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Health, Science, Environment

A St. Louis woman's dream of better housing is lost to illness, crippling bureaucracy

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Bruce Seymour
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Kim Daniel after receiving her Section 8 voucher in the summer of 2021. Actually moving to a better home was trickier than anyone could have predicted.

This story was produced in partnership with the Pulitzer Center. 

The Georgian Apartments, a newly renovated apartment complex near Lafayette Square, promotes itself as welcoming, safe and secure.

Kim Daniel would go much further than that. To her, it is the Promised Land.

After waiting 10 years, Daniel had in hand a Section 8 housing voucher late last summer. It would provide the means for her to move from her increasingly violent surroundings in the Preservation Square neighborhood north of downtown to the safer, more economically and ethnically diverse Lafayette Square neighborhood where the Georgian sits.

She wouldn’t have to wander the desert for 40 years to get there. The Georgian complex is just a 10-minute drive from Preservation Square, nearly a straight shot south down Tucker Boulevard.

But on Nov. 30, Daniel’s journey started to get biblical and not in a good way. Daniel nearly died that day from blood clots in her abdomen, legs and upper left ventricle. She now requires a wheelchair and a walker to get around effectively.

She is now unemployed and, worse, her effort to move to the Georgian remains beyond her grasp. Now going on 75 days and 75 nights, Daniel has faced choices that have added fear and anxiety to her malady. Here are her options:

  • Returning to her Preservation Square apartment, which is unsuitable for people with disabilities.
  • Moving under the provisions of Medicaid to a nursing home that had been cited for 57 deficiencies over the past three years.
  • Crowding in with hard-pressed family members in their homes.
  • Staying at a hotel for as long as she and family members can afford it.
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Kim Daniel
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Daniel took this selfie after awakening from surgery.

Kim Daniel came into this world 55 years ago with a congenital heart disorder, a condition that has taken her to death’s door several times as a child and an adult.

Even so, she had managed to build a life for herself. She raised two sons. She took on jobs that found the sweet spot between what she was physically able to handle while maintaining her health and benefits through federal health care and anti-poverty programs.

At the same time, she became a pillar of her community at Preservation Square, where she has lived since 2003. She has been a surrogate auntie to the little ones, a mentor and tutor for preteens and teenagers and an organizer of holiday events.

But the coming of COVID and a series of other events have taken a toll.

With her fragile health, Daniel resisted taking the vaccine, fearing it would upset her equilibrium. And, frankly, she was skeptical. As is the case with many impoverished African Americans, her treatment by health care providers had been difficult, often insensitive, sometimes incompetent. How could she trust their word concerning a vaccine that had been developed in just months?

At the same time, she accepted the scientific findings that COVID could be more dangerous to her if she became infected. So she masked up and ventured out only as necessary.

Still, she wanted to earn a living. Last summer, she landed a job in the mailroom at the Goodfellow Federal Center. Three days each week, she would drive 10 minutes to the center, put on her mask and go to work. Later she transferred to the mailroom at the Robert A. Young Federal Building, at 1222 Spruce St.

By fall, the work began to exhaust Daniel. “By the time I would get home, I basically would pass out,” she recounted in a Zoom interview. “I would lay down on the sofa and I just didn’t have the strength to keep getting up. That’s what got me into trouble because I was too tired to remember to take my (blood thinner) medication on time.”

Nevertheless Daniel kept reporting for work, even taking on extra shifts for fellow workers during Thanksgiving week.

Street shot of Preservation Square. April, 2020
Wiley Price
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St. Louis American
The Preservation Square neighborhood where Kim Daniel lived for 19 years.

But why?

“I wanted to pay off the loan on my vehicle and then get my credit card paid down,” she said.

Debt grates on Daniel. She has always paid her credit card balance in full. At the same time, she is always searching for ways to put her hard-earned dollars to better use. Her goal has long been to build a nest egg so she could purchase a home of her own. Never did she want to depend on a government program like Section 8.

Even so, the Section 8 voucher presented an immediate opportunity to improve her circumstances. And as the holidays approached, Daniel was filled with hope. After searching for weeks, she found the Georgian with its controlled-access parking, fitness center, indoor-outdoor lounge. One day in early November, the building manager gave Daniel a tour. “I was awestruck,” Daniel recalled.

Even better, the Georgian was just a mile from the Young Federal Building. On a nice day, she imagined, she could walk to work.

After completing the necessary paperwork with the St. Louis Housing Authority and Georgian management, Daniel paid an application and background check fee of $300. The rent overall was $995 a month. The housing voucher would cover $804, and Daniel would pay the balance. She was scheduled to move in Dec. 10.

But then Daniel started feeling poorly. Over a two-week period, she said she had lost 26 pounds mostly attributable to diarrhea.

On Nov. 26, she said she went to work with her calf muscles feeling like Jell-O. “I had signed up to work, and there was no one else to fill that spot,” she said.

On the evening of Nov. 30, “I was having difficulty breathing,” she recalled. “I wanted to stand and could not feel my legs.” She called her son Michael Holman and her niece Cheryl Walker for help.

When Holman and Walker arrived, Daniel tried to get up to let them in. She fell and had to drag herself to the door. Alarmed at her condition, the two persuaded Daniel to let them call an ambulance.

“By midnight I was having emergency surgery,” she said.

Daniel would require another surgery on Dec. 17, then faced weeks of rehabilitation. As she was able, she kept friends and family posted with messages on Facebook, supplying photographs as well.

While her health was improving, prospects for her housing were not.

She would need a larger unit designed for people with disabilities, which would be more costly. The Georgian had such a unit, with features like lower countertops and appliances, and a wheelchair-accessible bathroom.

But the current Housing Authority voucher would not cover it. Surely, given Daniel’s bona fide disability, the amount could be adjusted. Or maybe the Georgian could reduce the asking price for the unit.

No. That was the first answer Daniel got.

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Kim Daniel
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Despite her challenges, Kim Daniel stayed upbeat. Having her sister, Kenvee, with her helped a lot.

Amid all this misfortune, Daniel had the good fortune of having her younger sister Kenvee Daniel arrive in town from Hawaii on Dec. 4. It would be hard to imagine anyone better suited for the task of helpmate and patient advocate than Kenvee. She is an Army veteran trained in logistics, who went on to earn a degree in health administration. Kenvee later worked in a nursing facility and in-home care and now holds a job as a senior veterans benefits adviser for the Veterans Administration. She is also working toward a master's in social work.

“I think all along it’s what God was preparing me to do, to help my sister,” Kenvee said in a Zoom interview in late January.

And when she sized up her sister’s situation, Kenvee had one thought:

“I was pissed!”

Kenvee opened three fronts on behalf of her sister: the hospital and rehab centers that in her view were providing indifferent or incompetent care; the St. Louis Housing Authority that was failing to respond to Kim’s need for an increased housing benefit, and the Georgian management that was requiring Kim to prove that she had the financial wherewithal to cover three times her monthly rent. She enlisted the aid of Niya Foster, fair housing specialist at the Metropolitan St. Louis Equal Housing Opportunity Council. Leaving nothing to chance, Kenvee rallied prayer teams for her sister in Virginia and Hawaii where they have friends and family.

Each day, and often more than once, Kenvee sent emails to administrators politely demanding action or updates on where matters stood with her sister.

Some communications were brief. Some were several hundred words, and a few were much longer. They were assertive, and by turns clinical, lawyerly and passionate. One memo in particular might be considered a classic of the genre — a 2,300-word email to the administration at Barnes-Jewish Hospital seeking a medical ethics consultation. In it, Kenvee cites the hospital’s Patient Rights Policy subsection by subsection and the ways in which caregivers fell short when it came to Kim’s treatment.

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Kim Daniel
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Kenvee Daniel's arrival to help her sister Kim has been crucial to helping Kim maneuver the bureaucracy to get new housing.

“My sister has voiced daily of the pain in her upper left thigh, and no one is LISTENING! She has voiced several times that she can not withstand Tylenol … but it is not noted in her records and they offer it to her constantly…

“I am hoping that someone from the ethics, social service or executive director’s department will pay a personal visit to room 7237 to discuss this email in detail and resolve all concerns stated.”

The next day, Kenvee and Kim received visits from the unit’s head nurses and her surgical team, and they got a phone call from her case management team.

Kim later reported to her Facebook friends that her care was improving. But the prospects for finding a better place to live were starting to go sideways.

The Georgian was willing to knock $100 off the monthly rent for a wheelchair-accessible room. But the management still wanted written assurances that Kim had the wherewithal to cover three times the monthly rent and that she could pay the utilities.

The amount provided under the previous allotment for the voucher wasn’t going to cover all that. Kim needed an increase in her allotment, but whether the Housing Authority could approve it was up in the air.

At that point, Kenvee stepped up to say she would cover the utilities. And that may have been a mistake, as she was later told it would be considered part of Kim’s income. If so, Kim’s Section 8 subsidy would have to be lowered accordingly.

Kim’s income through the Supplemental Security Income program was changing as a result of her no longer working. She would be getting more money, but that increase wouldn’t come so quickly that it could count toward providing the financial assurance necessary for the Georgian. Then, of course, she would no longer have her income from work.

If all this bureaucracy seems hard to follow, that’s because it is.

The compliance issues among the Georgian, the Housing Authority and the Supplemental Security Income program continued to morph all through January and early February while Kim was in pain or struggling through a rigorous rehab at the Rehabilitation Institute of St. Louis in the city’s Central West End.

In the meantime, the clock was running out. She could not stay in her rehab facility forever. The caretakers extended her stay an extra week, but she would have to be released on Jan. 31.

Her caregivers prepared her for the contingencies. If she had to return to the complex in Preservation Square, which does not have elevators, they showed her how she could maneuver out of her wheelchair and put her posterior on a stair step, then hoist herself up step by step. Of course, once Kim managed this and got inside her apartment, how might she be able to respond to an emergency, like a fire?

Her caregivers provided another option. She could be taken to Creve Coeur Manor, a nursing home that accepts qualified Medicaid patients. At age 55, Kim could hardly stand the idea of living in a nursing home. Even so, on Jan. 31, she and Kenvee drove to the facility. Kim was appalled by the exterior, and the two decided not to go inside.

“It looked like the place was falling apart,” Kenvee said.

“A homeless shelter that happens to accept Medicaid,” Kim said.

(Note: ProPublica, an independent, nonprofit newsroom that produces investigative journalism, published a story about the nation’s nursing homes that included information about Creve Coeur Manor. Data from the U.S. Centers for Medicare and Medicaid Services showed Creve Coeur Manor had been cited for 57 deficiencies and penalized with at least $122,000 in fines between 2019 and October 2021.)

Kenvee kept on driving to a hotel in Maryland Heights. They have been sharing a wheelchair-accessible room ever since with Kenvee footing the bill at a rate of $92 a night. Kenvee took an unpaid leave from her job at the VA in Hawaii to care for her sister. She said she stands to lose her position if she doesn’t return by March 1.

Each day, Kenvee sends an email to the Housing Authority asking for an update on Kim’s request for an increase in the value of her voucher so that it would cover the rent at the Georgian.

The good news is that the Housing Authority is willing to increase the amount of the allowance. Georgian management now tells Kim it is willing to rent the wheelchair-accessible unit to her based on additional financial evidence that she has provided. The unit is waiting for her.

The bad news is that the Housing Authority needs approval from the HUD regional office to issue her new voucher. Alana Green, executive director of the Housing Authority, said she had made a personal call to a HUD manager to expedite the request.

The winter weather may have slowed the response from HUD.

But now the snow is melting. Nearly all the roads are clear — just not the one to the Promised Land.

Before Ferguson Beyond Ferguson’s 63106 Project has stayed in touch with Kim Daniel for nearly two years as part of a series of stories about her life in the time of COVID-19. This is the sixth story in the series. Researchers have identified her 63106 ZIP code as the region’s most problematic when it comes to the social determinants of health. Daniel, because of her particular circumstances and even before her current health crisis, appeared to be among the most vulnerable.

Before Ferguson Beyond Ferguson, a nonprofit racial equity project, is telling the story of families in 63106 one by one over the course of the pandemic. St. Louis Public Radio published the first chapter in Daniel’s life on April 28, 2020. You can find an archive of her stories and other family stories at https://beforefergusonbeyondferguson.org/63106-project/

Send questions and comments about this story to feedback@stlpublicradio.org.