Several hundred people gathered at USC's Town and Gown building April 17 for a summit conference on homelessness. They heard more than twenty speakers in four panels from Los Angeles city and county government and a wide range of leaders of homeless agencies and programs, as well as university faculty members. The presentations ranged from academic studies to workers in the trenches who deal with the homeless and their problems on a daily basis. Following are highlights of the conference.
- Mark Ridley-Thomas at USC Homeless Summit
The summit opened with County Supervisor for the Second District, Mark Ridley-Thomas. He said his agency has seen homelessness as its top priority for several years, and that the county has set aside $100 million in new one-time funding over the next two years. "But one-time funding won't do it. We have to find a regular annual funding stream if we are to succeed."
USC President Max Nikias. "There is a moral imperative to help those in our community who are struggling just to survive." The homeless, he added, are not of one type. They include the elderly, the disabled, veterans, mentally ill, youth emerging from foster care, the poor who have lost their jobs, the formerly incarcerated, and young families who have lost their homes. "Homelessness," he insisted, "is the defining issue in the county of Los Angeles. Instead of averting our eyes from the crisis we must see it. If we don't act now the problem will worsen. We will have more to contend with than we can possibly handle."
The solution, he said, is creating affordable housing with supportive services. President Nikias highlighted a unique contribution USC has made to this effort: "Our engineering department has developed a technology that can build a whole house, including electricity and plumbing, in 24 hours."
Curren Price, City Council member for District 9, told the audience, "We have failed the homeless. We have failed to provide adequate housing, health care, jobs, and services. We have a duty to address not only homelessness, but why people become homeless." He added that there are 400 units of affordable housing in the pipeline in the 9th. "But we are going to lose about 10,000 units of affordable housing in the coming years." He said his office is working closely with the Los Angeles Homeless Services Authority (LAHSA) and the Homeless Outreach Program/Integrated Care System (HOPICS).
Elise Buik, CEO of United Way Los Angeles. "People who are permanently housed, with the services that they need, can lead a thriving life that is 40% cheaper than having them go through the devastating experience of our jails and our emergency rooms. This is an issue that requires investment. We are going to see a serious reduction in the number of homeless because of an increase in investment."
She added that recent polls indicate that there is a reasonable chance that voters will approve a new tax or bond, as they rate the homeless problem as a major issue. An obstacle, she said, even if the funding goes through, is opposition by residents to having any homeless living or using storage facilities in their neighborhoods. "We need to rally people to oppose NIMBYism."
Panel 1: An End to Homelessness in Los Angeles
Phil Ansell, Executive Director, Los Angeles County Homeless Initiative. "The vast majority of money spent is not on homeless services. It is in hospitals and jails. The current system is fragmented, with services coming from many separate agencies, while there is a client population who have difficulty navigating such a system. This is a serious problem."
Most homeless people have the ability to increase their income, either through employment or applying for federal benefits. As far as this can be done, many homeless people can pay a share of their own housing. Services are better than jail unless incarceration is absolutely required.
Ansell then presented an overview of what needs to be done to end homelessness and the difficulties in raising the funding to fulfill these goals:
- Identifying families heading toward losing their homes and supplying them with rent subsidies.
- Subsidizing housing for those already homeless.
- Increasing homeless people's income by finding them jobs or helping them apply for disability income.
- Jail in-reach, to try to match up soon-to-be released inmates with jobs and housing.
- Providing case management services.
- Coordinating existing county and city agencies' homeless work.
- Investing in permanent affordable housing for the homeless.
Carrying out any of this depends on funding. The city spent $100 million on the homeless in 2014, 87% for police interventions and emergency room hospitalization. In the 2015-2016 fiscal year it was only $38 million, but this was more directed at short- and long-term housing. In contrast, six LA County departments for 2014-2015 spent a staggering $965 million on the homeless; 40% of that went to just 5% of the homeless. These are people with chronic medical conditions or forms of mental illness that send them repeatedly to high-cost emergency room care. The panel urged that this high-cost 5% be prioritized for housing, as this would free up considerable money for other aspects of homelessness.
Potential sources of funding include a 1/2 cent increase in the sales tax, a 1/2% increase in city taxes on incomes over $1 million, a parcel tax, or a marijuana tax. Another source would be redirection of the income from 2002's Measure B, which placed a tax on structural improvements to fund trauma centers and emergency medical services. In the 2011-2012 fiscal year Measure B generated $256 million.
Peter Lynn, Executive Director of the joint city-county Los Angeles Homeless Services Authority. L.A. County, with 44,000 homeless, has 8% of the national total of 565,000. "New York has more, but ours is largely an unsheltered population." He said that poverty and high housing costs are key generators of homelessness. Nationally, 24% of Americans live in poverty. If you go by income alone that is true of Los Angeles also, "but if indexed to costs of housing, our poverty is 37%." He said there is a shortage of 527,000 housing units in the city and county.
"We are the inverse of the national profile on sheltered vs. unsheltered. Most are sheltered elsewhere, while here it is the opposite: people are living on the streets in encampments; 70% are unsheltered." The one bright spot has been the concentration on housing homeless veterans, who make up 10% of the homeless population. These numbers are the only ones that have been going down instead of up, due to investment in finding them housing.
Of the 30% who are long-term chronically homeless, Lynn said, "most have some kind of disabling condition: mental health, substance abuse, domestic violence, physical disability. Within the city this disproportionally affects the African American community."
Panel 2: Homelessness and Supportive Services
Peggy Edwards, Executive Director, United Homeless Healthcare Partners.
There are three areas that are beginning to succeed:
- Workforce development.
- Reentry from incarceration.
- Helping people get an income to support themselves.
Workforce: "We need to focus not just on housing but on retention of housing. This is the most critical part and the hardest. Formerly homeless people need training on how to get and hold a job, and how to maintain their living space. We have a ten-month program: three weeks online followed by one-day in-person training."
Reentry services: "Reentry from jail is a public health issue, not a criminal justice system issue. What is needed are housing, legal services, mental health services." Roughly 20% of people exiting prison and jail have nowhere to go and directly become homeless. The major reform of the state prison system in the 2011 AB109 law redirects thousands of nonviolent felony convictions to county jails instead of prison, and some to the equivalent of parole. The law is funded to about $1.4 billion a year from a portion of sales taxes and vehicle license fees. At present, however, 80% of these funds go to incarceration and only 20% to services.
Getting the homeless an income: SSI and SSDI income frees up funding for other people. About 13% of those who are homeless are on Social Security. Large numbers of people who are qualified aren't signed up, but we are not doing much about it now. Many of those eligible don't have state IDs, medical or work records, so they need skilled help to get through the application process. "In a pilot program that ended in 2013 those we helped to prepare their applications had a 90% approval rate."
Nancy Gutierrez, Public Services Coordinator, Los Angeles Unified School District. "How does homelessness affect the school system? We think of a single person on the street, not of children or even babies. There are a lot of children involved in homelessness. A lot of students do not come to class because of homelessness. They are focused on survival needs, may lack transportation, access to health care, or school supplies. 9,500 homeless students have been currently identified in LAUSD boundaries. We have a staff of 20 for our organization to locate these students and verify their status."
Children in homeless families are commonly transient. They often have to change schools. Many lack school supplies, acceptable clothing, or a place to study. Some are ill from lack of medical care. They are twice as likely as their housed peers to do poorly on reading and math tests, three times as likely to be put in special education classes, four times as likely to drop out, and eight to nine times as likely to have to repeat grades.
"Every school district is charged with providing assistance to homeless children and their families. We must first identify them. Most won't tell their teachers or schoolmates that they are homeless."
Much of the funding for the homeless comes from the federal Housing and Urban Development Department (HUD). To meet HUD's definition of being homeless you must literally be on the street, living in a vehicle, or in a shelter. Many homeless families with schoolchildren don't meet this criterion. They stay briefly with friends or relatives, sleeping on couches, and have to move often. "A large percent of the families LAUSD serves are in this precarious housing situation. Such families may not qualify for certain services."
Eric Rice, USC School of Social Work. "1.7 million young people between the ages of 13 and 24 have at least one night of homelessness each year. There are 6,150 unaccompanied homeless youth in Los Angeles on any given night. Most homeless youth are from Los Angeles or Southern California ‰ÛÒ 55%. The total from somewhere in California is 62%. They are not runaways from other states, as is commonly believed."
Sexual orientation is a major cause of youth homelessness. LGBT youth are often thrown out of their homes by family.
Others are from the foster care system. "But it is wrong to put the whole focus for the 18-24 year-old homeless kids timed out of the foster system; 60% are not from the foster care system, so focus only the foster system will not work."
A fifth of the homeless youths have had children. "7% in Hollywood are actively parenting a child."
Permanent supportive housing is a great way to support such youth, he said. "Here there is always competition for inadequate resources. It is understandable that priority is given to the most ill and expensive homeless, but that does not touch TAY youth [transitional age youth]. Their health may be impaired by living on the streets but they are young and generally healthy and do not often seek medical care."
It is best to get youth off the streets in the first 3-6 months. "It becomes harder later as they get socialized into that life. Many say they would like to have a roommate, but putting lots of homeless youth together leads to training for antisocial behavior. They are afraid of adult shelters for fear of being victimized by adults."
Marc Trotz, Director, Housing for Health, LA County Department of Health Services. The County has recently merged the Department of Health Services with two other agencies. The new entity is called The Health Agency.
"We are in the middle of a humanitarian crisis. It is time for action more than for more studies. Three things need to be done: street engagement with the homeless, immediate exit off the streets, and housing. There are three hot spots for the homeless: Skid Row, Hollywood, and Venice.
"Many of the existing shelters are only open during the night, especially the ones in Skid Row." There is only enough permanent supportive housing to supply a small portion of the county's 44,000 homeless. Shorter term temporary and transitional housing is better than nothing. It is hard to make progress with someone when they are on the street.
"The goal is to find housing with support services. In the final analysis this requires a rent subsidy. If someone has SSI it is $900 a month. The average studio costs $1000 to $1100 a month. Many have no income. The best known subsidy is the federal Section 8 rent subsidy. There are also local subsidies. Commonly what is needed is a subsidy of $800 a month, a reasonable cost to save a young person."
It is most important to get homeless people off the streets. Short-term shelters, whatever immediate benefit they confer, have little long-term effect. "Best is a small apartment, say, 300 square feet. But we don't want to just warehouse homeless individuals in places no one else would want to live in."
Question from the audience: "How do we know that if we save money by housing the homeless, that money will go back to serve the homeless, or does it mean that what is spent on the homeless is just new money and the saving is invisible elsewhere. Isn't it the case that when we invest in something that saves money we are not closing a wing of a hospital that is no longer needed?"
Panel members responded that unfortunately, this is true. The savings is from a diffuse number of places: emergency rooms in different hospitals, police and sheriff salaries from various divisions, social worker and similar people's salaries from many agencies. These savings are from a multiplicity of budgets. In aggregate the savings reduce the total budgets of city, county, private medical care, and some nonprofits. But few of these agencies will have their budgets cut to reflect the savings, and even where they are, little of that savings is certain to be reinvested in homeless housing.
Panel 3: Business and Technology
- Example of contour crafting. Note for scale the figurine of the human operator at the console at bottom right.
One of the most interesting panels included a presentation by Professor Berok Khoshnevis of the USC Viterbi School of Engineering. This was on the technology mentioned by USC President Max Nikias that can build a complete house in 24 hours. The process is called contour crafting, and is essentially large-scale 3-D printing using concrete. The process, invented by Professor Khoshnevis, won the Grand Prize in NASA's 2014 Create the Future Design Contest, competing with 1,000 other entries.
It works by using tall gantrys with computer-controlled robot arms that direct extrusion nozzles, connected to a cement supply. The arms, following a computerized model, follow the contours of the model, laying down layer-by-layer of concrete. Even fairly tall buildings can be constructed this way.
For a house, there is no wood frame or sheetrock walls. It uses very little labor, can make rounded walls as easily as square ones, is extremely cheap, and so fast it can finish an entire house in a single 24-hour day. Professor Khoshnevis pointed out that two billion people in the world live in slums. Here is a technology that could house many of them rapidly and at minimal cost. It would be equally applicable to building many houses or apartment units for the homeless here. "Conventional means take too long and cost too much," Professor Khoshnevis said. "Think of Katrina."
He said this method can also build large buildings and high rises by cell-by-cell extrusion using external platforms. "The costs are very competitive, only a little more expense than tents. Most of construction cost is labor and this is very little."
Lunch Period Presentation: Causes of Homelessness
- Professor Hortensia Amaro at USC Homeless Summit
Hortensia Amaro, USC Associate Vice Provost and Professor of Social Work and Preventive Medicine.
"Homelessness is just the tip of the iceberg. It is caused by widespread system failure or economic factors. If these underlying conditions are not changed they will just reproduce new homeless in the next generation." The effect of these failures impact very early in life and follow people thereafter. "A person's third grade reading level is a strong predictor of how many will end up in jail or fail in other ways." In the city of Los Angeles only 40% of third graders read at grade level, and a third do not graduate high school.
The systemic failures that produce homelessness, if they worked well, are those that should aid in "income maintenance, employment, corrections, child welfare, foster care, and care of mental illness and other types of disabilities."
In the economy, "As the supply of decent housing diminishes, more and more people are at risk of becoming homeless. The tighter the housing market, the greater the amount of economic and personal resources one must have to remain secure."
Deindustrialization, that has replaced good paying jobs with minimum wage, has increased poverty. As affordable housing falls behind need, and rental rates go up, those in poverty spend more and more of their income on housing, until housing is beyond their purchasing power and they go homeless.
For those who are unemployed, in jobs that pay too little to afford housing, or disabled, public assistance programs have lowered benefits and made them harder to get, leaving large numbers of people unable to pay for housing.
Particular populations end up homeless through failure of other systems. Deinstitutionalization of the mentally ill, beginning in the 1960s and escalating in the 1970s, left many homeless, with a lack of mental health services. Those reentering from incarceration often cannot get jobs and become homeless without adequate needed service linkages. Family violence is another important cause of homelessness.
Dr. Amaro said that prevention is cheaper than trying to fix the problem after large numbers are homeless. In the United States only 3% of healthcare spending goes to prevention before people become sick or disabled. Housing is created by supply side economics rather than choices made by public policy, so is weighted toward high end, expensive homes and apartments.
Panel 4: Housing Supply
Michael Alvidrez, CEO of the Skid Row Housing Trust. "LA is the most expensive housing city in the country. New York and San Francisco have higher house costs, but LA has lower income. One reason so little affordable housing is built is NIMBYism, not in my backyard opposition from home owner associations and others who don't want low-income or formerly homeless people in their neighborhoods.
"We need to address the underlying conditions that cause homelessness; just providing the housing will not succeed. We need wraparound services. It actually works and works quite well."
He called on USC "to bring to bear a big voice, to push the agenda politically. Homeless people are the most visible manifestation of the lack of affordable housing in our community. Long commutes are another. Where are seniors going to live on a Social Security check? Homeless are the canary in the coal mine on affordable housing."
Jan Perry, General Manager, Los Angeles Economic and Workforce Development Department.
"I represented Skid Row on the City Council, 2001-2013. The hard part was taking people from the street and putting them into housing with wraparound services. We are about to build about 5,670 affordable units in south LA. We have a grant to train people in skills, to get people prepared to go to work after they have a place to live.
"When you see people who are living in mental illness living on the street, your first interest is to serve those people. They will never recover, they will be hurt by others, get hit by cars, get respiratory diseases. We are trying basically to rescue people. We shouldn't live in a city where someone dies of hypothermia.
"I once tried to persuade a woman right in front of a shelter to go in. She refused. The next day her picture was in the paper - she had been murdered. I have thought ever since that if I had spent ten more minutes with her I could have saved her life."
Nicole Esparza, Professor, USC School of Public Policy.
"Homeless services have policies at the city, state, and federal levels. For the federal policies, HUD is the biggest agency that funds homelessness. The government has shifted from managing homelessness to trying to end it. In 2005 HUD concluded that very few local agencies were building permanent supportive housing. It ruled that 50% of federal grants must be invested in such housing. LA has done a pretty nice job. In 2005, 53.2% was spent on housing. Last year it was 70%."
Many shelters don't want to be involved in building housing. "The problem in LA with HUD's new focus is that the emergency shelters now don't get enough money, while there is not enough money to move the homeless into permanent supporting housing instead."
Comment from the audience: "Samaritan behavior is different when the recipient is part of an out-group, especially black people. If the recipient looks like you, you are more willing to sacrifice to help them. If not, they can be ignored."
Jan Perry: "Yes, there is a widespread feeling that the homeless, who are disproportionally African American, are expendable. There is not a sense of urgency. It doesn't look like Katrina or 9-11, but that is wrong. It is not a normal situation."
Final Comments: What Can the University Do?
Marilyn Flynn, Dean, USC School of Social Work. "USC offers many services out in the community. The Dental School has gone all over the county. Every school in the university has some stake in the fight to end homelessness, which is nothing less than a fight for humanity."
The university runs directly or contributes to existing agencies for more than 200 community service programs. A few examples are: A Better Chance, which preps high achieving high school students to get into college prep schools; arranging for internships with major companies; supporting after-school tutoring in the Exposition Park neighborhood; serving as advocates for elderly African Americans; conducting community diabetes and cardiovascular education; providing free child care for USC Medical Center patients; and holding four one-day volunteer community service days each year where USC students and faculty help community residents to clear trash, paint, garden, and other home chores.
- USC President Max Nikias
The conference was closed by USC President Max Nikias. "We need Housing First, real housing with no prerequisites. It can be done. In January 2015 New Orleans ended veteran homelessness using Housing First. In Los Angeles there are nearly 10,000 tents, cardboard boxes, and cars as shelter for homeless people. This is 5,000 more than in 2013. But there has not been an increase in homeless veterans, due to policy focused on helping this group. If we can help homeless veterans, we can help the rest.
"LA county has helped 25,000 people to transition out of homelessness. We hope to end homelessness within a decade."