The Los Angeles County Board of Supervisors voted Tuesday — on a 4-1 split — to reconsider the 47 strategies that drive its response to homelessness.

Supervisor Kathryn Barger recommended the review, citing rising homelessness despite all efforts.

“The status quo is not working. We spend hundreds of millions of dollars each year and we are still failing and, in some cases, falling behind,” she said.

It has been six years since the county established the wide-ranging set of strategies, largely funded through Measure H.

That measure has a 10-year life, and Barger and her co-author, Supervisor Janice Hahn, said this rough midpoint was the right time for a reassessment.

“We’ve got five years on the taxpayers’ dime to solve this problem,” Hahn said.

Supervisor Sheila Kuehl, who cast the dissenting vote, raised concerns about drawing resources away from efforts to establish more interim and permanent housing at a critical time.

“I’m really worried about diverting all of the talent that is now focused on trying to find housing for people … at just the wrong time,” she said.

Kuehl underscored the extensive work and wide range of experts who contributed to the original strategies, drawing on best practices across the country. She said she was worried that effective programs could be abandoned.

Barger and Kuehl also disagreed on how much mental illness factors into homelessness.

“In the last six years, the conversation on the role of mental illness and substance abuse has changed dramatically,” Barger said. “Six years ago, many estimated that only 30% of people experiencing homelessness suffered from mental illness. Now, some studies project nearly 80% of people experiencing homelessness suffer from mental illness or substance abuse.”

Kuehl took issue with that analysis and pointed to a recent count in Hollywood and East Hollywood that found a decrease in homeless encampments. The count attributed that drop to more available interim and permanent housing, supporting the county’s commitment to a “housing first” model.

The debate paralleled one prompted by Barger’s nomination — since withdrawn — of Dr. David Drew Pinsky to the Los Angeles Homeless Services Authority. The celebrity doctor, better known as “Dr. Drew,” has pointed to mental illness and drug and alcohol addiction as key drivers in the growth of the county’s homeless population.

Barger’s proposal to appoint him drew fire from critics including the Los Angeles Times editorial board, which mocked Pinsky’s comments that concerns about COVID-19 amounted to a “press-induced panic” and pointed to his assessment of the “housing first” model as a “hoax.”

Pinsky apologized in April 2020 for his early remarks on COVID, saying he “got it wrong.”

While the factors influencing homelessness remain a source of debate, Barger’s office pointed to a 2019 UCLA study of homelessness nationwide finding that 78% of the homeless people surveyed who were living on the street also self-reported a mental health condition.

Those numbers were much lower, but still high, among homeless people living in shelters or other temporary living situations.

The UCLA study highlighted mental illness as both a cause and effect of living on the street, but said the findings “reinforced the importance of stable housing as a social determinant of health and as essential for ending homelessness.”

The board directed the county CEO to work with LAHSA, city governments, service providers and other key stakeholders on recommendations to improve the strategies in place, including more racially equitable solutions.

In response to a request by Kuehl that more time be allotted to avoid a full-court press that might sap other efforts, the timeline was extended from four to up to six months.

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