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«The San Francisco Plan To Abolish Chronic Homelessness The San Francisco Plan to Abolish Chronic Homelessness Table of Contents Dear Mayor Newsom, On ...»

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The San Francisco Plan

To Abolish Chronic


The San Francisco Plan to Abolish Chronic Homelessness Table of Contents

Dear Mayor Newsom,

On behalf of the members of the Ten Year Council, I submit this report entitled "San

Francisco's Ten Year Plan" to end chronic homelessness.

The last five months have been an incredible education for all of us. We have the most

incredible City, bar none, and yet, as you know, we have one of the worse homeless crisis in the nation. We have some of the most incredible human beings who give so unselfishly of themselves to help the poor and yet we remain unable to take the poor off of the streets and into housing. We have the most lauded and successful plans in the nation and yet again, we lead the nation in people without homes. These are stark realities, and this Ten Year Planning Council faced them head on. The plan we present to you is a no non-sense plan, " lets house people now" plan, that I firmly believe is the key that will unlock the door to the homes our people so desperately need.

The focus of the plan is permanent supportive housing for the 3000 or so chronically homeless, out of the 15,000 general homeless populations. When you effect the 3000 chronically homeless, indeed, you dramatically effect the general homeless population.

The plan is a redirection of our resources, our attitudes and our strengths. Never easy, I know. But this Council of amazing people has given the City a plan that is courageous and necessary to end this disgrace. Now we need to implement it. The completion of the Plan is merely the beginning of the work.

For the first time in the twenty years that I have been in public life, I feel the united excitement, the electric energy, the profound intelligence, and the strong will to end chronic homelessness in our great City. I credit a lot of that to you, Mr. Mayor, for having the courage to make homelessness a priority in your administration. On behalf of the Council and me, we thank you!

It's time to roll our sleeves up, and get to work on what will be one of the most rewarding accomplishments of anyone's life. I certainly look forward to this particular "victory party!".


–  –  –

Mayor Gavin Newsom took the oath of office on January 8, 2004. One of the first acts of his new administration was his appointment of former Board of Supervisors President Angela Alioto to Chair a committee to write a plan to end homelessness in San Francisco in ten years.

Chair Angela Alioto recruited a diverse, non-partisan working group for appointment by Mayor Newsom to the Ten Year Planning Council.

The Council wishes to thank Philip F. Mangano, the Executive Director of the United States Interagency Council on Homelessness. As the founding Executive Director of the Massachusetts Housing and Shelter Alliance and as the formulator of the front door/back door paradigm of advocacy response that has been adopted by the National Alliance to end Homelessness, Mr. Mangano has been at the forefront of innovation regarding chronic homelessness. His insightful theories and unbridled enthusiasm for ending homelessness has been inspiring, and we in city of Saint Francis, thank you.

–  –  –

The Ten Year Planning Council, and committees of the Council, met eighty-five (85) times, beginning on March 19, 2004 and ending on June 30, 2004, when the Plan was presented to Mayor Gavin Newsom. Public hearings were held at San Francisco City Hall on May 26 and May 27, 2004.

More than 785 individuals representing over 400 organizations participated in one or more of these eighty-five meetings, and provided valuable contributions of information, funding, meeting space, and time toward the creation of this report.

The San Francisco Foundation provided fiscal sponsorship of the Council's work, and contributed accounting services to facilitate payment of expenses.

As of the printing of this report, generous contributions to support the work of the Council had been received from: The San Francisco Hotel Council, Pacific Gas & Electric Corporation, the Gap Inc., Plumbers and Pipefitters Union Local 38, the Levi Straus Foundation, the McKesson Corp, Charles Schwab Corporation, the San Francisco Foundation, the San Francisco Restaurant Association, JP Morgan Chase, the Bank of America, Providian Financial Corporation and Mr. Larry Nibbi.

A writing committee, lead by Barbara Meskunas, met for several weeks to organize the committee recommendations. The writing committee included council members Mike DeNunzio, Fred Martin, Ann Marks, Paul Boden, Dr. Francis Rigney and Chair Angela Alioto. A special word of thanks to Laruen Hall of the Corporation for Supportive Housing for her contribution to the final document.

The Council offers its sincere gratitude to our donors, who share our compassion and commitment to ending the crisis of chronic homelessness in San Francisco.

The San Francisco Plan to Abolish Chronic Homelessness 2 - San Francisco Ten Year Planning Council “Changing Direction” Executive Summary The "Housing First" model is a radical departure from the Continuum model in use for almost two decades in San Francisco.

San Francisco is Everyone's Favorite City. But San Francisco also has the dubious distinction of being the homeless capital of the United States.

There are estimated 15,000 people who are homeless in the city and county of San Francisco and 3,000 of them meet the definition of chronically homeless. New York, a city many times our size, has 2,700.

This plan is directed at the 3000 chronically homeless.

It is a crisis that must be addressed immediately. We need change now.

San Francisco spends approximately $200 million annually on homeless direct and related services, yet the numbers of homeless continue to rise alarmingly.

San Franciscans consistently identify homelessness as the number one problem in San Francisco. San Francisco voters have repeatedly sent a clear and overwhelming message to City Hall that they want change, and are willing to try any and all new approaches that look promising and do not perpetuate the status quo.

Mayor Gavin Newsom began his administration with the appointment of the Ten Year Council to End Chronic Homelessness in San Francisco. He asked former President of the Board of Supervisors Angela Alioto, to Chair the council and steer its agenda.

Our mandate is clear.

Our task begins with the admission that the city's focus to date -- based on Continuum of Care strategies, i.e. separating the provision of services from the provision of housing -- has not worked, as evidenced by the highest per capita number of homeless people in the United States.

We must have the courage to set aside our failed policies and change direction.

We must have the courage to say that we will no longer tolerate, as the compassionate City of St.

Francis, human beings living in abject misery and sleeping in our streets.

The "Chronically Homeless" The U.S. Department of Housing and Urban Development defines a "chronically homeless person" as "an unaccompanied disabled individual who has been sleeping in one or more places not meant for human habitation or in one or more emergency homeless shelters for over one year or who has had four or more periods of homelessness over three years."

An estimated 20% of San Francisco's homeless population meets the definition of "chronically homeless," yet these 3,000 individuals, including families, consume 63% of our annual homeless budget, comprising both City, State, and Federal funding.

The San Francisco Plan to Abolish Chronic Homelessness 3 - “Changing Direction” - Executive Summary The Ten Year Council targeted the 3,000 chronically homeless with this Ten Year Plan to the exclusion of other homeless populations because the chronically homeless are the most in need, they consume the lion's share of dedicated resources and, if their needs are met, the city will save money. The money we save can then be redirected to the remaining general homeless population.

Our focus is the 3,000 individuals who are the most visible reminders of our failure to find solutions.

We do not imply hereby that the needs of the other 12,000 should be neglected, but rather, that the resulting efficiencies of our targeted effort would result in more assistance for the general homeless population.

Permanent supportive housing has been proven to be the most effective and efficient way to take the chronically homeless off the streets. San Francisco has its own successful versions of permanent supportive housing, one of which, Direct Access to Housing, is regarded as a national "best practice."

We must build upon our successes and phase out programs that do not work.

Statistics show that the care of one chronically homeless person using Emergency Room services, and/or incarceration, cost San Francisco an average of $61,000 each year. On the other hand, permanent supportive housing, including treatment and care, would cost $16,000 a year. The $16,000 in permanent supportive housing would house the person, as opposed to the $61,000 in care and services that leaves the person living on the streets.

Logic and compassion dictate that moving our 3,000 chronically homeless into permanent supportive housing would be cost effective, saving the taxpayers millions of dollars each year. Doing so would also provide the chronically homeless with their best opportunity to break the cycle of homelessness that controls their lives.

Permanent Supportive Housing The recommended goal of the Ten Year Council is a simple one: create 3,000 units of new permanent supportive housing designed to accommodate the chronically homeless. The "Housing First" model is a radical departure from the Continuum model in use for almost two decades in San Francisco. Under the Continuum model, homeless individuals try to find space in a shelter. The next step is often transitional housing before eventual placement in permanent housing. The goal has been to stabilize the individual with a variety of services before permanent housing placement.

The "Housing First" model emphasizes immediate placement of the individual in permanent supportive housing, and then provides the services, on site, necessary to stabilize the individual and keep them housed.

This model has been endorsed by the Federal U.S. Interagency Council on Homelessness (USICH), the National Alliance to End Homelessness (NAEH), and by most other cities that have already written their Ten Year Plans.

The San Francisco Plan to Abolish Chronic Homelessness 3 - “Changing Direction” - Executive Summary San Francisco's Direct Access to Housing program has been honored nationally as a model of permanent supportive housing. Established in 1998, the San Francisco Department of Public Health's Direct Access to Housing (DAH) program provides permanent housing with on-site supportive services for approximately 400 formerly homeless adults, most of who have concurrent mental health, substance abuse, and chronic medical conditions. The DPH's reason for starting this program: "Without access to a stable residential environment, the trajectory for chronically homeless individuals is invariably up the 'acuity ladder' causing further damage and isolation to the individual and driving health care costs through the roof."

DAH has 360 units of permanent supportive housing in five single room occupancy (SRO) hotels and 33 units in a licensed residential care facility. The units have private baths and shared cooking facilities; three meals daily are prepared for the residents. DPH acquires the building through "master leasing," which has the added benefit of renovating buildings in troubled neighborhoods.

All six DAH sites have between three and five on-site case managers as well as a site director. Case managers assist residents to access and maintain health benefits, provide substance use, mental health, life skills and family counseling, assist in accessing medical and behavioral health (mental illness and substance abuse) treatment, assist with accessing food and clothes, and interface with property management in preventing evictions.

All six sites have access to a roving behavioral health team, which can place residents off-site in mental health or substance abuse programs when appropriate. All sites have access to medical care.

DAH residents are recruited into the program if they are high users of the public health system and have on-going substance abuse, mental illness and/or medical problems. Over two-thirds of the chronically homeless in the DAH program have remained housed since the program began in 1998, an astonishing success given the dismal recidivism rate of other programs.

Another successful local model is the Community Housing Partnership (CHP), which owns and operates housing for formerly homeless individuals and families. On Treasure Island, CHP provides us with a supportive model for replication.

It is the goal of the Ten Year Council to replicate the successes of Direct Access to Housing, Community Housing Partnership, and other successful permanent supportive housing national models, for the 3,000 chronically homeless individuals living on our streets and in our doorways.

Our model will be carefully refined to target the chronically homeless, (enhanced with a number of excellent suggestions from the Ten Year Council's research), and the money will be found to pay for additional master leasing and new housing production sufficient to meet San Francisco's goal.

Phasing Down Shelters and Transitional Housing Our City shelters and most transitional housing programs will be phased out as new permanent supportive housing units are brought on line.

The San Francisco Plan to Abolish Chronic Homelessness 3 - “Changing Direction” - Executive Summary In most cases, there is no exit from our shelter system. Available shelter space is insufficient, but the system itself is more problematic than its lack of funding for capacity expansion. New York City spent $4.6 billion dollars over ten years to expand its shelter system only to find that the shelter system is a dead end street. New York is now dramatically shifting its financial priorities to prevention and housing, and so should we.

Transitional housing programs are of limited duration, providing only a temporary respite from the condition of chronic homelessness, after which the individual usually returns to the streets.

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