It's the day before an atmospheric river is supposed to dump over Menlo Park and Steven Hough is on the go.
Hough is a member of the Homeless Outreach Team at LifeMoves, a Menlo Park-based provider of homeless services, where he manages a caseload of people lacking homes over a territory running from Belmont to East Palo Alto.
On this cloudy February day, he went through the marshes of Menlo Park, just inland from Bayfront Expressway, letting the people who live there know that because of the expected inclement weather, local homeless shelters will be, for a short time, opening their doors to all comers, no questions asked.
On days when it's less urgent to speak to all of his clients, Hough takes his time in the marshes, lingering with residents, getting to know them, developing trust, and if and when they're ready, aiding them in the process of accessing available homelessness services. But today, he's moving fast, picking his way along a narrow foot trail that connects the encampments.
Most encampments have only one trail leading in and out, which helps residents feel more secure, Hough explains. Others require bushwhacking to access. One wrong turn takes him through a patch of shoulder-high weeds that's clearly been used as a toilet.
"Anybody home?" Hough asks at one encampment, but receives no response. He leaves his business card wedged in a makeshift chicken-wire fence.
He moves on to the next. The marshland homesteads come in various states of repair, but many are surrounded by sodden debris – old shirts, waterlogged stuffed animals, remains of fires.
"People get pretty inventive," he says. "There are lots of good engineers out here."
In one location, a large hole the size of a small swimming pool had been excavated; someone appeared to have been living there, though a fair amount of water had collected in the bottom. At another encampment, the resident or residents had built a small wooden hut. Most involved some configuration of a tarp or tent as shelter, providing minimal protection from the elements.
On his route, Hough enlists passersby to help: He gives extra business cards to a man on a bike who says he is not homeless but would pass them to his friends who are, and recruits our photographer to explain the message in Spanish to one of the residents.
As he walks along the marshes – with a tall wall blocking a large storage facility on one side and Facebook's gleaming headquarters visible on the other, he talks about what he knows of the clients he works with, and what he has seen of homelessness in Menlo Park.
In this city, he explains, unhoused people tend to go to two places: the marshes along Bayfront Expressway, and downtown. During the summer months, some people also set up camp near the San Francisquito Creek bed, he adds.
People have different reasons for why they don't want to leave the marsh, even in bad weather – some don't want to leave their belongings unattended; others have had bad experiences at shelters.
There are three main factors that most often lead people into chronic homelessness: problems with mental health, substance abuse, or long-term disabilities, he says. Among Menlo Park's homeless population, he says, street or illicit drug use is less common than in other areas where he works.
Many of his clients grew up in the area, Hough says. About three in four homeless people in San Mateo County say they became homeless while living in the county, he adds.
His job as a member of LifeMoves' Homeless Outreach Team, he says, is to be aware of all of the homeless people in Menlo Park, connect with the people assigned to his particular caseload, and do what he can to help people who are ready to access support services.
"Our main goal is to make sure nobody's falling through the cracks," he says.
The outreach team he works on is just one of several programs in San Mateo County working to help the county reach its ambitious goal to end homelessness countywide by 2020.
How bad is it?
According to a new report released by the Bay Area Council Economic Institute, the Bay Area has the third-largest homeless population in the country, after the New York City and Los Angeles metropolitan areas. Homeless people number about 28,200, based on point-in-time counts conducted in each county in January 2017, the most recent numbers available. (A 2019 biennial point-in-time homelessness count in San Mateo County was conducted in January, and the results are likely to come out in June.)
The 2017 count found that there were 637 unsheltered homeless people and 616 people in emergency shelters and transitional housing in San Mateo County. While that figure is down somewhat from previous counts, it indicates that there are 51% of the county's homeless people who are considered unsheltered – defined as living in a car, an RV, a tent or encampment, or on the streets. Of the unsheltered population, a majority lived in RVs (34%) and cars (31%), while 20% were on the streets and 15% were in tents or encampments.
At the last point-in-time count, Menlo Park had 47 unsheltered homeless people – an increase of 74% from the previous count, while Portola Valley had one, and both Atherton and Woodside had none.
In an interview in November, now-Mayor Ray Mueller described his concerns with chronic homelessness in Menlo Park. "You can't go into downtown Menlo Park without seeing shopping carts and people who are suffering," he said. "When you see that, your gut tells you: This is a crisis that needs to be addressed."
According to Hough, any observed increase in homelessness downtown that city residents are reporting is most likely attributable to the fact that more homeless people are aging. In general, younger people, in their 20s to 40s, tend to seek the independence of the marshes, while older people want to be downtown, where they can access needed amenities more easily, and can more easily find shelter, should the weather turn sour, he says.
"We've found that as people get older, they seek more dense areas," he adds, explaining that people congregating to downtown have likely been homeless for some time, but are not hiding in, for example, a park instead.
In an interview, LifeMoves CEO Bruce Ives also said that he believes the number of people living in vehicles in the county is "pretty extensive" and that shelters are seeing more homeless seniors.
"A lot of families are living one paycheck away from disaster," he said.
In addition to running the homeless outreach team, LifeMoves operates several homeless shelters, and recently opened a safe parking site in San Jose where families with children can stay overnight in a secure, well-lit parking lot and access case management services.
"For a lot of people, it's their last resort before actually living on the street," Ives said. Living in an RV often doesn't come with heat, bathrooms or working showers, which can also cause health problems, such as compromises to one's immune system, he added.
A coordinated approach
"We are suffering, as everyone knows, from an intense housing crisis. That crisis is affecting almost all levels of our society," said Bart Charlow, CEO of Samaritan House, an anti-poverty nonprofit based in San Mateo.
Who is suffering most? The housing crisis is hitting seniors on fixed incomes especially hard, he said. They are often people who have lived here their entire lives, sometimes for generations, who helped to build the communities they live in, who can't afford to live here anymore, he added.
People whose jobs or incomes fluctuate, as well as youth newly emancipated from foster care are also especially vulnerable to homelessness, he said.
Laura Bent, chief operating officer at Samaritan House, explained that preventing homelessness requires that vulnerable households be able to access a spectrum of services, and that it is easier to prevent homelessness than to help people who are already unsheltered.
The bulk of the work of Samaritan House, Charlow explained, is to divert people from becoming homeless by helping them find other ways to decrease their living costs. It works with Second Harvest Food Bank to distribute nutritious food for free, and runs a free children's clothing shop. It also provides direct financial assistance to households across the county, runs medical and dental clinics, operates a worker resource center and can provide help with utility bills.
About two years ago, Samaritan House also began to operate what's called the "coordinated entry system" for the county. A federal mandate required that county agencies coordinate how they deal with homelessness, so the county launched this new system, which operates at eight locations across the Peninsula, Bent explained. These locations, spread out geographically, are called "core service agencies," and are intended to operate as a one-stop shop for social support and access to antipoverty tools and resources.
The core services agency serving Menlo Park is Samaritan House South at 1852 Bay Road in East Palo Alto, and the one serving Redwood City, North Fair Oaks, Portola Valley, Woodside and Atherton is the Fair Oaks Community Center at 2600 Middlefield Road in Redwood City.
Today, every person or household in the county seeking housing support or shelter has to go through one of these core agencies, and undergo an assessment to help providers understand that individual's or family's needs and vulnerability to homelessness.
This system allows the county to more methodically give priority for shelter beds to the most vulnerable individuals, and to help people with other resources and means access other tools, like vouchers or subsidies that provide partial help with housing. The county then is better able to reserve the most intensive services – such as permanent supportive housing – for people most likely to become and remain homeless on their own.
This more organized approach helps people to match needs to services better, and simplifies the process for applicants, keeping them from having to fill out numerous applications, explained Samaritan House's coordinated entry system program manager Christiana Weidanz.
In addition, by coordinating this service across the county, Samaritan House can track the need for shelter without duplications from people who might seek out services in multiple locations, Charlow noted.
The coordinated entry system helped to identify and provide housing solutions for 1,707 people during the 2017-18 fiscal year, Samaritan House reported.
The trend towards coordination doesn't stop at the intake level.
In addition to the coordinated entry system, agencies collaborate closely to develop plans for homeless individuals. LifeMoves' Homeless Outreach Team members, like Hough, do case management work and coordinate with health care providers, social service providers, law enforcement authorities and first responders, like the Menlo Park Fire Protection District.
However, even with collaborative efforts, it can be difficult to find permanent solutions.
Last month, following a steady trickle of emails from residents complaining of homeless people downtown in recent months, the Menlo Park City Council held a study session on how to address chronic homelessness in the city. Menlo Park Police Commander William Dixon, who has been leading the police department's homelessness efforts, told the council that several years ago, the police department made a concerted effort to tackle homelessness when an encampment developed at the Menlo Center building – the complex at 1010 El Camino Real where Kepler's Books and Cafe Borrone are located.
Over time, he said, the department developed relationships with the 10 or so people who had begun to camp there and worked with service organizations to find housing for them.
And while the initial outcome was heralded as a success, Dixon said, over time, their successes unraveled.
"They are all now back to where they were before," he said. The people the police department worked with may have different resources and might be staying in different locations, he added."We didn't do anything to solve homelessness in Menlo Park."
During that meeting, the council agreed to direct staff to look into creating a task force to concentrate on housing specific individuals in the city, bringing the Downtown Streets Team into Menlo Park, and figuring out how to set up Project WeHOPE's "Dignity on Wheels" program in the marshes near the Bay. Downtown Streets Team is a nonprofit that helps people lacking housing access work opportunities in exchange for basic resources and a stipend, and currently operates in Palo Alto. Project WeHOPE's "Dignity on Wheels" program provides mobile showers and laundry facilities to Burgess Park every Wednesday morning, starting at 7 a.m., but doesn't yet operate near the marshes.
Limitations on what can be done and what funding exists to support unhoused people in the long-run, however, continue to leave people vulnerable.
The Bay Area Council's report identifies permanent supportive housing – long-term affordable housing with social and medical services – as the real long-term solution for addressing chronic homelessness, but it is very expensive. The report's authors say that it would take $12.7 billion to create permanent housing for all 28,200 homeless people in the Bay Area, and another $3.5 billion to provide services to half those people for 10 years.
On a recent visit, Hough heads for downtown Menlo Park, where he finds Jane – that's Jane Doe, as Hough calls her, because she hasn't revealed her real name – pushing shopping carts on Santa Cruz Avenue. When he meets with her, he always gives her his business card and a coupon for a free meal at McDonalds.
She speaks rapidly to him, her remarks weaving in and out of reality. She tells him she's "Mrs. Steven Tyler," that "Bon Jovi" is her last name, that her walker is broken. Her bare arms and cheeks are flushed from the cold as she tells him she just wants to be able to sleep on the ground near Pharmaca, one of the few storefronts that provides shelter from the kind of rain "that comes sideways," she explains. "I don't know if I'm safe. I just need to sleep and not be rained on. It's not too much to ask."
Hough explains that he can help her if she's ready, but without her consent, there's not much he can do.
It takes a lot for someone on the street to be placed in an involuntary hold by police or others, he said. Such interventions typically require a person to be deemed harmful to oneself or others. In those cases, a person might be put in an involuntary "5150" hold for up to 72 hours, but is released afterwards.
According to the news publication CalMatters, state conservatorship laws – those that dictate when the state may step in to manage an incapacitated person's financial or personal affairs – were changed in 1967 to end "the inappropriate and often indefinite institutionalization of people with mental illnesses and developmental disabilities." But the Bay Area Council's report argues that this change didn't come with needed funding to develop better alternatives. As a result, many people have ended up on the streets or as part of the criminal justice system.
Some people also argue that for individuals with serious mental illness or substance abuse disorders, these 72-hour holds aren't long enough to help them get the support they need, and argue for a more humane form of conservatorship.
A law passed last year, SB 1045, authored by Scott Wiener (D-San Francisco), allows three counties – Los Angeles, San Francisco and San Diego – to pilot a five-year opt-in program to make it easier to provide individuals with serious mental illnesses and substance abuse disorders who refuse treatment and have been detained frequently by police with housing and comprehensive social and medical services. The law mandates that people be provided the "least restrictive and most clinically appropriate alternative needed for the protection of the person."
Currently, though, people have to say they're ready to make a change to a more stable housing option, Hough said. And until they're ready for that, he added, it's best to try to help people find ways to feel at home wherever they are.
"When you don't have a home, a car, a job, ... having your own space and taking care of it, no matter how simple, (is important)," he said.
"Even if it's just a cart and a bench – that's their world they control."
Health and safety challenges
For people experiencing homelessness who do decide they are ready to access services, there is still typically a 30-day wait to get shelter and a 45-day wait to access Medi-Cal, he said.
To fill the health care gap for people who don't have Medi-Cal, San Mateo County runs a Health Care for the Homeless mobile clinic, which offers urgent and primary care, screenings, vaccinations, physicals, family planning, mental health service referrals and needle exchanges.
The van moves throughout the county, but is in Redwood City on Tuesdays from 9 a.m. to 1 p.m. at the Fair Oaks Community Center parking lot at 2600 Middlefield Road, and Wednesdays from noon to 6:30 p.m. at 5th Avenue and Spring Street. It also runs a foot clinic for homeless clients at the Maple Street Shelter at 1580 Maple St. in Redwood City on the second and fourth Wednesdays of each month from 10 a.m. to 2 p.m.
Hough said he's very aware of medical issues among the homeless: He was a former medical school student before his circumstances changed and he began working with the street medicine team before transitioning into case management work. He says he finds it satisfying: "It's similar to prescribing medications, but instead, I'm helping people access Social Security cards," he said. "Health care is a very important groundwork to build on top of (to make sure) everyone's healthy, happy and housed."
Unsheltered homelessness can also create health and safety risks for the broader community, according to the Bay Area Council's report. Diseases like Hepatitis A and typhus have spread rapidly in recent years among encampments in southern California.
There's also the risk that encampments may catch fire, as occurred at Oakland encampments four times between September and November 2018, the report states.
Fires in the marshes are a serious concern for the Menlo Park Fire Protection District as well. Hough explained that when it gets cold out on the marshes, people can build fires close to their shelters without using proper fire safety procedures, increasing the risk of fire.
The fire district has responded to a number of fires and medical emergencies in recent years, including shootings, stabbings, and intentional fires set to other people's encampments, said Fire Chief Harold Schapelhouman in an interview.
Sometimes, people also set up booby traps around their encampments, presenting hazards to firefighters and police officers.
"These are folks that are hard to deal with that end up there," he said.
According to Fire Inspector Kim Giuliacci, the marshes present unique emergency response obstacles. The area is riddled with trenches and deep holes, some of which are used for housing or human waste. There's also no lighting, and the vegetation is tall and dense.
Giuliacci said that she's been working on how to improve safety in the marshes. One challenge is that, due to the presence of sensitive species, the fire district has been prohibited by environmental agencies from clearing the vegetation. It's also very challenging to get people to move out if they are not interested in available services, she added.
Schapelhouman noted that the fire district has worked with Caltrans and Caltrain to relocate some residents. However, there are probably still about 40 people living in the marshes, Giuliacci said, noting that the number fluctuates frequently.
"I never thought we would be as involved as we are," Schapelhouman said. "What's going on is not safe. It's not healthy. It shouldn't be allowed. Is it really compassionate to look the other way?"