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A Big Idea: Turn Two Local Crises Into a Regional Homelessness Solution



Fresno Mission CEO Matthew Dildine says it takes big ideas to solve big problems such as homelessness. (GV Wire Composite/Paul Marshall)
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Over the last couple of weeks, two stories — about something other than the weather — have dominated local headlines.

Matthew Dildine


The first concerns the closure of the Madera Community Hospital, an important community resource and sparkling facility. It sits nearly empty, seemingly destined to follow the same path as other failed hospitals that become financial albatrosses and force community leaders to wrestle over what to do next.

The second is a proposal by Fresno City Councilmember Miguel Arias to convert the Fresno Convention Center into a giant 1,000-plus-person congregant homeless shelter. Recognizing that the number of homeless on the streets keeps rising faster than we can build housing — and the inevitable closure of many shelters that were opened during COVID — the spirit behind Arias’ likely unsuccessful proposal should be applauded as a radical idea warranted by the severity of the crisis.

A Unique Opportunity to Address Homelessness

Both stories address different crises whose impacts are not limited to the city in which they are located. But the dual crises also present a unique opportunity to try and solve the most pressing issue of our time. Homelessness is a regional problem that knows no borders. It’s why the local coordinating body between government agencies and non-profit services providers is called the Fresno-Madera Continuum of Care.

But, the closure of the Madera Community Hospital, while tragic in one sense, also offers a chance that should not be missed and one that may align with the spirit of Arias’ proposal of doing something radical because the situation calls for it.

My Own Radical Proposal

So here is my own radical proposal: Fresno and Madera should come together to build a comprehensive campus that can provide emergency housing, supportive services, and long-term transitional housing to people experiencing homelessness in the Fresno-Madera region.

Converting the closed Madera Community Hospital into a campus providing wrap-around services, including meals and shelter, for homeless individuals and families would benefit the entire region. (Shutterstock)

Madera Community Hospital already has patient rooms, offices, kitchens, service areas, triage rooms, a warehouse, and social areas. It has multiple floors and buildings, allowing different populations needing different things to be segregated in healthy ways.  The facility also has multiple office spaces to house the various non-profits and agencies that are needed to provide services.  It has surrounding vacant land on which a series of permanent or transitional housing communities can be built ensuring that residents have a place to go long-term.

Why would Madera even consider allowing such a project in their community, potentially bringing Fresno’s homeless within its borders? The answer: Madera has a very unique opportunity to do what no other California city has done. Madera has the opportunity to make a major investment before the homeless problem in their community expands beyond the point of no return, sadly, like Fresno. But, Madera currently doesn’t have the financial resources to do it on their own. If, however, Fresno and Madera joined forces, it could be a win-win.

As housing is developed in Fresno County, clients would be relocated back into Fresno as units are made available. Both communities could coordinate to ensure that the benefits and placements are reciprocated.

Our crisis will not be solved by hotel conversions, tiny home projects, or the next politician to announce their plan to end homeless.  It will only be solved with very big ideas and incredible coordination between local agencies and service providers.

As opposed to spending the next two years arguing over where the next 50-unit tiny home project will go that will only provide a small dent to the problem, Madera has the opportunity to swing big.  Madera has around 300 homeless sleeping on the street or in shelters. With one facility, Madera can provide a bed for every person. It would allow the city the unique opportunity to enact no-camping ordinances, something Fresno would like but cannot do because they can’t meet the legal requirements.

Creating an Exceptional Environment

The best part about this plan is that we can work together as a community to make a truly exceptional environment.

We at the Fresno Mission are in the process of converting our own local hospital (the former Sierra Hospital near Manchester Center) into a master-planned campus called City Center.

We have turned a once dilapidated hospital into a facility where people come from all over the country to see how it benefits the surrounding community. In addition to emergency housing, it has a charter school, medical clinic, free grocery store, offices for 25 non-profits, mental health center, vocational training lab, barber shop, and even a mini soccer stadium.

Some of the biggest proponents of the project are community members who showed up to our first community meetings with pitchforks. When you present a new vision and design — something that speaks to the surrounding community — it is possible to create something that not only cares for those who need it most but also enhances the surrounding area. It’s just not something that Fresno has seen before and yet exists in other communities.

In San Antonio with a population double the size of Fresno County but an unsheltered homeless population that is half of ours, 80% of the homeless are cared for at a master-planned campus with over 20 different agencies/non-profits called Haven for Hope.

Likewise in Tuscon philanthropists, non-profits, and local government came together to purchase and develop an old hotel and convention center called the Center for Opportunity.  It provides emergency shelter, food, and transitional housing.  More importantly, it houses 20 different non-profits and agencies to provide services. Since the center’s opening several years ago, Tuscon has experienced a 15% decrease in its homeless population.

Major problems require major solutions; not tweaks. Our crisis will not be solved by hotel conversions, tiny home projects, or the next politician to announce their plan to end homeless.  It will only be solved with very big ideas and incredible coordination between local agencies and service providers.

Madera or Fresno leaders, if you need help with the details or how to execute big innovative ideas, you can find me at City Center.

About the Author

Matthew Dildine, a local attorney, is CEO of Fresno Mission, which rescues, restores, and empowers homeless individuals and families. Contact: