The Los Angeles City Council is moving forward with plans to explore the creation of a separate bureaucracy dedicated to addressing homelessness. This decision follows a similar initiative by L.A. County, raising questions about the future of the Los Angeles Homeless Services Authority (LAHSA), which currently oversees homelessness efforts in the region.
LAHSA is part of a system known as a “Continuum of Care,” which allows entities to apply for federal grants from the U.S. Department of Housing and Urban Development. As the lead agency for the Los Angeles Continuum of Care, LAHSA is tasked with coordinating resources and services aimed at alleviating homelessness. Despite its critical role, a series of reports and audits have revealed significant issues, including financial discrepancies where funds have reportedly vanished without clear documentation of services rendered or individuals aided.
A recent meeting of LAHSA’s Board highlighted its commitment to “drive the collaborative strategic vision to create solutions for the crisis of homelessness.” The gathering included a “land acknowledgment” that traced the roots of homelessness back to historical injustices. Yet, the complexities of the current crisis are more recent, with significant legislative changes contributing to the situation.
The National Alliance on Mental Illness identifies the 1965 Medicaid law as pivotal in shaping the landscape of mental health care. This law prohibited Medicaid from reimbursing states for care provided in large institutional settings, which led to the deinstitutionalization of many individuals with mental health issues. In 1955, there were 337 inpatient psychiatric beds available per 100,000 people. By 2014, that number had plummeted to just 29.7 beds per 100,000, leaving many without necessary care.
The dramatic decline in available psychiatric care has resulted in a troubling reality: the largest mental health facility in the United States is now the L.A. County jail system. This situation has sparked outrage and calls for reform, highlighting the urgent need for more mental health beds rather than additional bureaucratic layers.
In 2018, the administration of President Trump offered states the opportunity to request a waiver from the IMD exclusion, which could open the door for more extensive inpatient care in mental health facilities. California could apply for this waiver, potentially leading to the establishment of facilities that provide proper care for individuals in need, rather than leaving many homeless or incarcerated.
The current approach favored by homelessness bureaucrats involves a cycle of interactions with homeless individuals, resulting in funding for service providers. In November, L.A. County voters faced Measure A, which sought to double the temporary sales tax for homelessness services, projecting an annual revenue of approximately $1 billion. This initiative comes at a time when the city of Los Angeles is grappling with budgetary challenges and scrutiny from federal courts regarding its compliance with a homelessness lawsuit settlement.
While the creation of a new Continuum of Care and the pursuit of federal grants may be on the table, there is no assurance that funding will materialize. Instead, California could prioritize requesting a waiver from the IMD exclusion, providing a more direct path to addressing the needs of thousands living on the streets or in jail who could benefit from adequate mental health care.
The ongoing issue of homelessness in Los Angeles highlights the need for a fundamental re-evaluation of strategies employed to tackle the crisis. Moving forward, a focus on increasing the availability of mental health beds could pave the way for more effective solutions, ultimately leading to a better outcome for the most vulnerable members of society.
