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Each year, older adults make up a greater proportion of America’s homeless population and these numbers are only expected to keep rising. In part one of this story, Viewpoints Radio host Gary Price spoke with Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, and Dennis Culhane, PhD, professor, social policy, University of Pennsylvania, about the main societal factors driving this increase and why this group is particularly vulnerable to homelessness.

One hundred tiny home villages for people experiencing homelessness have opened in the US over the past five years. However, tiny homes, built mainly with philanthropic support, offer more patches than solutions to homelessness. Tiny homes can be built quickly, but issues with securing permits, financing, and local government approval can add costs and delays. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "I would say that tiny homes are an absolutely important part of the ecosystem, but they are not housing."

There’s a lot of misinformation about homelessness in California. It is one of the most prominent problems California faces today. Using data from the California Statewide Study of People Experiencing Homelessness, this article dispels several common myths.

The US Supreme Court's ruling in City of Grants Pass v. Johnson will make it easier for elected officials and law enforcement authorities nationwide to fine and arrest people who are experiencing homelessness. This decision could interrupt programs that expand street medicine services and other initiatives to help people experiencing homelessness find housing. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "What’s worse, though, is we are going to lose the trust that is so essential to getting people to take their medications or stop their drug use and, ultimately, getting people into housing."

The Supreme Court ruling in City of Grants Pass, Oregon v. Johnson, lets lawmakers impose fines and jail time on people experiencing homelessness who are sleeping outside. This decision will provide more clarity to state and local leaders about legal steps they can take to clear out encampments. However, advocates say that the ruling will enable lawmakers to effectively criminalize the state of being unhoused.  Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "It's expensive, it's inhumane, and actually there are real solutions that do work."

For the first time in six years, the number of people experiencing homelessness in Los Angeles decreased from the year before, according to the most recent point-in-time count. However, there has been less success in finding people experiencing homelessness permanent homes. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "If the underlying economic conditions don't change, and if the money gets cut, you're going to see an increase again."

In San Diego County, more than one-third of renters over 65 spend the majority of their income on rent. Along with a shallow rental subsidy pilot program, San Diego County is also working on adding more affordable housing units. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "The truth of the matter is that if we don't spend these small amounts of money we’re spending it on the back end but for really bad outcomes."

The number of older adults over the age of 50 experiencing homelessness is increasing in the US. Overall, 48% of the population of single homeless adults in California is 50 or older, with most of them living unsheltered. A new special report, Toward Dignity: Understanding Older Adult Homelessness, by the Benioff Homelessness and Housing Initiative at the University of California, San Francisco, took a deep look at the aging homeless population in California. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "We’re talking about older frail adults. That is who is outside."

The face of homelessness in America is growing older. Recent projections report that the population of unhoused older adults will triple between 2017 and 2030. As more generations reach retirement age, there is a need for policymakers to consider how housing and homeless services should be adapted to meet the needs of the aging unhoused population. Marc Dones, policy director at the UCSF Benioff Homelessness and Housing Initiative, said, "The country is in the midst of a housing crisis so severe that people who have worked their whole lives are suddenly becoming homeless."

Across San Francisco, there are 8,000 unhoused people on a given day and upward of 20,000 over the course of a year. With rising housing costs, some individuals have transitioned to living RVs on Winston Drive. However, new street parking restrictions will force people living in RVs to leave the area. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "People told us they preferred vehicles to shelters, but they would have preferred housing."