After all, he said, everything the state has done before has failed. One of the state’s prior attempts — a treatment referral program called Laura’s Law – helped just 218 people during the 2018-19 fiscal year, he said.

“That certainly is not demonstrable progress,” Newsom said. His new program would be different. 

But in the nearly two years since Newsom launched CARE Court, it has reached only a few hundred people. That’s barely more than the law he criticized, and certainly not the thousands he promised.

CalMatters requested CARE Court data from every county in California and conducted more than 30 interviews to compile the first detailed, statewide look at the program. Up and down California, the data show low numbers, a slow rollout and predictions that wildly outpaced reality.

The program was designed to allow family members, first responders, doctors and others to petition the courts on behalf of someone with severe psychosis who can’t take care of themselves. If the petition is accepted, that person can then agree to voluntary treatment, which can include counseling, medication, housing and more.

If they refuse, a judge can order them to participate in a treatment plan.

CalMatters received responses from all but four of the state’s 58 counties. Here’s what the data shows:  

• While Newsom’s administration estimated between 7,000 and 12,000 Californians would qualify for CARE Court, just 2,421 petitions have been filed through July, according to the Judicial Council of California. Only 528 of those have resulted in treatment agreements or plans.
• San Diego County anticipated receiving 1,000 petitions in the first year and establishing court-ordered treatment plans for 250 people. But in nearly two years, the county instead has received just 384 petitions and established 134 voluntary agreements.
• Los Angeles County saw 511 petitions filed – the most in the state. Of those, 112 resulted in care agreements or plans. In 2023, officials predicted to news organizations the county could enroll 4,500 people in the first year.
• Courts across California are dismissing a significant percentage of CARE Court petitions – about 45% statewide, although that number includes the handful of cases in which someone has successfully “graduated” from the program. The rate is even higher in some counties, such as San Francisco, where nearly two-thirds of petitions are thrown out. 
• The allure of CARE Court for many supporters was the promise of court-ordered treatment plans that would encourage sick people to accept the help they’d been resisting. But the courts have ordered just 14 treatment plans so far, according to the Judicial Council. Instead, most counties are solely offering voluntary treatment “agreements,” which sick people are free to ignore.
• Very few people have successfully completed CARE Court. Despite the fact that it has the most petitions, Los Angeles County has had no graduations. Nine counties have been operating CARE Court long enough to have graduations (the program takes at least a year to complete). 

“It’s going much more slowly than we thought it would,” said Lisa U’Ren, a former member of the  board of directors at the Solano County branch of the National Alliance on Mental Illness, who helped roll out the program in her county. 

The stakes are high for Newsom, who has tied his legacy in part to big promises that he would address California’s twin problems of homelessness and inadequate mental health services. The establishment of CARE Court was followed by a 2023 law intended to make it easier for a judge to order someone into involuntary treatment. A successful 2024 ballot measure issued $6.4 billion in debt to pay for new mental health housing. 

State officials say CARE Court needs more time to hit the goals initially set by the Newsom administration. Already some counties are doing an “incredible job,” said Stephanie Welch, deputy secretary of behavioral health for the state Health and Human Services Agency. She pointed to Alameda County, which has racked up 125 petitions — among the most in the state – since December. 

“I think this has been a complicated program to implement,” Welch said, “and that’s something that we recognize and we’ve been doing our best to support the counties to be able to expand this program.”

A spokesperson for Newsom’s office said 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,” Elana Ross said in an emailed statement.

But disability rights organizations say the low numbers are evidence that the program was a waste of money, a reactionary political gambit by a governor with presidential aspirations. And many families who initially threw their support behind CARE Court also say it has come up short. 

Anita Fisher advocated for the program when Newsom proposed it, speaking on 60 Minutes about her family’s story and meeting with the governor himself, she said. When the program was piloted in San Diego County, where she lives, she felt hopeful about its promise to treat people with serious mental illness, like her son.

“I’ve watched my son suffer too many times: jail, prison, homeless,” she said. “And I said, ‘so if this can stop that?’ I said, ‘Yes, I’m all for it.’”

But now?

“I look at it as a total failure.” 

A petition could be rejected because the person doesn’t meet the narrow eligibility criteria (only people with schizophrenia and other limited psychotic disorders qualify). When the subject of a petition is homeless, outreach workers sometimes have trouble finding them on the street. Other times, the client simply refuses services – and, CARE Court has little teeth to force them to accept, even after a judge’s order.

Making more people eligible for CARE Court

A bill making its way through the Legislature could boost CARE Court numbers by making more people eligible. If Sen. Thomas Umberg’s Senate Bill 27 becomes law, people who experience psychotic symptoms as a result of bipolar disorder would qualify for the program.

The program as it stands is not broken, the senator said, it’s a “work in progress” that needs some tweaking to reach its full potential.

“To some degree, expectations were raised, some that were accurate, some that were not accurate, that this was going to be a panacea,” Umberg said. “And I never thought of it that way.”

But it’s unclear how many more people could enter into CARE Court as a result of Umberg’s bill. His office has no estimate, and other guesses vary widely. San Diego County says the bill could increase its numbers by anywhere from 3.5% to 48.1%.

Many disability rights organizations strongly oppose the bill, saying it will significantly expand an ineffective program, doing nothing to solve underlying issues of housing shortages and inadequate mental health services

“They’re not trying to fix a problem, they’re trying to deliver political optics, and that’s all this ever was,” said Lex Steppling, a founding member of All People’s Health Collective. 

Eve Garrow, a senior policy analyst with the American Civil Liberties Union of Southern California, said that, “given what I consider to be the failure of CARE Court so far,” she expects Umberg’s bill is primarily an effort to increase the number of petitions. 

“A court order doesn’t make resources appear out of thin air,” she said. 

The state spent $88.3 million on CARE Court in the 2022-23 fiscal year, and $71.3 million in 2023-24, according to a Legislative Analyst’s Office analysis. With fewer than 550 people receiving services through the program so far, critics accuse CARE Court of wasting state money.

The Assembly Judiciary Committee’s July analysis of SB 27 described  CARE Court as a “very expensive” way to coordinate services. 

But California counties say the low numbers of CARE agreements don’t capture the entirety of the program’s impact. Even petitions that don’t lead to official agreements have afforded counties the chance to connect with and offer services to people they hadn’t previously known.

“I would say that I think the whole idea of looking at the numbers, it sort of misses the point,” said Michelle Doty Cabrera, executive director of the California Behavioral Health Directors Association. “With anything coercive, the goal is to try to engage people out of their own free will into services.” 

One of CARE Court’s successes, she said, has been in spreading the word about county services to people who might need them. If those people then express interest without the need for any coercion, “that’s a success and so far that has not been quantified,” she said.

The state has attempted to quantify that elusive number: As of December, people were diverted away from CARE Court and into other county services 1,358 times, according to a recent report from the Health and Human Services Agency.

Counties administering CARE Court also said it’s one of the few state programs that funds outreach. It can require a lot of attempts before outreach workers can coax certain people into services, they said, and this provides a mechanism to pay for those efforts.

A flood of petitions that never materialized

Eight California counties rolled out CARE Court at the end of 2023, as part of a pilot group. The rest of the state had the program up and running by December 2024.

As San Diego County counted down to the launch, officials worried they would be flooded with petitions immediately, said Amber Irvine, the county’s behavioral health program coordinator. 

The county hired nearly two-dozen people, including 10 clinicians, two psychologists and support staff to meet the expected demand. The money for those new positions came from county funds, not from the state.

That flood of petitions never materialized. 

Irvine thinks the process of filing a petition was harder than expected. Her team thought first responders, hospitals and behavioral health workers would jump at the chance to refer people into the program. But that didn’t happen. The petitioner has to attend at least the first court hearing, which is something many overworked first responders and clinicians can’t do, Irvine said.

Police and firefighters filed petitions when the program first started, but they were often dismissed – which made the first responders reluctant to file more, said Crystal Robbins, who manages a treatment referral program for San Diego Fire-Rescue.

“We quickly found out that it wasn’t a useful tool for the people that we see,” she said.

The process also is tough for families petitioning on behalf of loved ones, Irvine said. It requires them to prove their loved one has a qualifying mental health condition, but federal privacy laws can make that a big hurdle.

The county is trying to make the process less cumbersome, Irvine said. It is letting family members and some other petitioners attend court hearings virtually, for example. And in some cases, the court is allowing petitions to move on to the next step even if they don’t have all the required paperwork.

So far, San Diego County Superior Court has received the second-largest number of petitions in the state — 384, with 35% leading to CARE agreements.

But that’s still far behind initial projections.

The slow start could be a “happy accident,” Irvine said, because the low case load allows clinicians to spend more time with each CARE Court client. 

But Anita Fisher isn’t the only family member who feels discouraged about the program’s roll out in San Diego. 

Tanya Fedak said she has twice filed petitions in the county on behalf of her son, who continues to cycle between homelessness and jail despite being accepted into CARE Court.  

“These are our loved ones,” she said. “It’s our taxpayers’ money. There’s no accountability. And it’s frustrating to see it go down, because my son is going to end up dead.”  

Orange County, which was part of the initial CARE Court cohort, expected to receive 1,400 petitions and establish between 400 and 600 treatment plans its first year. Two years later, it has received at least 176 petitions , reached 14 CARE agreements and ordered one CARE plan, according to the county’s behavioral health department. That doesn’t include additional petitions that could have been dismissed by the court before reaching the county.

Orange County was the only superior court in the state with a significant number of petitions that did not disclose its data to CalMatters.   

Veronica Kelley, director of the Orange County Health Care Agency, said she never expected to reach as many people as the original estimate. She attributed that in part to the county already reaching many people with schizophrenia spectrum disorder through its existing assisted outpatient treatment program (the program created by the law Newsom criticized at the 2023 press conference), which provides similar services to CARE Court.

Kelley believes expanding the older program would have been a better use of the resources now going to CARE Court. In part, she said, that’s because Orange County’s assisted outpatient program makes it easy for people to ask the county for help, whereas filing a CARE petition is “a laborious process” that requires significant work from the petitioner.

Other people blame the low CARE Court numbers on a lack of awareness.

After CARE Court rolled out in Solano County, the local branch of the National Alliance on Mental Illness hosted town halls to teach the community about the program. An in-person town hall drew about 10 people, said NAMI Solano County Executive Director Deb Demello. Two Zoom meetings drew about four people each. And they didn’t see people from the main group they were trying to reach: family members of people with a severe mental illness.

“We had very little turn out,” Demello said.

How is CARE Court going in your county?

Several counties launched their CARE Courts in 2023, and the rest started by December 2024.

CARE Court use  varies widely county by county, with some smaller counties appearing to struggle with the resources to implement the program. Colusa County, with a population of fewer than 22,000 people on the edge of the Mendocino National Forest, told the state last year that its courts weren’t prioritizing CARE Court because of court vacancies. The county has received just one petition.

Eight small counties, including Mendocino and San Benito, said they’ve had no petitions filed. 

Some county courts refused to disclose their data to CalMatters because the numbers were too small, citing the California Rules of Court, which allow courts to withhold data if the sample size is so small that people could be identified. 

Courts are required to report limited CARE Court data to the California Judicial Council, including the number of petitions submitted, number of agreements and plans, and number of dismissals. But the council would give only statewide totals to CalMatters, not a county-by-county breakdown. 

Will expanding CARE Court help more people?

Even if someone becomes one of the few Californians represented in a CARE Court petition, it doesn’t mean they’ll get help.

In San Francisco, the majority of petitions filed end up getting dismissed – 49 of the 75 – or 65% – of those filed. That’s one of the highest dismissal rates in the state.

Some counties, including San Francisco, told CalMatters that people may still receive services even if their CARE Court petition is dismissed. But a state report released in July found that of the 160 people whose petitions were dismissed during the first nine months of CARE Court, 90 did not receive county behavioral health services. 

Of the 130 petitions dismissed in Los Angeles County between December 2023 and February of this year, 43 were dismissed because the person was already receiving “adequate mental health services,” according to a report by the county’s department of mental health. It’s the most common reason for a dismissal in that county.

Umberg wants to address that with his bill. Currently, someone can’t qualify for CARE Court if they are already “clinically stabilized” in another treatment program. Umberg’s bill would clarify that just being enrolled in an outside treatment program doesn’t mean someone is stable. He hopes that will cut down on the number of people whose petitions are dismissed even though their mental illness is not under control. 

His bill would also make it easier for the criminal justice system to funnel people into CARE Court, by allowing a judge to refer someone directly into the program if they are charged with a misdemeanor and deemed incompetent to stand trial. 

Irvine, San Diego County’s behavioral health program coordinator, is not thrilled about Umberg’s plan to expand CARE Court. The California Behavioral Health Directors Association also opposes the bill. 

Irvine takes pride in the amount of time and energy her staff put into each CARE Court client. She says they spend weeks or even months getting to know them, bringing them their favorite foods, and helping with minor tasks, such as getting a new phone, before finally convincing them to participate in the program. In at least one case, that process took as long as five months, she said.

By some accounts, San Diego County’s approach is working. It has had 10 graduations so far, the most of any county that reported that metric to CalMatters.

Adding a lot more people into the program would give clinicians less time to spend with each client, Irvine said. And Umberg’s bill doesn’t come with money to hire more staff.

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When President-elect Donald Trump moves into the White House in January, he will become a key figure in California’s homelessness crisis, holding the federal purse strings and setting policy at the national level. 

So what will this change of power mean for the state as it tries to move its nearly 186,000 homeless residents — the most in the nation — indoors? 

Housing and homeless services experts in California worry the Trump administration will cut federal funding in those areas, while also doing away with policies deemed too “progressive.” 

But surprisingly, based on what he’s said so far about one of the key issues regarding homelessness, Trump’s agenda isn’t much different from Gov. Gavin Newsom’s. Trump pledged to tackle the encampments that have made cities “unlivable” by working with states to ban urban camping and arrest those who don’t comply — something many cities in California started doing before Election Day, as Newsom encouraged them to clear camps.

“The homeless have no right to turn every park and sidewalk into a place for them to squat and do drugs,” Trump said in a campaign video posted online in April, 2023. The video appears to be the last time he revealed specific homelessness policy intentions. 

“There is nothing compassionate about letting these individuals live in filth and squalor rather than getting them the help that they need,” Trump said. 

Newsom, who in most other arenas is one of Trump’s biggest foes, has said nearly the exact same thing.

“There is no compassion in allowing people to suffer the indignity of living in an encampment for years and years,” Newsom said in September before signing a package of housing bills. In July, Newsom ordered state agencies to ramp up encampment sweeps, and he threatened to withhold state funding from cities that fail to do the same.

More than two-dozen California cities and counties already have introduced or passed new ordinances cracking down on camps (or updated existing ones to make them more punitive), after the Supreme Court gave them the green light to do so in June.

Trump also said he would move unhoused people to tent cities staffed with doctors and social workers. 

That plan alarmed Alex Visotzky, senior California policy fellow for the National Alliance to End Homelessness. 

“We need to remember that involuntary carceral approaches don’t work and just delay our efforts to end homelessness,” he said.

If Trump pushes these policies at the national level, especially if he offers federal funding for sweeps and tent cities, it could spur California cities to further crack down, Visotzky said. 

As the Trump administration gets to work replacing the heads of federal agencies such as the U.S. Interagency Council on Homelessness, there’s a good chance policies California has come to rely on will get tossed out along the way, said Sharon Rapport, director of California state policy for the Corporation for Supportive Housing. The new guard likely will scrap at least some policies viewed as the gold standard in California, such as “housing first,” which says unhoused people, even those struggling with an addiction or their mental health, should be offered housing with no strings attached, and then services to help them recover.

It’s also a good bet California would see large cuts to funding for federal housing and homelessness programs — including the voucher program that subsidizes rents for hundreds of thousands of Californians, Rapport said.

That’s worrying for organizations such as Abode, which provides housing and other services for homeless Californians in seven counties.

“Federal funding is the brunt of what we receive either directly or through other entities, so it could be really impactful if there’s a huge reduction,” said CEO Vivian Wan. “It’s just going to hurt all of our communities.”

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A new program created by California’s consumer protection agency aims to provide free, personalized help for Golden State borrowers struggling to navigate the complex, byzantine student loan system.

The Student Loan Empowerment Network is designed to provide financial coaching and assistance for borrowers, including help securing income-based repayment plans and federal student loan forgiveness for those working in public service jobs.

“The student loan system is fraught with systemic issues that make it practically difficult, if not impossible, for people to get the rights and benefits they’re supposed to be entitled to under the law,” said Suzanne Martindale, the senior deputy commissioner for consumer financial protection at the California Department of Financial Protection and Innovation.

Martindale said in many cases, borrowers might be eligible for some form of loan relief, but don’t know how to access it because “the information hasn’t been clear, because the goalposts keep changing, because the loan servicers can’t seem to give you an accurate answer.”

“People need somewhere to go to get accurate, fair information, working with someone who cares about their best financial interests,” Martindale said.

Borrowers who want help from the program can fill out an intake form at studentloanhelp.dfpi.ca.gov or call (888) 774-2227.

Borrowers will be connected with a financial counseling agency or legal aid agency. In Los Angeles, those include Public Counsel, the Legal Aid Foundation of Los Angeles and the Koreatown Youth & Community Center.

The program will offer a mix of webinars and financial coaching sessions. Some borrowers with “very complex legal issues” may require one-on-one help, including those who have older private loans from defunct issuers, or have been in default on their loans, Martindale said.

Gov. Gavin Newsom’s 2022-2023 budget set aside $7.25 million for the student loan assistance and education program and $2.25 million for a statewide marketing campaign.

The organizations working on the loan program will be required to track the number of people who switch to income-based payment plans, document their employment for public service loan forgiveness and have their loans discharged, Martindale said.

Helping Californians reduce their loan burdens using publicly available programs can have a major economic benefit for the state, she said. She said she hopes the program becomes a permanent fixture in the state, although the looming shortfall makes that less certain.

After the pandemic-era freeze on student debt expired last year, about 40% of borrowers with federal student loans missed their first monthly payment last fall, according to federal data.

Borrowers who are delinquent on their federal loans won’t be reported to credit bureaus until Sept. 30 of this year, but in the meantime, interest continues to accrue.

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Last month the Democrat unveiled his budget for the next fiscal year, admitting that ‘difficult decisions’ are needed to address the state’s deficit – including a 1.6 percent reduction in the state’s Department of Justice’s overall funding.

The proposed budget includes a $97 million cut to trial court operations, $10 million to the Department of Justice’s Division of Law Enforcement and over $80 million to the Department of Corrections and Rehabilitation, as reported by Fox News.

Newsom’s plan comes as major national stores and local businesses in California say they continue to face rampant theft. Videos of large-scale thefts, in which groups of individuals brazenly rush into stores and take goods in plain sight, have often gone viral.

Crime data shows the San Francisco Bay Area and Los Angeles saw a steady increase in shoplifting between 2021 and 2022. Across the state, shoplifting rates rose during the same time period but were still lower than the pre-pandemic levels in 2019, while commercial burglaries and robberies have become more prevalent in urban counties.

Meanwhile homelessness jumped 6 percent to more than 180,000 people in California last year, federal data show. And since 2013, the numbers have exploded by 53 percent with the state accounting for a third of America’s entire homeless population.

The state’s criminal justice record which saw the number of violent crimes jump by 27 percent between 2013 and 2022, and pickpocketing more than double.

This is the second year in a row the nation’s most populous state is facing a multibillion-dollar shortfall. State revenues have continued to fall amid increasing inflation and a slowdown in the state’s usually robust technology industry.

Officially, Newsom said the state’s deficit is $27.6 billion. But really, it’s closer to $45 billion when including previous spending reductions that Newsom and the state Legislature agreed to in March.

Including reductions in public education spending, which Newsom has not included, the deficit would be even billions of dollars more, according to recent analysis by the nonpartisan Legislative Analyst’s Office.

A spokesperson for Newsom told Fox News in a statement: ‘The budget proposes numerous ways to make government more efficient and reduce costs for taxpayers, including cuts on inmate spending.

‘Since Governor Newsom took office in 2019, the state has made record investments in law enforcement, including $1.1 billion to tackle crime, support police, and hold criminals accountable.’

So far, Newsom has not gutted some of his splashiest policy advancements, including free kindergarten for all 4-year-olds and free health insurance for all low-income adults regardless of their immigration status.

But as Friday’s proposal showed, Newsom is willing to chip away at some of those promises to balance the budget.

While Newsom has not taken away health insurance from anyone, he proposed the state stop paying for health care workers to care for some 14,000 disabled immigrants in their home. That would save the state $94.7 million. While he hasn’t pulled back the state’s commitment to expanded kindergarten, he proposed eliminating $550 million that would have helped school districts build the facilities they need to teach all of those extra students.

After promising to pay for child care for another 146,000 children from low-income families, Newsom on Friday proposed pausing that expansion at 119,000. And after promising to boost how much money doctor’s get to treat Medicaid patients, Newsom on Friday proposed canceling $6.7 billion that had been set aside to do that.

In total, Newsom is proposing $32.8 billion in cuts over two years, including eliminating 10,000 unfilled state jobs and an 8 percent cut to state operations — including things like eliminating landlines. He promised there would be no layoffs, furloughs or salary cuts for the state’s more than 221,000 state workers.

The size of the deficit is important as it will shape the national perspectives of Newsom, who is a top surrogate for President Joe Biden’s reelection campaign and who is widely believed to harbor presidential aspirations of his own.

Newsom has spent much of his time in office basking in the glow of historic budget surpluses that allowed him to greatly expand state spending. But back-to-back budget deficits — with more on the horizon — are testing California’s commitment to those increases.

Newsom had enjoyed unprecedented surplus budgets of more than $100 billion throughout the COVID-19 pandemic. But the past two years have saddled him with a pair of multibillion-dollar deficits, a less-welcome position for a governor seen as a potential future Democratic presidential candidate.

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Governor Gavin Newsom convened local leaders to discuss their plans to tackle the homelessness crisis and identify new strategies and opportunities to more ambitiously address street encampments across the state.

Earlier this month, Governor Newsom announced the state was holding the third round of Homeless Housing, Assistance and Prevention (HHAP) grants for local governments whose plans, collectively, would only reduce statewide unsheltered homelessness by 2% by 2024. The Governor, in partnership with cities and counties, set a path forward for applicants to receive their HHAP round three funding, with grants being released as early as next week – provided that local governments agree to more ambitious reductions in unsheltered homelessness. The Governor challenged local leaders to submit more ambitious plans for their next round of funding – 21 so far have pledged to step up in writing. The state is expecting the remaining applicants will do the same.

“This was an important conversation that allowed us to speak with candor and to share some good ideas with one another,” said Governor Newsom. “Local leaders talked about the need for more city-county collaboration, more land use reforms to build housing faster, and to focus on keeping people housed who may be on the brink of homelessness — these leaders are our partners, and we all recognize we’re in this together.”

The third round of HHAP grants provides a share of $1 billion to every county, Continuum of Care, and the 13 largest cities in the state, on the condition that each local government has a plan approved by the state that reduces the number of unsheltered homeless individuals and increases permanent housing. The state has so far provided over $1.5 billion of flexible emergency aid to address homelessness through the Homeless Emergency Aid Program and the first two rounds of HHAP funding.

HHAP round four applications are due by November 29, 2022.

Governor Newsom’s $15.3 billion plan to tackle homelessness is an all-of-the-above approach funding the largest expansion of homeless housing in California history, providing local governments more money than ever before to address homelessness, and creating groundbreaking programs like Homekey and Project Roomkey which have become national models for getting people off the streets faster than ever before and at a fraction of the usual cost.

Find your latest news here at the Hemet & San Jacinto Chronicle

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I never fully appreciated the meaning hidden in a snatch of a phone conversation I overheard when I was 23 between my mother and her older sister, my Aunt G.R., until I held several black and white photos in my hands two decades later.

The pictures were of my mother and aunt when they were little girls, along with their mother, father and, likely, other families in the same predicament. There they were posing on a car in open fields, in front of what looked like wooden barracks, and in front of a large canvas tent. 

“Guess what, G.R? Kristi loves camping,” my mother told my aunt, emphasizing the word camping.

My aunt and my mother had lived at times in a tent, in barracks or in other people’s houses. In other words, my mother’s family was homeless for many periods during her childhood. 

While covering homelessness in San Francisco for the last three years for The Frisc, I’ve periodically replayed in my head my mother’s Texas drawl telling my aunt about my affinity for spending recreational time in a tent. 

A lot of the homelessness we’ve seen in San Francisco and all over California is the result of a housing affordability crisis. Over the last decade, rents for two-bedroom apartments in San Francisco increased by 37% to 48%, depending on the real estate index used. Over the same time, the minimum wage in San Francisco increased from $9.92 to $15.59 per hour. It’s now $16.32, but that yields an after-tax income of roughly $30,000, not enough to afford even a studio apartment in the city.  

This lack of affordable housing showed up in the 2019 one-night census of unhoused residents in San Francisco, known as the point-in-time count. The number of people living on the streets or in unstable housing increased by 15% over the previous count, in 2017. 

Two out of every three respondents in the 2019 survey said the main obstacle to permanent housing was that they couldn’t afford rent. 

What made this jump in homelessness more startling was that it happened on the watch of the city’s Department of Homelessness and Supportive Housing (HSH), created in 2016 to streamline services previously provided by several city bureaucracies. The department would use information technology to track people across the social services system. This would solve the homelessness crisis, city officials said. 

But it wasn’t working. The Department of Homelessness and Supportive Housing was underperforming. That was the conclusion of a scathing August 2020 report by the investigative arm of San Francisco’s legislative branch. Most of the research was conducted before the pandemic. COVID-19 made the situation much, much worse. 

The Frisc’s series on SF Homelessness, supported by the Center for Health Journalism’s Impact Fund, focused on the city’s plans and programs for aiding its most vulnerable residents and on how a young department could fall so short of doing its job. I wanted to track HSH’s progress in improving its operations. 

The mayor was opening up the budget coffers for getting chronically unhoused people into supportive housing. I wondered whether this focus would leave others who may not be considered chronically homeless — because they have been homeless for a year or less or don’t suffer from mental illness or addiction — out in the cold. Were there plans for them? 

Finally, I wanted to know whether the strict focus on the chronically homeless would overstretch the city’s ability to provide behavioral health services needed to keep this group of vulnerable people housed. 

Of course, all of this was now happening in conjunction with the public health emergency of COVID-19. So I looked at how the city was dealing with the pandemic on top of the pre-existing condition of a homelessness crisis. 

I began by talking to service providers — the network of nonprofits that run supportive housing sites, provide transitional housing, and offer support services to unhoused families, youth and adults. They told me they had many open units of housing just waiting for people to move in, but the people weren’t coming. In fact, there were nearly 900 vacancies at one point.

I had trouble getting a response from HSH about this issue. The pandemic meant that some services created to help unhoused residents during the pandemic — leased hotel rooms for sheltering in place, for example — were not part of HSH’s responsibilities. The quickest responses I got were those telling me to contact yet another department. 

But an obscure city board proved helpful. It included people who had once experienced homelessness, worked as service providers, or represented subpopulations of unhoused San Franciscans. The interim director of HSH gave a presentation at the monthly meetings of this board, and these reports included key data, such as the vacancies in supportive housing. 

Board members and anyone else in attendance (usually service providers and advocates) could question the interim director and other department staff about the issues presented. These Q&A and public comment periods were a valuable way for me to see first-hand how the department interacted with service providers. Sometimes the director or a staffer stuck to talking points. But sometimes there was a straight answer.

Perhaps the most important asset at these meetings was the board co-chair, Del Seymour, a formerly homeless veteran who could crystalize what was at stake, just as he did when he finished listening to all the comments and questions on the vacancies. 

I’ll never forget the emotion in his voice when he said, “There’s 100 people laying outside tonight that could really be inside tonight … so I’m asking now that the department listen to these providers. Every one of them said they’re willing to sit down with you to talk about how to fix this thing.”

It’s really important to listen to people who’ve experienced homelessness or who are unhoused. They know what’s working and what isn’t. 

When I interviewed Nathan Caine and his family, they had been awaiting a placement into supportive housing for five months. The holdup? The department said they didn’t technically qualify as a family. Nathan’s daughter, Nova, was only 5 months old. Family placements were for people with school-aged children. 

That made me really think about how hard it is to see homeless families. They don’t look like single adults or youth. 

Unhoused families might live doubled-up with other families. My mother had to do that when my grandfather’s work didn’t provide housing for the family. That left my grandmother scrambling for a live-in housekeeping job where she could have my mother and aunt with her. 

People living out of their cars accounted for the largest increase among homeless San Francisco residents in 2019. 

Many moved into their cars mostly because they no longer could afford rent. It was their first, best alternative to living on the street, as they had doors that locked, and they could use their home to get to school or work. 

Although I’d internalized this, it really hit me when my editor and I talked about my story on bridge housing alternatives and said to each other: unhoused people are not a monolith. 

For now, San Francisco officials are focusing on permanent supportive housing and getting the most chronically unhoused off the streets. This emphasis makes sense, as many of these people have suffered trauma and long struggles with addiction and street living.

But as varied as the reasons are for people winding up without a roof over their heads, so, too, should be the solutions.

We are very grateful to the Annenberg Center for Health Journalism Impact Fund grant for giving us the ability to study how our city officials and service providers are performing at getting unhoused people off our streets. Our work uncovered several key issues needing attention, particularly the paucity of behavioral health support for the most vulnerable residents. We will keep at this investigation in the coming year. 

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