Establishing Common Sense Solutions for the California Homelessness Crisis

A U.S. Department of Housing and Urban Development (HUD) survey conducted in 2020 places the Nation’s homeless population at around 580,000 people (HUD, 2021). That same year, the California State Senate estimated that some 28 percent of the Nation’s homeless population resided in California, despite the state making up only 12 percent of the Nation’s population (California Senate Housing Committee, 2021).

And it’s only getting worse. In a May 2023 poll, 21 percent of respondents identified homelessness as the top problem affecting California—followed by the economy, the second-highest area of concern (RMG Research, Inc., 2023)

Why is California this country’s epicenter for the homelessness crisis? The core problem is that the state’s leaders view homelessness purely as an economic issue. While housing costs are much too high in California—in large measure because of government overregulation—homelessness is not just a financial matter. The failed “housing first” philosophy embraced by public officials emphasizes the government providing no-strings-attached housing to the homeless without addressing the role of drug abuse and mental illness in driving the crisis. The facts speak to the importance of addressing these other factors.

In 2019, a Los Angeles Times analysis[1] estimated that, of the Los Angeles County homeless population, 51 percent had a mental illness, and 46 percent had a substance use disorder. Moreover, the Times analysis surmised that the true figures were likely even higher, explaining that government figures tend to underestimate the prevalence of substance abuse and mental illness among the homeless population.

Indeed, California’s experience resonates with findings about the homeless population nationwide. Surveys indicate that 50 percent of unsheltered homeless individuals—those living in cars, tents, streets, or other public places— report that mental health conditions contributed to their loss of housing and that 51 percent report that substance abuse conditions contributed. Furthermore, at least three in four unsheltered homeless individuals self-reported mental health or substance abuse conditions, with most reporting both (HUD, 2021).

The link between homelessness and crime is undeniable. In a May 2023 poll, 61 percent of Californians said homelessness was playing a significant role in increased crime—a perception that resonates with reality (RMG Research, Inc., 2023). Nationwide, the data shows that neighborhoods next to street camps have higher levels of rape, armed robbery, and aggravated assault than those that are not near such camps. Additionally, diseases such as typhus and Hepatitis A have spread through homeless encampments in California.

The America First approach to reducing homelessness recognizes the importance of addressing its root causes and preventing the social ills and lawlessness that proliferate as a result. To do anything less and simply throw money at the problem is an act of false compassion. Success will be achieved only when vulnerable populations are empowered to live as productive American citizens in clean, safe communities. To achieve this outcome, the America First approach focuses on addressing the mental health and substance abuse crises contributing to homelessness, empowering law enforcement to act in defense of their communities and public spaces, and deregulating local housing markets to make housing more affordable.

Solving problems associated with mental health issues and homelessness requires flexible treatment options for severe mental illness. Medicaid statute has excluded federal payments to institutions of mental disease (IMD) for care provided to most Medicaid-eligible adults since 1965, which has limited access to care for low-income patients with severe mental illness. States can apply for Section 1115 waivers to pay for some short-term treatment in IMDs for serious mental illness. This policy would go a long way toward addressing the crisis in California, as would allowing waivers to cover short-term treatment for substance use disorders.

To restore law and order, state and local governments must both activate and enable law enforcement to remove vagrants from public spaces by disallowing camping and loitering. Public property must be restored to the use for which it is intended. Also, public services and regulations must be revised to incentivize or compel addicts to seek treatment. This could include redirecting funding mechanisms for public assistance to those treatment programs that most expediently treat drug users. Police must also be equipped to deal with drug traffickers, ensuring that their arrest, prosecution, and sentencing are carried out to their fullest extent.

Lastly, the America First approach to homelessness seeks to rein in out-of-control land use, building codes, and environmental regulations that impede development, inflate construction costs, and reduce the supply of available housing. All Californians desire safe buildings, accessible and enjoyable communities, and a clean environment—but too often, regulations on the books are driven by activist ideologies that disregard the day-to-day concerns of regular Californians. America First policies subject all such regulations to meaningful scrutiny, devolve power as much as possible to individuals, and unleash the ingenuity of workers and small businesses to solve problems through the market instead of with heavy-handed bureaucratic control.

THE FACTS

• The number of unsheltered homeless individuals—those living in cars, tents, streets, or other public spaces—increased by more than 50,000 during the last five years, and the number of sheltered homeless—those living in shelters—has decreased each year since 2014.
• In Los Angeles, 60 percent of crimes involving homeless individuals are violent, while just 32 percent of all crimes in the city are violent.
• Four people die in Los Angeles’s homeless camps every day.
• At least three in four unsheltered homeless individuals self-report mental health and substance abuse conditions.
• About eight in 10 voters want their legislators to ban street camping.

(California State Senate, 2021; RMG Research, Inc., 2023; Smith and Oreskes, 2019; U.S. Department of Housing and Urban Development, 2021)

IN CALIFORNIA, WE SUPPORT POLICIES THAT:

• Modify the IMD exclusion in Medicaid, which limits the circumstances under which federal Medicaid funding to states is available for short-term treatment for severe mental illness or substance abuse disorders, through Section 1115 waivers.
• Empower local police to enforce all public order laws.
• Abandon the failed “housing first” philosophy and instead address the underlying causes of homelessness first, then empower individuals to succeed on their own.
• Address overregulated local housing markets.
• Challenge the Ninth Circuit’s ruling in Martin v. Boise, which held that cities could not enforce anti-camping ordinances if they do not have enough homeless shelter beds available for their homeless populations.

[1] The Times examined more than 4,000 questionnaires taken as part of a point-in-time count conducted annually by the Los Angeles Homeless Services Authority.