Our City, Our Home Oversight Committee Needs Assessment

This report fulfills the OCOH Oversight Committee's responsibility defined in San Francisco Business Tax Regulation Code  § 2810 (e)(2)(B):

Conduct a needs assessment with respect to homelessness and Homeless populations, including but not limited to an assessment of available data on sub-populations with regard to race, family composition, sexual orientation, age, and gender.

The Our City, Our Home Oversight Committee reviewed and made comments on multiple drafts of the Needs Assessment of Homelessness in San Francisco over the course of a year. At the November 16, 2022 Special Meeting the Committee reviewed the final draft of the Needs Assessment. The Committee finalized and approved the cover letter and needs assessment at its December 15, 2022 Special Meeting.

Back to top

Who is homeless in San Francisco?

Data show that racism is a root cause of homelessness.

Black or African American; American Indian, Native or Indigenous; and increasingly Hispanic or Latin(a)(o)(x) people appear in the sheltered and unsheltered homeless population at higher rates than in San Francisco's general population. The overrepresentation of these racial and ethnic groups is also apparent at the state-wide, and national levels. 

Households of color are also more likely to experience housing insecurity and overcrowding in San Francisco. According to the SF Planning Department's Housing Needs and Trends Report (2018), Asian-Pacific Islander and Latin(a)(o)(x) respondents were more likely to live in overcrowded and severely overcrowded conditions, such as the family with minor children pictured below, living in a Chinatown Single Room Occupancy (SRO) hotel. The same report found that Black and Latin(a)(o)(x) San Franciscans experience housing insecurity at higher rates than white San Franciscans.

 

The current racial pattern of vulnerability to homelessness, housing insecurity, and overcrowding has roots in public policies, institutional practices, and cultural norms both past and present. Redlining provides a well-documented historical example of racial discrimination embedded in institutions and systems.

New Deal era (1933-1939) policies are remembered for bringing home ownership within reach for many. But, these government programs also institutionalized racial segregation by identifying neighborhoods with Black and other residents of color as "hazardous" investments to lending banks. In the above map of San Francisco from 1937, redlined neighborhoods include the Western addition, the Haight, Chinatown, parts of the Mission and other neighborhoods that were occupied by a largely non-white population. The result of this practice was fewer home loans granted to buyers in these neighborhoods. Because homeownership has been central to accumulating wealth, redlining prevented economic mobility for Black and other communities of color. 

Redlining is one example from a broader history of racially discriminatory federal, state, and local policies that include, but are not limited to the displacement of Native Peoples and the theft of their land; California's Alien Land Law (1913) prevented Asian immigrants and later Asian Americans from owning land; Japanese internment; the deportation of US citizens of Mexican descent during the Great Depression; as well as the displacement of Black communities under the auspices of urban renewal.

The accumulated impact of racially discriminatory policies appears today in the racial wealth gap, generational poverty, patterns of poor health outcomes, strained social and family networks, distrust of systems, higher rates of involvement in child protection, limited educational opportunities, mass incarceration, and barriers to employment. These population-level impacts resonate in first-person accounts of homelessness in San Francisco gathered through Our City, Our Home focus groups between August and October, 2022.

"I was in the hospital. His mom died. Then the house was taken because she owed.  To be homeless . . . we’d always had somewhere to live."  _{[Participant #16, Hispanic, Latino or Spanish, Female, Straight/Hetero, Age 45-54 years   &   Participant  #17 Black or African American; Male, Straight/Hetero, Age 45-54 years]}

"COVID knocked me out of the way."  _{[Participant #28, Black or African American, Male, Straight/Hetero, Age 25-34 years]}

---

Homeless households confront significant economic barriers to housing stability.

• 71% of homeless adults assessed through coordinated entry in fiscal year 2021-2022 reported less than $1,000 per month in cash income.
• The United Way of California's 2021 Real Cost Measures estimates the real cost of living for a single adult in San Francisco at $4,009 per month ($48,108 per year).
• 75% of families assessed  through coordinated entry in fiscal year 2021-2022 reported less than $1,500/month in cash income.
• The United Way of California estimates the real cost of living for an adult, a preschooler, and a school aged child in San Francisco at $9,567/month ($114,808/year)

Because of its cost, housing feels out of reach for people experiencing homelessness in San Francisco; particularly those on fixed incomes, like disability or retirement, and for low-wage workers.

"I was paying the whole check! Just to have a place to live."  _{[Participant #21, Hispanic, Latino, or Spanish; Female; Straight/Hetero, Age 45-54 years]}

"A place I can afford, that’s a decent place to live? That’s difficult to find."  _{[Participant #26, Black or African American, Female, Straight/Hetero, Age 55-64 years]}

Housing suitable for families with children is not affordable to extremely low income households in San Francisco.

A 2015 report from the SRO Families United Collaborative found that the families with children living in SROs or another inadequate residence are disproportionately immigrants, people with limited English proficiency, and people of color.

"The caller said her two younger children learned to crawl late because the SRO does not have space for them to move around. Her family of five sleep on a bunk bed with 2 people on the upper level and 3 on the bottom. Thirty households share one bathroom. There are long waits for showers and cooking. Her family was selected for an affordable housing development, but the rent was still too high."  _{[Cantonese speaking Public Commenter at the OCOH Oversight Committee regular meeting of April 28, 2022]}

 

---

Male, transgender, and non-conforming gender identities are over-represented in the homeless population.

• 62% of literally homeless persons identified as male at the 2022 PIT, compared with 51% of San Francisco’s population at the 2020 Census.

• 34% of literally homeless persons identified as female, compared with 49% of San Francisco’s population at the 2020 Census.

• 4% of literally homeless persons identified as transgender or gender non-conforming at the 2022 PIT.

• 2022 PIT Count survey indicated that Transgender and Gender non-conforming persons experienced higher rates of domestic violence than those identifying as female or male.

---

LGBTQIA+ sexual orientations are overrepresented in San Francisco's homeless population.

LGBTQIA+ identities were likewise over-represented among the Needs Assessment's qualitative respondents. 

Conflict with family was a primary cause of homelessness for LGBTQIA+ youth who participated in the focus groups. LGBTQIA+ adults described confronting housing barriers because of their sexual orientation.

"I was living at home with my grandmother. There was a lot going on there with people trying to control my decisions. I needed my own space to try to cultivate my own life. "   _{[Participant #43, Black or African American Female, Bisexual, Age 25-34 years]}

"Lot of verbal and physical abuse [in my family]. I was at my Grandmother’s house but wasn’t happy there either due to financial struggles and fighting. When I was running away at 19, I found out about this place."  _{[Participant #10, Black or African American, Female, Gay/Lesbian/Same Gender Loving, Age 16-24 years]}

"[I] lived with my partner in SF who died. [The] landlord wouldn't let me stay since I was not married, and not on the lease."   _{[Participant #48, Black or African American Trans-Male, Gay/Lesbian/Same Gender Loving, age 65-74 years]}

---

San Francisco has high rates of homeless youth, many with intersectional identities.

Youth made up about 14% of the homeless population at the 2022 Point in Time Count, more than double the national average of 6%.

As many as 1,700 youth households experience sheltered or unsheltered homelessness each year in San Francisco.

According to the 2022 PIT Youth Count, youth experiencing homelessness in San Francisco are:

• Disproportionately Black, Native and/or Latinx.
• More likely than adults to identify as LGBTQ+ (38% and 26% respectively)
• More likely than adults to identify as Transgender (7% and 3% respectively) or a gender other than singularly female or male (5% and 2% respectively).

Young people experiencing homelessness in San Francisco described unsupportive family relationships as a root cause of homelessness for youth. Youth people reported wanting to learn life skills, particularly about personal finances.

"My mom kicked me out and I started house surfing with friends, sisters, cousins. I ended up being in a relationship, I was staying with him. Then me and him broke up. Over the time there were different things. Homelessness was a consistent theme."   _{[Participant #36, Black or African American, Female, Straight/Hetero. Age 16-24 years]}

e"[I was] living in a car essentially for a long time. I got taken by foster care. Lived there for a while, it was nice. They weren’t my family, so when I turned 18, I got kicked out so to speak."   _{[Participant #4, American Indian or Alaska Native, Male, Straight/Hetero. Age 16-24 years]}

"Schools don't teach you how to keep track of money. And in  my household, I didn't have that at home."    _{[Participant #10, Black or African American, Female, Gay/Lesbian/Same Gender Loving, Age 18-24 years]}

---

Older adults experiencing homelessness have unique needs.

Homelessness among older adults has increased nationally over the past 30 years.

The 2022 Point in Time Count survey data showed 25% of people experiencing homelessness in San Francisco were age 51+ years. The previous PIT Count in 2019 found 35% of the homeless population was age 51+years.

However, 1 in 3 sheltered or unsheltered homeless adults who accessed coordinated entry in San Francisco during FY21-22 were aged 50 years or older.

Dr. Margot Kushel's research finds that homeless adults in their 50s and 60s frequently have the health characteristics of people 20 years older, including chronic health conditions, mobility impairments, cognitive impairments, and premature mortality (Fagan 2019).

In the qualitative focus groups conducted for this Needs Assessment, older adults described struggling to afford housing on fixed retirement or disability incomes.

Despite age and disability, some reported working and others said they were considering a return to work. 

"I’m on Social Security for rest of life and can’t get a job. I can’t read or write, so this is all I got. What should I do now?"   _{[Participant #50, Black or African American, Male, Straight/Hetero. Age 55-64 years]}

"I can’t walk anymore. We’re both older, we can’t do all the things they want us to do [to get benefits]."   _{[Participant #16, Hispanic, Latino or Spanish, Woman, Straight/Hetero. Age 45-54 years]}

---

Homelessness and Poor Health are Interconnected

People experiencing homelessness in San Francisco report higher rates of disabling health conditions than the general population

• The 2022 San Francisco Point in Time Count found that 39% of respondents reported at least one disabling health condition (n=768).
• The 2020 US Census 5.7% of San Francisco's population under age 65 years with a disability.

Qualitative data showed that poor health is a cause of homelessness: 

• Death of a parent or a partner.
• Disabling accident or a health event requiring hospitalization.

And, poor health is a consequence of homelessness:

• Accelerates the development of chronic health conditions
• Exacerbates existing health conditions

A review of Mental health SF data found that 46% of people experiencing homelessness who touch the homeless response and/or healthcare system have a Serious Mental Illness and/or a Substance Use Disorder diagnosis (N=18,995). This is the Mental Health SF population.

Consistent with the population of people experiencing homelessness more generally, the Mental Health SF population shows an overrepresentation of people identifying as men, as Black or African American, and as Hispanic or Latinx.

The qualitative research conducted for this Needs Assessment found people experiencing homelessness have significant behavioral health needs and are interested in programs and services. 

"I get nervous speaking to people. I have panic attacks. Maybe counseling? I’m depressed."   _{[Participant #30, Middle Eastern or North African, Female, Straight/Hetero. Age 45-54 years]}

"I get depressed and I feel suicidal. I need to try to work on being safe to be alone."   [_{Participant #3, Hispanic, Latino, or Spanish, Male, Straight/hetero. Age 16-24 years]}

"I didn’t know there was mental health support."   _{[Participant #1, Asian, Female, Straight/Hetero. Age 55-64 years]}

"Being on the streets, you will need someone to hear you out, help with your problems."   _{[Participant #10, Black or African American, Female, Gay/Lesbian/Same gender loving. Age 16-24 years]}

---

Domestic violence is a common cause of homelessness.

The San Francisco Family Violence Council published it's annual report in 2020, documenting: 

• Victims of reported family violence are disproportionately Black and Latin(a)(o)(x)
• Women make up 70% of victims of domestic violence who engage with policy.
• There is a significant unmet need for shelter and other supports for victims of domestic violence.

"I was staying with my family. I didn't think of it as homeless, but it was difficult. The situation was uncomfortable [I] started staying at domestic violence shelters. Then started going to school, had two jobs. I was comfortable bettering myself. But, overall, [homelessness] started because of family."   _{[Participant #40, Black or African American, Female, Straight/Hetero. Age 24-34 years]}

---

Take Away: Population Needs

Data about homeless populations and the words of people experiencing homelessness show the structural roots of homelessness in racial and economic inequality.

Racial inequality appears as barriers to education, stressed family networks, barriers to employment, and disabling health conditions. Combined, these barriers make the gap between income and the cost of living appear unbridgeable.

The population of people experiencing homelessness shows a significant need for ongoing housing and support service supports.

• 1 in 4 of adult households seeking help through Coordinated Entry were aged 55+.
• Public health data show that 46% of adults experiencing homelessness are suffering from a Substance Use Disorder or Serious Mental Illness.
• Households experiencing homelessness have extremely low incomes.

Against incredible barriers, people experiencing homelessness are resourceful and motivated.

• Youth have ambitions of economic stability and need programs to provide financial support, mental health services, and learning opportunities, as they become adults.

San Francisco should consider how understanding homelessness as a racial equity issue might change the kinds of responses that are considered appropriate and necessary.

Back to top

How many people are homeless in San Francisco?

The Point in Time (PIT) Count of people experiencing homelessness takes place every-other year and includes a visual count of unsheltered homelessness, a count of people in shelters, and a survey.

The count includes:

• People in shelters
• People sleeping in unsheltered situations, like on sidewalks, in tents, or in cars.
• Victims in domestic violence shelters

The most recent PIT Count shows a decrease in the number of people experiencing homelessness in San Francisco at a point in time.

This decrease broke with a trend of increases since 2015.

Using an evidence based method of estimating homelessness, data from the PIT Count and administrative sources, the City estimates that as many as 20,000 individuals experience homelessness in San Francisco over the course of the year.

Understanding the scale of the shelter and housing need means converting the estimate into households, since multi-person households will be served together. The population estimate translates into roughly 16,700 households experiencing homelessness during a year in San Francisco. 

Adults (including youth) make up about 90% of households experiencing literal homelessness in San Francisco, around 15,000 households each year.

Families with children (including parenting youth) make up about 10% of households experiencing literal homelessness in San Francisco, as many as 1,700 families each year.

Families and youth who are doubled up or living in overcrowded conditions are challenging to count because there are not many opportunities to observe this type of homelessness. Additionally, families and youth may hide their living situation to avoid unwanted attention, including intervention by systems like child protection.

There are a couple of sources that speak to overcrowded and doubled up families and youth.

In 2018, San Francisco School District reported:

• 1,661 students living doubled up with friends or relatives
• 291 in hotels or motels
• 628 literally homeless students in sheltered or unsheltered living situations

The SRO Collaborative's 2015 report estimated around 700 households with minor children living in SRO units.

Victims fleeing violence are are also difficult to count. For one thing, it is well known that violence is underreported, particularly when it occurs in intimate relationships, families, homes, and other trusting relationships. Victims' safety may depend on confidentiality and being hidden. For example, victim service providers do not use the same data systems as homelessness service providers, in order to protect victims' confidentiality.

There are two sources that point to the number of people fleeing domestic violence each year.

San Francisco's 2021 Continuum of Care Funding application estimated that 4,109 survivors of violence (all family members) by violence in San Francisco each year.

And, the 2022 Point in Time Count Survey found that domestic violence was the primary cause of homelessness for 8% of literally homeless families and 4% of literally homeless adults.

Back to top

Inflow & Homelessness Prevention Resources

Data suggests a higher rate of inflow into homelessness in the coming years. Current best thinking is that around 9,000 households lose their housing and become newly homeless over the course of the year.

About 7,900 of those newly homeless households are adults (including youth).

About 1,100 of households entering homelessness are families with children (including parenting youth).

There are a variety of program models designed to prevent homelessness or rapidly return people to housing.

• Eviction Prevention and Housing Stabilization services are targeted to low income renter households and provide legal services, tenant counseling, and rental assistance to prevent the loss of current rental housing and displacement.
• Targeted Homelessness Prevention services are targeted to Very and Extremely Low Income households and provide financial assistance and supportive services to preserve or find new housing.
• Problem Solving and Diversion interventions are targeted to people who will be homeless tonight and builds upon and reinforces the person's existing network and resources with mediation, flexible funds, and other supports. 
• Problem Solving/Rapid Exit interventions are targeted to people experiencing homelessness and builds upon the persons existing network and resources with short term rehousing supports, creative alternative resolutions, flexible funds, and other supports. 

Please see the full report for more on homelessness prevention programs, as well as the capacity of the homelessness response system to serve households most at risk of homelessness

---

The most common cause of homelessness for people of all ages was a breakdown or loss of the relationships that may have otherwise prevented homelessness.

"You can have family members, but you don’t want to put the burden on them because they’ve got enough on their plate. I’ve got two sisters, but they’ve got their own lives to live."   _{[Participant #27, Black/African American male, straight/hetero, aged 55-64, ]}

"Even with 5 of us earning in the family, we still couldn’t afford rent. So, we all went our separate ways."   _{[Participant #22; Hispanic, Latino, or Spanish, Female, Age 45-54 years]}

"Family is overrated."   _{[Participant #15, White, Male, Straight/Hetero, Age 45-54 years]}

Prevention services need to be accessible and timely to ensure people can get help when they need it and before they have lost their housing.

Flexible financial assistance, including help with rent, was the most frequently cited form of help that could have prevented homelessness.

"The City should have a 2-year program, if someone is in a bad situation, then you can go to a place and get 2 months of rent. Rather than get kicked out and losing your belongings, you get 2 rent checks to figure it out. This would keep people from becoming homeless, especially if they have kids."   _{[Participant #28, Black/African American, Male, Straight/Hetero. Age 25-34 years]}

Qualitative data identified both structural barriers and solutions for preventing homelessness. Structural solutions include:

• Early intervention for families with young children
• Life skills classes
• Rent regulation
• Right-sizing wages
• Access to better jobs
• Simplifying systems

Reducing the number of people who become homeless is an essential part of ending homelessness.

In San Francisco, the homelessness prevention system is taking shape. Partners are working to incorporate many of the components that people experiencing homelessness say would have helped them: 

• Flexible financial assistance
• Accessible through a variety of community based services
• Builds upon the strengths and resources of people most at risk of homelessness.

What else do people experiencing homelessness say is needed to prevent homelessness?

• Bringing interventions to scale
• Greater accessibility of supports from CalFresh and Eviction Prevention to Flex Funds.
• Targeting the neighborhoods and communities that are most at risk of homelessness
• Upstream solutions, like supports for young children and families
• Access to opportunities
• Safe, reliable and efficient public transportation
• Jobs and workforce training

Back to top

Resources Available and Service Needs of People Experiencing Homelessness

The number of shelter beds and crisis intervention slots a system needs depends on how quickly or slowly homeless households can move into permanent housing. Movement through the system is called flow.

When permanent housing is available, people leave homelessness creating outflow, and shelter beds and crisis intervention slots turn over and serve more households.

If permanent housing is not available:

• Shelter and crisis intervention beds will turn over slowly and serve fewer households.
• Unsheltered homelessness will increase.
• The length of time people remain homeless will increase.
• Demand for high-cost shelter beds will increase.

Increasing the rate of shelter outflow to permanent housing is essential to efficient and effective use of shelter and crisis intervention capacity.

The following section describes the kinds of interventions for people who are currently experiencing homelessness. More information about these interventions and the system's inventory can be found in the full report.

• Vehicle Triage Centers are temporary, outdoor safe places where people living in their vehicles can park overnight, with security and access to sanitation, drinking water, and connections to services
• Safe Sleep is a temporary, outdoor safe place where people can sleep safely in tents, off sidewalks, with access to services and sanitation.
• Shelter describes indoor safe places where individuals and families can reside temporarily with access to plumbing, ventilation, heating/cooling, electricity, and prepared food or/and cooking elements.
• Transitional Housing is time limited housing up to two years with intensive services to support the transition from homelessness to housing. 

---

Without enough permanent housing solutions and supports, people are remaining homeless for extended lengths of time. 

The chart below shows the length of this episode of homelessness using administrative data collected in the ONE System at the time of program enrollment. Data shows unduplicated households.

The data speaks to diverse needs within the homeless population:

Households with shorter lengths of time homeless may need a less-intensive resource to resolve their homelessness.

Households with extended lengths of time homeless will likely need significant economic and social supports to find and retain housing.

Because of the racial disparities in the homeless population and the legacy of systemic racism, disaggregating data by race and ethnicity is essential.

This chart visualizes the length of time homeless using administrative data collected in the ONE System at the time of program enrollment (FY21-22). Data reflects unduplicated households.

---

People experiencing homelessness have diverse experiences of shelter. 

"Many people don’t want to go into shelter because of the restrictions [program rules]. But for me, the restriction [of program rules] made it easier: eat and sleep at the same time."   _{[Participant #1, Asian, Female, Straight/Hetero. Age 55-64 years]}

"I prefer being outside."   _{[Participant #21, Hispanic, Latino, or Spanish; Female, Straight/Hetero. Age 45-54 years]}

"In shelters, you don’t have a chance. I didn’t feel comfortable."   _{[Participant #33, Hispanic, Latino, or Spanish; Male, Straight/Hetero. Age 65-74 years]}

"I was homeless for a year outside and in parks. I was so ashamed. I’m grateful to be here [in shelter]."   _{[Participant #30, Middle Eastern or North African; Female, Straight/Hetero. Age 45-54 years]}

---

Each year the Department of Public Health provides health care services to thousands of people experiencing homelessness through its integrated system of care. Please see the full report for more information about this integrated system of care.

Whole Person Integrated Care Services bring together non-traditional primary care, urgent care, and behavioral health clinical services. These services include:

• Street Medicine uses harm reduction techniques to engage and assess patients in non-traditional settings like streets, parks, encampments, and navigation centers.
• Sobering Centers provide care to intoxicated adults whose public use puts themselves or others at risk.
• Shelter Health provide clinical care in shelters.
• WPIC Urgent Care addresses urgent needs of individuals who are not getting their needs met elsewhere in the health care system.
• Medical Respite serves people experiencing homelessness who are leaving the hospital but still need time and care to recover from an illness or injury.

 Behavioral health services treat mental health and substance use disorders. Inpatient and outpatient services are available to people experiencing homelessness as well as a variety of street-based and shelter-based service models.

• Overdose and Harm Reduction Supports are services to stop and/or reduce the risk of an overdose, including naloxone distribution and education, buprenorphine induction, opioid acute care treatment, and pharmacy services.
• Youth Mental Health Services describe a continuum of outpatient mental and behavioral health programs serving youth, including harm reduction therapy.
• Behavioral Health Access Programs are an entry point to the substance use and mental health system of care, including residential treatment and outpatient services. 

DPH manages roughly 2,200 residential care and treatment beds. Approximately 90% of people served with these treatment beds are experiencing homelessness. 

---

Qualitative data shows a profound sense of isolation among people experiencing homelessness. Many described needing mental and behavioral health supports for themselves and/or others.

"People here don’t have anybody, just animals."   _{[Participant #18, Black or African American, Male, Straight/Hetero. Age 45-54 years]}

"Homelessness can be dehumanizing."   _{[Participant #30, Middle Eastern or North African; Female, Straight/Hetero. Age 45-54 years]}

"It’s tough. I don’t like being alone."   ^{[Participant #12, Black or African American; Male, Straight/Hetero. Age 16-24 years]}

"A lot of people have mental health issues. They need help, but there’s nothing."   _{[Participant #22, Hispanic, Latino, or Spanish; Female, Age 45-54 years]}

People experiencing homelessness described feeling hopeless about their situation and the future.

The qualitative research found some participants struggling to navigate the system or find help. This was particularly true of older adults.

Others described being ineligible for programs or supports that fell short of meeting their needs.

"I feel lost and don't know how to make a plan because there's so many choices, and options and [I] don't know how to get anything."   _{[Participant #16, Hispanic, Latino, or Spanish; Female, Straight/Hetero. Age 45-54 years]}

"Things are up in the air with me. I would like to get on some kind of list so I have some kind of contact."   _{[Participant #26, Black or African American, Female, Straight/Hetero. Age 55-64 years]}

"Everything I did, I had to do on my own."  _{[Participant #2, Black or African American, Female, Age 55-64 years]}

---

Take Away: Needs of- and resources for- people experiencing homelessness

Data show a growing number of people entering homelessness and many remaining homeless for a year or more. This means a large section of the population will need intensive supports to obtain housing.

Investments in shelter and crisis interventions must be paired with permanent housing investments.

Lost relationships, unsupportive family bonds, social alienation, and hopelessness emerged as commonalities across unique personal experiences of homelessness. Many people described wanting not to be alone as they move through the experience of homelessness.

Qualitative data show people have diverse needs and preferences as they experience homelessness; what is comfortable and safe for some isn’t for others.

---

Back to top

Outflow & Permanent Housing

Qualitative data reflect hopelessness and frustration among people experiencing homelessness: permanent housing resources are scarce, demand is high, and options are limited. And, as the prior section describes, when permanent housing is available, outflow increases, and shelter beds and crisis intervention slots turn over and serve more households, and the number of people experiencing homelessness decreases..

This section outlines the housing resources currently available in the system, and describes the needs of the population. Please see the full report for more information on permanent housing and the inventory of resources.

Permanent housing resources available in San Francisco's homelessness response system fall into two groups: ongoing and time-limited.

Permanent Supportive Housing (PSH) is an ongoing support that pairs a deep rental subsidy with intensive support services. PSH is for people with Extremely Low Incomes (ELI), one or more disabling health conditions, and extended lengths of time homeless. 

To get a sense of how many households need PSH, consider these population characteristics:

• Almost 1,000 families and 7,400 adults reported extremely low incomes at coordinated entry assessment in FY21-22.
• 39% of 2022 PIT Count survey respondents reported having one or more disability conditions.
• According to administrative data from Mental Health SF, roughly 8,800 patients who are homeless in San Francisco have a serious mental illness and/or a substance use disorder diagnosis.
• The 2022 PIT Count identified about 2,700 (rounded) chronically homeless people, 35% of the PIT

Participants in the qualitative focus groups met PSH eligibility criteria because of health conditions and income barriers. Many of those said they were waiting; some to get on a list and others for their name to come up on the list.

"I’ve been here [in this program] since just after Thanksgiving last year. I’ve applied for housing. They say my name is on the list, but it’s a slow process. [I only get] SSI, so I’m still here."   _{[Participant #27, Black or African American, Male, Straight/Hetero, Age 55-64 years]}

But, PSH is not right for every person experiencing homelessness. The qualitative data showed some people experiencing homelessness need less intensive interventions. And others wanted more independence than the PSH model affords.

"[It] seems like the system wants me to be on drugs or have some sort of issue for me to get housed. There aren’t programs for people who just need a temporary boost."   _{[Participant #47, Black or African American, Male, Straight/Hetero, Age 25-34 years]}

Time-limited housing  provides support with housing search, move in costs, and a limited-term subsidy that helps a household stabilize and become self-sufficient in housing. Time-limited housing programs frequently target households that are likely to increase their income, including people who are younger and healthier.

To get a sense of how many households need time-limited housing, consider these population characteristics:

• 49% of households assessed through Coordinated Entry during FY21-22 were between 24-45 years, about 4,300 households.
• Youth aged 18-24 make up 14% of people experiencing homelessness, according to the 2022 PIT Count Survey.

For households that may be a good fit for time-limited housing, increasing income remains a significant barrier to housing stability.  Although the qualitative data found many examples of people working even as they experienced homelessness, most worked in entry level positions and struggled to earn enough to afford housing.

"I just want to stay [in this shelter program], look into school. Save up if I can, pay off debt."    _{[Participant #28, Black or African American, Male, Straight/Hetero, Age 25-34 years]}

"I have 3 jobs, and I’m trying to save up to make progress."    _{[Participant #3, Hispanic, Latino, or Spanish, Male, Straight/Hetero. Age 16-24 years]}

"Just because someone's employed doesn't mean they can pay the full amount of rent." _{[Participant #49, Black or African American, Female, Gay/Lesbian/Same gender loving, Age 25-34 years]}

Access to the homeless response system's Permanent Housing Resources shows some variation from the demographics at the PIT Count. The below chart draws on administrative data to show the proportion of clients from each racial and ethnic group who have housing referral status, the proportion referred to housing, and the proportion of housed participants between 7/1/2021-6/30/2022.

• Orange represents the racial distribution at the 2019 PIT Count.
• Light blue are the number of households with housing referral status- meaning that they are eligible to be referred to system provided housing resources like PSH.
• The medium blue shows households referred to a permanent housing program.
• And navy blue represents households who exited the homelessness response system to a system provided permanent housing destination such as Rapid Re-Housing and Permanent Supportive Housing.

---

The State of California requires local governments to create a plan to meet the housing needs of everyone in the Community.

The plan - called the Regional Housing Needs Assessment - provides the number of housing units needed in cities and counties throughout the Bay Area. According to the State's Regional Housing Needs Assessment, between 2023-2031 San Francisco needs to add:

• 21,359 Units for Very Low-Income Households (50% AMI and below)
• 13,717 Moderate-Income Units (120% AMI)
• 35,471 Above Moderate-Income Units

 

---

Back to top

Conclusions

Homelessness is the result of racial and economic inequality.

People experiencing homelessness have diverse needs for crisis interventions, shelter, and housing. An effective response to homelessness will be modeled on the population's needs and may not include approaches that aren't currently part of the citywide response.

From the social safety net to permanent housing, resources are not available at the scale the crisis demands.

Adding investments with the twin goals of meeting diverse needs and increasing flow through the homeless response system will maximize capacity and effectiveness.

The Department of Homelessness and Supportive Housing's City -wide strategic plan, Home By the Bay: An Equity-Driven Plan to Prevent and End Homelessness in San Francisco, quantifies the additional resources needed, and takes steps to align systems of care to meet the needs of people experiencing homelessness. 

Effectively responding to homelessness will require significant new investment and coordinated effort across City departments to:

• Strengthen the social safety net
• Foster economic mobility for people living in poverty
• Realize housing stability

---

Back to top

Data Sources

Applied Survey Research. (2022). San Francisco Homeless Count and Survey, Watsonville, CA.

Applied Survey Research. (2019). San Francisco Homeless Count and Survey, Watsonville, CA.

Association of Bay Area Governments. (2021). Regional Housing Needs Allocation Draft Methodology: San Francisco Bay Area, 2023-2031.

California Housing Partnership. (2022). San Francisco County 2022 Affordable Housing Needs Report.

CalWorks. (2022). Data Tables: CA 237 HA: Homeless Assistance.

Coalition on Homelessness. (2020). Stop the Revolving Door.

Fagan, Kevin. (2019, March 8). “Aging onto the Street.” San Francisco Chronicle. https://www.sfchronicle.com/bayarea/article/Aging-onto-the-street-Nearly-half-of-older-13668900.php

Kidsdata.org (2018). Homeless Public-School Students, by Nighttime Residence.

Kost, Ryan. (2022, June 30). “Analysis: California has the highest share of residents who identify as LGBT.” San Francisco Chronicle. https://www.sfchronicle.com/california/article/california-lgbtq-17275649.php

National Network to End Domestic Violence. (2022). 16th Annual Domestic Violence Counts Report – California Summary. https://nnedv.org/resources-library/16th-annual-domestic-violence-counts-report-california-summary/

San Francisco Department of Homelessness and Supportive Housing. (2022) Income for FY Coordinated Entry Enrollees. ONE System.

San Francisco Department of Public Health. (2017). Promoting Housing Security & Healthy Homes for Families Served by Material, Child, & Adolescent Health Programs.

San Francisco Department of Public Health. (2019). Community Health Needs Assessment.

San Francisco Department of Public Health. (2020). Behavioral Health Bed Optimization Project Analysis and Recommendations for Improving Patient Flow.

San Francisco Department on the Status of Women. (2021). Family Violence Council Report, July 01, 2019 – June 30, 2020.

 

 

San Francisco Mayor’s Office of Housing and Community Development. (2022). Maximum Income by Household Size.

San Francisco Planning Department. (2018). Housing Needs and Trends Report.

San Francisco Planning Department. (2022). Housing Element Update 2022: Highlights.

San Francisco Planning Department. (2022). Draft Housing Needs Assessment and Assessment of Fair Housing, March 2022.

San Francisco Continuum of Care. (2022). Housing Inventory Count.

San Francisco Continuum of Care. (2021). Housing Inventory Count.

Social Security Administration. (2022). Supplemental Security Income (SSI) in California, January 2022.

SRO Families United Collaborative (2015). SRO Families Report.

US Census Bureau. (2019). American Community Survey (5 year).

US Census Bureau. (2020). Quickfacts: San Francisco County, California.  https://www.census.gov/quickfacts/sanfranciscocountycalifornia

United Way of California. (2021). Real Cost Measures. https://public.tableau.com/app/profile/hgascon/viz/TheRealCostMeasureinCalifornia2021/RealCostDashboard

Back to top