{"id":704,"date":"2023-02-09T10:30:25","date_gmt":"2023-02-09T10:30:25","guid":{"rendered":"https:\/\/healthynewsusa.com\/?p=704"},"modified":"2023-02-09T10:30:31","modified_gmt":"2023-02-09T10:30:31","slug":"the-country-is-watching-california-homeless-crisis-looms-as-gov-newsom-eyes-political-future","status":"publish","type":"post","link":"https:\/\/healthynewsusa.com\/?p=704","title":{"rendered":"\u2018The Country Is Watching\u2019: California Homeless Crisis Looms as Gov. Newsom Eyes Political Future"},"content":{"rendered":"
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SACRAMENTO, Calif. \u2014 Driving through the industrial outskirts of Sacramento, a stretch of warehouses, wholesale suppliers, truck centers, and auto repair shops northeast of downtown, it\u2019s hard to square California\u2019s $18 billion investment in homeless services with the roadside misery.<\/p>\n

Tents and tarps, run-down RVs, and rusted boats repurposed as shelter line one side of the main thoroughfare. More tents and plywood lean-tos hug the freeway underpasses that crisscross Roseville Road, and spill into the nearby neighborhoods and creek beds.<\/p>\n

At one of the more established encampments, Daisy Gonzalez used canvas and carpet scraps to fashion a living room outside her cramped RV. Inside, Gonzalez took a quick hit of fentanyl, and turned to a mirror to apply a fresh face of makeup. As the opioid coursed through her body, her anxiety settled, her thoughts grew more collected. But she knows the addiction can\u2019t end well and recounted a half-dozen failed attempts to get clean.<\/p>\n

\u201cI really need to get off this \u2018fetty\u2019 and stay clean, but it\u2019s so hard out here,\u201d said Gonzalez, 32, her eyes welling. She turned back to the mirror, finishing her eye makeup. \u201cI want to get help and find a program, but there\u2019s no treatment around here. It seems like nobody cares.\u201d<\/p>\n

Across California, homelessness is impossible to escape. Steep increases \u2014 Sacramento County saw a 67% rise<\/a> in its homelessness count from 2019 to 2022 \u2014 have so far blunted unprecedented government efforts to fund housing and treatment for people living on the streets. And although some communities have made progress, statewide the gravity of the crisis has deepened.<\/p>\n

Encampments have mutated into massive compounds proliferating with hard drugs and untreated mental illness. \u201cIsn\u2019t there supposed to be all this money and housing?\u201d asked Gonzalez\u2019s boyfriend, Joe Guzman, an ex-convict who enforces rules for their encampment. Guzman said he has experience in construction but can\u2019t find a job because of a felony drug record.<\/p>\n

Joe Guzman is recognized as the boss at his encampment along Roseville Road in Sacramento. Guzman says he would like to find real housing and a job in construction but his felony drug record scares off prospective landlords and employers. \u201cThe reality is, out here, we\u2019re all on our own,\u201d Guzman says.(Angela Hart \/ KHN)<\/span><\/figcaption><\/figure>\n

\u201cEverybody out here is using,\u201d said Guzman, 38, checking their emergency stash of naloxone, an overdose reversal medication, on a brisk November morning. \u201cWhat else are you going to do, especially when it\u2019s this cold? You have to be numb.\u201d<\/p>\n

At its heart, California\u2019s homeless emergency stems from a long-standing shortage of affordable housing. But it is also a public health crisis: The encampments are rife with mental health and addiction disorders. Rats and roaches are endemic, as are stagnant sewage and toxic camp smoke.<\/p>\n

Gov. Gavin Newsom brims with frustration \u2014 and purpose and new ideas \u2014 when confronted with what has become an age-old question for California leaders: Why, for all the money and good intentions poured into helping people out of homelessness, does it look worse today than ever? Experts on homelessness say California stands out as the state that has done the most in recent years to address the issue, yet communities are struggling to make headway.<\/p>\n

\u201cSome people are demoralized,\u201d Newsom said last summer, unveiling a strategy to fund housing for homeless people with mental health and addiction disorders. \u201cSome people have, frankly, given up \u2014 given up on us, given up on the prospect that we can ever solve this issue. And I want folks to know that they shouldn\u2019t give up.\u201d<\/p>\n

Newsom has muscled historic investments of public funds to combat the crisis, wresting a staggering $18.4 billion in taxpayer money in his first four years for initiatives directly targeting homelessness, a KHN analysis found. And more money is on the way: Spending is projected to grow to $20.5 billion this year.<\/p>\n

As he wades into his second term as governor, the stakes are higher. He has signaled his ambitions for national office and speculation abounds that he\u2019s positioning himself for a presidential run. He has cast himself as a vanguard for liberal values<\/a>, taking out ads to goad the Republican governors of Texas and Florida for their conservative politics and publicly chiding fellow Democrats for being too meek in their response to the nation\u2019s culture wars, including a right-wing assault on abortion and classroom speech on issues of race and gender.<\/p>\n

On this national stage, California\u2019s squalid tent cities loom as a hulking political liability, ready-made visuals for opponents\u2019 attack ads. Newsom\u2019s legacy as governor and his path forward in the Democratic Party hinge on his making visible headway on homelessness, an issue that has stalked him since he was elected mayor<\/a> of San Francisco two decades ago.<\/p>\n

\"A
Homeless encampments crowd the freeway underpasses and dirt shoulders along Roseville Road, northeast of downtown Sacramento, along with piles of trash and discarded goods. Stranded boats have become another form of shelter for California\u2019s homeless.(Angela Hart \/ KHN)<\/span><\/figcaption><\/figure>\n

And Newsom is recalibrating, injecting a new sternness into his public statements on the topic, something akin to \u201ctough love.\u201d He is enjoining local governments to clear out the unsanctioned encampments that homeless advocates have long defended as a merciful alternative in a state woefully short on housing options. And he is demanding that cities and counties submit aggressive plans outlining how they will reduce homelessness \u2014 and by how much \u2014 as a precondition for future rounds of funding.<\/p>\n

\u201cWe have written checks, but we\u2019ve never asked for anything in return,\u201d Newsom told reporters in August. \u201cThat has radically changed. We mean business. It\u2019s unacceptable what\u2019s going on in this state.\u201d<\/p>\n

Newsom has set in motion a costly, multipronged battle plan, in many ways a grand experiment, attacking homelessness on multiple fronts. Through his brainchild \u201cProject Homekey,\u201d the state has plowed about $4 billion into converting dilapidated hotels and motels into permanent housing with social services. Billions more have been allocated to cities and counties to clear encampments and open additional shelters and supportive housing.<\/p>\n

Separate from that, his controversial \u201cCARE Court\u201d plan seeks a novel approach to compelling people languishing on the streets with untreated psychotic disorders to get treatment and housing. It melds the \u201ccarrot\u201d of a court-ordered treatment plan, to be provided by local governments, with the \u201cstick\u201d of the prospect of court-ordered conservatorship if people deemed a danger to themselves or others refuse to participate. Newsom allocated $88 million to launch the initiative, and state funding is expected to grow to $215 million annually beginning in 2025.<\/p>\n

That\u2019s on top of his CalAIM initiative<\/a>, which over five years will invest roughly $12 billion into a blitz of health care and social services with the goal of improving health in low-income communities and averting the financial crises that can land people on the streets. This includes direct interventions like emergency housing assistance, as well as unconventional support like help with groceries, money management, and home repairs.<\/p>\n

Philip Mangano, a longtime friend of Newsom\u2019s who served as national homelessness czar during the George W. Bush administration, credited Newsom for using his political might to take on a seemingly intractable issue like homelessness after so many administrations ignored it.<\/p>\n

\u201cYes, we are spending a lot of money, and yet the problem is getting worse,\u201d Mangano said. \u201cBut look, the largest investment ever made in the history of our country, on homelessness, came from Gavin Newsom. He sees himself as responsible for taking care of the poorest Californians, and homeless people. I\u2019ve known him over 20 years, and there\u2019s no question that\u2019s where his heart is.\u201d<\/p>\n

Still, putting the issue front and center is a serious gamble for someone with Newsom\u2019s ambitions.<\/p>\n

\u201cDoing nothing puts him in peril, but doing something \u2014 he runs the risk of failing,\u201d said Darry Sragow, a Los Angeles-based political strategist<\/a>. \u201cPeople want strong, tough leadership and progress on this issue, but if Gavin Newsom is going to make headway in reducing homelessness, he\u2019s going to have to have a pretty stiff spine.\u201d<\/p>\n

\u2726\u2726\u2726<\/p>\n

Daniel Goodman slept on sidewalks, in a tent, or on a jail bunk throughout much of his 20s and early 30s. Now 35, he only in recent years committed to a regimen of psychiatric medication and counseling for schizophrenia, a condition he was diagnosed with at 24.<\/p>\n

\u201cI didn\u2019t want to take medication for a lot of years; I absolutely refused,\u201d he said, eager to discuss a change of heart that has enabled him to reclaim a life with his mom in a comfortable neighborhood in the Gold Country city of Folsom.<\/p>\n

Tall, with a bright smile and rock-\u2019n\u2019-roll hair, Goodman said he was addicted to methamphetamines for a decade, self-medicating to calm the voice in his head he calls \u201cthe witch.\u201d He panhandled, pushed shopping carts, and bellowed his agony in public fits of rage. It was a hungry, ragged existence during which he cycled from the streets to jail on charges of drunk and disorderly and then back to the streets.<\/p>\n

His mom, Susan Goodman, in her form of tough love, eventually closed her home to him after his untreated illness devolved into threatening behavior, including stealing from her and a violent bout of vandalism during which he shattered every window in her house.<\/p>\n

\u201cI lived from second to second, and I didn\u2019t have anything to eat or blankets, so I\u2019d think, \u2018What can I steal?\u2019\u201d Daniel said. \u201cI put my mom through a lot.\u201d<\/p>\n

Her heart broken, Susan would seek out her son on the streets, bringing supplies to his tent. In 2019, after a particularly cold spell, he begged her to let him come home. She responded with an ultimatum: He could move back home if he agreed to get clean and stay on his meds.<\/p>\n

\"A
Susan Goodman and her son, Daniel, are supporters of Democratic Gov. Gavin Newsom\u2019s \u201cCARE Court\u201d initiative, which allows courts to mandate treatment for people living homeless with untreated psychosis. Daniel spent years on the streets with untreated schizophrenia before a tough-love deal with his mother got him back home on medication.(Angela Hart \/ KHN)<\/span><\/figcaption><\/figure>\n

Susan, a lawyer, is among thousands of parents who support Newsom\u2019s CARE Court initiative<\/a>. For years, families who have watched in despair as children or siblings lost themselves to untreated mental illness have petitioned lawmakers to make it easier to mandate conservatorship and treatment, and CARE Court is a major stride in that direction.<\/p>\n

Eight counties, including Los Angeles, San Francisco, San Diego, and Riverside, have volunteered to launch the program this year. All 58 counties will be required to start programs by the end of 2024.<\/p>\n

Newsom calls it a paradigm shift. Pushing the measure to passage meant standing against virulent opposition<\/a> from civil and disability rights groups that argued people have the right to refuse treatment, and warned of a return to the horrors of forced confinement depicted in \u201cOne Flew Over the Cuckoo\u2019s Nest.\u201d<\/p>\n

\u201cThere\u2019s no compassion in stepping over people on the streets and sidewalks,\u201d Newsom said as he signed the Community Assistance, Recovery & Empowerment, or CARE, Act into law last fall. \u201cThey need intervention \u2014 sometimes that\u2019s tough.\u201d<\/p>\n

Some county leaders have also balked, saying Newsom is sentencing people to a system of care that doesn\u2019t exist. They worry a crush of patient referrals will overwhelm county behavioral health systems. They say they need more money, more time, and funding streams guaranteed year after year.<\/p>\n

\u201cThere isn\u2019t enough treatment capacity. And we can write a prescription for housing, but the reality under CARE Court is we don\u2019t have what it takes to fill that prescription,\u201d said Michelle Doty Cabrera, executive director of the County Behavioral Health Directors Association of California. \u201cIt\u2019s a matter of having the level of funding and housing that is going to help that person be successful.\u201d<\/p>\n

Newsom\u2019s response to the pushback has grown heated. He points out that local governments already get billions every year to provide mental health services and that recent state budgets have included funding to expand the system of care.<\/p>\n

\u201cI\u2019m exhausted by that \u2014 $15.3 billion we\u2019ve provided,\u201d Newsom said at a January news conference, referencing homeless investments over the past two years. The state has provided \u201cunprecedented support,\u201d he said, pounding his fist on the podium. \u201cI want to see unprecedented progress.\u201d<\/p>\n

Dr. Tom Insel, who formerly led the National Institute of Mental Health and has served as an adviser to Newsom, credits the governor for bold efforts to direct resources and attention to the nexus of mental illness and homelessness. Research indicates roughly 1 in 20<\/a> Americans have a serious mental illness, but for unsheltered homeless people, it\u2019s 1 in 4, Insel said.<\/p>\n

He sees CARE Court as a \u201ctwo-sided mandate,\u201d making counties legally liable for providing services for people whose survival is at risk because of untreated mental illness while putting individuals on notice that they are responsible for accepting that help. Still, he worries the state\u2019s homeless population is so overwhelming in scope, their isolation so entrenched, that it will be difficult to make headway.<\/p>\n

\u201cYou can have all the clinics and all the medicines and all this good stuff to offer, but if people aren\u2019t engaging with it, it\u2019s not going to help,\u201d Insel said. \u201cAnd if there\u2019s no relationship and no sense of trust, it\u2019s just really difficult to engage.\u201d<\/p>\n

For Daniel Goodman, the return to mental health took both carrot and stick. Looking back, he can see his refusal to take his prescribed medication after being diagnosed with schizophrenia \u2014 he felt \u201cfreer\u201d without it \u2014 set him on a dehumanizing spiral. A primal need for food and shelter led him to ask his mom for help. But without her \u201chammer\u201d \u2014 the ultimatum \u2014 he would not have agreed to treatment. And without the medication, he said, no doubt he would be back on the streets, at the mercy of his vicious \u201cwitch\u201d and scraping to survive.<\/p>\n

\u201cI\u2019ve battled this question [of needing medication] for years,\u201d he said, reaching for his mom\u2019s hand in her sunlit living room. \u201cI accept it now.\u201d<\/p>\n

\u2726\u2726\u2726<\/p>\n

If California is to make a visible dent in its homeless numbers, affordable housing presents the most daunting challenge. The state lacks the extensive shelter networks common in places with colder climates \u2014 an estimated 67%<\/a> of people living homeless in California are without shelter.<\/p>\n

And in recent decades, a mire of zoning restrictions and real estate development practices have transformed the housing market, jacking up rents and home prices and shrinking the options for low-wage workers. For every person moved off the streets, many others stand a paycheck or medical emergency away from losing their housing.<\/p>\n

\"A
Chilli Williams lives under a freeway in midtown Sacramento. He says his homeless trek started in 2014 when he was hit with a $200 monthly rent increase and quit his lease to find something cheaper. He regrets the decision. \u201cEvery time you look for a place, they want you to make three times the rent. I can\u2019t do that,\u201d he says. \u201cThe scary part is you get used to it out here.\u201d(Angela Hart \/ KHN)<\/span><\/figcaption><\/figure>\n

The longer people live on the streets, the more their health deteriorates. Addiction and mental health problems deepen. Chronic diseases advance.<\/p>\n

\u201cThere\u2019s almost nothing as destructive to health as homelessness, and there\u2019s very little that the health care system can do to make up for it,\u201d said Dr. Margot Kushel<\/a>, director of UCSF\u2019s Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital. \u201cYou just fall apart.\u201d<\/p>\n

The arrival of covid-19<\/a> \u2014 and fears the virus would carve a deadly swath through shelters and encampments \u2014 gave Newsom an unexpected opportunity: open housing units in record time by throwing pandemic emergency funds at the problem and circumventing land-use restrictions and environmental reviews that can drag out approvals.<\/p>\n

In 2020 he launched \u201cProject Roomkey,\u201d converting dilapidated hotels and motels into temporary housing for homeless people deemed vulnerable to serious covid infections. That morphed into a program to convert underused structures into permanent housing, and today the retooled Project Homekey<\/a> has laid the groundwork for more than 12,500 housing units.<\/p>\n

But much of that is one-time funding for start-up costs. If cities and counties want to participate, they are required to put up money for ongoing operations and services. And many have decided it costs too much to buy in.<\/p>\n

\u201cI really wanted to pursue a project, but it just doesn\u2019t work for a lot of rural counties,\u201d said Jaron Brandon, a supervisor in Tuolumne County, a forested province in the Sierra Nevada.<\/p>\n

\u201cRural areas like ours have much lower tax revenues, and we had to figure out five years of funding, so when you start adding up all these costs and requirements, all of a sudden, we can\u2019t afford to think big. It starts cutting into critical issues and basic services like funding roads and wildfire response and public safety.\u201d<\/p>\n

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