S.F. to tackle shelter waiting game for disabled and older homeless


San Francisco homeless policy director Bevan Dufty will lead an effort to improve the assignment of beds in homeless shelters, as well as assess the health needs of clients. Photo by Steve Rhodes / SF Public Press.

UPDATE: Listen to reporter T.J. Johnston’s updated report on this story at KQED news here.

The health of homeless people — especially older and disabled ones — is endangered by a time-consuming wait they endure daily when reserving a bed in San Francisco’s public shelter system, advocates and city officials say.

As a result of a hearing before a Board of Supervisors panel, the city has begun a series of public meetings with providers, city officials and clients, to seek improvements in shelter access and the health of senior and disabled clients. Homeless policy director Bevan Dufty and others hope to work out a plan this summer and present it to the board.

District 6 Supervisor Jane Kim, who had requested a meeting on shelter reform in early April, said she met a largely aging clientele at the Next Door Shelter on the night she stayed there in January.

“I did not expect our shelter clients to be so much older,” she said. “I did not see a lot of young people in our shelters. I was one of the few younger people there.”

Though estimates vary on how many of 1,134 beds for the homeless go to seniors, Kim’s observations from her shelter immersion agree with a recent data sample from the city’s Human Services Agency. During select months from March 2009 to March 2011, city-funded shelters admitted more than 200 clients aged 60 or older for at least one day. The agency also surveyed shelter residents last year, reporting that 55 percent of clients have a disabling condition.

But the city has a problem tracking individuals to determine who might get shorted on services. The computerized intake system only measures how many of those beds are occupied each night. It doesn’t record which people are filling them.

Navigating the system can be draining. Clients frequently line up outside resource centers overnight, waiting for an opening. When the centers open their doors, the first few people might get available reservations. Some get a bed for 90 days, others a one-night booking. But most are left out, and take their chances at another resource center to wait it out again.

Life on the streets usually takes a physical and mental toll. The Department of Public Health estimates that 75 percent of its homeless patients have chronic medical or behavioral problems. Deborah Borne, former co-medical director of the Tom Waddell Health Center, said the problems of sheltered clients demand a high level of maintenance.

“The No. 1 issue affecting our clients is their ability to function within the system,” she said. “There is a gap between the level of services that we’re able to supply at the shelters giving the best care and the levels our clients have.”

In a video presentation to the supervisors’ Rules Committee, homeless client Greg Allen said he camps outside the Mission Neighborhood Resource Center before its 7 a.m. opening.

“We’re stuck out here praying for a bed,” he said. His mobility curtailed by degenerated discs and a bad knee, Allen forgoes one-night stays at the Providence Baptist Church shelter, about three miles away, and hopes for an opening at a nearby shelter. “I have been on the priority list for a medical bed, but no Sanctuary or Next Door beds have popped up on the screen, because they are gone by 7 o’clock.”

Why are so many unhoused San Franciscans locked in a cycle of “hurry up and wait?” The way beds are allotted to subsets of the population plays a role. Joyce Crum, director of the agency’s homeless services division, told the committee that 390 beds — about one-third — are slated for clients who are guaranteed a 90-day placement when they enroll in the county welfare program, known as Care Not Cash.

But the agency reports that only 568 of the city’s 6,544 homeless folk are active in the program, and advocates from the nonprofit Coalition on Homelessness say tying the proportion of beds to Care Not Cash recipients forces others with different income sources — such as Social Security and disability benefits — into a waiting game, because they make too much money to qualify.

“They make up only 7 percent of the homeless population, and they get to keep the beds even if they do not use them,” said LJ Cirilo, a board member of the Coalition. “The unused beds are released one night at a time. This creates an undue burden on people with disabilities.”

The Board of Supervisors adopted Kim’s resolution calling for a work group to seek improvements in providing shelter access and assessing the health needs of senior and disabled clients.

Amanda Kahn Fried, Dufty’s assistant, said the group will explore the option of booking reservations with the 311 telephone system for city services.

“We’re thinking of using 311 as an additional entry point,” she said, “not as a replacement to reservation centers.”

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Goals of the city’s new shelter work group

  • Assess shelter access beyond a queueing-based system
  • Improve programming within shelters
  • Assess health needs of shelter clients