5 ms·

California to spend $100M of state's Medicaid money per year on housing

25 points by lxm 4y ago

downrightmike 4y ago
A lot of chronic problems from frequent flyers to the ER can be resolved by housing them.
- exabrial 4y ago
  Yes and then sort of no, but YES. The largest expense for running an ER is dealing with people that use it as a homeless shelter. I have first and second hand knowledge of this. Weather gets cold? Visit Er. Due to federal regulation, even if a person visits 13 times a day (facility record btw) they can’t be turned away. Progress needs to be made on both avenues. ERs need the ability to turn expensive frequent fliers away and be absolved of liability, but also shelter programs that are metrics based (job placement, illicit substance abuse, participation in mental health) need private funding. California funds an enormous prison population, a significant portion of them are non violent or victimless crimes. So that being said, the money is already available.
  - ericmcer 4y ago
    My friend did part of her residency at an ER in Los Angeles. She went from being generally upbeat but overworked to being a full on misanthrope in 6 months. I am not sure what the solution is but we should recognize that our healthcare workers are critical members of our society and dealing with this shit burns them out fast.
    - deleted 4y ago
      [deleted]
    - techdragon 4y ago
      The solution is reforming the American healthcare system… because at least from what I can anecdotally tell… usually it takes years of even decades (global average worldwide)to turn a upbeat medical resident into a cynical misanthrope. That’s astonishingly quick to have someone go negative on humanity that fast… and it really reflects on how fucked healthcare is in America… even in a state that’s trying it’s best
  - lxm 4y ago
    Considering how geographically concentrated homelessness tends to be in large cities, wouldn't it be more cost-efficient for the state to run its own clinic or two in each major city?
    - dragonwriter 4y ago
      > Considering how geographically concentrated homelessness tends to be in large cities, wouldn't it be more cost-efficient for the state to run its own clinic or two in each major city? While they are administered at lower levels than the State (though significant funding flows through the state, including Medi-Cal funding, for them), there are more than “one or two” publicly-operated clinics in each of California’s major cities.
- smileysteve 4y ago
  But this isn't directly for currently homeless people, so it will be even more effective. Because it's not targeting the chronic homeless, whom are more likely to have begun a cycle of depression, disassociation, and addiction.
- gamblor956 4y ago
  https://www.latimes.com/california/story/2023-03-26/skid-row-housing-trust-collapse-los-angeles-homeless-housing https://www.latimes.com/california/story/2023-03-26/skid-row... It turns out that housing is not the solution for the frequent flyers. Hospitalization is. (TLDR: drug addicted and mentally ill residents trashed up many of the Skid Row Housing Trust's units and buildings, rendering them uninhabitable, ultimately leading to the organization's demise.)
- jseliger 4y ago
  CA's biggest problem, however, is the limitations on housing construction and bureaucracy designed to prevent housing construction, not money and funding per se: https://seliger.com/2017/08/30/l-digs-hole-slowly-economics-fills-back-proposition-hhh-facilities-program/ https://seliger.com/2017/08/30/l-digs-hole-slowly-economics-.... That is from 2017 and as far as I can tell, little has truly changed since.
  - bacchusracine 4y ago
    >CA's biggest problem, however, is the limitations on housing construction and bureaucracy designed to prevent housing construction Well what would the alternative be? Letting the poors live right next to the people who matter? They should only be seen when I want my expensive coffee milkshakes, right? </sarcasm> That sounds like a self-inflicted problem. What I don't understand is why so many stick around rather than finding some place that wants good hard working people and is willing to allow them to actually have a place to live. I know it's not easy to relocate but it can be done and is usually worthwhile in the long run.
smileysteve 4y ago
> up to six months of housing for people who are or risk becoming homeless; are coming out of prison or foster care; or are at risk for hospitalization or emergency room visits. So this helps prevent people from becoming homeless in the first place -- some because of issues the state/country create. Which is the best way to prevent the cycle of homelessness from starting.
- ericmcer 4y ago
  Yeah totally agree with this, right now in CA we say "the homeless" as one homogenous group. The reality is there are a bunch who could probably get back on their feet for just a few a thousand dollars. There are others who will never find stability no matter how much help they get. Helping those two groups requires totally different solutions.
say_it_as_it_is 4y ago
Such an extreme measure without strict requirements on developer profit margins turns this kind of act into flowing more cash into the pockets of for-profit development corporations. Zero-profit development should be mandatory. Match people looking to work with funding to do so, without the profit margins and investors seeking gains.
- mistrial9 4y ago
  except, in California and elsewhere, there is a new, large population of hardened homeless, complete with a menu of mental illness, emotional damage including prison and police interactions, and super, ultra-strong drugs on a daily basis. What ordinary apartment could house populations like this? Since California desires no undocumented slums, as found commonly on a large scale in the South Americas, someone has to build something. The real danger is similar to totally crooked locals like Phil Tagami in Oakland, who has a "housing project" that has been going for TWELVE YEARS without building anything, nothing. Other crooked people involved, depending on how you define it. If this money results in actual buildings that can handle the intended crowds, that are not prisons, that is progress here.
  - notch898a 4y ago
    Maybe we should just offer a one way ticket to anyone who desires to go to Swain's Island, where all the fentanyl and other hard drugs they like will be provided with pharmaceutical grade purity. Anyone caught performing property or other crime with an identifiable 3rd party victim will be offered the choice to serve their term in California or a one way ticket to Fentanyl town on Swain's Island where they can get high to their heart's content.
    - reducesuffering 4y ago
      And if your child or sibling hits a rough patch, becomes a drug user, and chooses their inevitable death on Swains Island before you can do anything about it, you will still think it’s a good idea?
dragonwriter 4y ago
Just for scale, California's annual Medi-Cal (the state’s implementation of Medicaid) spending is over $100 billion, so this represents less than 0.1% of Medi-Cal spending. The article throws a lot of numbers around that are tangentially related, but, oddly, not that one.
newmanah223 4y ago
I support helping people with housing for a year or so to get back on their feet but let's address the elephant in the room. The government of California is the reason housing is so expensive in the first place. Now they toss a token amount of money at a problem they created. It's similar to how the US government pays billions to corn farmers to produce corn syrup, which then causes obesity, which the government spends millions to address.

25 points by lxm 4y ago

downrightmike 4y ago

A lot of chronic problems from frequent flyers to the ER can be resolved by housing them.

exabrial 4y ago
Yes and then sort of no, but YES. The largest expense for running an ER is dealing with people that use it as a homeless shelter. I have first and second hand knowledge of this. Weather gets cold? Visit Er. Due to federal regulation, even if a person visits 13 times a day (facility record btw) they can’t be turned away. Progress needs to be made on both avenues. ERs need the ability to turn expensive frequent fliers away and be absolved of liability, but also shelter programs that are metrics based (job placement, illicit substance abuse, participation in mental health) need private funding. California funds an enormous prison population, a significant portion of them are non violent or victimless crimes. So that being said, the money is already available.
- ericmcer 4y ago
  My friend did part of her residency at an ER in Los Angeles. She went from being generally upbeat but overworked to being a full on misanthrope in 6 months. I am not sure what the solution is but we should recognize that our healthcare workers are critical members of our society and dealing with this shit burns them out fast.
  - deleted 4y ago
    [deleted]
  - techdragon 4y ago
    The solution is reforming the American healthcare system… because at least from what I can anecdotally tell… usually it takes years of even decades (global average worldwide)to turn a upbeat medical resident into a cynical misanthrope. That’s astonishingly quick to have someone go negative on humanity that fast… and it really reflects on how fucked healthcare is in America… even in a state that’s trying it’s best
- lxm 4y ago
  Considering how geographically concentrated homelessness tends to be in large cities, wouldn't it be more cost-efficient for the state to run its own clinic or two in each major city?
  - dragonwriter 4y ago
    > Considering how geographically concentrated homelessness tends to be in large cities, wouldn't it be more cost-efficient for the state to run its own clinic or two in each major city? While they are administered at lower levels than the State (though significant funding flows through the state, including Medi-Cal funding, for them), there are more than “one or two” publicly-operated clinics in each of California’s major cities.
smileysteve 4y ago
But this isn't directly for currently homeless people, so it will be even more effective. Because it's not targeting the chronic homeless, whom are more likely to have begun a cycle of depression, disassociation, and addiction.
gamblor956 4y ago
https://www.latimes.com/california/story/2023-03-26/skid-row-housing-trust-collapse-los-angeles-homeless-housing https://www.latimes.com/california/story/2023-03-26/skid-row... It turns out that housing is not the solution for the frequent flyers. Hospitalization is. (TLDR: drug addicted and mentally ill residents trashed up many of the Skid Row Housing Trust's units and buildings, rendering them uninhabitable, ultimately leading to the organization's demise.)
jseliger 4y ago
CA's biggest problem, however, is the limitations on housing construction and bureaucracy designed to prevent housing construction, not money and funding per se: https://seliger.com/2017/08/30/l-digs-hole-slowly-economics-fills-back-proposition-hhh-facilities-program/ https://seliger.com/2017/08/30/l-digs-hole-slowly-economics-.... That is from 2017 and as far as I can tell, little has truly changed since.
- bacchusracine 4y ago
  >CA's biggest problem, however, is the limitations on housing construction and bureaucracy designed to prevent housing construction Well what would the alternative be? Letting the poors live right next to the people who matter? They should only be seen when I want my expensive coffee milkshakes, right? </sarcasm> That sounds like a self-inflicted problem. What I don't understand is why so many stick around rather than finding some place that wants good hard working people and is willing to allow them to actually have a place to live. I know it's not easy to relocate but it can be done and is usually worthwhile in the long run.

smileysteve 4y ago

> up to six months of housing for people who are or risk becoming homeless; are coming out of prison or foster care; or are at risk for hospitalization or emergency room visits. So this helps prevent people from becoming homeless in the first place -- some because of issues the state/country create. Which is the best way to prevent the cycle of homelessness from starting.

ericmcer 4y ago
Yeah totally agree with this, right now in CA we say "the homeless" as one homogenous group. The reality is there are a bunch who could probably get back on their feet for just a few a thousand dollars. There are others who will never find stability no matter how much help they get. Helping those two groups requires totally different solutions.

say_it_as_it_is 4y ago

Such an extreme measure without strict requirements on developer profit margins turns this kind of act into flowing more cash into the pockets of for-profit development corporations. Zero-profit development should be mandatory. Match people looking to work with funding to do so, without the profit margins and investors seeking gains.

mistrial9 4y ago
except, in California and elsewhere, there is a new, large population of hardened homeless, complete with a menu of mental illness, emotional damage including prison and police interactions, and super, ultra-strong drugs on a daily basis. What ordinary apartment could house populations like this? Since California desires no undocumented slums, as found commonly on a large scale in the South Americas, someone has to build something. The real danger is similar to totally crooked locals like Phil Tagami in Oakland, who has a "housing project" that has been going for TWELVE YEARS without building anything, nothing. Other crooked people involved, depending on how you define it. If this money results in actual buildings that can handle the intended crowds, that are not prisons, that is progress here.
- notch898a 4y ago
  Maybe we should just offer a one way ticket to anyone who desires to go to Swain's Island, where all the fentanyl and other hard drugs they like will be provided with pharmaceutical grade purity. Anyone caught performing property or other crime with an identifiable 3rd party victim will be offered the choice to serve their term in California or a one way ticket to Fentanyl town on Swain's Island where they can get high to their heart's content.
  - reducesuffering 4y ago
    And if your child or sibling hits a rough patch, becomes a drug user, and chooses their inevitable death on Swains Island before you can do anything about it, you will still think it’s a good idea?

dragonwriter 4y ago

Just for scale, California's annual Medi-Cal (the state’s implementation of Medicaid) spending is over $100 billion, so this represents less than 0.1% of Medi-Cal spending. The article throws a lot of numbers around that are tangentially related, but, oddly, not that one.

newmanah223 4y ago

I support helping people with housing for a year or so to get back on their feet but let's address the elephant in the room. The government of California is the reason housing is so expensive in the first place. Now they toss a token amount of money at a problem they created. It's similar to how the US government pays billions to corn farmers to produce corn syrup, which then causes obesity, which the government spends millions to address.