According to the report, 1 in 5 people who enrolled in state-funded homelessness programs were considered “chronically homeless” — unsheltered for at least a year while living with a complicating health issue.  But more than three times as many – two-thirds of all who sought state-funded services for homelessness — were people who hadn’t popped up in the system for at least two years, if ever.  These might be families evicted and temporarily residing in a car, someone couch surfing while gathering the money for a rental deposit, or people who got their own apartment only to get slammed with an unexpected car payment and find themselves back in a shelter.

Drawing on the most recent “point-in-time” survey, which provides a blurry snapshot of how many people are living outside on a given night, the report emphasizes the stark racial and ethnic disparities that exist across the state’s unsheltered population. Black people made up roughly 30% of the people counted on the street, more than five times their share of the state population. Indigenous Californians likewise were overrepresented five-fold. And though Latino Californians were underrepresented, between 2015 and 2020, their numbers in surveys of the unsheltered increased by 65%, the fastest growing ethnic or racial group.

The report tracked more than half a million Californians who, over the three year period, made use of at least one of the services that the state funds, as recorded in a new state database. The good news: More than 40% ended up in housing — supportive, subsidized or otherwise. The bad news: The majority didn’t, or the state lost track of their whereabouts.

Between 2018 and 2021, the state spent $9.6 billion trying to move the needle on homelessness.  Many Californians will be able to relate: The bulk of the spending, $5.5 billion in this case, went to the cost of housing. That includes everything from building new units to preserving old ones, converting unused hotel rooms during the pandemic into temporary housing, building shelters, and setting up permanent supportive housing facilities that provide a long-term subsidized place to stay along with other on-site social services. According to the report, the state produced or kept online 58,714 affordable housing units in the three year period, and added 17,000 new shelter beds.

The answer to those questions, according to the report: The state has spent nearly $10 billion and provided services to more than 571,000 people, each year helping more people than the last.  And despite all that, at the end of year three, the majority of those more than half a million Californians still didn’t end up with a roof over their heads. The number of unsheltered Californians continues to swell.

Housing development Streamline and expedite the approval process for new housing projects. Simplify funding applications for affordable housing projects. Expand permissible residential development on commercial property (Metcalf et al. 2021). Expand the use of CEQA exemptions. Amend CEQA to eliminate the automatic right of appeal for meritless cases and to prevent ambushes in which claimants raise issues too late (Kolkey 2019). Shelters, interim housing, and alternative housing options Expand shelter capacity, including congregate and non-congregate shelters. Improve the quality and safety of congregate shelters and eliminate unnecessary rules such as restrictions on pets. When there are shelter spaces, the “right-to-shelter” should be enforced. Other rules such as no public defecation and public urination should be enforced to address the quality-of-life issues. Increase the development of innovative, cost-effective housing, such as tiny homes and modular homes. Promote shared-housing and consider reducing the implicit tax on housing sharing  (He, O’Flaherty, and Rosenheck 2010; Ellen and O’Flaherty 2007). Permanent supportive housing Conduct in-depth research on the long-term outcomes of permanent supportive housing (PSH), to understand the effects of PSH on labor force participation, drug use, and psychiatric symptoms. County governments conduct site inspections on whether the PSHs have a sufficient staff-to-client ratio and whether homeless clients living in PSHs can receive timely, adequate treatments for their mental illness and drug addiction. Mental health treatment Increase psychiatric beds at the acute, sub-acute, and community residential levels (to prevent mental health patients being released prematurely). Lower the barriers for the homeless with a mental illness to seek treatment (e.g., shorten the wait time for intakes to accommodate the needs of mental health patients). CARE (Community Assistance, Recovery & Empowerment) Court, a new framework that’s still unfolding, has the potential to provide useful tools to help those with severe mental health and substance abuse problems. For individuals lacking insight into their illness or unable to access community treatment voluntarily, Laura’s Law should be invoked to compel them to receive treatment detailed in the assisted outpatient treatment (AOT) order. Use Lanterman-Petris-Short (LPS) conservatorships for adults with serious mental health illness and gravely disabled (i.e., cannot take care of basic, personal needs for food, clothing, or shelter). Drug addiction Build the infrastructure for addiction treatment inside hospitals to broaden the access to addiction treatment. Lower the barriers for homeless drug addicts to seek treatments (e.g., not requiring phone calls to be the first step of enrollment since many homeless have no easy access to phones). Increase the number of treatment facilities that accept Medi-Cal, which covers most homeless persons. Increase the number of treatment facilities with detox beds and residential care to reduce wait time and achieve “treatment on demand.” Make appropriate use of drug courts to incentivize people into receiving and completing addiction treatments. Improve accountability by enforcing the law on petty crimes, which are used by some homeless persons to sustain drug use habits. Jialu Streeter a Research Scholar and the Director of Partnerships at the SIEPR. Her research primarily focuses on the economics of aging, retirement security, and financial security and mental wellbeing of older adults.

Building permanent supportive housing was embraced with similar enthusiasm in Southern California. In 2016, Los Angeles voters approved Prop. HHH, which authorized city officials to issue up to $1.2 billion in bonds to reduce homelessness by developing and remodeling permanent supportive housing. According to a report by the L.A. Controller Ron Galperin, five years after the passing of the proposition, only 14 percent of promised projects had been completed, a total of 1,142 units. Development costs were high and continued to rise. In 2021, the average per-unit cost was almost $600,000. Some units are extremely expensive. Fourteen percent of the units exceeded $700,000, and at least one project is estimated to cost nearly $837,000 per unit.

Drug addiction and mental illness are consistent risk factors for homelessness (Tsai and Rosenheck 2015; Thompson et al. 2013; Yamamoto et al. 2019). Substance use can be both a cause and a result of homelessness (Johnson and Chamberlain 2008).

About 70 percent of the homeless in California are unsheltered, more than in any other state. A primary reason for the sizable unsheltered population is the low stock of emergency shelters and transitional housing. Between 2007 and 2020, while the total homeless population increased in California, the shelter capacity remained flat for a decade before rising again after 2017, and the bed counts at transitional housing facilities had a continuous decline.

Another challenge lies in the interactions between mental illness, drug addiction, and homelessness.  In 2020, about 25 percent of all homeless adults in Los Angeles County had severe mental illnesses such as a psychotic disorder and schizophrenia and 27 percent had a long-term substance use disorder. Moreover, a higher percentage of so-called chronically homeless1 have drug addiction, a severe mental illness, or both.