San Francisco, California

“The San Francisco Plan to Abolish Chronic Homelessness” was adopted in 2004, supported by Mayor Gavin Newsom, who made ending homelessness a priority in his mayoral campaign. Strong support from the mayor brought governmental and nonprofit agencies into the process. The plan targeted 3,000 chronically homeless individuals, contending that getting this high-cost, high-burden group into stable housing would make it easier to manage the homeless problem in San Francisco. Dariush Kayhan served as coordinator of the citywide homeless initiative, working closely with Trent Rhorer of the San Francisco Human Services Agency, Dr. Josh Bamberger of the San Francisco Health Department, and Mark Trotz, who directed the Department of Public Health’s Direct Access to Housing. In implementing the plan, new housing resources were directed at chronic homelessness. Single-site housing settings were preferred since they facilitated concentration of services in one place. Old hotels were leased by nonprofit developers, who negotiated with landlords to undertake renovation and create spaces on the ground floor for case management and medical services. A percentage of units were then set aside for chronically homeless people with mental illness. The plan prioritized outreach to the street homeless, a group likely to include individuals with multiple disabilities.

To create a good referral system, regular meetings focused on ten high-need individuals at a time, getting into each person’s story, assessing clinical needs, and then matching housing to clinical need. When necessary, difficult cases were “hand-held” to get them into housing. Federal support for housing was obtained from HUD’s Continuum of Care, and the mayor allocated county general funds for housing leases and operating costs.

Since the adoption of the Ten-Year Plan, San Francisco has created 2,699 units of permanent supportive housing. The retention rate in supportive housing is 90 percent. Chronic homelessness declined by 57 percent between the peak of the recession in 2009 and 2015 (from 4,039 to 1,745) (Applied Survey Research, 2015; San Francisco Human Services Agency, 2014).

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