Homeless in Sacramento

Sacramento Bee photographers found a few people willing to tell us why they are homeless.
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Sacramento Bee photographers found a few people willing to tell us why they are homeless.
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Editorials

People are sleeping in dirt. Will Sacramento County ignore millions in free money for homelessness?

By the Editorial Board

August 04, 2017 12:00 PM

Last weekend, as the temperature climbed toward the triple digits in midtown Sacramento, a bearded homeless man in an Army coat stood muttering outside the Sutter Medical Center emergency room.

“They’re tryin’ to kill me,” he said, his toothless mouth working behind bushy white whiskers.

A woman scurried through the glass doors, pulling two wide-eyed children. Down by the sidewalk, another homeless man stood with a walker, gazing into the distance; a homeless woman sat smoking, hair disheveled, her back to the building.

The city’s request isn’t some application for a property tax break or a county building permit. It’s an attempt to deploy something new against a humanitarian crisis that is ruining lives, threatening the local economy, and diminishing and demoralizing an otherwise vibrant region.

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“I sleep in the dirt!” the bearded man ranted. “I sleep in the pollution! There’s no room! There’s nowhere to go! You might as well pick yourself up and punt yourself to the moon!”

This was one hospital, in one neighborhood of California’s capital city, but it could have been almost any emergency room in the county – Kaiser, Dignity, UC Davis Medical Center. That mentally ill homeless people are still congregating around local ERs is just one sign of the glacial pace with which Sacramento County has approached this region’s most urgent social and economic challenge.

Eight years after the Board of Supervisors slashed spending on mental health and addiction treatment during the recession – and two years after a Sacramento County grand jury issued a scathing report on the county’s continued abdication of its duties – too little progress has been made toward rebuilding care for the mentally ill and addicted, key homeless cohorts.

Police still have no urgent care center where they can take homeless people in the throes of a breakdown. The county’s mental health treatment facility near UC Davis Medical Center is at half-capacity and doesn’t take walk-ins. A new 15-bed crisis residential facility opened in Rio Linda in June, but the county has yet to settle on locations or start dates for three others that by now should have opened.

County news releases promise that such resources are “slated” or “targeted” to materialize by the end of the year, and supervisors say the county is spending all it can afford on homeless services, tens of millions of dollars annually. Meanwhile, every day, overwhelmed county mental health workers toil thanklessly at a job in which success is, at best, incremental.

But nearly a decade has passed since 2008; even discounting for the fact that homelessness is a notoriously complex problem, in most California counties, progress this slow would have decision makers wondering whether a different strategy, if not a new staff, might be in order.

In fact, a different and promising strategy has been put forth, one that would leverage city and county resources to generate millions of additional dollars to get homeless people off the streets and into care and housing. Armed with a $32 million federal grant for an approach known as Whole Person Care, the city would identify and move homeless people who use emergency rooms most often into more appropriate facilities for their treatment. To make it work, the city has asked the county to make this group of homeless people a priority for county-run mental health and addiction services, as well as county-controlled housing vouchers.

If supervisors and staff agree, private and nonprofit organizations have promised to award millions of dollars in matching funds. But that’s only if the county and the city can make their gears mesh and pull in the same direction. The county, inexplicably, has resisted, though it has promised to give the city’s request consideration.

Consideration isn’t enough. If the county affirmatively pitched in, the planned 75-bed triage unit that Supervisors Phil Serna and Don Nottoli see as an answer to the homeless camps that have overwhelmed the American River Parkway might, for example, be turned into two triage facilities that also could serve the chronically mentally ill people wandering around midtown.

Or the mental health services usually stretched so thin could be leveraged toward a targeted goal to, say, house every homeless person in César Chavez Park – a visible success that would show NIMBYs that suburban neighborhoods could actually benefit from nearby mental health beds.

The more than 2,000 people huddled outside in the county’s parks, riverbanks and alleys sound like a lot, but the number is manageable compared to the homeless populace in Los Angeles or San Francisco. Sacramento Mayor Darrell Steinberg is right: With all hands on deck, this goal is doable.

The problem is that making homelessness a county priority means, to some extent, pushing some other imperatives down the to-do list. And the bureaucracy that goes into changing the well-worn approach to delivering mental health and addiction services can, if the county wants, take forever.

That’s why the Board of Supervisors must support Steinberg’s ask and free county staff to think bigger than the minutia of process, to use their creativity in giving this Whole Person Care windfall its best shot.

The city’s request isn’t some application for a property tax break or a county building permit. It’s an attempt to deploy something new against a humanitarian crisis that is ruining lives, threatening the local economy, and diminishing and demoralizing an otherwise vibrant region.

As the man outside the hospital said, people are sleeping in dirt. People are sleeping in pollution. The county has a choice: It can keep punting, or it can realize that opportunity is the flip side of crisis.

Steinberg’s request may seem like a long shot. But if Sacramento County can house and treat even half of the lost souls wandering the streets now, every elected official for miles will look like a genius.