Homeless Czar Outlines Action Plan to Get People off Streets

It’s been a few years since Philip Mangano served as the federal government’s “Homeless Czar” — working under the administrations of both George W. Bush and Barack Obama — but the tag sticks. And for good reason. Mangano made serious waves while working as the head of the U.S. Interagency Council on Homelessness under Bush. Using his federal position as a bully pulpit, Mangano challenged cities and counties receiving federal homeless assistance to come up with real plans — not merely good intentions — to bring down the number of homeless on their streets. Going through the motions — even actual service — was no longer enough. Mangano, an evangelical optimist in the face of what appears to be an intractable problem, brought a keen eye for the bottom line. By putting the homeless in some form of housing, service providers could more efficiently focus their efforts on those most service-reluctant. And yes, he acknowledged, such efforts would cost money. But the alternative, he pointed out, was dramatically far more expensive.

Mangano left the Obama administration after three months to start a new nonprofit, the American Roundtable to Abolish Homelessness. This Monday, he’ll be in Santa Barbara, hoping to jump-start a strategic plan adopted before the recession to reduce the number of homeless on the streets of Santa Barbara. For most of the day, Mangano will be meeting with elected officials, service providers, and business leaders as part of an effort organized by the Central Coast Collaborative on Homelessness, otherwise known as C3H. On Monday at 7:30 p.m., he’ll be part of a public forum on the subject held at UCSB’s Campbell Hall. Admission is free. The Santa Barbara Independent had a telephone conversation with Mangano a week ago, and the following is an edited version.

You were here in 2008 to see about how we could best deal with the homeless. Any recollections as to your impressions? I was struck by the number of homeless people living on the streets. I felt that Santa Barbara, for its size, had a disproportionate number of homeless people for such a beautiful community. The idea was to develop a plan that would reduce the number. What I’ve said many times is there’s only a single metric on homelessness and that single metric is that fewer of our neighbors fall into the long misery of homelessness. Back then in the mid-2000s in Santa Barbara, you had over 4,000 people who were homeless on any given night. That number has come down a bit in recent years, but it’s ticking back up. The chronically homeless — those who are most vulnerable, those who are randomly ricocheting through a variety of systems in the community, the emergency rooms, the hospitals, the acute side of substance abuse, mental health, being seen by police, by judges, by the prosecution — those were our primary focus. My sense of Santa Barbara was the problem was a finite problem. I had very high hopes in terms of what could be accomplished. Back then, of those 4,000, only 500 were experiencing chronic homelessness. It seemed to be accomplishable to make the situation on the streets commensurate with the beauty of Santa Barbara.

People like to blame Ronald Reagan when he was governor for shutting down the mental institutions, but it seems like the problem of homelessness is so much bigger than that. What I wonder is, what gives rise to such large numbers of people who are so disconnected? I’ve heard it many times that in California it was Ronald Reagan who led the deinstitutionalization that led to homelessness. What most people don’t realize is the impetus for deinstitutionalization in our country was already a progressive policy initiated by John F. Kennedy when he was president. The hard reality of it is that in every country of the world where deinstitutionalization has been tried, no one has done it the way it was supposed to be done. First, it required placement of those released into the community in stable residential conditions. Second, it required that the new psychotropic medications that were then available be taken. And third — and most importantly — that there was community support for these people in their communities. That’s the hard part. We provided a place, we provided the psychotropic medications, but we did not provide the community support services that were needed, whether it was in Ronald Reagan’s California or Mike Dukakis’s Massachusetts, or wherever.

As a result, you had people leaving large mental hospitals medicated and feeling great. They began feeling that they were cured and that the problem was not them but their surroundings, which were atrocious, fetid, and unconscionable. Then they stopped taking their medications. If a person isn’t encouraged to take their meds, they don’t. People were left alone in their housing; they stopped taking their meds, and then they decompensated. They’d then lose their place, and and when they fell, the institutions had been closed. So they fell to the streets. That’s the origin of contemporary homelessness.

Most of those people have aged along, but the hard reality is the mental health system itself has not fully embraced the initiatives that get the job done for this population. Part of the population remains people with mental health issues who don’t get the services they need from the mental-health system. The same could be said for the disease of substance abuse. The problem is much greater than the resources available for treatment. So you get people falling into homelessness from those two areas. Then, add on domestic violence, bad outcomes from foster care, people coming out of the military service, and a number of other systems that haven’t done a good enough job in discharge-planning. People are often discharged to places like Skid Row.

And then there’s the economy. During the economic well-being of the 1980s, in cities all over our country, there were many lodging houses where someone could stay for $4 or $5 a night. In Boston, there were 20,000 of those kinds of units. It was a step above a flop house. In the economic boom of the ’80s, that real estate became that much more valuable. Many of those lodging houses were converted to luxury apartments and condominiums. We did a study of that in Massachusetts. What we discovered was that we lost 96 percent of those single-room-occupancy units — lodging-house rooms for people on the fringe of economic stability who could still find a place to live at night even if they had an addiction. As those were wiped out, we made a graph of the diminution of those rooms and another graph showing the increase in number of shelter beds in the state. It was perfectly aligned, except the number of shelter beds was far less than the number of rooms that were lost. The shelter became the surrogate for living on your own.

So how do put that genie back in the bottle? What can be done about that? The “housing first” response is the appropriate response. What we need to do is restore the units that have been lost, and wherever that’s happened — in New York, San Francisco, St. Louis, Miami — wherever there was a restoration of the units the poorest people could live in, the number of homeless on the streets dropped.

When I was in Washington, we created 55,000 units. What we saw throughout the country was that the number of people on the street dropped dramatically. We knew we had a strategy that works. Years ago, we couldn’t say we knew what to do. Today, not only do we know what to do; we know how to do it. That’s a giant step forward.

That’s sounds great, but I don’t see how you do this. Where’s the money for it? It’s not like there’s a lot of vacant land laying around. The flop houses have been converted, the redevelopment agencies — which provided funding — have been shut down. Where’s the money for this? Part of the answer is that for years the federal government has targeted monies for homelessness and the creation of such tenancies. In recent years, it’s been the Department of Veterans Affairs that’s put out a lot more resources to the homeless, specifically to house homeless veterans. So there are financial mechanisms from the federal government. But here’s the economic dilemma: The hard reality is that homeless people are already costing us much more than it would cost to literally house them. Why is that? What we found in study after study after study is that without direct intervention, this hardcore chronic population won’t make it on their own. Most of the homeless eventually do, but the chronically homeless don’t. And as they randomly ricochet through the very expensive health and law enforcement systems, they cost us a lot more than if we provided them a place to live and the services to support them in that housing.

I emphasize services. If there’s one thing we’ve learned, it’s that housing without services just sets people up for failure. But we’ve also learned that services without housing just leaves people where they are. Only when you combine the two can you move forward. In cost study after cost study after cost study, in 70 cities, the cost of housing with services is less than them randomly ricocheting. For someone ricocheting through the system, the cost is $35,000 to $150,000 per person per year.

I hear what you’re saying. But one of the arguments I hear is that when you get one person off the streets, it just opens up room for someone else. I hear people say it’s like trying to dig a hole in the sand and fill it up with water. Here’s the reality. One of the things we discovered is that the cost of housing with services combined ranged from $12,000 to $25,000 per year per person. You don’t need to be Suze Orman to figure this out. Every single study says exactly the same thing. As to your point that every time you house somebody, someone else comes along, it only seems like that. In communities that have actually implemented strategic plans to reduce chronic homelessness, they’ve seen consistent decreases over time, over years. The numbers go down; there are fewer people on the street; there are fewer people the police deal with; and there are fewer people in the emergency rooms.

South of Santa Barbara, there are 10 communities in Southern California that have plans. Eight of them have had multiple-year decreases of chronic homelessness. That’s visible; that’s quantifiable. And the tenor of things has changed in those communities. Pasadena has had multiple years of reductions, and the streets of Pasadena look a lot different now than they did before by virtue of the implementation of the strategic production of “housing first” units. All around our country and in Southern California, we have seen dramatic changes.

Santa Barbara has adopted all kinds of plans, but it doesn’t seem that different. What happened in Santa Barbara — and this is important — just when they created the plan, that’s when that dramatic recession hit and discombobulated people. Now the intent is to do a recalibration of that long-term plan to make sure the focus is on the “housing first” strategy. That’s the intent. There are certain things we know correlate with success. The most important is political will. You have a mayor there who, when she was a city councilmember, was very focused on the issue of homelessness, so you do have political will. The second thing, you have a 10-year plan that’s strategically focused based on business principles and practices. It’s not guess work and anecdote. It’s field-tested and evidence-based.

Here’s a new element: The third thing that we found that’s most important is the involvement of the business community. It’s critical. You need the business mindset. The focus is on performance and outcomes as opposed to the social service mindset, which is too often about the process and services. That’s a huge shift. It’s a serious mindset change to move from process — worrying about how things are — to performance where there are absolute benchmarks that have to be met. The question is now, how many people are no longer homeless as opposed to how many people got served? Anytime that’s a critical part of the plan, you get much better results. In Santa Barbara, the business community is stepping up and wants to make certain that the planning there is focused deliberately on outcomes and performance.

So that’s what you’ll be talking about on Monday? That’s the focus of that day of meetings: the recalibration of the existing plan, the resuscitation of the political will, and the re-involvement of the business community.