The problem often appears monolithic, entrenched and clouded by stereotypes. A closer look reveals an alarming spike in numbers, a system struggling to help—and the human face of unrelenting need.

This is the story of a woman with a coat at least two sizes too large. She's young—20, 25 tops. I see her waiting across the street at the intersection of High and State. She stops me in the crosswalk. She doesn't want money, just food. I debate giving her the $2 in my wallet and going on my way, but I know that a couple singles won't buy her a meal.

“What do you want?” I ask.

Anything, she says. “I've been eating out of the trash.”

We walk to Pizza Rustica, a block away. She orders cheesecake and Mountain Dew, and after a little prodding, a few slices of pepperoni. She's worried about asking for too much. We find a table.

She left her small hometown outside Columbus a couple of weeks ago, and this is her first real trip to Downtown. She says it wistfully, imagining a world where everything turned out better. She came to find work, but her possessions were stolen and she can't get a job without an ID. The shelters are full, she says, so she was placed on a waiting list with 39 people ahead of her. She's in the top 15 now. A tent off Broad Street has served as her makeshift home. I give her my last piece of pizza and she puts it in a takeout box with the remnants of hers. There's no cheesecake left. She loves cheesecake, she says.

She gets up to leave. She doesn't like being out late because Broad Street gets dangerous the further west she goes. Someone gave her pepper spray and she clutches it when she walks alone. She thanks me for at least the fifth time and then disappears.

This is her story, but there are many others like her—so many it's hard to fathom.

A Growing Dilemma

Government agencies endlessly quantify homelessness, and yet there's no definitive figure for how many people are homeless. What seems inescapable, though, is that it's growing unabated in Columbus, defying national trends. The Community Shelter Board's 2016 single-day, point-in-time count reported the number of homeless had increased 22 percent since 2011, though that method struggles to capture people who want to avoid detection. A separate report shows that the city's shelters served 10,558 people in fiscal year 2016, 40 percent more than five years ago. The numbers for women have increased 50 percent, and family use shot up 68 percent. By contrast, the number of homeless people nationwide has decreased 13.7 percent since 2010, and family homelessness has decreased 19.5 percent, according to the U.S. Department of Housing and Urban Development (HUD).

Concerned by the increase, the shelter board and the Columbus Foundation reached out to research firm Abt and Associates and helped create the Task Force to Prevent Family Homelessness, helmed by Franklin County Commissioner Marilyn Brown. Those combined efforts revealed systemic problems: a loss of $72 million in annual public benefits for the county's poorest residents since 2001; a shrinking rental market; extensive waits for low-income housing; and disproportionate numbers of African-Americans using the shelter system. Sources for this story say that homelessness is also up among youth and young adults, and the opiate epidemic is intensifying the problem.

“There are more people on the streets than we've ever seen,” says Kent Beittel, founder of the Open Shelter and a longtime Columbus advocate for the homeless. “It's increasing all the way across the board and it's going to continue to increase because, as far as I can tell, no one is doing anything to end homelessness, in spite of all the PR. What we're doing is we're dealing with how to help you overcome your homelessness. But that doesn't change the fact that in Columbus, Ohio, we are pushing people into the street faster than we are getting them off. That is the dilemma.”

Navigating Shelter

Homeless shelters were once like a loose system of flophouses, but no more. Antonio Caffey, the director of Friends of the Homeless shelter in Olde Towne East, says it's not “three hots and a cot” these days. It's a housing program now—an incredibly complex one involving a vast group of organizations operating within a dizzying web of regulations. In Columbus, this system is directed mostly by the Community Shelter Board, which oversees planning, funding and evaluating homeless programs for 19 provider organizations, including the city's shelters. The shelter board adheres to the Housing First philosophy, which states that people can't address other problems without the stability of a home. It aims to move people quickly from shelters, or even directly from the street, into permanent housing and then offer supportive services to maintain stability.

Shelters can be accessed only through the centralized Homeless Hotline, which is run by HandsOn Central Ohio. Representatives with HandsOn attempt to divert as many people as possible from the crowded shelter system by connecting them with other resources or suggesting alternatives, like staying with family, to protect the scarce supply of beds. HandsOn CEO Ernest Perry says that about 26 percent of single adults and 48 percent of families are currently diverted.

In the winter, the shelter system enters overflow, and more beds are added so that anyone who needs one gets one. There's typically a waiting list for single adults during the rest of the year. Shelter board CEO Michelle Heritage says that last year's average backlog was 29 people for men and 36 for women;

Sue Villilo, the executive director of Faith Mission, says that generally it's a two- to four-day wait for men, but as long as a couple of weeks for women.

The shelter board promised to do away with waiting lists before the opening of its newest shelter, known as Van Buren, which was originally intended for single adults. But family homelessness pushed the YWCA Family Center far beyond capacity, forcing the board to add a new family section. The system received another shock when the Van Buren women's section opened. The wait list at the time was 50 women, says Sue Darby, the executive director of the Downtown district YMCA, which operates Van Buren. But within eight weeks of opening, it was housing 300 women—250 more than originally expected. Men were forced to wait another few months.

“Just very clearly: The shelter board hates waiting lists,” Heritage says. “I think that human beings that need shelter and services should get it right away, and this is fully a resource issue. So if we had adequate resources, we would eliminate those waiting lists immediately.”

Heritage estimates the addition of another 100 beds a night would meet the need. She says, however, that the shelter board's preference isn't to add more shelters, which she likens to emergency rooms. “Shelter does not solve homelessness at all. Not at all,” she continues. Shelter provides a safe and dignified environment, Heritage says, but services are the key to eliminating homelessness. That means more case managers, called navigators. The system employs about 30 now, and she estimates needing at least 50.

None of this surprises Beittel, the shelter board's most vocal critic since its inception 31 years ago. He says the board consistently underestimates the homeless population and therefore plans based on bad data. His Open Shelter was once a part of the system, but a public falling out with the board ultimately led to the loss of his government funding and eventually the building itself. They became an example, he says. “There were literally people who were told, ‘This could happen to you.'”

Don Strasser, the co-chair of the Columbus Coalition for the Homeless, says that because providers are funded in part by the shelter board, it prevents them from speaking candidly. “They really have to be very careful because they're very fearful that there will be repercussions if they are too critical.”

The Open Shelter now operates in St. John's church Downtown, providing meals, clothing, supplies, outreach and advocacy, but no beds. Despite lingering acrimony, Beittel is quick to praise the shelter board for all the good it's done—addressing family homelessness, creating lots of permanent supportive housing for the homeless with disabilities—but he has a problem with the one-size-fits-all approach, resolutely adhering to solutions that help many people but leave others behind. Heritage balks at the notion that the board is overly rigid in its services, saying that providers offer a wide range of programs, though she acknowledges that money from HUD, a major funding source, comes with strict rules.

Sandy Stephenson believes in Housing First, just not for everyone. The director of integrated health care for Southeast Inc., which runs Friends of the Homeless, says she wishes there was a “goodness of fit” model instead, in which some people are housed within the ideal 30-day timeframe, while others are given up to six months to address problems first. Right now, she's seeing more people placed into housing that they can't maintain long term.

Darby witnesses the same thing at Van Buren, where families are repeating through the system two or three times. “They don't have the tools in the tool chest to stay stably housed.”

A Tale of Two Houses

The Holy Family Soup Kitchen in Franklinton is a hub of outreach on a Thursday morning in January. The Mount Carmel Street Medicine team's Mobile Medical Coach is parked in the lot to dispense free primary care; it is just one of several agencies on-site. There are a great number of people helping to fight homelessness at every turn, and yet they always seem to be eclipsed by the need.

Inside Holy Family, Tamar Harvey sits across a table from one of the four Mount Carmel nurses working the triage room that all the patients must visit before they enter the RV-turned-mobile-clinic outside. Tamar walks with a profound limp, dragging his right leg behind him, the most visible symptom of a stroke that affected his entire right side and caused a traumatic brain injury. He's shy and speaks in a gravelly rumble.

He was homeless for more than two years and spent the last year of that time sleeping in front of a church at Fifth Avenue and High Street. He spoke to some construction workers there every day; he thinks they placed a call on his behalf. Tamar then spent about six weeks in a shelter before being placed in permanent supportive housing nearby in Franklinton. He's been there slightly over a year, and he just received his Section 8 voucher to move anywhere that will take him. He wants to find a place near Ohio State to get away from the gunshots he frequently hears. Tamar is a success story.

David Palmer lives at the other end of the spectrum. He goes by Vern and is all kinetic energy. “Selfie!” he yells, throwing his arms around me and Mount Carmel's media relations person while mugging for our photographer. “I made that look good,” he says as he gets up. Vern tells me he has no filter several minutes after making that patently obvious.

He's sitting in a provisional exam room in the cab of the RV, talking to a Street Medicine nurse practitioner named Jackie White. Usually he sleeps in his brother's van, which is for sale. He admits that finding housing is hard for him. “I don't do shelters,” he says. “I like my blade.” He pulls a small pocketknife from inside his coat and explains that he uses it for eating; he has no teeth. He doesn't like having his things taken from him by shelter staff, and knives are prohibited.

He was homeless for six years the first time around. He was eventually moved into Southpoint Place, another permanent supportive housing complex. It's on the South End, unfortunately, and he's more comfortable with the West Side. He tried, he says, but ultimately it didn't work out, and he's been back on the land since last spring. He says he was told he could have refused the placement, but then he'd still be homeless. Also, if someone refuses they're pushed to the bottom of the waiting list, White says. So Vern is hopeful that Maryhaven's outreach team will help him find housing today. But not that hopeful.

White has been working with Mount Carmel outreach for more than 16 years. In addition to the mobile coach, she and the Street Medicine team also take medication and supplies to the homeless camps around the city each week. She saw more alcohol use in camps in the past, but that's been surpassed by heroin. She's seeing more adolescents now, too.

“Research tells us that within two years, a quarter of youth who age out of foster care without support from mom or dad become homeless,” says Ann Bischoff, the director of OSU Star House, a drop-in center for the homeless between ages 14 and 24. She estimates there are about 1,500 homeless transitional-age youth in Columbus, and about half came from the foster care system. They're reluctant to use the shelters because of the preconceived notion that the adult population is dangerous.

The Street Medicine team tries to link everyone in the camps to housing opportunities whenever they can. They give out the hotline number to call for shelter beds on cold nights. “We don't give up on people,” White says. “We keep reminding them that there's a better life for them, and we really try to encourage them to get the services that they need.”

Letters, Needles and Demons

Inside the Franklin Station building, social workers and volunteers assign alphabetical letters to the drug users who come to the Safe Point needle program seeking sterile syringes—the first person through the door is A, the second is B and so on. At 8:40 in the morning, only 10 minutes after the doors open, letters A through F are already sitting around a conference table inside the clinic, run by Southeast Inc. Some are homeless, but not all of them, and everyone I see appears to be a heroin user, some of them deeply addicted.

I was invited by Bela Koe-Krompecher, the clinical director of housing with the Downtown YMCA, to witness this scene on the West Side, where it's like a “heroin-explosion bomb went off,” he says. Equitas Health operates the Safe Point program twice a week in the Short North and once a week here in Franklinton, with the goal of promoting safer drug use and fighting the spread of disease while offering access to treatment.

Every person through the door waits to be called into a private room with one of the nurses to get instruction and needles. Koe-Krompecher sits at the conference table with his laptop ready, offering social service triage of sorts. You need Medicaid? What about legal help? A bag of food from the YMCA pantry down the hall? He also offers to connect the homeless with the shelter system, though his effort is half-hearted. He already knows what most of them will say.

“Our shelters suck here, man,” one person complains to no one in particular. Koe-Krompecher says the thing he hears most at Safe Point is, “How can I get housing?” He tells them they have to call into the Homeless Hotline, and they typically decline.

“In their mind, it's not safe for them. They're vulnerable,” Koe-Krompecher says. “They're not allowed to have needles. It's impractical. It's not inviting. I don't know how you get around it. I really don't because I don't know all the technicalities. I just know what we're doing isn't.”

Antonio Caffey, the director of Friends of the Homeless, says that many heroin users aren't able to deal with the amount of control they lose by coming into the shelters. Some still make it in, he says, and gestures toward the overdose-reversing Narcan kit by the shelter's front desk. Malcolm Henry, a nurse with Southeast's PATH outreach program, says that some of his clients tell him they stay away from shelter because they're trying to beat their own addictions and heroin is easily accessible there, despite the shelters' best efforts. Kythryn Carr Hurd, the vice president of clinical services with the Alcohol, Drug and Mental Health Board of Franklin County, says the board has heard from the YWCA Family Shelter that many people are coming in with opiate addictions. In December, ADAMH approved a new initiative to fund treatment for addiction at the YWCA through the Heritage of Hannah Neil program.

Mike Hauger takes a seat in the Safe Point conference room. He's a case manager with the PATH program, which provides mental health, addiction and primary care services to the homeless. He's been working for Southeast since 1994. The crack era was rough, he says, and alcohol is a constant scourge. But he's never seen anything as devastating as this heroin epidemic.

Hauger says that putting the homeless directly into permanent housing and then helping them solve their problems—the Housing First model—doesn't always work well for heroin users. “Just because you take a person with a lot of demons off the street doesn't mean the demons won't follow them.”

Three women walk in and sit down at the table. Hauger motions in their direction: You didn't see young girls like this before, he says. A girl in a black sweatshirt dives into a Kroger bag full of food. She turns to Koe-Krompecher. “Do you have any resources for anyone who's pregnant or whatever?”

He asks if it's for her. No—she points over her shoulder at her friend Tasha. Koe-Krompecher tells Tasha he can call the Van Buren women's shelter to let them know she'll be coming, but she'll still have to call the Homeless Hotline to access the system. They make the call and she waits for a representative to answer, eventually nodding off in her seat. She's still on hold about 20 minutes later when her letter is called. According to the letter-assignment sheet, they're at V. In barely two hours, 22 people have walked through the doors. Tasha follows a nurse out of the room with the phone still pressed to her ear, waiting, her eyes nearly closed.

Price of the Streets

While homelessness is on the rise among families, women and youth, there's one other undeniable fact about the homeless—they're disproportionately black. A vast racial disparity was identified by Abt and Associates and the Task Force to Prevent Family Homelessness: 73 percent of families and more than 60 percent of single adults who used the shelters were black, in a county where they make up only 22 percent of the general population. To begin addressing that discrepancy, Columbus joined a multicity project called Supporting Partnerships for Anti-Racist Communities, which aims to form initiatives that will be shared among the cities, including Atlanta, Dallas and San Francisco, by the end of the year.

In the short term, everyone agrees that stemming the tide of evictions is crucial; Heritage says that nearly everyone who comes through the shelters has been evicted. There were 18,441 evictions filed in 2015 in Franklin County; New York City has approximately seven times the population but only 19 percent more evictions, according to a New York Times article. In his work as a policy analyst for county Commissioner Marilyn Brown, Mike Hochron receives calls from people who say they're being evicted and will be out on the streets. For a long time, the best answer he could give them was to call him back afterward, because then resources to help would become available.

“In addition to being the saddest and most infuriating part of my job, it also became abundantly clear that there was something lacking in the way that we responded to people in those situations,” Hochron says. There's growing momentum now for avoiding evictions through funding or interventions.

“Preventing someone's homelessness does so much good for that human being—to be able to keep them in their home, keep their life stabilized,” says Faith Mission's Villilo. The cost of prevention is far less than the cost of responding to their homelessness, she continues.

Columbus City Councilmember Jaiza Page, who was on the task force, issued ordinances in December that made $48,000 available for rental assistance to those in need, typically in the form of $400 to $700 one-time payments. Organizations like the Legal Aid Society of Columbus and Community Mediation Services also provide programs aimed at resolving tenant-landlord disputes.

The issue of evictions points to a broader problem: Columbus has an obstinate affordable housing crisis. As of August 2016, there was a waiting list of 3,240 households for public housing, and 17,000 people in Central Ohio were on the waiting list for Section 8 vouchers, says Roberta Garber, the Columbus Metropolitan Housing Authority's vice president for planning and development. Currently, 54,000 people are paying 50 percent or more of their monthly income toward rent, Garber says—well beyond the 30-percent guideline. Thousands are stretched so thin they're just one bad break from potentially becoming homeless themselves.

Page mentions the possibility of implementing inclusionary zoning, a set of codes or statutes that require developers who receive a subsidy or tax abatement to set aside a certain number of units for below-market-rate rentals. She admits she needs to research the idea more to see if it's workable here, but it finally gets to a core problem: Columbus appears to be in the midst of a housing boom, but very few of the new units are affordable for large swaths of the city's population.

Columbus needs legally mandated, economically integrated housing, Beittel says. Sometimes he drives around the city, awed by everything that's being built. Where are these people coming from, he wonders—what are their jobs? They must be amazing; these places are expensive. “We're pricing people into the street,” he says, “and somehow or other, we have to deal with that.”