Analysis: Lack of beds keeps homeless on the streets longer

In Tulare County, 95% of homeless who enter housing stay off the streets, but less than 13% can find beds

By Reggie Ellis

TULARE COUNTY – Visalia has the highest percentage of homeless people with highest need in the entire country. 

The Sun-Gazette reported last week that Tulare and Kings County, where most of the homeless population lives in Visalia, had the highest percentage nationwide of unsheltered, chronically homeless people, according to the U.S. Department of Housing and Urban Development’s 2018 Annual Homeless Assessment Report to Congress. 

Nearly one-third of the homeless in the Tulare-Kings Continuum of Care (CofC), statistical areas where homeless people are served, are considered chronically homeless, meaning they have been without shelter for a year or at least four separate times in the past three years. To make matters worse, 95.8% of those who are chronically homeless in the area have no place to go for shelter. That’s the highest percentage in the nation, more than Los Angeles, Fresno, Oakland and Long Beach and 10% higher than similarly sized areas, urban areas not among the nation’s 50 largest cities, in Eugene, Ore., Vallejo, Calif., Oxnard, Calif. and Savannah, Ga.

Machael Smith is executive director of the Tulare-Kings Homeless Alliance, the CofC provider for the two-county area. She said none of the local numbers on homeless were a surprise, since the Congressional report relies on CofC data, but what was shocking was how dire the situation here was when compared with other, similar-sized areas. 

“We have a significant number of unsheltered, but as a smaller community, you don’t really think yours will be at the top of list,” Smith said.

According to the report presented to Congress in December, Tulare and Kings Counties ranked fourth on the list of CoCs with the highest percentage of homeless people who are unsheltered. More than three-quarters of the homeless here (823 people) live on the streets without shelter from weather. That only trails the Vallejo and Pasadena areas in California and the Eugene area in Oregon for urban areas not among the 50 largest cities in the nation. Nearly half (47%) of all unsheltered people in the country, about 89,000, live in California. The state with the next largest number of people experiencing homelessness in unsheltered locations was Florida, with 7% of the U.S. total, or about 13,393 people. 

Tulare and Kings counties also ranked third among urban areas outside the 50 largest cities with the highest number of chronically homeless. Locally, 286 people were identified as chronically homeless, trailing only Eugene, Ore. And Vallejo, Calif. in the largely urban category. California is home to about 85% of the country’s chronically homeless. 

“Encampments in our region may be smaller but they have higher needs than Skid Row in L.A.,” Smith said.

The most obvious answer for getting people off the streets is more low-cost housing options to get people out of the elements and then address any obstacles to a more stable form of housing. When housing is available, Tulare County has done a good job of keeping people off the streets. Of the 81 households who entered supportive housing from 2017-2019, about 95% remain stably housed, according to the Pathway Home reported completed by Home Base consulting in November. Due to the area’s lack of available housing, at every income level and for both owned and rental units, Smith said the CofC has poor outcomes in regards to transitioning homeless people into transitional housing and those housed in transitional housing into permanent housing.

“We can’t compare with outcomes in other areas because we’d have to kick people out to make room,” Smith said.

Housing for the homeless can be broken down into two groups: Rapid rehousing and permanent supportive housing. Rapid Rehousing (RRH) means short-term rentals that provide supportive services for up to 24- months, with the goal of helping people to transition into more permanent housing. Tulare County has only seen an increase of 71 beds for a total of 104 RRH beds since 2012 but nearly 1,000 people have been assessed as needing RRH beds in the last four years alone. Only 60 of those people have been placed in housing. RRH is funded primarily through CoC and ESG programs, TulareWorks, and Supportive Services for Veteran Families. 

“We have had no rapid rehousing dollars for the last year because the state is that slow [in distributing them],” Smith said.

Similarly, those wanting to transition into more permanent housing are also struggling to find those units. Permanent Supportive Housing (PSH) provides long-term housing with intensive supportive services to persons who would not be able to retain housing without significant support. Tulare County has only seen an increase of 146 beds for a total of 238 beds since 2012 but nearly 600 people have been assessed as needing PSH since mid 2015. Only 77 households are currently enrolled in the program. 

In 2018 alone, an average of 23 new households were identified as needing either RRH or PSH each month but, due to the scarcity in PSH and RRH resources, only 6 households were enrolled each month. Between 2016 and 2019, number of chronically homeless increased by 36% (180 to 244 people, respectively), but the number of total PSH beds only increased by 7% (from 223 to 238 beds).

“The situation is already worse,” Smith said. “Those who were not homeless a year ago are now chronically homeless due to a bureaucratic nightmare.”

Recently, Smith said the state took half of the funding going to the highest allocated areas, such as the Valley, and gave them to the lowest allocated areas. For example, Tulare-Kings was budgeted for about $375,000 for 2019 of the California Department of Housing’s Emergency Solutions Grant (ESG) Program but was only awarded a little less than $200,000. Conversely, the CofC covering Amador, Calaveras, Tuolumne and Mariposa counties was budgeted for just over $150,000 in ESG for 2019 but was awarded more than $450,000. Fresno and Madera counties’ CofC was so frustrated, Smith said they didn’t even file an application, potentially leaving a quarter of a million dollars on the table. Tulare County was already receiving about half of the homeless funding per person compared with Sacramento, Bakersfield and Fresno, one-third of Oakland’s funding and a quarter of San Mateo County. 

“This is a formulaic issue,” Smith said. “They are putting people in positions who have no idea what they are doing.”

Smith said the Tulare-Kings region is also not an entitlement region, meaning it does not automatically get funding from the state government for homeless like larger cities, such as Los Angeles and San Francisco. Instead, she said Tulare-Kings must apply for funding through a competitive process against other places they may have more staff and resources. This differs from the federal process where funding is guaranteed based on population. 

“We qualify for the bare minimum in funding under the state’s scoring system,” Smith said. “They don’t take into account the realities of our community.”

In addition to a lack of housing, Smith said there is an overabundance of meth. From spring of 2016 until spring of 2018, Tulare County had a higher rate of hospitalizations for amphetamine-related overdose than the state average, according to the California Opioid Overdose Surveillance Dashboard. Unlike opioids or cocaine, Smith said there are no proven medications to help addicts transition into sobriety. 

According to the American Addiction Centers, there has been some success to treating meth addiction with naltrexone, a drug generally used in the treatment of alcoholism. UCLA researchers discovered that patients who were given naltrexone after they completed their detoxification had “significantly reduced” cravings for meth, were even less aroused by meth when in its presence and reported that they didn’t enjoy it as much as they used to and were less likely to want meth again. However, longitudinal studies are lacking on the subject. 

“There is not a medical solution to get to the other side of the disease,” Smith said. 

Nearly a quarter (24%) of all people experiencing homelessness, an estimated 130,000 people, call California home, followed by New York (17% or 91,897 people); Florida (6% or 31,030 people); Texas (5% or 25,310 people); and Washington (4% or 22,304 people). California and New York had the largest numbers of people experiencing homelessness and high rates of homelessness, at 33 and 46 people per 10,000. However, California has also seen the largest decreases in homelessness in the last year (-1.2% about 1,560 people) and the fourth most in the last decade (-6.5%). 

In 2018 alone, an average of 23 new households were identified as needing either RRH or PSH each month but, due to the scarcity in PSH and RRH resources, only 6 households were enrolled each month. Between 2016 and 2019, number of chronically homeless increased by 36% (180 to 244 people, respectively), but the number of total PSH beds only increased by 7% (from 223 to 238 beds).

“The situation is already worse,” Smith said. “Those who were not homeless a year ago are now chronically homeless due to a bureaucratic nightmare.”

Recently, Smith said the state took half of the funding going to the highest allocated areas, such as the Valley, and gave them to the lowest allocated areas. For example, Tulare-Kings was budgeted for about $375,000 for 2019 of the California Department of Housing’s Emergency Solutions Grant (ESG) 

Program but was only awarded a little less than $200,000. Conversely, the CofC covering Amador, Calaveras, Tuolumne and Mariposa counties was budgeted for just over $150,000 in ESG for 2019 but was awarded more than $450,000. Fresno and Madera counties’ CofC was so frustrated, Smith said they didn’t even file an application, potentially leaving a quarter of a million dollars on the table. Tulare County was already receiving about half of the homeless funding per person compared with Sacramento, Bakersfield and Fresno, one-third of Oakland’s funding and a quarter of San Mateo County. 

“This is a formulaic issue,” Smith said. “They are putting people in positions who have no idea what they are doing.”

Smith said the Tulare-Kings region is also not an entitlement region, meaning it does not automatically get funding from the state government for homeless like larger cities, such as Los Angeles and San Francisco. Instead, she said Tulare-Kings must apply for funding through a competitive process against other places they may have more staff and resources. This differs from the federal process where funding is guaranteed based on population. 

“We qualify for the bare minimum in funding under the state’s scoring system,” Smith said. “They don’t take into account the realities of our community.”

In addition to a lack of housing, Smith said there is an overabundance of meth. From spring of 2016 until spring of 2018, Tulare County had a higher rate of hospitalizations for amphetamine-related overdose than the state average, according to the California Opioid Overdose Surveillance Dashboard. Unlike opioids or cocaine, Smith said there are no proven medications to help addicts transition into sobriety. 

According to the American Addiction Centers, there has been some success to treating meth addiction with naltrexone, a drug generally used in the treatment of alcoholism. UCLA researchers discovered that patients who were given naltrexone after they completed their detoxification had “significantly reduced” cravings for meth, were even less aroused by meth when in its presence and reported that they didn’t enjoy it as much as they used to and were less likely to want meth again. However, longitudinal studies are lacking on the subject. 

“There is not a medical solution to get to the other side of the disease,” Smith said. 

Nearly a quarter (24%) of all people experiencing homelessness, an estimated 130,000 people, call California home, followed by New York (17% or 91,897 people); Florida (6% or 31,030 people); Texas (5% or 25,310 people); and Washington (4% or 22,304 people). California and New York had the largest numbers of people experiencing homelessness and high rates of homelessness, at 33 and 46 people per 10,000. However, California has also seen the largest decreases in homelessness in the last year (-1.2% about 1,560 people) and the fourth most in the last decade (-6.5%). 

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