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iAUDIT! - Last year, I wrote about the hellish conditions in many local homeless shelters. Unsanitary facilities, assaults, property crime, and a lack of support services are common throughout the shelter system. In August 2025, independent reporter Sam Quniones detailed the dangerous conditions at a shelter in Los Feliz, where the chaos culminated in the murder of a shelter resident. More recently, in November, LA Public Press published an investigative article on complaints about the conditions in many of the city’s tiny home villages. Hoarding, drug abuse, and physical violence were common themes in incident reports filed by residents and village staff. Tying these stories together are the findings from a review by Alvarez & Marsal (A&M) that found the City and LAHSA paid providers regardless of performance. Among the problems A&M found were providers billed for unverified staff time at some shelters and charged for three meals per day while serving only two.
A lack of adequate facilities and support services is not unique to Los Angeles. For the past few months, CalMatters has been running a series of reports on the state’s CARE court system. Touted as a way to get people with the most serious mental illness off the streets, it has underperformed over its two-year implementation. One of the biggest problems is that only about one-third of the petitions filed for acceptance were made on behalf of the unhoused. The rest came primarily from family members who lacked other resources to obtain care. In Los Angeles County, home to at least 75,000 homeless people, about half of whom may have some kind of mental health problem, only 511 CARE court petitions have been filed, and 270 (52.8%) have been dismissed. Only 106 (20.7%) have progressed to the agreement stage (where the client, court, and providers agree to a recovery plan), and only six (1.1%) have had CARE plan imposed by a court. Despite its imposing title, participating in CARE Court is voluntary, and a client can leave at any time, which they often do. A family member described the futility of trying to get someone who needs help to agree to it, “You have to be at your worst for them to help. It kind of makes no sense. They expect you to be at your worst to be accepted. At the same time, they expect autonomy from patients to make their own decisions when they’re at their worst.”
The CARE Court’s problems can be attributed to several causes. It was, and continues to be, opposed by many advocacy groups, including the ACLU, who argued it was denying “personal agency” to the mentally ill by wresting away control over treatment decisions. Advocates raised the specter of pre-1970’s California, when family members sometimes had relatives committed to state institutions on the flimsiest of grounds, usually as a way to gain access to the relative’s assets. The CARE legislation was watered down to make the program voluntary and to make it more difficult for family members to force relatives into a treatment plan. Eligibility is limited to only those with schizophrenia and other psychotic disorders, excluding those who may benefit from treatment before they have a full-blown crisis. Counties, some of which (including Los Angeles) delayed implementing the system until the deadline of December 2024, have been slow to enroll people in their programs, either due to a lack of resources or because fewer petitions than expected have been filed. Due to the complicated eligibility criteria and the program’s voluntary nature, a statewide average of 45 percent of all petitions are dismissed without the client completing the program. Although there is a provision for court-ordered treatment, only 14 mandatory treatment plans have been implemented statewide in almost two years. Like many homeless programs, the CARE Court was advertised as a path to success when in fact it is so flawed and contains so many loopholes, it has been rendered virtually ineffective.
LA County, in particular, has a track record of failure when it comes to helping the unhoused who have mental health needs. As I described in an October 2023 column, the County’s Department of Mental Health has a history of underusing its funds and not tracking its programs’ performance. A survey of Inside Safe clients showed 75 percent never received mental health services, and only seven percent received drug treatment, despite the high incidence of mental illness and substance abuse among the unhoused. The survey’s results are consistent with the findings of a review of County services from the LA Alliance for Human Rights that showed the County chronically underserves unhoused people in need of mental health or substance abuse services. (I helped write that report). The disconnect between what the County should be doing and what little it actually does can best be summarized in the report’s section on MHSA funding. While the Director of the Department of Mental Health was decrying the state directing MHSA money to new mental health facilities, budget documents showed the County consistently underspent its funding, to the degree the State Auditor found it was sitting on 175 percent of its MHSA budget in its uncommitted fund balance.
In light of the inhumane conditions in many shelters and the failure of the CARE Court system, everyone from Governor Newsom to local Council members should be taking “bold action” (one of their favorite catchphrases) to improve and reform those programs. Yet the common reaction seems to be one of denial and indifference. According to CalMatters, state officials say the CARE Court needs more time to achieve its goals. Already some counties are doing an “incredible job,” said Stephanie Welch, deputy secretary of behavioral health for the state Health and Human Services Agency. Elana Ross from the Governor’s Office told CalMatters the administration is pleased with what the program has accomplished so far. “Thanks to the CARE Act, thousands of people are engaging in critical behavioral health treatment through stabilizing medications, community-based care, and — if needed — housing,” she said in an emailed statement.
Locally, news about the terrible conditions in shelters has been met with a collective shrug, and a circling-the-wagons mentality to defend the city’s large corporate nonprofit service providers. When reporter Sam Quinones asked Councilmember Raman’s staff about conditions in the Los Feliz shelter, he received mostly stock answers, such as “While our office continuously strives for better management and outcomes at the shelter, what we have seen across the district is that crime goes down when you can shelter and house people who are living in tents and encampments” and “Ambassadors, trained in trauma-informed care, work alongside other outreach teams including LAHSA, CIRCLE, and Healthcare in Action to ensure a positive community environment both in ABH Riverside and the surrounding area through a combination of outreach, support events, and community engagement.” Local residents beg to differ. Interviewees told Quinones that Raman has refused to order a special enforcement zone around the shelter to curtail drug trafficking and violent behavior. Raman ignored most of the recommendations for improvement included in a 2023 128-page citizens committee report, which requested improved security and service provision. As Quinones reported, she did manage to find funds for a no-bid contract with SELAH, a nonprofit she co-founded, to provide food, water and burn care, but not security services.
As for LAHSA, it is still reeling from the fallout of a November 2024 County audit that found it paid providers with little or no proof of performance. We could hardly expect LAHSA’s Commission nor the County Board of Supervisors to demand reform when both bodies have created the environment that fostered the current dysfunctional system.
The key to understanding how leaders can ignore--or support--such an inhumane system is to realize this is the system they created and now must defend to maintain the narrative they’ve invented. As I wrote in October, maintaining and protecting the narrative is one of the most important goals of current homelessness policy. That narrative includes the myth of comprehensive and compassionate services for those in the throes of mental illness or addiction. Admitting shelters are mismanaged or CARE courts aren’t successful means admitting the philosophy behind the system is broken. Leaders have created a narrative that says all of these programs would work if they just had a few more millions of dollars or if community members were more open-minded. Nearly every official interviewed in the articles I linked claimed funding shortages were to blame for the failure to fully implement the CARE Court or to properly manage shelters. In their world, the system doesn’t need reform; it just needs a few tweaks here and there, and even more commitment to keep doing the same things. Human suffering is incidental to the narrative, something to be ignored, denied, or excused away. As long as these leaders are allowed to continue to protect the narrative, people will suffer and die on our streets and in shelters.
(Tim Campbell is a longtime Westchester resident and veteran public servant who spent his career managing a municipal performance audit program. Drawing on decades of experience in government accountability, he brings a results-driven approach to civic oversight. In his iAUDIT! column for CityWatchLA, Campbell emphasizes outcomes over bureaucratic process, offering readers clear-eyed analyses of how local programs perform—and where they fall short. His work advocates for greater transparency, efficiency, and effectiveness in Los Angeles government.)
