Safe streets
Safety comes first. Violence isn't tolerated, sidewalks and parks aren't anyone's permanent campsite, and the border is controlled. Once that floor is in place, each city can run itself however its residents want.
A big reason people with severe mental illness end up living on the sidewalk is a 1965 Medicaid rule. For adults aged 21 to 64 it won't pay for care in a psychiatric hospital with more than 16 beds, and the exceptions added since are narrow and short-stay. States closed their hospitals and nothing replaced them.
- Repeal the 16-bed rule. Pay for the beds before enforcement starts.
- Commitment standards that cover people too sick to take care of themselves.
- Enforce public camping laws.
- Put police where the trouble concentrates, starting with the blocks around downtown.