For Seattle resident Elisabeth James, the reality check came when a homeless man forced his way into a glass-enclosed ATM lobby with her after she swiped her card to open the door for after-hours access. After a few nerve-wracking minutes, the man left the lobby but stayed outside, banging on the glass. Police were too busy to respond so James called her husband, who scared the man away and walked her home. The man, she believes, just wanted to get out of the rain.
A neighborhood pocket park has become a flashpoint, too: When James took her 2-year-old grandchild there, she saw people injecting heroin.
"I'm not a NIMBY person, but I just think that we can do so much more," said James, who founded an activist group called Speak Out Seattle last year. "I wanted to do something that was effective, that brought frustrated people together to find solutions. We're spending a lot of money to house people and we're getting a bigger problem."
The crisis is not limited to large metropolises. In Oregon City, a suburban, working-class town of 36,000 people, the police department this summer added a full-time position for a homeless outreach officer after roughly half the calls concerned trash, trespassing, human waste and illegal encampments.
The city has no overnight shelters and never had a significant homeless population until about three years ago.
On a recent fall day, officer Mike Day tromped into a greenbelt across from a strip mall to check on a man he recently connected with a counselor, calmed an intoxicated man and arranged emergency care for a man who was suicidal.
"How many social workers have you met that go into the woods to follow up with the homeless population and to help with mental health? This is a bit of a hybrid position, certainly, and maybe it's not exactly the role of a police officer — but it's a creative approach to find a solution to the problem," he said.
The question was, "What can we do differently? Because right now, it's not working."
All along the West Coast, local governments are scrambling to answer that question — and taxpayers are footing the bill.
Voters have approved more than $8 billion in spending since 2015 on affordable housing and other anti-homelessness programs, mostly as tax increases. Los Angeles voters, for example, approved $1.2 billion to build 10,000 units of affordable housing over a decade to address a ballooning homeless population that's reached 34,000 people within city limits.
Seattle spent $61 million on homeless-related issues last year, and a recent budget proposal would increase that to $63 million. Four years ago, the city spent $39 million on homelessness. Sacramento has set a goal of moving 2,000 people off the streets in the next three years and may place a housing bond before voters in 2018.
Appeals for money have angered residents who see tent encampments growing in their cities despite more spending.
"Those are like whack-a-mole because they just sprout up and then they disappear and then they sprout up somewhere else," said Gretchen Taylor, who helped found the Neighborhood Safety Alliance of Seattle in 2016.
Seattle is initiating competitive bidding among nonprofit organizations for city dollars going toward homelessness programs. It's also pouring money into "rapid rehousing," a strategy that houses people quickly and then provides rental assistance for up to 18 months.
Like San Francisco, Seattle has started opening 24-hour, "low-barrier" shelters that offer beds even if people are abusing drugs, have a pet or want to sleep together as a couple. But the city's first 24-hour shelter has only 75 beds, and turnover is extremely low.
A team of specially trained police officers and social workers has also been visiting homeless camps to try to place people in shelter. After repeated visits — and with 72 hours of notice — the city cleans out the camps and hauls away abandoned belongings.
These efforts are starting to yield results, although the overall number of homeless people continues to swell.
Nearly 740 families moved into some type of shelter between Oct. 2016 and Aug. 2017, and 39 percent of the people contacted by the new police teams wind up sheltered, according a recent city homeless report. That's an improvement from a 5 percent shelter rate 18 months ago, said Sgt. Eric Zerr, who leads that effort.
But the approach has its detractors. The American Civil Liberties Union filed a lawsuit alleging the sweeps violate the constitutional protections against unreasonable search and seizure. And a debate is raging about whether the sweeps are necessary "tough love" or a cruel policy that criminalizes poverty in a city with a reputation for liberalism.
"When a city can't offer housing, they should not be able to sweep that spot unless it's posing some sort of significant health and safety issue," said Sara Rankin, a professor with the Homeless Rights Advocacy Project at the Seattle University School of Law.
"If someone doesn't have a place to go, you can't just continue to chase them from place to place."
Above all, the West Coast lacks long-term, low-income housing for people like Ashley Dibble and her 3-year-old daughter.
Dibble, 29, says she has been homeless on and off for about a year, after her ex-boyfriend squandered money on his car and didn't pay the rent for three months. Evicted, Dibble says she lived in the back of a moving truck and with several different friends around Seattle before winding up on the streets. She sent her toddler to live with the girl's paternal grandparents in Florida.
She and her new boyfriend were sleeping under tarps near Safeco Field, home of the Seattle Mariners, when an outreach team referred them to a new shelter. Now, Dibble talks to her daughter daily by phone and is trying to find a way back into housing so she can bring her home.
With an eviction on her record and little income, no one will rent to her.