Mon, Mar

Homelessness Numbers and the Merry-go-Round from Hell


iAUDIT - I’ve written a few times before about the appalling numbers behind L.A.’s homelessness crisis: billions spent while year-over-year homelessness increases.  Despite the City and County telling us they’re housing more people than ever, the number of people dying on the streets each night increased from five to six.  Inside Safe managers claim people are being sheltered in record numbers, but in fact the program has achieved permanent housing for about one person a day, despite spending more than $40 million.  This seems like a good time to look at some recent numbers, and what they mean for the unhoused population and how local government is responding.

“Homelessness is a Housing Problem”. This is the mantra of the Housing First lobby and its advocates.  Build more housing and the cost will decrease for the housed and unhoused alike.   While there is evidence that loading neighborhoods with high density housing actually increases housing  costs by making land more valuable, the mantra also ignores the inconvenient truth of who the homeless population is. 

The data from the UCSF/Benioff survey of homelessness, which advocates say “proves” homelessness is a housing problem, flatly refutes that mantra. Some of the survey’s key findings include:

  • 82 percent of the respondents reported having some period in their lives when they experienced a serious mental condition; 66 percent reported current mental health problems.
  • Of the 27 percent of respondents who said they’d been hospitalized for mental health reasons, more than half (57 percent) said the hospitalization occurred before they became homeless.
  • 65 percent said they’d had some period in their lives when they regularly used illegal drugs
  • 62 percent said they’d had periods in their lives of heavy drinking.

In other words, more than half of the unhoused cannot live on their own without significant support services. Advocates want us to believe mental illness and substance abuse are the results of, rather than a cause of homelessness. Despite the high rates of mental health issues and histories of substance abuse among the homeless population, the report goes on to say the primary cause of becoming homeless was low income and/or loss of income. A reasonably intelligent person would make the connection between the prevalence of behavioral problems and income loss, and perhaps suggest heavy drinking or other negative behaviors could have a detrimental effect on one’s ability to hold a job. However, the report was written by the head of the Benioff Institute, Margot Kushel, an outspoken advocate of Housing First; the report did not even mention a possible connection between the two, except to say, “Even if the cause of homelessness was multifactorial, participants believed financial support could have prevented it”.  That rather improbable conclusion is actually half-right, at least as far as financial support—more on that later.

Most people accept that substance abuse and mental health issues are medical problems, requiring the proper interventions from medical professionals. To that end, the L.A. County Department of Mental Health provides the Homeless Outreach and Mobile Engagement (HOME) team.  According to the department’s website, the HOME program “provides field-based outreach, engagement, support, and treatment to individuals with severe and persistent mental illness who are experiencing unsheltered homelessness.  Services are provided by addressing basic needs; conducting clinical assessments; providing street psychiatry; and providing linkage to appropriate services (including mental health services, substance abuse treatment, and shelter)”.  By reading this description one would think HOME is a robust program fanning out all over the County, connecting those most in need with the appropriate services.  The real numbers are more disappointing.

According to the HOME program’s website, the team served a total of 2,100 people in 2021.  Again, another set of numbers may help put the number of people served in perspective.  The 2023 RAND survey of homelessness found that 54 percent of respondents had been diagnosed with a mental condition.  The UCSF survey found 66 percent had mental health issues sometime in their lives. The latest LAHSA PIT count (remember LAHSA has been roundly criticized for chronically undercounting homeless numbers) says at least 26 percent of the homeless have mental issues. Let’s ignore LAHSA’s fabulist numbers and for the sake of good faith knock UCSF’s high number off the top.  That leaves RAND’s count of 54 percent. There are at least 75,000 homeless people in L.A. County; 54 percent of that is 40,500. Of the 40,500 homeless people with mental health issues, the HOME team has served 2,100, or 5.1 percent.  Those are hardly impressive numbers.

The budget numbers behind L.A.’s homelessness intervention programs are staggering.  $1.3 billion of L.A.’s City budget is dedicated directly to homelessness, not including the indirect costs of public safety and other departments responding to emergencies.  The County adds another $3 billion.  LAHSA’s budget is just over $800 million, some of which is paid from City and County contributions.  When it’s all added up, we’re spending about $4 billion, or $53,330 for each homeless person in Los Angeles County.  In 2021, the median annual per capita income in L.A. was $39,900; we’re spending 130 percent more per homeless person than many people earn in a year.

An example of the numbers  behind the programs is a recent story in the L.A. Times about a $60 million State of California grant to alleviate homelessness in Skid Row. The grant will be added to an existing $280 million program funded by the City, County, state and federal governments, for a total of $340 million, targeted at 7,300 homeless people in the area. The program is intended to provide shelter, supportive housing, and metal health and substance abuse recovery services to Skid Row’s inhabitants, at a cost of $46,580 per person. We’re told, once again, that a few more million dollars is all it will take to solve this crisis, at least in Skid Row.

One would expect significant benefits for investments of this magnitude. However, as we know, L.A.’s homelessness crisis has only worsened.  LAHSA’s latest PIT count--to the extent it can be believed—shows homelessness increased nine percent throughout the County, and more than 40 percent in some areas. The number of chronically homeless people—those on the streets for a year or more—increased at a higher percentage than the total unhoused population.  This is significant because the chronically homeless include those who most need support services like mental health and substance abuse interventions, and as we know, few are receiving them.  Both the UCSF and a 2023 RAND studies show only about 44 percent of unhoused people have been offered any kind of services; that means 42,000 of the County’s 75,000 homeless have received no services of any kind. So, we know more than half of the unhoused need support services to live on their own, and we know most of them never get those services

Just how poor a job local government has done with its $4 billion in funding is illustrated by comparing L.A. to New York.  A 2023 McKinsey & Company report estimated 49 percent of Los Angeles County’s homeless people are unsheltered—living on the streets or in encampments—or about 52,500 of the County’s 75,000 homeless. That is eight times higher than the unsheltered population in New York.  The report said, despite the billions spent, LA has shelter bed capacity for only about 36 percent of the unhoused.  The report attributes the shortage of shelter beds to the City and County’s emphasis on building expensive and time-consuming permanent housing, at the expense of faster, more economical, and more effective solutions. In terms of human cost, the report said 84 percent of those 52,500 unsheltered people reported negative effects on their physical health caused by living outside.

And that brings up to the last number in this column—zero. That is the level of confidence we can have in the numbers of people the City and County claim to have sheltered or permanently housed.  The City, County, and LAHSA websites claim they have housed tens of thousands of people in the last few years.  However, those numbers have little connection to reality.  For one thing, “housed” is often a matter of semantics, and does not necessarily mean permanently housed and living independently.  “Rapid Rehousing” program like Projects Roomkey and Homekey can be counted as housing someone, but we know residents in these programs often move between their hotel rooms and street encampments so they can engage in behaviors not allowed in housing facilities.  Judging by media reports, citizens’ primary complaints about bridge shelter, Project Roomkey/Homekey hotels and other transitional housing are the tent cities that often proliferate around the facilities. The service provider organizations that manage these facilities claim they cannot be responsible for resident’s activities outside their boundaries, and there seems to be no other public agency able to enforce camping bans around them. Even a zealous opponent of anti-camping ordinances, like Katy Yaroslavsky, admits camping around bridge shelters is a major problem.

Referring back to the UCSF study on homelessness, the report concluded housing loss is primarily a financial problem. Its naïve at best to think substance abuse and untreated mental illness are not primary drivers of homelessness, especially in light of the opiate epidemic. But the report is correct in the sense that relatively inexpensive rent subsidies could keep many working poor out of homelessness. As little as $500 per month could help thousands stay housed.  Yet advocates insist Housing First, with the time and costs associated with its obsession with construction, is the only solution to homelessness, and many people needlessly become and stay unhoused.   

A stunning example of how poorly local governments manage housing programs is the report to the LA City Council on the latest Inside Safe statistics.  At a recent Housing and Homelessness Committee meeting, Council members were told “The nonprofits that serve unhoused people are supposed to log when unhoused people exit the motel room program. But that requirement has not been enforced by LAHSA, which contracts with the providers and manages the data system. The agency’s system allows providers to “bypass” disclosing whether a person has left the program, said Emily Vaughn Henry, LAHSA’s deputy chief information officer”. As Councilmember Bob Blumenfield said, it means the City may be paying for rooms where nobody is living.  The City may not know it’s paying for empty rooms until a City employee—not LAHSA nor its onsite provider—checks.  Such lax oversight has a number of consequences: a person who needs a room may not get one because LAHSA doesn’t know how many vacancies it has; the person who left simply disappeared and may never receive the services he or she needs; and the City is wasting money paying for empty rooms.  Its little wonder Councilmember Monica Rodriguez referred to the program as a “merry-go-round from Hell.”

Perhaps the most heartbreaking number of all is six.  Six people die in the streets of Los Angeles every night because the City and County either cannot or will not use the resources they have available--$4 billion—to alleviate the suffering of our most vulnerable citizens.

(Tim Campbell is a resident of Westchester who spent a career in the public service and managed a municipal performance audit program.  He focuses on outcomes instead of process. Tim is a regular contributor to CityWatchLA.)