 Mechanics Institute online. We're very pleased to welcome our guest speakers and authors for how 10 global cities take on homelessness, innovations that work, and we're pleased to welcome Muzzy Rosenblatt, Tamaru Mamoru, and Kristin Meisner-Guterres, and our program is moderated by John King, who is urban design critic for the San Francisco Chronicle. I'd like to give a shout out to our friends over at UC Press, particularly to publicist David Olson for collaborating with us. We've certainly enjoyed doing many events together. If you're new to the Mechanics Institute, we were founded in 1854 and we're one of San Francisco's most vital literary and cultural centers in the heart of the city. We feature our general interest library, our international chess club, and ongoing literary and cultural programs, and of course our Friday night cinema film series. So please visit our website and also come down in person. The library is open five days a week. After our talk, we'll be having a Q&A with you, our audience. So hold your questions and put them in the chat for the end. Also, if you'd like to purchase how 10 global cities take on homelessness, innovations that work, please purchase at Alexanderbook.com. Thank you for showing the book. Thank you, thank you. Or you can purchase it at any one of your independent bookstores near you. This book of course takes on one of the most formidable issues facing urban cities and metropolises today. The number of homeless people is expanding throughout the cities, especially with COVID. And we've got four dedicated experts to talk about this and how various cities around the country and around the world face the problems and find solutions. I'd like to introduce our guests. John King is the San Francisco Chronicles Urban Design Critic, taking the stock of everything from Salesforce Tower to public spaces and homeless navigation centers. He has been at the Chronicles since 1992 and also covered City Hall before creating his current position. Muzzy Rosenblatt is the Chief Executive Officer and President of Bowery Residence Committee, which is a nonprofit organization committed to bringing stability and dignity to nearly 10,000 homeless and at-risk individuals each year in New York City. Tamaru Mamu is a Consultant Manager of Social Services at Bloomberg Associates, where he has led homeless reform efforts in the U.S. and also international cities. Previously, he worked as a Health Advisor in New York City's Mayor's Office and as Chief of Staff to the President of NYC's Health and Hospital Corporation. And also, we have Kristin Meisner Gutierrez, who is a Consultant who is living currently in Seattle and is a contributing writer to our current book that we're discussing today. She has spent over 15 years working in New York City government where she was Deputy Commissioner for Supportive Housing and also Chief of Staff to the Deputy Mayor for Health and Human Services. So, please take it away, John King, and thank you for joining us. Okay, I want to start by thanking the Mechanics Institute for having me to do this. It really is a remarkable institution and in a city where so much is constantly churning and changing, there's a real pleasure and now that it can again be done, walking into the library up on the second or third floor, whatever, and just enjoying the settled calm of the place, including a especially good interior stairway I like, but that's neither here nor there. As Laura mentioned, I've been at the Chronicles since the early 90s and one of the first big projects I worked on involved what was the Matrix Program because San Francisco and San Francisco decision makers are really concerned about homelessness. There was lots of tension between the left and the right in San Francisco and what you saw was this was a defining issue. Arguably, it's the issue that toppled our agnos from office. Frank Jordan was elected to deal with it. We are now about five mayors later on this and homelessness is still a huge issue in San Francisco and I think it's an issue that a lot of people think is unique to San Francisco or the Bay Area and kind of exacerbated by issues unique to this city. But as the book that we're going to be kind of basing the discussion on today shows homelessness really does exist everywhere, be it street homelessness, be it people in need of supportive services, be it people who are really strained by the pressures of housing prices and just job instability and everything. And the great thing about this book that came out earlier this year is that the authors, because of the work they've done and the different aspects of who they're connected to or whatever, know that there are a every city, every large city has homeless problems and they're constantly and every city kind of thinks it's a unique problem that's the fault of local politicians or local advocates or local businesses or local housing prices. And it's fascinating that Bloomberg associates and Bloomberg philanthropy is kind of coming out of the New York experience and started by former Mayor Bloomberg has tackled this on three different continents and cities ranging from Edmonton Canada to Nashville, Tennessee to Athens, Greece. And so what I think is great about this program in the next hour or so is that we've got some really smart people in the virtual room who can talk about lessons learned and then also I think one of the big challenges one of the big lessons is just the remarkable number of people that keep pushing ahead on this through crisis after crisis through administration after administration. I just want to pull one particular sentence from the introduction to the book that I think kind of rings true for any of us who have seen people give so much of themselves to try and make progress in a situation that just goes on for decades. I'm saying each dedicated city worker, nonprofit staffer and advocate brings talent, energy and resources to the task, approaching their efforts with determination to withstand the setbacks and maintain momentum in a field with tough odds. I think that's something that really needs to be a backdrop to this which is whatever we see around us it would be a lot worse if you didn't see people trying hard to make differences in other people's lives. And when we want to conduct this is just start with I'm going to toss out a few questions to the panelists and just kind of let them all answer that and then we'll kind of pick up on the discussion from there and focus in and then as Laura mentioned there'll be questions afterwards. So my start is just to pick up on what I was saying before and you know for the three of you I mean every city does kind of think like what is wrong with my city that there are homeless people on the streets and you can say those same words and it can come out much differently depending on who you are saying it. But to what extent are distinct cities distinct in their problems and what are the common threads you know this is a book about 10 very different cities on three continents. What are some of the what's the starting point that you can all agree on? So if you don't mind maybe I'll maybe I'll just start off and I want to name the 10 cities first of all for those who hadn't had a chance to read the book. And so the 10 cities very very different very different problems very different social systems very different healthcare systems very different public health systems if there is even public housing and Athens Greece Bogota Columbia Baltimore Maryland Edmonton Canada Houston Texas Los Angeles California Mexico City Mexico and Nashville Tennessee New York City and Paris France so so very diverse places so so why are we talking about these different cities and that are so different and and I could you know we could talk later about what how the the the problem that the the the the population is very different the homelessness population is very different but there are commonalities and we worked with these different cities and and it didn't occur to us initially that that we were going to find these these commonalities but when we got everyone together first of all we shared a common language the cities wanted to talk to each other and we're sharing advice and sharing ideas and so there was a common language there was a really a willingness to innovate and take chances but I think that we're also finding that everyone was critical the cities were critical of the low levels of national initiative whether it was policy or funding support high fast changing needs and then I think a lot of the cities struggled with the problem that citizens have dual mentalities you know the citizens were saying we need to help people but but keep them away from me and my children and and then and then housing prices low wages poverty common problems and you know limited resources that the cities had to deal with this problem racism gentrification you know structural problems as well immigration migration was was a big one and and we didn't necessarily expect to find that but when you if you if you go to the the airport the galler port in in Paris France and and take a taxi into the city you're going to see these tents everywhere and they're mostly migrants and refugees and Athens Greece same thing you know Bogota Columbia getting Venezuelan immigrants and so we can go on and on and on with la and mexico city etc so so these are some of the the the commonalities that we found and and and and we were and because we had you know some commonalities there were also some common solutions too so i'll just but i'll stop there and and let my colleagues respond to that if they'd like terrific Kristen or mussy so i would say one other thing that we found is that all of these cities there was a common thread across them of systems level thinking and good management right and so you know from someone who lived in New York now I live in Seattle and there are so many different providers and so many different competing interests and people trying to solve this problem with very good intentions and very big hearts but it also is very complicated and it's very hard and I think sometimes to to you know outsiders or you know the general public it can feel like a game of whack-a-ball right where you're just trying to like hit one thing here and there and something else pops up and and you don't feel like you're ever making any progress and we were so struck by the variety of cities in their ability to bring people together and to weave a network together to to really you know overcome that right so it wasn't one person operating here and one person operating there it was a real system and I think that's something that you don't see often in every city and it's something that is essential in really you know making progress and moving forward so I'll go back to John your introduction a little bit and the history of mayors in San Francisco I worked for three in New York each one of them you know asked a similar question why do we have this and and I'll share a little story that I think kind of ties it back so rather than comparing cities geographically to use your point I want to kind of go across you know time time time warp your time travel so in March there was this article in Harper's magazine I don't know if you saw it about a guy named Henry Shelby and the article is called the subways are for sleeping and we have a huge crisis in New York City and of unsheltered homelessness and our city has a right to shelter we still have unsheltered homelessness and the subways are a very common place for people to sleep they're they're safe they're clean they're warm in the winter and air conditioned in the summer and so this this article tells the story about how Henry Shelby navigates how he finds his way through Grand Central knows where to sleep safely where to get good food you probably didn't see it because it was written in March of 1956 65 years ago and yet we kind of have this groundhog day kind of experience I think I think partly driven by political realities that look for quick fixes and fast solutions that somehow this happened and it can be fixed because it came up overnight and it'll go away it's always been here we've called it different things BRC started on the Bowery that's what the B stands for the Bowery residents committee long time ago even before Henry Shelby there were the so-called Bowery bums or the Flophouse residents that you know lived up all along the Bowery our skid row and so this notion whether it's our city is unique whoever that city is I proudly brought my New York Giants baseball cap with me tonight you know it's that often becomes an excuse for not dealing with it that we're always looking or leaders are looking to blame somebody where did this come about how did this happen and then the citizens look to blame as if this weren't here and so I think part of what we're trying to show here is that this isn't unique different approaches different conditions different solutions but you can embrace it but you have to embrace it pragmatically not with the notion we're going to end it because as aspirational as wonderful as that is until we end poverty and racism and marginalization and stigmatization of mental illness and substance use disorder and other things homelessness is a symptom of those diseases it's not a disease in and of itself and so yeah I'll stop there I was just gonna say one commonality and one new factor in the mix obviously is the pandemic that started in early 2020 and continues to change and morph before our eyes and keep wearing us down I was very impressed the book has a chapter on managing and emergencies or whatever the exact title is and talks about how the 10 cities responded to the initial challenge of how do we keep people safe how do we get them off the streets how do we spread them out you know in shelters you know kind of the systems that we're working weren't necessarily designed for a pandemic I'm kind of curious to the extent you know that I'm impressed it's in the book but even so you know the time goes on to the extent you've caught up and stayed in touch with the cities how how big of a hole is being dug how tough is it for them just to keep trying to deal with this in the pandemic and help this whole new type of hurt being inflicted on a vulnerable population and maybe I'll start with Kristen since you've got the West Coast Coast perspective as a resident whether or not you're doing work in Seattle so I think um encouragingly I know you know from the public's perception I'm sure in San Francisco in Seattle it seems like you know street homelessness exploded right but that's not necessarily the case and there was a lot of really innovative things that came out of the pandemic not only in terms of funding but we always say homelessness is an emergency but I think during the pandemic it was really treated like an emergency and so people started putting you know all their differences aside right and a lot of the things that get in a way get in the way of really making progress and making decisions kind of people you know put those aside and we're able to focus on trying to address this I think bringing in public health so having public health really be at the forefront of driving some of this and taking the you know the questioning out of what we need to do was really helpful um some of the successes just for example right in Tennessee they had a rapid rehousing strategy and they were able to reduce the time of enrollment from 180 days down to just 29 days right and that's something that theoretically was always possible but because it really felt like an emergency you know I think you know people just started doing things differently they started putting bureaucratic barriers aside right and they just jumped through hoops and jumped over hurdles and really made it happen another example is also from I think there was another city that was able I think was Houston they were able to house more than 3,500 people which improved their monthly housing rate by 600% right so it goes to show you and I know I talked a little bit earlier about this kind of network but when you have the pieces in place and you have a strategy and you have kind of an overarching plan um and then you move into crisis you can really activate all that all that planning and and be effective and so what we're hoping and I think what we're starting to see is that business as usual and business the way it was prior to the pandemic is not okay anymore people see that there's a path forward that's that's more effective and that can work better and hopefully they're going to adopt that and continue using it going forward and I know I'm going to pass it to Muzzy because I know New York City and Muzzy in particular was at the forefront of really trying to help change some of those barriers to making it more difficult to enter shelter in New York. Thank you Kristen and we did not plan this but I think what you speak of speaks to a point where I think again that there is a sense that homelessness for mayors and for local leaders is kind of a third rail that there's there's kind of no no way to win on this issue right and so it almost becomes this thing that that you know it's like the medicine you have to take you know you got to do something about it but you really don't want to like for me exercise um and so but all of a sudden it went from this thing that mayors hated to something that mayors felt they needed to do and kind of embraced in communities too with empathy as opposed to vitriol not that it went completely from one to completely the other there was always a little bit of empathy before and there was always there's still a little bit of vitriol now but there was I think a deeper understanding that homelessness isn't just a housing issue it's a health issue it's a vulnerability issue I see my friend Bobby Watts here who runs the national health care for the homeless coalition came out of New York and is in Tennessee that we have to recognize these intersections and we have to look for ways not to keep people out right even a progressive so-called city like New York creates barriers to access services almost every government benefit gives and yet puts up barriers we needed to as Kristen said find a way to move the barriers completely out of the way in New York City BRC runs the outreach program to people living unsheltered in the subways 472 subway stations we're out there 24 7365 and yet every time we met somebody and we know people I mean we build relationships this isn't this isn't a hey I'm a stranger I'm going to save your life jump in my van and I'm going to take you to a wonderful place guess how many people say yes to that proposition we build relationships we earn people's trust these are human relationships that we're talking about about people who've often been betrayed and harmed and traumatized by other human beings so that people will eventually come with us and then when we finally get to that pre-pandemic we take them to an intake center where they then have to get on to another best to actually go to where their bed is and that was creating a huge log jam to an all of a sudden the New York City subways closed and everybody put up their hand and said I want to bet because I don't want to be walking the streets all night and and we didn't realize it we the government and we who contract with the government and my colleague from city government Hilary Kunins is here she found her heart in san francisco and runs your behavioral health care system for the department of public health um you know so we found out about this one the tabloid press published a photograph of 30 buses coming from 30 subway stations all lined up first avenue trying to discharge all the people we had rescued and put on these buses to go to the intake center and it was chaos right and so we quickly rewrote the script literally the policy the procedure book on the subway platforms the commissioner of homeless services myself and a few others with our workers of we know these clients we know where the beds are let's get them straight into their bed they'll want that that'll be more customer friendly that'll get them to where they need to be more likely to save their life and so it was those kinds of strategies the use of hotels tom room may talk about that um that when we actually see homelessness as an opportunity where we can save lives as opposed to a problem we've got to solve because everybody from the business chamber of commerce to the editorial boards are yelling at us when we see it as as an opportunity to save lives we can actually do great things so Kristen mentioned how homelessness was was now perceived as uh as you know as a crisis that was a concern to everyone because it was a also a public health issue so definitely raising the prominence um for issues like eviction for example evictions a national issue it's no longer just a local concern uh but people are talking about it writing about it you know uh and worried about the you know the expiration of the eviction uh moratorium and as well as the the local and uh state moratoria as well um you know that the different differ in their uh stringency but um so so definitely the the pandemic brought this these issues to light but this is also not the first crisis and so there have been hurricanes in houston where and houston has been able to you know to learn from those experiences and um and you know bring people off the street because of it and and there have been like i mentioned earlier the refugee crisis crises in uh athens greece and uh in paris france as well so so there's been uh crises before uh but but it was really unique how this pandemic uh brought uh such a great attention to it and um we'll just say one more thing i think i think um cities we found that that cities really made a lot of progress in bringing people off the street and i think that there's a desire to to make progress and not uh you know lose this opportunity and so i think there's a lot of national funding and that people have uh have been very aspirational and trying to move people from temporary shelters to uh to permanent housing and they're getting a lot of funding right now so hopefully that's something that continues and i think that's uh i think support to the cities is uh is very necessary but it's unclear whether that support will continue and that's part of the challenge is that we can focus on the homeless you know the problems facing the homeless people have been exacerbated by this but also the responses but there are so many other issues every city is facing right now that there's a lot of competition i want to do one thing real quickly uh tambourine you mentioned the different cities involved if one of you could just explain real succinctly kind of how these 10 cities came to be in the book um you know again it's athens and paris and bogota and then north american cities um was it essentially kind of cities that had been working with the philanthropy or how did that work out if you could just explain to the listeners for the viewers well we um we didn't pick the cities the city picked picked the cities picked us we like to say uh so bloomberg uh associates is this consulting organization founded by the city's former mayor which basically said if you're brave enough and bold enough city that you're willing to tackle these issues he will bring the best of his administration people like tom room and christin who worked for him um linda gibbs our other co-author and jay bainbridge uh academics practitioners uh current practitioners like myself and we will bring all that to you at no cost you've just got to make a commitment to deal with it and so these were the cities that stood up and said we want to deal with this we were working with them each individually and we started as tom room was describing finding these common themes so then we didn't say oh let's write a book then we say let's bring them all together because we may be the so-called experts but they're the real experts and they can learn as much from each other as we can learn from them yet alone teach them so we brought them all together and it was so exhilarating and impressive and exciting and yet being able to help them all together and that's really where we realized there's a book here not only to tell the stories of the ten cities but to use the stories of the ten cities to inspire other cities and to create a framework for that and again not that cities aren't doing it there's incredible stuff happening in the bay area in san francisco that i'm sure we'll talk about but that was the the origins of the book and that that's one thing i wanted to ask christin you mentioned how this can feel like whack-a-mole to people in cities that you kind of tackle one thing and it pops up i also got the sense when i was reading the book of i don't remember exactly the the city involved but it was just referring to the city embracing continuum of care and that was a phrase that suddenly i was it was san francisco in like you know 2007 or eight or something like that and the young dynamic mere Gavin Newsom was talking about continuum of care and we're going to figure out how to make this all work and things and it was it was like a blast of nostalgia i mean did you find a certain bit of kind of deja vu looking at the different cities where they're saying oh and we're trying this or we're trying that and you're kind of thinking oh this is a set bit of remedies being tried or did it get down to intricacies in each city so i think what was most illustrative and most exciting for us was the multifaceted approach that every city has to take and i think recognizing that a lot of people say oh you know the answer is housing or the answer is not just housing right or the answer has to be prevention oh we can't afford prevention right and there's so many different facets to the problem and when you really dig into it you realize how complicated it is and there were lessons to be learned i think in all the different parts of the answer right so the answer it's not just housing right housing is one part of the answer but it's supportive housing it's rapid rehousing it's bridge housing right there's multiple kinds of housing it's prevention right it's creating a systems level approach to managing the whole problem it's also you know doing a street count so you know how many people are living on the street it's high quality shelters right it's improving your shelter system it's engaging and taking the time that's really needed to engage the unsheltered and Muzzy can talk you know at length about what that process is like and how he's been so effective at doing it but there's so many different components to it and i think for us what was really most exciting was was seeing people digging really deep and find some really nuggets of success whether it's in prevention or bridge housing and and they you know people would do different variations on it based on the cities and based on the problems for example like one difference that we saw is density when i moved from new york to seattle i was like so impressed at the you know how much less people were like on the streets right like you could like walk to your car and not encounter 40 people on the way but then when you're building housing land is really important and so the approach towards housing that new york takes is very focused on innovation around building up can you put we started looking at shelters and say could you put housing on top of the shelter right is there extra far on top of the shelter to build more housing there but houston is much less dense right and so for houston they're looking at they have the ability to build more housing and for them the problem may be more around whether it's funding or finding the capacity for people to build the housing so i think there's there's a lot of similarities in all the multiple approaches you have to take and then opportunity for a lot of innovation within those various areas and sharing those lessons across the various areas and across across the various cities and countries was really motivating and this is a hard field to be in i think i would venture if someone did a study that this might be you know one of the areas where people leave the field the most because it just it's really prone to burnout it's really hard it's really personally taxing because i think people put except for muzzy muzzy stays in a lot of it no but it's really hard you know and and people put their heart and soul into it and so in order to avoid burnout i think part of this book was trying to bring some hope to all the different cities in like showing these lessons that's one thing i was thinking is that fatigue sets in i mean fatigue has to set in or the homeless person who's living on the street because they're unhoused and they don't have a shelter or they have shelter but it's barracks type of storage space until the virus came along it's fatigue for the workers who you know we could say oh my gosh look at these lives you've intervened with in a positive way but they also know all the victims of the streets who they couldn't intervene with successfully it's fatigue for the people who you know the compassion fatigue whatever um so i'll i'll take you on on that because it's it can be fatiguing and tiring it's it's an exhilarating fatigue in some ways because we're also saving lives you know i mean if you get into medicine and you become a doctor because you think you're god and you can save every life then you're you're going to be quickly disappointed but if you recognize that you can contribute and in a way of doing it and bringing your skill and your expertise and your energy and your fortitude um to save lives that otherwise wouldn't be saved um and it's to the quote that you read at the beginning john it's it's not any one of us there are so many people there are many people right here on this call today who have been doing this uh for decades and there are other great organizations uh in the bay area who are doing it as well that um that recognize and again it's so much about setting expectations i think the two things i'd add to the to the list that uh christin articulated uh to carry through on this conversation about fatigue is very much about setting expectations and it goes to my original point too if we set us a goal we're going to end homelessness we're going to get disappointed very quickly in the same way if a doctor sets us their goal that they're going to save every life but if we think we can make and this is the other the other part of it is expectations and then how do you know measurability and accountability the edmonton story that that we write about that christin was sharing about where they didn't spend more money but what they did was organize that continuum of care coordinate 61 different municipal and nongovernmental organizations that were all often working and tripping over each other or in parallel universes not knowing each other and instead all get around a table in a formulaic way to prioritize people's vulnerability to match the need with the services that are available to be able to define what of all those different types of housing there's there's the venn diagram from the book you know do we have too much supportive housing and not enough bridge housing based on who we are actually seeing today or vice versa so that scarce resources can priority be prioritized and allocated they reduced homelessness in edmonton by 43 percent now you'll still see people living on the streets of edmonton right so the average or the streets of san francisco all the streets of new york because you always will but if you have data and evidence and systems to do that um and people who are in it for the long haul who don't look for a quick win because quick wins don't exist then it isn't fatiguing it's exhilarating maybe um to talk about the exhilaration i mean i'd be curious if each of you'd pull out one example of a city's innovation that you feel did kind of move the it did move the bar in that city you know this kind of different ones because i think every city can point to good things every city can point to bad things but were there like were there particular things you've seen the last few years maybe one from each of you that it did seem to change things in that setting in a powerful and we would hope sustaining way yeah i can i can give an example um paris friends and the the city worked hard they they worked with the national government to come up with a you know 106 point plan you know 106 different recommendations to address homelessness and and when we asked them well what's your target and and how many how many people are experiencing homelessness right now they they couldn't say exactly there were different estimates and people had you know different ideas depending on who you asked you know uh advocates community members politicians one politician said there were no homeless people on the streets which is you know i i don't know how you could even say something like that just walking around paris friends but uh so so one thing that we we we asked them to do and and we work with them to to conduct a street count we just go out and actually and and ask people what their housing status was on the street on one night it's called a point in time count methodology just to get a number and so so they had a strategy but they didn't have a number so so they they did this and the national government wasn't exactly happy about it but they said we're going to do it and um and and actually we're going to list volunteers so they so they ended up enlisting thousands of citizens i think more than 3000 parisians who volunteered to go out and do this and survey people on the street and and what happened was kind of unintended consequence says is it's citizens did this and felt really empowered involved and wanted to know what more they can do to address the problem and then the city set up these innovation laboratories to allow people to come in and brainstorm about ideas or and do everything from offer tutoring to people living on the street to bring in clothes or or find a way to be trained and actually do a street outreach and but but the other big thing was other cities caught on to this as well and others and so paris now said well we know what the magnitude of the problem is and we can adjust our strategy to address this strategically and move people off the street into housing and etc and other cities started doing the same thing and they trained other cities and now the the national government has said we'll look to paris and and we recommend everyone do a street count use the paris methodology so that's that's an example okay and and residue city so i'll give us so not every city that we've worked with and not all the work that we've done has always been in the same structure but just since you guys are the host you know i want to acknowledge some things i went out to see the west coast i've been reading all about it i wanted to see for myself and i came out to la in san francisco briefly 48 hour visit and i basically just did a crash course on on folks who are out there and there are things that that are happening in in california and in the bay area and in la that we're not doing in new york and other cities aren't that we can learn from so yeah i kept hearing i'm at this guy bill pickle right who runs brilliant corners and the work that they're doing and rebecca foster with the san francisco housing accelerator fund because you know you can have the greatest idea but if you don't have the capital to actually kick start projects which usually nonprofits don't have it's just an idea it's not a reality and you know that from architecture as does another great author sam davis who is here who's written on homelessness long before we did designing for the homeless about the architecture and now he's giving me shit because i didn't go visit him we're recording sorry about that but sorry about that sam it was i know it's going to get caught on that but and then finally the nonprofit finance fund which is a national organization with the office in oakland and jennifer kawar who's there so you know one of the things that that san francisco is doing is recognizing again what we spoke of long before there was a pandemic that there's a health factor for so many in homelessness and in the same way we might prescribe somebody who was chronically ill medication to alleviate their suffering or physical therapy to alleviate their suffering why don't we prescribe housing um and in in california now medicaid is being used to help finance the development of supportive housing for people who have chronic health and mental health and behavioral health challenges i mean talk about being innovative you know and i kept hearing about this guy mich katz mich katz mich katz who was the san francisco health commissioner and the la health commissioner well now he's running our hospitals in new york so we got him now and hopefully we can take what he's done out there but all to say there's some really extraordinary things happening uh right where you are and it's important to realize that there's still water in the glass and we can keep filling it and and christine can san francisco take lessons from baltimore or nashville well i think um i think everybody can continue to learn from everyone um and especially in the arena as mazzi was saying of supportive housing and so i think uh supportive housing is one of the best interventions for chronic homelessness and for people with severe mental illness um or substance use disorders and you know addresses a lot of the problems on the streets and you know la did proposition proposition hh right they created like a constant funding mechanism for supportive housing um baltimore right is looking was looking at creative ways to partner they didn't necessarily have the money for supportive housing but what they do is they took their um public housing right they had empty public housing apartments that they couldn't afford to renovate and they were able to bring supportive housing dollars in to the public housing um apartments right and and partner with a not-for-profit to turn that into a type of supportive housing and so i've been really impressed um and really motivated there's a lot of evidence base around the effectiveness of supportive housing i think there was a question about you know cost benefit and i think supportive housing is one area where there's been a lot of cost benefit analysis done um and but there's also a lot of room to grow because supportive housing there's no real you know um definitive term like what is supportive housing right it's housing with additional support but what those supports could be you know employment they could be you know mental health supports they could be you know daily checkings medication management right there's a whole range of opportunities and they could you know i've noticed a lot of cities are targeting them towards specific populations now right so we're going to focus this one on youth and teens this one on veterans right and looking at what those services are to help those populations and lastly i'll say mexico city never had any type of supportive housing and you know they started kind of hearing about it i think as part of this partnership and they started developing something that you know we here in the us wouldn't call it supportive housing because you know there's some some pieces of it that aren't quite consistent with how we define it but it's their first foray into really looking at housing with supports to serve you know entrenched homeless that really need services and so um i think there's i think there's a constant um the field is constantly changing our world is constantly changing and so there's a constant need i think to always be learning from each other and and and last question this is something mesi touched on a bit in his we kind of curious and then we're going to move on to questions from the audience uh what is the impression you folks have of san francisco and how would the homeless feel you this i mean people locally just see tents on the streets they see drug problems very very visible in some neighborhoods the whole fentanyl scourge was late getting here but it really has come in with a vengeance um you know high costs still people on the streets but what's the view from afar of san francisco it yeah i guess i'll start and um it's so it's very invisible san francisco as opposed to new york city where new york city you have most of the people experiencing homelessness in the shelter system and there's a right to shelter and in uh in san francisco the the the great majority of people are actually on the street so very visible although it's much lower magnitude than new york city um and so but but i think that what i've seen because it's i mean it's such a difficult issue to address mesi mentioned it is mayors get blamed for the the problem because you see it and people want an immediate solution and it's a very complicated problem when you have to address structural issues like poverty and like housing costs that have you know uh that are extremely difficult for for people with jobs um like substance abuse and you know and a dysfunctional health care and behavioral health care system um and you know and so so you're dealing with these structural issues and the mayor kind of gets left with solving this very complicated problem but but she london breed the mayor london breed is doing a lot and and compared to a lot of mayors that i've seen she's she's not hiding from it and to me that's significant it's you know i won't say it's okay to fail but it's really important to try and so she's putting money towards the issue she has a strategic plan she's doing innovative things and has dealt with a pandemic in the meantime and uh and and so it counts for a lot but but i just i just want to use the term that one of the one of our cities uh use one of the the cities that actually had a lot of um uh you know success in addressing homelessness the term relentless incrementalism is that you you need a lot of time uh and you need a very deliberate uh uh plan and um and you need to stick to it but it's it's i know some citizens want the problem to go away overnight but you um you know but i think the mayor has a good vision for it she has very strong people working for her um so i think that counts for a lot and you know and there's still a long way to go it's it's you know so that's that's what i see i don't know how how muslim christin might see it so just to follow on that theme mayors not only get people don't only expect mayors to do it and blame them when they don't they also blame them when they do right so because when people say do something about it and then lo and behold on your block is the affordable housing is the shelter is the treatment program that people can come in off the streets to well i didn't mean on my block i didn't mean here i meant over there and so you go over there and over there says well well we didn't mean here and if you think that's unique only to certain like privileged neighborhoods that happens everywhere poor neighborhoods feel like we don't need more poor we went to build the program that christin was describing where we co-locate housing and shelter in a neighborhood where the elected official said i don't need any more poor people in my district so you know to to find the the political courage to do something is you know sometimes it's easier to not and blame all the systemic issues and say it's more than i can deal with so how did i feel when i came to san francisco besides guilty that i didn't call sam is very much at home not only because you know my giants were there but and i was at the game when said to say hey kid came back to new york but because these issues aren't unique i felt like oh my god this isn't that different here i remember getting into the bar and then i learned you have like two different subway systems that was kind of cool um uh getting into the bar seeing somebody sleeping at the bottom of the stairs getting on the train and two people were yelling but they weren't yelling at each other they were each responding to their own internal stimuli and i'm like god this is just like new york um and of course the difference is new york we have a right to shelter and we still have some of those issues now the chamber of commerce is going to use that as their example of san francisco's like everywhere though well right but the point is is that uh it's a commerce point um you've got the courage to do something about it and i think part of it one point john you actually touched on and i meant to get to and didn't but real briefly is on the fatigue question um the people we serve the people experiencing homelessness and and again the notion i think too often that people have a pity um the people we serve don't want pity they want a hand up they want support they want encouragement they want our secret sauce is love um to be loved and understood but the reason i say not to pity is because when we see them when our average workers go out we don't say oh you know your life is a mess and we're gonna save you we don't tell people what they already know um but what we do tell them is what they don't really realize which i think it's important for all of us to realize which is their strength and resiliency when you think about what it takes to survive it may be fatiguing but it's also extraordinary it's extraordinary resiliency like the story of henry shelby in the march 1956 harbors of having the creativity the entrepreneurial skill speaking bay area language to actually survive and know where to go to be able to do it and what we try to do is channel that empower that guide that to better more constructive uses as opposed to where am i going to get my next meal great and um christin do you have a real quick thought on this or should i go to i can't top that so just go right to questions yeah well that we've got about 10 minutes left and um no we i think pam is going to kind of filter through some of the questions and and put a few out there for me yes we have quite a few in chat um rick uh has rick asks did the authors conduct any kind of financial analysis such as in public spending per homeless person or studies that link public funding to outcomes i could i can say that we didn't do a robust analysis but we do have an idea of how much each of the municipalities spent per capita and what we found was actually kind of surprising is that uh the municipalities like such as uh houston and edmonton for example who who've had the biggest impact over the 10 years spent the fewest municipal resources but the important thing again was that they had very strong systems approaches and they had many partners so cumulatively when you include you know whether it's an edmonton the provincial and national and the the private the non-profit support um you know they did add up so it was you know the ability to to to collaborate and bring in all the important stakeholders that was i think that that's also a resource that we don't always look at we often look at how much is the city spending and how much are these people spending but it's actually how how many people from the entire system can you bring in to have a difference but that was the surprising thing is that houston spent very little money from their budget edmonton spent very little money from their municipal budgets and had really big impacts like mozzie said 43 reduction over 10 years and edmonton 50 reduction in houston over 10 years incredible okay um next next question yeah um wendy beck asks was the homeless population asked in each city what they believed would help them and if so what did you learn from that and she also asks did san francisco asked to be part of this program christin so um we basically worked with all the city officials and all the officials you know whether it was through their continuum of care had ways of engaging the community i know mozzie you know has in the book there's some interesting personal stories and i know tamaru has a really interesting story about you know talking with some folks around supportive housing and what they needed to to leave shelter and really get into housing and so there were definitely opportunities for the authors themselves to talk with people directly but then we also relied on oh and i say doing street counts also in paris right so we worked with folks to you know implement street counts and we were able to converse with the homeless them but i would say in a more in a systemized approach it was through the different elected officials and governments of the cities that we were working with and and if uh and even you know did san francisco reach out to bloomberg associates and say hey we can always use some more help yes and uh and we're and we're actually i my colleagues not not me uh are are working with uh with san francisco uh right now kind of gearing up oh that's that's good to know next question adel facic asks did anyone try to find out how many people were lifted out of homelessness for a long time months or years i mean not across the board for the book but many of the ngo's like like ours at the barry residents committee that is critical the the the data work that we do is important but it's not just measuring how much we do uh or the effort we put in but what what the long lasting impact it is sorry about the dog crying in the background um and you know one of the ideas we talk about in the book which again is all about agency for the individual is the safe haven model which mayor bloomberg launched with us uh in 2006 where he said why if we have a right to shelter are people voting with their feet and not exercising that right and staying on the street and so we talked to people we created a model called the safe haven or what we realized the l.a. also created bridge housing which really is a barrier free model to housing and coming in so that is really dealing with i think what most of us think is homelessness or the public does which is the unsheltered homeless which is the tip of the iceberg but a very prominent tip and so we then studied the folks we served how many of them actually achieved positive outcomes over a seven-year period we worked with about 1800 individuals and just under a half 47 percent had a successful outcome which doesn't mean that 53 percent failed it just meant they're still on the journey and of those that did based on the different types of housing they moved to we measured their recidivism but overall we saw in excess of 80 percent stay stably housed where they had left to and not re-enter the shelter system for over a year that's good next question um this next question from patrick wolf homelessness is a problem both the people without housing who are suffering in the general population for whom the homeless population creates issues how should we think about solutions to each of those that's a long question for a meeting with five minutes left so maybe if i could ask one of you to um kind of well 10 minutes left sorry about that still a long question for that so maybe i mean i think it speaks to what we've been talking about and what the book is about which is it's this integrated strategy not just systems based in coordination but a continuum of care like you said john it's about prevention it's about various forms of transitional and permanent housing it's about the quality and not just the quantity of it and then it's about accountability and measurability and transparency and i think there's an aspect of that question that's you know how do you address the concerns of people who you know uh who have to witness suffering in the streets who uh are sometimes afraid situations of someone who may be injecting in front of them or their children things like that how do you deal with those issues as well and um and you know and and the the truth is it's very difficult um and uh and it's a contentious issue that people often want to help people who are suffering but don't want shelters in their in their neighborhood and you know people uh often want to spend more municipal funding but but don't want to increase taxes in places like you know paris or la where you actually give people a chance to um to you know to to to vote on those questions and in paris there's a participatory budget process where people are are you know deciding to how to spend city uh dollars and and some of them are choosing to spend it on homelessness programs to address homelessness and la christin alluded to the fact that i mean there are two different types of taxes that cities that the citizens decided to impose on themselves to address this problem because uh you know and and that's so that's that's a two-way commitment they have they have an expectation from the government to do something but then they've committed uh their own resources to address it as well so i think engaging uh citizens and allowing them to uh to weigh in on solutions as well um but it's a it's a two-way it's a two-way street i think that the the expectations shouldn't be just one way i'll say too there there was a campaign in new york city many many years ago and um my colleagues gary jinkins and uripolic who are on this call may remember this but it was it said make change don't give change and so it was about like how do you figure out in your community to be part of the solution and the solution is not just giving a dollar to somebody living on the street right there are other ways that you could you know figure out how to be supportive like new york city for example has a 311 right so if you see somebody who's homeless or who's suffering you call 311 and an outreach team like muzzies will come out and they'll call you back and they'll tell you hey we found him we spoke to him here's the situation here's what's going on and so there's something i think really gratifying about that and i know you know other communities have other responses right where you could try to figure out you know police response is not always the right response right what is the right way to really help somebody beyond kind of the thought of just giving change to somebody and then we heard a really interesting idea you know like tomrew said we're still working we are working now with san francisco and and i think we can mention jeff right tomrew and describe the project with the tents i mean we know it's controversial there's nothing about this that isn't controversial if you're going to get into this and everybody's going to be grateful and send you accolades just google me um and you ain't going to find a lot of wonderful stuff you find some good stuff but a lot of not so nice stuff um but you got to be courageous you got to be bold and and you got to try and strike a balance and and so the tent go ahead tom oh sure so so uh san francisco started up a problem um called uh safe sleeping villages so when when the pandemic uh started up and they they couldn't get uh uh you know all the people into uh the hotel sometimes they were unwilling or you know didn't want to adhere to to the to the rules of going in or wanted to stay with their community out on the street that they've you know with whom they've built relationships over several years uh and so the city found a way to commission these safe places for them to camp out and um so they can stay there there were no uh curfews there were very few rules um and uh and it was an amazing way of actually bringing people in to engage but the idea was you don't just bring people into kind of camp on the streets the idea is you want to engage them over time and get them into services and uh and so yeah i won't go in i go i won't go into a lot of detail uh but there are a few stories you could find you could find i'm sure john i don't know you know i'm sure there's been a few articles written in the chronicle about it but but it's it's it's a it's a unique low threshold kind of harm reduction approach to bringing people off the streets during an emergency and i think the city learned a lot of lessons from it that muzzi said people vote with their feet and they got a lot of people to to come into these villages and get engaged and i think it's something that that san francisco is probably going to continue doing as part of the solution not comprehensively it's not a comprehensive solution but it's one of the many things they're going to do and one of the lessons learned during the pandemic next question next question is from urie pollock um can the panelists talk a bit about if and how interagency collaboration was used in the various cities to address homelessness especially for individuals and families that may have already been involved with and receiving services from multiple government agencies so yeah just real quick from one of you like cities kind of having agencies work together maybe i'll jump in um kind of quickly the two biggest things i think are by name lists and case conferencing right and so when you start bringing everybody together you start realizing that different systems might be touching the same person and so when you start realizing like okay we all are touching john smith then you bring those folks together and you start talking about how do we all intervene on helping john smith so whether the hospital's about to discharge him onto the street or whether you know the prison or the jail right like all the different systems that are touching him um or her for that matter are working together i think those are the kind of the two most effective ways of using the collaboration and quickly on that just because why not stir up a little controversy i write about it in the book it includes working with police departments so we we meet regularly or we used to with police departments to focus on the individuals that they are most concerned about that are causing the most problems that they don't want to arrest but they want they see them more often than we do at times and so it helps when we can share with them what we're doing and they communicate to us when they see them and then instead of having a police response when some community or commuter is complaining about it they can call us and say oh you know john king is acting out again um and we'll go and and and respond to it so there is a role for law enforcement here to be supportive and communicative so that those of us who are doing the social services work can be even more effective okay and let's see if we can squeeze one or two more questions in real quick pan okay just a quick question from paula h just she wants prognosis do you think this is going to get worse with eviction moratoriums in general housing costs rising well i can say that we we actually conducted a survey of some of the cities that we work with we have kind of a like outside of this book we just have a a peer group of city but you know 15 to 20 it varies um uh cities and counties and and so what we're what we heard from almost all of of those uh the peer cities is that they expected to get worse because of the the expiration of the eviction moratorium that the long-term economic impacts um and uh you know so i think there's a sense out there that that um as well as disconnection from the the health care and behavioral health care systems because sometimes people have been uh you know living in isolation uh not getting the care they need um and so so yes there's there's an expectation that's going to get worse i would say from from a uh the group of cities that we work with and there weren't a unique moment right now right where like you know it hasn't happened yet and so there's still opportunity i think to take advantage of federal policy local policy right to try to prevent that from happening like clearly there's there's a potential for a big wave to hit but a lot of things are changing and people are really attuned to it now and so now is the time and now is the opportunity to you know prevent that from ever happening but also and not just because of covid right but all the other underlying that we're seeing in so many communities and so many different kind of demographic groups children uh older people the mental health issues substance use and opioid addiction and overdoses are going through the roof even as covid has began to stabilize at least in terms of hospitalizations and death um opioid deaths are are are are exploding at an exponential rate you know bobby and hillary could speak so much more eloquently to it but if we don't see those as intersecting with homelessness is triggering homelessness as being a response to homelessness and deal with that then we're we're we're missing a lot right now everything is so complex and seemingly intractable because one thing kind of gets solved and the next one comes up um ham is there a last thing or should we wrap up now well i'll combine two questions um because they're kind of related to each other can you discuss why houston was so successful with their homeless solutions and what other cities are using these same ideas and actions and gets and someone else says it says can you give actual examples of successful programs from the book yeah i mean i get you know houston's goes back to the fact that uh that that i think it's two mayors back actually goes two mayors back and and you know the the mayor uh became a leader on the issue and decided uh despite the fact that that there were a few resources that they were going to try to do something about this and kind of put themselves out there and um and but it's a housing led approach really that's what houston decided they they they started small they started with the pilot program to bring veterans off the street then they then they moved on to chronically homeless and so they started small and they found success they learned lessons on a small scale and then they expanded it and like christin mentioned their recent uh you know initiative to to to move the people that have that have come into uh into shelter since covid to move them into housing like you know more than 3500 people it's absolutely uh incredible so so it's really taking a housing led approach and what that means for people who don't want to know what that terminology means is regardless of a person's uh readiness you get them into housing if they're not if they're still experiencing addiction and still you know experiencing serious mental health issues get them into housing first get them stabilized get them engaged and then connect to them to services and i'd like to just maybe end on a hopeful note right is one is through it all even during the pandemic uh we have been housing people we haven't just been bringing in the unsheltered and and giving them stability and safety we've actually been stabilizing people and have and seeing them move into housing and becoming more and more independent so that is happening every day and it is it is definitely a challenge um and the need continues and more coming in but there's there's an incredible amount of success and hope second is you know just a little pivot to washington which we didn't talk about the biden administration for the first time and congress is talking about fully funding section eight so the federal government has basically two federal housing policies one is to buy a home you can write off the mortgage interest deduction and everyone who buys a home and borrows money up to a certain amount can write that off their taxes everyone only one in four people who are eligible for a rental subsidy who meet the eligibility requirements only one and forget it because congress has never fully funded it even for people who are eligible you can debate the eligibility but one in four get it three and four don't imagine if that was the case with your mortgage interest deduction and your accountant said you were too late you don't get to deduct it there would be riots in the street but poor people don't riot in the streets but in the reconciliation bill and the omnibus budget bill is full funding of section eight that four in four people will get it and that will drive the housing market that will drive investment particularly if we invest in nonprofits who who aren't making money on building housing we're just building it for people who need it and for people who are poor and so there's a lot to be hopeful for because i'm confident that that legislation is going to pass and they're going to be opportunities to do great things and san francisco is doing them the housing accelerator fund non-profit finance fund you know get out of the way let's get this done and i'll say a one last plug for the book a lot there's a lot more specificity in the book and there's a lot of examples of stuff that didn't work either so i know someone asked about that right there is stuff that we that would try to cross cities that we try that i tried in new yorksy that did not work and we write about some of that too so if you if you like this go get the book that's a good point it's a great resource absolutely i'd like to uh thank everyone thank you john king for moderating our talk today and much thanks to christin mozzi and tom room for a really inspiring conversation and i think the message is as the song goes give them shelter please so thank you audience for being with us today and join us for mechanics institute online or come on down to the library at 57 post street san francisco and be with us in our gorgeous bozards library uh we look forward to seeing you again soon and once again thanks for for all of your contribution to this great book and really guiding the way to solutions to this issue which is so pervasive today thank you so much thank you everybody and um hope to see everybody again and another at our next event and take care i'm going to go ahead and shut everything down now