We Know How to Solve Homelessness. We Just Need to Do It.

one black, one white. I'm a historian and I'm a journalist. And this is some of my best friends are some of my best friends are I'm not a blank. Some of my best friends are that thing. In this show, we wrestle with the challenges and the absurdities of a deeply divided and unequal country. And man, this episode is about inequality. Yes, yes, we're gonna talk to someone doing some of the most innovative and important work to address

our poverty problem and affordable housing problem. Houseless. We're going to break that down. Let's go. Hey man, Hey, Hey, yeah, man, So I don't think I've ever told you this story. Um, It's something that was profoundly impactful on me when I first got started at the Shamberck Center. So I'm gonna tell you about it. My heart dropped for a second. I thought you were gonna tell me like the breakup story. No, no, no, And it's totally connected to what we're talking about today.

All right, let's hear it. I've become director of the Schoenberg Center for Research and Black Culture, located in the heart of Heart in two eleven. This is like historic ground that all sorts of amazing people have walked on, from James Baldwin to my Angelo to Malcolm X himself.

All right, so I'm doing some early programming and I'm trying to drum up interest in the place, and we have this event one night in our auditorium and a woman comes up to me and she says, you know, this event was amazing, but I think you should invite homeless people to the Schaumberg. They can have kind of like an American idol for homeless people. And we ignore

homeless people constantly. So she's like, homeless people have so much talent and they just need opportunity to showcase their talent. And so just because they don't have a home doesn't mean that they don't have something to share. What's your response. Yeah, you're hearing this and you're like, let's do it. I'm thinking, I'm thinking this job is crazy, Like I'm just trying to get a paycheck and get the fuck out of here.

Like I'm running a research archive. I'm supposed to be working with scholars, and here I am having a conversation about houselessness. Homelessness talent show. Yeah, so her name is a Ratha speaks and turns out that like within a week. I come back to work on a random weekday and she's out front and has built a cardboard compound. So I want to show you a couple of pictures so that you see what this looks like. All right, all right, oh man, And there's like there really is like a

living room. Yeah, a bedroom. She's got a photon. You guys are like in a home. It's a house, but it's outdoors and boxes. Oh man. She put tile on the floor inside the cardboard boxes. That's right. This is incredible, Like it's part of the community. She has taken cardboard and put it together in such a way that she has a bedroom she's got an eating living room, she's got a library with book crates and books on the crate, and it's on the sidewalk. It's right in front of

the building. You cannot enter this building with out almost stepping over this compound. And I'm like, holy smokes. So I talked to her and say, what's going on in Rathla. She's like, well, you know, I just wanted you to know that the issues of homelessness need more attention. And I'm gonna be here bringing attention because this is the Schaumberg Center for Research and Black Culture. And if there's any place in America where homelessness ought to be important,

it is here. And I'm like, oh yeah. She's like, I know who you are. You're Elijah Mohammad's great grandson, and I know if anybody will take this issue seriously, it is you. And you know what, I think you should rename the Schaumberg Center the Elijah Mohammad Center for Nation Building. Yeah. Yeah, So it is a fascinating moment. She's like, you're the person. This is divine that I'm here. I have set up this compound. I want to draw attention to the problem of homelessness, and you're the person

is going to help me do it. I'm like, oh, okay, but I can't let you keep this construction zone here of cardboard housing. I can't. I can't let this happen. And in fact, while I'm talking to her, a woman comes up and literally brates her is like, this is despicable. Get this trash out of here. This doesn't belong here. And this woman obviously lived in the neighborhood. And I went to interject. I said, hey, you know I'm the director. She said, I know who you are. I said, oh snap,

She didn't care one bit who I was. So I talked to a rough and I said, listen, here's what we're gonna do. I'm gonna hire a videographer to shoot what you've done here, and I'm gonna use that video to help you tell your story. And in exchange for that, you will agree that within two weeks you will leave the Shaunberg Center and take the cause elsewhere because it

was unsustainable. So here is the day when I sat down with her, because part of the deal was she wanted me to be interviewed with her so that she could tell her story. How did she feel did she feel that she was both seeing and that her cause and voice were having an effect. Absolutely. What Ratha Speaks was trying to tell us was that we don't deal

with the root causes of this problem. We keep addressing it in band aid ways, and we're criminalizing poverty by treating houseless people as if they don't actually belong in our society. And she's like, no, we have a voice, man. I love that, Khalil. I love that you took the time to get to know a Ratha Speaks and to do this work. And you're right. Today's show, we are talking with Heidi Beferous. She's a doctor of internal medicine and she's the medical director of Housing for Health in

Los Angeles County. Yes, and exactly what you said. Housing for Health tackles this problem in a way that's different. That's right. It looks at homelessness or houselessness as a healthcare matter as well as a housing one. And that's innovative. And what they do in La County is also massive. They house and care for nearly twenty thousand people. Yes, this is a big deal and a really innovative approach to a massive problem that spans coast to coast, from

La skid Row to the streets of Harlem, USA. And I think maybe we'll find out that the solution is to get you to go from city to city across the country with a videographer and that nice suit that you were wearing in that picture, and you know, just talk to everybody and you can handle this. Let's get going with Heidi. All right, let's do it, doctor Heidi Beferus, Welcome to some of my best friends. Are Yes, We're so happy to have you, Thank you, thank you for

inviting me. I'm so excited to join this conversation. Heidi. We want to know more about what you do and what Housing for Health does in Los Angeles County. So yeah, yeah, what is Housing for Health? Housing for Health is a program of Los Angeles County, the Department of Health Services, and it was started about ten years ago by Mitch Katz now at New York City Health and Hospital Corporation.

It's a gorgeous vision, right, How do we, as social justice warriors in the realm of healthcare, address the obscenity that is houselessness in Los Angeles County and think about not only providing roofs over people's heads. But helping those people who've been historically traumatized and marginalized get re enfranchised and be able to pursue meaning and purpose in their lives and address all the issues that they haven't been able to address because of their dire life circumstances, which

often started from childhood. Yeah, yeah, you said something just now that's really striking, and I know for some of our listeners it will be. It was striking to me the first time that my twenty year old daughter came in my home. Her name is Jordan, and she scolded my wife and I for using the word homeless. We were like, whoa, what the what? Like? What is happening here? Like what's wrong with that? Work? So so we now

use houseless, But I don't really know why. And so maybe you help me and Ben and our listeners understand why houselessness is more appropriate. I think a couple of things. One one of the things that you find when you are accompanying people who are experiencing houselessness is that they create home wherever they are, whether that's on a riverbed or an encampment or an a shelter in their car.

The concept of home, which is that sense of belonging community is not obviated by the lack of walls and roof And I think it also reminds us that when we commodify housing and we create circumstances in which housing is just not affordable or not available. Yes, that in just providing the housing, that's one important thing, but we also have to address the structural violence that God us there in the first place to really achieve the healing and the wellness that we want. And I think that's

why we call it houselessness. So I think we want to remind ourselves of that really important human element. Right, So not having a house is not a moral judgment on the character of a person, that's right, whose home can actually be a sense of belonging in a community, even if you're on the street, as opposed to the fact that you don't actually have a brick and mortar place, which to most of us, at least in this conversation, is more an indictment of the society we live in

than the individual. That's right. And unfortunately, a lot of today's rhetoric sort of criminalizes homelessness and people experiencing homelessness, and we need to realize is really a supply and demand issue as well as speaks to the structural violence

and institutional racism that are allowing and well today. And maybe you could paint a picture for us of a specific case, a specific person that you met on the street and what you did and what happened next, just to give us a sense of what actually housing for health does. I always goes back to the story of James.

It's not his actual name. James scold me about the story and how important it is to understand that people come to houselessness and what it takes to really restore their dignity, which at the end of the day is what we're trying to do. So James, I met him,

actually was a thirty seven year old guy. I was in clinic at Martin Luther King Community Health Center in Compton and he was scheduled to see me, and I had read up on his chart before he came in, and in the chart was the usual vitriol about this

black man. Okay, right, I'll tell you the words that are being used, right, so angry, defiant, conferenceational, aggressive, non compliant, difficult, challenging, And what you could tell from looking at the chart was that James was literally coming into the emergency room every nine to ten days. He would come in at night in congestive heart failure. He's a thirty seven year old black man. Why is a thirty seven year old

black man having congestive heart failure? Then you could see the frustration in the notes about like, he's not adherent, he's not doing what we're telling him to do, and this sort of revolving door. And at no point did I sort of see any notation about what was going on with James, any sort of attempt at understanding what was happening with him. And one of the things that was disturbing to me, so you know, normally when your

heart pumps khalil or ben. Every time your heart pumps, about seventy percent of the blood that's in one of your chambers is pushed out into your body to give it oxygen and trition, right, And James's fraction was ten ten percent, So he was only getting tablespoons of blood out with each squeeze, which means he was really sick. Right in his life expectancy is typically six to twelve months, and at one point in one of the hospitals because he was deemed sort of non compliant. He was put

on hospice. Hey, you're dying, You clearly don't care about your health. So he's being ridden off as a thirty seven year old, you're basically saying. And the process is because he's not doing what we're telling him to do. Right. One of the things that we're supposed to do is put in an automatic defibrillator in their chest so that if that happens, you know, they automatically can get shocked

out into a normal rhythm. But he was deemed too non compliant to be referred for the placement of the defibrillator, and instead they gave him a vest. Then in the pocket is a little defibrillator and he was told to wear that. And I was fascinated that he was coming to clinic because he hadn't been to see anybody in the outpatient clinic for years as far as I could tell.

And I was waiting and I heard some screaming coming from the lobby and I went out, and of course I had been running late because I usually do, and he was quite upset about my being late. And got him into the clinic, and you started just taking a moment and just sitting with him for a little while, and he started crying and I said, James, what's going on? And he said, I just can't take it anymore. Said last night, my ten year old boy, I woke up at two in the morning and he was staring at me,

and I said, why are you awake? And he said, I'm worried You're going to die. This ten year old said this to him. Yeah, and then the story came out and James grew up in the South side of Chicago, Wow, broken home, living on the streets as a ten year old. Remembers being dropped off at the emergency room by his friends because he had passed out. Didn't start into medical care at that time because life was really challenging for him.

He was in and out of the juvenile justice system, got involved with his woman as he called her, started having kids, and then began this journey of sort of going from state to state, and he ended up now in LA. He was living in his pickup truck with his women and four kids, ten, seven, three and a

ten month old. His pickup truck was actually parked in the community clinic parking lot at the time, and I asked him, you know, James, what makes it hard for you to stay in the hospital, because I'm really worried about you. You know, your heart is really sick and that's probably because of the years of high blood pressure weren't treated. And he said, look, my woman is slow. What did he mean by that? I think he meant

that she had some developmental delay. Got it okay? And he said, the most important thing to me is that my kids get an education, because I didn't have that chance. And he said, I go in at night when my kids are asleep. I have to be back in the car at seven to make sure they get breakfast and I drive them to school. I can't afford to be admitted in the hospital and every nine to ten days, asked my tune up because that's what I can afford to do. Wow. And I said, James, what makes it

hard for you to take your pills every day? And he said, where am I going to put those pills? I'm living in a car. And I said, you know, why aren't you wearing your vest and he said, well, I don't want my kids to get electrocuted if that thing goes off. We're sitting on coils with James. What we were able to do. And it was actually a

beautiful story until we sort of lost contact. But we actually were able to get Department of Children and Family Services involved with his consent, which is important, and they were able to place him in an apartment, three bedroom apartment, and he was able to start taking his pills. We were able to get that defibrillator into him. Oh my goodness, that's incredible. He came off hospice. This is what we do. One. You have to listen first. Nobody was listening and understanding

that his houselessness was a symptom of greater issues. But I think James is very illustrative in the sense that houselessness is just a piece of his story. Putting him in an apartment is just the beginning. And I think

that's what Housing for Health is trying to do. Is, Yes, we need to give people access to roof and walls and those basic levels of protection, but then we also need to unpeel those layers of trauma and institutionalization, you know, social and fiscal disenfranchisement and figure out, like, how do we help this person get to where they want to go? Heidi, can we spell this out using James as a model to understand what you do. So, like you said, first you had to have a contact with him, he had

to come in. Then you had to spend time listening to him. And then you use a kind of housing first model, which you know, as I've learned about, is before someone can be helped in any other way, they need they need a safe and you know, livable place to be. But then you're talking about also housing first. Then what comes second, third, fourth, fifth, And that seems to be like what you do is is if it's not radical, it's at least different. Can you unpack that

a little bit more? It really does take a village. And so you know, what we're trying to build is, yes, there's medical staff, but there's also social workers. There's also peers what we call you know, what I call a company tours, people who company people who maybe have lived experience, who who share the journey with James. As trying to

navigate the system right and get what he needs. We had to get the Department of Public Social Services involved to get him income because one of the things that we learned was James was selling his hospice meds to provide for his family, and we had to get the Department of Children and Family Services involved because they made sure those kids got to school, they got them wick, they got them closed, they got them housed, and they

provided respite care for mom. We were able to get him connected to a program called Sea Beast to apply for Social Security disability payments again to augment the income. So all of that is what we call intensive care management, right, making sure that people are getting access to the resources they need to live as full of life as possible. Right.

And you can't discount the fact that these people have incredible assets, right, And when you're thinking about a recovery model, how do you build on those assets to help them achieve wellness and purpose? And just to be clear, you're using assets in the sense of his moral character, his intellectual capacity and gifts, his thoughtfulness. You know, he's someone who is in control and making good decisions as with

the limited resources he has. Absolutely, Heidi, I think this story of James is incredibly illustrative of how important what your organization and what your team does. And I'm curious given that this individualized, intensive engagement with individuals like James, and I'm sure their stories are as diverse and specific to their circumstances, as one could imagine, there's a huge population of homelessness. I mean, I'm out on the East

coast bends in the Midwest. You're in LA. I mean, let's talk about how do you first of all, how should we understand the scale of this problem, and how you and your organization think about addressing the skill of that problem. Yeah, so you know New York in LA or I shouldn't say competing for because that would suggest that it's a good thing, but for the country's sort of worse houselessness problem. They're at last count close to seventy thousand houseless people in Los Angeles County. And how

does that mean people living on the street, living in shelters? Like, what's the that's right? And the majority of people Unlike New York, where sort of the houseless individuals are somewhat hidden because it's a right to shelter state, you don't see them as much as you do in LA, the majority of people I eat, close to fifty thousand of

the seventy thousand in LA County are unsheltered. Okay, so let's just talk a little bit about how you and your organization come to terms with what you're facing on the streets of Los Angeles. In terms of the scale of the operation that you oversee, I'm curious what you have right now, Like, I just want to see the operation, So tell us, like how many people, Like what what's the operation look like right now? In housing? We have

about nineteen thousand individuals. Amazing, It's incredible. Yeah, Okay, we're also providing intensive case management services. Heidi. We're going to take a quick break, but I just want to say before the break that you know, you said James schooled you. You just schooled us that in a way. We asked you about about houselessness, and we wanted to hear about people on the street, and you talked about medical care,

you talked about people's past. You schooled us on all that's behind it, you know, the thing we might see on the street. You're talking about the much deeper, deeper problems that you have to address. When we come back, we're going to talk to Heidi about her past and how she got into this work. So, Heidi, this is just an incredible conversation. And Ben and I are learning so much, right Ben, You're learning a lot, I am. I am. Yeah, Yeah, and listen We want to know

more about you. We want to know how did you come to take on this incredibly challenging work. I was born in Iran. I lived there till after the Iranian Revolution, my family immigrated here. I think one of the things that was just a tremendous experience for me my father grew up very poor in a small dirt village near the Afhani border, and just visiting his old home and recognizing that despite what some would deem poverty, there was

an incredible richness and community. And my understanding and appreciation for resilience and beauty in the face of material suffering, and recognizing that every person deserves the opportunity to create a community as they define it. And I think one of the things that has always struck me in this country is the incredible inequality. And I used to talk about this with my mentor, Paul Farmer, because I worked with partners in health from the time I was in

medical school. That's huge. Okay, so let's let's just stop for a seconds. Oh yes, so we weren't talking about Paul Farmer, but our listeners won't all know, So give us a brief like boiler play, this is the guy who did X, Y and Z. All right, So, when I was in medical school in Boston, I was at Harvard Medical School. I was very interested in going back to ran and I wanted to spend a summer looking at sort of the circumstances and nomadic tribes in south

central I run around Shiraz, where I grew up. And I was struggling with getting through the Ministry of Health that wanted to stick me in a chemistry lap instead. And I went to Paul Farmer because Paul was working in Haiti with a program called Partners in Health, and this is a program he helped to found in nineteen eighty seven. That's right to address HIV, the crisis of HIV happening in Haiti at the time. That's right. You know your stuff, Khalil, he does, Okay. Paul's big take

was making a preferential healthcare option for the poor. I don't even want to just go there and give them band Aid care. I want to build an Ivory tower where they get as good a care, if not better care than what a Harvard Medical School teaching hospital provides. And that was Paul. I want to ask this another question, Paul Farmer related. I'm interested in this jump from this work that we imagine, like you know, doctors without borders.

We can do stuff in other countries other like third world in quote countries, but we can't do things next door. Like so like this kind of philosophy where you put this in practice, I want to hear about that, like that it's right here at our doorstep and we can

do the work here. That's right. One of the key differences, this is what I was getting to that I talked to Paul a lot about, is that it's different when you go into an area that has nothing and you build it, whereas you go into a place that should have everything but people can't access it or utilize it. It's a very different set of problems. That's really helpful. Distinction.

In the United States, you're always near everything, is what you're saying, like right, but there are structural forces that prohibit everybody from accessing and utilizing those services. And in some ways, I think the psychology of being a poor black man in Roxbury is very different, not better or worse, but very different than being a psychology of a poor

black man in that squater settlement in Haiti. And I think you have to understand that to know like, what is it that we have to help build within that one individual? But what do we have to do to sort of dismantle or confront the structural violence that's peating

his utilization of resources? Not just healthcare, right, but when you think about employment discrimination, housing discrimination, mass incarceration, the exposure to violence and the lack of safety from violence even from the state, what does that do to someone? And I'll tell you. I was twenty years old. I was walking down the median of Columbus av in Eggleston Square, Khalil you know this, And I was walking with Eric, who was a teenager eighteen year old black kid, played

football in high school, Beautiful Soul. And we were going down the street and we've just heard the car doors locking click click click click click, And Eric turned to me and he said, this is what I live with. What does that do to you? And realizing that the work that we were going to do in Roxbury and Worchester wasn't just about going to people and saying, hey, you should get healthcare insurance or you should go see a doctor for that, but it was like, why why

are they not going? How are they treated? When they're there. And I think one of the things that we were able to bring from Haiti is this accompany term model is we needed to have like people alongside accompanying them, that act of witnessing. When you have someone by your side who's standing there, that person behind the front desk may be going to treat you a little better. Different right when you have someone in that office with you while the doctor's talking to you, maybe the doctor will

listen a little better. A patient advocate, which has probably in the last twenty five year, has become a huge part of the movement for a patient bill of rights.

And my mother, who's elderly. Ben's parents are elderly. You know, we're keenly aware that we sometimes have to be there for our parents when they're having conversations with doctors, because in the routinization of just like, hey, this is another old portion of my office and they're either going to follow my orders or not, you have to step up and say, hey, let's slow this down. Let's make sure

that my mom understands exactly what you're saying. That's really fascinating to understand that model coming from Haiti here into the Boston area and Roxberry as a way of really addressing this crazy complex landscape of structural barriers and structural violence that you've talked about that people like Eric were experiencing. Yeah, And I think the other thing that we brought with

us was accompaniment is for life. There's this concept in the United States, it's very cultural, which is, hey, you should be able to like pull yourself up by your bootstraps. We'll give you a leg up. Ah, there it is. We'll give you that little welfare check or we'll give you a general relief and then you know, you should be good. Yes. And a lot of times when I was submitting grant proposals for these accompany tours, I'd be like, well, how long how long do they have to be there?

Is it like six months? And then you could dismount, taper off and when it things that you know, the accompanytors in Haiti taught us was they have AIDS or they're living in poverty, they don't have a thatch roof that doesn't leak over their heads. For life. So I'm here for life. And it's sort of that concept, which is sort of antithetical to our esthetic in the United States, that I really struggled with because everybody wanted to see

what is a short term return on investment? Oh my goodness, yeah, return on investment. I mean what you do, Heidi is obviously very expensive and requires so much coordination between so many different groups, and yet there are all these savings. There is a return on investment you were talking about, James, he goes to the emergency room all the time. That's

crazy expensive. They are these savings. In the end, you're saying, on the side of the status quo is wasting a ton of resources as it is as opposed to the upfront cost of a program like this, It's clear. But what happens Ben, which is really interest interesting, is when people stop feeling the pain in the short term, Right, James isn't going to the hospital in the emergency room, and we're like, okay, we're going to keep them out

by keeping them housed, by keeping those services going. Then the healthcare system is like, why is it on me to house James? But I'm like, well, who else is it going to be on? Right? We keep pointing the fingers, and then meanwhile it gets dropped because it's no longer viewed as fiscally sustainable. Or as a healthcare problem. It's

James's poverty problem. That's right. We want to take another break, and you touched on a raw nerve for both Ben and me, and that is this intersection of the politics of houselessness, this idea that people are responsible for themselves, that we live in a society where everyone has the opportunity to live their best lives, and if they don't, it's on them. And so there's only so much we can do to help you. And it seems to me that what Paul Farmer and Partners in Health have shown

is that America's got it wrong. So after the break, let's come back and talk about how we think about this model scaling up and why it isn't happening elsewhere. We are back with Heidi Beferus of Los Angeles County, who runs Housing for Health there. And Heidi, you guys serve nearly twenty thousand people. You just told us that,

which is an extraordinary number. And partly what you're telling us is that the model that you're describing housing first, but then all these other wraparound services and coordinating them, that it works. And that's powerful to hear. It's a better use of resources. So then then it begs the obvious question is like, why aren't more places doing it? Why aren't more cities and states and municipalities in the United States doing exactly what you're doing. I think they're trying.

I think it fundamentally comes down to an issue of like money and politics, okay, and I think that I'm very fortunate to live in California in the sense that the public is committed to this. You know, we got Measure H, which is huge funding that has allowed us

to build. Tell us what that is, because we're not Californians. Yeah. So, so Measure was passed a little bit over five years ago, and basically what it was is like the people in La County said, yeah, I'm worried about this, so I'm willing to pay a quarter cent tax to invest in our houselessness problem. And when you said this, I'm worried about this. Everyone is seeing people on the streets unavoidable. They're like, this is a crisis. We want this addressed

in some way. A quarter cent tax and what's it going to do. It's one billion over like the ten years. It's a start, right, but it's not enough to build the housing and provide the services that we need given the scale of the problem. But also when you think about what has sort of prevented us from building housing, a lot of it comes back to like redlining, all of the issues around the zoning laws, the community sort of uproar about putting in housing. Those things get in

the way of building housing quickly. Those are the politics that you're referring to. Those are the politics that we, you know, we have to overcome. I'm chomping at the bit to kind of put a little color on this, so I remember Mayor is it London Breed? Is that

her name? In San Francisco, she opposed attacks on high revenue companies in the tech center after Salesforce CEO was proposing attacks on every company above a certain amount of revenue to say, look, you know, if we tax ourselves, we are incredibly wealthy people, we can help to solve this problem of houselessness in our city. And Mayor Breed, who's a black woman, was essentially saying, no, we shouldn't

do this. And why was she saying it. She was saying it because she didn't want to create this scene of dependency where there'd be a sign at the border of San Francisco, saying you know, all poor people, welcome to San Francisco. We're going to take care of all your needs. And this like tension between a society that is built on inequality, there's no way around it. Capitalism built on inequality, there will be winners and by DeLine losers.

Then has this mythology attached to it that those losers are to blame for losing in this race to the top. Some of us might be surprised to think of, like the pushback that comes when these solutions are proposed and people are willing to tax themselves to pay for them.

It's outrageous, it is, it's nonsensical. You're absolutely right, Khalil, And I think like you know, when you think about how people talk about people experiencing houselessness, and I'm seeing it now where I live, where you're seeing more in more people houseless on the street. It's unbelievable. The rancor and they've never taken the time to listen or to really understand. There's a lack of imagination in addition to

a lack of empathy. And how do we fight that when our society, like you said, is built on this concept of inequality and for those to have there have to be those who don't. Yeah, And I think that it's something that keeps me up at night is how do we have that conversation, how do we make this into a collective we problem as opposed to you need to fix this. They're having this conversation in New York

right then? Yeah, I mean that Khalil and I are talking about that collective we all the time, I mean, and sort of thinking about our nation's problems. Maybe another way to think about this is like why don't more municipalities do this? Is to ask about what's going on in New York now? And so in December, the mayor there, Eric Adams, said it was a priority to clear the homeless from the streets and even to remove people and

hospitalize them even if they don't want to go. What's wrong or right about that approach school us a little bit more? Well, I think the first thing I would say is confronting it. Even if the tool you're you're using isn't the right one, is good. So I have to give them props for that, right, as opposed to saying like, hey, we got this. The problem is that this isn't a hospital problem houselessness? Isn't it something that

the going to the emergency room is going to fix? Yeah, here we are sending people who are houseless, traumatized, may have comorbid mental health substance use issues, and saying to the emergency room do something. Just we got to get them off the street. What is the emergency room staff supposed to do? Are they supposed to miraculously be able to find permanent housing or they just like stabilize them And what does that mean? And then put them into

a shelter? And then what that shelter keeps them and they don't end up back on the street. Right, So it's sort of like it's not the right approach. It makes you feel like you're doing something, but you're really re traumatizing not only the people who are experiencing houselessness, but also like that emergency room staff. What does that feel like? Yeah? So I just want to get this straight. So is it just shuffling people to somewhere else that

they're eventually going to shuffle back? Meaning if you say we're going to send it to the emergency room, but if there's no larger systemic solution and like an organization like yours that is thinking about how all these different pieces work together, and there's sort of these long term holistic solutions. It's just moving someone away for a little while until they go back. Yeah, And I think there are plenty of great organizations in New York that are

doing similar work to housing for health. I think the issue there is the stock of housing again. Right, So if the fundamental solution to addressing homelessness or houselessness is having housing stock housing first, you do need that first step. You do second, third, fourth, fifth, but you need that first step. You need that first, and then you have the resources to provide those supportive services in that intensive care management, in that trauma informed way to keep people

housed and support them towards achieving wellness. And that's what needs to sort of be invested in. Then I've been thinking about your question about New York, and obviously I'm in the media bubble of the city and so I hear these stories a lot. And one of the things I'm struck by, which connects with Heidi's sort of story about the notes in James's file, about his lack of appreciation, his aggression, his defiance, you know, James was being criminalized

in a way. He was made to be undeserving of the attention that he was getting. That was not that was failing to meet his needs. And it strikes me that that Eric Adams is doing two things. He is calling for greater hospitalization and he is calling for some of the vacant office buildings downtown to be converted to

either temporary or permanent housing four houseless people. I think that's a good thing because COVID has created vacancy rates in office buildings downtown, which means there's just a lot of empty space currently and the city is trying to figure out a way to use some of that space. And maybe to a surprise to a lot of people, New York has long used hotels. They've rented entire floors

of hotels for the purposes of housing people. So I think Heidi's right about that there is a spirit of goodwill and there are effective ways in which people do get help, But there's a spirit of meanness right now that is being articulated in the Adam's plan, and that is it's attached to this concern about the mentally ill being on the street and the crime problem, and so I just keep thinking about Heidi, the way in which there's a broad culture of punitiveness directed towards houseless people,

and they're essentially blamed for everything. They're blamed for disorder, they're blamed for uncleanliness. In this case, they're blamed for contributing to New York's rise in crime, which is not really evident other than in these high profile news stories where you know, someone pushes someone tragically onto the subway

track and a person dies. I get that that's not anything to belittle, but to use those moments to then say we're gon we're gonna sweep the streets of the mentally ill who who are homeless, which is essentially collapsing those two categories into one, strikes me as another version of the story that you told about James Yep, that only a crazy person could refuse, you know, could refuse our services, when in fact we're not actually dealing with

the broader circumstances. It brought this person to our attention in the first place, that's right, and very few people who are experiencing houselessness have that sort of high level psychotic illness, and so you sweep up a lot of people who's to say who is mentally ill right, and that the hospital system if you don't have an understanding of that person. Let's say we do determine that they have an acute psychosis that should be handled, Like where are we going to put them? Do we have enough

psychiatric treatment facilities? Do we have interim housing that can support them after their discharge from the hospital. Do we have the supportive housing that they move into that can continue to support their thriving as someone who's living with mental illness. You have to build all those pieces. I think if you're going to say we're doing this as

an act of beneficence, otherwise you're right. It is sort of like very punitive in the end, very traumatizing, because what happens is if you don't have those other pieces, people end back up right out on the street, and

it just creates the circle of a violence. I mean, hearing all these echoes of things like the criminal justice system and the need just to show a response which isn't actually solving the larger systemic problems, and all the ways that we think about collective responsibility, and you know, the problem of houselessness is often also this idea of

like making the city more livable. But when we say that, we mean for whom, and we mean for people who are not forced to sort of pass individuals who around the street and so on, Heidi, Just as a way to wrap up, what do you say to make people know that this is we need to all invest in this and sort of get behind this work. I think it's for me. It's really important that it's a message

of hope and optimism. People feel these problems are intractable, and it's really important to say we can solve this, we know how to solve this, we just need to do it, and people get stuck with that in that paralysis of it's too big, it's too hard, And I'm like, let's just start with changing the tenor of our conversation, which is we can do this, we know how to do this. We just need to make that commitment. That's the most important thing to me. And it's so interesting.

The other day I was with my daughter and she was with a friend and her parent and a person experiencing houselessness that I've learned to know in my neighborhood, who's this incredibly sweet, funny trans woman who has these like outrageous outfits, and my daughter was wearing these like platform rainbow converse shoes and Tatiana came up to her

and was like, oh girl, I love your shoes. And you know, Layla was engaging with her, and I saw the other parents sort of recoil and she texted me and said, sorry, I had to leave, you know, I just didn't feel safe. Oh wow. And I texted her back and I said, Tatiana is such a lovely person. I wish you had gotten to hear her story. And she texted me back and she said, maybe next time I'll stop and listen. That for me is a win.

How do we how do we amplify that? Wow, that is both inspiring and depressing because he said maybe, But you know, it's a start. We got to take that Khalil, Oh my goodness, we know how to solve this. That's that's the place to start, Like, that's the conversation. Yeah, like and then and then to show people how m Yeah. Well, we're very inspired by what you do. We are grateful for the time you took to be with us today, and we'll do our part to share the good news

about the work that's going on in Los Angeles. And hopefully it can spread across the nation. Thank you so much, and we'll continue in La Luja. Thank you, Hidie, thank you Okay, thank you Hidie. Take care. Wow, Khalil, I'm thinking about the story you told me at the beginning about a Ratha speaks outside the shan Burg Center and horror them, and about the story that Heidi told us at the end of the conversation about her interactions with Tatiana,

the trans woman in her neighborhood. That's right, And both of those stories they seem so connected about taking this leap of getting to know somebody, of humanizing somebody who is houseless as we've learned to call it, that's right, and then allowing them to tell their deeper story that if we're going to think about any solutions, it has to involve those people and their histories. That's right. It

can't just be something on the surface. Yeah, those feel so connected, of like as book ends to this conversation. Now they totally are. And I love you bringing up Tatiana in the experience that Heidi shared with us, because partly what she was saying is that we have to connect with our own humanity by seeing the people who are struggling in our mits, not because they have failed themselves,

but because we have failed them. That is the story that Heidi shared with us about the people she works with, the work that she's doing. And I gotta say, like, that's a lesson that a taught me. But I also have to say it's really hard because at the end of the day, in the case of Arafa, I mean, I consider her a friend to this day. But it didn't end well. Oh you mean it didn't Andy, even

in that moment outside the Schaumburg. No, it didn't end well because while she did leave, she came back and she set up again, like several weeks later, and I said to her, I was like, a Rafa, this isn't the deal, and she's like, but I got nowhere else to go. Yeah, And so I just want to acknowledge, like we have to solve this problem in the deeply

systemic way in which we created the problem. And as much as we want folks to lead with their own voices and they should be at the table to do it, it's not going to be solved one Tatiana and one a rough at a time. Yeah, because your deal meant nothing about where she was going to sleep that night or those problems. That's correct, yeah, man, well love you, love you too, man. Some of My Best Friends Are

is a production of Pushkin Industries. The show is written and hosted by me Khalil, Gibron Muhammad and my best friend sometimes Ben Austin. It's produced by Jonasanti and Lucy Sullivan. Our editor is Sarah Knicks, our engineer is Amanda Kawang, and our managing producer is Cottonstanza Gallardo. At Pushkin thanks to Lee Tall, Mulad, Julia Barton, Heather Faine, Carly Migliori,

John Schnars, Greta Khne, and Jacob Weisberg. Our theme song, Lil Lily is by fellow chicagoan the brilliant Avery R. Young. It is from his album Tubman Okay. You definitely want to check out more of his music at his website Avery R. Young dot com. You can find Pushkin on all social platforms at pushkin Pods, and you can sign up for our newsletter at pushkin dot fm. To find more push in podcasts, listen on the iHeartRadio app, Apple podcast or wherever you like to listen. Hey, and if

you like our show. Please give it a five star rating and a review. And okay, even if you don't like it, come on, give it a five star rating, review it, and please tell all of your best friends about it. Thank you so much,