The pandemic gave a chronically homeless veteran in Los Angeles a chance at permanent supportive housing, but his experience differed from what state leaders envision. Can California offer the right support as it adds tens of thousands of new units?
By the lone tent under the cement overpass, just visible from the Hollywood Freeway, Fernando Maya waited with several backpacks stuffed with clothes, electronics and food.
Once a constant roar of traffic below his makeshift home, the freeway stood empty in the waning days of spring 2020 as the first wave of coronavirus tore through California. Here, occasional cars whipped up gusts of wind, their whistles morphing into the voices of people he had let down.
A car pulled up alongside a chain link fence that separated a service road from Maya’s camp. He hadn’t taken down his tent, raised from the dirt by a wood pallet to let rats pass. He was leaving and he didn’t know how long he’d be gone.
Maya slid into the back seat, his mind spinning with doubts. At 6-feet-1, the 56-year-old brimmed with an energy that could swing from charming to intimidating. When agitated, he slung his words faster, then harder.
“I don’t want to go anywhere where there’s a curfew,” Maya said to the driver, Jorge Soria, his case worker. “I don’t need the headache of having to follow directions.”
“You’re getting a good place, but it’s not like a free-for-all,” Soria recalls saying as he pulled the car forward.
California’s pandemic response marked the start of Maya’s journey indoors. Through Project Roomkey, the statewide effort to take vulnerable and elderly people off the street, he was given the keys to a hotel room of his own that June. Later, Maya would credit the program — and Gov. Gavin Newsom — with having ended his homelessness.Over the course of a five-month stay at a hip West Hollywood hotel, Soria helped Maya renew his application for a federal housing program for veterans, in an apartment complex with 90 affordable units set aside for people experiencing homelessness.
By September, his application was approved. The state would claim Maya as a successful transition into permanent housing — on paper at least.
So-called permanent supportive housing programs like Maya’s — which pair ongoing rental assistance with supportive services such as case management, substance use programs and mental health treatment — represent the gold standard for housing chronically homeless people such as Maya. For every one open unit in Los Angeles now, about seven people are waiting.
Having slept in the alleyways, underpasses and sidewalks of Los Angeles throughout much of his adult life, Maya longed for a place to call home. A chameleon by nature, Maya assumed he would transition quickly, just as he had adapted to the Navy, prison and living in a tent. He’d have his own keys, his own coffee maker. Safety. Ease.
He didn’t think the hardest part was yet to come.
* * *
For years, openings in permanent supportive housing have not kept up with the growing number of Californians facing chronic homelessness. In the three years before the pandemic, the number of permanent supportive housing slots in California grew by about 10%. In contrast, the state counted a 36% uptick in chronically homeless people.
California is trying to increase capacity. Last year, state lawmakers approved a $12 billion two-year plan to tackle homelessness. According to the Newsom administration, these investments would convert 35,000 hotel and motel rooms into permanent supportive housing over five years, growing California’s stock by over 50%. This month, he proposed another $1.5 billion to place people with complex behavioral health issues in tiny homes and other temporary housing while they wait for slots to open.
But demand outstrips supply. While conservative estimates put the total number of chronically homeless Californians at around 49,000, it’s been growing each year. The vast majority live outside and about half live in Los Angeles County.
If the state executes its plan, tens of thousands of people like Maya, sick and scarred from years of living on California’s streets, will finally come inside all at once. Whether they get the support they need to stay housed will determine the future of California’s homelessness crisis.
* * *
On the morning of Oct. 28, 2020, Maya packed his life into plastic bags and duffels once again, leaving the upscale hotel behind. He loaded his belongings into Soria’s car, and the two men drove east.
Sandwiched between the Hollywood Freeway and a busy boulevard lined with auto shops, the brand new apartment complex towered six stories over a commercial zone where little else was as modern or sleek as the building’s white, red, gray and glass exterior. Maya had grown up just blocks away.
He carted his belongings past a debris-filled encampment of tents that snaked around the building, then through the glass front door, and into a pristine courtyard of cement and manicured lawns.
Maya waited, jittery with coffee and anticipation, in a room strung with Halloween decorations where residents watched a communal television.
Minutes after signing his lease, he surveyed his new studio. Shaped like an L, the unit opened into a galley kitchen that widened into a bedroom, already equipped with a bed and dresser. Maya bid Soria goodbye, thanking him profusely for his help. Having secured housing for his client, Soria would soon clear Maya from his caseload at The People Concern, a nonprofit provider of housing and mental health services in Los Angeles.
Several days later, sitting at his new kitchen table decorated with a flowerpot of pens, Maya contemplated his goals.
Decades of stimulant use had left his face gaunt. His smile revealed rotting and missing teeth. But while at the hotel, Maya had gained 10 pounds that filled out his pockmarked cheeks. A red lanyard hung around his neck, weighted by his new apartment keys. He felt optimistic.
He said he wanted a real job before the market locked him out for good. His housing voucher subsidized his rent so it only ate through $52 of his $221 monthly cash assistance. He still wanted to prove to the world — and to himself — that he had something to contribute.
He wanted to visit his mother, now in her early 80s, whose life waned as she battled an alphabet soup of immunocompromising illnesses. They’d only spoken on the phone twice in the past five years or so, both times at the start of the pandemic.
Now she lived an 8-minute bike ride away, but something told Maya he wasn’t ready. He wanted to show her a version of himself that she would finally be proud of: drug free and employed.
* * *
In 2016, California created a homeless coordinating council and adopted a model known as housing first for all state homelessness programs.
The model, pioneered by a psychologist in New York in the 1990s and soon embraced by the federal government, is straightforward: End a person’s homelessness by getting them into a permanent home as quickly as possible, regardless of whether they use drugs or alcohol, or participate in treatment. Offer them hands-on counseling once they’re inside. Let them choose where they live and which services they receive.
In contrast with how service providers had operated for decades, this approach viewed housing as a tool, rather than a reward, for recovery.
Extensive research shows that permanent supportive housing that follows this approach works better, especially for chronically homeless people. They stay housed at higher rates, reducing the taxpayer costs they would otherwise rack up in shelters, jails, ambulances and emergency rooms.
Critics, including the previous homelessness czar under former President Donald Trump, say that the model hasn’t proved its worth, as homelessness skyrockets. Several conservative think tank voices point out that housing first has a mixed record when it comes to addressing serious mental health issues, substance use or employment. Others argue that it writes a blank check for rent, without moving people toward the goal of self-sustainability.
Republican state lawmakers called housing first “the most expensive and difficult policy” this month when they implored Newsom to declare a special legislative session on homelessness. Proponents insist that their aim is more realistic and less paternalistic: to permanently end a person’s homelessness, and help that person achieve individual goals. But the plan only works if it’s executed well.
A team of University of Southern California researchers found that the reality often falls short. In a pre-pandemic study of 26 housing first programs in Los Angeles, residents tended to report social isolation and unchanged substance use after their first year, though their mental health significantly improved. Most said they received little assistance from the in-house support team, contributing “to tenants’ isolation, difficulty navigating a complex health and social services system, and inability to develop additional life skills.”
The housing supervisors described offering comprehensive case management, primary and mental healthcare and substance use treatment, but the researchers’ interviews with frontline staff revealed gaps. Case workers reported that a patchwork of outside agencies providing services were difficult to communicate with. Caseloads averaged 36 residents per staff member — far higher than the recommended caseload of 12 to 15 — and staff struggled to focus on anything more than keeping people housed.
Understaffing, turnover and burnout plague homeless services throughout the state, as California faces a growing shortage of providers, including psychiatrists, psychologists, therapists, clinical counselors and social workers. COVID-19 has only exacerbated staffing shortages.
So people fall through the cracks. According to research by the California Policy Lab, at least one in five people placed in permanent supportive housing in Los Angeles between 2010 and 2019 returned to homelessness.
* * *
Maya recalls that when he was about 7, his father taught him how to bike by pushing him down a narrow alleyway behind their duplex on a three-speed without trainer wheels.
In the last few years, Maya rediscovered bicycles as a way to cope with his frustrations, memorizing the streets of Los Angeles. When major events occurred — mass grief after the death of Kobe Bryant, protests after a police officer killed George Floyd — he watched history unfold from his bike. During the early months of the pandemic, he swerved across empty boulevards and zipped the wrong way down desolate streets, Linkin Park blaring through his headphones.
On Maya’s 11th day in the apartment, Nov. 7, 2020, he recalls leaving around noon on his beach cruiser. He needed to withdraw his first month’s rent, already late, from an ATM.
He biked along one side of the complex before arriving at a busy intersection with a six-lane thoroughfare prone to traffic jams.
He remembers turning left. Then his memory blacked out.
* * *
Born in Los Angeles to Ecuadorian immigrants, Maya recalls a middle class childhood in a neighborhood of Cuban newcomers. Maya was always a mama’s boy, holding onto Leticia’s pinky even when he was old enough to let go. If his father, Joseph, showed his son what responsibility looked like, Leticia taught him resourcefulness. She attended night school when Maya was in high school. She filled steno pads with new words in English or bits of information she learned from clients and colleagues.
Maya’s parents divorced when he and his younger brother Paul were teenagers. As the brothers remember it, Leticia was fed up with Joseph beating up Maya and cheating on her.
He enlisted in the Navy when he was 18 at his parents’ urging, after dropping out of a boys Catholic high school. Trained as a radar operator, Maya sailed overseas twice, stopping in Bahrain, Japan, Malaysia, the Philippines, Singapore and Hawaii.
He first tried crack cocaine while in the Navy. He still remembers how the drug felt. A short-lived rush of intense euphoria. Then a gnawing need for more.
In his fifth year of service, Maya failed a drug test for cocaine, and then another for marijuana. After his second unauthorized absence, he was discharged in 1986. A Navy medical evaluation classified him as an occasional user, not drug dependent.
Maya returned home. Crack had seeped through his neighborhood. Soon he was selling or stealing to buy more.
At 25, his parents shipped him to a recovery program. After a few weeks, Maya abandoned it with nowhere to go. It was a hot, dry year. During his first year of homelessness, Maya remembers wearing shorts every day.
The next two decades, he recounts with a series of numbers. A total of 8 years spent in nine state prisons between 1990 and 2011. He was charged with two second degree burglaries, one sale of a controlled substance, and two petty thefts, according to California Department of Corrections and Rehabilitation records. Once out, he would get into sober living and work parole programs, but before long he’d get the itch for crack. He often landed back in prison for violating parole. For stretches, he stayed with family, rented, or paid month-to-month in a downtown hotel. But he usually procrastinated on applying for jobs, he acknowledges, and no one wanted to offer him one anyway, so he returned to the streets, stealing to get by.
Paul, who also used crack and heroin but quit 23 years ago, said that addiction always gripped his older brother with tighter claws. And it ruptured their relationship when Maya stole from Paul a family heirloom — a ring from Ecuador.
The drug was a chasm Maya could never fill. When he wasn’t high, his body ached. At the depths of addiction, crack could consume 18 hours of each day: finding, buying, using.
However, Maya’s last three appearances in Los Angeles court records in 2017, 2018 and 2019 show something new: possession of methamphetamine.
Someone suggested he try smoking crystal meth to help him beat crack. It worked.
* * *
Days after Maya left on his bike to withdraw his rent, his memory resumed to the unmistakable chemical smell of a hospital. He was in a sixth floor intensive care unit. An ambulance had delivered Maya to a county hospital with only a red multitool in his pocket. No bike, no wallet, no phone. Nurses shared few details, besides that he’d arrived with a traumatic head injury requiring five staples, four CT scans and anti-seizure medication. Ambulance records requested by CalMatters reveal that the 911 caller referred to the accident as a hit-and-run.
Maya believes he left the hospital about a week later with a walker, and took a bus home.
After the hospitalization, Maya’s days changed. He rarely left his apartment, biked less. His dizzy spells continued, sometimes so extreme that he could hardly stand up from bed without losing balance.
He smoked crystal meth most days. He now rarely felt a high, just freedom from the cravings.
He stayed up until dawn watching late night news and cop shows, or playing solitaire on his phone. He often thought of his goals when he first moved in, but couldn’t muster the will to apply for a job or to walk to his mom’s house.
Paranoia dogged him. He’d emerged from the hospital with no bruises or scrapes other than a gleaming scar about an inch long and shaped like a whale’s tail on the back of his head. He suspected someone attacked him from behind and might do it again.
You know I didn’t even think that the transition would be as tough as it has been. I always just assumed that others who struggle are just weak to begin with. When in reality thinking back it’s not a weak thing to begin with. It’s a readiness I’ve never really had.
A highly addictive stimulant, methamphetamine floods the brain with dopamine, a neurotransmitter associated with pleasure and reward. Heavy use decays the body and brain, sometimes leading to delusions and paranoia that mimic psychiatric disorders, such as schizophrenia. Unlike other drugs like opioids, there are no good replacement medications that can help a user wean off.
Maya’s doctor prescribed daily anti-depressants and a monthly injection of a drug used to treat opioid dependence, a combination found to slightly reduce cravings for some meth users.
Meanwhile, his mental health provider continued to prescribe him Zoloft, a drug often used to treat depression and anxiety, and Zyprexa, an antipsychotic medication often used for schizophrenia and bipolar disorder. But Maya distrusted the meds. He didn’t want to feel sluggish or numb.
As summer turned to fall, Maya increasingly perceived threats in the apartment complex.
He fixated on the idea that neighbors — perhaps people living in the encampment outside or other residents or security guards — hacked into his internet and monitored his behavior. Sometimes he heard their voices, jeering as if they knew what he had just typed on his phone.
Before his father was diagnosed with Parkinson’s disease, Maya thought Joseph was going crazy. In the years before he died in the early 2000s, Joseph heard voices, saw people who weren’t there, imagined threats everywhere.
Now Maya empathized.
He said he reported the issues several times to his housing case manager and the property manager, and even called the cops.
It’s hard to get a clear picture of what was really happening. People Assisting the Homeless, or PATH, a major statewide nonprofit that runs Maya’s permanent supportive housing, citing privacy, declined make his housing case manager or anyone else available to discuss Maya.
Security concerns are common in the complex, said Chester Reyes, the in-house case manager for veterans. Reyes, who works with up to 45 veterans at two different housing complexes, said many say they feel unsafe due to the encampment outside, crime and drug use near the building, and a lack of staffing after hours and on weekends.
It’s also difficult to pin down how various teams in Maya’s building coordinate support for him.
PATH owns the complex, contracts with an on-site security team and runs the supportive services, partnering with a nonprofit medical clinic, a nonprofit mental health provider, and county Department of Mental Health substance abuse services. An affordable housing management company maintains the building and collects rent. Meanwhile, the U.S. Department of Veterans Affairs pays for Maya’s rental subsidy and his case manager, Reyes.
Together, these providers are supposed to help Maya recover from homelessness, set goals, develop skills and build community. According to PATH, the team meets on a weekly basis to discuss individualized plans for residents.
However Maya says he received no assistance with job applications or other goals. He doesn’t blame the in-house staff; He’d mostly avoided them, especially after he didn’t see them act on his safety concerns. He’d never been one to stick to treatments or open up to counselors. At least now, he observes, that doesn’t get him kicked out of housing.
By Maya’s account, his mental health provider did not coordinate with his primary care provider, though he thought they should. Reyes was on leave for most of the year, with a rotating cast of veterans’ social workers from other buildings filling in. Maya missed Soria, his previous case manager, who helped him get off the streets.
As Maya’s distress grew, his studio felt more cramped. Clutter covered his kitchen counters and stove. Shopping carts held bike parts and clothes. Socks and towels hung on a rope strung across his kitchen. He kept his blinds drawn. He often felt trapped in his room, worried that if he left, he’d be attacked.
He’d rigged a security system at his door to ward off intruders. A red shoelace tied around the inside door handle would impede lock pickers. A three-sided ruler duct-taped under the door blocked anything from sliding under. When inside, he often pulled out his refrigerator to block the entrance. He kept a knife tucked in his back pocket.
On his one-year anniversary in the apartment, Maya mulled over the idea of returning to the streets if he couldn’t move soon.
He still had a new tent that Soria once gifted him, he said. He still slept on the sleeping bag he used at the underpass.
* * *
Maya’s experience echoes what the USC researchers found: a disconnect between the lofty goals of program supervisors and the realities that formerly homeless residents and frontline staff face.
Reyes said his main goal for his clients is to help them enroll in any mental or health care they need, and keep up with rent. But researchers and county administrators and state officials are more ambitious about improving Maya’s wellbeing:
- Dr. Margot Kushel, a UCSF professor who studies health and homelessness, said Maya’s team should help him relocate to a place where he feels safer. In a study of 169 permanent supportive housing residents in Santa Clara County, in which nearly all remained housed, Kushel and other researchers found that 70% needed to move at least once.
- The medical director for the substance use branch of the county Department of Public Health, Dr. Brian Hurley, said that Maya should have a team of specialists who coordinate his treatment plan, and access to contingency management therapy — a well-evidenced treatment for meth use that incentivizes sobriety with small rewards, like cash or prizes.
- Dr. Jonathan Sherin, a neuroscientist who directs the Los Angeles Mental Health Department, said he wished he could pair Maya with a well-trained occupational therapist who could meet with him frequently to work through questions like What do you care about? What do you want to do? What are your goals? What’s your vision of a future that’s bright?
After a year in permanent supportive housing, Maya’s own goal for himself was simple and urgent: move out.
Maya could transfer his housing subsidy to a different kind of permanent supportive housing, known as scattered-site, where he would rent a market-rate apartment but would continue to receive veterans’ case management and other services. But, his caseworker Reyes described, it’s a long, bureaucratic process, and it will be on Maya to find the rare landlord willing to accept his voucher — a challenge in Los Angeles’ hot housing market.
* * *
In early November, desperation pushed Maya to stop smoking meth cold turkey and apply for a job at an Amazon warehouse.
His monthly aid had covered life outdoors. But life inside required new expenses: rent, cleaning supplies, and food for which he no longer relied on the Salvation Army. Mostly, he wanted to get away from the anxiety he felt in his building.
After eight harrowing days, endured mostly alone in his apartment as the voices teased and harassed him, Maya left the apartment on a sunny morning, arriving two hours early to a nondescript office building. Inside, a man behind a glass partition click-clacked on a keyboard as Maya answered his questions. Within 15 minutes, the man assigned Maya his first shift: the following Friday from 10 p.m. to 3 a.m. The man directed Maya to one of the drug test stations across the room.
He held a swab to the inside of his cheek for several minutes before sticking it in a plastic vial.
“You’re good to go,” he recalls an attendant saying.
Maya stepped into the warm autumn sunlight, relieved and proud.
The text arrived several days later.
“Hi! This is Amazon, with a message about your recent job application. We need you to schedule another appointment due to an error with your drug test results.”
Energy drained from Maya’s body.
In the weeks that followed, Maya would schedule another Amazon drug test, only to miss it. He would talk himself out of calling his mother again. An employee badge would continue to elude him. He would eye the tent he stored in his closet.
Maya doesn’t remember whether he relapsed before or after he received Amazon’s text. As soon as the smoke hit his lungs, he felt a rush of relief.
* * *
The state, too, has fallen short on many plans. A 2020 audit called California’s efforts to address homelessness disjointed, with at least nine state agencies operating 41 different programs that fund homeless services. The nonpartisan Legislative Analyst’s Office criticized Newsom’s homelessness spending plan in both 2020 and 2021 for lacking a clear strategy.
Lawmakers are pushing change from the top. They reformed the state’s homeless council last year, naming the secretaries of California’s health and housing agencies as leaders, in an effort to improve coordination. The state built a data system to track whom counties are serving and how. Newsom’s budget plan last year included a $2 billion boost for local governments to provide homeless assistance as they see fit – but only if they make progress toward concrete goals. At the same time, the state is overhauling its low-income health insurance program to provide high-needs patients, especially those who are homeless, with care coordinators who make sure they get all the rehabilitative services they need.
It’s unclear whether these efforts to bake in accountability and coordination will trickle down into the apartment complexes, clinics, shelters and encampments where social workers, doctors, therapists and addiction counselors try to help people heal from chronic homelessness.
One of Newsom’s point people on these initiatives recognizes the difficulties ahead. Dr. Mark Ghaly, the state health and human services secretary, will now co-chair the California Interagency Council on Homelessness. As California pours billions of taxpayer dollars into tens of thousands of units, Ghaly said, supportive services will have to “catch up and be really strong, fast for us to see the dividends.”
* * *
On New Year’s Day, chilly and clear after heavy rains, Maya biked past his old home under the freeway underpass. He noted no new tents, its emptiness almost inviting. But he didn’t plan to return.
Over the holiday, the voices he heard in his apartment quieted. He attributed it to the clearing of a government-sanctioned encampment across the street. He started leaving the apartment more, and rode farther.
The new year held some promise and many unknowns. Maya had filled out paperwork for free dental work to replace his broken and missing teeth. He’d begun registration for an app that pairs freelance labor with odd jobs. For the first time in his life, he had started to regularly see a therapist. He planned to end 2022 a little more self-sufficient, he said, though he no longer expected he’d get sober. He also didn’t plan to move, after he’d learned he’d have to pay a security deposit but didn’t qualify for assistance.
A year and a half after leaving the underpass, Maya had found a new, albeit tenuous, stability. He remained a statistical success story in California’s fight to reverse its mushrooming homelessness crisis. Yet 14 months into permanent supportive housing, he still felt little support. Maya’s battle to build a new life for himself was still one he waged largely in solitude.
A few evenings later, Maya biked to a 99 cent store to load up on bell peppers, tomatoes, cucumbers, Pepsi, a can of chili and a raspberry strudel. His backpack heavy, he peddled the wrong way down empty boulevards for several hours, the cool winter air whipping at his face.
Close to midnight, he challenged himself up a hill not far from his building. At the top, a second burst of energy. Exhilarated, Maya peddled home.
He had groceries to put away.
This article is part of the California Divide project, a collaboration among newsrooms examining income inequality and economic survival in California.