Beyond the Built Environment: Dr. Alisa Orduña on Homelessness Strategies & the Fight for a Continuum of Care

Alisa, last time you were interviewed by TPR in March of 2020, you were the Senior Advisor on Homelessness for the City of Santa Monica. The pandemic was just beginning, and it ended up changing a lot of service delivery systems, as well as the membership of Santa Monica’s City Council. Bring us up to date on what you’re presently doing through your work with the Florence Aliese Advancement Network (FAAN).

Dr. Alisa Osunfunke Orduna: It's good to be here again, and I hope I can knit the threads together from our last conversation.

FAAN stands for Florence Aliese Advancement Network. It's named after my two grandmothers. It’s a concept I've had for a number of years of wanting to do consulting around project management, community engagement, and community research on the issue of homelessness and in building communities, particularly in low-income communities.

I want to build them up so that we foster cultures of belonging and address the human side of some of the systemic issues. Yes, we need the built environment, but how can conversations and people knowing each other on a more intimate level be able to inform what that design is so we all have a sense of safety or belonging?

Since leaving Santa Monica City government, I finished my PhD. The layoff allowed me time to do that and do some personal reflection, as we all did during the pandemic, around the community engagement piece of homelessness. I reflected not only about how our society has begun to discard people with mental health and substance use and all the other issues, but what do we need to do now? How do we begin to repair human connection? That is a lot of what I bring into my work now.

Elaborate on the impact that homelessness has had on city life. How, from your work and research, do local governments learn to better address the systemic challenges related to homelessness?

We have to stop looking at the encampment outside and begin looking to the upstream systems.

The nation is in the middle of this substance disorder crisis with opioids and fentanyl. When we look at bed capacity, or we look at the system, how do you engage someone dealing with substance use in a harm reduction way and connect them back to housing? We haven't thought of it like that before. We have a long-term response, but we don't necessarily have a crisis response for all of the social conditions that, left by themselves, will lead someone into homelessness.

When we describe the challenge as “systemic”, I'm literally thinking about someone I see outside today. Maybe they've expressed that they want help for their substance use? Who do I call besides 911? There are a few outreach teams, but that could be a day or two later. We do have some models of psych urgent care, but it's not enough compared to what the need is for the community.

Structure is, to me, developing that participant's journey to their state of wellness in a smooth way without worrying about what insurance they have. So many of our programs screen people out versus screening people in. It’s about having low barriers so people can access the wonderful services that we know are taking place.

The issue of homelessness has been defined by policy makers around the world as a “housing and shelter” problem. Is this framework constructive?  Are cities, counties, regions, states and nations addressing the challenge appropriately by relying on the aforementioned framework.

I think there is more understanding by policymakers that housing is the solution to homelessness. That framework has certainly unlocked resources. We've been lucky in LA with Governor Newsom unlocking some one-time funds that have helped spur some development or even brought interest from private developers to do affordable housing. I just don't think there's enough. I still think we have an issue where there's this myth that if you build affordable housing in a neighborhood, the value of homes are going to go down.

The piece that I think we're missing is that there's a continuum. Homelessness is one part of the affordability issue, but we're also talking about teachers and employees on strike and writers in the entertainment industry and bus drivers and housekeepers. When we talk about affordability, there's a range of incomes. That's a piece I think we don't get.

I support having mixed income communities that are affordable to people in those communities. I think we're still siloed where, if there's a homeless issue, then we have to build 100 percent homeless housing. Affordability is something else that we have to do.

Our communities are already  mixed income. We haven't quite figured it out. I don't know if it's the financing structure or political will. I don't know if we’re thinking “who wants to live with people experiencing homelessness?” I don't know what it is, but cities that have done those projects have been successful.

Every major city appears to be struggling with how to provide more shelter. In Santa Monica the motto was/is, “build, build, build,” but  the dearth of affordable shelter hasn’t been alleviated. Help our readers understand what should be done differently today if you were Mayor of LA.

I would not be mayor. It’s the way the City of LA is structured. Santa Monica is different because there was, at least when I was there, more collaboration. The mayor rotated around and there was this collaboration around the City Council. We also had a strong city manager who had a vision.

In LA, you have so many council members who have their own vision for their district. I do think Mayor Bass is doing a great job. If anyone could do it, it would be her. We need a unified vision of how to move this city forward. It is about several initiatives running in parallel. To do it, having a great team would make a difference, but it would be a little overwhelming for me.

What we can do now and what worked in Santa Monica was instead of just focusing on removing people from the street and hiding them in shelter, we were taking all the services that you would have in shelter to the street. We’d say, “Let's get to know you.” If you have a broken ankle, we can fix it. What could we do on the street to build that relationship to get people to come and trust us to come into a clinic?

Some of the street medicine pilots that we're seeing across LA have potential. There are multidisciplinary teams where you have a social worker, a substance use counselor, and others. I think we have to meet people where they are.

What scares me about the strategy around shelter-only is not just diversion of resources from permanent housing. I studied refugee camps in Kenya and other places in East Africa. They're still operating with families that have now been there for 10-plus years. In North America, we're starting to see people stay in shelters, that ideally you want for only 90 days, for a year and a half. That is not a conducive environment to help people thrive.

But, what can we do now, while the focus is “housing”? How do we meet people's other needs? Maybe it's employment, job training, family reunification, or anger management classes. Whatever it is, I feel like we have to take more services to the street.

I've seen a difference in some of the encampment communities. When they're more entrenched, I even wonder if they see themselves as unhoused. Of course, they're unhoused, but do they take on that identity or is this their community? How do we deliver services to that community is the approach we have to take.

How would you deal with encampments on the street?

I think we have to empower some of the neighborhood-based outreach teams. There’s SELAH in the Los Feliz area that started off with concerned neighbors. They've activated themselves by saying, “These are people in our community--we're going to go out and get to know them.” They’ve since built up to do showers and food and connect people to the local Coordinated Entry System, which is the pathway into housing.

I would empower a community-based approach, like a get-to-know-your-neighbor approach. That way, we're having dialogue. We're not isolating people in these encampments. We're beginning to have dialogue because people in encampments have a say; they're part of a community too.

Everyone in a community has a responsibility to safety, to cleanliness, and to protecting our children and our elders. If you don't feel like you're a part of the community or you feel like you're discarded from society, you're not going to care about the children or the elders as much. That's why I believe we have to do this kind of community-driven approach. I've seen it work in certain communities, and I think there's enough people, between our faith-based communities and other people who still have concern, that we can build those bridges to people.

The conundrum seems to be that well-informed people know they ought to be providing a holistic approach for those who find themselves on the street, but they're getting pressure from people in neighborhoods and communities and schools to address the on-street encampments even before you have available housing or the services. How would you address that push and pull?

With services, there is a huge capacity issue. There is a lot of turnover and vacant positions. When Measure H came along, which was such a huge initiative, it created 1,000 job openings. People were being recruited from Canada and all across the country to be social workers and case managers.

I think we have to, one, utilize our local pool of people that have lived expertise. I know Southwest College has a training program now. If we can bring in the community college system and actually train people in case management and trauma-informed and other evidence-based practices, we start to cultivate a workforce.

I also think we have to figure out how systems work together. When I say there's a capacity in the homelessness system, there's not a deficit of services. The services just have a difficult time connecting. There could be one database. Privacy is a big issue, but it's like when I go to the doctor, I hate repeating my medical information. Imagine you're trying to coordinate mental health, physical health, substance use, housing and school districts. Those are four different systems with four different databases with four different program eligibility requirements. We could have one streamlined intake. Someone could ask what a family needs, and on the back end, we'd be coordinating as system leaders, so the burden isn't on the person.

Until we can figure that out, I do think it's this cat and mouse game or who cries the loudest that gets the help. There's an interest in solving this, but we just haven't quite figured out how to do that at scale.

But to refine the policy challenge, let’s assume you’re a city councilor and your office is asked by constituents to move an encampment, but there are no beds or accompanying services availability. What's the best way to address this conundrum?

I would do what we learned in the pandemic. I'm sure a motel is available. You could do everything from modular housing to RVs to putting up a tent with pony walls. There is a way to provide alternatives. As long as we have a relationship with the people and they have some input into that design, they'll move into it.

Safe parking is another. Before the pandemic, a lot of organizations wanted to do it, but trying to get through zoning and all the legislation to allow for safe parking was nearly impossible. During COVID, we broke through so much of the red tape that we are still able to do certain things now.
Also, the City of LA is trying to buy The Mayfair Hotel. I hope we learned from Project Roomkey. There were certain conditions that we put on people, like curfews, that were off-putting to participants. I think some college campuses had more liberal policies than we did with some of these programs.

Some people moving into those shelters and hotels are not accustomed to that environment with the result that there’s been significant physical damage and maintenance challenges.

There are so many models for building a community. I started off in homeless services. I worked in an emergency shelter situation, and we brought in a model of trauma-informed care. We met with residents and we asked what's going on and what they did and didn’t like. There are so many opportunities to engage people.

I get the staffing issue. People are fatigued. Staff are burned out, and we have to reinforce these programs with a level of civic responsibility and building community, and I don't think we always do that.

You also have to make allowances. If I lived on the street for 20 years by myself and you put me into what I'm going to call a box, that's disorienting.

I think of the late Mollie Lowery who said, “Do whatever it takes.” You saw the movie The Soloist, where she dealt with Nathaniel Ayers, who was a musician. Find out what their humanity is. If it’s music, there are programs like Urban Voices Project. There's also the Skid Row Arts Alliance or the 526 studio or Painted Brain. There are so many programs that are on the fringes of homeless services that we haven't quite brought into the mainstream, but we're seeing their outcomes and that these programs work.

If I were mayor and city council, it would be a fully integrated community. We would have regular community meetings, arts programs, and things for people to do. We would have mentors and volunteers teaching people how to do laundry. We would think of mental health not just always as a pharmaceutical response.

Another policy challenge has emerged for big city mayors with the number of Red State governors who are shipping people to places like LA and New York, and consequently causing social service and political havoc. Diagnose for our readers what's going and what the receiving city policy responses should be. Have the aforementioned Governors identified a winning political issue?  

First, I don't think I'm qualified to diagnose the Red State leaders who are doing that. That's far beyond my capacity, but I don't think it is a policy failure. This level of migration is something I remember back in Mayor Garcetti’s time. We attended a conference in New York with world leaders at the time. It was the Brookings Institute that brought together people from nations that were receiving migrants from all parts of North Africa, Asia, etc. There were people who worked in homelessness, too. For people working in homelessness, we know it's almost the same thing. We're not talking about a temporary crisis like an earthquake or even a civil war, though, these are ongoing, permanent migrations.

Being a receiving city, like most urban communities are, we also happen to be blue. How do we build that infrastructure? How do we work with our federal partners to say that we're on the front lines of this international crisis? Whatever the root is, we're on the front lines. It's our responsibility to come together with our federal partners to see if we can help people settle with their family members of choice or connect to their anchor.

With splitting families up at the border, you have parents now worrying about where their children are or where their husband is. We have to stop that. We're in a global migration crisis, and it's not going to go away. I don't care who's president or which governor is running it. We've got to go back to the 1920s or other times where we had these large immigration populations coming into this country.

Clearly, in California local governments have not appeared capable of addressing the challenges of homelessness in a way that satisfies their constituency. As a result,  public attention has moved to drafting state legislation addressing homelessness, housing, and affordability. What advice can you offer legislators who are trying to step in the place of local government to provide state policy solutions for this crisis?

Take a regional approach. I would gather those mayors and county officials from the regions that you're working with, even some of the service providers, so that you're not doing harm thinking that you're doing good. Take time to really understand what the barriers are for people accessing services. Is it zoning issues? Are there issues around certain populations being ineligible for other kinds of public benefits? How do you remove those barriers? That’s what I would do, but I would definitely take a reasonable approach.

It's also not just an assembly person. In this particular region, it could be working’with SCAG, within a Council of Governments, whatever it is, I would take a reasonable approach so that you're getting more of a 360 perspective versus the crisis that's right in front of you.

Stepping back, what did you learn from your PhD research at Pacifica Graduate University or from being on the ground in the City of Santa Monica that now informs your work?

Always on the ground every day is different. You don't know if you're going to get that constituent who is experiencing homelessness and trying to figure out how to navigate the system or if you’re going to try to keep morale up among law enforcement and fire or trying to do what you can to, not appease, but build grace with angry constituents who just bought a million-dollar condo and now they can't walk up to their local coffee shop.

To me, that is the best. That was how I learned and that's why now I work with different projects. I can still have that on the ground experience to stay connected.

Only because of time and space, we must end our interview. Are there other entities outside of government that you work in collaboration with that could inform what policymakers now trying to address the challenges of homelessness?

I would say Akido Labs is one. They work in smaller communities like Santa Monica. I think they tried in LA, but it were just too many competing interests. I do think their ability to capture data and humanize the issue and increase communication among multiple partners is a huge game changer. I’m a full fan of Akido.

The other one I work with is the Homeless Policy Research Institute at USC. They are bringing in scholars, practitioners, and people with lived experience from across the country for what they call rapid response research. Then, when you have this tough problem, you can pull in a team of researchers to address it. To me, those are really important partners.