Why SF City Governments Knows So Little About the Homeless, And How That Prevents Us From Helping Them

The lack of data about this population is a giant roadblock to getting them housed

Credit: Michael Yan, flickr

A major crisis plays out on the streets of San Francisco every day. Thousands and thousands of people make their “homes” in tents erected on sidewalks or under freeways, in makeshift shanties tucked into doorways or alleys, or just sprawled out across the pavement with little to no food, clothing, or security.

This is a horror for those who live on our streets. It’s also a threat to our city’s quality of life and economy. And when so many San Franciscans walk by our fellow humans suffering on our streets and so often doing nothing, it erodes our character and the very soul of our communities.

Despite decades of well-intentioned bills, spending efforts, or guiding plans, the same tragic scene continues day after day and year after year. Indeed, in recent years the situation has become so much worse. Yet too often City Hall is still making decisions on homelessness based on folk wisdom rather than hard evidence. While we can all look online and see the exact speed and placement of every single one of Johnny Cueto’s pitches, City Government still doesn’t know some of the most basic facts about our homeless population or the effectiveness of the services it’s funding.

As Supervisor, I would overhaul the culture at City Hall and bring an evidence-based attitude to confronting homelessness. We would no longer invest a single public dollar without knowing if it was doing any good. City Government will collect the data we need to better understand our homeless population, double down on the programs that are working, and shut down those that are not. With better data on homeless individuals we can more effectively provide them the services they need to rebuild their lives, and make immediate progress in turning the tide on our street homeless epidemic.

Does City Hall really not know how many people experience homelessness here?

The way we know how many homeless there are in San Francisco is through a visual count, which was last performed in January 2017. The count is performed every two years by hundreds of volunteers¹ who fan out across the city who are instructed to tally all those folks they encounter on the street, who after a visual inspection, appear to be homeless². The shelter population is also recorded, along with a separate count of homeless youths. In 2017, these volunteers tallied 7,499 homeless, with 4,353 of those unsheltered living on the street³.

Asking volunteers to count people who appear to be homeless once every two years is fundamentally inadequate to ensure City Government has the information it needs to adequately respond to this epidemic. We should be tracking our population in real time. Otherwise, we have to wait far too long to know whether what we’re doing is working. We should also be tracking individuals across time, rather than just counting the homeless population overall, so that we can track whether the services we are providing are actually helping.

At BART, where I serve as a Board Director, we deployed paid staff on a nightly, monthly, and quarterly basis to track the homeless population who sleep in entrances, stations, and on trains in response to the worsening street homeless crisis that was overflowing into stations. With this information, BART’s professional homeless outreach teams can determine how successful we are at connecting each homeless person with services. While we still have a long way to go, we are tracking the problem in detail and can determine in real time whether what we are doing is working or not and adapt accordingly.

As Supervisor, I will make sure we are collecting enough high-quality data to quickly identify which responses are working and which are not so we can quickly re-deploy resources to the most impactful interventions. No public dollars will be spent without knowing if that spending is doing any good.

Does City Hall really not know how much it spends on homelessness?

For fiscal year 2017–18, San Francisco budgeted $305 million⁴ to provide services and housing for the homeless and formerly homeless. It’s good that we at least know this figure, although it doesn’t tell the whole story.

City Hall does not track the cost of providing medical services and ambulances to the homeless, for instance, despite a budget analyst report showing that medical costs are the most significant homeless-related expense.⁵

In February, the Fire Department requested an increase of $100 million⁶ in its budget for next fiscal year to provide emergency ambulance services that mostly go to homeless people, which it very well might need. But it could not produce an exact dollar amount of how much it spends today on those services.

The Public Works Department recently estimated that it spends more than $30 million a year⁷ to clean up things like feces, needles, and tent encampments, which are all byproducts of allowing people to sleep outside in a dense urban environment. That’s also half of San Francisco’s entire street cleaning budget.

City Hall also spends nearly $38 million⁸ a year responding to calls for service regarding homeless people, with the Police Department footing most of that cost. In 2015, for instance, officers responded to 57,249 homeless-related calls, but rarely made arrests (0.2 percent) or gave citations (8 percent) and are unable to make referrals to services⁹.

And City Government does a poor job, or nothing at all, when it comes to systematically tracking the cost of providing social services to the homeless population that can benefit all lower-income residents. These include CalFresh (California’s food stamps) and various other welfare payments such as Medi-Cal (California’s Medicare), County Adult Assistance Programs (CAPP)¹⁰, CalWORKS, the Earned Income Tax Credits, and various state and federal programs for the disabled. Despite many of these funds being reimbursable from the federal or state government, knowing how much City Hall spends on these programs is essential to ensuring the funds are generating the maximum impact.

It’s unacceptable that City Hall does not track the public funds it’s spending on our homelessness epidemic.

Oklahoma City, for example, started tracking every dollar it spends on homelessness in 2009¹¹ — from supportive housing to medical costs to education and food¹². This provided a baseline from which that city could evaluate the success of various interventions and pushed it toward developing a robust coordinated entry system. As a result, it has managed to maintain the number of people sleeping on its streets relatively steadily over the past five years at a rate more than 10-times lower, on a per capita basis, than San Francisco¹³.

As Supervisor, I would immediately start tracking every dollar City Hall spends on homelessness. And once we figure out how much we’re spending, I would make sure that no public dollars are spent without knowing if that money is doing any good.

Does City Hall really not know the effectiveness of its homelessness spending?

Since the 2011–12 fiscal year, City Government has, respectively, allocated $157 million, $181 million, $198 million, $213 million, $242 million, $275 million, and $305 million for services focused primarily on the homeless population¹⁴. These are the figures we do know, and they amount to more than $1.5 billion in just 7 years.

This money goes toward many services offered by many organizations (8 city departments oversee 400 different contracts with 76 separate organizations¹⁵), and since 2016 funds the Department of Homelessness and Supportive Housing that was created that same year. Programs include rental and other housing subsidies for families, bus tickets back home for out-of-towners, and substance abuse and mental health services¹⁶. Yet without standardized tracking and accountability, we don’t have an accurate picture of how effectively this money is helping those who need it most and which programs are working best and which are not working at all. That has to change.

The new homelessness department is apparently working to create a single system to track the services that individuals are receiving and how their outcomes are improving. The need for such a system was initially identified in 2002 by the City Controller’s Office¹⁷ and the system was finally unveiled last year¹⁸. This integrated tracking system, though, has yet to launch¹⁹.

So what are we doing in the meantime? Two of the city’s biggest departments — Human Services and Health — each have their own tracking systems that do not communicate with one another. These systems also do not include comprehensive information on the 400 different contracts funded by the city that are supposed to tackle the exact same problem. As for homeless outreach providers, they use 15 different data-collection platforms that also never communicate with each other²⁰. So, for example, City Hall cannot accurately compare the outcomes of two different drug addiction treatment providers to see which one is better at helping addicts get clean.

On an even grander scale, City Hall does not even keep track of the outcomes for folks who have been given the most expensive intervention: subsidized housing. The budget analyst studied the outcomes of 1,800 adults who were placed in supportive housing in fiscal years 2010–11 and 2011–12 and found that 50% had left their original housing placement within 5 years²¹ and City Hall had no idea whether they ended up in jail, back on the streets, or found stable housing on their own.

San Francisco should learn from Salt Lake City, which has virtually ended street homelessness. More than 60% of individuals entering Salt Lake’s shelters transition to housing within a month, and chronic homelessness has been declining to almost nothing since 2005²². The Utah city has a tracking system that offers data on when a homeless person is placed in shelter or gets counseling or other services from either the city government or a contracted organization²³. Having this info all in one place and easily accessible means counselors can better serve people’s needs. It also makes for easier and better coordination between government and nonprofits.

Credit: David Hanwell, flickr

New York City used to do data collection the same way as San Francisco — as in, no standardized system that was accessible to all the outreach workers who encounter homeless people on a daily basis. This created a lot of redundancies and wasted resources, but it also meant New York officials didn’t have a clear picture of the homeless population. The city now uses a platform called StreetSmart that provides “agencies and non-profit groups a comprehensive view of all of the data being collected on New York’s homeless on a daily basis.”²⁴

As Supervisor, I would require that all homeless service providers collect data on their effectiveness and report it out in a standardized way, like in Salt Lake City and New York City. I would also make sure that frontline staff have access to all the information they need on each homeless individual to most effectively help them.

Without good data about San Francisco’s homeless population and the money we spend to deal with it, it will be impossible to ever make meaningful gains and help people rebuild their lives and find stable housing. It’s unacceptable to live in a city where we know more about Johnny Cueto’s slider than we do about those who are suffering on our streets. We must fully understand the problem before we can ever hope to change it.


Sources:

  1. http://hsh.sfgov.org/wp-content/uploads/2017/06/2017-SF-Point-in-Time-Count-General-FINAL-6.21.17.pdf
  2. https://www.sfchronicle.com/bayarea/article/SF-homeless-count-What-it-s-like-and-why-10889702.php
  3. http://hsh.sfgov.org/wp-content/uploads/2017/07/2017-Point-in-Time-Count-for-BOS-7.17.17-w-ASR-Slides.pdf
  4. http://www.sfexaminer.com/mayor-lee-unveil-10-1b-budget-increased-spending-address-homelessness-opiate-abuse/
  5. http://sfbos.org/sites/default/files/FileCenter/Documents/56163-061316%20Homeless%20Services%20in%20SF_Bud%26LegAnalyst.pdf
  6. http://www.sfexaminer.com/fire-officials-seek-budget-boost-highlight-cost-ambulance-subsidies/
  7. https://www.nbcbayarea.com/news/local/Vacant-Businesses-Rising-in-San-Francisco-Real-Estate-Agents-Believe-Dirty-Streets-Partly-to-Blame-479041303.html
  8. http://sfbos.org/sites/default/files/FileCenter/Documents/56163-061316%20Homeless%20Services%20in%20SF_Bud%26LegAnalyst.pdf
  9. http://sfbos.org/sites/default/files/FileCenter/Documents/56163-061316%20Homeless%20Services%20in%20SF_Bud%26LegAnalyst.pdf
  10. We do know that about $500,000 a year goes to serving 481 homeless people through CAAP. But as for San Francisco residents enrolled in things like CalFresh or Medi-Cal, we have the total number and total spend but no breakdown of the figure to find out how many served are homeless.
  11. The headline on the section of Oklahoma City’s Planning Department website that deals with homelessness is “Understanding homelessness is the first step to creating solutions.”
  12. http://homelessalliance.org/wp-content/uploads/2010/08/Final-Cost-of-Homelessness-study.pdf
  13. Oklahoma City has an unsheltered homeless rate of 42 per 100,000 residents, compared to San Francisco’s rate of 492 per 100,000 residents.
  14. http://hsh.sfgov.org/overview/budget/ and http://www.sfexaminer.com/mayor-lee-unveil-10-1b-budget-increased-spending-address-homelessness-opiate-abuse/
  15. https://www.sfchronicle.com/bayarea/article/S-F-spends-record-241-million-on-homeless-6808319.php
  16. We’re also not spending all of this money just on homelessness. In the 2015–16 fiscal year, almost half of that $242 million, or $112 million, was spent on supportive housing for formerly homeless residents and another $29 million went toward eviction prevention.
  17. https://www.sfchronicle.com/bayarea/article/S-F-spends-record-241-million-on-homeless-6808319.php
  18. https://www.modernluxury.com/san-francisco/story/fix-homelessness-san-francisco-first-has-clean-its-data-mess
  19. http://hsh.sfgov.org/overview/one-system/
  20. http://www.govtech.com/health/Single-Platform-Data-System-Serves-All-San-Francisco-Area-Homelessness-Outreach-Professionals.html
  21. http://sfbos.org/sites/default/files/FileCenter/Documents/56163-061316%20Homeless%20Services%20in%20SF_Bud%26LegAnalyst.pdf
  22. https://jobs.utah.gov/housing/scso/documents/homelessness2015.pdf
  23. https://www.sfchronicle.com/archive/item/What-S-F-can-learn-from-Salt-Lake-City-30428.php
  24. https://www.wired.com/2017/05/new-york-citys-businesslike-tech-fighting-homelessness/

UP NEXT: Dispelling myths around Prop. 47 and how auto burglary suspects are prosecuted.

Over the coming months leading up to the November election, I will be sharing stories and data about the top challenges we face in San Francisco—from homelessness and property crime to street safety and affordability. I’ll explore tactics used in other cities and whether they resulted in any meaningful changes. And I’ll present datasets that offer meaningful insights into what can be done differently by our city government.


Paid for by Nick Josefowitz for Supervisor 2018. Financial disclosures are available at sfethics.org.

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