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10/19/03
Homeless solutions within reach
San Francisco's homeless problem, as I wrote a week ago, is too important to be left solely to politicians. Too many mayors -- as yet another one will do after next month's election -- have proclaimed their dedication to tackling this difficult situation and then gotten nowhere.
One explanation for the political inertia is the city's thick tapestry of homeless advocates, who bring genuine passion to the issue but also competing agendas and conflicting interests.
That's one reason some advocates, including the Rev. John Hardin, executive director of the St. Anthony Foundation, have been quietly meeting with members of the business community in recent days to see if ways can be found to break the gridlock.
"The advocacy community has not been as effective as it could or should be," acknowledged Maryann Leshin, who heads the California office of the nonprofit Corporation for Supportive Housing, which helps municipalities nationwide cope with homelessness. "Having the business community take it to a whole other level could be just the ticket."
Supportive housing, which I've focused on in a series of columns, provides participants with a room to live in and the services required to stay off the streets. It drastically cuts use of public services by those with serious medical conditions.
One city-run supportive-housing program, Direct Access to Housing, has shown since its establishment in 1998 that visits to emergency rooms by participants have been reduced by nearly 60 percent, saving taxpayers hundreds of thousands, if not millions, of dollars annually.
San Francisco's homeless problem can be solved. Supportive-housing programs in the city and elsewhere clearly show that this is a way the streets can be cleaned up and the needs of the down-and-out can be humanely addressed.
But current efforts will need to be significantly expanded. This will require political vision and commitment. And it will require money.
There are now about 2,000 units of supportive housing in San Francisco, ranging from apartment-style facilities owned by nonprofit organizations to renovated single-room-occupancy hotels leased by city agencies.
The scope of the homeless problem is another matter. Some say San Francisco needs to focus on the roughly 1,500 "high utilizers" of public services -- those who filter most frequently in and out of hospitals and jails. Others say that the city's entire homeless population -- conservatively estimated at 13,000 -- should be addressed in any proposed solution.
I say you have to pick your fights. The place to start is with the 7,000 "chronically homeless" and shelter residents -- those with the most urgent mental illnesses or substance-abuse issues who comprise the most visible aspect of San Francisco's homeless population.
To meet this need, the city's existing stock of supportive housing will need to be tripled or even quadrupled. This will require greater organization than currently exists.
At the moment, as I've noted, there are varied players in the field, and they don't always see eye to eye.
"Everybody has their own idea about what a program needs to look like," said Jonathan Vernick, executive director of Baker Places, a San Francisco nonprofit that provides supportive services at 15 local homeless facilities.
A larger, more comprehensive supportive-housing plan will require a central coordinating entity. I can't think of a better agency than the city Department of Public Health, which now offers 400 supportive-housing units through its Direct Access to Housing program and is best situated to measure the impact of an expanded system on public services.
This is vital because the key -- the absolute key -- to making this work is to reinvest savings from supportive housing back into the program. In New York, where a large-scale supportive-housing system has been in place since 1990, studies show that savings from reduced use of public services can cover more than 90 percent of related costs.
San Francisco's next mayor can make a strong contribution here. He or she needs to articulate a long-term commitment to supportive housing and to make it the city's unequivocal policy that savings from reduced use of ERs, hospitals, psychiatric facilities, ambulances, jails and other resources are reallocated to the housing system.
Still, to reach desired levels of savings and economies of scale, first you need to get an expanded program up and running. This is expensive, whether new housing stock is purchased or leased. Millions of dollars will be required annually.
That's where the private sector needs to step up.
I've already advocated a 1 percent surcharge on all restaurant meals over $50. With $4.4 billion in San Francisco restaurant and bar sales last year, this could be an effective means of having the city's residents and 14 million annual visitors help fund a lasting solution to homelessness.
But the business community, which has long lamented the sorry state of the city's streets, has an equally vital role to play. To this end, I suggest creation of a foundation exclusively intended to fund supportive-housing programs in San Francisco.
To be sure, similar resources already exist. The philanthropic San Francisco Foundation, for example, has invested about $410,000 into various supportive-housing endeavors citywide in recent years.
But to provide even greater transparency and accountability, a whole new entity -- the San Francisco Supportive Housing Foundation, say -- could be a narrowly focused conduit for funds from industry groups, merchant associations and individual corporate donors.
Its trustees, working closely with the Department of Public Health, would have no other charge but to bolster supportive housing resources and restore a sense of decency to San Francisco's streets.
This would hopefully allay the concerns of Lee Blitch, president of the San Francisco Chamber of Commerce, who told me that "before business gives more money, we need to do a better job of seeing how it's spent."
At the same time, Blitch accepts that the business community must be a part of any effective plan to end homelessness. "We need to work together to make this happen," he said.
That's a good starting point for the partnership required to end homelessness in San Francisco, a goal that, if we're serious about it, can be accomplished in just a few short years.
As I wrote a week ago, solutions are out there. Now let's do something about it.
By David Lazarus [San Francisco Chronicle Columnist]
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