Bug infestations, tent-lined streets: California's homelessness crisis is at a tipping point. Will a $12B plan put a dent in it?

Tent-lined streets with belongings scattered everywhere. Infected wounds with bugs living inside. A man who hasn't showered in over a decade. An 80-year-old woman who can't feed herself. People who ride the metro rail lines because the trains are a safer place to sleep.

California's homeless problem has been out of control for decades. Then came COVID-19.

The result has been a deadly combination of medical crisis, human hopelessness and bureaucratic red tape as the state, reeling from the effects of the virus, tries to rebound with a plan for the 160,000 homeless people. That number eclipses any other state – and accounts for half of the country's entire unsheltered population.

A severe shelter and housing shortage is becoming not just a social services problem but a political one as well, unlike anywhere in the country – thrusting the problem before the eyes of Californians who see people suffering and dying on the streets each day.

"There isn't real clear leadership, there isn't clear accountability," says John Maceri, who heads The People Concern, one of the largest homeless relief organizations in the Los Angeles area, the epicenter of the crisis. "You have this very fractured system. It really is like herding cats."

The state is at a crossroads in its post-pandemic attempt to curb homelessness, and the rest of the nation is watching. Gov. Gavin Newsom has set aside $12 billion in what he called a historic budget to combat homelessness. COVID-19 protections are nearing an end, meaning evictions will soon be allowed and could worsen the problem.

And all of it is happening while a lawsuit threatens to reshape how Los Angeles – and perhaps the state – has tackled homelessness after a federal judge issued a scathing rebuke of the decades of failed plans, leadership and promises to fix the problem.

Layers of housing bureaucracy and years without solving homelessness

Solving the cycle of homelessness has befuddled policymakers for decades. Money is thrown at it, as are new ideas. Yet more people end up living on the streets.

For about 30 years, Karen Barnes has worked to help people experiencing homelessness in the state. Many of those she and her team have worked with suffer from extreme mental illness and other illnesses, from out-of-control diabetes to sexually transmitted diseases and wounds and abscesses that went untreated for such a long time that maggots have infested them.

"The fact that people are somehow able to survive out there for that long is you know, amazing, but they have to be really tough," said Barnes, who helps lead an outreach team at PATH (People Assisting The Homeless) in Los Angeles aiming to help those experiencing homelessness on transit lines. "These are humans and we can't lose sight of that."

More: California tops list of states with the most unsheltered homeless people

She told stories from those living on the streets and the successes she has seen with finding a person shelter or care, including one man who had a severe mental illness and was later found with terminal cancer. They helped him get into hospice care, where he died.

"We went to give him a birthday cake and had a little birthday party with him right before," Barnes said. "At least the end wasn't, you know, what it could have been. He was happy at the end. That made it worth it."

It can take years to get someone into stable housing because of the distrust within the homeless community and concerns about being burned by a system that has failed them, she said. Many shelters are rough places and come with rules that include curfews. Instead, some choose to stay in a place they know, even if that means sleeping outside, without a bed or any shelter – something California's climate makes more possible than in other areas of the country.

The state accounts for more than half of the country’s unsheltered population, according to a report released in January from the Department of Housing and Urban Development. While New York has a large number of people experiencing homelessness, the state offers shelter to 95% of those people. In contrast, about 70% of those experiencing homelessness in California lived outside or in vehicles.

At its core, experts, advocates and state officials say a handful of issues have made tackling homelessness even harder: a high cost of living, lack of affordable housing, scattershot efforts with too many agencies, too much red tape and an unclear direction.

The state is one of the most expensive to live in, a problem only worsened with a shortage of about 1.3 million affordable rental homes, according to the California Housing Partnership. The lack of affordable housing hasn’t been easy to solve. New housing ventures take years, sometimes decades, to complete.

And they aren’t cheap. The Los Angeles Times chronicled one affordable housing project’s decadelong path, identifying the various issues that led to the project shrinking to about half its size and growing to more than double its cost – about $1 million per unit.

Layers of bureaucracy require developers to navigate a labyrinth of departments and funding sources that drag out the process, all while strict rules on labor and environmental standards drive up costs. Along with lack of funding, such projects are often met with opposition from the community.

Advocates and experts have watched public officials roll out various plans over the years only to eventually see money dry up or a lack of meaningful progress.

"What happens is we roll out a new pilot program only to have to ramp it down when the problems are still mounting and people are still needing help," said Jennifer Hark Dietz, deputy chief executive officer at PATH. "We really need an ongoing commitment from the state and local level to kind of dig us out of this hole."

A report by the nonpartisan state auditor this year found the state’s approach was fragmented and hindered efforts to house people. It noted California had spent $13 billion over three years through various agencies and programs to address the problem, yet it lacked a centralized way to oversee efforts or track progress and spending. The office of State Auditor Elaine Howle said California continues to have the largest homeless population in the nation “likely in part because its approach to addressing homelessness has been disjointed.”

Since the report, the state has rolled out a new database that tracks homelessness and those who seek help across the state, aiming to identify best practices and where money should be spent.

“You can’t fix what you can’t measure and having a statewide data system will help us determine what’s working and what isn’t,” Newsom said in April when the database was unveiled.

Deaths on city streets and in cars

The crisis in California has left a trail of death.

Some come from drug overdoses, violence or untreated illnesses that compound over time. Others come from suicide. These people die under freeways, along sidewalks and in alleys, hospitals and vehicles. More than 1,300 died last year in Los Angeles County alone. An additional 1,200 died the year before that.

Some, like Joshua Ray Williams, are never reunited with their families even after death. He was found dead last year of a drug overdose outside a Jack in the Box along bustling Sunset Boulevard in Los Angeles. A manager of the restaurant found him and called first responders after seeing his face was blue. Crosstown, a local news outlet in Los Angeles, wrote about his death and others who died last year, deaths they say are largely forgotten.

A homeless family of four dressed in pajamas died in a parked van outside a CVS in Garden Grove, about 30 miles outside Los Angeles, in 2018. Both children were in diapers. Sheets covered the windows, aiming to keep the sunlight out. They'd been living in the van for a long time. Authorities said carbon monoxide was to blame.

While California's typical warm weather makes living outside more feasible than in other regions, it isn't safer. Greg Tarola was found dead in November after cold temperatures and batch of storms hit the Sacramento area. The father of two who suffered from diabetes and epilepsy was found wrapped in wet blankets, according to Sacramento Loaves & Fishes, a homeless organization that serves the area.

$12 billion and a judge who could force a different housing plan

Those experiencing homeless in California range from someone riding the metro to sleep to those who have set up tent communities that feature everything from forms of government with elected leaders, security mirrors and bee hives set up to act as protection against unwelcome visitors. Many have mental illnesses. Others suffer from physical ailments.

"I've done this work and similar work in Boston, in New York, and I think I see the most vulnerable people that I've ever seen on the street in this community," said Ciara DeVozza, who helps lead outreach in the skid row community for The People Concern.

The pandemic cast a new spotlight on the state’s homelessness crisis, laying bare the danger of living in such unsanitary conditions. Even without the pandemic, people experiencing homelessness die each day in Los Angeles County. Last year, the county’s medical examiner documented more than 1,300 deaths, a number advocates say is probably much higher.

Homelessness groups rushed to house people while also getting people access to coronavirus tests and vaccines once they were available.

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Tent encampments are typical sights under freeways and in areas such as skid row – a pocket of downtown Los Angeles known for its vast homeless population – but the pandemic, shutdowns and quarantines caused them to spread across the city. Encampments popped up in parking lots, neighborhood parks and outside schools, not only in Los Angeles but other parts of the state.

In San Francisco alone, tent encampments grew by 70% and became more visible across the city, according to the San Francisco Chronicle.

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Last month, Newsom proposed a $12 billion investment to fight homelessness using a budget surplus and federal dollars passed to help COVID-19 recovery efforts.

The proposal includes $8.75 billion over two years to create an estimated 46,000 housing units, expanding on a program launched during the pandemic to convert motels and other properties into housing. It also includes $3.5 billion on rental subsidies, new housing and shelter resources with the aim of ending family homelessness within five years.

Los Angeles Mayor Eric Garcetti similarly made homelessness a centerpiece of his budget, setting aside about $1 billion for the city’s homelessness crisis.

But as state and city leaders pitched their plans, a lawsuit filed last year by residents, business owners and developers aiming to force the city and county of Los Angeles to house those on skid row was working its way through the courts. A federal judge ordered in April that the city and county must provide shelter for the nearly 5,000 unhoused people living on skid row by October, an order that's being appealed.

“All of the rhetoric, promises, plans, and budgeting cannot obscure the shameful reality of this crisis – that year after year, there are more homeless Angelenos, and year after year, more homeless Angelenos die on the streets,” Judge David Carter wrote in a scathing 110-page order that documented the history of the area’s homelessness crisis and chastised elected leaders for their efforts. He noted the systemic racism that has also played a major role. While African Americans amount to less than 6% of the state's population, they account for about 31% of those who access homelessness services.

Carter wrote the city had “lost its parks, beaches, schools, sidewalks, and highway systems due to the inaction of city and county officials who have left our homeless citizens with no other place to turn.”

State and local leaders, along with some advocates, said they worried that the order, which included forcing Los Angeles to put $1 billion in an escrow account, would just warehouse the problem and halt progress on permanent solutions.

Benjamin Henwood, a licensed clinical social worker, an associate professor and director of the Center for Homelessness, Housing and Health Equity Research at the University of Southern California, noted this could mimic a similar system that was created in New York after a landmark case argued the city should be required to provide some form of shelter for those experiencing homelessness.

While such a system creates more sanitary and humane living arraignments, Henwood said in many ways it merely removed the crisis from the eyes of New Yorkers without a clear path to helping solve it.

"I think essentially, it created a huge shelter system that, while it got people off the streets, it didn't get them out of homelessness," he said. "In fact, it just sort of created a cycle of homelessness because the way the system set up, you get in, you have to get assigned, you move around. It doesn't it doesn't really facilitate an exit from homelessness."

Those behind the lawsuit argue immediate action is needed to prevent deaths. They say going through the courts was a last resort but something that could provide a broader precedence helping to house those experiencing homelessness in other areas.

"Even in these very interesting political times we're living in, homelessness is like the one issue that cuts across all demographics, where everyone basically agrees it's terrible and something needs to happen," said Daniel Conway, a policy adviser for the L.A. Alliance for Human Rights, the coalition of residents, business owners and developers behind the case.

"With this lawsuit, we were kind of trying to force that decision making process. And also recognizing that anything you did in L.A. could set a set a model, a precedent for the rest of California, if not the rest of the western U.S."

This article originally appeared on USA TODAY: California's homeless crisis is at a crossroads. Will $12B fix it?