All right...My heart is full of gratitude. And you know, it's awesome. I mean you don't see people like this that help people out you know.
To try and ensure the homeless don't end up back on the streets, social workers check in on them regularly.
Ashley: Do you mind if I have a seat?
Frank Clements: Well of course you can.
Frank Clements needed more help than most. The morning after he got an apartment, we found him finishing off a bottle of whiskey.
Frank Clements: I ain't no angel. I'm a damn drunk.
In the weeks that followed, social workers tried to help Frank get treatment, they even drove him to appointments. He'd get sober for a while, then start drinking again, then be filled with remorse. He was so disruptive when drunk he had to be moved out of two different apartments. Some critics of the 100,000 Homes Campaign question whether scarce housing resources would be better spent on homeless kids or working-poor families rather than somebody like Frank.
Anderson Cooper: Is it fair to give somebody an apartment who's made bad choices and is being irresponsible?
Becky Kanis: I don't think fairness is the right way to look at it. What I would prefer to look at it is what's good for everybody. So having somebody on the streets, fair or not fair, is costing us as a society as taxpayers more than it would cost to have them in housing.
Anderson Cooper: It does seem like you're rewarding somebody though, who's-- you know, drinking or doing drugs or just being irresponsible.
Becky Kanis: I see it as giving them a second chance. And most people, given that second chance, do something about those behaviors.
So far, Robert McMurtry has made the most of his second chance. He made friends in his building, and three months after he got his own apartment, we were amazed to see him jogging in a nearby park. Researchers at the University of Pennsylvania found that when homeless people in Philadelphia were given housing and support, more than 85 percent were still in housing two years later...and were unlikely to become homeless again.
Ingrid McIntyre: How's it going? Everything went great this morning? I'm so glad, you look awesome.
Man playing guitar at luncheon:... 2,3,4 everywhere that I go...
In September, homeless advocates in Nashville held a luncheon for some of the people they had helped. In 100 days, they had gotten nearly 200 people into homes, and all but a handful were still in their apartments. But there weren't enough apartments for everyone. Ernest Thomas didn't get one. He ended up back in prison on a parole violation and then homeless once again.
For Nashville and the other communities across the country that have joined the 100,000 Homes Campaign getting 100,000 people off the streets is an important milestone. It doesn't solve the problem completely, but Becky Kanis says it proves that the problem can be solved, and that no one is unreachable.
Becky Kanis: We have an amazing collection now of before pictures and after pictures that just captures the transformation that's possible once someone's in housing. There is something that's really dehumanizing about living on the streets in so many ways. And then, really, in a matter of days, from having housing, the physical transformation is almost immediate. And they're unrecognizable from their former selves. And I don't think that there's anybody, once they see that, that would-- say, "Well, let's put them back on the streets again."