On a crisp November morning outside the Exploratorium, amid throngs of excited schoolchildren, stands another group on a field trip. Much older and grizzled looking, the collection of veterans has the same kinetic laughter as the kids, cracking jokes and eagerly waiting to get inside the museum.
But between recounting memories of his time as a bike messenger and stories about his old naval base with details that would rival a historian’s, Mark Shaffer laments how difficult it is for veterans to access government resources at various levels, such as food assistance or Social Security benefits. “They just ask if you’re a vet, for statistical purposes,” he said.
Shaffer knows firsthand how difficult it is to navigate the system. Though he now lives in permanent supportive housing run by the San Francisco nonprofit Swords to Plowshares, he was homeless when he first encountered the organization. The Exploratorium visit is part of a pilot program to reduce isolation and build community, with the goal of helping veterans stay housed.
As California’s population grows older and social safety nets suffer budget deficits and federal funding cuts, more people need help aging in place. This is true especially of veterans, a demographic with higher-than-average rates of homelessness. So Swords to Plowshares launched a pilot program offering enhanced onsite services and staffing in subsidized housing to help them stay healthy and stable.
More than two years in, preliminary results suggest that the program is helping participants remain stably housed and get the care they need. But future funding remains uncertain as the Trump administration moves away from evidence-based long-term housing interventions, including rental subsidies for people at risk of homelessness.
“You could have a beautiful room that you build, and you put them in it and you shut the door — and you’re just warehousing people,” said Amy Fairweather, director of policy at Swords to Plowshares. “They’re going to be isolated. They’re going to be depressed. Their health is going to decline. Going to assisted living or to a nursing home or back on the street is extraordinarily expensive in many ways, both dollar figures and just tragedy.”
The pilot is enabling people to age while living in dignity, she said.
Encouraging early results
The federal government has made large investments in permanent supportive housing for veterans since 2008, but veteran homelessness persists. Studies show significant service gaps in current long-term subsidized housing for veterans, especially for those who are aging or have health issues requiring more care.
In 2023, the California Department of Veterans Affairs launched the Veterans Support to Self-Reliance pilot with grants totaling nearly $25 million. The program provides extra support staff and services for veterans in permanent supportive housing across six counties, including San Francisco. Specialists focus on peer support, mental health counseling, transportation and more. The program also offers funding for meals and social activities like museum visits to build community.
Data about participants in the program for at least a year showed noteworthy and in some cases statistically significant improvements in several metrics, though it was not a randomized controlled trial and the population being surveyed was small — in the hundreds of people.
Some of the most promising results include a 63% decline in emergency medical visits and a 59% drop in 911 emergency calls. Missed medical appointments decreased by 63% and the percentage of veterans eating three meals a day nearly doubled. Many participants reported better health and increased emotional support.
Evidence suggests also that the number of participants exiting their housing is low compared to what is typically observed in permanent supportive housing, and exits have continued to decline with time. Reasons for exit can include death, eviction and transfer to settings with higher levels of care.
“That’s good news, that it seems that these extra supports are helping people stay in place,” said Sarah Hunter, director of the RAND Center on Housing and Homelessness, which is conducting a third-party analysis of the program.
Providing housing alone isn’t enough, said Christopher Martinez, a mental health specialist at Swords to Plowshares. Complementary services offering mental health support or benefits assistance can help those struggling to transition from the streets to stable housing.
Though not explicitly focused on suicide prevention, Martinez said, the program has helped create and maintain connections with veterans, letting them know someone cares. In one case, he said, a staff member’s routine check-in stopped a veteran’s suicide.
Not every trend observed was positive. In its recent analysis, RAND found that people were venturing out of their units less frequently over time and that substance use increased.
However, Hunter said, “it might be that the veterans are now becoming more comfortable with the pilot specialists and being more honest in their reporting than they were when they started the program.”
Building trust with veterans is a key part of the program’s success and takes time, providers said. The range of support services and coordination between staff helps.
Creative model of care
Nestled in a corner of the Presidio, from where the Golden Gate Bridge is often obscured by fog, sits a permanent supportive housing site for veterans. In the lobby, a woman with glasses perched atop a friendly face greets residents as she pushes a cleaning cart toward the elevator. Upstairs, she gently knocks on a door. “Mr. Thomas, it’s Imelda. I’m here for you today.”
Imelda Byanyima is the coordinator of the pilot’s service assistants, going into participants’ rooms once a week to clean and check in on them.
“For us, we try to gain their trust, and we are in their space,” Byanyima said.
While some veterans are hesitant to open up to social workers or medical professionals, consistent staff like Byanyima build relationships with participants and can communicate with case workers about behavioral changes or other concerns.
“They’re not going to open up to people who are, quote, ‘professionals,’ who they see periodically, or somebody just shows up at their site out of the blue,” Fairweather said. “At our sites, we found that often they would — rather than talking to a mental health specialist, they talk to the janitor because they were there, and they see this person on a regular basis.”
In the unit, Byanyima works alongside another employee collecting trash and cleaning up a spill on the floor while the resident thanks her from the other side of the wall. “I love you,” he says.
The resident initially didn’t want people coming into his unit but has since allowed staff to enter as their relationship with him grew, Byanyima said.
She takes great pride in cleaning units and connecting with veterans. “They really appreciate the services,” Byanyima said. “Once a week when we come, it makes a difference.”
Funding troubles
Despite the program’s success, its future remains uncertain. President Trump has attacked funding for programs that have proven to support unhoused people. His administration proposed drastic changes severely whittling down the long-term rental subsidies that veterans in the pilot rely on. Facing several lawsuits, the administration has walked back those changes for now, and a federal judge temporarily blocked the changes on Dec. 19.
These cuts are a real betrayal for veterans experiencing homelessness, Fairweather said. “They basically turned over their lives to this system — a disenfranchisement, a marginalization.” Many people, she said, think veterans are fine because they have the U.S. Department of Veterans Affairs to take care of them, but they still struggle. “A lot of these problems are outsourced onto the communities.”
California has extended the pilot multiple times and will operate it until early 2027. Swords to Plowshares is working with providers across the state to find local funding to keep it going, but securing money is hard. Though staff had hoped the VA would be interested in further funding the program and see it as a humane and cost-effective model to keep older adults housed, federal support is now questionable.
“We’re doing everything we can to simultaneously argue for the program and find funding, but also to figure out ways that we can mitigate a really harsh ending,” Fairweather said. The veterans are aware that this is not necessarily forever, and they worry about it, for themselves, their neighbors and the staff.
At the Exploratorium, Shaffer mourned the loss of a formerly homeless resident in his building named Jerome. They had crossed paths numerous times while Jerome was living on the streets.
“I never knew all those decades he was a veteran,” Shaffer said. “He was so resilient.”
For veterans, stable housing can mean the first chance in years to build community, relationships and lifesaving support. But for now at least, the fate of this support system is not in their hands.
CORRECTION 1/6/25: An earlier version of this story misspelled Mark Shaffer’s name.