San Francisco is expected to give a five-year extension to a pilot program that provides homeless people with mental health or substance use issues a place to stay overnight once discharged from Zuckerberg San Francisco General Hospital’s psychiatric emergency services.
The 2-year old Hummingbird Place Respite Program, run on Potrero Avenue under city contract by the nonprofit Baker Places, is a 29-bed overnight facility for mostly homeless persons who repeatedly use emergency services at San Francisco General Hospital.
Hummingbird gives health officials another option to offer people being discharged from the hospital who are unwilling to enter treatment. Instead of being discharged directly to the streets, they can choose to stay at Hummingbird, which is located on the hospital’s campus. There they can stabilize and receive psychiatric care services, with potential for entering treatment once ready.
The Board of Supervisors Budget and Finance Committee voted Wednesday to approve a $17.3 million contract extension with Baker Places from June 30, 2021 through June 30, 2026. The full board is expected to vote on the agreement next week. The program costs about $3.3 million annually.
Supervisor Ahsha Safai called it a “very cost effective program,” noting that a stay in psychiatric emergency services costs about $2,000 a day and in the emergency room about $1,000 per day. But said he wished to see better tracking of the outcomes of those served and a “stronger referral to housing.”
In fiscal year 2019-20, Hummingbird admitted 638 people, of whom 538 were unique individuals, while others returned multiple times, according to Kelly Hiramoto, special projects manager for the Department of Public Health.
“Historically, those individuals will be discharged back to the streets,” Hiramoto said. “Hummingbird gives us an option to actually have a safe space to receive these individuals to have a shot at trying to help get them to feel ready to accept ongoing care.”
Most of those who stayed last year ended up self-discharging and it was unclear what happened to them next, but Hiramoto said the agency is improving its ability to track clients. The average length of stay was about 13 days.
“The proportionate share of people still predominantly self-discharge back out,” Hiramoto said. “So about 57 percent of folks are not yet ready to engage in care. But I do feel like it gives us an opportunity to reach people in a way that we’ve never historically been able to reach and it also provides a period of time where folks are able to come off the streets to rest and regain kind of sense of self.”
The outcomes of those who didn’t self-discharge was a “mix,” she said.
About 50 of those who stayed there last year went into a 90-day or year-long treatment program. Others moved into a shelter or board and care facility, while a few were admitted to The City’s skilled nursing facility, Laguna Honda Hospital.
A detailed breakdown of the outcomes of those who stayed at Hummingbird last fiscal year was not presented at the hearing, and the information, which was requested from the Department of Public Health, was not provided by press time. Referrals to Hummingbird largely come from San Francisco General Hospital but may also come from other hospitals and behavioral health programs.
Hiramoto said outcomes should improve with the work being done through Mental Health SF, The City’s larger effort to overhaul the behavioral health system.
“If we have better access to housing options and interim shelter options and intensive case managers, I think that the destinations of folks who have touched Hummingbird would be greatly improved,” Hiramoto said.
The model, she said, “has shown some success in bringing some people into care that have historically not been in care.”
Plans to open a second Hummingbird facility have been in the making in Supervisor Rafael Mandelman’s district at 1156 Valencia St. The facility is expected to open there next week. It will be slightly different since it is located in a neighborhood, not directly across from a hospital where people can be walked over to stay there.
“It will be our opportunity to see if we can engage people directly from the street into this kind of a setting,” Hiramoto said.
The Valencia Street site will have 30 overnight beds and be able to serve up to 30 drop-ins per day. It will initially operate with a more limited capacity due to the pandemic, with up to 24 beds and 20 day guests. The cost is about the same as the Potrero Avenue facility and it will be funded for its first 18 months through a grant.
Mandelman praised the model but said the need far exceeds just two sites.
“I think it responds to a real need for exits from the street for folks with significant behavioral health issues,” Mandelman told the San Francisco Examiner. “That need is far, far greater than Potrero and Valencia Hummingbirds will be able to meet combined.”