Policies for dealing with the homeless in American cities have come and gone, but the question remains: Why can't officials fix this problem, after decades of trying?
Some cities have tried to provide additional services for their homeless populations while others have cracked down by limiting panhandling or prohibiting overnight sleeping in public areas.
"I would argue that several prior approaches failed," says Dennis Culhane, professor of social welfare policy at the University of Pennsylvania. He points to unsuccessful policies such as arresting the homeless, and to repeated reforms in the shelter system.
With a renewed energy in the fight against chronic homelessness, downtown revitalization projects have encouraged several cities to crack down on panhandling.
Atlanta Mayor Shirley Franklin has promoted a law that makes it illegal to beg for money near downtown businesses and in tourist spots. Advocates for the homeless are not happy with the policy.
San Francisco has tried various approaches since its homeless population exploded in the 1980s, but the problem only grew.
In 1993, San Francisco Mayor Frank Jordan, a former police chief, activated Matrix, a plan to move the homeless through police action. Next came the 1996 Continuum of Care program, which lasted five years.
Today, San Francisco officials are touting the Care Not Cash initiative, under Mayor Gavin Newsom, which aims to replace cash grants to the homeless with guaranteed mental-health services and housing opportunities.
The programs of the late 1980s and 1990s generally stressed emergency services and shelters, which some researchers see as a failure.
"The early to mid-1990s probably saw a doubling of federal spending on such services, and a near doubling of shelters in the United States, but, alas, shelters don't cause homelessness, so reforming them or even building more of them doesn't do anything to reduce homelessness," Mr. Culhane says. "In fact, perversely, more shelters may only institutionalize the problem."
The Interagency Council on Homelessness, led by Bush administration czar Philip Mangano, has backed a 10-year plan to end chronic homelessness. An increase of $200 million has been allocated for homelessness in the 2005 federal budget.
What are cities doing with the money? The latest buzzword is supportive housing: homes that come equipped with a safety net of outreach workers who are on call to help keep them afloat as they work to re-enter society.
"Individuals change before your eyes," said Janelle Simmons, director of development and communications for the Community Shelter Board in Columbus, Ohio.
Once they have a safe, clean place to live, and they are getting the counseling they need, "they start dressing different, acting different. ... They have a sense of pride that they have a home, and they want to maintain a home," Mrs. Simmons said.
The Christian Science Monitor last year hailed Columbus' approach as "part of a blueprint for cities fighting homelessness nationwide."
The city's Community Shelter Board, a nonprofit intermediary organization funded with private and public money, in 1999 created the Rebuilding Lives program and helped fund 800 new units of permanent supportive housing.
Some analysts are skeptical about "feel-good" approaches to homelessness. "At the core is the understanding that we've been doing homeless services all wrong during the past 25 years," Jeffrey M. Jones, a fellow at the Hoover Institution, wrote in a recent article.
Mr. Jones pointed to "the irresponsible tendency of government to endorse reform schemes on a grand scale that have had only limited success in specific circumstances. The critic can become overwhelmed by the sheer number of bad ideas masquerading as good policy."
A phrase heard often from those who work with the homeless is "housing first." Sister Mary Scullion uses it frequently.
A Religious Sisters of Mercy nun, Sister Mary is the director and co-founder of Project Home, the homeless housing and counseling center in Philadelphia. She personally has led many of Philadelphia's homeless off the streets and into supportive housing.
"Housing is the key issue, but only if you have the right mix of housing and support services," Sister Mary said.
Project Home has outreach workers around the clock who "engage people -- get to know who they are, make contact with them on a regular basis and try to work with them to come in" off the street, Sister Mary said.
Having someone look after them regularly "gives [homeless people] the confidence to come in, and to care about themselves. Relationship-building is key," she said.
"What we can say with great confidence is homelessness is a solvable problem only if we have the political will and resources," Sister Mary said.
Sister Mary said this approach is more comprehensive than the shelter system.
Her team uses three ways to get people off the street, and not every person will get into a supportive housing situation, she said.
The first method, a "harm-reduction model," applies to the worst cases and is the "safe haven" approach. "This is a place where people who might be mentally disabled and addicted can come, and they have to agree to no violence and begin the journey," she says. Here, the homeless are evaluated in temporary shelters.
The second way is the "housing first" approach, which puts people into low-income housing where their rent is 30 percent of their income. "This has proved very successful," Sister Mary says.
The third is "clean and sober housing," for those with active addictions, and involves "working in a group community to get support toward recovery," she said.
Mr. Culhane and others noted that New York has shown a decline in chronic homelessness. Many credit Rudolph W. Giuliani with transforming New York while he was mayor, but Mr. Culhane said improvements have less to do with cracking down on panhandlers and more to do with a "very strong commitment to develop supportive housing for people with mental illness and for people with drug-abuse problems [and] with AIDS."
By the mid-1990s, more than 35,000 subsidized and supportive housing units were built in New York City for the mentally ill and/or addicted, Mr. Culhane said.