Homelessness in San Francisco. (Photo: davitydave / Flickr)An early version of this article first appeared in Street Sheet, a newspaper produced by the Coalition on Homelessness in San Francisco and given to homeless persons who are able to sell the newspapers on the street and keep money they make from the sales.

Last year the San Francisco Chronicle reported the number of homeless families in San Francisco had reached a record high and, now, one year later, San Francisco’s Board of Supervisors have decided to act.

On April 30, city supervisor Mark Farrell held a hearing in City Hall to discuss cost-effective strategies for housing the homeless, one in a series of five hearings to address different aspects of homelessness in San Francisco.

Farrell said he hopes to combat homelessness in a cost-effective way in order to decrease the number of families who have been forced onto the street, while avoiding unnecessary expenses.

“At the end of the day, this is a human issue,” Farrell said. “We need to provide the best services possible and get these people, these individuals that are on our streets, the best outcome for their own lives.”

Currently, single homeless people who seek housing may call the city’s shelter reservation system and place their name on a waitlist. Each morning, the San Francisco Human Services Agency conducts a lottery and generates random reservation waitlist numbers for the previous day’s entries. This means that homeless people who have placed their name on the waitlist are given a number that determines when they will be provided a bed. As of June 11, the waitlist was 517 people long.

For families, shelters require a more extensive screening process, where they are assessed and placed on a list they have to call into weekly to maintain their status. In May, the list included one family that had been waiting nine months for a shelter, but the wait is typically a bit shorter than that.

“It takes families six months to get a longer-term shelter bed,” said guest speaker Jeff Kositsky of the Hamilton Family Center.

Most of these families were experiencing homelessness for the first time, and most were San Francisco residents at the time they became homeless. Homeless people who receive housing through the shelter reservation program are given a 90-day length of stay. After 90 days, they are required to move out and either find a permanent home, place their name back onto the shelter reservation waitlist or return to the street.

A Second Option

In 2006, San Francisco’s Department of Public Health began a permanent supportive housing pilot program to evaluate a second option for homeless individuals and families. Permanent supportive housing is different than shelter housing in that it provides homeless people with long-term housing and on-site support systems, rather than short-term solutions and limited support systems.

Joyce Crum, director at the Housing Services Agency, explained the benefits of permanent supportive housing: “A reduction in emergency medical costs, a decline in criminal justice system costs, an increase in substance abuse treatment and decrease in substance abuse use and an improvement in employment because when you’re housed, you’re stable, and you don’t have to worry about carrying your belongings or moving to a different shelter every night.”

During the supportive housing’s pilot program, 106 studio apartments were made available to homeless people. Prior to moving into these supportive housing units, the total annual medical costs for these homeless people were approximately $3 million. After moving in, the annual medical costs were approximately $800,000. The total cost to run the program was $1 million, which means that the permanent supportive housing program did save the city about $1.2 million.

But supervisors at the hearing were skeptical of the overall cost savings of permanent supportive housing programs. True, they said, these programs do decrease medical costs, but this decrease does not exceed the cost to build or refurbish apartment complexes to house homeless people. For example, if a given permanent supportive housing building cost $10 million to build, then saving $1.2 million in medical costs would still result in a net loss.

Although this would initially be a net loss, city supervisors did concede that after a certain number of years of medical cost savings, permanent supportive housing would result in a net gain. Therefore, not only does permanent supportive housing help improve the lives of homeless individuals and families, but it is also a solution that will become cost effective over time.

Is the City Really Concerned About Cost Effectiveness?

The city has not yet decided to build the needed number of units of permanent supportive housing for homeless families because initial construction costs for these buildings appear too great. But, last year, the city provided Twitter with a $56 million dollar tax break to stay in the city. Such a handout to a private company seems like it would be worrisome to those who are concerned about cost effectiveness. Therefore, one must ask: Does the city truly want to find cost-effective solutions in order to help those in need, or do they want to find cost-effective solutions to more pressing issues, such as attracting companies like Twitter?

Recall that city supervisor Mark Farrell opened the hearing with this statement: “At the end of the day, this is a human issue.” In a closing statement, guest speaker Joe Wilson of Hospitality House reminded the audience of Supervisor Farrell’s poignant opening words. Wilson, in a calm but declarative voice, told the audience that the Charter to the United Nations was written in 1948 right here in the city of San Francisco.

Wilson stood in front of the supervisors and read a section of the preamble.

“Several years ago, a group of people gathered in this city to propose an alternative model for cooperation,” he said. “I’m quoting from that meeting here: ‘The reason that we are proposing this model is to reaffirm faith in fundamental human rights, in the dignity and worth of the human person, in the equal rights of men and women, to practice tolerance and live together in peace with one another as good neighbors.'”

Wilson then paused, looked directly at the supervisors, and closed with a statement full of subtext in a city that has decided private corporations are more important than the well-being of long-time, poverty stricken residents.

“I think that that [United Nations preamble] should guide us as we move forward on pursuing cost-effective strategies on tackling homelessness.”