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Fri, Apr

Inside Safe, LAHSA and More Inconvenient Numbers

LOS ANGELES

iAUDIT! - When I began writing weekly articles for CityWatch back in March, I confess I was a bit concerned I’d run out of subject matter.  My primary subject, homelessness program performance, is a bit of niche, and can be repetitive if nothing changes.  How wrong I was.  It seems the City, County, and LAHSA are always creating new ways to put their failures on display.  News often comes up so fast I develop a backlog of pending articles. The past couple of weeks have created yet another traffic jam in my flow of articles.

Let’s work backwards from Sunday, December 10, when L.A. Times columnist Erika Smith wrote an article about Mayor Bass’ latest pronouncements concerning shelters and housing. The article’s premise—that success in mitigating homelessness is a matter of perception rather than reality—is inherently nonsensical.  Homelessness programs are either working or they are not. If perception was all that matters, then performance measures would be unnecessary and meaningless.  Facts are the only response to perceptions, either positive or negative.

The article touts Mayor Bass’ claim that more than 21,000 people have been sheltered or housed since she took office. To support that claim, Ms. Smith talked to all the right people: Bass's staff, LAHSA's CEO, the UCSF professor who did the 2023 homeless survey, and the head of LA Family Housing, manager of North Hollywood’s notorious shelter.  What she didn't do was talk to a statistics professional or a critic of Housing First. She didn't mention a story in her own paper a few days before that quoted the City Controller’s Office as saying LAHSA has no clue how many people are in Inside Safe or other shelters, so the "21,000" housed could be the same 100 people cycling through shelters 210 times.  She didn't write about the $67 million spent by Inside Safe to permanently house 255 people.  The article is nothing more than an advertisement to justify everything wrong with homelessness programs: pumping more money into Housing First and building massive developments all over the city.

In the article, Smith writes, "Numbers are tricky."  No they are not. Numbers can be inconvenient things.  They don’t care what you believe or want to be true.  They don’t care if you try to spin them into saying something they don’t.  In mathematics, there is only one correct answer to any problem.  Two plus two is always four because it cannot be anything else. Even the twisted politics of homelessness cannot change numbers.

To fully understand numbers requires context.  Consider the Mayor’s statement about housing (or sheltering) more than 21,000 people.  Add some context; a December 7, 2023 LA Times article mentions that same number, but then adds, “…about 7,100 people went back to the street, were reunited with family, went into medical facilities, were incarcerated, died or disappeared from the system, according to figures provided by LAHSA, the Los Angeles Homeless Services Authority”. So about one-third of those “sheltered” left or simply disappeared. In addition,  a December 6 Times article describes the laughable job LAHSA does tracking use of shelter beds.  “Poor and unreliable data collection by the Los Angeles Homeless Services Authority makes it ‘nearly impossible’ for unhoused people and the city to know how many interim beds are available and how many are being used at any given time”. Therefore, the 21,000 number is highly suspect.  In reality, LAHSA has no idea how many people are in shelters at a given time.  Its computerized system for tracking shelter bed usage is so cumbersome and inaccurate, City employees resort to calling individual shelters looking for beds.  Combine that with LAHSA’s claim it has housed more than 22,000 people in 2022, but notes an unknown number of those are repeat housing actions. (LAHSA 2023 PIT count report, slide 31). The PIT count itself is often called into question, with some advocacy organizations saying LAHSA undercounts the homeless population by as much as half—making the real homeless number closer to 150,000 than LAHSA’s estimate of 75,000. Taken together, these statistics paint a picture of a system that has no idea of the population it serves, how many it shelters our houses, how long they stay sheltered, and what happens to them when they exit the system.  And yet agencies insist they need more funding and more building.

Inside Safe, Mayor Bass’ showcase effort for moving people from the street to interim housing, has underperformed financially and programmatically. To date, $67 million has been spent on the program, yet only 255 people have been permanently housed; and as we know, even those appallingly low numbers are suspect.  Assuming the numbers are correct, that comes out to more than $262,000 per person housed; how long they stay housed and what their quality of life is while housed is another question.

Besides shelter and housing, local government doesn’t know how many people receive needed support services like addiction recovery and mental health interventions.  County agencies report inconsistent numbers and chronically underspend funds meant to provide services.  In 2020, the California State Auditor issued a report on L.A. County’s use of Mental Health Services Act (MHSA) funds and found several problems, including a lack of coordination among various programs, resulting in clients falling out of the program with no follow-up. The auditor’s report stated, “Los Angeles’s staff acknowledged the weaknesses in the county’s system for coordinating continued care with medical facilities, stating that in some cases the county is only aware of individuals being discharged from short‑term holds if the treatment facilities holding them decide to notify it”. 

The County Department of Mental Health is the lead agency providing services to the unhoused, through its Homeless Outreach and Mobile Engagement (HOME) team. On the HOME program webpage, DMH states 26 percent of LA County’s unhoused suffer from undiagnosed mental illness. According to LAHSA’s 2023 PIT count, of the approximately 75,000 homeless, 73 percent, (55,155) are unsheltered; using LAHSA’s estimate, there are 36,402 unhoused people in L.A. County with mental health issues. The HOME webpage claims, “In 2021, HOME has helped over 2,100 clients and provided over 19,000 client-days of community outreach, mental health and medication support, crisis intervention, and targeted case management services.” In other words, the HOME team assisted just over six percent of the mentally ill people on L.A.’s streets.  And there is no explanation of what a “client day” is or how it measures performance.

Between fiscal years 2019-2020 and 2023-2024, the County has spent only an average of 46 percent of its MHSA revenue’, leaving about $236 million per year unspent. The County is sitting on large reserves of mental health and substance abuse funding while thousands of people suffer on the streets. Among the unhoused, the number of deaths due to overdose continues to climb while the County underfunds its intervention programs. As a result, overdose has become the leading cause of death among the unhoused.  

Unsurprisingly, Ms. Smith, Mayor Bass, and other leaders of the current homelessness structure brag about the numbers that suit their agendas, using them to justify following the same path to failure they’ve followed for decades.  In a neat display of mental gymnastics, both Ms. Smith’s and the December 6th article state that although the programs are working, homelessness will likely increase in the 2024 PIT count. They claim, as does Mayor Bass, that expiring eviction protections and the dearth of affordable housing will drive the increase.  They are already making excuses for failure, even after more than three decades of supporting Housing First and plowing billions into expensive construction projects.

The real numbers, hard and unrelenting, tell a far different story than the Mayor or LAHSA. At least 75,000 homeless people live among us, 55,000 of whom are unsheltered.  Anywhere from one-half to two-thirds suffer from serious mental health and/or substance abuse problems.  Six die on the streets every night and an unknown number die alone from overdose in spartan hotel rooms cruelly mislabeled as “housing”. Thousands wander the streets tormented by unseen demons or desperate to escape reality with another dose of fentanyl. According to the LAFD, more than half of all fires are started by the unhoused.  Homeless people, especially women, fall victim to personal crimes at rates far higher than the housed population.  And each year, their numbers grow, even as government agency and nonprofit budgets balloon.

Numbers never lie, but politicians and self-serving advocates do.  The lie to fool themselves into thinking their failures are successes.  They lie to make the public think they are making progress when they are falling behind from one year to the next.  Worst of all, they lie to continue a flow of revenue for programs they know to be ineffective, unaffected by the human destruction caused by their intransigence.

(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.)