Proposition N could help pay off first responders’ student loans with the goal of attracting new hires amid staffing shortages.

Listen to a summary of what this ballot measure would do.

Support

Proponents say the measure would help alleviate staffing crises across multiple departments. They also say it would act as an “innovative incentive” to attract highly skilled talent in a competitive market. 

“Our public safety and health care ecosystem is severely strained right now, and we need to create incentives to prevent a catastrophic breaking point and ensure that we can attract and retain excellent, qualified candidates to serve our city’s public safety ecosystem,” said Supervisor Ahsha Safaí, who co-drafted the measure and is running for mayor, at a July 22 Rules Committee meeting. “These are the people we count on every single day, and we must prioritize proper staffing levels.”

Supervisors Shamann Walton, Matt Dorsey, Joel Engardio and Connie Chan also support the measure, as do Service Employees International Union Local 1021, the San Francisco Police Officers Association, the San Francisco Deputy Sheriffs’ Association and San Francisco Firefighters Local 798. 

Opposition

Larry Marso, the registered opponent of this measure as well as of propositions C, E, G and M, argued in his official opposition statement that Proposition N fails to address underlying issues that lead to student loan debt among first responders, such as rising education costs and inadequate compensation. He also said the measure could encourage early retirement, as workers may be more inclined to leave once their loans are forgiven.

What it would do

Proposition N would create a fund to help police officers, firefighters, paramedics, sheriffs, nurses and 911 dispatchers employed by the city pay off their student loan debts. Money from the fund could also pay for job-related educational and training expenses that today aren’t eligible for reimbursement.

To qualify, first responders would need to be hired in 2025 or beyond, and work for the city for at least three consecutive years. The city would pay off at most $25,000 per person. Proposition N does not have a funding mechanism. The mayor and Board of Supervisors could later decide to put money into the fund, which could also receive donations from private philanthropy.

Regarding the lack of funding, Safaí said that asking for taxes in an economy still struggling to recover would be a hard sell, and that he preferred to not automatically set aside funds from the city’s annual budget for a narrow group of individuals as City Hall faces persistent budget deficits.

When asked for examples of private philanthropy in city government, Safaí cited Mayor London Breed’s recent bid to fundraise $25 million to acquire pandas from China for the San Francisco Zoo. He also mentioned donations from Salesforce to the San Francisco Unified School District and a donation of at least $1 million from an individual to the San Francisco Police Department “to help with their technology purchases.”

Cost

The San Francisco Controller’s Office estimated that it would cost $315,000 annually to administer the fund after the program had been set up. The city could begin paying off loans once the fund collected $1 million.

Campaign finance

As of Oct. 7, the “Yes on N” campaign committee had raised $101,000, according to data from the San Francisco Ethics Commission. That includes $50,000 from the San Francisco Deputy Sheriffs Political Action Committee and $20,000 from Marina Cleaners Inc. The campaign committee that backed the failed Proposition B on the March ballot — the measure would have set minimum staffing levels for the police department — also gave $25,000.

No group opposing Proposition N had reported fundraising activity to the city.

History and context

City officials and department employees have been vocal in recent years about vacancies among law enforcement, 911 dispatchers, nurses and others involved in emergency management and response. The mayor and several supervisors have deployed numerous strategies to increase hiring. Proposition N is one of several proposed measures — including propositions F, H and I — on the November ballot that address first responder recruitment and retention.

Supervisors Hillary Ronen, Rafael Mandelman, Myrna Melgar and Aaron Peskin voted against putting the measure on the ballot. While they don’t oppose Proposition N, Supervisors Peskin, Melgar and Mandelman expressed concern about overloading the ballot.

Peskin, the Board of Supervisors’ president and mayoral hopeful, said it was unnecessary to put the issue before voters when the supervisors could establish the fund on their own, a sentiment Mandelman echoed.

“Sometimes you’re bringing something to the voters and it’s really important to get them to weigh in on it, but I don’t really see that,” Mandelman said. “It seems like it certainly could have been done just as a regular old ordinance, although I think people would have asked, even if it weren’t on the ballot, ‘How are we funding this?’”

Safaí said he wanted a mandate from voters to create the fund.

“It’s important that the voters of San Francisco have an opportunity to weigh in on this and make a strong statement,” he said at a July 30 Board of Supervisors meeting.

Votes needed to pass

Proposition N requires a simple majority of “yes” votes to pass.

Click here to return to our full voter guide.

Editor’s note: This story was updated Oct. 9, 2024, to clarify that the “Yes on N” campaign committee received donations from the campaign committee that had backed Proposition B on the March ballot.

The post Proposition N — Create Fund to Pay Off First Responders’ Student Loans appeared first on San Francisco Public Press.

Proposition I would improve retirement packages for 911 call dispatchers, as well as nurses who transitioned from temporary to full-time staff positions, in an effort to attract more people to those city jobs.

The measure could help fix persistent staffing shortages and improve emergency and health services in San Francisco, supporters say. 

“When we look to the future, we have to ask ourselves, who’s going to answer these calls?” said 911 dispatcher Valerie Tucker, referring to emergency phone calls, at a July public meeting about the measure. “Currently, we’re not even replacing the members that are leaving due to retirement.”

Listen to a summary of what this ballot measure would do.

Support

Proponents argue that if Proposition I increased recruitment and staffing, City Hall could reduce expensive overtime, saving taxpayers money.

The measure is endorsed by the full Board of Supervisors and Service Employees International Union Local 1021, the chapter that represents nurses and emergency dispatchers. 

Opposition

The Libertarian Party of San Francisco opposes Proposition I. The city’s government is already too large, and spending more money on public employees while expanding their ranks would increase the burden on taxpayers, the party says in its argument against the measure.

What it would do

Registered nurses working for the Department of Public Health can take shifts on a temporary basis, as needed, or they can be full-time city employees with pensions. The more years that employees work, the greater their retirement packages are.

When a temporary nurse transitions to a full-time position, the process can take months or even years. In the meantime, they are still treated as temporary, meaning their work hours do not count toward retirement benefits.

Proposition I would allow registered nurses who made that transition to then pay the city to retroactively include up to three years of prior temporary work for the city in calculations of their retirement benefits. 

Proposition I would rectify a long-standing inequity: Today’s nurses, most of whom are women, are the only city workers who cannot buy back pension time when they become permanent employees, said Heather Bollinger, a registered nurse and president of the chapter that represents them at SEIU Local 1021. 

Proposition I would also switch 911 dispatchers, their supervisors and related staff to better retirement plans on Jan. 4, 2025, though the new plans would be inferior to those for other emergency responders like firefighters and police officers. 

Cost

The cost to implement the measure would be between $3.8 million and $6.7 million in the first year and increase over time, according to estimates by the controller’s office. 

The city’s expenses would depend in part on how many nurses participated. As of July 2023, there were 1,400 registered nurses working for the city who would be eligible to buy back work credit, the controller’s office said. 

Costs tied to the retirement packages of emergency call staff would rise with other payroll expenses, including hiring new employees or giving people raises. The city employs 175 emergency dispatchers and related staff, the controller said. 

Campaign finance

As of Oct. 7, the “Yes on I” campaign committee had raised $110,000, entirely from SEIU Local 1021, according to data from the San Francisco Ethics Commission.

No group opposing Proposition I had reported fundraising activity to the city.

History and context

A nationwide shortage of registered nurses, as well as long hiring and training processes, have created vacancies among San Francisco’s nurses in recent months. That has fueled burnout, which in turn threatens to cause more vacancies. Dispatchers have faced similar challenges. 

“This is not something that’s unique to San Francisco,” said District 11 Supervisor and mayoral candidate Ahsha Safaí, who co-wrote Proposition I, at the July public meeting. 

“But I can tell you, talking to nurses, talking to 911 operators,” Safaí said, “they are at a breaking point.” 

Between 20% and 25% of dispatcher positions were vacant as of April, according to data that Safaí obtained from the Department of Emergency Management, which employs dispatchers. The measure’s authors say the vacancies have caused longer wait times between when someone calls 911 and when a dispatcher picks up. The department aims to pick up 95% of calls within 15 seconds, but that rate was 90% in January 2022 and 73% in February 2024. 

And an estimated 169 registered nurse positions were vacant as of March, according to data that Safaí obtained from the Department of Public Health. Those vacancies have caused the quality of care to drop at Zuckerberg San Francisco General Hospital and Trauma Center, a public hospital, according to a 2023 Civil Grand Jury report. 

The city is filling staff shortages by hiring temporary nurses, through corporate contractors, who are paid 14% more than their full-time counterparts would be, Safaí and other Proposition I supporters say.

By letting nurses put their prior work hours toward pensions, Proposition I could draw people away from private hospitals and toward full-time positions with San Francisco.

“Private hospitals can provide better salaries and benefits and work conditions but they cannot compete with the city’s retirement package for employees,” said Esther Lee, legislative aide to Safaí. 

Votes needed to pass

Proposition I requires a simple majority of “yes” votes to pass.

Click here to return to our full voter guide.

The post Proposition I — Give Nurses and 911 Operators Better Pension Plans appeared first on San Francisco Public Press.

Proposition G would reduce rents for hundreds of housing units in San Francisco so that extremely low-income seniors, families and people with disabilities could afford them.

Today, even San Francisco’s so-called affordable housing is often out of reach for those tenants. Proposition G would subsidize rents on certain affordable housing units so owners could offer them at a discount to extremely low-income tenants.

Listen to a summary of what this ballot measure would do.

Support

Proposition G aims to help households inadequately served by state and federal government housing assistance programs, according to the measure’s proponents. They call it a key step toward making the city more affordable and keeping its most vulnerable residents off the streets. 

The proposition’s architects are local groups Faith in Action Bay Area, the Community Tenants Association and Senior and Disability Action. Aaron Peskin, president of the Board of Supervisors and a mayoral candidate, sponsored Proposition G’s placement on the ballot, a move that the full board then supported. Incumbent Mayor London Breed, who is running to keep her seat, also supports it, as do groups representing racially diverse communities throughout the city.

Opposition

Proposition G would leave it up to city officials to decide how to pay for the new rent subsidies. The measure’s authors designed it to encourage use of certain tax revenues already earmarked to fund that type of assistance, said “Yes on G” campaign spokesperson Meg Heisler. It’s also possible that officials would draw money from elsewhere in the city’s budget, she said. 

If that were to happen, the measure could end up “draining critical resources from essential services like public safety, infrastructure, and education,” said Larry Marso, who wrote the argument against the measure. Marso, Proposition G’s sole official opponent, also wrote arguments against several other measures on the local ballot. 

The measure’s opponents include GrowSF and TogetherSF Action, groups funded by tech and venture capital. The “right way to fund these programs is through the regular budgeting process,” reads a statement in the GrowSF voter guide. 

But Heisler disagreed, saying that the annual budget process is too unpredictable and outlays can change from year to year. In order for affordable housing landlords to offer units to extremely low-income households on an ongoing basis, they need certainty that the money will keep flowing without interruption. 

What it would do

Market-rate housing in San Francisco is far too expensive for many people, and so demand is high for the city’s meager supply of affordable housing, which receives government subsidies so that rents can remain artificially low. 

Affordable housing owners and landlords must still charge rents high enough to cover expenses for initial construction and, later, their buildings’ operations and maintenance. They typically set rents at levels recommended for households earning up to 60% of the local area median income, which is $71,950 annually for two people. But that might be four times what extremely low-income tenants could pay. 

Proposition G would create an Affordable Housing Opportunity Fund that would pay affordable housing owners the difference between their typical rents and what would be within reach for certain extremely low-income people:

• Seniors or people with disabilities, with household annual incomes less than or equal to 25% of the local area median income, or $30,000 for two people. 
• Families with household annual incomes less than or equal to 35% of the local area median income, or $52,450 for four people. 

The fund would subsidize about 550 to 600 housing units, Heisler said, and at least 80% of the money would go to units in buildings that have yet to be built.

The state has mandated that San Francisco make a plan to build nearly 14,000 housing units for extremely low-income people by 2031. The Affordable Housing Opportunity Fund would not be big enough to achieve that goal, Heisler said, but officials could expand it in the future. 

Cost

San Francisco would begin paying into the fund in 2026. That year, it would dedicate at least $4 million to the fund, and after that it would inject at least $8.25 million annually through 2046. Each year, the mayor and Board of Supervisors would decide whether to allocate the minimum amount or a figure that was, at most, 3% higher than the preceding year’s contribution, depending on the financial health of the city. Over 20 years, the fund would receive between $161 million and $222 million, City Controller Greg Wagner wrote in an analysis of Proposition G’s estimated financial impact.

For some local taxes, City Hall requires that the revenue be spent on certain purposes. Tax revenues earmarked for rent subsidies, a common form of government assistance, could power the Affordable Housing Opportunity Fund, Heisler said. That includes the Homelessness Gross Receipts Tax, which voters approved in 2018; a tax on homes held vacant for at least half the year, passed by voters in 2022; and Proposition M, a new tax on the ballot for this election.

Campaign finance

As of Oct. 7, the campaign committee backing the measure had received $94,777 in donations, according to data from the San Francisco Ethics Commission, with over $50,000 from San Francisco Communities Against Displacement and $25,000 from the Housing Accelerator Fund.

No group opposing Proposition G had reported fundraising activity to the city.

History and context

The city has roughly 66,000 extremely low-income households, more than 75% of which include people of color, according to a Planning Department report. Adults 60 and older, often with fixed incomes, also live in many of those households, and their numbers are growing. Over 30% of San Franciscans will be in that age group by 2030. 

San Francisco has not built enough housing for people with lower incomes. From 2015 to 2023, the city failed to hit state targets for affordable housing construction permits while it exceeded goals for housing priced at the market rate.

Without adequate housing options, many of San Francisco’s poorer residents have found themselves in homeless shelters or single-room-occupancy buildings, which are often run down, with cramped quarters. Hai Ling Li, a member of the SRO Families United Collaborative, a group of nonprofits that fights for tenants’ rights and access to safe affordable housing, lives in such a building with her husband and their two young daughters. 

Their unit, a single room smaller than 100 square feet, is “not a good environment for children to grow up in,” Li said.

The family has tried to move, but their income is too low to afford other rents. Li’s husband earns less than $1,000 a month working “a tiring and low-paying, part-time job.” Li, who has struggled to find suitable work, stays home and takes care of their kids. 

“The Housing Opportunity Fund will finally give families like mine the chance to move out of an SRO and into truly affordable housing,” Li said at a July 8 committee meeting of the Board of Supervisors. She spoke in Mandarin, with the help of an English interpreter. 

Votes needed to pass

Proposition G requires a simple majority of “yes” votes to pass.

Click here to return to our full voter guide.

The post Proposition G — Fund Housing for Extremely Low-Income Tenants appeared first on San Francisco Public Press.

In the wake of years of FBI probes and ongoing scandals, Proposition C aims to fight corruption in San Francisco by creating a local inspector general position for investigating government fraud, waste and abuse of city resources. 

Listen to a summary of what this ballot measure would do.

Support

The measure’s supporters hope it would let San Francisco lead the effort to root out bad actors at City Hall.

“Rather than having the FBI get to the bottom of our dirty laundry, we can have our own city do it,” said Aaron Peskin, president of the Board of Supervisors, at a July public meeting. Peskin wrote the measure and is running for mayor. 

Proponents argue that the measure would improve government accountability, increasing efficiency and saving taxpayers money. Its backers include all members of the Board of Supervisors, former Controller Ed Harrington and California Assemblymember Phil Ting, among other current and former city officials. 

Opposition

The measure’s opponents include Larry Marso, an official opponent of multiple measures on the San Francisco ballot, and Jay Donde, president of the Briones Society, a local Republican group. Marso argued that voters should fight corruption by electing better politicians, rather than by creating more bureaucracy with a new position. Donde said that because the mayor and Board of Supervisors would be involved in approving the inspector general’s appointment, that person would lack the independence to hold those officials accountable and effectively fight corruption.

Local groups TogetherSF Action and GrowSF also oppose the measure. Both are backed by tech and venture capital and aim to reshape local politics, in part by giving the mayor more power. Proposition C concentrates too much power in the inspector general position, TogetherSF Action has said. 

The San Francisco Democratic Party also opposes the measure. The party’s leadership shifted in March away from the political left and toward the center.

What it would do

If passed, Proposition C would create an inspector general position within the controller’s office, which oversees the city’s finances. The inspector general could lead investigations into potential violations of city law and, alongside the city services auditor, review complaints from citizens and whistleblowers. The inspector general would coordinate with and refer complaints to the city attorney, district attorney, Ethics Commission and Department of Human Resources. 

The inspector general would publish reports on their investigations twice per year.

To enable this person to carry out their duties, Proposition C would empower the controller’s office to issue subpoenas to lobbyists, people and companies contracting with the city, and recipients of city permits or services. The controller’s office could also execute search warrants.

The controller would appoint the inspector general with approval from the mayor and a majority of the Board of Supervisors. 

Implementing Proposition C would cost $725,000 to $775,000 annually to cover salaries for the inspector general and two staff members, according to an analysis by City Controller Greg Wagner. The city would likely incur additional costs that varied each year, for legal services like executing subpoenas and preparing search warrants. 

History and context

At least 18 people, including city officials and private contractors, real estate brokers and construction executives, have been convicted in the last five years on charges including bribery, money laundering and fraud, Mission Local reported.

That includes Mohammed Nuru, former director of the Department of Public Works, who was sentenced to seven years in prison after pleading guilty to wire fraud. Nuru received bribes — like a $40,000 Rolex watch from a city contractor and upward of $1 million from a former Recology employee — and used the money to pay for lavish parties. 

Peskin has called the inspector general model the gold standard of municipal public integrity, and noted that local governments across the country have them but “San Francisco is one of the only major cities that does not and is arguably the city that needs it the most.” 

New York, Chicago, Philadelphia and Atlanta are among the cities with inspectors general. 

Campaign finance

As of Oct. 7, the Ethics Commission had reported no official campaign spending for or against the measure.  

Votes needed to pass

Proposition C requires a simple majority of “yes” votes to pass.

Click here to return to our full voter guide.

Editor’s note (10/10/2024): This article has been corrected to accurately convey Jay Donde’s position on Proposition C.

The post Proposition C — New Inspector General Would Fight Local Corruption appeared first on San Francisco Public Press.

Some providers are cutting back services even as more people queue up for free meals and bags of groceries.

“We’ve seen that line just grow and grow and grow,” said Humberto Pinon, senior health educator and communications coordinator for Curry Senior Center.

The pandemic spurred governments to pour money into nutrition programs that offered free meals and groceries, in large part to protect seniors — they no longer had to risk infection at crowded stores or fully contend with soaring grocery prices. But as emergency measures wound down, the subsidies dwindled, and recent local budget cuts to San Francisco service providers have further threatened food programs.

Nonprofits are scrambling to fill their budget holes and preserve their services in an environment where private funders are also pulling back.

“We’re just left holding the bag, to have to make up the difference through more and more fundraising,” said Winnie Yu, chief programs and compliance officer for Self-Help for the Elderly, which offers free meals and many other services like housing, case management and hospice.

“And it’s not just us. All of the nutrition providers throughout the San Francisco Bay Area and nationally have the same challenges,” Yu said.

Deficits in the millions

Local, state and federal funding cuts have forced the San Francisco-Marin Food Bank to significantly reduce services, according to an October press release. The organization faces estimated deficits of $2.1 million for last year and $6.6 million this year, said Keely Hopkins, associate director of marketing and communications.

The bank had expanded its Home-Delivered Groceries program during the pandemic to serve older adults who were more susceptible to the coronavirus, as well as other groups such as pregnant people and families with children who had disabilities. It served 13,000 households weekly at its height, but today that number is down to just under 8,000 households, said Seth Harris, the program’s associate director. By June 2025, the organization is also slated to close multiple food-distribution sites that opened in response to COVID-19, Harris said. The sites serve 18,000 households, Mission Local reported.

Budget cuts from City Hall last year forced local organization Bayview Senior Services to stop providing meals on weekends. This year it faces $500,000 in additional cuts, said Executive Director Cathy Davis, compelling it to stop offering take-out meals, though it will continue to offer home deliveries. Davis said she wishes she could scale up meal deliveries to meet demand, but the organization is “really not financially equipped to do much more unless we can increase our support.”

And the money the city gave the Curry Senior Center this year for one of its food programs, providing free weekly groceries, was about half what it gave last year, said Ruben Chavez, the organization’s deputy director. Facing a growing waitlist, staff have begun giving walk-ups groceries that are registered to people who are unable to pick them up, Pinon said.

‘Like squeezing water from a turnip’

Organizations are receiving less funding from private sources too.

With emergency pandemic measures phased out, the public perception is that nutrition programs are less essential, so organizations are receiving fewer donations from generous individuals, said Jim Oswald, director of marketing and communications at Meals on Wheels San Francisco, which delivers free meals to people with disabilities and adults aged 60 and over.

Self-Help for the Elderly is getting fewer voluntary contributions from the people who receive food through its dine-in and home-delivery programs. Before the pandemic, the nonprofit received 80% of the contributions that it budgeted for, but after the pandemic that fell to “10% on a good day,” Yu said, leading to $1 million in losses for the organization.

“Folks don’t have the capacity to give because everything is so expensive,” Yu said. “It’s like squeezing water from a turnip.”

Food insecurity for older adults — when they don’t have enough to eat and are uncertain how they will get their next meal — is not a “hot topic” for larger funders, Yu added. 

Corporate sponsors have helped fund the San Francisco-Marin Food Bank’s Home-Delivered Groceries program. When the organization lost sponsorship, it was a major factor forcing the bank to scale back the program.

Waning government contributions

In interviews with the San Francisco Public Press, many providers stopped short of criticizing City Hall for its cuts.

“The city’s done the best they can but we also understand they don’t have as much money as they used to,” Davis said.

City Hall is still struggling to financially recover from the pandemic, which created remote-work norms that emptied downtown offices and depressed commercial real estate values and tax revenue. Mayor London Breed signed a $15.9 billion budget on July 27 that closed a projected two-year deficit of nearly $800 million. 

That included shrinking the budget of the Department of Disability and Aging Services, which funds food programs for older adults and people with disabilities, said spokesperson Joe Molica. To maintain services at current levels, plans to expand certain programs were postponed. The department will invest nearly $30.5 million in food programs over the next year.

Food providers and recipients are still reeling from the loss of other public funding as the threat of COVID-19 has receded.

As the novel coronavirus threatened lives and incomes, the federal government increased funds to CalFresh, the state program formerly known as “food stamps,” giving people more money each month to buy groceries. When that emergency funding ended in April 2023, the monthly allotments decreased — for some people, by hundreds of dollars. A spike in food insecurity across the state followed, according to data from the California Association of Food Banks.

The federal government also pumped tens of millions of dollars into food programs serving San Francisco’s older adults and residents with disabilities, but most of that money stopped flowing in 2022. The main funding target had been the Great Plates Delivered program, which brought restaurant meals to homebound seniors and other adults who were especially vulnerable to COVID-19.

Disproportionate impacts of food insecurity

In the coming years, nutrition programs for older adults will only become more needed.

For decades, food insecurity in the United States has been on the rise for households with adults age 65 and older, according to a 2023 study by the U.S. Department of Agriculture. It is most common among seniors who live alone, at about 11% of those households, up from about 6% in 2001 — the percentage rose sharply amid the pandemic.

Adults 60 and older are the fastest-growing age group in San Francisco and will comprise over 30% of residents by 2030, according to the California Department of Finance. They can face barriers to obtaining healthy food that other groups might not, often related to their physical and financial limitations.

Mobility issues make cooking and shopping for groceries difficult for people who cannot drive or easily handle heavy bags on public transit.

Many older adults also rely on social security as their sole source of income, and those dollars don’t go as far as they used to. Grocery costs over the past four years have risen 25% even as chain supermarkets raked in enormous profits.

“When you’re living on less than $1,300 a month, you have to make some hard choices of what bills you’re going to pay,” said Oswald, of Meals on Wheels San Francisco. Nearly two-thirds of the people the organization serves live on less than that.

People with disabilities, another growing population in San Francisco, can face similar financial challenges when their sole source of income is disability insurance payments from the government. The average monthly payment is about $1,538.

Food insecurity disproportionately affects people of color. In California, mixed-race adults are the most food-insecure racial group, with 50% possessing that status, followed byAfrican Americans, at about 49%, according to a 2023 report by the UCLA Center for Health Policy Research.

People of color also suffer from diet-sensitive diseases at elevated levels. In San Francisco, Native Hawaiians and other Pacific Islanders are hospitalized for diabetes, hypertension or heart disease at rates nine times higher than the citywide average, according to a 2023 report by the Department of Public Health. African Americans are hospitalized about four times above the average. These are also the city’s racial groups with the shortest life expectancies.

‘We pick up the slack’

On a recent Wednesday morning at the Dr. George W. Davis Senior Center, several older adults stood outside, waiting for the doors to open so they could choose free produce at the organization’s pilot food program, which resembled a farmers’ market. They had lined up early because they were worried they might not get all the items they needed, said LaTonya Young, a case manager for residents living on site. She added that there was enough food for everyone that morning.

The free groceries were “a big help” to Rogelio Balbin, 60, and his wife, who recently immigrated to the United States and were still looking for jobs. Balbin had been coming to the food pantry for three months, he said. The grapes and apples were two of his favorite items.

The program is funded through June 2025, and it’s unclear whether it will continue beyond that. As other organizations pare back or shutter their own food programs, it’s likely that this line will fill with more people like Balbin.

For now, “we pick up that slack,” said Young, who takes joy in her work.

“What motivates me every day,” Young said, “is the seniors and seeing their stories. Some come from being homeless but still use the vegetables, and we provide hot meals as well. It’s a wonderful thing to see what we’re doing.”

The post Budget Cuts Threaten SF Food Programs for Seniors and Adults With Disabilities appeared first on San Francisco Public Press.

The Homeless Outreach Team’s years-long staffing woes and decisions to redirect outreach workers to special projects have left them less time for their core mission: building trust with unhoused people and helping them get case managers, social services, temporary shelter and permanent housing.

In perhaps its highest-profile special project, the team worked to prepare the downtown area for the Asia-Pacific Economic Cooperation summit in November by removing visible evidence of homelessness. This meant prioritizing unhoused people in that zone for the city’s scarce shelter beds. The summit was widely considered an opportunity for Mayor London Breed to redeem San Francisco’s image after years of bad press. Breed is running this year to keep her seat.

The mayoral race is heating up, with candidates sparring over homelessness and making it a key issue in their campaigns. It is a critical issue to San Franciscans, surveys show. Nearly 40% of residents said homelessness was the city’s worst problem, and over 70% said it was among the top three problems, a 2022 survey by the San Francisco Chronicle found. It was also a top issue for more than half of respondents to a February poll by the San Francisco Chamber of Commerce.

The Homeless Outreach Team’s field work volume has dropped precipitously from its zenith during the COVID-19 pandemic, when the work entailed many brief interactions to help people weather the citywide shelter-in-place order.

Some service providers and homelessness advocates said they approved of one of the team’s special projects, the Street to Home program, which has placed 58 people in housing.

Even targeting high-priority areas, like downtown during the summit, wasn’t necessarily bad if it included offers of shelter, said Christin Evans, a member of the city’s Homeless Oversight Commission.

But it “needs to be done also in a way that the people with the highest needs are getting the resources that they do need, as opposed to moving them along,” Evans said.  

And when scarce resources are used for political reasons, it can damage trust-building between the team and unhoused people, providers and advocates said.

The Homeless Outreach Team could end up doing even less field work if officials follow through with plans to reduce its budget by $3.5 million over the next two years. The cuts might land on its neighborhood-based teams, further reducing or eliminating outreach outside the city’s downtown core, said Emily Cohen, deputy director of communications and legislative affairs at the Department of Homelessness and Supportive Housing.

Joe Wilson, executive director of Hospitality House, said it would be a bad idea to cut outreach, especially in the wake of the U.S. Supreme Court’s recent decision in City of Grants Pass, Oregon v. Gloria Johnson. The court ruled that cities may enforce bans against sleeping or camping in public spaces, even if no shelter is available, and issue fines — causing many to worry that governments will prioritize policing over providing housing or services.

“The Grants Pass ruling clearly opens the doors to outright criminalization without any pretense of offering support,” Wilson said. “It’s even more imperative, even more vital, that we invest in outreach and connection and getting people connected to needed resources.”

The San Francisco Public Press asked the Department of Homelessness and Supportive Housing who, at City Hall, had decided to shift the team’s work priorities.

“HSH, in partnership with other city departments is responsible for deciding priorities and determining special projects,” spokesperson Deborah Bouck wrote in an email.

Waning outreach and possible political motives

The Homeless Outreach Team’s interactions with unhoused people peaked shortly after the pandemic touched down in San Francisco, when Mayor Breed issued a citywide shelter-in-place order to slow the spread of the novel coronavirus. Engagements numbered 14,664 in April 2020 and have been trending down ever since. They fell to their lowest level this April, the most recent month for which the Department of Homelessness and Supportive Housing provided data, with only 1,808 encounters.

The rate of engagement soared during the pandemic because many interactions were brief, with the team on the streets talking to as many people as possible, distributing masks, educating on basic public health and helping people move into hotel rooms repurposed as homeless shelters.

In recent months, time-intensive special projects have meant less time for other outreach work, reducing the team’s overall interactions with unhoused people.

The team met its contractually required 35,000 engagements last year. Data for 2024 shows that the team’s engagements were about 7,900 through the end of April, the most recent month for which data was provided. If the downward trend continues, the team will likely miss this year’s target.

But the workers have many targets, said Bouck, of the homelessness department — not just those related to outreach. “There are 23 service objectives that HOT is evaluated on, and encounters is one of them,” she said, referring to the Homeless Outreach Team.

In its new prioritized work, the team placed 58 people in housing through the Street to Home program from its inception in June 2023 through this March, during which only one person left the housing, The Frisc reported. The program takes people directly from the streets into permanent supportive housing, where they generally can access case managers and social services. Service providers and homelessness department staff said Street to Home has helped some people who have struggled for years to come indoors.

For the Asia-Pacific Economic Cooperation summit, aka APEC, about a dozen team members targeted their field work in zones where event activities would take place: near City Hall, the Moscone Center, the Asian Art Museum and the Embarcadero.

That month, the team continued general outreach throughout the city. But some of its other work, sending staffers out in response to phone calls from the public requesting help, stopped almost entirely. Those dispatches numbered 65 in October, then eight the following month, rising again after the summit concluded. In the team’s work notes about how it responded to phone calls, staffers wrote, “Due to APEC assignments not able to dispatch.”

Critics were troubled that the team’s other work might be affected by political motives.

“It just seems like a ridiculous diversion of effort and kind of classic,” said Jennifer Friedenbach, executive director of the Coalition on Homelessness, referring to the Homeless Outreach Team’s work at the November summit. She called it the latest “example of HOT being politically diverted into other jobs instead of focusing on their existing clients.”

For example, she said, the team has often shifted its work toward areas of the city where there were upticks in complaints, to the detriment of unhoused people elsewhere who had already been promised resources. Friedenbach said the Homeless Outreach Team “has a lot of really strong staff” but that when it changes priorities before following through on earlier commitments, it can end up “disintegrating trust with folks.”

When the team is not dispatched or cannot find those who call for assistance — which occurs in most cases — callers are left to fend for themselves or find help elsewhere.

As the Homeless Outreach Team’s engagements have generally declined, encampment clearings, also called sweeps, have increased. Outreach team members help with clearings by offering shelter and other resources to the encampment dwellers whom city personnel displace.

Breed has been a vocal proponent of clearings, saying it’s not healthy or safe to camp on the streets. She submitted an amicus, or friend-of-the-court, brief in support of clearings to the Supreme Court as it deliberated the Grants Pass case.

Unhoused people, their advocates and service providers have long criticized clearings for reducing the visibility of poverty instead of addressing its root causes, and for further destabilizing people experiencing homelessness.

Looming budget cuts and staffing woes

Cohen said past staffing troubles had contributed to the Homeless Outreach Team’s decreasing field work.

Turnover has been high, according to a 2023 city audit. Heluna Health, the nonprofit hired to run the team, has struggled to keep the team at least 90% staffed at all times, as required by its city contract.

The situation improved by this summer. The team was 95% staffed as of July 2, Bouck said.

But looming budget cuts, which Breed has proposed and the Board of Supervisors may approve this month, could slash the team’s ranks, Cohen acknowledged. That would put social services further out of reach for San Francisco’s less visible unhoused people, in particular, those who tend to steer clear of downtown, such as seniors and families living in vehicles.

One of the outreach team’s roles is to help people navigate the city’s complex services system, said Lydia Bransten, executive director of the Gubbio Project, which gives food, medical assistance and places to rest to people experiencing homelessness. If the team’s budget was cut, she wondered, then what would the plan be for providing that type of hand-holding? Police don’t have the time to do it, she said.

Unhoused people “with chaotic behaviors are the ones who need the most help, and it takes skill” to help them, Bransten said.

‘Outreach from what, to what?’

Several service providers said thinning outreach was just one of many structural problems with the city’s homelessness response system.

One of the bigger problems, they said, was that the city doesn’t have adequate services and housing to offer people in the first place.

Amber, an unhoused woman who declined to give her last name, recalled positive experiences with a Homeless Outreach Team member when she was pregnant five years ago, but said that today the team doesn’t have “too much shit to offer us.” She said she was told last week that she wasn’t eligible for single-room-occupancy housing because of her dog.

Vinny Vizgaudis and Max, who didn’t provide a last name, also described difficulties accessing housing that met their needs.

Max said he has been cycling through prison and probation since he was a teenager, because of substance use. He and his girlfriend were trying to get into shelter but he said the outreach team recently told him that there were no available spaces for couples.

Vizgaudis said he could not stay in a congregate shelter due to his post-traumatic stress disorder, but that when he tried to work with the team to find other options, none were available.

“They told me that I have to get lucky, that I have to basically win a lottery,” he said. “They have to have a room open on the day that they come to service my area and maybe I might get it.”

Because of past negative experiences, he doesn’t interact with them much, he said.

In the meantime, Vizgaudis and Max are shuffled from place to place as city workers conduct clearings.

Wilson, of Hospitality House, said the Homeless Outreach Team is the most responsive of the city’s field teams. But “what we need is something on the end of outreach,” he said.

“Outreach from what, to what? That’s the unanswered question,” Wilson said. “We don’t have the resources available for the people who need them, and even for the people who are trying to get them.”

Madison Alvarado reported this story while participating in the USC Annenberg Center for Health Journalism’s 2023 Data Fellowship, which provided training, mentoring and funding to support this project.

The post Homeless Outreach Declines With Street Team’s Shifting Priorities, Staffing Woes appeared first on San Francisco Public Press.

Bystanders might wonder how to summon help from the city — and what will happen if they do.

We created a flow chart to answer those questions, though it does not capture all possible outcomes. Scroll down or click here to find it.

Cases traverse a tangle of pathways, through handoffs between dispatchers and myriad public workers. The person in crisis might spend days or weeks tumbling through the criminal justice system or health care facilities. They might get a reprieve from the outdoors in a sobering center or a communal recovery setting, where they can access food and information to help them seek social services. Their path depends on many factors, like the availability of the Street Crisis Response Team, what the bystander tells city personnel and whether responders can calm them.

Often, the person returns to where they started: the streets.

San Francisco emergency dispatchers can receive tens of thousands of calls per year about mental health incidents, including suicide attempts. According to a recent study by a city working group, there were nearly 13,700 recorded involuntary psychiatric detentions in the fiscal year that ended in 2022 — a conservative tally as the analysis did not include some facilities in San Francisco. The study found that African American residents were detained at disproportionately high rates, and unhoused people were frequent users of psychiatric emergency services.

(Click the link below the chart to see a version that allows you to zoom in.)

The San Francisco Public Press spent months investigating how people can be detained involuntarily due to mental health crises and what happens to them afterward. The psychiatric detentions are commonly called “5150” holds, a nod to the section of state code that defines the criteria for this intervention. We examined hundreds of pages of call records, department procedures and training documents, and interviewed staff at numerous city departments directly involved in crisis response to map the city’s system of care.

A single phone call about an incident can trigger responses from multiple departments. Major responders include the Department of Emergency Management, Fire Department, Police Department, Sheriff’s Department, Department of Homelessness and Supportive Housing, and Department of Public Health.

People witnessing a crisis generally request help by calling either 911, the city’s emergency line, or 311, for general services and assistance. Dispatchers do their best with the information the caller provides to quickly determine whether the distressed person poses an immediate danger to themselves or others.

Calls about mental health crises often ping-pong between 911 and 311 as details emerge, said Burt Wilson, president of the union chapter that represents the city’s emergency dispatchers.

Many unhoused people carry weapons to defend themselves at night, and they might struggle with drug addiction or be mentally unstable, Wilson said.

“I don’t know how you differentiate, on the phone call, who to transfer to 311 and who to transfer to the police,” Wilson said. “Most of the 311 calls end up coming back to our call center because 311 just has to say a certain trigger word like, are they ‘aggressive?’ And then it comes right back to us.”

The Department of Emergency Management dispatches police in cases of calls about people threatening violence or wielding weapons; that doesn’t include people who are merely yelling, said Officer Robert Rueca, a spokesperson for the San Francisco Police Department.

But what qualifies as “violence?” The Department of Emergency Management could not say.

“‘Violent’ is not something we have a concise definition for,” a spokesperson said. “It will vary based on circumstances and the level of information the reporting party is providing.”

And a “weapon” is broadly defined as “anything that can be used as a weapon,” according to department guidelines. For many types of small weapons, such as pocket knives, possession alone is not considered a threat.

If a person is in severe crisis, police and medical personnel can put them on a 5150 hold.

But involuntary hospitalization can be harmful, said Sarah Gregory, a senior attorney at Disability Rights California. The organization advocates for community-based services for people with mental health disabilities, as an alternative to forced stays in hospitals or psychiatric wards.

Gregory called it a “traumatic” experience when someone “who’s already having a mental health crisis calls for help, and then receives a response that takes away the person’s rights.”

“Client after client says, ‘I came out of there worse than I went in,’” Gregory said, referring to places where patients were involuntarily detained.

When a person in mental distress is not an immediate threat, the call goes to medical personnel like the Street Crisis Response Team, Fire Department or paramedics. The crisis team is one of many created in recent years as San Francisco and other cities have shifted away from a law enforcement response following high-profile police killings, including those of Mario Woods, Tony Bui and George Floyd, in which the officer was convicted of murder.

The San Francisco Police Department “would never be dispatched to a medical call” even if the Street Crisis Response Team or an ambulance were unavailable, said the spokesperson for the Department of Emergency Management. The police were the crisis team’s backstop in its early years, but that stopped in June 2022, they said.

The team uses de-escalation strategies to calm a person in distress, like speaking softly, asking questions to get to know them, and offering snacks or water. When the person regains composure, the team might connect them to treatment or follow-up care with the Office of Coordinated Care, Homeless Outreach Team or Post Overdose Engagement Team, the spokesperson said.

The team might also simply leave the scene once the person is no longer in distress.

People who engage with the city’s crisis-response system might benefit most from having long-term case managers who can help them fully resolve problems with their health or living situations, said Mark Salazar, chief executive officer of the Mental Health Association of San Francisco. The organization provides case management and peer support services at courts, jails and Zuckerberg hospital after someone is released from a 5150 hold.

“But the shortage of support and funding is really a challenge,” Salazar said. “Without having continued support after being 5150’d, or [receiving] forced treatment, you’re just setting up someone for more failure.”

Support for people struggling with their mental health

San Franciscans struggling with their mental health can call many local and national hotlines. To learn about the resources that are available, and potentially speak with counselors, reach out to the organizations below. 

Mental Health Association of San Francisco: Talk to a peer about your feelings and get information about available mental health services.

• Warm line is open 24/7
• Call or text 855-845-7415

San Francisco Behavioral Health Services: Find local mental health or substance use services that meet your needs.

• Clinicians are only available Monday-Friday from 8 a.m. to 7 p.m., and Saturday-Sunday from 9 a.m. to 4 p.m.
• Behavioral access helpline is open 24/7
• Call 415-255-3737 or 888-246-3333

Harm Reduction Therapy Center: Speak with someone if you are experiencing homelessness and seeking peer counseling or harm reduction services.

• Community helpline is open Monday-Friday, from 10 a.m. to 8 p.m.
• Call 415-863-4282

San Francisco Night Ministry: Speak with counselors trained in trauma-informed care, interfaith spiritual support, suicide prevention and crisis management.

• Care line is open every day from 8 p.m. to 2 a.m.
• Call 844-467-3473

Mobile Crisis Team: Speak with clinicians who can help someone experiencing a crisis. The team may visit the person to assess whether they meet the criteria for involuntary psychiatric detention, and they can request support and transportation by paramedics or police.

• Helpline is open 24/7
• Call 628-217-7000

SF Suicide Prevention Hotline: Speak with a counselor if you or your loved one are considering suicide. Counselors can provide referrals for mental health, HIV and addiction services.

• Hotline is open 24/7
• Call 415-781-0500 or text 415-200-2920

Other resources

California Peer-Run Warm Line

• Warm line is open 24/7
• Call or text 855-600-WARM (9276)

California Suicide Prevention Lifeline

• Hotline is open 24 hours
• Call 988

Crisis Text Line

• Crisis counseling is available 24/7
• Text HOME to 741741
• Visit their website to connect via online chat or WhatsApp

Like many media organizations, the San Francisco Public Press is experimenting with artificial intelligence (A.I.) tools that aid the creation of images for use in some stories. Nearly all our visual content is produced by humans.

The Public Press is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity and newsrooms in select states across the country.

See our related article, The Often Vicious Cycle Through SF’s Strained Mental Health Care and Detention System

The post You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next appeared first on San Francisco Public Press.

Uncertain what to do, we dialed 311, San Francisco’s non-emergency helpline. Seventeen minutes later, a red van arrived, carrying members of the city’s Street Crisis Response Team. Jay told them he was schizophrenic. The paramedic recognized him from previous calls and greeted him. Looking at Jay’s digital records, a member of the group realized his prescription had been refilled about two weeks prior, but Jay didn’t remember picking it up.

As they spoke, it became clear that Jay had previously been placed under involuntary psychiatric detention, also called a “5150 hold.”

That fall day, Jay asked to be detained again.

[ Read also: “You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next” ]

That was how he had gotten a dose of Benadryl, one of two medications he used to manage his condition, he said. Benadryl is among the antihistamines that can help control anxiety. Schizophrenia requires lifelong treatment, even when symptoms have subsided.

“They give me my pill with a 5150,” he said.

The paramedic bristled. “That’s a lot of resources just to get one pill.”

Jay was one of thousands of people last year who fell into San Francisco’s complex, reactive, strained system for treating severe mental health and drug-related crises. As with many of the people who enter that system — including those who are unhoused or are detained without their consent following a call from an alarmed observer — Jay had received temporary care, entailing multiple involuntary psychiatric holds, that failed to address his long-term problems. That left him back on the streets to fend for himself or, with the help of passersby, try again to get the help he needed.

Since the start of the COVID-19 pandemic, much of the public discussion about homelessness and mental health in San Francisco has focused on the people who desperately need care, but who reject it. Jay’s story diverges from this common narrative.

“When’s the last time you were at Gen?” the paramedic asked, referring to the emergency room at Zuckerberg San Francisco General Hospital and Trauma Center, the facility in the city with the highest number of beds for people on 5150 holds.

“Today,” Jay said. He had gone there seeking medication, then waited in a hallway for four hours before staff gave him a dose of Risperdal, an antipsychotic that he did not usually take. It had not been effective.

Who responds to mental crisis calls

Emergency service providers may not legally turn people away. For many San Franciscans, this is their only option for accessing medical care.

City officials have made recent efforts to improve the crisis care system. A few years ago, police might have been dispatched to Jay’s call and that would divert them from situations they might be better trained to handle. Today, the city routes mental health-related calls to other teams instead when there is not an immediate safety threat, said a spokesperson with the Department of Emergency Management.

One alternative is the Street Crisis Response Team. It was created in late 2020 and aims to offer trauma-informed care to people facing mental health crises or minor medical issues, potentially reducing unnecessary emergency room visits.

When team members arrive on the scene, they address the person’s immediate needs first — for example, food or a warm blanket — and might connect them with other services and take them to a shelter, sobering center or health clinic.

The many units that respond to the city’s increasingly visible street-level crises cost millions of tax dollars each year: The Street Crisis Response Team’s budget will be $12.3 million for the fiscal year ending in 2025; the Homeless Outreach Team’s budget for the same year will be $8.9 million; and the Homeless Engagement Assistance Response Team was authorized last year to receive one-time funding of $3 million.

City dispatchers must decide which team to send — they might send more than one — relying on the caller’s description of the scene. Calls about mental health crises often ping-pong between 911 and 311 as details emerge, said Burt Wilson, president of the union chapter that represents San Francisco’s emergency dispatchers.

“It’s a huge amount of resources,” Wilson said.

Involuntary detention’s disproportionate impacts

Dispatchers received at least 24,000 calls about mental health crises or attempted suicides in 2023, including calls from bystanders as well as police, based on a Public Press analysis of government records. In many cases, responders couldn’t find the people in crisis.

In the most serious instances, crisis responders put people in 5150 holds, named after the section of California’s Welfare and Institutions Code that defines this procedure. The law permits police and trained medical personnel to detain someone for up to 72 hours if their mental health disorder is making them a danger to themselves or others, or it leaves them unable to provide for their basic needs.

The city recorded nearly 13,700 psychiatric holds for the year that ended June 2022 — but that figure, the most recent available, captures a fraction of the total situation. The number was calculated in a report by a city working group, which found that not all hospitals reported detentions and that the available data did not allow for robust analyses of patient characteristics like race, gender or housing status.

Some people were put on 5150 holds multiple times at Zuckerberg hospital. Using data from that facility in its analysis, the working group found that 425 people received at least two psychiatric holds, 86 had at least four holds and 13 had eight or more. African Americans, despite making up only 6% of the city’s population at the time, accounted for over 42% of people detained four or more times.

Most people who received emergency psychiatric services from the hospital, including 5150 holds and voluntary visits, had experienced homelessness in the prior year.

Numerous service providers told the Public Press that people are more likely to cycle repeatedly in and out of crisis-care facilities when they don’t have access to preventive or non-emergency care, because small problems can become larger ones that require hospitalization.

Experts said also that it’s vital for people to receive culturally competent care — for example, when the health worker speaks the patient’s language or knows which medical guidance will conflict least with social norms.

Underfunded care system

San Francisco has seven designated psychiatric facilities with a total of 187 beds for patients on psychiatric holds, according to the California Department of Health Care Services, which approves facilities for this use.

But not everyone on a 5150 hold gets a bed. The crisis care system is notoriously underfunded, with inadequate capacity and staff. When no bed is available, someone is detained in an emergency room for up to 24 hours.

The 2023 passage of state Senate Bill 43 might further strain the system. The law modified the eligibility criteria for 5150 holds for the first time in decades, making it possible to detain people gravely disabled due to substance use. In response, San Francisco has acquired additional beds. Many other counties are waiting to implement the policy, saying they need more guidance and resources from the state to comply.

Meanwhile, Proposition 1, a separate package of state policies that voters approved by a razor-thin margin in March, could add treatment beds to the system, including those for 5150 holds. The proposition forces counties to redirect a large portion of their mental health spending to housing programs, many of which must benefit unhoused people and veterans. A coalition of mental health organizations and disability advocates opposed the ballot measure, fearing it would cause cuts to vital community-based programs. 

Among its many mandates, Proposition 1 authorized the sale of $6.4 billion in government bonds. Of the total bond revenue, $4.4 billion is slated to pay for building behavioral health facilities. Gov. Gavin Newsom, who campaigned for Proposition 1’s passage, has said it will enable adding more than 11,150 behavioral treatment beds.

For people who are able to get beds, their problems are far from solved.

“There’s a perception that if you put someone on a hold, something good will happen for them, like something miraculous,” said Dr. Maria Raven, chief of emergency medicine at the University of California, San Francisco. People might think that an intervention by psychiatric workers would set in motion a process that leads to long-term treatment or, for those experiencing homelessness, permanent housing, she said.

“That doesn’t really happen,” Raven said. Instead, “you just put someone where there’s a bed.”

[ Read also: “Mental Health Advocates Call for Voluntary Treatment as Spears Conservatorship Ends” ]

Back on Market Street, the Street Crisis Response Team was trying to find help for Jay in this overburdened system. As they made phone calls to locate a facility that could fill Jay’s medication, one team member tried to comfort him with snacks and water, which he was hesitant to accept.

“Every time I drink something, bad stuff happens,” Jay said.

“You can drink it,” the paramedic told him calmly. “We’re not going to leave you.”

After about 15 minutes and at least four unfruitful calls to multiple agencies, the paramedic suggested that the outreach workers try the Westside Crisis Clinic. They checked its operating hours but found conflicting information online. A call revealed that it was closed for the day.

“It’s very unfortunate that the city runs on banking hours,” another team member said.

Finally, the team found a bed at the Dore Clinic, which provides psychiatric urgent care. Jay could stay there for up to a day. He would have a bed and access to a shower and a phone. That would enable him to call his sister, who could pick him up and help him obtain his medication.

“You can get all your meds tomorrow, something that we can all look forward to,” the paramedic said.

Like many media organizations, the San Francisco Public Press is experimenting with artificial intelligence (A.I.) tools that aid the creation of images for use in some stories. Nearly all our visual content is produced by humans.

The Public Press is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity and newsrooms in select states across the country.

See our related article You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next

The post The Often Vicious Cycle Through SF’s Strained Mental Health Care and Detention System appeared first on San Francisco Public Press.

Read this story in English.

Cuando Karen Rodríguez llegó a San Francisco tras huir de su país natal, Colombia, con su marido y su hijo de 6 años, Juan, la familia se alojó con la madrina de su hijo. Sin embargo, cuando tuvieron que marcharse dos meses después porque el contrato de alquiler no permitía alojar a más personas en la vivienda, recurrieron a dormir en el auto que tenían.

Como la familia era recién llegada, Rodríguez y su marido carecían de permiso de trabajo, lo que les dificultaba en gran medida encontrar empleo y poder pagar el alquiler.

Desde entonces, han estado alternando estancias en su coche y en hoteles pagados por el ayuntamiento y Fe en Acción del Área de la Bahía, una red de organizadores comunitarios de varias congregaciones religiosas. Juan tiene necesidades especiales, por lo que un refugio de emergencia sería traumático para él, dijo Rodríguez.

La familia Rodríguez es una de muchas familias de migrantes recientes que buscan refugio y una nueva vida en San Francisco, y que se encuentran en situación de calle sin tener una solución sencilla.

Los proveedores de vivienda en San Francisco, los defensores legales, los grupos religiosos y los propios migrantes advierten que no hay suficientes viviendas temporales como para dar cabida a la creciente necesidad, y que el sistema de respuesta de la ciudad no está equipado para manejar las complicaciones que surgen en la intersección entre la falta de vivienda y la migración. Los proveedores de vivienda afirman también que la ciudad subestima y subrepresenta intencionadamente la necesidad que existe.

Aunque los representantes de la ciudad dijeron que el Departamento de Personas sin Hogar y Vivienda de Apoyo está tomando medidas para reasignar fondos para abrir un refugio para familias y acelerar el ritmo al que las familias salen del refugio y acceden a una vivienda de más largo plazo, no fueron capaces de proporcionar un periodo de tiempo o instrucciones sobre qué deben hacer las familias que duermen en la calle mientras tanto.

Una necesidad profunda y pocos datos

La idea de que no hay suficiente vivienda temporal para estas familias entra en conflicto con el inventario de albergues de la ciudad, el cual es una plataforma en línea que tiende a mostrar un 7% u 8% de las vacantes que hay en los albergues para familias. No obstante, Hope Kamer, directora de política pública y asuntos externos en Compass Family Services, una organización sin fines de lucro que se ocupa de las familias en situación de calle, afirma que esta cifra no es un fiel reflejo de la necesidad que hay.
“Las familias vienen a nuestro punto de acceso a las 4:30 de un viernes y dicen: ‘No tengo dónde ir el fin de semana con mis dos bebés'”, dijo, calificando la necesidad como “profunda”.

A menudo, se rechaza a las familias porque no hay lugares disponibles en los albergues.

Eso fue lo que le ocurrió a Álvaro Tovar, su mujer y sus dos hijos pequeños cuando se presentaron recientemente a un punto de acceso a albergues, donde se evalúa si las familias reúnen los requisitos para recibir servicios, explicó Tovar. El personal le dijo que tardarían dos semanas en inscribirlos en la lista de espera, y más tiempo en conseguir camas. Le aconsejaron que comprara una tienda de campaña para su familia mientras esperaban.

“Eso me rompió el corazón porque, en primer lugar, no teníamos dinero, no conocíamos la ciudad. Perdí toda esperanza”, dijo Tovar en un evento de la comunidad el 7 de marzo que realizó Fe en Acción del Área de la Bahía para llamar la atención sobre la necesidad de refugio para las familias.

Kamer explicó que el refugio en Buena Vista Horace Mann, un gimnasio escolar que funciona como albergue nocturno para familias, recibe hasta 10 llamadas al día de organizaciones comunitarias que buscan camas para familias que no tienen dónde alojarse, muchas de las cuales el albergue no ha podido aceptar.

Laura Valdez, directora ejecutiva de Dolores Street Community Services, la organización sin fines de lucro que gestiona el centro de albergue para familias en Buena Vista Horace Mann, declaró al San Francisco Standard en diciembre pasado que la ciudad instruye a la organización para que no contabilice la cantidad de familias que rechaza.

Emily Cohen, subdirectora de comunicaciones y asuntos legislativos del Departamento de Personas sin Hogar y Vivienda de Apoyo, dijo que no tenía conocimiento de esa instrucción. Más bien, dijo, el departamento quiere que la gente vaya a los puntos de entrada al sistema de respuesta para personas en situación de calle para crear una lista de espera centralizada del albergue.

En los últimos seis meses, esa lista de espera ha tenido constantemente unas 200 familias, dijo Kamer. Explicó que en Buena Vista Horace Mann, el departamento evalúa la ocupación del albergue a las 5 de la tarde, antes de que los papás y mamás hayan regresado de trabajar y, por tanto, subrepresenta la necesidad.

“Esta falta de voluntad para captar la magnitud completa del problema significa que no hay rendición de cuentas ante estas familias y que, a su vez, no hay presión pública para construir la cantidad de albergues que necesitamos”, dijo.

Las mismas familias inmigrantes se han unido para ejercer esa presión. En colaboración con Fe en Acción del Área de la Bahía, las familias han exigido al Departamento de Personas sin Hogar y Vivienda de Apoyo que garantice alojamiento en el mismo día o que se proporcione un vale de hotel a cualquier familia que acuda a un punto de acceso; que acelere la transición del alojamiento de un albergue a una vivienda de largo plazo; y que haga un control en línea que le permita a las familias comprobar qué posición ocupan en la lista de espera de un albergue.

El grupo se reunió frente al ayuntamiento el 12 de marzo, el día en que el supervisor y candidato a alcalde Ahsha Safaí presentó una resolución no vinculante en la que pedía a la alcaldesa London Breed y al Departamento de Personas sin Hogar y Vivienda de Apoyo que respondieran a las necesidades de vivienda de las familias migrantes. La Junta de Supervisores celebrará una audiencia sobre la resolución el 22 de abril, según el personal de Fe en Acción del Área de la Bahía.

Otras barreras para encontrar vivienda segura

Además de la falta de camas en albergues, las familias migrantes se enfrentan a otros problemas cuando intentan navegar el sistema.

“Para muchas familias, el sistema de respuesta para personas en situación de calle en San Francisco es el primer punto de contacto con servicios sociales en Estados Unidos; es más, el sistema carece fundamentalmente de los recursos necesarios para proporcionar la atención informada sobre trauma y la navegación legal que necesita una familia que acaba inmigrar a San Francisco”, dijo Kamer.

Vanessa Bohm es la directora de los programas de Bienestar Familiar y Promoción de la Salud del Centro de Recursos Centroamericano, una organización sin fines de lucro que ayuda a inmigrantes latinx y a las familias con menos recursos del Área de la Bahía de San Francisco. Bohm explicó que hace 15 o 20 años era más fácil que la gente consiguiera hospedaje o trabajo a través de la economía informal o a través de conexiones con personas que conocían en el área. Hoy en día, no está tan segura de que sea así.

Silvia Ramos, gestora de casos y facilitadora de grupos de apoyo para el programa de bienestar familiar del Centro de Recursos Centroamericano, dijo que muchas familias llegan a San Francisco con trauma del viaje que emprendieron y que se sienten desplazadas al entrar en un sistema al que les es difícil adaptarse. Cuando las familias llegan sin ningún lugar donde alojarse y la ciudad no tiene camas disponibles, Ramos busca en albergues en Oakland o en otras ciudades cercanas y le enseña a la gente a utilizar el sistema de transporte rápido del Área de la Bahía (BART).

Muchos proveedores explicaron que navegar estos sistemas puede ser aún más difícil para las personas que no hablan inglés o que proceden de entornos culturales diferentes.

El papel del sistema judicial de migración

A la vez que buscan tener acceso a una vivienda, las familias también deben preocuparse por el proceso de asilo y el tribunal de inmigración. Sin embargo, los proveedores se han dado cuenta que hay una falta de conexión entre los sistemas de respuesta legal y para personas en situación de calle, y los grupos que ofrecen otros recursos como atención médica o alimentos.

“No hay ayuda gubernamental para conectar el sistema de respuesta legal y el sistema de respuesta para personas en situación de calle”, dijo Kamer. “Los proveedores de atención directa están averiguando cómo hacerlo”.

Milli Atkinson, directora del Programa de Defensa Legal para Inmigrantes en el Centro de Justicia y Diversidad del Colegio de Abogados de San Francisco, dijo que los casos de asilo de la mayoría de las personas no se deciden hasta dentro de años y que a menudo se preocupan más por cubrir necesidades inmediatas como la vivienda o la comida.

“Muchas personas se pierden en el sistema, simplemente porque no tienen la capacidad mental de resolver todas estas cosas a la vez, y primero atienden a sus necesidades básicas”, dijo.

Sin embargo, tener representación legal durante el proceso de asilo ayuda a los migrantes a obtener un permiso laboral, lo que les permite ser más autosuficientes.

La inestabilidad de vivienda puede afectar los casos de inmigración de otras maneras. Uno de los mayores obstáculos para las personas en situación de calle, según Atkinson, es que el sistema judicial se basa en gran medida en tener todo por escrito y en papel por lo que la comunicación se realiza principalmente por correo tradicional. La expectativa es que las personas mantengan al tribunal al corriente del cambio de domicilio.

“Si el tribunal te envía por correo información sobre tu caso y no la recibes, es culpa tuya”, explica.

La llegada de migrantes

Los proveedores de vivienda, los defensores legales y el Departamento de Personas sin Hogar y Vivienda de Apoyo contaron como anécdota un aumento en el número de personas que buscan servicios y que huyen de Latinoamérica debido a los disturbios políticos, la pobreza y otros tipos de violencia.

Atkinson dijo que en los últimos años, su organización ha visto un mayor número de migrantes procedentes de países como Nicaragua, Colombia, Perú y Cuba. Como la cantidad de países que viven inestabilidad política en los últimos años ha aumentado, la cantidad de personas que llegan a la frontera también ha incrementado, dijo.

Dado que San Francisco es una ciudad santuario, las preguntas sobre el estatus del migrante o refugiado durante el proceso de entrada coordinada (un sistema que se utiliza para determinar qué recursos se pueden solicitar) son limitadas. Esto dificulta decir qué porcentaje de la reciente oleada de familias que buscan refugio son inmigrantes, dijo Cohen, aunque señaló a forma de anécdota que ha habido más personas de Centro y Sudamérica que llegan en busca de ayuda.

Los datos de la ciudad muestran que la cantidad de hispanohablantes y personas latinx en situación de calle está en aumento. El porcentaje de hispanohablantes en el sistema ONE de la ciudad, que monitorea a las personas que reciben asistencia del Departamento de Personas sin Hogar y Vivienda de Apoyo, aumentó a más de una cuarta parte de la población de personas que reciben apoyo del departamento en 2024. Además, de 2019 a 2022, hubo un aumento del 55% en la cantidad de personas latinx que carecen de un techo, según los datos recopilados en ese momento determinado en 2022, que es un recuento bianual de la cantidad de personas que se encuentran en situación de calle.

La historia de Leslie

Una vivienda segura y estable les permite a las familias migrantes prosperar.

Leslie, que pidió mantener su apellido en privado, huyó de Nicaragua en noviembre de 2019 con su hija y su pareja cuando el país se enfrentó a un aumento en la violencia política lo que provocó que tanto ella como su pareja perdieran sus empleos.

“Había una guerra y mataron a mucha gente. Había mucho caos por todas partes y la economía ya estaba en mal estado”, dijo al señalar que no tenían qué comer. “Así que nos fuimos en busca de un futuro mejor”.

Cuando llegaron, Leslie se enfrentó al maltrato de los familiares con los que se alojaba y se vio obligada a mantener a su hija, que tiene autismo, en su habitación para protegerla del acoso.

“Sentí mucha frustración, mucha desesperación; no sabía qué hacer”, dijo.

Al final, Leslie, su pareja y su hija se marcharon. Cambiaron de domicilio al menos tres veces; pasaron de un albergue a la casa de una amistad, y luego a un hotel financiado por la ciudad. Fue allí, donde dejó de dormir en el suelo y donde empezó a sentirse más cómoda. Leslie empezó a ver a un terapeuta y a recibir atención médica, y aprendió cómo inscribir a su hija en la escuela.

Sin embargo, Leslie no sabía cuánto tiempo iban a poder quedarse, lo que le causaba ansiedad; además, había otros problemas.

La terapia “me abrió los ojos al maltrato que estaba sufriendo a manos de mi pareja, así que decidí dejarlo”, dijo. “Aquí no tenía familia ni amigos. Solo tenía a mi hija”.

Con la ayuda de Compass Family Services y servicios prenatales para personas en situación de calle, Leslie pudo finalmente solicitar una vivienda permanente para ella y su hija de 7 años de edad. Se mudaron en septiembre de 2023.

“Ahora que hemos encontrado una vivienda estable, ella se siente segura, las dos nos sentimos seguras”, dijo al señalar que la estabilidad es buena para su hija.

La seguridad le ha permitido a Leslie hacer prácticas profesionales en un preescolar y formar parte del Consejo Asesor de Familias de Compass Family Services para compartir sus experiencias sobre cómo ha navegado la vida sin un hogar en San Francisco. Haber vuelto a la escuela le ha hecho sentirse útil.

“Me hace sentir que tengo un futuro mejor aquí”, dijo y señaló que no estaba segura de si tendría que dedicarse a limpiar inodoros de por vida en Estados Unidos. “Realmente me llena de vida y me encanta estar con los niños. Me encanta aprender”.

Madison Alvarado realizó este reportaje a través de la Beca de Datos 2023 del Centro Annenberg sobre la Salud de USC, el cual proporcionó formación, tutoría y financiamiento para la realización de este proyecto.

Traducido al español por Andrea Valencia a través de Linguaficient, una empresa local que ofrece servicios lingüísticos profesionales. Valencia interpretó nuestra entrevista con Leslie, una hispanohablante monolingüe. Yesica Prado, periodista de San Francisco Public Press, interpretó nuestra entrevista con Karen Rodríguez.

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A separate, possible $20 million outlay could help unhoused families cover rent for a limited time, the department’s spokesperson also said at the Board of Supervisors Rules Committee hearing. The funds must be approved in budget negotiations this summer.

But these new measures would fall short of serving all the families in need, the spokesperson acknowledged.

“There’s these huge communities of people fleeing violence, persecution, gangs, all these things, trying to survive and we’re basically telling them, ‘Sleep on the streets,’” said Supervisor Hillary Ronen, who chairs the committee and represents District 9, which contains the Mission District.

Migrant families have joined service providers and faith-based advocates in a push for a policy response to the mounting crisis, including increasing access to temporary housing and providing greater transparency about where families are on the waitlist for shelter. Supervisor Ahsha Safaí, who represents the Excelsior, Oceanview and other neighborhoods of District 11, recently took up the issue and wrote a non-binding resolution that called on the city to ensure migrant families would receive immediate shelter, among other services. He then convened Monday’s hearing, in which District 10 supervisor and committee member Shamann Walton was also present, to discuss potential policy solutions with staff from various city departments.

Following the homelessness department’s proposal, Ronen questioned whether the migrant families would be eligible for the rent subsidies that the $20 million infusion would fund. She referenced existing programs that prioritize recipients who have been homeless in San Francisco for many years.

Those programs are “not for the newcomer people that are coming, because they’re going to be really low on the list,” Ronen said.

Families from several countries shared their struggles accessing safe housing and pressed the city to do better.

“I don’t want my kids to end up on streets to relive trauma,” said Luz Mejía, an unhoused migrant from Peru. Her family had gotten a slot in the city’s temporary shelter system, but it had space for only three people so her husband stayed there with their kids while she remained on the streets.  

“We need to respect our kids’ integrity, we need more transparency, more humanitarian effort, and more movement to find permanent housing for families,” said Margarita Solito, a mother of four from El Salvador who works with Faith in Action Bay Area. The organization has helped migrant families pay for short hotel stays, outside of government programs, and raise the alarm about the dire situation.

Supervisors Ronen and Safaí questioned why no one had declared a state of emergency.

Safaí, who is running to unseat Mayor London Breed this November, said Breed had the power to make that declaration, as she had in 2020 to give the government greater flexibility to confront the coronavirus pandemic. Department staff can recommend that she make a declaration.

Immigrant families newly arrived here might struggle to find housing or jobs, experts say.

“The increased number of migrants arriving don’t have the support networks or systems that previous waves might have had,” said Jorge Rivas, executive director of the Office of Civic Engagement and Immigrant Affairs.

The city lacks robust quantitative data on migrant family homelessness, Rivas said. That’s largely because many departments do not ask about immigration status when assessing people for services, in accordance with San Francisco’s “sanctuary city” policies.

But “all the qualitative data affirms that we are experiencing a steady stream of newcomer asylum seekers,” Rivas said.

For example, the number of public school students who are recent immigrants has risen steadily over the past three years, he said, and during this school year it reached its highest level in the last decade, at 1,566 children. Some of those students reported being unhoused, Rivas said. And a waitlist for legal representation by the San Francisco Immigrant Legal Defense Collaborative has ballooned to more than 900 people; typically it hovers at around 100 to 200 people, he said.

The supervisors said community members were raising these issues with them.

“We’re hearing anecdotally that hundreds of people are coming into the Bay Area every day,” Ronen said. She added that one family shelter reported “turning away people every single night. We’re hearing from our outreach workers that they find children sleeping on the streets every day.”

The Department of Homelessness and Supportive Housing will issue 35 new hotel vouchers, each giving the recipient household a two-week stay in a hotel. At the end of the period, the department could extend the stay or the voucher could go to another household, said spokesperson Emily Cohen.

The requested $20 million would pay for up to 100 five-year rent subsidies for families. That could still leave many families on the streets, based on figures Cohen presented at the hearing. As of last week, at least 375 families were waiting for rooms in homeless shelters to become available, she said.

Safaí said he would probably hold a follow-up hearing within the next two months to check on whether the homelessness department had issued the new vouchers and waitlist management had improved.

Fixing migrant family homelessness will require long-term solutions, said Hope Kamer, director of public policy and external affairs at Compass Family Services, which serves the unhoused population.

“I really, really hope that money will hit the streets and the safety net will be supported,” she said.

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