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Oct. 26, 2023 - Epoch Times
42:46
Doctor Explains Why Los Angeles' Homeless Deaths Are on the Rise | Brett Feldman #californiainsider
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Time Text
I've been doing this for 15 years.
We dispense medications, draw labs, we do ultrasound on the street.
We're trying to prevent them from dying.
You know, 2,000 people died on the streets last year in LA. Some people are losing sympathy for the homeless people, unfortunately, at this stage, because we've heard about the drug addiction side of it.
A lot of the women that we treat, in fact, it's like over 90% in the past month are sexually assaulted.
It's dangerous for them to sleep.
And so they might start using methamphetamine in order to stay awake at night so they can just walk all night long so that they don't get raped.
So if you see somebody sleeping during the day, it might not be because they're lazy.
It might be because they felt like they had to be up all night for their own safety.
My guest today is Brett Feldman, Director of Street Medicine with USC. He and his team go out to the street every week and provide treatment to over 300 homeless people a year.
Despite California offering health insurance to the homeless, most are not able to use it and visit emergency rooms.
In order to get health insurance, you need an ID. And IDs are hot commodities on the street.
If I steal your ID, I can sell for $250.
So the very thing that you need to get into the system is a constant target for theft.
The health insurance is available, right?
How does it work for the homeless people?
There are people suffering on the streets with these illnesses and they don't see a way out and the system doesn't understand because they're not out there.
So a lot of folks actually just don't get care, which is why we see so many dying on the street.
I'm Siamak Karami.
Welcome to California Insider.
Brett, it's great to have you on Welcome.
Thank you very much.
We want to talk to you about a phenomenon that's happening with homelessness.
There's five in LA. Five people are dying in the streets of LA every day.
And also there's emergency rooms that homeless are going to.
You are on the ground.
You're dealing with healthcare for homeless.
Can you tell us what you see on the streets of LA? What we're seeing is that folks that are staying on the street just can't access healthcare the way the rest of us do.
And there's things that are personal to them and things that are just inherent in the environment of being unsheltered.
So, for example, we know that there's higher rates of physical illness.
People are dying on average 20 years earlier.
Before the past few years, the most common reasons of death were heart disease and cancer.
So they're the same reasons why a lot of other folks are dying.
In the past few years now, drug-related things have taken over that.
And of course, higher levels of mental illness, which they're not dying from necessarily, and substance use disorders.
But then there's environmental problems that make it that they literally can't make it to the brick-and-mortar clinic.
So for example, preoccupation, understandably, with basic survival needs.
So if you don't know where your next meal is coming from, where you're going to sleep tonight, if you're going to be safe doing those things, you can't possibly begin to think about things like your health care.
Or the idea that if you leave your tent to go to a doctor's office, then everything you own will be stolen because it's happened so many times before.
And then also, something that we don't think about in healthcare is wait times exceeding their planning horizon, which is how we say it.
So, for example, even if we reach our goal of giving them an office visit within a week, if because of the chaos of the street they can't plan for more than two days, they're never going to remember that it's time to go.
And then one that we don't like to think about is there's been a lot of trauma related to healthcare.
So studies have shown that the reason why people experiencing homelessness don't access brick-and-mortar care is because of previous negative experiences.
So part of the act of street medicine is an act of reconciliation and healing because of things they might have experienced with either ourselves or our colleagues in other settings.
Right now, how does it work for the homeless people?
We're hearing about overdoses, people, and there's videos of people on the street that are dying, or like we're hearing situations on the ground, but what happens now?
Yeah, so right now if you're experiencing homelessness and want medical care, either you have to go to the ER or you don't get care.
And so a lot of folks actually just don't get care, which is why we see so many dying on the street.
And it's really hard to get care even if you want it.
So for example, one of the very first patients I'll never forget that I met in LA, he was actually sleeping at the bus stop right outside of one of the big community hospitals.
And he had an irregular heartbeat that was giving him strokes.
And he had at least seven strokes that he knew about and had a paralyzed left, both lower extremities and left upper extremities.
We had one working right upper extremity.
And so the outreach workers were trying to get him to see his assigned doctor so that he could get into a nursing home because he couldn't care for himself on the street.
After a few months, they finally got him in to see the doctor, and the doctor said, I don't know this person.
I need to request their medical records.
The person got very upset because he's been living on the street this whole time.
It took all these months.
Now he has to wait even longer to certify that he has a disability and needs a nursing home.
So he never went back.
And so there are people suffering on the streets with these This episode is sponsored by Birch Gold.
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Now let's go back to the interview.
Why did it take so long for him to want to get the care?
What's the process in that?
Because some people are losing sympathy for the homeless people, unfortunately, at this stage, because we've heard about the drug addiction side of it.
And was there a reason that he didn't want to take the care?
So he wanted the care.
It was working through the system that took so long.
And so, for example, if you want to go see a doctor, you have to have health insurance, or they just won't accept you.
In order to get health insurance, you need an ID. And IDs are hot commodities on the street.
If I steal your ID, I can sell for $250.
So the very thing that you need to get into the system is a constant target for theft.
So first you need the ID. Depending on your situation, it could take us months to get you an ID. If you have no birth certificate, we have to get the birth certificate from the hospital.
And so after the birth certificate, then we get the ID. Then we register for you for health insurance.
This is months of time.
And we know that the average person in LA either moves or is moved over four times a month.
Which means if it's going to take months to get something done, we have to keep track of them for so long.
And a lot of, you know, it's hard to follow them that way.
Because the health insurance is available, right?
This is something the state has made available.
Yes, they qualify for health insurance.
And even if they have health insurance, there are still gaps that we've been working to close between benefit eligibility, so things that they're eligible for based on having health insurance, and benefit access, actually being able to access those things.
So one of the problems that we see is transportation.
So as a Medi-Cal member, you're eligible to get a ride to your doctor's appointment, but not the people we serve because you need an address to get a ride.
And so we pay for it, Street Medicine pays for it, but even then it's hard because, so we'll call a ride share, and when the ride share comes up and they see the person they have to pick up, they drive right by.
And so we developed a technique which I'm ashamed we have to develop it, but we don't see any other choice.
It's like a bait-and-switch type of thing, where the rideshare will pull up, and I'll flag it down, they stop, and I say, wait, let me get my friend, and then go bring the patient that we're really trying to help, because they'll drive right past if it's not one of us.
So you can imagine how hard it would be for them if they tried to do this on their own.
And if they go to the emergency room, how does that work?
They're accepted, right?
Yes.
If they go to the emergency room, they're eligible to get emergency care.
So that will only take care of that visit.
There's no follow-up that happens after that care.
And so if you imagine, like I said, besides substance use disorder, the number one cause of death is heart disease.
It would be like expecting you or I, if we have a heart attack, to only go to the ER. No blood pressure medications, no medications for hypercholesterol, no cardiologist.
Just the ER when you're having a heart attack.
And that's how we're asking them to use care.
Now, how much of this is the substance abuse?
How much of the problem, and how much of it is other health-related issues?
So I think the perception is that people on the street, there's a few stereotypes that are just not right.
They're wrong.
One is they're all on drugs.
Statistics show it's between a third and a quarter on drugs.
And even the ones that are, a lot of them that we talked to didn't start until they became homeless.
It did not lead to their homelessness.
So, for example, a lot of the women that we treat, they get sexually assaulted regularly.
And, in fact, it's like over 90% in the past month are sexually assaulted, but in the ones we talk to, it's at least that, to be honest.
And so it's dangerous for them to sleep.
And so they might start using methamphetamine in order to stay awake at night so they can just walk all night long so that they don't get raped.
And then sleep during the day when there's more eyes on them.
So if you see somebody sleeping during the day, it might not be because they're lazy.
It might be because they felt like they had to be up all night for their own safety.
The other perception is that everybody on the street is mentally ill.
It's about the same percentage, it's about a quarter that have a severe mental illness.
So it's not, but I think those are the ones that we see.
You know, we remember the one that was in traffic yelling and screaming at cars a lot more than we do the others that are just sitting, minding their own business at the coffee shop or on a park bench.
Those don't stick in our mind as much.
You go in the streets and you help people like you.
How do you do your work?
Yeah, so what we do is called Street Medicine, and it recognizes all the different types of poverty that people experience on the street.
Of course, there's the material poverty, which is how we usually try and solve homelessness.
We want to build houses, we want to give them food, and of course, you know, it's great that people are doing that, but it's more than that.
There's also the poverty of health, the Physical illness or psychiatric illness or substance use disorders that we've talked about, that if not treated now on the street, it can't wait six months for housing, will prevent them from ever walking over that threshold into housing, or if not treated properly, will prevent them from keeping that housing.
But there's also this spiritual poverty that we like to ignore.
It's the poverty of feeling unwanted or unloved by anybody.
A poverty that is deepened every time a neighbor or a policy is made that pushes them around the city that they call home with no place to actually put their physical body.
Or a poverty that's deepened every time we lock the restrooms of our businesses or the parks at night, forcing them into a dehumanizing act of open defecation.
In fact, in LA, 85% are forced into open defecation.
And so we go to them on the streets with the goal of first providing a love, a tender love, and then the same quality of care on the street that you would expect in a clinic.
And health care is more than the office visit, even if that office is under the bridge.
One of our patients who will go by the name Bullet.
And when we first met him, he was complaining of shortness of breath.
He could barely ride his bike a few blocks because he had severe congestive heart failure.
And so this is very challenging to treat on the street because we treat it with Lasix, which is a water pill, a diuretic.
If you give too much, you cause kidney failure.
If you give too little, you cause heart failure.
And the dose that you would give somebody in a clinic or in a hospital is not in the setting of walking around all day, wearing multiple layers of clothes, which somebody might also construe as mental illness, but in fact there's no dresser to keep the clothes.
In the heat and you're sweating.
And so being in the patient's reality, suspending ours and meeting them in their reality, is one of the most important parts of street medicine.
And you don't know that reality unless you're there with them and you see it.
And so that's why we go to the people.
It looks like you're building really deep relationship with these people, right?
That you're treating.
It takes a while, right?
It takes some serious effort, right?
To get to know them.
Yeah.
And to develop this trust, right?
Yeah.
I mean, that's what we hope to do.
You know, as we were saying before, folks come with a long history of trauma.
And so I'll give you kind of like a story to illustrate it.
Picture that you're in this big shipwreck and everybody died around you, but you're holding on to this lumber.
And it's not a good piece of lumber, but it's the only thing keeping you afloat.
When everybody else has died.
And then somebody comes along to you in a boat and says, swim to me, I'll save you.
And you have to decide, am I going to let go of this lumber and swim to them, knowing that if my trust is misplaced, I'll drown just like everybody else?
Or do I stay with what I know at least I'm surviving?
And one of the problems that we've seen in LA more than any other place is that there's a whole lot of outreach.
And people have not always followed through on their outreach.
So a lot of them have stories of that boat coming up to them and them letting go and drowning.
And so not only are we fighting trauma related to the healthcare system, but trauma related to outreach as well.
Because we do both.
Outreach with healthcare.
Can you explain that, this outreach?
Because for average residents in LA, people have done whatever the government asked them.
The taxes, whatever is necessary, people wanted to deal with this homelessness issue.
What do you mean the outreach was...
was not delivered on.
How did that work?
In LA there's lots of different outreach teams and their job is to go out onto the street get to know folks and then walk through with them through all the steps to get them into housing and for various reasons it doesn't always work out and so some of those reasons are just like just like any profession there's some that are better than others There's high turnover in the outreach
positions, partially because Frankly, they don't pay all that well, and there's been a lot of media about what they're paying.
But also, of no fault of their own, even with perfect outreach, it's a really hard job.
People in LA either move or are moved over four times a month, so if you're a judge based on the volume of people that you're putting in, it's hard to follow the same people every week and know where they are.
You'll lose them.
So putting pressure on the outreach workers to house hundreds of people a year when each individual person is getting moved so often is an unrealistic expectation.
Also, the housing is like months away.
It takes months to house somebody.
For some of the reasons that we talked about would be getting all their documents ready, getting their ID, birth certificate, all those things ready, and then waiting for housing takes months.
So there's bureaucracy in the process of finding somebody's ID and this kind of thing.
And what about shelter space?
Is there enough No, there really is not a whole lot of shelter space in LA. The last numbers there was, what was there, like 60,000 people experiencing homelessness and about 15,000 shelter beds.
But this is something that I think everybody understands, which is why With Mayor Bass coming, they're working really hard to streamline the process to get people into housing and working to build more housing quicker.
So that's part of the work of Street Medicine, is that if it takes six months to house somebody, What do we do in those six months?
And so what's happening now is if it takes six months to house somebody, the outreach worker comes up to the person, they form a relationship, they fill out their paperwork, and then after a few weeks it's like, where's my housing?
You said I was going to get housing, and the outreach worker has no We have control over the availability of a housing unit.
So they're saying, you know, we just have to wait, we just have to wait, and then both parties start to get frustrated, they start coming back a little bit less, the person's still moving four times a month, and they eventually lose them.
And so in street medicine, we give them reason to stay engaged.
We can keep moving forward on their mental health, physical health, substance use disorders, so that when that housing does come through, that they're much more housing ready.
And so we work with our housing partners in order to keep track of folks, because there's a reason to keep seeing them.
So it's why that partnership works so well.
So you find a way to build a relationship with them that's outside of giving them physical things.
It's more like a deeper relationship.
Yeah, it has to be deeper because of all those different types of poverty, you know, the physical poverty, health and spiritual poverty, we can't just address the material poverty.
That's not the only thing.
They've had a whole life full of a lot of trauma before they got onto the street.
And so when we talk about if you want to solve homelessness, the first thing to do is that you have to learn how to separate the person from their housing status.
And to hate homelessness with everything that you have, but to love the person even more.
And so if you're only giving them housing, you're only solving that material poverty, the homelessness part, but you haven't loved the person.
And so that's where we try and focus.
Now, you go on the street, right?
Has it been dangerous for you?
Have you had situations where things got out of control?
Because there is the substance side of it.
And in your data, you're saying 25% people.
And we've heard from other outreach organizations that a lot of people are high.
Have you faced any incidents where you were...
Kind of out of control.
So we have to be aware of our surroundings.
But I've been doing this for 15 years.
I've never felt threatened.
So I think the idea that they're all dangerous and scary and ready to jump out the bushes and get us is a fear-based mentality.
Even if 25% have mental illness, doesn't mean 25% are dangerous.
Mental illness does not equal danger.
And so that's part of the reason why I say to get to know the people is that you'll find that they're actually beautiful people that aren't scary.
So that's why it's the best way to do it.
Now was there a situation where you were kind of feeling you're in a bad situation and you were able to manage to turn it around?
Yeah.
So, for example, there are areas that we go, and this is different from the single person you see getting off of the freeway.
So we actively look for people.
And so there was one patient who had left the hospital with a severe burn, third-degree burn.
And how she got this burn, and this is why I say you have to understand the people, is she was a paraplegic, so her lower extremities Didn't work.
And in order to survive, she lived in this area that they call the Devil's Playground.
There were a few of these type of areas, and she would melt copper wire because she could get really close to the fire without feeling it because of her legs.
And that's how she survived.
And so we went to go find her, and the area was controlled by gangs.
And so we have our community health worker.
who has lived experience in homelessness and understands the street and was able to talk to the gang and so we would go and he would go and bring her out and we could so we could do her dressing changes and after a few weeks they actually invited us in and when they invited us in it was shocking at the level of pathology that we found down there there was one guy who was hit by a car which is the one of the top five causes of death And he had what's called an X-Fix
on it.
So it's actually like hardware.
He had a broken pelvis.
Hardware that's sticking out of his pelvis.
You only have that on until the bones are healed and then you take them off.
So it's, you know, six to eight weeks usually, sometimes three months.
He had it on for nine months.
But never went back because he couldn't get back.
And another guy with a congenital heart defect whose life expectancy would have been in his 40s and he was 50 and had signs of heart failure just sitting back there.
And so they took us down there and showed us around all the different people that they felt needed help.
Out of the people that you see on the streets, is there a percentage of them that, you mentioned 25% are using substances and 25% are mentally ill.
Is there, the other half, is there a percentage of them that can be working on their own?
Because some people look at this issue and say, okay, you know what, some of these people can be working, they don't want to do it.
Yeah, absolutely there is a percentage that can be working.
The challenge is, And this is something that maybe out there, some listener can help with, is that if you're Two things.
If you're understandably preoccupied with where you're going to sleep tonight, where your next meal's coming from, and your own safety.
Because remember, outside of Skid Row, where over 90% of the people are in LA, we do a ton of surveying.
A lot of people are only getting two to three meals a week.
So their day is taking up looking for food, looking for ways to get that next meal.
They can't even begin to think about Where are they going to work?
Or there's really nowhere to get showers.
So if you are crawling out from under a bridge or out from a riverbed, who's going to hire you?
You need a shower, you need clean clothes, you need to be presentable for a job interview.
So you have to get them to that certain point.
You know, people say, oh, you could give somebody a fish they eat for a day, teach them how to fish and they eat forever.
These folks can't even hold the pole.
So we have to at least get them to that point.
And then, yes, there is a percentage that will be able to fish on their own.
But they're not there yet, sleeping on the street.
Do you face opposition with your work?
People saying, okay, you guys, we're kind of normalizing this living in the street.
What are your thoughts on that?
Because before, it wasn't like this, like 10, 20 years ago.
And then now, there's a group of people that want to be on the street.
They say they want to be on the street.
I'm not sure if it's true, but...
I've actually never...
There was one person in 15 years I met that said that they wanted to be on the street, and they lived in the woods in Pennsylvania.
So they really saw themselves as being like living off the grid versus like on the street.
You know what I mean, the difference with that?
The rest of the folks, they don't want to be on the street, but maybe they don't like what's being offered to them.
And I know some people that are housed and say, well, they shouldn't be so picky.
The truth is that some of these places that are being offered are more dangerous than the street.
They're inside.
They're infested with all kinds of bugs.
There's violence happening all around them.
In some ways, they're actually safer on the street than some of these places.
So you're going and dealing with the people, so you have built relationships with different categories, and you know, we're thinking percentages, but how about the people that are using substances?
Have you been able to build a relationship with them?
Because some might be younger, right?
The people that are using substances are the same as you and I. A lot of times we call it self-medicating, but they're hurting inside.
And it's really hard to live on the street.
And so, for that moment, they are not living out there, at least in their mind, that they can escape reality.
In some ways, When you get home from work and you're like, man, that was a really hard day.
I just want a nice dinner.
I want, I don't know, a glass of wine, something to relax a minute.
And we allowed ourselves those things, those small consolations.
And for them whose day was 10 times as worse, sometimes they want to escape 10 times as bad.
And this is the way that they know how to.
But what's the way out of that?
So are you able to build a relationship with someone like that on the street?
Yes.
And that's exactly the way out of it.
Is to show them that they don't have to do this.
That, you know, like I said, honoring their sacred humanity.
That you don't have to do these things in order to escape.
That we love you now.
You don't have to earn that.
And that will be there to help you.
So even though you might be doing these things, that's okay.
We'll still come out.
We'll try and make it as safe for you until you're ready to stop.
And then when you're ready, we have other medicine that we can help you stop.
But as long as they're on the street, it's really hard because there's going to be that pull to escape the reality.
I've seen more people stop once they get inside.
And so it's why when we build housing where the prerequisite is to not use substances, it creates this horrible cycle where they're on the street.
It's, you know, hard to stop using substances while you're still on the street, but you can't get into housing until you stop using substances.
It's really, really hard.
But then others, we've had some other guests on the show that actually complain about when people can't do substances in the housing because they've had family members that go into the housing and do the drugs and then they overdose and then they pass away and they kind of blame the housing for the death.
So it's like this complicated, what are your thoughts on that?
It's so complicated.
It's exactly right.
It's so complicated.
And that's why it comes down to the individual.
You know, and once they're in housing, it doesn't mean it's over.
You know, successful housing placement.
We did a great job.
Congratulations, everybody.
It's over now.
It's why we need to keep showing them that we love them, that we care for them in housing.
And you, through your process, you have been able to get a number of people off the street.
How were you able to do that?
Yeah, so last year, 38% of everybody we saw wound up in housing.
And the reason why we're able to do that is because we are very focused.
On when we pick up a patient that we feel responsible for how things are going with them.
And so we do have an advantage over some of the other outreach groups in that they're really pushed to do big, big volumes.
And in doing so, they lose people because you just can't keep track of 500 people.
And so we keep a smaller volume and we follow through and complete tasks on the folks and can take care of these other things like we talked about.
If we can treat mental health on the street and treat substance use on the street, maybe housing will be more successful at that time.
Doesn't mean we always can, but sometimes we can.
Especially mental health, we start that treatment on the street.
So do you offer them some sort of medicine for mental health, or how do you do that?
Yeah, so...
We would love for them to have a psychiatrist, but I look to my left, I look to my right, there's no psychiatrist.
And so we've had to train ourselves up to do a higher level of behavioral health care, the highest that primary care, family medicine can do.
And what about the people that are doing substances?
Have you been able to get those, help them?
Is it very hard to do that?
With all the stuff that's on the street, with fentanyl and Yes, it's hard.
We offer MAT, medication-assisted therapy, which is Suboxone, where we give them the treatment and it replaces heroin or fentanyl.
It's hard to do that while they're still on the street.
We found it more successful in housing, but it's still possible there are patients that definitely do that.
There are a number that have been successful with that.
But it's not 100%.
The best treatment is housing, but we don't build houses, we do medicine.
So that's what we use.
And does it take a long time?
Is it easy to build, is it possible to build a relationship with them because you approach them on the health issues?
Yes.
Or is it harder to deal with them than other patients?
Oh, if they're using substances?
So I don't think it's harder to build trust if they're using substances.
Or I should say to earn trust if they're using substances.
It's hard to get them to stop using because there's a mental addiction to it, you know, like that escape that we were talking about.
And then there's also a very real physical addiction.
Addiction to it, which is what the Suboxone helps with.
But it's not 100%.
So their body is telling them that they need it, and if they don't get it, they get sick.
And nobody wants to feel sick.
Vomiting, chills, all kinds of horrible things, especially when you're on the street.
That's a very scary position to be in.
So, this funding that comes into it, and you can have your, if you can tell us your opinion about, we're building houses, literally.
Yeah.
Does it make sense to you?
It's kind of like, it feels like if we were to invest in programs like yours, where we were going out, meeting the people, figuring out what they really need, we're physically building housing.
Yeah.
What are your thoughts on that?
I think we have to build the housing because it's not enough what we're doing.
You know, we're trying to prevent them from dying.
You know, 2,000 people died on the streets last year in LA. We can do our best on the street, but if there's no outlet, if there's nowhere for them to go after that, we can't do it forever for them.
We can try, but there's only so many patients we could take on.
So there has to be housing available.
Maybe what we're building is not efficient.
Well, that's a different question if what we're building is efficient.
I'm not a builder, so I don't know how to build it more efficiently.
What I can say is that the shelters are always full.
And I've seen really amazing things that have happened to folks when they stay in a good shelter.
There are good shelters and there are bad shelters, just like there's good and bad of everything.
And I think we're missing the boat if we think that it should all be housing.
There's enough people on the streets that we need all of it.
We need housing and shelters and transitional housing and tiny homes and whatever you can think of, the shipping containers.
We need all of those things to give them a chance.
Because it seems like we're building housing, but those units cost a lot of money, and they take forever to get built, and they'll house a very small fraction of the people in those communities.
Yes, that's true.
And we saw during COVID when they were putting up some of the bridge home shelters, for example, and people would go.
They would be full.
And yes, the shelters have to be safe.
And people do get assaulted at shelters.
Things get stolen from them at shelters.
But that's not inherent in shelters.
You just have to make the shelters good shelters.
And so I don't think that sometimes some of the advocates just say, shelters are not appropriate, we need housing.
But when you talk to the people on the street, there's room for both.
And if we want to house or get, you know, 60,000 people off the street, I know a lot of folks that would take shelters.
Do you have any recommendations for the policymakers and leaders of the state?
I would say that I've learned so much from the people and what policies might be effective for them because I've spent time with them.
And so I would want the policymakers to come spend time with them too.
And they could, you know, they do listen to advocates.
They do spend time with people and listen to people.
It's hard for advocates sometimes because we have our own agendas.
You know, you talk to the housing people, they want more housing built.
You talk to, you know, whatever it is that they're, you know, the people that provide food, they want resources for more food.
And that's all good.
It doesn't mean that we don't.
But I think for policymakers, to spend time to see the people, all the smells, the whole experience will help inform what needs to happen next.
Yes, listen to the advocates.
We have valuable things.
Listen to the people first before us, though.
Now what about average Californians that are watching this show that might be frustrated with what's going on?
They feel bad, at the same time they're frustrated, at the same time they don't know what to do when they see a homeless person and they're with their kids and they don't know.
Yeah.
Again, I'll go back to the idea that they should find one person, just one, that they see every day.
Pay attention to the person that you're passing by, that you're getting out on the freeway.
Is it the same person that was there yesterday?
Or the same person that was there the day before?
And do your best to get to know them, even if you're going to bring them coffee every day.
Find out what their name is, where they're from, what they do every day, what they're interested in.
I have one friend who doesn't do anything to do with homelessness and they met Ernie coming off of their freeway with coffee.
Ernie likes crossword puzzles.
They brought him some crossword puzzles.
Learned that he doesn't really get to eat except from the taco truck that gives him food three times a week for lunch when the truck is in town.
And they know all these things about Ernie.
Connected him to one of the outreach workers and he's in housing now.
So essentially building a meaningful relationship than handing a dollar or two to the person.
As I was saying, if you want to solve homelessness, first you separate the person from their housing status.
And if all we're doing is addressing the housing status by building homes, which we need to do, but not paying attention to the person that we're supposed to be loving, we've missed the biggest part of the solution.
Now, Brett, with all that you see, all that you've seen, how do you feel about this situation we're in?
It seems like you're going out there, there's some groups that are going out there, but you're reaching a very small percentage of it.
Yeah.
So it depends on how you look at it.
So we don't treat, you know, there's 50,000 or so people experiencing unsheltered homelessness at any given night in LA. We don't treat 50,000.
We treat one.
And then we treat one more, and one more after that.
And if we can do our best with each one, then I think we're doing a good job.
The 50,000, that's for the policymakers to look at.
But when we're on the street with the person in front of us, that's the most important thing to us.
And what keeps you going?
The next one.
Was there a moment where you looked at this and said, this is worth it?
I can't remember a moment where I didn't think it was worth it.
Brett Feldman, USC Streetcare, it was great to have you on California Insider.
Thank you for having me.
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