Interview: Va Lecia Adams Kellum, PhD

IHH: In your career, you’ve worked closely with local and state representatives to address the homelessness crisis. What kinds of policies do you think need to be in place to both prevent and, hopefully, one day end the homelessness crisis?

Dr. Adams Kellum: It has been my life’s commitment to fight poverty and address homelessness. The data show that people of color, especially Black people, are disproportionately represented among those experiencing homelessness. In Los Angeles, while Black residents make up about 9% of the population, they account for roughly 32% of the homeless population. We see similar disparities nationwide which tells us systemic racism is at play.

Historically, redlining and disinvestment in communities of color denied Black and Brown people access to bank loans, mortgage financing, and broader economic opportunity. Those discriminatory practices directly translate into today’s wealth, educational, and health disparities and ultimately into disparities in homelessness. We must acknowledge and address these systemic issues in order to reverse the trends we see today.

We must also address prevention to truly tackle homelessness. Affordable housing, workforce development, access to food, educational opportunities all play essential roles in slowing the inflow into homelessness. 

Addressing homelessness begins with ensuring that enough affordable housing exists for people at every income level. Many communities across the country do not face homelessness at the level we see in Los Angeles, and a major factor is simply the number of available housing units at price points people can afford. It’s not a simple issue, but it ultimately comes down to whether there is enough housing and whether people can afford it.

When rents rise and wages remain stagnant, homelessness increases. The UCSF Benioff Homelessness and Housing Initiative (BHHI)’s recent California Statewide Study of People Experiencing Homelessness (CASPEH) confirmed that housing affordability is a primary factor in how people fall into homelessness. Often, there is very little time between when individuals recognize they’re in trouble and when they actually lose their housing. Many people interviewed in the study said that if they had received just a little help or if there had been a place to turn quickly for assistance, they might have been able to stay housed. All of this underscores the systemic issues that continue to push people into homelessness every day.

As I said, when it comes to addressing homelessness, we know that housing, especially affordable housing, is the solution. We need more of it. I also strongly support creating immediate housing options for people living outdoors. After Mayor Karen Bass won the election in Los Angeles, I helped pioneer her innovate housing program Inside Safe. 

The idea behind the Mayor’s initiative is that people living in street encampments, if offered an immediate and safe place to go that same day, would overwhelmingly say yes. From there, we work to transition them into permanent housing as units became available. Inside Safe engages people humanely through multidisciplinary teams: physicians, nurse practitioners, social workers, mental health professionals, substance-use counselors, and people with lived experience. Often the most powerful person on the team is someone who has walked in their shoes.

Helping even one individual say yes to housing, shifting from mere survival to actually living, is transformative. In Los Angeles, we initially used motels because there was not enough interim or emergency housing available. We negotiated with motel owners to allow people to stay temporarily and then transitioned them into interim or permanent housing. Some motels have allowed extended stays. I believe this approach, immediate safety paired with long-term housing solutions, is essential both for addressing homelessness and for reducing the inflow into homelessness.

IHH: Yes, it’s so important to engage with communities and hear from them what needs they perceive to be the most important as they’re the ones experiencing it. They often know the solutions and then organizations like yours usually have the resources to execute on goals, so that partnership is so important. 

Dr. Adams Kellum: I’m glad you bring up that component, because there’s an amazing person, Dawan Moses, who worked closely with me at St. Joseph Center (SJC) and then eventually on the launch of Inside Safe. We were the team at SJC that went to Venice Beach during the COVID-19 pandemic and housed all the people living in the encampments there as a result of increased community concern regarding the growing encampments and concern for the wellbeing of the people living in those encampments. It was a real challenge. During COVID, people were encouraged to remain in their tents to stay safe and prevent further spread, which meant large encampments grew, particularly on Venice Beach. Taking on something of that scale required real risk because when you try to address a problem that no one has taken on before, there’s always the possibility you won’t succeed. And failure brings criticism. But Dawan and I have always felt this work is our calling and purpose, so we stepped into it wholeheartedly.

One of the core elements of our model at St. Joseph Center and what later informed and shaped Inside Safe is that we go into encampments before “move-in day” and ask people a key question regarding housing and services: “What would get you to accept housing? What are you willing to say yes to?”

Some people say, “I’ll go to shelter as long as I can bring my dog.” Others say, “I’ll accept interim housing if my partner can come with me.” Others say, “I will accept a motel room if it’s nearby because of my job or medical appointments.” When you ask that question and when we have the ability to bring the right resources together, we can often move toward a successful move-in day. And by the following week, that area is no longer an encampment.

But we must provide an option that actually aligns with what people said they would say yes to. That is how someone decides to give up a tent that has been their home. From there, they work with the team to gather all their belongings. There is a lot of concern about how people in encampments are treated and rightfully so. Those spaces have been their homes, and they hold their valuables and personal items. When teams conduct what are referred to as “sweeps,” people lose everything over and over again, and that destroys hope.

So the key component of Inside Safe is pre-engagement. It’s about building a relationship, asking people what they would say yes to, and then walking with them as they pull together their documents, get their IDs, and gather their belongings. It’s a humane, respectful partnership from start to finish.

IHH: Who do you see as the most important collaborators for organizations working to end homelessness?

Dr. Adams Kellum: I truly believe in collaboration. It is absolutely key to ending homelessness. The partners I’ve found to be most essential are:

1. Nonprofits — They are the boots on the ground, doing daily outreach and engagement, move-in assistance and case management.

2. Government entities — They establish policy and often provide the sustainable resources, like housing, that are critical.

3. Developers — They can design and build housing models tailored to unique populations and incorporate on-site mental health or healthcare services, which is hugely important.

4. The business community — Their involvement brings credibility, visibility, and broad public support.

In Los Angeles, when United Way launched the Home For Good campaign and in 2018 the Everyone In initiative, it truly took all of these partners; the business community, nonprofits, philanthropy, elected officials, government agencies, faith leaders everyone coming together to say, “everyone deserves to be inside.” The goal of both initiatives was to align resources, streamline access to housing, and support people in staying housed for good. That required multidisciplinary teams and real coordination among all these entities.

Collaboration with the business community helped bring in broader community support because the public saw that respected business leaders led by the Los Angeles Chamber of Commerce, and local influencers were standing behind a shared solution. That created a sense of hope.

It was also during this period in 2017 that the people of Los Angeles demonstrated a real commitment to addressing homelessness humanely and investing in sustainable, proven solutions. This was evidenced by Angelenos voting to tax themselves through Measure H and some 7 years later approving Measure A.

When we collaborate and align resources, we not only increase our chances of success, but we also gain the ability to identify what isn’t working, take collective ownership, and use data to adapt and improve.

IHH: It really is such an all-encompassing effort that requires buy-in from everyone, whether you’re part of this field or not. 

Dr. Adams Kellum: Absolutely. Churches, in particular, are a vital part of the emergency response system. They often receive very few resources and rely heavily on their parishioners and congregants to step in and support the work. The business community is also on the front line, both experiencing the challenges associated with street homelessness and serving as an important part of the solution. Many business leaders are extraordinary thought partners who bring fresh ideas and influence.

Philanthropy plays a critical role as well, helping to support innovation and early-stage models that are not yet fully tested, like our work on Venice Beach, which the Hilton Foundation helped fund. These are the types of partnerships we need in order to bring everyone together.

And, of course, we cannot do this work without elected officials and government entities. One-time solutions can help in the moment, but long-term sustainability is what truly moves the needle.

IHH: Given that the Initiative on Health and Homelessness is based in the School of Public Health, what do you think is the role of public health in addressing homelessness?

Dr. Adams Kellum: Homelessness is a public health crisis. We saw this clearly during the COVID-19 pandemic. In Los Angeles County, 66,000 people were experiencing homelessness, and 70% were unsheltered at any given time. Then we asked people to stay home, avoid gatherings, shower regularly, and wash their hands. Yet thousands of vulnerable individuals had no safe place to sleep, no place to shower, and no access to basic hygiene. This only deepened their vulnerability.

Many people who are unhoused live with chronic illnesses that go untreated, making it even harder to survive on the streets. This is why we see 7 unhoused people dying in Los Angeles County every day. Homelessness is undeniably a public health emergency.

Los Angeles’ response has been to bring collaborative partners to the table by highlighting the chronic health conditions and severe mental illness often seen among people who have been on the streets for years. Emergency rooms, hospitals, and street medicine teams have become key partners in this effort because when community members see an unhoused neighbor in distress, struggling, unresponsive, or not doing well, they call 911 or contact an outreach agency. That places ERs, hospitals, and street medicine teams on the front lines of this crisis.

Los Angeles has taken an important step by embracing the idea that housing is health. When we place people in housing, we immediately begin addressing their health conditions simply by giving them safety, stability, and an environment where care is accessible. This is why the Initiative on Health and Homelessness at the Harvard Chan School of Public Health is such a vital endeavor. I am truly honored to be part of a model that brings together health and homelessness, recognizing them as deeply interconnected areas requiring coordinated intervention.