Homelessness in California

The United States Department of Housing and Urban Development estimated that more than 171,500 people were experiencing homelessness in California in January 2022. This represents 30% of the homeless population of the United States (California has slightly less than 12% of the country's total population).[1] More than two-thirds of homeless people in California are unsheltered (meaning they sleep on the streets, in encampments, or in their cars), which is the highest percentage of any state in the United States. Half of the unsheltered homeless people in the United States live in California: about 115,500 people, which is nine times as many as the state with the second highest total.[1]

A tent city at Oakland California (E. 12th Street) set up by local homeless people.
Homeless man in Fresno, California.

In both the 2007–22 and 2020–22 spans, California experienced higher increases in the number of people experiencing homelessness than any other state.[1] Between 2010 and 2020, the number of people experiencing homelessness in California increased by 31%, while nationwide the number fell by 18%.[2] Between 2020 and 2022, the number increased 6% in California and less than half a percent in the rest of the country.[3][1] Approximately 0.44% of Californians are homeless.[1] In 2021, 19% of Californians surveyed said they or someone close to them had been homeless at some point during the previous five years.[4] 36% of homeless people in California are categorized as "chronically homeless"—which means that "they have a long-standing disability that significantly impedes their ability to live independently and have been unhoused for a consecutive year or on at least four occasions within a three-year period." The other 64% are categorized as "experiencing short-term homelessness."[5] 80% of homeless people in California are adults not with children, and an estimated 40% of those are aged 50 and older. 14% are families with children. 7% are unaccompanied youth (where "youth" is defined as being under age 25).[5]

A 2022 study found that differences in per capita homelessness rates across the United States are not due to mental illness, drug addiction, or poverty, but to differences in the cost of housing, with West Coast cities including San Francisco, Los Angeles and San Diego having homelessness rates five times that of areas with much lower housing costs like Arkansas, West Virginia, and Detroit, even though the latter locations have high burdens of opioid addiction and poverty.[6][7][8][9] California has the second lowest number of housing units per capita, and an estimated shortage of one million homes affordable to the lowest income renters. Another 2022 study found that moderate decreases in rents would lead to significant declines in homelessness.[10]

Health aspects
See also: Homelessness in the United States § Health

In 2019, homeless people were hospitalized in California 119,815 times and made 324,823 emergency department visits.[11]

In March 2019 The Atlantic reported that outbreaks of what it called "Medieval diseases" such as tuberculosis and typhus were spreading in homeless shelters throughout California. These outbreaks have been described as a "public-health crisis" and a "disaster" by public health officials who are concerned they might spread into the general population.[12]

Street medicine is defined as "health and social services developed specifically to address the unique needs and circumstances of the unsheltered homeless delivered directly to them in their own environment." Health services provided via street medicine include chronic condition diagnosis, disease management, and preventive medicine. As of 2021 there were at least 25 street medicine programs operating in California. The average program had 615 patients and conducted 2,352 patient visits, but most programs had fewer than 500 patients and conducted fewer than 500 visits.[13]

Possible Causes

A number of things have contributed to the recent increase in the number of people experiencing homelessness in California.

Insufficient housing
Main article: California housing shortage

In California housing costs are exceptionally high and the supply of affordable housing is low. California ranks second from the bottom among U.S. states in the number of housing units per capita.[14] As of 2021 California had only 24 homes that were considered affordable and available for each 100 of the lowest income renter households, putting the housing shortage in California for this category of renters at about one million homes.[15]

In the 2022 book Homelessness is a Housing Problem, the authors studied per capita homelessness rates across the country along with what possible factors might be influencing the rates. They found that high rates of homelessness are caused by shortages of affordable housing, not by mental illness, drug addiction, or poverty.[6][7][8][9] They found that mental illness, drug addiction and poverty occur nationwide, but not all places have equally expensive housing costs.[7]: 1  One example cited is that two states with high rates of opioid addiction, Arkansas and West Virginia, both have low per capita rates of homelessness, because of low housing prices.[7]: 1  [8]: 1  With respect to poverty, the city of Detroit is one of the poorest cities, yet Detroit's per capita homelessness rate is 20% that of West Coast cities like Seattle, Portland, San Francisco, Los Angeles, and San Diego.[7]: 1  [8]: 1  The Sacramento Bee noted that large cities like Los Angeles and San Francisco attribute increases in the number of people experiencing homelessness to the housing shortage.[16]

A 2002 study found "that the incidence of homelessness [in California] varies inversely with housing vacancy rates and positively with the market rent for just-standard housing" and concluded that "moderate increases in housing vacancy rates and moderate decreases in market rents are sufficient to generate substantial declines in homelessness."[10]

Deinstitutionalization

A nationwide policy of deinstitutionalization (the closing of state mental hospitals which confined mentally ill people) in favor of smaller community-based psychiatric inpatient units between the 1960s and 1980s was not accompanied by a compensatory increase in such community-based units. This was also the case in California, and as a result there are fewer adult psychiatric residential, acute, and sub-acute slots available than would be necessary to meet the need.[14]

Deinstitutionalization coincided with the swelling of the U.S. prison system, and many people who previously would have been confined in state mental hospitals became confined in jails and state prisons instead.[17][10] In 2012 there were about ten seriously mentally ill people incarcerated in the United States for each such person hospitalized.[18] Recent California reforms meant to relax this mass incarceration have had the effect of releasing many of these people, whose mental illnesses, compounded by the trauma of incarceration, and combined with the stigma of being an ex-con, can make it especially difficult for them to find housing.[14]

Climate

The climate in California is relatively mild compared to many other regions of the United States. Especially because housing is very expensive in California, people with limited resources may rationally prioritize spending on things other than housing even if this threatens to lead to homelessness, in a way that would be less-rational in a place where homelessness means exposure to a more dire environment. Some evidence for this is that even within California, rates of homelessness are lower in regions that experience colder winter temperatures.[10]

Youth

According to the Annual Homeless Assessment Report to Congress for 2020, 36% of homeless youth (defined as people under the age of 25) in the United States live in California.[19] As of January 2022, 7% of those who are homeless in California are considered to be unaccompanied youth (people under the age of 25 not accompanied by parents or guardians).[5] More than 220,000 public school (K-12) students in California experienced homelessness in 2020–21.[20]

Many accompanied homeless youth are considered to be "throwaway youth", e.g. adolescents that were forced out of their houses and onto the streets. There may be multiple reasons for this, such as parents unaccepting of gender identity or sexual orientation, pregnancy, abuse, etc. Other homeless youth may be “runaway youth” who flee their houses and live on the streets. Abuse, neglect, conflict, or poverty are among the reasons they run away.[21]

State-level political action

The California State Auditor reported in 2021 that "[a]t least nine state agencies administer and oversee 41 different programs that provide funding to mitigate homelessness, yet no single entity oversees the State’s efforts or is responsible for developing a statewide strategic plan."[22]

In February 2023, California's Interagency Council on Homelessness reported that the state had spent $9.6 billion on alleviating homelessness between 2018 and 2021, and had provided related services to 571,000 people during that time. However, most of those served did not end up housed, and the number of homeless people in the state increased during that period.[23]

In November 2022, Governor Newsom briefly threatened to withhold homelessness-related state financial support from the state's counties in response to what he called "simply unacceptable" homelessness reduction plans that the counties had submitted. Those plans would have reduced homelessness by a mere 2% over four years.[24] Newsom relented two weeks later, releasing the funds on the condition that the counties submit more ambitious plans for the next set of grants.[25]

In 2016, California adopted the Housing First model to govern all of its state programs that provide shelter to people experiencing homelessness. The chronic housing shortage in California made such a model difficult to implement in practice.[14]

Homeless Data Integration System

In 1993 the U.S. government created the "Continuum of Care" (CoC) system which divides states into regions containing organizations like homeless services providers and local governments, for the purpose of Housing and Urban Development department funding. There are 44 such CoCs in California.[26]

In an attempt to improve policymaker legibility, California adopted the Homeless Data Integration System (HDIS) in April 2021. It coordinates and consolidates data collected by the state CoCs. HDIS is administered by the California Interagency Council on Homelessness.[27]

Housing roadblock reforms

California Senate Bill 35 (2017) and Senate Bill 9 (2021)—which both became law—aimed to reduce bureaucratic and local government roadblocks to building housing. SB35 made it easier to get multifamily housing developments approved, while SB9 allowed many homeowners to build granny units on their property or to subdivide their property into an additional lot on which a house could be built.[14]

Local NIMBY sentiment, in part from homeowners who benefit from the rising prices associated with restricted housing supply, have led to single-family zoning and other restrictions on residential development.[14] In 2021 new California laws limited the ability of local governments to prevent such housing,[28] and in 2023 the state government became more assertive about rejecting local housing & zoning plans that it viewed as being unreasonably restrictive—in some cases this meant that proposed developments would be approved by default without the explicit approval of local authorities.[29]

Tiny house villages

In 2023, California announced plans to spend $30 million to build 1,200 tiny houses in parts of the state as alternatives to homeless encampments.[30] Such tiny houses can be built for about $73,000, which is a fraction of the cost of building permanent housing in the state.[14]

Hospital discharge plans

In 2019, California Governor Jerry Brown signed Senate Bill 1152, mandating that hospitals have a discharge plan for homeless patients before discharging them and that they ensure such patients have food, shelter, medicine, and clothes for their posthospital care.[31] While many homeless people are eligible for free health insurance from Medi-Cal, it can be arduous for homeless people to apply, causing many homeless people to not have health insurance.[32]

Projects Roomkey and Homekey

Project Roomkey is a homeless relief program designed to mitigate the spread of the COVID-19 virus among homeless people. It began in March 2020, with funding largely coming from FEMA. The program was slated to end in late 2020, but continued with state and local funding. The program housed homeless people in vacant motel or hotel rooms, particularly those aged 65 or older or who had an underlying medical condition. [33]

Project Homekey is a continuation of Project Roomkey that focuses on the creation of low-cost housing by repurposing hotels, motels, vacant apartments, and other buildings. Phase one received $600 million in funding combined from the United States federal government's Coronavirus Aid Relief Fund (CARES Act) and California's general fund, and ended in December 2020.[34] Under this program, local governments purchased 94 hotels and motels and converted them into some 6,000 permanent housing units.[35]

In 2021, the state authorized $12 billion in spending on homelessness, including $150 million to continue Project Roomkey and $5.8 billion to build new housing units for phase two of Project Homekey.[36]

Forced mental-health and addiction treatment

Former state Assemblyman Mike Gatto proposed in a 2018 opinion piece that a new form of detention be created as a method to force drug addicted and mentally ill homeless people (who he claims make up two-thirds of California's homeless population) off the streets and into treatment, as well as to lengthen the jail terms for misdemeanors.[37]

A law enacted in September 2022 with broad bipartisan support established county-level "CARE courts",[38] which can order some people with untreated schizophrenia or psychosis into housing and treatment programs. It includes sanctions for counties that do not comply with the program by December 2024; some counties are to begin implementing the program in Fall 2023.[39][40] Under the provisions of the bill, families, clinicians, first-responders, and other behavior control specialists may petition the CARE Court, and after a clinical assessment that the person who is the subject of the petition is severely endangered or a threat to others as a result of untreated schizophrenia or psychosis, a judge would be authorized to mandate up to 24 months of court-ordered medication, substance abuse treatment, and housing. A bipartisan group of mayors gave tentative support.[41] The group Disability Rights California has sued in an attempt to stop the implementation of the law.[40]

Mental health housing and residential services

A ballot initiative is anticipated in California in 2024 under the provisions of which the state would issue bonds to pay for new residential behavioral health facilities as well as housing and residential services for people with mental illness and substance abuse disorders.[42]

Housing assistance via Medi-Cal

In 2022 California launched the CalAIM program under which a small number of particularly vulnerable patients can use their health insurance plans to help them find affordable housing, pay rental deposits, prevent evictions, or address health hazards in the home. A pilot program conducted in Alameda County in 2016–21 assisted 30,000 patients. Of those who were homeless, 36% ended up in permanent housing.[43]

California asked the federal government for permission to also issue short-term rent subsidies through Medi-Cal, California's version of Medicaid, to patients who are homeless or who are vulnerable to losing their homes.[44]

Criminalization of homelessness

To various extents, California local governments have experimented with criminalizing homelessness. This is accomplished with laws that, for example, make it a criminal offense to sleep out of doors or in a vehicle in some jurisdiction.[45]

The 2018 Appeals Court ruling Martin v. Boise restricted governments' abilities to enforce anti-vagrancy laws of this nature. The court held that cities cannot criminalize sleeping outdoors on public property if there are not enough shelter beds available for homeless people, as this would be a violation of the Eighth Amendment to the United States Constitution.[46]

[T]he Eighth Amendment prohibits the imposition of criminal penalties for sitting, sleeping, or lying outside on public property for homeless individuals who cannot obtain shelter.... That is, as long as there is no option of sleeping indoors, the government cannot criminalize indigent, homeless people for sleeping outdoors, on public property, on the false premise they had a choice in the matter.

— Martin v. Boise

Public bathrooms

The Right to Restrooms Act of 2021 would have required that public agencies must have bathroom facilities available for the public, provided without any cost or charge.[47] As of 2023 the bill had not been approved by the legislature.

Counties

Los Angeles
Tents of the homeless on the sidewalk in Skid Row, Los Angeles, 2018

As of February 2022 more than 40% of people experiencing homelessness in California lived in Los Angeles County.[5] The homeless population of L.A. County increased by 65% between 2020 and 2022.[3][1]

In June 2019, L.A. County officials reported over 58,000 people were homeless in the county.[48] In its January 2013 census, the county counted 39,463 people sleeping on the street or in homeless shelters. When including persons sleeping on private property with permission to stay no more than 90 days, the total estimated number of homeless people in L.A. County was 57,737 in 2013. The number of people in the latter category, called "precariously housed" or "at risk of homelessness", was estimated by means of a telephone survey. The number of homeless people in L.A. County, including the precariously housed and those at risk of homelessness, was 51,340 in 2011, of which 23,539 were in the City of Los Angeles, and 4,316 were in the 50 block area east of downtown Los Angeles known as Skid Row. It is estimated that 190,207 people are homeless in Los Angeles County at least one night during the year.

As of 2019 51% of homeless adults there had severe mental illnesses, and 46% had a substance use disorder (for 25% and 14% respectively, these were "permanent or long-term" conditions).[14] A 2013 census noted that 31.4% of homeless people in L.A. County abused drugs, 30.2% were mentally ill, and 18.2% had a physical disability; 68.2% of homeless people were male, 38% were African American, 37% were Caucasian, 28% were Hispanic, and 57.6% were between 25 and 54 years old. By 2015, there were an estimated 44 thousand homeless people living in Los Angeles. Homelessness jumped to a record level of more than 55,000 people living in shelters and on the streets in May 2017. On a given night, about 12,934 homeless people stay in a shelter.[49]

The Board of Supervisors of L.A. County wrote to the State Legislature asking that California "pass a resolution urging the Governor to declare a state of emergency with respect to homelessness"[50] in June 2016. In 2019, California governor Gavin Newsom fulfilled this request.[51] L.A. County Supervisor Mark Ridley-Thomas in an opinion piece said that homelessness had reached emergency levels in L.A. County, with over 900 people dying on the streets in 2018, and over a thousand projected to die in 2019. Exposure to the elements cuts the lifespan of those who survive on the streets by 20 years. He attributed the crisis to rising rents, lack of affordable housing, and stagnant wages.[52]

There are an estimated 4,021 homeless young-adults between the ages of 18 and 24 on any given night in L.A. County as of 2019, a 22% increase over 2018, per the Greater Los Angeles Youth Homeless Count.[53] The count defines youth as people 24 years old and younger.[54]

Los Angeles spent $619 million on 36,000 homeless people in 2019, approximately $17,194 per person, however the number of people who are homeless continues to grow.[55] Peter Lynn, head of the Los Angeles Homeless Service Authority (LAHSA) who saw homelessness rise 33% during his five years in spite of $780 million in additional funding, resigned his job at the end of 2019.[56]

A homeless person in Los Angeles sleeps on the street.

City of Los Angeles

According to a 2019 Los Angeles Times poll, 95% of voters called homelessness a serious or very serious problem in the city, more than for any other issue.[57] L.A. County officials reported that in 2019 there were over 39,000 homeless people in the city.[48]

More homeless people die from hypothermia in Los Angeles (average winter low temperature: 49 °F (9 °C)) than in New York City (average winter low temperature: 26 °F (−3 °C)).[58]

In November, 2022, voters approved Measure ULA, a tax on high-price real estate sales with the proceeds designated to fund affordable housing and homelessness services. The tax went into effect on 1 April 2023.[59]

In December, 2022, new mayor Karen Bass declared a "state of emergency" and issued an executive order aimed at removing hurdles to developing affordable housing and shelters for homeless people. The order instructs city agencies to process the bureaucratic paperwork associated with such projects within sixty days, rather than the six to nine months the agencies are accustomed to, and reduces the number of regulatory veto points for such projects.[60]

In 2016, voters approved a $1.2 billion bond measure designed to create permanent supportive housing. A report from the L.A. Controller's office criticized the implementation of the measure: five years after it passed, only 14% of the housing had been completed, and the average per-unit cost was about $600,000.[14]

The Los Angeles Police Department has issued citations and fines against people living in public areas as part of the Safer Cities Initiative that began in September 2006.[61] This Central Police division's initiative entailed assigning fifty full-time officers to clearing out "homeless encampments" in different parts of downtown. Once they cleared an area, they would stay for seven days before moving on to another area.[61] In 2015, the city was spending roughly $100 million a year on homelessness with approximately half of this funding going to policing the homeless population.[62] Proposition HHH was approved by voters 77% to 23% in 2016. This was a $1.2 billion bond measure to build permanent supportive housing for homeless people and people at risk of becoming homeless.[63][64][65][66][67] Rising rent and relatively few laws protecting tenants from predatory landlords are significant drivers of surging homelessness in Los Angeles.[68][69]

A Sprawling Homeless Encampment in Los Angeles at Venice & Clarington

City of Santa Monica

Santa Monica experienced a decrease in the number of homeless people downtown of 19% downtown accompanied by a 3% increase in overall homelessness in 2019. Positive results are credited to outreach and engagement strategies and to prioritizing homelessness, cited as a Top 10 Santa Monica Story of 2019 which reported on "In the Image", a statue of a homeless man installed in downtown Santa Monica.[70][55] Rising homeless numbers are attributed to the Los Angeles housing crisis.[71] Santa Monica has approximately 400 emergency shelter beds across 330 permanent supportive housing (PSH) units, and provides an access center for showering, mail, and medical assistance.[71]

Orange County

The 2019 Orange County Point in Time count documented 6,860 homeless people. Per the count, 2,899 of them had found some type of shelter, while 3,961 had no shelter. The Point in Time count is a federally required biennial census of homeless people to collect demographic data and other information and to determine how much federal funding Orange County will receive to address homelessness issues.[72]

A 2017 census in Orange County, California recorded 4,792 homeless people.[73] 193 homeless people died in 2017, with drug overdoses and suicides being the leading causes of death.[74]

San Diego

A 2017 count showed 9,100 homeless people throughout San Diego County.[75] Veterans make up a significant portion of this population, with 1,300 homeless veterans.[76] A Hepatitis A outbreak in November 2017 resulted in a declaration of a health emergency, which affected the homeless population due to inadequate sanitation.[77] In response to the health crisis, San Diego opened three emergency shelters which are expected to cost $12.9 million per year to operate.[78] The city approved a 500-bin storage center for homeless people to store their belongings.[79] San Diego has a history of insufficient healthcare provided to the homeless population, with a majority of homeless people in 1989 lacking any regular access to healthcare.[80]

San Diego's homeless population has fallen in recent years, but is the 6th largest in the United States with 4,801 people homeless in 2022.[81] The large count of homeless people is juxtaposed with the existence of over 30,000 vacant housing units.[82] San Diego has taken action to alleviate the homeless population living on the streets by encouraging housing within vehicles. In February 2019, San Diego repealed a long-standing law which made living within vehicles illegal.[83] This came two years after the construction of a parking lot designed to provide safe residence for people who live in their cars, complete with restroom and shower facilities.[84] The City of San Diego currently has 2,040 emergency and bridge shelters for homeless people, providing temporary housing options.[85] The City of San Diego adopted a "Housing First" program in 2018, which plans to spend $79.7 million for programs assisting homeless people[86] including temporary housing development, permanent housing development, rent assistance, and incentives for landlords to rent to homeless people.

Sacramento

In August 2019, the city of Sacramento filed a lawsuit against seven transients accused of theft, drugs, assaults, and having weapons. The lawsuit seeks to exclude them from the business corridor around Land Park and Curtis Park.[87]

San Francisco
Main article: Homelessness in San Francisco
A homeless camp in San Francisco, 2017

The city of San Francisco, California has a significant and visible homelessness problem. Approximately 61% of the homeless population were already living and working in San Francisco when they became homeless, indicating that a majority of people experiencing homelessness did not come to the city for its resources but rather are being priced out of their homes.[88] The city's homeless population has been estimated at 7,000–10,000 people, of which approximately 3,000–5,000 refuse shelter due to the conditions within the shelters— including violence, racism, and homophobia and transphobia. There are only 1,339 available shelter beds for the approximately 10,000 people sleeping outdoors.[89] The city spends $200 million a year on homelessness-related programs.[90] On May 3, 2004,[91] San Francisco officially began an attempt to scale back the scope of its homelessness problem by changing its strategy from cash payments to the "Care Not Cash" plan, which however has had no visible impact on reducing homelessness in the city. In 2010, a city ordinance was passed to disallow sitting and lying down on public sidewalks for most of the day.

An October 2018 report by Leilani Farha, the UN's Special Rapporteur on the Right to Adequate Housing, said that "cruel and inhuman" conditions for homeless people in the Bay Area violate human rights, which include being denied "access to water, sanitation and health services, and other basic necessities." Farha's fact finding mission found conditions in homeless encampments rivaling the most impoverished neighborhoods in Mumbai, Delhi, and Mexico City. She urged the Bay Area to provide more affordable housing.[92]

A proposition on the Nov 2018 elections ballot (Proposition C), would apply a tax to the gross receipts of San Francisco's largest companies. The revenue from the tax would add up to $300 million a year to the city's homelessness budget (double what it is right now). It would also fund shelters, mental health services, addiction treatment, and prevention to keep people from becoming homeless.[93] It passed with 61% of the vote and was upheld as valid by the state Supreme Court.[94]

Santa Barbara

The rising cost of rent and property prices forced hundreds of middle-class people, including teachers, chefs, and nurses, to live out of their cars in parking lots. In 2017 a count showed 1,489 homeless people.[95] There were 44 deaths in Santa Barbara County in 2016.[96]

Ventura

A preliminary 2018 count released by the Ventura County Continuum of Care Alliance board indicated that the county's population of homeless men, women, and children was 1,299.[97] It was also reported that there was an increase of 24% for the unsheltered population.[98] Overall, in 2017, the City of Ventura experienced a double-digit increase in its homeless population from 2016[99] and 63 deaths.[100] Ventura residents have placed pressure on city leaders to do more about the growing homelessness problem.[101]

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