For 25 years, the Bailey-Boushay House has provided both inpatient and outpatient support for men and women afflicted with HIV.

The peaked roof of the building has been a beacon of hope at 2720 East Madison Street since the height of the HIV/AIDS epidemic in the mid-1980s.

Now Brian Knowles, executive director of the Bailey-Boushay House, is taking the facility to a next step.

In response to a request for proposals from the city of Seattle to provide services to the homeless, Knowles is hoping to get funding to allow a homeless shelter for HIV-positive individuals in the building.

“An increasing amount of our outpatients are homeless,” he said. “In the 80s, we would have inpatient care for the last months of a patient’s life. We had outpatient care for the last six or seven months. When effective medication for HIV came out, we started seeing a marked difference between haves and have-nots.”

According to Knowles, people with money, a stable family structure or some kind of support were much more likely to stay on medications consistently and survive the diagnosis for years. Those who were homeless were far less likely to follow the medication regimen and thus far more likely to get sicker and die.

Knowles said more than half the patients who have ever died of HIV/AIDS in King County have done so in the facility.

The Bailey-Boushay house treats more than 350 outpatients, and Knowles said more than half of those are homeless or in unstable housing. The Virginia-Mason-owned facility is asking the city for $500,000 to convert the large main room and six smaller rooms to a 50-bed homeless shelter for HIV-positive individuals. The plan is to open the shelter by January 2018.

“We used to open at 8 a.m. every day,” Knowles said. “And when we did we would have a long line outside because homeless shelters would kick them out at 6 a.m. We now open up at 6:30 a.m.”

The Bailey-Boushay House has been a resource not only for HIV treatment, but also for many of the other issues plaguing the homeless.

Knowles’ staff started skills classes to help people learn how to manage money and better take care of themselves.

“Clients who secured housing would quickly lose it,” Knowles said. “After living on the street, carrying what you own on your back, clients wouldn’t throw anything away. They would become hoarders and their places would become health hazards and breeding grounds for rodents and insects. They would be kicked out and back on the street in months.”

For the patients at the facility, homeless shelters were sometimes a daunting prospect.

“Many of our clients were targets for their sexual orientation,” Knowles said. “And because they often had medications, they would be mugged in the hopes there were some prescription drugs.”

Many of the Bailey-Boushay House clients sleep on the streets around the facility, and feel a part of the community. Knowles believes that a shelter will increase that level of civic ownership.

“They are so connected to the Bailey-Boushay,” he said. “Most of the people aren’t wandering very far. They are afraid to go too far away from the house.”

A 12-person volunteer advisory board decided the facility needed to become more involved in housing, and the timing of the city’s request for proposals was a convenient way to take steps toward that.

Knowles said around 40 of the 50 beds will be assigned to specific clients so they can get the full breadth of services to get them into stable housing on a permanent basis. The other 10 beds will be reserved for those undergoing a medical crisis.

The cubicles and beds will be able to break down each morning as the facility opens to make room for treatment in the 3,500 square feet of the ground floor. There are no plans to make any changes to the exterior of the building. Everything will be done in the existing facility, Knowles said. A locker room of sorts is also part of the plan, allowing homeless individuals to have a safe place to store their belongings during the day.

The six smaller rooms will allow the facility to take in women, couples and pets. Many shelters do not accept pets or couples, preventing some homeless from using shelters.

“They want to be a part of community like any of us do,” Knowles said. “We want them to achieve independence.”

The Bailey-Boushay House just received $70,000 from King County (using federal funds) to appoint a chemical dependency counselor to go out and talk to members of the HIV-positive community who might stay away from medical facilities.

“We hope our clients are healthy, but we know that abstinence is a very black-and-white way of looking at things,” Knowles said. “We practice a harm-reduction model.”

Patients staying at the proposed shelter will have access to therapy, classes and other services meant to help them find permanent housing. The clients in the shelter would be people who have been coming to Bailey-Boushay House for months or years and who the facility employees have a relationship with.

Security would continue to be on site 24 hours a day.

Nearby residents are invited to two community forums to express concerns, ask questions and offer support. The open houses are at 4:30 p.m. on Saturday, August 12 and 6 p.m. on Wednesday, August 16.