From sfweekly.com
Originally published by SF Weekly Jun 16, 2004
©2004 New Times, Inc. All rights reserved.

Street Shuffle
Gavin Newsom's push to move the "chronic" homeless into supportive housing has made him the darling of the Bush administration's homelessness czar. But is there enough money to make it work?
BY RON RUSSELL

There's a hint of triumph in his voice when Eric Jaye, who coined the term "Care Not Cash," talks about the homelessness initiative credited with getting Gavin Newsom elected as San Francisco's mayor. The slogan, which popped out of his computer during a fit of inspiration in the spring of 2002, couldn't have been better suited to its purpose. Not only was there something lyrical in the way the words flowed off the tongue, its deceptively simple message was impossible to demonize.

In the run-up to the November 2002 election, in which voters overwhelmingly approved Newsom's plan to swap food and shelter for the cash received by homeless people enrolled in the welfare program known as General Assistance, Jaye, Newsom's political consultant, knew he had struck gold. "Even while dissing it," he recalls, with an impish chuckle, "our opponents were endlessly forced to repeat the essence of what we were trying to get across."

Despite the remarkable extent to which it has burrowed into the collective consciousness of a city fed up with being the nation's homeless capital, Care Not Cash is little more than the prologue to a much larger anti-homelessness agenda that Newsom has made the lodestone of his fledgling administration. Contrary to expectations that flourished during Newsom's pole-vault into the Mayor's Office, there is little connection between the famously familiar catchphrase program and actually finding housing for the estimated 3,000 to 5,000 hard-core homeless people who've transformed the city's once-proud streets into latter-day Hoovervilles. It turns out that the vast majority of the so-called chronically homeless -- the most visible segment of a total homeless population pegged at between 8,000 and 15,000 -- possess no welfare check to take away in exchange for housing that would get them off the streets.

After a state appeals court in late April overturned a Superior Court judge's ruling that had invalidated Care Not Cash on technical grounds, finally clearing the way for it to go into effect, Newsom didn't glory in the outcome. (Opponents last week appealed the decision to the California Supreme Court.) These days, even Jaye speaks of Care Not Cash as only "one of many steps that need to be taken."

Indeed, the mayor who invited voters to judge him on how he deals with the homeless issue has in his first months in office steadily gone about turning the conventional wisdom of the homeless service-provider industry upside down, while hitching his wagon to a set of ideas that echo those of the Bush administration. Newsom makes no secret of his intent to focus his efforts on moving those 3,000 to 5,000 chronically homeless people -- the ones whom tourists, merchants, and hoteliers most often complain about -- from the streets into "permanent supportive housing," a strategy that closely mirrors the approach espoused with an almost religious zeal by Bush homelessness czar Philip Mangano.

Armed with a sheaf of new research and a bottomless pit of determination as a former private-sector advocate for the homeless, Mangano has assumed the unlikeliest of roles for someone in a Republican administration: cheerleader in chief for the goal of not just reducing homelessness, but eradicating it. And guess what? From the moment he was sworn into office, Newsom has assumed a similar posture. Even the centerpiece of the mayor's new strategy for dealing with the problem -- the establishment of a much-ballyhooed 10-Year Plan Council, presided over by Angela Alioto, Newsom's own homelessness czarette -- is a page drawn from the federal playbook.

There is much about the new approach that is appealing. Already, San Francisco is for the first time trying to collect meaningful data about its homeless, starting with those who use the city's roughly 1,300 temporary shelter beds. Despite squeals from some in the provider community who've complained about invasion of privacy in having to collect Social Security numbers and require that homeless people be fingerprinted, the new computerization program, with the acronym CHANGES, is going well, says Trent Rhorer, director of the city's Department of Human Services. Later this year it will be expanded to include people accessing drug and alcohol counseling and drop-in services.

That, too, is part of the new federal mandate, a reaction to two decades of well-intentioned but often incoherent efforts to deal with homelessness at the federal, state, and local levels. And it's merely the beginning. According to the new doctrine, providers that offer only a cot or a warm meal are clearly out of fashion. The new emphasis (even though it has been around for a long time) is "permanent supportive housing," with on-site support staff, including nurses and counselors, available around the clock. Cities that don't follow the program can expect to be snubbed, much as San Francisco was for the current fiscal year based on its adherence (or lack thereof) to the new dogma during the last year of Willie Brown's tenure as mayor. During a round of grants announced in December, the feds doled out more money for Alameda County than for San Francisco, which has more than twice as many chronically homeless people.

But there's a serious rub with the new-think.

Despite Mangano's rhetoric, the Bush administration is giving only lip service to funding the lofty (and, in the long run, adherents say, cheaper) goal of providing supportive housing as a substitute for the patchwork of services that has failed to dent homelessness in the last 20 years. In fact, by targeting scarce resources on chronically homeless people, critics say, the new approach amounts to a mirage. For even as the Bush team has become hip to sweeping the streets of the most worrisome offenders, it is dramatically scaling back the Section 8 federal rent-subsidy program that prevents many poor people who are living on the margins from falling into homelessness. The unwelcome implication is that Newsom, greeted with a $352 million budget deficit as he entered the Mayor's Office, may find that he has little more than a rhetorical partner when it comes to raising the whopping $450 million needed to build -- let alone maintain -- enough new supportive housing to provide for the chronic homeless. That assumes that they number no more than 3,000. And it doesn't begin to address the impacts that a massive reallocation of scarce resources is likely to have on the rest of the city's army of destitute.

"It's reshuffling the deck," says Allison Lum, shelter outreach coordinator at the San Francisco Coalition on Homelessness, a leading advocacy group.

Although his political rivals and homeless service providers may be doubting Thomases, Newsom is not without a cheering section. In fact, there is no bigger fan of what he is trying to accomplish than the homelessness czar. "The mayor is absolutely a leading role model for what he's attempting to do," effuses Mangano, who praises Newsom's courage for making homelessness the lead issue of his new administration.

Mangano didn't invent the playbook, with its emphasis on providing permanent supportive housing to the chronically homeless. But he knows no equal when it comes to promoting it. In the not quite two years since Bush appointed him to revive the moribund U.S. Interagency Council on Homelessness, the congenitally enthusiastic Mangano has won converts among legislators, big-city mayors, academicians, the media, and -- surprisingly, considering his indictment of the way the problem has been handled for the last 20 years -- a fair share of nonprofit service providers.

His approach flows from a simple premise: Everything else that has been tried since widespread street homelessness began to appear in the late 1970s has failed. It matters little that the road to failure has been paved with good intentions. The number of homeless people has only increased, even after the Clinton administration followed years of neglect by tripling the funding for homeless programs. He makes a compelling case that the hodgepodge of often competing federal, state, and local programs has exacerbated the problem, while few of these offerings have been accountable for the results they've produced.

Mangano's crusade is not only to bring accountability to what critics derisively refer to as the "Homeless-Industrial Complex" -- the array of agencies, public and private, that provide one form of care or another -- but to zero in on a particular segment of the homeless population, the chronic homeless, something never before attempted. The words "national" and "disgrace" tend to fall from his lips in consecutive order a lot. He sees ending homelessness as a moral imperative. "I'm an abolitionist," he's fond of saying.

Although the problem may seem as intractable as ever, Mangano insists that in terms of how to go about remedying it, there's already a breakthrough. He points to research done in the last decade by Dennis Culhane, a professor of social welfare policy at the University of Pennsylvania. Using homeless populations in New York and Philadelphia, Culhane is credited with providing the first clear quantitative picture of homelessness in America.

Culhane's studies revealed, for example, that about 1 percent of the nation's urban population was homeless each year, more than anyone expected. But the zinger was that a hard-core 10 percent of the homeless population -- the chronics -- consumed 50 percent of resources provided for all homeless people. Tracking 10,000 mentally ill homeless people in New York, half of whom were placed in ostensibly much more expensive supportive housing and half who were funneled through temporary shelters, Culhane found that over time the first group ended up costing the city no more than the second. That's because getting people into housing and off the streets meant that fire and police departments, ambulance crews, and hospital emergency rooms were racking up far fewer hours dealing with them. (Of the nearly $200 million a year San Francisco spends on homeless people, nearly half of it is associated with such "indirect" assistance.) Since then, a slew of similar research has reinforced his findings.

In his previous role as a well-known advocate for the homeless in Massachusetts, Mangano had worked with Culhane. By the late 1990s he'd concluded that the long-entrenched, scattershot approach to dealing with the problem was leading nowhere. One group whose leaders had reached the same conclusion was the National Alliance to End Homelessness, born in the early years of the Reagan administration. Its co-chair, Susan Baker, the wife of former Secretary of State James A. Baker, is a longtime Mangano ally. Not long after President Bush named Mel Martinez as his new HUD secretary, Baker landed a meeting with him and sold him on the idea of having Mangano appointed as homelessness czar.

Mangano would appear to be the perfect salesman for the Bush team. Even his critics do not question his sincerity. A former rock manager who represented members of Buffalo Springfield and Peter, Paul & Mary, he had an epiphany years ago while watching a Franco Zeffirelli film about the life of St. Francis of Assisi. He quit his job on the feast day of St. Francis in 1980 and took up volunteering full time at a Boston soup kitchen. He ended up running the Massachusetts Housing and Shelter Alliance, consisting of about 80 nonprofit agencies.

These days, with ordinary citizens and politicians alike exasperated by the proliferation of street people, Mangano is accorded a welcome more befitting a folk hero than a government bureaucrat as he travels about the country. And he travels constantly, prodding cities and counties to develop 10-year plans to end chronic homelessness, à la Newsom's 10-Year Plan Council. He is looking to fund programs that are results-oriented, ones that can demonstrate with cold hard numbers that they are actually moving people off the streets and into housing with on-site nurses and counselors to help keep them there.

As noble and intelligent as the goal of moving the chronically homeless into supportive housing may appear, there are gaping inconsistencies within the strategy. For one thing, concentrating resources on the chronic homeless (which in San Francisco's case is more like 30 percent, as compared to the 10 percent typical of most cities) raises concerns that many of the rest of the homeless will be left to fend for themselves. Critics say the new approach will end up merely swapping one population of chronically homeless people for another.

More important, the Bush administration isn't putting its money where its rhetoric is. Although homelessness spending for the 2004 fiscal year will top $1.3 billion -- the most ever, as the administration points out -- that appropriation masks an administration proposal to slash $1.6 billion from the federal Section 8 rent-subsidy program considered by even some of Mangano's most ardent supporters as vital to keeping people on the fringes of poverty from becoming homeless.

"Trying to end chronic homelessness in the absence of ending overall homelessness I'm afraid simply won't work," says Nan Roman, president and CEO of the National Alliance to End Homelessness, the group Susan Baker co-chairs. She counts herself among Mangano's admirers. "I don't fault Phil for this. I think he's doing the best he can. But there is a real disconnect between Phil's efforts and the administration's willingness to adequately fund what he is talking about."

Newsom wasn't the first big-city mayor to take up the Mangano mantra. By the time he took office in January, more than five dozen mayors -- many of them fellow Democrats -- had already authorized their own 10-year plans aimed at the chronic homeless. (To date, the count stands at 117.) But Newsom may be the homelessness czar's most prized teammate. "From the moment the mayor and I first met, we both agreed that new ideas are as important as new funding," Mangano says. "This is one of those times where partnership trumps partisanship."

Although Mangano is encouraging cities and counties throughout the country to take the 10-year pledge, with the implication being that those that do not can forget about new federal funds coming their way, there's nothing to suggest that Newsom is anything but a true believer. "The mayor is firmly dedicated to the idea that focusing on the chronic homeless is the way to go and that supportive housing is the answer," says Angela Alioto.

Within weeks of taking office Newsom appointed the 33-member 10-Year Plan Council to devise what is expected to be his official blueprint for solving the homeless problem. Since March the group has convened most Friday afternoons in a packed conference room next to the mayor's office on the second floor of City Hall, with Alioto presiding. Its report is due to be unveiled at the end of this month.

Noting San Francisco's dubious distinction as having the highest proportion of chronically homeless street people of any city in the nation, Mangano sees the city as a "tipping point" in conquering the problem nationally. "It's a top tourist destination. It's a top convention destination," he says. "I know for a fact that if we can make a visible difference in the streets of San Francisco, the ripples will spread throughout the country."

He has been here three times since January to confer with Newsom. They've huddled twice in Washington, once before and once after Newsom's inauguration, and another half-dozen times by phone. Newsom was a key pitchman in April during a telephone conference of mayors arranged by Mangano to exhort members of Congress to cough up more money for the Samaritan Initiative, Bush's much-trumpeted new program aimed at the chronic homeless.

The Mangano influence doesn't stop there. He and Alioto, the mayor's point person in devising San Francisco's 10-year plan, confer almost daily. "Phil's a godsend; he walks on water," she enthuses. Indeed, to talk to Alioto is amazingly akin to talking to Mangano. They even use the same anecdotes. "Let me tell you about San Diego," she says, launching into how just 15 chronically homeless people there were discovered to have cost the city $2 million in a recent year. It's a parable Mangano is equally fond of sharing.

Alioto clearly takes her job as the Newsom homelessness czar seriously. "I'm absolutely focused on the 3,000," she says, referring to the most often-used figure of how many chronically homeless people the city has. "I'm not going to rest until we end homelessness in the city of St. Francis. I'm dedicated to that."

Details about the forthcoming 10-year plan are under wraps, but there is little doubt that it will be compatible with the Mangano line in proposing a dramatic reordering of how the city spends homelessness money, with the emphasis on supportive housing. Indeed, one such housing component administered by the city, called Direct Access to Housing -- with 400 units scattered among several formerly ramshackle hotels and complete with the requisite team of on-site counselors -- has already elicited the czar's praise.

But knowing what works is easier than making it work. Already, Newsom's housing efforts have run up against a wall, with his opponents on the San Francisco Board of Supervisors having apparently succeeded in preventing his touted housing bond initiative, which would have included $85 million to house the homeless, from qualifying for the November ballot. His homelessness program faces the same boulder on the tracks that critics predict will derail the Mangano agenda. "Where's the money going to come from?" asks Paul Boden, director of the San Francisco Coalition on Homelessness and an outspoken member of the 10-Year Plan Council. ("I'm the designated asshole," he says of his role with the group.)

The $450 million price tag associated with creating enough supportive housing for 3,000 street people assumes that the city builds half the units and leases the other half in buildings modified for the purpose. That's just to establish the units. Officials estimate it will take another $30 million a year to maintain them. Those kinds of numbers easily swamp the $85 million included in Newsom's hoped-for November housing bond, even if he had been able to get it before voters. "The housing bond is critical," says Trent Rhorer, the Human Services director. As for Boden's question about where the money is to come from, he says, "The short answer is that it's going to be a long process."

A favorite refrain of those in the mayor's camp who say it can be done is to point to New York as an example. Before Mayor Rudolph Giuliani's "tough love" approach to clearing the streets of homeless people got under way in the early 1990s, New York -- not San Francisco -- was considered the national capital of homelessness. Now, despite having a population 10 times as large, it has fewer people living on the streets than San Francisco. The Big Apple, with only twice as many street people as San Francisco when the transformation began, spends $1 billion a year on helping its homeless, providing either supportive housing or a shelter bed to practically everyone who wants it, dwarfing the $200 million San Francisco spends. New York gets $200 million a year in help from the state; San Francisco last year got just $6 million from the state of California.

Neither is Newsom likely to get much help from the feds, despite Mangano's cheerleading. The Samaritan Initiative, the administration's showcase program for its new approach, amounts to a mere $70 million. The effort begun in April by the mayors, including Newsom, has been aimed at getting $45 million added to it. "It's chicken feed," says Donald Whitehead of the National Alliance on Homelessness, the nation's oldest and largest homeless advocacy group. "And this is a three-year competitive grant program. So you're talking about the lucky winners among the nation's largest cities being dealt a few million dollars here and a few million there. It's unconscionably paltry."

Even Dennis Culhane, whose research provided the academic underpinning of the Bush "10-year plan" theme, is dubious. "I admire their attempting to bring efficiencies into the equation. But I fear it is little more than rearranging the lifeboats. Talking about eradicating homelessness is great, but if the resources aren't there, it's all sound and fury."

Meanwhile, as he attempts to deliver on expectations he helped to create, the new mayor has one thing working in his favor: the dismal track record of everyone who has preceded him at City Hall in the Age of Homelessness. "The fact is Gavin Newsom is seen as the only politician willing to even try to solve this," says political consultant Mark Mosher. "He gets points from a lot of people on that basis alone." Mike Farrah, a senior adviser to Newsom, agrees, and insists that when it comes to homelessness, the mayor is in the saddle for the long haul. "In the end his administration won't be judged on gay marriage. It will be judged on what he's able to do with the budget and on homelessness."

As the sidewalk body counts of the future take shape, much depends on how many homeless people San Franciscans decide are too many.