As COTS’ CEO, each month I take a moment to consider what I want our community to know about our organization and our progress in serving Sonoma County’s homeless. I look forward to sharing these thoughts with you in this Virtual Cup of Coffee – my monthly communique about the business and mission moments of COTS (Committee On The Shelterless).

My best,

Treatment and Accountability – The Solution to Homelessness

The Housing First (HF) philosophy has existed since the early 1990s. Its core principles include moving people directly from the streets into permanent supportive housing and then addressing the issues that led to their homelessness, and choice or self-determination meaning that treatment or support for their substance abuse/addiction, mental health, lifestyle choices, or other issues that led to their homelessness are optional. In other words, requiring that the homeless work toward sobriety, getting mental health counseling, job training, or life skills as a means of accessing housing or shelter are a “barrier” and prohibited. Actions have consequences, and under HF, accountability and assistance requirements became a barrier.

HF promised to reduce the use of other public systems (hospitals, law enforcement) and save taxpayer dollars. The federal government adopted HF, and made it mandatory for homeless service providers that receive federal money. California adopted HF in 2016.

Since its adoption, billions have been spent on homelessness and the problem has only worsened. Unfortunately, more investment in housing did not correlate to a decrease in homelessness. There are more homeless on the streets, and encampments and street disorder have multiplied. Homelessness is a top concern of voters in California. The pandemic, the economy, inflation, increased cost of living, lack of affordable housing, and systemic racism and inequities have exacerbated the situation. In California, the homeless population in 2016 was 118,142. In 2020, it was 161,548 or a 37% increase from 2016. So what went wrong?

Despite the belief from Housing First that homelessness is a housing problem, it is not. Homelessness is a “human problem.” The 2020 Point in Time Count in Sonoma County showed that 36% of the homeless suffer from drug or alcohol abuse; 40% from a psychiatric or emotional condition; 23% from chronic health problems, and 39% have a history of domestic violence. A study by UCLA in 2019 showed even higher numbers – 75% of the unsheltered have substance abuse disorders; 78% have mental health disorders; and 84% have physical health conditions. Adding to this, many have criminal histories, a lack of education, or work experience. These are not people who simply lack housing. These are people suffering from “profound human pathologies” that must be addressed.

Moreover, the primary metric of success for HF was the number of people housed and that stayed housed even if they fell deeper into addiction, depression, or mental health crises. Prioritizing a physical space over the safety and well-being of those inside the home misses the connection between respect, dignity, and compassion for human life and responsibility.

To successfully address and decrease homelessness, we must first treat the symptoms and causes that led to homelessness instead of first putting them in a house. We CANNOT make it optional. Doing so enables the homeless into dependency. It also constricts the taxpayers into more funding for those who could work and provide for themselves with the proper case management, tools, and supportive services. Resources are limited and we cannot continue to invest billions without results.

The most effective pathway to self-sufficiency, long term housing and stabilization, and a dignified life, is a “Treatment First” approach, not a Housing First Approach. We must require treatment. And we must require accountability as part of their change management process. Accountability fosters ownership and without that, the pathway to a different life cannot be sustained. We must go back to what worked before, at COTS and many other places five to ten years ago – a housing readiness approach. That is, a gradual process of addressing the issues that led to one’s homelessness before getting housing.

Please know that I write the above with all the love and respect for those experiencing homelessness. I and my colleagues desperately want to do the right thing. We see the results of HF every day and it’s demoralizing and frustrating. And that causes compassion fatigue and burnout. As caring human beings, and as a homeless system of care, we can do much better. We appeal to our state and federal policy makers to rethink Housing First, which has failed to reduce homelessness and human suffering. They must adopt a Treatment First program that provides the most effective pathway to a dignified and self-sustaining life. Policy makers should also reward homeless services providers on results – stabilizing and keeping people in their homes. It worked before and it will work again. Stop messing with a good thing.

CEO Search

The CEO Search Committee is making progress. We meet weekly with Robert Half Executive Search (RHES) to discuss potential candidates, their background, and experiences. They are still in the process of identifying candidates and then bringing them to the committee for discussion. Some are local but most are out of County or State. For each serious candidate, RHES presents a multi-page summary of each candidate based on their vetting process, plus the candidates resume. Those documents are then the basis for the committee’s discussion. It is a very efficient process. It will be a while before actual interviews begin.

Until next month,

Chuck Fernandez