Most of them raised issues in a handful of key areas. We’ve pared them down to these topics, and highlighted this year’s questions.

Ask any dozen people in the Bay Area what they think of homelessness, and you’ll get a dozen different answers. For the past two years, we asked Chronicle readers to submit questions about this most vexing, heartbreaking, seemingly insoluble problem in the Bay Area, and received more than 700 submissions.

While housed residents hunker down indoors as much as they can, many of them struggling with unemployment, thousands of people on the street have nowhere to go and little hope of climbing out of their predicament. Even those in shelters and government-rented hotel rooms face an uncertain, frightening future, realizing that there’s more exposure to the virus in congregate settings and that someday, those safe hotel rooms will no longer all be available.

Homelessness was already a confounding crisis, but the coronavirus pandemic and the economic ruin it wreaked have amplified the existing challenges and created new ones.

For the fifth year, The San Francisco Chronicle is leading the SF Homeless Project, a consortium of media organizations focusing on the seemingly intractable problem of homelessness. The Chronicle’s ongoing coverage, including stories, videos and interactive graphics, can be found at SFChronicle.com/homelessness .

New answers for 2020

The full effect has yet to hit. Gov. Newsom and his homelessness policy advisers are sticking to their pre-pandemic plan of spending $750 million statewide on the issue, but because of the virus crisis they are now focusing that money on converting hotels being used for emergency rooms for the homeless into permanent housing.

The explosion of tent camps, up by more than 70% citywide, has left its mark in every major district of the city, most visibly in the Tenderloin. The number of tents there shot up 285% between January and early May, when the mayor launched a program to address the problem in response to a lawsuit by residents and UC Hastings School of Law. A settlement reached in early June says 300 of the more than 400 tents in the Tenderloin must be gone by July 20, and hundreds of campers have already been moved into hotels and sanctioned encampment sites.

How much have tent camps proliferated during the pandemic, and what’s being done about it?

It’s incredibly hard under state and local laws to force anyone into treatment for substance abuse or mental illness, and also difficult to force someone to accept a shelter bed. New York many years ago passed a law basically forcing street people to choose between jail and shelters if pressed, but the chances of trying that approach in the Bay Area have been considered slim to none.

Several San Francisco leaders, most notably Mayor London Breed, think the famously compassionate city is attracting new street people looking for help in the pandemic. Typically about 70% of San Francisco’s homeless people were housed here before they lost their roofs — it’s more like 80% in other cities — but as early as April, Breed said she believed there was a worrisome influx throwing that figure off. No solid data to date document such an influx, and some homelessness experts say the influx may be more anecdotal than significant.

Several plans are being prepared statewide to try to house homeless people now in emergency hotel rooms or safe sleeping tent sites, and most involve trying to buy or lease some of those hotels and financially strapped properties to use as housing. San Francisco homeless policy leaders hope to obtain at least two hotels, and nonprofits, including the Tipping Point Community, are identifying what they expect will be hundreds of vacant apartments in the city that can be rented using philanthropic donations. The argument for hotel owners will be that, with the economy still expected to be awful for months to come, leasing or selling to governmental agencies will guarantee income at a time when they’ll be hurting for customers.

To help the homeless avoid contracting the coronavirus, officials have decreased the shelter populations to create social distancing and rented emergency hotel rooms for the vulnerable (those over age 60 or with underlying health conditions) or COVID-19-infected homeless people.

What is being done to help homeless people during the pandemic?

More than 35,000 homeless people were counted across all nine Bay Area counties in the federally mandated one-night tally taken in January 2019, and about 30,000 of them — 86% — were unsheltered. That means they were living on the street or in vehicles and not in homeless shelters. That bracingly high percentage of unsheltered people is reflected statewide, where the one-night count found an overall population of 151,000 with 108,000 unsheltered. Most experts say that because these counts are so hard to do, the actual numbers are probably at least double what’s reported.

The mayors and homeless policy leaders of the biggest cities in the Bay Area, including San Jose, Oakland and San Francisco, regularly consult each other about funding, shelter and housing plans and other key issues, but there is no one governmental agency that coordinates the efforts for the region.

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Click a question to see the answer.

1 How many homeless people live in the Bay Area? An estimated 35,005 homeless people were counted across all nine Bay Area counties during a one-night count made in January 2019 — a 24% increase over 2017. That number comes from a volunteer-driven, one-night survey that happens every two years under federal requirements. Many who work with homeless people believe this methodology understates the true numbers. However, because the counting methods are consistent, the numbers are useful for determining overall trends in the homeless population over time.

2 How many homeless are in San Francisco and how are they counted? The latest one-night count in San Francisco found 8,011 homeless people in the city, 17% more than in 2017. Hundreds of volunteers participate in this one-night count, which attempts to cover streets, shelters and other programs in every sector of the city. That number does not include people in prisons, hospitals and rehabilitation centers who are counted in a supplemental tally that still gets done but is no longer included in the final number because those categories are not used in other communities. Adding those numbers would put the city’s homeless population closer to 10,000, 30% higher than in 2017, but that rise was also partly attributable to changes in methodology.

3 It seems that most, if not nearly all of the homeless people in the Bay Area come here from other states due to the region’s progressive politics and generous benefits. Is that true? Not as much as people might think. Up to 80% of homeless people became homeless in the communities they are in. Some do travel to the Bay Area because, like others migrating here, they like the weather and the liberal environment. But virtually every major city in America also claims to be a magnet for homeless people.

4 California has the largest homeless population in the nation, about 130,000. Why? California has 12% of the overall U.S. population, but about 25% of the nation’s homeless population. The cost and dearth of housing is the No. 1 reason. If people lose their housing, it is much harder to find another place to live in California, which is short millions of housing units. California’s overall population is the largest in the United States as well.

5 Why has there been an increase in homelessness? There are many reasons.Two of the main ones: Wages have not kept up with the rising cost of housing for lower-income people, and the epidemic of opioids, fentanyl and methamphetamine use. People living in RVs and cars — a population that probably at one point had stable housing but lost it for various reasons — make up one of the biggest parts of the recent increase. San Francisco’s programs lifted more than 2,000 people out of homelessness in 2018, but for every person who got housed, there were three newly homeless people.

6 How many homeless people are on drugs? Alcohol? How many are mentally ill? An estimated 42% of homeless people struggle with drug or alcohol abuse in San Francisco; 39% have psychiatric or emotional conditions.

7 How many homeless people are military veterans? The 2019 one-night homeless count in San Francisco found 608 veterans, 11% fewer than in 2017. This means 8% of the total homeless population consists of veterans.

8 How many families are homeless, and what’s being done to help them? The 2019 one-night homeless count found 612 people in 201 families, similar to the 2017 one-night count of 601 persons in 190 families. That means 8% of the total homeless population is made up of families. The Coalition on Homelessness says the count is actually much higher, pointing out that the school district — using its own definition of homelessness — lists more than 2,000 students as being homeless. And the subcategory of chronically homeless people in families grew from 26 in 2017 to 175 in 2019. However, the city has a robust network of programs specifically for homeless families, including Compass Family Services and Hamilton Families, and it is rare to see families living outside. San Francisco offers 800 family shelter beds, a range of rent subsidies for families, and 2,388 permanent supportive housing beds for families.

9 Do homeless people often relocate — move to a particular city because of better services, sense of community, weather, etc.? A vast majority stay in the community they are most familiar with. That said, a small percentage may select cities where they think they will get more assistance. In San Francisco, the city found in 2019 that 55% of homeless people reported living in San Francisco for 10 or more years, and just 6% said they’d lived in San Francisco for less than one year.

10 Reports say tens of millions of Americans nearing old age don't have financial resources or a plan to fund a secure old age. That seems to indicate a coming large increase in homelessness. What are the numbers of those people, and what’s being done to deter those in other areas from coming to the Bay Area? UCSF researchers recently found that 44% of homeless people over 50 became homeless after their 50th birthday, and the researchers believe the numbers will grow. The trouble is that too many older, low-income Americans are unable to save or plan for retirement, so when they become physically unable to work they run into financial trouble. UCSF statistics show that in 1990, only 11% of the homeless population nationwide was 50 or older. Today it’s 50%. The UCSF study, based in Oakland, also found that the overwhelming majority of older homeless people remained in their own communities after losing housing.

11 What percentage of the homeless are employed? Of those identified in the city’s 2019 count, 11% reported being employed full time or part time. Nationally, that figure is closer to 25%, according to the Urban Institute.

12 Why are there fewer homeless people in the North Bay? There generally aren’t as many poor people in North Bay communities. Most homeless people like to be in urban centers where there are more services, housing and — if they are acutely troubled — easily available drugs to feed their habits.

13 Do longtime homeless individuals think homelessness is a problem? Do they think they have a right to live on the streets of San Francisco? Nobody likes living outside for years at a time. Most homeless people will say yes, it’s a problem they would like to see solved humanely. Most homeless people will argue that they have a right to sleep outside if they have no choice, and federal court rulings support that right.

14 Since there is a housing shortage, does a person moving off the street mean someone else is becoming homeless? Homeless people generally don’t displace residents when they move inside because they almost always go into units specifically tailored for them, but for every 1 person who is housed in San Francisco, 3 more people become homeless. The rate of people becoming homeless is much higher than those who are housed at current rates. Because of the region’s lack of housing, there is a problem moving people into an emergency shelter, then into supportive housing and eventually into low-income housing.

15 Is there an expectation that homeless people placed into housing will be able to support themselves at some point? I’m concerned that, if not, over time the program will grow to consume the entire budget for help. You have to talk about different kinds of housing. Chronically homeless people, or 38% of the city’s homeless total population, need intensive help. Once placed into housing, most are unlikely to find work and support themselves. The rest of those housed generally do move on to self-sufficiency. One thing to keep in mind: A chronically homeless person on the street costs the city about $85,000 a year in police, medical and other costs. The city spends about $25,000 per person to maintain them in supportive housing.

16 If the new Navigation Center (on the Embarcadero) is built, what are the demographics of the homeless population to be served? Will this be an older cohort? The city aims to take only the most acutely needy homeless people into its Navigation Centers, since they have far more counseling services and flexibility (you can come and go 24-7, bring in partners, and more) than a typical shelter. There’s no specific age target, but counselors concentrate on people who have been on the streets for more than a decade. About half of the homeless people along the Embarcadero say they’d like to move into the nav center, and the center will be focused on taking in those who are in the immediate area.

17 I am worried about the lack of affordable, accessible housing for older adults and people with disabilities. What are regional governments doing to ensure that people with chronic illness and in wheelchairs are not living and dying on the streets? All service providers say they give higher priority to homeless people with disabilities and chronic illnesses, but there is never enough housing to instantly place them inside. In San Francisco, 27% of homeless people report having physical disabilities and 31% report chronic health problems.

18 Can Navigation Centers be expected to successfully support people suffering from a variety of issues (addiction, mental illness, poverty, lack of education) or will Navigation Centers "specialize" in areas of support? Navigation Centers are geared toward the most troubled people by having intensive counseling on-site, which is why they cost about $100 per bed per night, or about double the typical shelter bed cost. Conceived in San Francisco, they have generally been shown to be successful enough to be emulated in other parts of the nation.

19 What are governments doing to push back on opposition to Navigation Centers? Elected leaders and homeless-program directors reach out to neighborhoods where nav centers are proposed, and this typically garners support. The centers usually get built because they are planned to be at some distance from residences. And once a nav center gets built and some of the area’s homeless people are taken in off the streets, much of the opposition fades. Recent proposals encountered fiercer opposition than usual in Fremont and along San Francisco’s Embarcadero. In the Embarcadero case, city leaders are going ahead with construction despite a lawsuit by residents to block the new center.

20 What reasons do individuals give for declining shelter and/or services? About 30% of homeless people say they don’t want government assistance, but street counselors have found that many say they don’t want to go into shelters because they are wary of having their belongings stolen, or having to leave some of their belongings outside. Fear and an entrenched survival routine make it hard for chronically homeless people to make big changes like taking a shelter bed. It can take up to two years of engagement by street counselors to persuade such a person to trust the system enough to accept help. Navigation Centers, with their more open rules, help overcome the reluctance, and UCSF and the city are expanding techniques to help those who are resistant to services.

21 What is the status of the Tuff Shed housing initiative in Oakland? Is it still going on? What are the costs and outcomes? Is any other city doing this? The city just opened a new “cabin” settlement (it doesn’t use only Tuff Sheds) this month, meaning it now has four such sites in operation housing more than 100 people. In the year and a half since the city’s experiment began, nearly 200 people have been moved into shelter or housing. Each unit costs about half of what a typical shelter bed would cost. Other cities have been slow to emulate the program, however, waiting to see what the long-term results are.

22 I would like to know how zoning is being streamlined to increase new home development. Rezoning is notoriously tough in San Francisco — as in most big cities in Northern California — and high construction costs and city fees make it difficult to get new projects going. Efforts are now being made at City Hall to streamline the process. And a flurry of state legislation has been put forth in recent years to speed up development, but little has been passed. The highest-profile proposal, SB50 by state Sen. Scott Weiner, D-San Francisco, was shelved in June. Gov. Gavin Newsom has said he wants to spur the construction of millions of new homes in the next six years.

23 How is the potential for disease due to feces in public areas being dealt with? Street cleaning crews try to keep up with the mess in camps and on sidewalks, but the problem is tough to combat because so much of it accumulates in the streets throughout the day.

24 Why are we not trying to establish mini-home areas, where the homeless can live? There is movement on this front. Many homeless-policy experts think tiny homes — both standalone and stacking modulars — are a cost-effective way to create housing quickly and cheaply. But getting community approval and finding areas to locate them is tough. About a dozen tiny standalone homes for veterans opened in Santa Rosa this year. San Jose is trying to get a small village of them going, several hundred stackable modulars are planned in the next few years in San Francisco, and Berkeley has complexes in the works.

25 Why do so many city supervisors spend years "looking for appropriate sites" for Navigation Centers in their districts? How can we tell if the delay is a legitimate lack of sites and not endless bad-faith stalling? Supervisors generally come under enormous pressure from residents to keep homeless shelters of any kind out of their neighborhoods, though there are also residents who welcome them, so it requires balancing interests. Some, like Hillary Ronen, have actively and successfully pushed for the centers in the past, and recently there’s been a surge of support on the Board of Supervisors for building more centers. But such things rarely move fast at City Hall.

26 If you’re evicted, are there programs to help you obtain a new apartment so that you’re not homeless on the streets of San Francisco? There are many programs that help people deal not just with eviction, but fight to prevent being evicted. One foremost resource is the Eviction Defense Collaborative, also the Coalition on Homelessness advises those in distress. The city’s outreach counselors and aid centers help house homeless people with Rapid Rehousing funds, housing vouchers, supportive housing programs and more.

27 Are enough shelter beds available to match the number of people who are homeless? No. There is always a waiting list of at least 1,000 people wanting a shelter bed. A year ago, Mayor London Breed set a goal of creating 1,000 new shelter beds by the end of 2020; so far she’s added 286. An additional 126 new beds opened after she became mayor, but before she set her goal.

28 Yesterday, I saw several empty buildings along auto row in the Serramonte shopping area in San Mateo County. They used to house Toys R Us, car dealers, etc. — large empty buildings that could serve as new Navigation Centers. Why can't San Francisco partner up and convert these buildings into much-needed housing for our homeless? Converting unused buildings requires zoning changes, lengthy governmental approvals, community support, funding and construction contracts. There is a growing desire throughout the Bay Area — and the state — to cooperate regionally on homeless issues, including housing, but it is in an early stage. No city really wants to take in big numbers of homeless people from other areas, but governments are realizing they need to cooperate more, because problems just over the city line can easily spill over.

29 Why do so many homeless encampments include huge amounts of junk? These are people living in desperate situations, and anything they can own is considered precious. Homeless people generally have nothing but what they can carry with them or pile up at a camp; just like anyone else, they become attached to their possessions. Mental illness is another reason people hold on to items that may seem like junk to others.

30 Why are homeless people allowed to build camps when it’s clearly unsafe, a fire hazard and a sanitation problem, to name a few issues. Why are they allowed to live in unsafe conditions? The city has stepped up its enforcement against tent camping so much over the past couple of years that large encampments are now rare, though camping persists. The city has laws and policies against sweeping away camps if there is no shelter space available, but it also has laws against blocking sidewalks that are enforced when housed residents complain. Street counselors are most interested in moving people away from the streets and into healthier situations, but they don’t have enough resources for everyone. Homeless people often prefer to stay where they are, fearing they may lose their independence and few belongings if they move. It’s a continuous balancing act that is always controversial.

31 Why do homeless people choose to lie down and sleep and set up camp in heavily trafficked places like Valencia Street doorways and on Market Street? Those who sleep and camp in heavily trafficked places often do so for safety. They can be around their friends for protection and company. It also helps to be near crowds for panhandling, and being near welfare, soup kitchens or other organizations they need. Not every homeless person wants to camp and hang out in the thick of things, though. Some pitch their sleeping bags in hidden, out-of-the way places for privacy.

32 Why do many people remain unsheltered for years? Do they avoid shelters because of safety concerns, restrictions on family/pets/storage, paranoia, laziness, or something else? What would convince them to enter a shelter or permanent housing? People with disabling conditions who remain unsheltered for more than a year, or are on the street four or more times in the past three years, are categorized by homeless experts as being chronically homeless — the hardest people to shelter and house. Most struggle with substance abuse, mental illness or both, and find it very difficult to accept help because of fear, confusion, a desire for independence and more. It can take outreach counselors up to two years of repeated engagement with hard-core homeless people to persuade them to move inside.

33 What steps are being taken to temporarily provide camps for homeless? Why not provide long-term, clean and orderly tent cities? San Francisco is planning to open a pilot-project parking place for people living in vehicles soon. San Jose already has one, and Oakland has been establishing small “cabin” communities as temporary shelters for more than a year. Most governments move gingerly toward temporary camps, however, because maintaining order at them is difficult — as indicated by a camp allowed to grow in Santa Rosa until it became so unruly it was dismantled last year. Program managers prefer to use actual buildings to house people because it’s considered safer for everyone involved.

34 Why doesn’t the government build apartments on barges and put the homeless half a mile out in the ocean? Or let them camp on Alcatraz? Shipping homeless people onto isolated islands or boats would make them more like prisoners than people being helped into healthy lives. Every once in a while, someone sincere, such as former Mayor Art Agnos, proposes using retired Navy vessels or similar craft docked in the harbor as temporary homeless housing, but that is considered costly, unwieldy, and politically dicey.

35 Why does it cost $700,000 to create a unit of permanent affordable housing? Construction costs in San Francisco are among the highest in the nation, and there are many layers of costly governmental approval required for building. Land is expensive, city fees for construction are high, unions have resisted cheap modular housing proposals and have extensive requirements for projects. Also, mandates that all large multifamily construction projects set aside units for affordable housing can stall market-rate building projects.

36 There's tons of space beneath all of the freeway overpasses coursing through S.F. Can the city work with Caltrans to develop all of that empty land into homeless communities? The city has indeed used Caltrans property for creating shelter, such as at Fifth and Bryant streets, and city planners are in continual talks for using more of that type of land. However, Caltrans won’t allow the construction of housing or shelters directly below freeways.

37 Why is city government not fighting for and utilizing enhanced conservatorship for the mentally ill? The city actually passed legislation recently to expand conservatorship authority, but it’s not enough to sweep in all the ill people who need it. The debate is the same that has raged in the city, state and nation since the closure of mental facilities began in the 1970s and ’80s — the right of the mentally ill to determine their own fate versus governmental power to force people into treatment.

38 Why doesn’t the city help a homeless person connect with their family and send them home? If they have no home and they are drug addicts, we should be offering them rehabilitation instead of phones and money. The city does exactly that through the Homeward Bound program, which since 2005 has sent more than 10,000 people home with the goal of reconnecting and finding housing with loved ones or close friends.

39 Do experts in this area feel that some degree of homelessness is unavoidable? Or, using a variety of programs, can everyone be housed in one program or another? Most experts think the problem can be solved, at least temporarily, in some communities with a big infusion of effort and funding. That happened in Salt Lake City a few years ago, though its chronic homelessness problem inched back up again after attention to it lapsed. And in Houston, homelessness dropped 54% in the past eight years as the city stepped up tracking its housing and programs and more efficiently routed people into services. But many also think the problem can’t be fully solved until the federal and state governments devote more resources to make up for severe cuts in poverty housing and other support programs over the past four decades.

40 Why don't we pay homeless people to clean up the streets? Vouchers or cash per bag of trash? There are several governmental and nonprofit programs, such as Downtown Streets Team, that do exactly that. But there aren’t enough such programs to employ all the homeless people who could participate. Also, minimum wage is not enough to get someone out of subsidized housing.

41 What restrictions are placed on homeless people who want help finding a place to live? Generally, they have to cooperate with the counselors trying to help them, and show good faith in wanting to go inside. They also need to cooperate with finance managers arranging the housing, and usually they need to accept a shelter spot while their situation is being worked on. Permanent supportive housing complexes — housing with counseling on-site — don’t require residents to be free of their drug or alcohol addictions, with the idea that they can work on those problems much better when they move inside.

42 What percentage of homeless people would accept housing if it meant no drugs or alcohol? That would be very hard to determine, but experts and counselors have found over decades of experience that it’s much more effective to house people first, and then work on reducing their addictions while inside. Hence the terms “housing first” and “harm reduction.” Depending on the addiction, somewhere between 40% and 60% of people in the general population relapse, which means those people would be back on the streets after every relapse, making it harder for them to get clean.

43 What do homeless individuals say is needed for them to come off the streets? Are there homeless individuals who truly do not want to be housed? Why do they feel this way? Most homeless people want housing and a job. The most severely dysfunctional at times say they just want to be left alone, but nobody likes sleeping face-down in the dirt.

44 Are any government agencies working on a program that would exchange regular work done by homeless individuals for benefits like housing or food vouchers? Are any “workfare“ programs in place? There absolutely are, in San Francisco as well as other communities including San Jose. You get a little more welfare money if you agree to work in a job program. And some nonprofits, such as the Downtown Streets Team, give vouchers for food or retail to homeless people who participate in their homeless-aid programs.

45 Thinking about homeless individuals who are unwilling or unable to follow the rules required under various programs, are there ways to overcome these specific situations? Extensive, professional case managers and counselors are the most effective. Simply throwing someone out of a program is not a desired option.

46 How can I help combat homelessness? Where is the best and most effective place to donate money or resources? Scores of Bay Area nonprofits work with the homeless, providing help with housing, shelter, food, clothing and more. The Chronicle’s “SF Homeless Project How You Can Help” guide is a good place to start looking for opportunities.

47 Are there examples in other countries of successful methods/processes that have been used to decrease homelessness? Can some of those be applied to the Bay Area? Other Western countries don’t have the same kind of homelessness problem we have here because they have national health systems, living-wage laws, unemployment payments that pay basic bills and national social low-income housing programs, many with laws providing a legal right to a roof.

48 What are the three main reasons for homelessness and what are the top three solutions? The top three reasons for homelessness are loss of job, loss of housing, and drug or alcohol abuse. The top three solutions are housing aid — counseling-intense supportive housing for the most troubled — employment programs and substance abuse rehab.

49 What are all the different ways San Francisco as a city has tried to solve homelessness, and which has been most effective? Initially, as homelessness grew in the 1980s, San Francisco did what every other big city did, which is erect shelters and mostly expect people to pull themselves back into stability. As the severity of the crisis deepened, it developed housing and counseling programs, and then, as compassion fatigue set in, it tried get-tough law enforcement in the 1990s. During this millennium, the emphasis has been on housing people with counseling on-site if they need it, doing intensive street outreach to pull people into programs — and in the past couple of years, creating a strong data system of tracking homeless people through services to help them more effectively and to reduce wasted efforts. As hard as it is to see the distress in the streets, the latest era has the best grip on what are now considered best practices toward solving homelessness. Bringing programs to effective scale in the face of inadequate support from the federal government is difficult, however. Cuts in federal social and housing programs in the 1980s are what began the modern era of homelessness, and those cuts have never been restored fully.

50 Why do West Coast cities like San Francisco have so many fewer shelter beds per capita than the East Coast cities like New York? Has there ever been discussion of a California right-to-shelter law similar to New York's? New York City is indeed the big example. In the 1980s, it passed a series of laws mandating a right to shelter for every homeless person, and then forcing most homeless people to either take the shelter bed offered to them or face penalties. It cleared up the visual problem in Manhattan to a large extent, but much of the city’s 61,000-person homeless population now lives in teeming shelters away from downtown, with inadequate aid programs to get them into permanent housing. West Coast cities decided in the early 2000s to focus on creating housing opportunities instead of shelter, with the idea that it’s a more permanent solution. The right-to-shelter idea does surface in California from time to time — and it is currently being considered by Gov. Gavin Newsom’s new homelessness council — but hasn’t found substantial support. .

51 What are local churches doing to help combat the crisis? Most churches do have homeless-aid efforts, and probably the best known in San Francisco are Glide Memorial, which runs extensive counseling, job and food programs, and St. Boniface Catholic Church, where the Gubbio Project allows large numbers of homeless people to sleep in the pews during the day. Catholic Charities of the East Bay, in Oakland, is another religious organization that aids the poor and homeless. The Chronicle’s “SF Homeless Project How You Can Help” guide lists several of these organizations.

52 Why doesn't the city put more portable toilets out so people have a place to go to the bathroom? The city already spends more than $3 million a year on dozens of portable toilets, and proposals in next year’s budget would add millions more dollars for them.

53 Where can I take someone who doesn’t want to stay in a shelter but wants a shower? The easiest solution would be connecting with a community program such as Lava Mae, the nonprofit that provides portable showers around town, drop-in centers such as at Glide Church, or city pools.

54 San Francisco spends more than $300 million a year on homelessness and yet the number of homeless people went up last year. Where does all that money go? It goes to several city departments, mainly the Department of Homelessness and Supportive Housing, which then either runs directly or contracts with nonprofits to provide a wide range of services, including street counseling, medical aid, housing, substance abuse rehabilitation and mental health help. About 20% goes to providing shelter, and half or more of the money is for supportive housing that keeps roofs over more than 9,500 formerly homeless people.

55 How much does San Francisco spend per capita on homeless and/or housing-insecure persons? Is it more than comparable cities?" That is no simple calculation, and you can’t just divide any city’s homelessness budget by the number of street people there because a lot of the money goes toward preventing people from becoming homeless, capital spending, administrative costs and more. And each city and county reports its figures differently.

56 How much does San Francisco spend to combat homelessness? How much money was spent five years ago? And 20 years ago. Twenty years ago, the city spent $60 million a year on homeless programs. Five years ago, the city was spending $165 million annually on homeless programs, with about half going toward keeping formerly homeless people in supportive housing. Today, the homelessness department budget is $285 million, also with about half going toward supportive housing. Millions more are spent on law enforcement and other costs not included in the Department of Homelessness and Supportive Housing budget, but there’s no central accounting of that.

57 What makes us believe that the money we are spending addresses the root causes and makes the situation better? It can be tough to be optimistic if you see the distress on our streets every day, but in shelters and housing programs throughout the region, a lot of work is being done. Most big cities, where the main homeless populations are concentrated, follow best practices learned nationally over decades — housing people and providing counseling on-site, rapidly rehousing people who get evicted before they become entrenched into hard-core homelessness, tracking people as they use services to avoid duplication, and more. There is always wisdom in assessing spending to ensure efficient use of public money, but if homeless programs were not being funded to the degree they are, the populations on the street would grow astronomically.

58 Are there cost-control reports or audits of the city’s spending on homelessness? San Francisco’s homeless program funding is required to be assessed annually for efficiency to qualify for federal funding. Those assessments are conducted by several authorities, including the Local Homeless Coordinating Board and the city Department of Homelessness and Supportive Housing. The city controller’s office, grand jury, and the Board of Supervisors and its budget analyst also look at homeless funding, with supervisors often weighing in on money issues. Still, there is always a desire for tighter assessment and more evaluation.

59 What are we actually doing to address the issue? Our city officials seem to be just talking and not doing anything, while the problem only gets worse each day. San Francisco spends more than $300 million a year on outreach, counseling and housing programs and it regularly comes up with new plans. If it didn’t, the number of homeless people would be much higher than the 8,000 to 10,000 found daily in the city’s streets and programs. Low-income housing aid limitations by the federal government, which began making huge cuts in the 1980s, is often blamed as a major cause of homelessness that makes it nearly impossible for local communities to solve the problem. Nationally, an inadequate health care system, income inequality and institutional racism are also to blame. There are two parts of the homeless epidemic: the visible, chronic population and the largely unseen population, people who may be living on friends’ couches or in shelters. City leaders generally have been loath to crack down hard on the visible, chronic population in part because there are not enough shelter beds and not enough substance abuse and mental health programs to serve them all.

60 Why can't San Francisco make an arrangement with another county that has lower land values to build affordable units, and use lower-cost manufactured housing? There is a Bay Area-wide and statewide push on right now for communities to work collaboratively to create affordable housing, but construction and land use is still up to each city and county, each with its own challenges. However, no city wants to take on other cities’ problems. Nevertheless, this was a proposal raised by candidates in last November’s election, and the issue seems to be gathering support among some politicians.

61 San Francisco owns a lot of land outside its borders. Why not build a new community outside the city where things could be cheaper — modest accommodations (like earthquake shacks) with communal bathrooms and kitchen facilities? That idea has come up over the years, but shipping people away is often seen as impractical. Homeless people, like housed people, want to be near the things they need and depend on — in their case, soup kitchens, counseling services, friends, family and more. Forcing them elsewhere can be seen as insensitive and counterproductive to getting them to move toward healthy and stable life choices.

62 Has our leadership focused on a housing shortage when the predominant factors require treatment and care? Homeless-aid leaders say they’re equally focused on both, and indeed, about half of San Francisco’s homelessness budget pays for supportive housing, which is housing combined with counseling services. That same ratio is roughly true for the rest of the Bay Area, though it’s difficult to determine exactly because each county uses different accounting methods.

63 Our lawmakers show intense interest in the safe and sanitary conditions of children at the border (and rightly so). However, our local streets at times are neither safe nor sanitary for the homeless or residents. Why haven’t we demonstrated the same level of care or interest in solving that? The city tries to be compassionate rather than punitive about bad behavior, and the people elected to solve such problems appear to anguish over the best approaches. Law enforcement officials say cracking down on drug use is ineffective and makes criminals of people with severe addictions. Most jails or prisons have some treatment behind bars — San Francisco provides mental health and substance abuse care in its jails, paid for the general fund — but they are not as intensive as full rehab programs outside, and prisoners often relapse after they are released. Experience over decades has shown that forcing people to be clean before they are housed is ineffective. The current practice is to house addicted homeless people, then work with them to get clean once they’re inside. (Note: This answer has been updated to clarify the level of treatment offered in San Francisco jails.)

64 How does the federal decrease in low-income housing affect the current crisis in San Francisco? It vastly reduces the number of new housing units the city can offer to poor and homeless people.

65 Why is the city beholden to the Coalition on Homelessness? What is the history of the relationship between the two? Why does the coalition wield so much power? City officials’ relationship with the coalition has varied depending on who has been elected to City Hall and who is in charge of the coalition, and that intersection, with nonprofits added in, can be politically touchy. The coalition’s role is to vigorously advocate, but at times it has been all but ignored. It is considered an important part of the conversation on homelessness, and it does some important research, but it doesn’t seem to have outsize influence compared with other organizations involved in policy discussions.

66 What do homeless people think the problem is, and what are their solutions? They generally think it’s a problem not just for themselves, but for society, and the solutions they propose vary wildly. Some think a better job and housing market would fix things, others want more governmental help for the poor.

67 Why do local leaders refuse to acknowledge that this is a drug crisis first and a homeless issue second? It's incredibly frustrating to see open-air drug use and dealing without consequences. The two issues are related, but have separate elements. As acute and frustrating as the drug abuse is, the overarching bottom line is that addicts can’t get clean while they’re on the streets. And local officials generally do not think that arresting people for drug use is the best use of resources. Additionally, most people in unstable situations have a significantly low rate of rehab success.

68 San Francisco relies on a network of nonprofits to deliver services to the homeless. To what extent have these groups become powerful lobbyists for their own funding, making it impossible to develop streamlined and more effective policies and programs? The services provided by all those nonprofits — numbering more than 60 in San Francisco — are evaluated each year by a range of committees and the Department of Homelessness and Supportive Housing, and if found to be coming up short, their funding is reduced or cut. The leaders of those nonprofits advocate for their programs, but then so do the leaders of all programs that get government money. Nonprofits are often much cheaper administrators of homeless programs than city-staffed programs, but contracting for services can limit the ability for all shelters to operate in the same manner, for example. However, the city’s homeless department is working on one software system to better track the effectiveness of any help being provided. The possibility of nonprofits protesting on the steps of City Hall over government cuts is a powerful image, and one most politicians would like to avoid. Homeless activists, meanwhile, are a much smaller source of campaign contributions than corporations and other political expenditure funds.

69 I have seen estimates of close to 3 million homeless Americans. Can we get support and attention that this is a serious national crisis that demands more funding from the federal government? Isn't this problem too big for local governments to solve individually? Most homelessness and poverty experts say that until the federal government restores the social safety net and housing funding that was decimated beginning in the 1980s, it will be extremely difficult if not impossible to solve homelessness. Nearly one third of Americans live near or below the poverty line, and while the nation has that kind of economic distress with inadequate support from the federal government, there is a constant pool of newly homeless people hitting the streets. The current federal climate favors cutting poverty funding, not restoring it. That 3 million estimate, by the way, is for the national homeless population throughout the year — nightly, the federal government estimates it to be about 600,000.

70 Why aren’t tech companies and the people profiting from the tech boom held accountable for the deteriorating quality of life for people with fewer resources? This has been a roaring debate since the tech boom gentrified San Francisco in this millennium. Ushered in by the “Twitter tax break” for tech companies in 2011 and other enticements, tech companies have made many in the city wealthy, and critics say they aren’t doing their part for the underclass. This debate will not be resolved soon. However, some companies and individuals have stepped up to help the city’s most impoverished people, such as Zendesk with its robust program of encouraging employees to volunteer at homeless programs, and Salesforce co-CEO Marc Benioff, who has donated tens of millions of dollars toward homeless causes.

71 What are the primary causes of homelessness? In San Francisco, the top causes reported by homeless people are: job loss (26%); substance abuse (18%); eviction (13%); being kicked out of a home after an argument with a friend or relative (12%); mental illness (8%); and divorce or breakup (5%).

72 Why don’t homeless people want to work? A lot of them do go back to work, but many others cannot hold stable jobs for a variety of reasons, including physical disabilities, mental illness and substance abuse. The entry-level jobs that they might qualify for are unlikely to pay enough to live in an expensive city like San Francisco, which has a dearth of very low-income housing.

73 San Francisco has had a homeless problem since the days of Mayor Art Agnos. What factors have made it so much more visible? Has the incidence of mental illness and substance abuse increased? The common belief is that the mental illness and substance abuse problems have worsened since the 1980s. Also, thousands of formerly homeless people have been housed since then but continue to panhandle or just hang out during the day, making the homeless population seem bigger than it is. San Francisco also used to have more spaces for homeless people to gather, such as China Basin or Mission Bay — neighborhoods that have been highly developed since then.

74 Didn’t homelessness greatly increase after President Ronald Reagan’s cuts to mental health in the 1980s? It did, but those drastic cuts were not solely responsible for the rise in homelessness. Mentally ill people constitute about one-third of the homeless population nationally, and in San Francisco 39% of homeless people were reported as dealing with “psychiatric or emotional conditions” in the 2019 one-night count.

75 Shouldn’t addiction treatment combined with housing be a key component of the solution? About 40% of the overall homeless population has substance abuse issues, but among the most acutely homeless — the chronically homeless people who have been on the streets for more than a year — the percentage is higher. Permanent supportive housing programs address this by taking in chronically homeless people off the street and then counseling them, and San Francisco has more of such housing per capita than any other city.

76 Do we really understand what’s causing homelessness and the numbers behind who’s on the street and why? Homeless policy leaders and counselors do understand the causes — job loss, housing, addiction, mental illness, rising hardship on the economic underclass and more — but bringing programs and funding to full scale in the face of inadequate federal support over the years has been very hard.

77 Does homelessness provide a sense of freedom? I’ve known guys for whom it gives a sense of freedom from such things as the pressure to make rent/mortgage payments, dealing with unpleasant neighbors, and the seemingly simple task of maintaining a place. Only for a while, if at all. Some people, particularly young wanderers or people in RVs, like the freedom of going wherever and whenever they want, but before too long a life of hunger, instability, frequent danger and continuous instability wears them down. The vast majority of homeless people say they want to be inside — but they have various conditions under which they would agree to do so.

78 What are the reasons homeless people say why they don’t or won’t accept help? Some don’t like the rules imposed in shelters — particularly those where they cannot bring a partner or pet. Others say they are afraid shelter environments are dangerous. Some don’t want to be away from their drug suppliers; some are scared of a change in their survival routines. And others are mentally ill and unable to decide.

79 Have we inadvertently created a drug ecosystem, in which addicted homeless people remain clustered in San Francisco to remain close to dealers and to sources of income such as panhandling of tourists and petty theft? Some would say yes. Homeless addicts do tend to group in areas where addicts to similar substances hang out and sleep — parts of the Mission District for heroin, and parts of the Tenderloin for crack or methamphetamine, for example. For many years, city law enforcement and courts have preferred to steer drug offenders toward rehabilitation rather than prison, with the understanding that hard time behind bars is often ineffective. The fact is, however, that rehabbing from drugs or alcohol usually takes several tries. For a homeless person, each failure puts that person right back on the streets.

80 How do the unsheltered homeless get medical treatment? The city-run health care system and public health facilities take care of that for free for the most impoverished. Chronically homeless people lean heavily on Zuckerberg San Francisco General Hospital and Trauma Center and the Tom Waddell Urban Health Clinic near City Hall, both of which have specialists in homeless care.

81 What has led to a rise in behavior like public defecation? Many businesses don’t let noncustomers use their restrooms, and public toilets often are not easily accessible. Sometimes, more troubled homeless people are simply angry or frustrated with their plight and feel they can’t go through the hassle of finding a restroom at that moment. Mental illness also certainly plays a role; up to 40% or more of the city’s homeless population is considered mentally ill.

82 Are there people who pretend to be homeless while panhandling? Some police and other officials estimate as many as half of the panhandlers in San Francisco live in subsidized housing. Panhandling gives them something to do during the day and also gets them quick cash that can be used on things like food or drugs.

83 Are the stories about panhandlers getting into fancy cars at the end of their workdays true, or are they urban legends? Urban legend only.

84 How much money and other donations do various panhandlers collect on a daily basis? It can be anything from $2 to $100. The higher amounts go to people who are disabled or otherwise unusually sympathetic in a way that touches people’s hearts.

85 Do panhandlers on the street work cooperatively, and do they claim territories? It is loosely territorial. Some have regular spots, but even if they don’t, the general rule is not to panhandle too close to the next person.

86 Does giving money to homeless panhandlers make the homeless problem worse or better or have no effect? On one hand, much of the money given to hard-core panhandlers goes straight into drugs or liquor. On the other hand, giving someone some respite with cash for a cheap meal or something at a store can help enliven their otherwise bleak lives. Some say all you’re doing is feeding addiction by giving money, some say kind acts can’t hurt. In the end, giving a panhandler money doesn’t solve the problem. Aid programs do.

87 What legal and financial liability do cities and counties have to enforce laws that prevent disruptive homeless activities such as peeing/pooping in the street, sleeping in a public place, being drunk in public, using and possessing drugs in the open? Every city and county has different “quality of life” laws on the books, and they enforce them variously. It’s left up to each community. It is illegal to openly defecate in the street and to use illegal drugs, but police in Santa Cruz, for instance, are more stringent about enforcing such laws than in San Francisco, where tolerance is politically balanced with community pressure to clean up the streets. Homeless advocates often push back on quality-of-life enforcement, saying it is simply harassing people who have nowhere to go, while other residents often argue for more enforcement to get disruptive behavior off their blocks. Federal law also protects people’s right to sleep outside if they have no choice.

88 What is being done to support law enforcement to get the homeless and their garbage, body waste and dirty needles off the street? San Francisco has a police unit specially assigned to dealing with homeless people, and its main emphasis is getting them into services rather than citing them. Homeless advocates say police can be too heavy-handed at times, but city leaders say they want officers to balance compassionately helping people into housing and counseling with stopping bad behavior like urinating in public and clogging up sidewalks. The city also has a fairly new unit called the Healthy Streets Operations Center that is a collection of agencies, including Public Works and the Police Department, that dispatches teams to trouble spots such as growing tent camps. Polls reflecting public dismay over homelessness, however, indicate there is much room for improvement.