There is pretty powerful statistical evidence that when Regan moved homeless services from the federal level to a state responsibility it cratered the numbers of beds (especially in small towns) and created an unsolvable situation in that when you're struggling in your small town who has zero homeless support, you make a move to some place else, somewhere where being homeless is not has bad weather wise and has a bit of infrastructure. So now you have all of the struggling people from "Mainstreet usa" moving toward the main cities all at once (over a couple decades) an essentially a burden on them to deal with EVERYONES homeless problem instead of historically their own.

This problem was working much better in the 70s and 80s when their was a national framework for it. While SF and LA's government is flawed, this blame state/city is like blaming the individual ushers when the fans run on the field after a football upset. It was more of a structural failure than a local.