San Francisco's homeless problem is both long-standing and controversial. In a city where the median single-family home price is now nearly $800,000, a multitude of homeless people still remain on the streets — a discordant fact that blights the landscape and character of this otherwise attractive cosmopolitan city. One of the latest proposals to address the homeless crisis is Mayor Gavin Newsom's Care Not Cash initiative, which finally took effect in May 2004, after the setback of an eventually unsuccessful legal challenge.

Previously, San Francisco offered homeless adults without dependents cash payments through the County Adult Assistance Program (CAAP). After much debate over the efficacy of CAAP, Mayor Newsom promoted Care Not Cash as an alternative, making the proposal the cornerstone of his mayoral campaign. As its name suggests, Care Not Cash offers homeless adults a variety of other resources — e.g., food, shelter, mental-health assistance, plus drug and alcohol treatment — in lieu of a simple cash payout. One of the costliest and ambitious aspects of the program is the pledge to create permanent supportive housing to provide the homeless with a secure place to live, along with a set of built-in comprehensive services. This aspect of Care Not Cash aims to meet the needs of people requiring more in-depth treatment and care.

Care Not Cash was gradually phased in from May to November 2004, but debate surrounds its effectiveness thus far. While Mayor Newsom has declared the program a success, homeless advocates claim otherwise. Full implementation has been hobbled by the defeat of Proposition A, a $200 million housing bond of which $90 million was earmarked for supportive housing. Since Care Not Cash had passed with a clear majority of votes in November 2002, Proposition A's failure on the November 2004 ballot perhaps signaled voter skepticism of such a far-reaching and costly commitment. However, the City is moving ahead with limited construction of supportive housing and San Franciscans will have to suspend final judgment until these limited experiments are in full operation.

To stay current with Care Not Cash developments, visit the Web sites for the Mayor's Office on Homelessness, the San Francisco Department of Public Health's Homeless Services Division, and the City's Department of Human Services.