     
San Francisco is spending about $22,000 every hour on homeless
people this year, but still can't get Joe Dinovo and thousands like
him off its streets.
The Chronicle and horrified passers-by encountered Dinovo, a
one-legged drug addict, lying in his own vomit at high noon last
summer on the sidewalk near 16th Street and South Van Ness Avenue.
He was naked from the waist down.
Dinovo, an Ohio native who has been periodically homeless in San
Francisco for six years, was old news to paramedics called by one
concerned citizen.
"It's only Joe," said the ambulance driver, pulling away soon
after arriving. "We see him eight or 10 times a week."
Awakened, Dinovo cursed bystanders, ate from a trash can, then
urinated and gushed diarrhea into the street.
Then the 31-year-old, on probation for stealing a woman's purse,
rolled his wheelchair to a nearby intersection and begged money from
aghast motorists caught in traffic.
By the city's last count, there were some 2,000 people living on
the streets like Dinovo - acting out, sleeping, eating, doing drugs,
begging, performing all bodily functions, often in the paths of
those who would shop, do business, dine or be entertained in San
Francisco.
About 70 percent of the street homeless are mentally ill or
substance abusers or both, says Jo Ruffin, director of Community
Mental Health Services in San Francisco. Many also have other
chronic medical conditions.
These chronically homeless people have become a defining
characteristic of San Francisco.
"You walk down Market Street and step over comatose bodies,
debris and human waste. It's just not a pleasant experience," said
Dave Myers, a real estate investor who lives in Cupertino.
He and his wife, Karen, used to make regular overnight visits to
San Francisco for dinner and theater, Myers said, but now they
usually go elsewhere.
"Leave politics out of it. Leave all the issues of needy folks
out of it. We're talking about hygiene here," he said. "It's where
people walk and take their kids. It's dirty and nasty and not
healthy."
City officials say they've done their best, and The Chronicle
found they are spending more than $200 million this year on the
homeless, about the same as San Francisco spends annually on its
Fire Department.
Still, they admit they haven't put a dent in the problem of
visible homelessness. There are about as many people living on the
city's streets today as there were a decade ago.
A Chronicle investigation suggests the city may be misspending
its money, investing in long-term programs aimed at "breaking the
cycle of homelessness" instead of getting people off the streets and
into shelters.
New York City, credited with cleaning its streets of the
chronically homeless, offers shelter to every person needing it -
27,000 a night. San Francisco instead focuses on long-term housing
solutions featuring full services for those lucky enough to get in.
San Francisco views shelters as "a dead end," in the words of
Marc Trotz, director of the city Department of Public Health's
housing program, which targets the mentally ill.
"If you divert money from housing and put it into homeless
shelters," said Trotz, "then you have your homeless and indigent
populations living in huge warehouses."
The city's last census found more than 5,300 homeless people in
San Francisco, including the 2,000 street people. Those not on the
street were in emergency shelters, hospitals, treatment centers and
jail.
The U.S. Department of Housing and Urban Development has an
expanded definition of homelessness that includes people living in
transitional and permanent supportive housing programs. When these
people are included, San Francisco's total estimated homeless
population rises to 12,500.
San Francisco has permanent supportive housing units for 3,818
people. The city considers people in those units to be marginally
housed.
However, the city has only about 1,700 year-round, emergency
shelter beds to serve the 5,300 still homeless residents it has
counted. Most of those shelters don't serve the mentally ill or
people exhibiting bizarre behavior, said a draft city application
for federal funds this year.
Those people stay on the streets, and San Francisco has no plan
to put them any place else - despite the extraordinary costs they
impose on city services and the city's quality of life.
Beyond the money Mayor Willie Brown's office estimates the city
is spending on the homeless - $175.6 million this year - The
Chronicle identified nearly $51 million that can be traced largely
to that street population:
-- At least $41 million in health care bills at San Francisco
General Hospital;
-- Another $3 million in paramedic costs;
-- A $3.8 million allocation for public crews to clean streets
and parks of urine, excrement and other leavings;
-- And $3 million on psychiatric services for jail inmates,
mostly homeless substance abusers.
There is an untabulated cost, too - lost business revenues and
tax money because people like Dave and Karen Myers would rather skip
a night of entertainment in San Francisco than have to encounter
some of the scenes The Chronicle observed in the downtown area of
Market Street and its side streets, in the Mission, the Castro, the
Haight and on Potrero Hill over a period of several months:
-- Public urination and defecation;
-- Blatant drug dealing and use, with vendors calling out their
substances -
marijuana, crack cocaine, heroin - on street corners, and addicts
sticking needles into their veins on the sidewalks;
-- Drunks sprawled across sidewalks, sometimes in their own
vomit;
-- Delusional sidewalk ranting by mentally ill men and women;
-- Aggressive panhandling.
First-time visitor Joan Eccles, a retired nurse from
Huddersfield, England, said she and a friend were frightened and
saddened when they left the York Hotel at 940 Sutter St. at 8 a.m.
one day this September and saw numerous homeless people waking up on
the sidewalk.
"It was awful, really," Eccles said.
"It's vomit and feces, every day," said Jack McGann, street
sweeper for the Union Square Business Improvement District, wearing
plastic gloves as he cleaned the sidewalk in front of the old
Emporium building on Market Street.
"I was disturbed by it for a week," said Embarcadero resident
Julie Patterson, 24, recalling the day she saw a man defecating in
the street near Fisherman's Wharf.
Mayor Brown, who declined to be interviewed for this story,
recently said the city's highly visible homeless population and its
dirty streets were costing San Francisco tourist dollars. This was
only a month after the mayor angrily proclaimed that "San Francisco
is not a dirty city."
Brown has clearly had difficulty getting his arms around the
problem of homelessness in this city.
He ran for office promising a humane but firm approach to the
street homeless.
"It makes no sense to spend San Francisco taxpayers' dollars to
arrest and prosecute those whose only crime is poverty," he said
early in his term.
Within seven months, though, Brown admitted, "I don't have an
answer," to homelessness. "The problem may not be solvable. I'm not
working toward anything at this moment except the maintenance of
current programs, but that's not a solution."
Two years later, he said in his state of the city speech: "We
don't intend to criminalize poverty, but we do not want to become a
city where people who hang out on the streets do so at the expense
of the rest of us."
And last month, acknowledging visitor reaction to homelessness,
he said: "Right now, you get a negative impression of the city."
In 1999, when seeking re-election, Brown was asked about the
issue of confiscating shopping carts used by the homeless to
transport their possessions. The last thing he needed to do three
weeks before the election was alienate San Francisco liberals by
appearing hostile to the homeless, he said, and added:
"I'm not trying to get the Giuliani vote."
He was referring to Mayor Rudolph Giuliani of New York City,
whose tough- love cleanup of that city's homeless problem is a
regular source of comparison in San Francisco these days.
Bob Begley, executive director of the Hotel Council of San
Francisco, said visitors always compare San Francisco to New York,
which a decade ago had thousands of street people littering
Manhattan, but no longer does.
A notable difference between the two cities is that New York is
required by court order to provide shelter to all who request it,
and today its shelters hold nearly 27,000 people a night. Beds are
also available indefinitely.
In addition to providing at least temporary shelter to all who
need it, New York also makes it relatively difficult for people to
sleep or loiter in public places.
Giuliani made national headlines when he threatened to arrest
homeless people who slept in public and refused to go to shelters.
Dennis Culhane, a researcher and associate professor of social
work at the University of Pennsylvania in Philadelphia, said there
is no evidence that New York conducted mass arrests of homeless
people. The city did, however, begin using citations for nuisance
crimes such as public urination as a way to get mentally ill people
into treatment.
Jill Berry of New York's Department of Homeless Services said the
city invested greatly in outreach services, assigning police and
psychiatrists to teams that persuaded large numbers of people to
come inside.
All of which leads Begley of the Hotel Council to ask:
"If New York can do it, why can't San Francisco?"
E-mail Patrick Hoge at phoge@sfchronicle.com.
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