An Infant's Death and the California Family Homelessness Crisis
The modern crisis of homelessness began in the 1980s, when the cost of housing began to rise faster than wages for many Americans. Nationally, 11 million low-income households use at least half their income for housing. This was the case for Frost and her family.
FRESNO, Calif. -- Akifa Frost was without a home to call her own for nine months.
Her eldest child, now 2 years old, was also homeless in Fresno with her, along with her baby girl -- who died this summer.
Tears rolled down Frost's cheeks as homeless advocate Dez Martinez with Homeless In Fresno/We Are Not Invisible talked about when then-pregnant Frost was found one cold, rainy day in November while food was being given to homeless people on the streets of Fresno.
She crawled out of a sleeping bag," Martinez said, "and a baby crawled out behind her."
The former foster youth lost the apartment she was living in with her children's father the month prior, last October.
This spring, at 9 months pregnant, Frost spoke at a Fresno City Council meeting, pleading for help.
"I know a lot of people say, 'Oh, go to the Poverello House. Go here, go there.' First of all, we've tried," Frost told the council. "I've been going down there multiple times. I'm on a budget. I'm 21 years old. I got another child on the way in two weeks.
You think I want to be out here on the street? You guys tired of seeing homeless people? Guess what, we're tired of being homeless."
Frost gave birth to her second child, Naszar'ie "Zar'ie" Butler, while homeless.
Her baby girl died July 14 at 3 months old.
Zar'ie is remembered as a good baby who rarely cried or smiled, "she'd just look at you."
Her funeral was held at First Congregational Church of Fresno, United Church of Christ (Big Red Church) in August.
This really is a tragedy, and it's OK to say that it is," a pastor said during a eulogy for Zar'ie. "It's one that breaks even the very heart of God."
Homeless Families in Crisis
Homelessness is often more complicated for families. There are far fewer homeless shelter beds and low-income housing units in Fresno than are needed to meet the need, and among those already limited resources, there are even fewer spaces available for homeless families with children, especially large families and those with fathers or teenage boys.
Frost did receive some help, including stays at two homeless shelters, but still spent months on the street. She said she was made to leave shelters during the day with her newborn baby and toddler, even after a doctor told her she needed weeks of bedrest following a high-risk surgery. She ended up having a pulmonary embolism, a blood clot in her lungs that nearly killed her.
Martinez recalled watching hospital staff try to find Frost a place to go once discharged from the hospital a second time this year, somewhere she could rest with her two children. They called homeless shelters from Madera to Visalia, to no avail.
There wasn't nobody able to take Akifa with the one-and-a-half-year-old and the newborn," Martinez said.
How Many Homeless Families Are in Fresno?
Part of the lack of shelter beds is because of limited data -- and subsequently, limited funding.
Much of what is known about homeless individuals in Fresno comes from a count of them one day each year in January by the Fresno Madera Continuum of Care, called the Street and Shelter Point-in-Time Count.
The most recent count this year showed 1,152 homeless people in the city of Fresno -- nearly half of the 2,508 homeless counted in all throughout Fresno and Madera counties. Of the total, 241 were families with children: 16 were found on the streets, and 225 in shelters.
Education data shows far more homeless children in Fresno.
There are 5,000 homeless students from kindergarten to 12th grade in Fresno County, according to the Fresno County Office of Education. Of those homeless children, Fresno Unified School District said 368 currently attend its schools.
There's also a database shared by a number of homeless service providers, called the Homelessness Management Information System (HMIS), where homeless outreach teams in the Fresno area input information about people they encounter.
That system shows that of 966 people counted in shelters this year, 103 were families, and of 929 counted on the streets, 15 were families.
Far more families received rapid rehousing support. Of 967 homeless who received this help, 583 were families.
These HMIS numbers are from October through the end of August, the most recent available (the federal fiscal year ends Sept. 30), said Laura Moreno, program manager of Fresno County Department of Social Services' Program Development and Grants.
Typically with families, we don't even want you in emergency shelter," Moreno said. "We move them right into rental assistance."
But data also shows there aren't enough affordable housing units in Fresno to meet its need, which means some people don't have a place to go. Only a small percentage of housing available through the Fresno Housing Authority is set aside for homeless. Fresno County has one of the highest rates of unsheltered homeless in the nation.
Nicole Linder, executive director of the Marjaree Mason Center, which operates shelters in Fresno and Clovis for survivors of domestic abuse, said homeless families with children aren't as visible as many chronically homeless on the streets, making them harder to count, but that she knows the need is far greater than statistics show.
"We're very specific -- to support victims of domestic violence," Linder said about the Marjaree Mason Center, "but we have people every day coming to our door that just need homeless assistance."
Linder last year co-wrote a letter with Ambra Dorsey, executive director of Fresno Unifed's Department of Prevention and Intervention, to Mayor Lee Brand and the Fresno City Council expressing concerns that many homeless families "don't often make it on your radar or into data sets that are often presented to you."
Matt Dildine, executive director of the Fresno Rescue Mission, said Fresno has difficulty defining the problem.
We spend so much time focused on who shows up on the PIT (point-in-time) count," Dildine said, "and so much money and attention gets attributed to that group, that sometimes I fear that we ignore Fresno's bigger population, which is people who are in deep, deep cyclical poverty that float in and out of being homeless. ... That population is so much bigger than who will show up in a point-in-time count."
Martinez said she's aware of many homeless families living out of their cars, and that she's seen more of this over the past half year as rent costs have risen in Fresno.
Fresno Police Department and Fresno County Sheriff's Office officials say it's rare to see children on the street in homeless encampments (4,697 camps were cleared in the city of Fresno between January and September). But officials say finding evidence of kids having been there happens a little more often.
Fresno County Child Welfare Services looks into reports of homeless children, but children are taken from their parents only if something has reached an "unsafe level," said Tricia Gonzalez, its deputy director.
It's definitely an issue we face in the Valley disproportionately," Gonzalez said about homeless children. "And we know the majority of families are doing everything they can to get any resources to take care of kids and keep them safe. Our goal is to help them with what those options are when they come to our attention."
Gonzalez said her department doesn't keep statistics about homeless children, but that they would fall under the general neglect category, and "very few" of 1,621 substantiated allegations of neglect last year involved homeless children.
Frost isn't the only pregnant mother to find herself homeless on the streets of Fresno this year.
Martinez said she is aware of three other homeless pregnant women on the streets of Fresno now with children.
This summer, The Bee interviewed another homeless woman for a story about homelessness, who said she wanted to get off the streets but the city runs out of shelter beds each night.
"The shelters are first-come, first-serve. I know I should think about myself, but I see a lot of women and their children out here," Natasha Hernandez, then seven months pregnant, told reporter Manuela Tobias for a story about homeless housing options in Fresno.
So I let them take my spot because they need the help more than I know I do. I know I need help as well but their children are with them right now. I'm pregnant so I still have some time."
Pregnant on the Streets and the Death of a Baby
Frost was first homeless as a teen, when she ran away from home after her father died and her mother was in and out of prison. She said she stole food and toiletries from stores to survive. She ended up in juvenile hall and foster care.
Frost said she learned at a group home in Fresno that, "You got to understand that the things you do have consequences, whether they are good consequences or bad consequences, but every action has a reaction."
She went back to school, got her high school diploma, and was attending Fresno City College with dreams of going into the medical field.
"Even though I felt like the system failed me in a lot of ways," Frost said, "I got a lot of help through the system, as well."
Frost reached out for more help last October when she lost her apartment, and she received some.
She stayed at the Sanctuary Transitional Shelter in downtown Fresno for young adults, run by the Fresno Economic Opportunities Commission, and later, Rescue the Children, part of the Fresno Rescue Mission. There were also stays with friends and family, and in motel rooms for periods of time.
Frost said she was asked to leave the EOC Sanctuary after a disagreement, but was able to return there later. She went to Texas to stay with family, then returned to Fresno in February for doctor appointments.
In March, a sheriff's deputy found the then-pregnant Frost and her young daughter sleeping in front of a Fresno courthouse. They were taken to Rescue the Children.
I was waiting for shelter," Frost said, "so I was happy to go."
Not long after, she gave birth to Zar'ie in early April. It was a complicated pregnancy and birth involving a high-risk cesarean section. She said a doctor told her she needed six to eight weeks of bed rest without heavy lifting.
But when she returned to Rescue the Children, Frost said she was told she could stay there only at night and was made to leave during the day with her children. She was staying in its emergency services shelter, not its 12-month residential program.
Frost said a shelter worker told her that "I had two C-sections and I came right back to work, and our rules are our rules. You have to be up and ready to go."
"I said, 'OK, whatever.'"
A couple weeks later, Frost had her pulmonary embolism. Frost said she was then offered a respite bed at Rescue the Children, but that she could have only her newborn with her.
"Because I couldn't split up my family, and I wasn't sure where my kids were going to go, or whether I'd be able to be there, we chose not to go back to Rescue the Children," Frost said.
Frost said her daughters went to live with a friend for over a month while she was again on the streets until a family room opened up at the EOC Sanctuary. Soon after, she said, she found housing with help from homeless service providers and was put in a hotel room while she waited to move in.
They put us into a hotel and the next morning, my daughter did not wake up," Frost said.
Frost said despite being homeless, her baby never went hungry, but she did have trouble breathing.
Frost thought it might be asthma and took Zar'ie to the hospital. She said a doctor said the baby was too young to determine if the issue was asthma, but the trouble breathing was "probably just air quality outside -- she's small and it's hot outside."
She wonders if that air quality, along with living conditions while homeless, contributed to her daughter's death. Frost said she doesn't use drugs.
The Fresno County Coroner's Office said Zar'ie's cause of death is still pending. Spokesman Tony Botti said baby autopsies often take half a year to complete, but that "we don't expect anything suspicious to surface."
Recent tours of Rescue the Children and the EOC Sanctuary showed well-kept rooms and compassionate staff. Leaders at these shelters couldn't comment specifically on what happened to Frost without violating privacy policies, but stressed their devotion to helping homeless.
Rescue the Children said while some homeless are asked to leave during the day -- if housed through emergency services versus programs with longer stays -- a mother with a newborn baby who didn't want to leave wouldn't be forced to go. They said transportation is provided to homeless, and decisions about respite care are made by an outside health care group.
Transportation is also provided at the EOC Sanctuary, where residents have to leave during the day, unless they are hanging out in the facility's drop-in center. EOC Sanctuary leaders said a disagreement between individuals at their drop-in center wouldn't result in someone being banned from their room or asked to permanently leave, except in serious circumstances.
Shelter Beds -- Then and Now
This summer, Fresno opened its first low-barrier emergency homeless shelters, also referred to as triage centers -- 127 beds between Turning Point of Central California (67 beds), Mental Health Systems (50 beds) and Poverello House (10 beds) -- but only 50 of these beds, with Mental Health Systems, can be used for families with children.
Turning Point said it doesn't take children in its emergency shelters because of the way they are configured -- not wanting kids to sleep beside adults who aren't in their family.
The new low-barrier shelters, where people don't have to meet certain requirements to get a bed, filled almost as quickly as they opened.
They were opened with about 40% of new state dollars given to the Fresno Madera Continuum of Care (it received nearly $11 million in all) and about half of what the city of Fresno received ($3.1 million) this year via the Homeless Emergency Aid Program (HEAP) and California Emergency Solutions and Housing (CESH). The city received only HEAP dollars. The continuum asked the county to serve as the administrative entity for its new state funds.
Almost all Fresno shelter beds previously available for families with children were at two places: The faith-based Fresno Rescue Mission and the 162-bed Marjaree Mason Center, which serves only survivors of domestic abuse.
The Fresno Rescue Mission's Rescue the Children campus was its only shelter designed for families with 48 emergency services beds for women (soon to be moved downtown) and 45 residential beds for women in a program, both with or without children.
Dildine, its executive director, considers the emergency services beds to be low-barrier. There are another 48 of these beds at the Fresno Rescue Mission's downtown campus that are in the process of being converted to a new family center that can take fathers with children, although some families were already sheltered downtown. The overflow shelter will remain, which has accommodated anywhere from 20 to 40 people a night, Dildine said.
More than half of the Fresno Rescue Mission's 400-plus beds are residential beds for men.
The Fresno Rescue Mission doesn't get state dollars.
New state funds in Fresno also added "bridge beds" for people with a housing plan, including those who just need somewhere to stay while waiting for an apartment. The continuum funded 33 of these at Mental Health Systems, and 12 at Fresno EOC Sanctuary, for $1.9 million.
The city designated about a fifth of its dollars for homeless families and children: $314,000 for family services, and $300,000 for youth services. That will add four bridge beds at the Fresno EOC shelter, two rooms (12 beds) at the Marjaree Mason Center, and additional services there and at the Poverello House and Saint Agnes Medical Center.
Other new homeless resources, while not earmarked specifically for families, can also help them. This includes the continuum's remaining $4.5 million state dollars going primarily to WestCare for efforts such as diversion -- helping people on the brink of homelessness remain in their homes, or helping them move to other housing -- and staff to get people rapidly rehoused.
Priorities: How important Are Homeless Families to Fresno?
A vulnerability screening tool, called VI-SPDAT (which can be reviewed and downloaded below), is used by many to prioritize who gets services first by looking at a number of risk factors. Families with children don't necessarily go to the top of the list.
At the Marjaree Mason Center, Linder said clients are often placed low on the list because they don't score high in certain areas, such as how long they've been homeless.
How new state homeless funds were divided in Fresno was largely informed by a report released in September 2018 called "Street2Home Fresno County: A Framework for Action," prepared by Barbara Poppe and associates. The report was engaged by the city of Fresno and Fresno Housing Authority, and funded by the latter.
Later, Fresno County drafted a list of 14 homelessness priorities using input from county departments and rural communities whose representatives didn't feel included in the Street2Home report, said Sonia De La Rosa, principal analyst with the Fresno County Administrative Office. Those priorities were adopted this year by 15 incorporated cities in Fresno County, including Fresno.
One difference: The Street2Home report focuses on chronic homelessness and single individuals, and the county-drafted 14 priorities does not, De La Rosa said.
Two of the priorities apply directly to families: "Increase transportation to outpatient programs and regular prenatal/medical care for pregnant and parenting women and children who are homeless" and "Priority access to emergency housing for pregnant and parenting women and their children, also families with children with significant medical issues, as it is difficult to manage the continuum of care when the family is homeless."
Linder wonders what will be used in the future -- the 14 priorities, or the Street2Home report -- in funding additional homeless services. She called them "very, very different reports."
If you don't put something as a priority and it's costly, there are very little incentives to create the most expensive social service project," Linder said of sheltering homeless families.
H Spees, director of strategic initiatives with Mayor Brand's office, said the reports are compatible and that the priorities are a "more specific version of what appeared in the Street2Home report."
Preston Prince, executive director of the Fresno Housing Authority, said, "we don't mess around when there are children on the streets."
As an example, he talked about how a homeless mother with a child under the age of 1 were put in a motel and given groceries within an hour of an outreach member contacting the woman after Prince got a call from a city councilmember, who saw the mother and daughter on the streets.
"I feel like that is Fresno," Prince said.
But some other service providers said while they don't doubt anyone's heart when people say homeless families are a priority, the way homeless dollars are divided tells a different story.
Fresno City Councilmember Esmeralda Soria, a member of Gov. Gavin Newsom's new homeless task force, said more support is now going to homeless families, and what existed before "didn't cover the gaps that existed with current populations -- one of them being women and children."
Yet Soria and homeless advocates say there is still a gap.
Fresno's work to address homelessness is only starting to make a "little dent" in a large problem, Soria said.
Lack of Affordable Housing
A lack of affordable housing in Fresno was cited as a major cause of homelessness by over 20 people interviewed for this story.
The Street2Home report called this a "severe lack" in Fresno County. The county needs 41,108 more affordable rental homes to meet the needs of its lowest-income renters, the report states.
There are only 24 affordable units in Fresno County for every 100 households with extremely low incomes (earning at or below 30% of area median income).
Rent costs are rising faster in Fresno than most U.S. cities, with an increase of 6.2% between March 2018 and March 2019 -- a higher percentage spike than every other large California city except Oakland.
Plus, there isn't enough of what does exist. Fresno has a low vacancy rate, estimated around 2% for rentals.
The modern crisis of homelessness began in the 1980s, the report continues, when the cost of housing began to rise faster than wages for many Americans. Nationally, 11 million low-income households use at least half their income for housing.
That was the case for Frost and her family. Frost receives assistance from CalWORKS, a state program for some families with children, operated by county welfare departments. She thought that funding would have helped her find a new apartment more quickly after becoming homeless in the fall.
Moreno with the county said people working to help homeless in Fresno "are all aware if they run into someone, the first question they will ask someone is, 'Are you on CalWORKS?' And if you have a child, you most likely are eligible for CalWORKS."
Frost said that didn't happen in her case. She was homeless for nine months before getting her apartment.
The Fresno Housing Authority, a public agency that provides housing assistance to low and moderate-income families, is one place homeless individuals can turn for help. But only a small percentage of rental assistance vouchers the authority provides each year are for homeless, about 600 of 13,000 vouchers. And only 158 of nearly 4,000 units the authority owns and manages are dedicated to permanent supportive housing for homeless.
Close to 100 new units will be built for homeless or those at risk of homelessness with a mental health disorder using over $14 million No Place Like Home dollars awarded to the Department of Behavioral Health. The properties are being developed in partnership with the Fresno Housing Authority and others.
The lack of affordable housing impacts the most vulnerable first, said Dawan Utecht, behavioral health director and public guardian.
When there is a lack of affordable quality housing, we are the canary in the coal mine," Utecht said. "Our people (those the behavioral health department serves) are going to end up on the street first, but it impacts everyone."
One of these vulnerable populations are former foster youth. Twenty percent of former foster youth age 18 and older are homeless, the Street2Home report states. Frost was among them.
Housing help is available for former foster youth up to the age of 24 in Fresno County, said Maria Ramiu, senior staff attorney at the Youth Law Center based in San Francisco, but there is a "lack of understanding" about that.
There are "several counties who place the onus on the young people to secure housing" although the agencies have an obligation to help, Ramiu said.
Frost said the father of her children previously tried to get help through this extension.
"He had tried before and they said, 'You're already 21,' stuff like that," Frost said.
Frost was told she is not eligible for the same help because she exited the foster care system shortly before turning 18 to live with her mother.
Fresno's Future: More Work Needed to End Homelessness
Utecht said it's easy for communities to identify homelessness as a problem of mental health or substance use, but those factors usually just complicate the issue, and some homeless turn to substance use once on the street because of a feeling of hopelessness.
We really have to go upstream," Utecht said, "and as a community face the realities of, 'How are people ending up homeless?'"
One tool she utilizes to help is called the Multi-Access Agency Program (MAP) that her department pays several partners to administer. Utecht said she hopes this tool, which acts like Google -- it helps people find resources, but doesn't have any -- will be expanded and utilized more in the future. It was started by the Fresno Housing Authority at the Poverello House a handful of years ago.
But this database isn't an exhaustive list. Neither are the shared lists of current homeless and their needs. Only some service providers have to input this data into a coordinated entry system, the ones that receive government funds.
Compiling a comprehensive list of resources has been a struggle for years, Prince said, because it "feels like it's shifting all the time."
Centralizing efforts and growing partnerships among service providers was cited as one of four main recommendations, called "pillars," in the Street2Home report: "1. Engage community and align resources. 2. Reduce inflow to homelessness. 3. Improve crisis response. 4. Expand permanent housing options."
The good news: Partnerships between homeless service providers do exist, many facilitated by the Fresno Madera Continuum of Care.
"It is through collaboration that we will solve this problem," Prince said.
To this aim, De La Rosa said a new working group is planned using the 14 priorities as a starting point, which are not all-inclusive. It was approved by the Fresno County Board of Supervisors this month.
If we have any hope of solving the problem," Utecht said, "the leaders in our community have to use their authority to be accountable for the problem, and I consider myself one of those leaders."
More state homeless dollars will be available next year, with Fresno expected to receive a little more than it did this year, and the region has made strides in reducing its number of homeless.
Fresno has seen a 60% reduction in homelessness between 2011 and 2017, "tremendous progress" compared to other West Coast cities, the Street2Home report states. Yet there was a rise in homelessness of about 5% between 2017 and 2018, and an increase of nearly 9% in unsheltered homeless, although chronic homelessness decreased by about 38% during the same period.
Soria said the Unhealthy and Hazardous Camping Act ordinance passed by the city of Fresno in 2017 pushed homeless "into the shadows or into places that can become dangerous," such as sleeping alongside highways, which are outside the city's jurisdiction.
Fresno County Sheriff's Office Sgt. Melissa Voisenat said the number of homeless in rural areas seems to be growing over the past several years, with more increasingly moving west and south outside Fresno since the mid-1990s.
Voisenat and Fresno Police Lt. Robert Beckwith said space has been available at shelters for the homeless they transport. Martinez and Frost said it's a different experience for homeless who bring themselves there, who are often told there's no room.
It shouldn't take me to lose my child or to complain about living situations in order to get help," Frost said, "and nobody should have to go through that, especially the ones that are out here on the streets with their kids."
Spees said data suggests most homeless families are experiencing situational, rather than chronic, homelessness, and that Fresno is already "really good at addressing those types of situations quickly." He cited Rescue the Children as an example of this.
But for those with concerns about that shelter, such as Frost and Martinez, there aren't many other options. And getting more shelter beds elsewhere in the city isn't likely unless Fresno gets more data that shows a greater need.
"Strengthen the data foundation -- what gets measured, gets done," is one goal in the Street2Home report. Spees acknowledges there are flaws in what exists now, but said it's the best that currently exists.
Community leaders say more money is also needed. Soria said more is especially needed from the federal government, which "hasn't done much on this issue."
Soria said local leaders have to be careful how much they ask residents living "paycheck to paycheck" to contribute to address homelessness, since Fresno already has so many needs. "It's hard to expand a pie that is so small."
Jennifer Chou, an attorney with the American Civil Liberties Union, said the ACLU has had a number of cases around homelessness in Fresno over the years, including a $2.5 million class action settlement in a case filed in 2006 over the seizure and destruction of homeless individuals' personal property.
Chou called Frost's story "a good example of the need for really specific services for families with children."
Emilia Morris, legal director of Central California Legal Services, said homeless service agencies don't have enough staff to effectively operate a system that is "so complicated and requires so much expertise."
They are just not equipped to navigate this really complicated system," Morris said, "and it's heartbreaking because with so few people able to, or available to, assist them, there are always going to be people who fall through the cracks."
What happened to Frost, Morris said, is "a tragic example of this happening."
How We Reported This Story
This story began with a news tip that a homeless baby died in Fresno.
It evolved into a two-month investigation into what help is available for homeless families with children in the city, highlighting challenges and concerns from those interviewed. Its intent isn't to blame an individual or group for the baby's death.
We interviewed 28 people over two months, and have included information from reports and budgets utilized by Fresno city and county, and homeless services and education data. Those interviewed include Fresno county and city leaders, providers at shelters and agencies, law enforcement officials, homeless advocates and attorneys, and homeless individuals.
You can support this work and other Fresno Bee investigations with a digital subscription.
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Review and download the vulnerability screening tool VI-SPDAT: