Effort underway to overhaul supportive housing for homeless

A decade after San Francisco prioritized the creation of supportive housing to bring the homeless in off the streets, a new report offers a rare glimpse into the multimillion-dollar supportive-housing program and identifies key challenges facing it.

The audit by the City Controller's Office illustrates areas where the effort to provide homeless in The City with services to help them stay sheltered may be falling short, such as through tenuous case management, the inability to find below-market-rate units in San Francisco and longer than ideal stays.

The Human Services Agency oversees more than 3,800 permanent supportive housing units for adults and families costing in excess of $35 million annually. The program is a key element of San Francisco's strategy to house the homeless.

“HSA has not made self-sufficiency a priority in its program goals, and as such, certain gaps in linkage and services exist, leaving some clients unable or unwilling to transition to other forms of stable housing without support services attached,” said the city controller's “Moving Beyond Stability” audit. “A lack of affordable options also plays a significant role in limiting these transitions.”

The report represents one of the first in-depth examinations of supportive housing. Another report, being conducted by the budget analyst at the request of Supervisor Mark Farrell, looks at other aspects such as cost and intake criteria. Farrell plans to request a hearing on both reports at the board's meeting Tuesday.

The reports come as the homeless population in The City has remained mostly flat at about 6,500 for more than a decade.

The city controller's report said the overall program should expand its core “stability” goal.

“Adding self-sufficiency to program goals potentially saves public funds by encouraging tenants who do not need support services to move to units without this extra cost,” the report said. “By encouraging these moves, supportive housing units can be made available for homeless residents needing housing and services. Additionally, building self-sufficiency improves client quality of life.”

The report found that 47 percent of those living in adult sites and 60 percent at family sites have lived in their building for more than five years.

The report calls into question the level of services the clients are receiving. Interviews with more than 500 clients suggest that while case managers on the average meet with them on a monthly basis “it is unclear whether interactions resulted in service delivery (e.g., a referral) or were more casual 'check-ins.'”

The responses indicated clients were referred more often to building events like food pantries or social hours than more robust services like employment or education.

A review of 85 case files for clients found “case manager engagement was most often light or minimal, with contacts commonly relating to income or rent stabilization needs, and many contacts occurring in writing only (e.g., a flyer or notice left on a client's door).”

Based on interviews with 12 case managers there was a need for more specialized staff: “Interviewed case managers highlighted the need for increased clinical support, with additional behavioral health and nursing services mentioned.”

The audit offers a glimpse of what is happening to those housed. The median income of surveyed clients was $9,348 for adults and $10,854 for families.

During fiscal year 2012-13, 13 percent, or 489, of the adult clients exited supportive housing and 6 percent of 33 families did. Of the adults, 23 percent were evicted, 20 percent moved to other but unknown housing situations, 15 percent died and 17 percent were for other reasons such as “left voluntarily, no housing.”

However, the report also found that “actual outcomes for many clients was unknown.”

The report offered some ways to improve the program.

“Given the price of market rate housing, the amount of subsidies needed to transition out of permanent supportive housing may be insurmountable for many clients,” the report said.

But this could be solved, the report suggested, by creating below-market-rate units only for supportive-housing clients to move in to or by moving people outside of San Francisco.

“HSA should explore partnerships with regional housing providers to create more direct linkage to housing stock outside the City limits,” the report said.

But it notes, like most longtime residents, “many current clients in supportive housing are resistant to moving outside of San Francisco.”

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