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Floyd Howard Jr. calls it his comfort zone — a canopy-covered courtyard in the heart of Skid Row where he can charge his phone, smoke a cigarette and catch up with friends.
At Skid Row Care Campus, homeless residents chart their own path to services
It’s also the centerpiece of what Los Angeles County administrators say is the nation’s first community-designed homeless services campus.
The Skid Row Care Campus opened in May on a 36,000-square-foot site near downtown Los Angeles. It’s the first county program to formally incorporate input from people living in Skid Row, according to officials, including so-called “harm-reduction” programs that focus on keeping drug users safe and alive.
“It was imperative that the plan be designed by the community to repair the harm done by decades of plans that did not involve people who live in Skid Row,” said Molly Rysman with L.A. County’s Department of Health Services.
The care campus is funded with nearly $26 million a year in local, state, federal and private dollars over the next two years. About 2,000 people visit the new campus each day, according to Homeless Healthcare L.A., the main nonprofit staffing the campus.
Although it’s only been open a few months, the center appears popular with unhoused Angelenos who desperately need a place to rest. Last month, one woman visited the campus for her first shower in months, she said, after receiving a buprenorphine injection to help her stop using fentanyl.
But some nearby business owners complain of more drug activity on the street since the facility opened.
Howard, a longtime Skid Row resident, said he visits the campus often to pick up the testing strips he uses to check his crystal methamphetamine supply for fentanyl.
Sometimes, he drops by for art classes or acupuncture treatment.
“It’s like a safe haven,” he said.
Centering the community
The site provides a range of services, including showers, laundry, medical care and housing referrals. Booths line the south side of the plaza, where a rotating cast of representatives from the county’s three health departments provide pop-up services to connect people with addiction treatment or case management.
The primary clientele are the more than 1,800 unsheltered people living on the neighborhood’s streets who — despite the large concentration of homeless programs in the area — have access to few public restrooms and public gathering spaces.
The campus is the result of an initiative called the Skid Row Action Plan, a $280 million effort to expand services and housing funded by L.A. County, the city of L.A. and the state.
L.A. County Supervisor Hilda Solis launched the initiative in 2022 to address historic racism and disinvestment in the neighborhood, where the majority of the unhoused population is Black.
“Engaging the community was not just important; it was essential,” said Solis, whose district includes Skid Row. “Their voices must guide the path forward. Real transformation can only be led by those who live this reality every day.”
A committee of 10 current and former Skid Row residents collaborated with government agencies in 2023 to come up with recommendations for the plan in 2023. That group, known as the Skid Row Action Plan Resident Advisory Committee, recommended the new campus.
They said they wanted a fun community space where they could connect with services and a place where drug users can pick up harm reduction supplies, such as clean needles or pipes, overdose reversal medication and drug testing strips.
As a member of the advisory committee, Skid Row activist General Dogon said he pushed for the campus entrance to be staffed by “community ambassadors,” rather than private security guards.
“Uniforms don’t go good with homeless people,” said Dogon, an organizer with the L.A. Community Action Network. “We want everyday faces to be at the door, not some G.I. Joe in a uniform.”
General Dogon observes an encampment sweep along a block of Skid Row.
L.A. County officials said input from members of the unhoused community is sometimes ignored, and they are not properly compensated for their efforts. So authorities said they wanted to take a different approach at the care campus.
After the Skid Row Action plan started taking shape, the county hired an additional eight unhoused or formerly unhoused people to serve on resident councils for the Skid Row Care Campus. Each is paid a $10,000 consulting stipend and tasked with surveying other community members about what’s working and what isn’t. They also provide training and technical assistance for the campus’ programs.
“I like the fact that it’s focused from the ground up and not the top down,” said Dwight Wilson, a member of a resident council. “It wants to incorporate the actual feeling of the people in the community that need the resources.”
Even the name, “Skid Row Care Campus,” came from the community. It was suggested by Henriëtte Brouwers, associate director of the L.A. Poverty Department, a nonprofit arts organization and theater group that’s been in Skid Row since 1985.
“ People often talk about Skid Row like it’s a bad place; they don’t care to find out why it’s here,” Brouwers said. “But people recover when they build relationships, and you build relationships when you care about somebody.
“I think if we want to end homelessness, we need to actually care.”
An estimated 3,593 homeless people live in Skid Row, including those in homeless shelters, according to the region’s latest count. While the overall unhoused population in the neighborhood has declined by 27% since 2022, the remaining population faces greater health risks, according to survey data.
About 41% of the people in Skid Row’s unhoused population have a serious mental illness, such as schizophrenia, bipolar disorder or post traumatic stress disorder. Roughly 31% deal with substance use disorder, and 26% claim a physical disability.
To meet some of those needs at the Skid Row Care Campus, the nonprofit health agency John Wesley Community Health Institute runs an on-site clinic and a 48-bed board-and-care facility, which provides permanent housing to people who need help with basic activities like dressing or eating. It’s moving in residents this week, according to county officials.
In several months, Skid Row’s first-ever methadone clinic will open here.
Case workers from the county’s three health departments, LAHSA and other departments rotate through booths within the main courtyard of the Skid Row Care campus.
People can check in at the medical wing, which includes a clinic, a harm reduction dispensary and dozens of respite beds. The first methadone clinic in Skid Row is expected to open there this year.
Harm reduction
Many programs at the facility focus on harm reduction, a public health approach that recognizes addiction is a health condition and that some people aren’t going to immediately quit using drugs.
Harm reduction interventions typically focus on minimizing the negative health effects of drug use.
Public health officials and addiction experts say there is ample evidence these approaches not only save lives, but can also help people get into treatment or sobriety, connect them with other services or get them off the street.
But harm reduction remains controversial. Some view these approaches as enabling illegal behavior.
Last month, President Donald Trump signed an executive order encouraging the U.S. Department of Housing and Urban Development to give priority for housing grants to local agencies that enforce laws against open illicit drug use.
Trump’s order directs his attorney general to ensure that federal substance use disorder grants do not fund harm reduction programs. It also directs HUD to require people with substance use disorders or serious mental illness to seek treatment before they participate in federal housing and homelessness assistance programs.
Days before the executive order, a Trump-appointed HUD administrator told L.A. County officials at a meeting that he believed the region wasn’t doing enough enforcement and was critical of providing housing subsidies to people who use drugs, according to local officials who were there. L.A. County officials said it’s too early to tell what the actual effects of the new order will be.
Drug overdose is the leading cause of death for unhoused Angelenos, according to the county Public Health Department. Skid Row is home to the largest homeless population in L.A. and the highest rates of drug overdose mortality.
There are no designated safe-consumption sites — where people are allowed to use drugs under supervision — in California, although some exist in other parts of the country. A few years ago, Gov. Gavin Newsom vetoed a state bill that would have allowed them.
On the street outside the Skid Row Care Campus, there are many signs that people are using illicit drugs. But they can’t use them inside the facility. The staff won’t allow it.
Last month, when one woman hit her meth pipe while lounging on the patio, a staff member tapped her on the shoulder and asked her to put it away. She complied.
The Skid Row Care Campus’ main harm reduction provider is Homeless Healthcare L.A., best known for its overdose response teams who roll through Skid Row in Jeeps to pass out supplies like clean smoking kits and naloxone, the opioid overdose reversal drug.
“Harm reduction was created by people who use drugs,” said the nonprofit’s Aurora Morales. “And everything that we do reflects what they need.”
On a recent afternoon, Floyd Howard Jr. folded squares of clean tin foil to be packed into kits for fentanyl smokers, as part of a campus work program.
“People that smoke fentanyl, they use the foil to put their drug on and smoke it,” Howard said. “So it’s safer to get this from them than to just use some off the ground or something that’s not clean.”
Howard added that he’s seen supplies like these save countless lives, including his own.
“If it wasn’t for these people, a lot of people would be dead,” he said. “I have a whole lot of people that I met downtown here that passed from overdose.”
An unhoused couple who go by “Porkchop” and “Angel” prepare to visit the Skid Row Care Campus to take their first showers in months. Both had recently taken long-acting injectable doses of buprenorphine to quit using fentanyl, after years of daily use.
Building community
The care campus sits beside the Umeya Apartments, a 175-unit supportive housing complex managed by the nonprofit Little Tokyo Service Center. Representatives say tenants will start moving in this month.
Most of the site’s neighbors are also homeless services providers. But some business owners complain of increased loitering and drug use outside the campus gates.
“ A lot of people don’t want to come here anymore just because the street is so bad and they’re scared,” said one representative from a nearby business, who requested anonymity to avoid retaliation. “ They should be helping people get off drugs instead of helping them do drugs.”
Morales of Homeless Healthcare L.A. said she’s working on partnerships with local businesses, including sending work program participants to clean up debris in alleyways.
Many unhoused Skid Row residents say they’re frequently denied service and restroom access at local businesses. Some go days without a proper meal and weeks or even months without a shower.
That’s why the care campus is a refuge.
“ They cater to everybody, and they’re not biased about anything,” said Lisa Parizo, a formerly unhoused Skid Row resident who visits the space daily. “If you come in with a dirty shirt, dirty pants, they don’t care. They’re not gonna give you any less attention.”
It’s too early to tell how the care campus may transform this section of Skid Row.
Months after opening, most people living on Skid Row’s streets still haven’t heard of the campus, said resident councilmember Dwight Wilson, whose responsibilities include evangelizing for the site.
“I haven’t run into too many people that have actually been there,” said Wilson. “I’m usually letting them know for the first time.”
Wilson has been living in transitional housing in Skid Row for the past year, since getting out of prison. He saw a listing for this opportunity a few months ago and applied.
He said he’s learned a lot about his neighborhood during the last few months on the job.
“When I was sent down here, I was really upset,” Wilson said. “But actually being down here has been a very humbling experience for me. What I learned is that it is actually a community.”