Doorways

History: Community leaders and representatives from the area's major religious denominations founded DOORWAYS in 1988. Their purpose was to address the growing need for housing for people with HIV/AIDS, especially the very poor and medically indigent.

Population Served: DOORWAYS serves all individuals affected by HIV/AIDS, regardless of race, religion, age, gender, sexual orientation, pregnancy, status as a disabled or Vietnam-era veteran, mental or physical disability. A fundamental concern is for the very poor and underserved, those who are homeless or at imminent risk of becoming homeless. Since 1988, DOORWAYS has served over 3,100 households and currently assists approximately 400 adults and 75 children.

Programs: Housing is healthcare. DOORWAYS programs allow persons living with HIV/AIDS to focus on treating their illness, rather than on homelessness, hunger, and looming financial crises.

-The Supportive Housing Facility provides 36 beds for residents whose HIV-related illnesses require 24-hour nursing, medication, and nutrition care. This facility is the only one of its kind in the region and one of only a few in the nation. In spite of the poor health of clients upon arrival at DOORWAYS Supportive Housing Facility, over 70% become well enough to move to independent housing.

-The Residential Program provides 80 subsidized apartments with supportive services at four sites in St. Louis for low income individuals and families with HIV/AIDS who are capable of independent living but whose financial and health issues limit their ability to pay market-rate rents. Programming includes medication adherence and HIV prevention education, childcare, household management, practices for avoiding infections, and nutrition. DOORWAYS' staff works with local officials to stabilize the children's education. Job readiness training and assistance with job searches are available for those who are able to work. At two buildings dedicated to single mothers and their children, an on-site Learning Center offers computer training and other educational programming to both parents and children.

-The Own Home Program provides over $1 million a year in rent and utility subsidies for individuals and families who are able to remain in their own homes but cannot afford these basic expenses. This program serves more than 600 people each year.

-The Clearinghouse develops cooperative property managers, maintains lists of available rental units, and provides placement assistance and outreach to all HIV-affected individuals and their families. DOORWAYS helps clients find homes and works with landlords to insure housing stability. In addition, DOORWAYS provides central intake and coordination for over 90% of the 400 specifically HIV dedicated beds in the St. Louis EMSA, and works closely with HUD, Shelter Plus Care, the Urban League, the United Way, and the St. Louis Housing Authority to gain housing for people with HIV/AIDS that is funded from non-AIDS specific sources.

The Need: Persons living with AIDS face profound financial, physical, and spiritual challenges. They often lose their jobs, their health insurance, and even their homes. They are unable to access social services, substance abuse treatment, and mental health programs. Homeless people living with HIV/AIDS have no place to keep their medicine, rest, and obtain proper meals, and fresh water. As a result, some physicians refuse to prescribe complicated medication regimens, dooming the homeless to even more rapid progression of the disease.

-Thirty-six percent of all HIV positive individuals in the U.S. have been homeless at some point since their diagnosis, and 50% will need some form of housing assistance during their lifetime.

-In the St. Louis region, which includes the city and six Missouri counties, 4,113 people had been diagnosed with AIDS by the end of 2000.

-African Americans, who comprise 18% of the population of metropolitan St. Louis, accounted for 60% of all new infections in 2000.

-Fifty percent of all new infections are in persons less than 25 years old. The majority of these young people are extremely poor residents of our urban center, and an increasing number are women, including single mothers of young children who may also be HIV-positive.

-According to the federal Centers for Disease Control and Prevention (CDC), African American women between the ages of 15 and 44 are the fastest growing group to contract HIV/AIDS.

The Impact: According to the CHAIN report published by Columbia University's School of Public Health, people living with HIV/AIDS who have secure housing are 4 times more likely to enter and remain in appropriate medical care than those in need of housing, 9.5 times more likely to receive help from social services, 8 times more likely to receive drug therapy, 7.25 times more likely to receive mental health services, and 6.25 times more likely to enter substance abuse programs.

The high tech nursing, infusion therapy, medication adherence program, and nutrition programs provided at DOORWAYS Supportive Housing Facility are estimated to save Medicaid over $1 million per year in reduced emergency room visits and hospitalizations.

Since 1988, DOORWAYS has served more than 3,100 individuals and their families. Today, DOORWAYS receives over 200 new referrals each year and serves approximately 450 individuals and 75 children each month.

Awards: DOORWAYS has received local and nationwide recognition for its demonstrated ability to create, develop, support and manage its projects with skill and success.

-U.S. Department of Housing and Urban Development, Best Practice Award.

-Since its founding, DOORWAYS has won over $17,000,000 in non AIDS specific state and federal funding to provide housing and related resources for people living with HIV/AIDS in the St. Louis EMSA.

-DOORWAYS', President Lynne M. Cooper, D.Min., has served on the Presidential Advisory Council on AIDS, and has received the Administrator's Citation from the Health Care Financing Authority.