In July 2020 Mayor London Breed announced a goal of getting 6,000 people off the streets within two years as part of her Homelessness Recovery Plan. With roughly six months left on the Mayor’s self-determined objective, just 2,662 housing placements, 44 percent, have been made, though the number may be higher because it doesn’t account for those housed during the last quarter of 2021.
Even if the Mayor achieves her 6,000-person goal, there’d still be more than 2,000 people without permanent shelter in the City, given that an excess of 8,000 individuals were counted as homeless in 2019, the latest data from the San Francisco Homeless Count and Survey Comprehensive Report. What’s more, homelessness has likely risen since 2019, according to Jennifer Friedenbach, San Francisco Coalition on Homelessness executive director.
“Social and economic indicators suggest the homeless population is going to increase,” she said.
Yet roughly 400 housing units set aside for unsheltered individuals sit empty, even after accounting for those that’re being repaired or are already spoken for but haven’t yet been occupied. Bureaucratic blockages appear to be largely responsible for the gap in housing placements.
“Ultimately the Mayor is in charge of all the departments,” Friedenbach said. “There are conflicting priorities.”
The Mayor’s office didn’t respond to multiple requests for comment.
The Mayor also wants to create 2,100 non-permanent housing beds by July, by reopening those closed during the pandemic and adding new ones. However, presently only 1,057, 50 percent of the goal, are available according to the Homelessness Recovery Plan website.
“Beds are sitting empty and they’re not available to how many people need them,” Friedenbach said. “Every day, everyone is trying to get shelter but they can’t. [The City] doesn’t make it easy for people to get help.”
“Sheltering is terribly complex,” said Wes Saver, senior policy manager at GLIDE, a center for social justice. “The average person who’s seeing visible homelessness, and there are many more in San Francisco who go unseen and are housing insecure, may have no idea what people are up against when it comes to getting a room.”
San Francisco’s homeless service system is opaque and confusing. For single adults, pre-pandemic, an individual in need could call 311 to get on a waitlist for a 90-day bed, according to Saver.
“That waitlist was usually 1,000 people or more and it would often take a month to get a 90-day bed, but that’s not even an option now,” he said. “During the pandemic, there has not been a way to sign up for one-night shelter beds. There’s no way to get on a waitlist. In addition to the lack of shelter access, there is no self-referral process for shelter-in-place hotels or safe-sleep sites.”
In December, 45 organizations submitted a letter to the Mayor and municipal department heads calling for the self-referral process to immediately be reinstated.
“The current centralized placement system is failing,” the letter stated. “The process routes some unhoused people into shelters from SIP hotel closures, Healthy Streets Operations Center tent encampment ‘resolutions,’ hospital discharges, and HOT [Homeless Outreach Team] referrals, but the current policy fails to serve the unhoused community at large. Rather than providing a workable system to help people out of homelessness, the current system serves the policies of removing the visibility of homelessness and ‘fiscal prudence.’”
When the Mayor was asked why the self-referral process hasn’t been reinstated at a Board of Supervisors meeting, she cited COVID-19 testing protocols and technological complications, neither of which should have taken two years to sort out, according to Saver.
The Department of Homelessness and Supportive Housing has opened its winter shelters for walk-up referrals. GLIDE is one of five community partners that can refer people to winter shelters, but there are only a few beds and no waitlist or queue.
“The winter shelter system is very temporary,” Saver said. “Once we move on from that, we’re right back to where we started with no way for providers or individuals to get into a place. A policy that keeps doors closed to people experiencing homelessness only serves public health if the unhoused are excluded from the definition of ‘public.’”
The unhoused need shelter as well as mental health and substance abuse assistance.
“Overdose deaths among people experiencing homelessness doubled in recent years and account for at least one-quarter of all overdose deaths in the City,” according to Zoe Harris, a Department of Public Health public relations officer. “We do know that housing status impacts health and that people experiencing homelessness who use drugs are at higher risk of overdose and developing adverse health conditions.”
The Department of Public Health relies on street and community-based outreach efforts, such as Street Medicine and the Street Overdose Response Team, to make services accessible, low-barrier, and proactive, Harris said. The Street Medicine Team offers open-access clinic hours in nontraditional sites where patients feel comfortable and are evaluated face-to-face with a physician or nurse practitioner. The Street Overdose Response Team is a collaboration between the Department of Public Health and the San Francisco Fire Department that responds immediately after an overdose, and again within 72 hours, to connect users with care and treatment.
The Board of Supervisors passed legislation in 2019 that required all adult San Franciscans who are homeless, uninsured, or enrolled in Medi-Cal or Healthy San Francisco with mental illness and/or substance abuse issues to be provided with access to mental health services, substance use treatment, and psychiatric medications. The resulting program, Mental Health SF, is allotted approximately $55.5 million on an ongoing basis, funded almost exclusively by Proposition C, a 2018 San Francisco ballot initiative that authorized the City to pay for housing and homelessness services by taxing businesses that earn more than $50 million annually in gross receipts.
“There’s a lot of potential for expanding the behavioral health treatment system with funding by Prop C,” Friedenbach said. “Hopefully when we finally do get some of these interventions we’ll be able to correct some of the problems that have led to so much severe acuity on the streets and we’ll have access to treatments we haven’t had in the past.”
A group of community organizations, municipal departments, elected officials, unhoused constituents, service providers, advocates, and academics are working to create a new kind of street response that doesn’t rely on the police, the Compassionate Alternative Response Team (CART). Presently, the principal way for concerned residents to request assistance for homeless individuals is to call the police non-emergency line, a practice the San Francisco Police Commission wants to end.
Under CART a two-pronged approach would be pursued: a dispatch response and a street response. In the dispatch, a specialized police-alternative dispatcher would respond to calls from and for unhoused neighbors in crisis, with a hotline available to call CART directly. The street response team would consist of staff who have experienced poverty and/or homelessness, enabling them to deal compassionately with unhoused individuals. Instead of focusing on a hotline caller’s complaints, the team would concentrate on the well-being of the unhoused. No official announcement has been made as to when the program will go live.
“The program has been designed and funded [at $3 million] but the mayor is sitting on it,” Friedenbach said. “They’re doing the ‘institute for further study’ thing even though it’s been thought through carefully already. There’s some internal, political hold up but we’re going to keep pushing to make this happen and continue to build broad support because the status quo isn’t working.”
Bay Area counties continue to delay a federally mandated one-night count of people living on the streets amidst concerns over omicron. The U.S. Department of Housing and Urban Development mandates a Point-in-Time count every two years. The tally was supposed to occur in 2020, but was canceled because of the pandemic. San Francisco’s rescheduled reckoning, calendared for last month, has been deferred to late February.
Other jurisdictions, including the cities of Reno and Bakersfield, are working to eradicate chronic homelessness by employing a “Built for Zero” model, a national data-driven initiative that matches housing with individuals in the context of understanding the dynamics of homelessness, making system improvements, andtracking whether efforts are successful. In January 2021, Bakersfield announced that it was the first California city to end chronic homelessness.