[Hpn] San Francisco, CA - SHAME OF THE CITY: The high cost of homelessness - San Francisco Chronicle - December 3, 2003

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SHAME OF THE CITY: The high cost of homelessness

City has blinders to big picture
Kevin Fagan - San Francisco Chronicle - December 3, 2003

SHAME OF THE CITY (Fourth of a five-day series)

San Francisco, CA has the nation's worst problem with hard-core
homelessness. Thousands of people are without shelter, and
as many as 5,000 spend virtually all their time on the

Chronicle reporter Kevin Fagan and photographer
Brant Ward spent four months among the homeless and those
who deal with them. In this series, they explore how one of
the nation's wealthiest and most cultured cities came to
have so many people living on its streets.

Drugs, alcohol and mental illness are among the troubles
that keep the chronically homeless on the street. Dealing
with those problems costs the city $200 million every year.

Nearly half goes toward putting the homeless in jail or
handling medical problems. The kindness San Francisco
extends to the homeless - welfare checks and daily handouts
- has combined with political gridlock to allow the problem
to persist

People walk past the homeless on San
Francisco's streets every day. They curse, ignore, hand over
spare change. They feel sorrow, guilt, rage, disgust.

workers search out the homeless around the clock, handing
out blankets and food, urging them to come into shelters and
get counseling and help to find housing. But they can't
force anyone to take those offers.

Police move the homeless from street to jail and back again.
Politicians fight over welfare checks of up to $410 a month
given to the homeless -- the biggest in the state -- and
come up with plans to solve the problem. Some stick, some

How did this happen? How did one of the most sophisticated
and cultured cities in the world, come to have thousands of
people existing in Dickensian wretchedness on its streets?

One reason: San Francisco has become a city of political and
social enablers, as psychologists would put it.

There aren't
enough programs or housing to help all of the 8,600 to
15,000 homeless get off the street -- and there haven't been
since the crisis began in the early 1980s.

Most of the
chronically homeless get just enough to survive on the
streets, but not enough to move into a healthier life.

Over 20 years, a politically accepted, coordinated,
consistent policy has never emerged to solve the city's
problem with hard-core homelessness -- now the worst in the
United States.

The city fails to get untold millions in
federal, state or private grants that other cities are able
to capture because it doesn't have a comprehensive plan.

"The city has no shared vision of what results it is trying
to achieve, and the issue is so politically charged that its
officials and administrators cannot agree on what the city
is trying to do," read a scathing report issued last year by
the office of the controller on San Francisco's homeless

The city can't even determine how many homeless
people it has, the report said, or compile enough data about
who they are.

U.S. Sen. Dianne Feinstein was San Francisco mayor when the
crisis surfaced. Since then, she has seen homelessness all
over the nation.

"We have the worst," she said. "It is so dominant when you
come into the city. Every time I come into the airport, I'd
say I see at least 20 homeless people just on my way to my

Statistics show the severity. The U.S. Interagency Council
on Homelessness estimates that 10 percent of any city's
homeless population consists of the hard core -- those who
chronically live on the street. In San Francisco, the hard
core constitutes about 40 percent of the homeless

San Francisco residents don't like the morass. The
professionals who try to fix it don't like it. And the
homeless themselves don't like it.

The situation evolved out of the city's liberal character
and temperate weather, both of which made it attractive to
drifters. A bad economy, the high cost of housing and
decades-old cuts in support for the mentally ill made it

"We're not Calcutta, so we're not going to tolerate people
dying in front of us," said Philippe Bourgois, chairman of
the UCSF Department of Anthropology, History and Social

"They really are as desperate as they look, and a
lot of them are kept alive by our sandwiches, the tents and
blankets we give them, the dollar we hand out now and

But that will never be enough to solve the problem, he said.
The only solution is providing the homeless with "supportive
housing," meaning a room and enough on-site counseling to
cure the substance abuse, mental illness or joblessness that
rendered them homeless in the first place.

Barring that, "we've really got a stupid system for dealing
with them," Bourgois said. "It's like we're forced to enable

Tourists are shocked, and the businesspeople who serve them
are confounded.

Mary Concannon and Michael Mee, visiting from Ireland in
July, were panhandled six times in six blocks on their way
to shop for baskets at Pearl Art and Craft Supply near Sixth
and Market streets. They also watched crack cocaine dealers
hawking and smoking drugs in the open.

"Oh, my gosh, it's so amazing,'' said a shaken Concannon.
"Isn't there something anyone can do?"

John Marks, president of the San Francisco Convention &
Visitors Bureau, said there is no way to quantify how much
encounters like that hurt business downtown. "But to me, it
is the single sore spot we have for our residents and
visitors. ... This has just gotten so out of hand."

Outgoing Mayor Willie Brown is leaving office after eight
years frustrated about the stubbornness of the crisis in his
streets, even though the city spent more money on
homelessness and created more supportive housing than ever
during his administration.

"San Francisco cannot solve the state's mental health
crisis, or the nation's poverty crisis, alone," Brown said
in a statement to The Chronicle. "As long as we remain the
only city in Northern California truly committed to
addressing homelessness, we will continue to be the beacon
in the fog, and we will continue to see homeless people on
our streets.

"No one mayor, no one city, can change that alone."

Social workers know the system isn't
working, and they feel helpless. "Everyone seems to be
involved in the homeless situation for their own benefit,
especially the politicians," said Willie Hall, who as a
director at the downtown McMillan Drop-In Center for the
homeless sees it all. "If they really cared, they'd make
something happen that would last.

"But everyone is just lost in their own inaction, their own
inability to get things done. It's ridiculous."

The homeless are not on the sidewalk because they like a
hardy and free outdoor life, says Dr. Barry Zevin. He is
medical director of the San Francisco Department of Health's
Tom Waddell Health Center, which treats 10,000 homeless
patients every year.

"I get a little angry at the impression that somehow it's
comfortable to be homeless on the street, that some of them
like it out there," he said. "But it's miserable.

"Some people think tough love would do it. But it's more
complex than that."

Zevin, who has worked intently with the chronically homeless
for 13 years, said he is sure their plight can be improved.

Some already pull themselves up from the depths, he said,
applying what he calls the "cliche rule of thirds" -- that
one-third of the patients he sees can be helped by him,
one-third will stay the same or help themselves and
one-third will get worse or die.

The Coalition on Homelessness, the city's foremost advocacy
group for indigents, vociferously defends their right to
stay outside if they want to -- but also has few illusions.

"Nobody wants to be out there, not really," said Chance
Martin, editor of the coalition-sponsored Street Sheet
homeless newspaper.

"But what can they do, with things the
way they are? It's gotten so bad, we measure success in not
dying next week, then maybe by getting off the street, then
last of all getting a job and staying inside."

The key is addressing problems that hobble the homeless, the
vast majority of whom are drug addicts or mentally ill. But
the reality in San Francisco is that the city's inadequate
treatment system leaves most homeless people bouncing in and
out of housing, rehabilitation, hospitals or jails.

Seventy-three-year-old Jack, who like many homeless people
wouldn't give his last name, illustrates the point.

In an alcoholic stupor, he lay in his own excrement on a
sidewalk near Union Square one hot day in June, mumbling to
himself. Tourists and workers walked past, hands covering
their noses.

About an hour after he collapsed, Jack was picked up by Ben
Glendenning in his Mobile Assistance Patrol van. MAP is a
city program that helps the homeless, and shopkeepers had
called the agency.

Glendenning recognized Jack as he pulled up: "A frequent
flier," he sighed. He put on surgical gloves, gently lifted
Jack up under the armpits and helped him walk to the back of
the van, where he laid down with a groan.

As the van headed to the hospital, Jack said he liked being
outdoors. "I gotta be my own man," he mumbled. In the 15
minutes it took to get to San Francisco General Hospital,
Jack sobered up enough so that he was able to walk alone to
the emergency room.

There, he stood swaying in line, waiting for a nurse. "How
come they don't have a real place for me to stay anywhere?"
he mused in a voice still thick with booze. "I'd love a real

Glendenning shook his head as he watched Jack in line.

"It breaks your heart," he said. "I'm picking up guys like
Jack, and old ladies, all the time, people 70 years old who
should be home with their grandkids.

"They pass out on the sidewalk downtown, I bring them here
to get cleaned up, and a couple days later they're right
back where I found them."

Jack spent several hours at the hospital. Nurses cleaned him
up and deloused him. Then he was released back to the

Police officers are just as frustrated
as social workers. Their main tools for managing the
homeless are issuing vagrancy tickets to people "encamping"
on the street (occupying a space without permission), or
asking them to move -- unless the person is threatening or
commits a crime. Then he or she can be arrested.

people also can be arrested if they don't show up for their
court date to answer the vagrancy charge, or if several such
tickets stack up.

Last year, 2,324 "encamping" citations were handed out -- in
many cases, multiple tickets to the same person. Some 237
people were sent to court -- representing 1,048 of the
tickets -- but there they were either sent to counselors or
were sentenced to no more than a couple of weeks in jail,
according to the district attorney's office. The maximum
sentence is six months in jail and a $1,000 fine.

Virtually all the city's 800 annual busts of the homeless
for possessing drug paraphernalia -- the second most common
ticket -- result in the offender being sent to a rehab

The city's policy for years has been to emphasize
treatment over incarceration, recognizing -- as have experts
around the country -- that simply jailing the homeless
doesn't cure them of addiction.

But the strategy is inefficient, said Alissa Riker, jail
services program director for the Center on Juvenile and
Criminal Justice.

The residential rehab slots often require weeks on a waiting
list, which means weeks on the street without help. What
help there is in the meantime comes from drop-in clinics --
which again leave the homeless back on the street with
insufficient support.

Cops who deal with the homeless say treating the underlying
social problems is essential. And they know that won't
happen effectively enough without more programs.

"All we can do anymore, really, is move them around from
place to place," said police Sgt. Joe Garrity of the
Tenderloin Station. "I hardly ever even arrest them anymore.
It doesn't do much good."

Sgt. Steve Balma, whose Southern Station arrests more
homeless on "encamping" tickets than any other, says he has
found that most of the hard core won't seek any help unless
they are forced to -- so he keeps trying to push the tide.

"What else can we do? We can't just wave the white flag
here,'' he said. "The only way this person is going to get
help is to put them into the system. We do them a favor by
arresting them. We are the only outreach workers on the
street, really. We give them a chance to hook up with

The Coalition on Homelessness just released a survey of 300
substance abusers showing that most wanted rehabilitation.
But they failed to get it because the programs were too hard
to get into quickly, and they weren't given enough help to
keep from relapsing.

The Center on Juvenile and Criminal Justice's Homeless
Release Project, which diverts homeless inmates to rehab
services, is an example of how this cycle can be broken.
It's just not big enough.

Of the 136 indigents it placed into intensive drug rehab,
health care and counseling from July 2002 through June 2003,
97 percent did not re-offend.

But the criminal justice center estimates about a third of
the inmates in the county jail at any given time are
homeless. (There are 50,000 bookings each year, but
officials cannot say how many people that represents, since
many are repeat offenders.) Not all inmates need the drug
rehab the criminal justice center offers, but they need a
lot of other counseling services to get stable. They aren't
getting them.

"The frustrating thing is you know what the solutions are,
but there just aren't enough resources," said director
Riker. "The reality is that the criminal justice system is
not the place to address this -- and it's a lot more
expensive to keep someone in a cell than in housing.

"But instead of getting enough money, what we often get is
new and different ways to arrest homeless people (such as
the city's new panhandling law). Gee, that helps a lot, eh?
Not at all."

The hard-core homeless are so
ubiquitous and so woven into the city's everyday life that
it can seem that the rest of the citizenry hardly notices
them except to step around them or hand out change. But they

"On one hand, I've learned to walk right by them, right
through the crowds," said downtown publishing manager Jeff
Wyneken, shortly after strolling, seemingly unaware, past
two drunks asleep in puddles of their own urine on Market
Street. "But it doesn't mean I don't care." He has merely
learned not to react.

"You never really, truly ignore them, do you?" Wyneken said.
"When you do this day after day, you get an accumulated
sense that something is wrong. You can't avoid it."

Several blocks down Market Street, between two pillars near
the Transbay Terminal, 60-year-old Rick Roberts was
shivering in his blanket on top of a piece of cardboard,
even though it was a hot summer evening.

He and the small group he huddles with stay so quiet, day
after day, that the people working nearby tolerate them.
Nobody working nearby had any idea that Roberts was bleeding
out of his mouth, nose and anus.

"They're people, too," said Katherine Nedd, a receptionist
at Chiro Medical Group, against whose building Roberts
sleeps. She gives Roberts' little group a smile when she
walks by, sometimes some extra food if she has it.

"You have to find a way to get along with them, because
they're not going away, so we just let them be."

San Francisco Chronicle source page: http://tinyurl.com/xhwm
ŠTHE HOMELESS NEWS - H.C. Covington, Editor  http://tinyurl.com/2yg2