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iAUDIT! - One of the seminal songs of the classic rock era was the Temptations’ 1970 hit “Ball of Confusion”. The song is an anthem to mid-20th century angst with lyrics that resonate more than 50 years later: “people moving out, people moving in because of the color of their skin”; “the sale of pills at an all-time high”; and “politicians say more taxes will solve everything. “Ball of Confusion” speaks to the paradoxes of the era: a successful moon landing against the backdrop of a fruitless war in Vietnam; strides in civil rights versus the rise of George Wallace and the new Dixiecrats; industrial might and wealth juxtaposed against grinding poverty. As the song says, “and the band plays on…”.
A perfect modern allegory for “Ball of Confusion” could be the swirl of misinformation enveloping the City’s homelessness programs. We’re told homelessness has slightly decreased, but new encampments and derelict RV’s seem to appear every day. We’re told Housing First is effective, but the City’s performance reports show only a few hundred people have been placed in permanent housing, and many of those fall back into homelessness. We’re told Harm Reduction works, but local programs do little more than support addictions by distributing free drug paraphernalia while offering no recovery services. Cities like San Francisco tell us the unhoused must either accept shelter or move along, but shelters are often dangerously mismanaged. We’re told all that’s needed to achieve final victory over homelessness is more money, yet the County hasn’t spent much of its services funding, and the City can’t tell us what was achieved with its funding.
I and other columnists like Christopher LeGras have already described problems with LAHSA’s 2024 PIT count and its claim that homelessness in LA decreased by about two percent. To quickly summarize, the supposed reduction is well within the survey’s margin of error, so there very well could have been an increase. As Angela McGregor describes in her Westside Current column, the PIT count is based on a set of assumptions and omissions that make it, at best, a structured guess. If past is prologue, the 2024 count seriously underestimated the true number of unhoused people in L.A.
In the face of the Supreme Court’s Grants Pass decision and Governor Newsom’s directives to clear encampments on state-owned land, coupled with his threat to withhold funding to ineffective programs, LA’s City and County leadership struck a defiant tone, insisting existing Housing First policies will continue to be used. Anything else, they say, “criminalizes homelessness” and denies the proven success of their programs. And yet there is scant proof of success. As I pointed out in my last column, the City’s program data is meager and conflicting; depending on which report you read, five major City programs have housed no one or as many as 135 people. There is no way to tell which set of reports is correct. The City Controller reports 609 people have been housed under Inside Safe, after an expense of $341.9 million, or $561,400 per person housed. However, a report from a collation of advocacy groups showed that at least 236—more than 38 percent—lost their housing.
As if the housing numbers weren’t confusing enough, a LAHSA report claims 6,111 people entered permanent housing in fiscal year 2023-24 (page 3), but 2,800 (46 percent) of them are in time-limited subsided housing (page 4); as the name implies, people are housed only as long as the subsides last, and may be out on the streets once they expire.
And there is a whole other question about the City’s claims of interim or permanent housing. LAHSA’s report says 8,906 people entered transitional or permanent housing in fiscal year 2023-24. Yet—at most—744 people entered permanent housing via Inside Safe and five major transitional programs (609 from Inside Safe and 135 from other programs). One is left to wonder where the other 8,162 people came from and where they went, but that is a subject for another column.
The claims supporting Harm Reduction programs are as confusing as those surrounding shelter and housing. In a recent All Aspect report, Christopher LeGras details the lack of empirical support and failed management of the County’s Harm Reduction efforts. On multiple occasions, Dr. Barbara Ferrer, Director of County Public Health, has been challenged to provide support for her statements that “study after study” proves the efficacy of Harm Reduction programs. She has yet to provide any news outlet with such proof. LeGras vividly describes the almost complete lack of substance abuse counseling that is supposed to be part of the County’s Harm Reduction effort. As a video from the Santa Monica Coalition shows , providers like Venice Family Clinic do little more than pass out drug paraphernalia, and make no effort to take the small step of collecting old used—and dangerous—needles.
The County can provide no meaningful performance measures for the millions it spends on Harm Reduction. Like the meager numbers on homelessness, the best the County can do is claim a “plateau” of deaths from overdose, due mainly to the widespread availability of Narcan. However, the object of Harm Reduction shouldn’t be responding to overdoses; it should be preventing them in the first place. Despite Ferrer’s unsupported claims of success, overdose continues to be the leading cause of death among the homeless. Deaths from heart failure, which are often caused by long-term drug abuse, run second.
My previous column detailed the deplorable conditions in many homelessness shelters. Apparently, City and County leaders consider these conditions to be perfectly acceptable, since they habitually grant the same under-performing providers contracts to mismanage new shelters.
Perhaps the most confusing thing about homelessness in LA is the swirl of misinformation about funding. Between them, the City and County spend about $4 billion per year on homelessness programs. Less than 10 years ago, the City spent about $100 million on homelessness; now it spends $1.3 billion, fully 10 percent of its entire budget. LAHSA’s budget has increased eightfold since 2016. The County receives more than $400 million per year from Measure H and about $1 billion from the state Mental Health Services Act (MHSA) fund. The City receives $150 million from Measure ULA, and spends more than $470 million from its General Fund for homelessness. And yet we are told that is not enough.
This November, voters will be asked to approve a County measure doubling Measure H’s sales tax from a quarter-cent to a half-cent, and making the increase permanent. Proponents say the funding is needed to make “game-changing” improvements to homelessness programs, like housing, more outreach, and additional support services.
But the County seems incapable or unwilling to spend the money it has now. A December 2023 report from the L.A. Alliance for Human Rights details how the County has historically underspent its dedicated homelessness funding. (Full disclosure, I played a major role creating the report). In 2020, the Sate Auditor found the County was sitting on funds equal to 175 percent of its total fiscal year 2018-19 MHSA allocation, over and above a prudent reserve. The Alliance report also shows only 10 percent of Measure H money goes to the Department of Mental Health, and only four percent is actually spent. As the report states, “Therefore, the burden of providing supportive services and treatment falls to the Department of Mental Health, which was budgeted 10 percent of D7 funding and accounted for only four percent of actual expenditures”. And, as the report shows, the County can provide scant proof its programs have had any effect on reducing homelessness.
The supporters of the new sales tax measure are a collation of corporate nonprofits that already benefit from lax contract management and no expectation of effective performance. They are joined by construction firms and labor unions that will also benefit financially from a perpetual flow of funds to expensive housing projects. Supporters claim there will be strict oversight of the measures’ expense, and regular performance reports for the public to view. However, the funds will flow to the same agencies that have consistently proven incapable of showing how they use current funding, and who have only begun to provide rudimentary performance data because they were forced to by a federal judge. There is no reason to think things will dramatically improve under the new measure, expect perhaps for the bottom line of a few well-connected nonprofits and developers.
In many ways, the current state of homelessness programs in Los Angeles echoes the turmoil and contradictions captured in The Temptations’ "Ball of Confusion." Just as the song highlighted the chaos and conflicting messages of its time, today we find ourselves lost in a similar fog of misinformation and ineffective solutions. Despite the billions spent, the real impact remains elusive, and the promises made often ring hollow. As the band played on in 1970, so too does the cycle of confusion continue in our city’s efforts to address homelessness. As we approach the next election, it’s clear that we must demand more than just playing the same old tune—we must seek real, accountable change.
(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.)
