5 days ago
An Asheville respite supports the unhoused after hospital stays. It is now expanding.
ASHEVILLE - Trokon Guar was finally walking without a wheelchair. He'd come to Haywood Street Respite eight months earlier with a fractured leg. In July, the respite's screened-in porch dimmed the summer heat, an alcove tucked away from the near-constant activity of the downtown church. Guar demonstrated a few calf raises, grinning.
He is a composer and musician. When it comes to genre, he's not picky — R&B, rock, jazz. But he favors spoken word hip hop. In a new music video on his YouTube channel, snippets of footage are filmed in Haywood Street Congregation's sanctuary, backlit by stained glass.
The 12-bed respite offers post-acute, short-term care after hospitalization for people experiencing homelessness. The intervention is intended to give them a place to recover, rather than ending up directly back on the street.
'This place has changed my life," Guar, 34, told the Citizen Times July 17. He has been homeless for years. In-and-out of the hospital. If not for the respite, he said, "I had nowhere else to go."
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Respite expansion underway
The respite is slated for expansion using funding from a $1.6 million grant, awarded by Buncombe County via American Rescue Plan Act dollars in September. The Continuum of Care recommended funding for the program after issuing a request for proposals last year to bolster area shelter beds.
The project will grow the respite to 25 beds, more than doubling its capacity, adding a second-story addition to the building, along with an elevator and 3,300 square feet of new offices, bedrooms and common areas.
Haywood Street Congregation, an urban ministry with the mission, "relationship, above all else," opened the respite in 2014. The brick church sits on the outskirts of downtown. It hosts a midweek Downtown Welcome Table, often a refuge for the city's unhoused.
If the welcome table is the ministry's "hub," respite is its "heart," said Executive Director Laura Kirby.
The city began processing its permit application July 1. Construction on the $1.9 million project is expected to begin construction in late September, Kirby said. It will take about 12 months.
The respite will temporarily relocate residents to allow for uninterrupted operations.
Respite Director Nicole Brown said the expansion will mean, first and foremost, turning less people away. Staff will also have more flexibility to keep people longer, leading to better outcomes for residents.
A stay starts at two weeks, but lasts 45 days on average. Placements are made by referral, with many coming from Mission Hospital and the county's community paramedics.
Those in respite care have a safe place to rest, meals, transportation to follow-up appointments and assistance accessing services and support. In 2022, the National Institute for Medical Respite Care selected Haywood Street's program, along with four others in the country, to receive capacity building assistance to increase the integration of medical respite with behavioral health care.
There is a licensed clinical social worker on staff, as well as an in-house case manager, a peer support specialist, nurses and other 24/7 support.
Asheville faces lack of affordable housing
The goal is to create an exit plan for each person in respite care, like working toward long-term housing or connecting them with a behavioral health provider. It ensures people are added to the by-name list — a standard practice for an area Continuum of Care, with real-time information used to prioritize people to be slated for available housing programs dedicated to those exiting homelessness through coordinated entry. Asheville's list includes 690 people actively engaged with providers, according to Emily Ball, manager with the city's homeless strategy division.
For the respite's first decade of operation, 70% of residents went somewhere other than the streets upon departure, and 87% were newly connected with primary care, with most attending at least the first follow-up appointment, according to Haywood Street figures.
Guar, for example, is awaiting documents he needs to replace his identification and Social Security card before he can take next steps toward housing. He is hopeful for placement in a group home, before eventually moving into his own place. Others are waiting for housing at Vanderbilt Apartments or the housing authority.
As the ministry shifted its model to work with people facing more complex issues — like those with intersecting medical and behavioral health needs — it can be more difficult to exit them into shelter, Brown said. Some shelters also may not be structured to support people in wheelchairs or on oxygen.
'So it might be that they're going outside, but they're going outside hopefully a lot more supported than they were when they came in," Brown said.
Asheville also faces a lack of affordable housing options, Brown said. The city's 2024 Affordable Housing Plan found that 36% of all Asheville households are "cost-burdened," meaning they spend more than 30% of their income on housing costs.
Between 2015 and 2021, median rent increased 33%, from $866 to $1,152, while median wages for workers in Asheville's top industries increased only 15%, the study found. Asheville has among the highest rents in the state.
For this reason Haywood Street embarked on its own housing venture: constructing 41 permanently affordable apartments less than a half-mile from the church, aiming for occupancy by November.
More: Haywood St.'s 41 affordable apartments named for Asheville activist Gloria Howard Free
Community 'changes things'
In the respite's kitchen July 17, hospitality manager Elizabeth Bower, affectionately referred to as the "house mom," was serving up a baked potato bar. She and Brown remembered the earliest days of Haywood Street Congregation's welcome table, back in 2010, making large batches of scrambled eggs in a residential kitchen. They didn't know the color changed when kept warm for too long.
Faced with a pot of green eggs, they just made ham, too, Bower said.
At the kitchen table was Tracy Fowler. He was homeless for about three years before coming to respite.
'I've been able to get the rest I've needed, get off the streets, get regulated on my meds. Become myself again," Fowler, 57, said.
Accepting someone into a community is crucial to respite's mission, Brown said.
"(It) just instantly changes things," she said.
'While the stay in respite might be short, the relationships that you build, and the support we offer, is long term with that connection with Haywood Street.'
John Madden, 78, who prefers to go by "Jaunito," was living in Mexico when he fell ill. Unable to afford a doctor there, he came back to Asheville, where he lived for more than a decade before the pandemic in 2020.
"I came back with no plans but to stay alive, if I could, or find out what was going on,' he said. He's experienced homelessness before — he estimated about 25 days total in the last five years — but the 10 days on the street before securing a spot at respite were brutal.
One night on the street, "and I unravel in a way that is startling," he said.
'This place has been beyond miraculous," Madden said of the respite. "The staff are astonishing. I call them ninjas, because they have to handle every kind of problem, from psychological to housing ... I started to exhale once I got through the door.'
Phillip Lucero, 65, was clear about the emotional and physical toll homelessness takes. He was in shelters for about three years, and on the street "fairly recently."
'This can really happen to anybody. I had a very good job. I had a really good apartment … And it just, piece by piece, fell apart in a matter of months," Lucero said.
'A couple of bad decisions and here I am. And it is extraordinarily difficult to survive."
Places like respite make it possible, he said. They do a good job to make you feel "at home."
He, Madden and Fowler are on various housing waitlists. Lucero said he has been on some of them for years.
'You become a target'
The respite is working to break a cycle people can become trapped in when experiencing homelessness: bouncing from the street, to shelter, to jail, to the hospital and back.
It is complicated by a lack of shelter beds. Further complicated by difficulty finding affordable housing. Sleeping or existing outside while homeless can result in a second-degree trespassing charge, Brown said.
'When you're homeless, you become a target for a lot of people. No one really cares about you," Guar said. You are arrested for disorderly conduct, for trespassing or are kicked out of buildings. It was enough to make him feel like no one "wanted anything to do with me."
'But these people here care," he said of respite. "They've shown me that there is people out there that care. My mentality has changed completely.'
How to get help
Call Haywood Street Respite at 828-301-3782. Learn more about respite referrals at
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Sarah Honosky is the city government reporter for the Asheville Citizen Times, part of the USA TODAY Network. News Tips? Email shonosky@ or message on Twitter at @slhonosky.
This article originally appeared on Asheville Citizen Times: Downtown Asheville's Haywood Street Respite is expanding its beds
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