This post was originally published in the Voice of OC
Elected officials in Orange County are grasping for a quick, showy solution to their expanding homeless population by calling for more outreach. But without more housing, outreach can’t possibly end homelessness.
With great fanfare, Board of Supervisor Chair Todd Spitzer has ordered county Health Care Agency workers to do more outreach to the growing number of people—many with disabling conditions—who camp out in Civic Center Plaza, a stretch of grass and concrete just steps from the county administration office in Santa Ana.
This approach is disingenuous.
For starters, Orange County doesn’t even have sufficient emergency shelter beds to address the mounting number of individuals forced to sleep on the streets most nights, much less safe, affordable housing. It has only one year-round shelter that provides fewer than 50 beds, and over 2,000 people living on the streets, without any shelter at all, on any given night.
Secondly, an outreach-only approach is based on the dubious belief that the services needed to end homelessness are available but that potential recipients are either unaware the services exist, or reject them because they distrust our fragmented service systems.
Such assumptions, however, are unfounded. Chronically homeless individuals—people with disabilities who experience long or frequent bouts of homelessness—need permanent supportive housing, a model that combines immediate affordable housing with supportive services. Without it they are unlikely to escape homelessness.
Yet existing permanent supportive housing beds in Orange County are filled to capacity, with only enough new beds in the pipeline this year to house about one in five of the nearly 600 persons who are chronically homeless on any given night.
Indeed, nobody is more aware of the regional scarcity of housing for homeless persons than the people who desperately need it, such as Falcon, a 58-year-old woman who is struggling with cancer and Post Traumatic Stress Disorder.
After becoming homeless, she called the referrals for housing and transitional programs on the list that an Orange County outreach worker gave her. Every program she contacted was filled to capacity, put her on a waiting list and never called back, or told her she wasn’t eligible. So she moved into a tent under a noisy freeway overpass in the Santa Ana River bed.
Referral programs also run up against the hard reality of the housing shortage. At a recent forum for Orange County homeless service providers, a representative from a nonprofit mental health organization proudly described the more than 2,000 referrals for various social services provided by the agency’s hotline.
Yet, she admitted that the agency is unable to connect people to housing, given the current shortage. She recounted midnight calls to the hotline from people with mental illness—alone, frightened, and in need of a place to stay—and hotline workers who could do little more than lend a sympathetic ear.
“We run into issues all the time with housing,” she said. “It’s a major issue. What we do is to provide emotional support and encouragement while the person is navigating the maze.”
Of course, linking people to mental health services and benefits is valuable in its own right. But let’s not kid ourselves. Without affordable housing, it won’t end homelessness. According to the National Low Income Housing Coalition, connecting people to Supplemental Security Income benefits, for example—the primary income support for indigent persons with disabilities--provides recipients with enough income to afford $263 in rent. That’s not even close to the actual Fair Market rent of $1,283 a month for a one-bedroom apartment in Orange County.
And health and mental health interventions are far less effective when people are unhoused. Stresses of street life make people sick and exacerbate existing illnesses, interfering with treatment effectiveness and adherence. That’s why the federal government and public health officials view housing as the most vital health intervention for people who are experiencing homelessness.
Officials may think that calling for outreach instead of investing in housing will save public dollars, but such thinking is without merit. Combining housing with services actually costs less than services alone for chronically homeless persons.
This is because people become heavy users of costly public services such as emergency rooms and inpatient hospitalization when they are homeless for long periods. One study found that the typical public cost for chronically homeless persons living in Los Angeles was five times greater than the typical public cost of similar residents in permanent supportive housing.
Like elected officials in Orange County, Los Angeles County supervisors and city council members have called for more outreach in the face of rising homelessness. But unlike Orange County officials, City of Los Angeles leaders have also declared a homeless “state of emergency” and have proposed $100 million to fund housing and other homeless programs.
Meanwhile, Orange County devotes exactly none of its expanding budget to permanent supportive housing for chronically homeless people.
It’s clear that elected officials in Orange County are not rising to the challenge of the homeless crisis in a serious way. They may give the impression that they are committed to ending homelessness when they call for more outreach, but this is an empty promise. They need to throw their political clout behind real solutions, particularly permanent, affordable housing, with supportive services when needed. Only then will outreach end homelessness.
Eve Garrow is homelessness policy analyst and advocate at the ACLU of Southern California.