Care for homeless can be a long road for some in San Mateo County

The client is accompanied by a dog, who doesn’t have the required vaccination and registration paperwork required for the pair to enter the shelter system. The client doesn’t have a working cellphone, making it more challenging for him to complete the Coordinated Entry System assessment required for obtaining temporary housing in San Mateo County.

And the client has, in the past, had negative experiences with communal shelters — his property has been stolen by others, he said.

Within 24 hours, he’s been placed into a temporary shelter. That isn’t always the case in San Mateo County, where shelter waitlists can go up to two weeks, or even longer. In this case, however, the complex and sometimes-fractured system of homelessness care in the county is working as directed.

“We work as a team,” Valencia said of the coordination between LifeMoves’ homelessness outreach team, local police and other service agencies, like Samaritan House — who run the Coordinated Entry System that finds shelter placement and services for homeless individuals.

But disputes remain even here, where challenges are being promptly addressed — the dog’s paperwork is eventually retrieved, the client uses Valencia’s cellphone to complete his assessment, which looks at details like demographics and time unhoused.

Barriers on the road to shelter

Police and residents may want an immediate relocation of a homeless person, particularly if they’re in a populated or residential area, like this case. And those desires might not always align with the realities of how quickly services can be provided or individual impediments can be addressed, Valencia said.

“There are some days where there’s been a disagreement. … They want things done quickly. But sometimes, we need to work with the system that’s in place,” he said.

San Mateo County uses eight core service agencies — including Samaritan House, Coastside Hope and the YMCA, among other providers — to offer a variety of services, including food pantries, emergency needs and rent assistance, in specific areas of the county.

LifeMoves homeless outreach team staff, like Valencia, work as an on-the-ground go-between for homeless individuals and county services — including a variety of temporary shelters, including LifeMoves-run facilities like Redwood City’s Navigation Center.

Even so, Valencia said, a lack of readily available shelter beds can often be an issue when transitioning unsheltered individuals to temporary shelter. The residency requirements for receiving homelessness services in San Mateo have gone down over time — from 90 days to 30 to now, only 24 hours — and bed capacity doesn’t always keep up with the fluctuation.

“Then they’re placed on the waiting list, because there’s no beds available for that day. And it’s going back every single day and connecting with the [Coordinated Entry System] to see if there’s a better available for the client,” Valencia said. “That’s a barrier that we see.”

It can be challenging for service providers to regularly get in touch with clients to communicate those openings and ensure they make it to potential appointments.

Even if a bed becomes available, homeless individuals might not always take the space for a variety of reasons — they can’t bring their possessions, for example, or they feel their current living situation, like an RV, is preferable, Sarah Fields, LifeMoves director of community engagement and public affairs, said.

Cost of living

Once short-term housing becomes available, finding permanent housing comes with its own trials.

Long-term housing vouchers are seen as the gold standard of assistance for moving into stable living situations, particularly in a region like the Bay Area — indisputably one of the most expensive places to live in the world.

Putting them to use, even if an individual gets off potentially yearslong waitlists, is another issue. One client Valencia assists has been unable to successfully use a housing voucher because of a criminal record, which services providers need to help him expunge.

Other times, prior marks on a background check like the previous evictions that unhoused an individual to begin with can work against them.

“Sometimes our clients have been unhoused, because they’re unable to pay their rent or unable to pay certain bills … and then they have that eviction,” Valencia said. “Then they get issued a voucher and they can’t find a place to live.”

The cost of living in the Bay Area isn’t only a factor in rehousing people. It can often be the impetus for homelessness to begin with, Fields said — despite a perception that mental health or addiction issues are the two most common catalysts.

“It is really expensive to live here. And we can’t ignore the fact that it’s so expensive to live here,” she said. “Many of our clients do have some kind of substance use challenge or mental health challenge, but many people who live here and afford to live here, also do too.”

Program directors both in the field and at shelters have anecdotally said surges in homelessness correspond to layoff trends in the Bay Area, she said.

Chronic homelessness

LifeMoves served 1,117 clients between July 2022 and July 2023, and 128 of them moved to permanent housing destinations. Around half of those total clients are deemed “chronically homeless,” meaning they’ve experienced long-term or repeated homelessness.

Chronically homeless clients — who align with another group of particularly at-risk individuals, adult single males over the age of 55, who make up 7 in 10 of LifeMoves clients — are most challenging to reach and offer long-term housing, LifeMoves Impact and Learning Vice President Jocelyn Michelsen said.

“At one time, every person who’s chronically homeless now and has been experiencing being unhoused for a number of years or for a number of cycles, was first-time homeless once,” she said. “It would have been much easier at that point to help them secure permanent housing, and get back on their feet.”

Although numbers of homeless individuals are on the rise in San Mateo County, the organization is seeing more first-time clients — a bright spot in the data, because those clients might require less comprehensive services and are easier to move into permanent housing.

The longer an individual experiences homelessness, the more likely they are to develop a chronic and unmanaged health condition that will require medical attention or care, which decreases permanent housing success rates, Michelsen said.

Complex relationships between homelessness and mental health and substance abuse issues can also play a role in chronic homelessness, David Johnson, San Mateo Police Department homelessness and mental health outreach coordinator, said — particularly when it comes to accepting services.

“The public has a hard time understanding that if you offer services, or offer housing, offer shelter, offer vouchers, someone could say no to that. And people say no all the time,” he said. “Usually, it’s usually some sort of a mental health component. There’s often what’s called self-medication for drugs and alcohol, but it’s usually stemming from some sort of a mental health component.”

Chronically homeless individuals can also have trouble adapting to sheltered environments. Johnson gave an example of one individual who, after finally securing permanent housing, set up and slept in a tent in his living room each night.

“That’s what he was used to for all those years. That’s where he was comfortable all those years,” he said. “So he created that in his apartment.”

Law enforcement collaboration

Law enforcement are often first responders on calls regarding homeless individuals, and traditional systems of policing and criminalization, like issuing citations, isn’t always conducive to systemic solutions, Johnson said — who has been working in the field for 15 years.

“The tools on the typical police tool belt is, while we want to get them to a shelter or maybe get them into a detox program, if they’re not cooperating, maybe it ends up being a citation for drinking in public or arrest for public intoxication,” he said. “The next day, they’re back in the same place, doing the same thing. [We] used to call this like the movie ‘Groundhog Day,’ over and over, the same thing.”

The city of San Mateo’s Homelessness Outreach Team applies a progressive community policing model to alleviate these challenges and reduce the number of patrol officer interactions with homeless individuals. Instead, the team works closely with local service providers.

“We can just make calls and say, ‘Hey, can we bring this person to detox?’ Let’s get a medical clearance, or what kind of long-term residential program, or can we get our mental health clinician to come out? Or can we take them to a shelter that specializes in mental health?” Johnson said.

Conversations around the role law enforcement and the criminal justice system plays in homelessness issues have been ongoing — the Board of Supervisors recently passed an ordinance to compel individuals in unincorporated areas of the county to accept services or face criminal charges. Those charges would be eligible for diversion programs, with the goal of the program to help people accept services they may need, supervisors said.

Victoria Asfour, San Mateo homeless outreach analyst, maintained the importance of a compassionate and empathetic approach at all levels of outreach, referencing a common misconception that homeless individuals can be simply moved away from public spaces.

“‘Why can’t you just put them in somewhere?’” It just doesn’t work that way,” she said. “That’s somebody’s mom, somebody’s dad, somebody’s sister, somebody’s brother. It didn’t start at homelessness. It started somewhere.”