At a bustling makeshift flea market on a street corner in San Francisco’s Mission District, Ladybird sells her wares. One afternoon in December, wearing a black hoodie, faded black jeans embroidered with roses and carefully applied makeup, she biked three blocks from the city-sanctioned tent encampment where she lives, carrying a bag with a still-sealed Minnie Mouse stationery kit and a brand-new pair of brown high heels. Almost immediately, she was approached by a man interested in buying the stationery kit to give to his daughter for Christmas. “Eight dollars,” she said. He talked her down to five, and a deal was made.
During a pause in bartering, a text message appeared on her phone. “I’ve been assigned a case manager! It happened this morning,” she exclaimed, calling over her friend Johnny to tell him the news. “I’m going to be moving indoors in the next couple weeks.”
Ladybird said she hasn’t lived indoors in seven years. This winter, she said, she finally got approved for a permanent supportive housing unit — a subsidized room with health, employment and social services, paid for by the city and federal government. But despite her optimism, that didn’t mean the end of her wait. In San Francisco, the path from homelessness to housing can take as long as two years, and that’s for someone lucky enough to make it onto the waitlist.
San Francisco’s struggle with housing its homeless population is notorious across the nation. Multiple mayors have promised to get the crisis under control. The city’s dedicated homelessness department, created in 2016, has an annual budget of $598 million — a sum that has more than tripled in its short existence.
Nonetheless, as of early February, the city’s Department of Homelessness and Supportive Housing reported 1,633 homeless people like Ladybird — approved for housing and awaiting their turn to move in. Yet records provided by the department show 888 vacancies in its permanent supportive housing stock as of Feb. 22. Filling those empty rooms would not just cut the waiting list by more than half. It would be enough to house roughly one in every eight homeless people in the city. The homelessness department said it cannot talk about individual cases, but officials acknowledged that at least 400 people have been waiting more than a year, far beyond the department’s professed goal of placing applicants into housing 30 to 45 days after they’re approved.
These persistent vacancy numbers stem largely from two new bureaucratic problems. First, the homelessness department created a policy that bumped hundreds of people who had previously been approved for housing to the bottom of a new list. In December 2020, the department rolled out a plan that reserved all available permanent supportive housing units for residents of shelter-in-place hotels, which had been opened during the pandemic to keep people who had been living on the streets safe from COVID-19.
This led to a spike in vacancies as many hotel-dwellers opted to stay in place rather than accept a more permanent option. It also meant that everyone else — people on the streets, in shelters, in navigation centers and in city-sanctioned tent sites — was out of luck, simply based on where they slept at night.
It’s into this void that Ladybird fell. A resident of a tent site, she was behind an even larger number of people on an already-massive list.
Second, even when someone is approved to move in, the city is slow to send the paperwork — what’s called a “referral” — over to the private nonprofit organizations contracted by the city to manage housing units. Over the course of the pandemic, this problem has grown steadily worse.
Doug Gary recently retired from one of those organizations, Delivering Innovations in Supportive Housing. A year ago, he reported that the organization had 38 vacant units, with no referrals. Gary remembered passing people sleeping on the sidewalk as he walked to work, knowing he had empty units languishing in his buildings.
“There are going to be 38 people stuck on the street tonight, and they could be in DISH housing,” he recalled thinking. “And that’s been true for months.”
The last count of San Francisco’s homeless population numbered more than 8,000. There is not enough housing for all of them. To try to help, the city’s mayor, London Breed, is pursuing a new goal: She has allocated hundreds of millions of dollars to procure 1,500 new units by the end of 2022. The city is on track to hit Mayor Breed’s goal, and may even exceed it.
But with so many units of housing already sitting vacant — a number that according to the department has roughly doubled during the pandemic — a critical question arises: Will the city be able to fill them?
A Deprioritized Population Struggles to Get Indoors
Funding for permanent supportive housing constitutes the largest piece of San Francisco’s budget for the homeless, and the supply of housing is growing rapidly. It consists mostly of older hotels converted into single-room-occupancy residences. The city contracts with a dozen nonprofit organizations to run the nearly 150 buildings and manage social services, such as moving people in and out of units, maintaining the properties and managing individual cases, including everything from connecting people to treatment for substance use disorder to helping someone apply for food stamps. Residents pay 30% of their income, including Social Security benefits, toward rent, and the city subsidizes the rest.
All of the 1,633 people in line for a permanent supportive housing unit had to answer a series of questions to determine who is most vulnerable and therefore most in need of housing. Every year, more than 3,000 people take this assessment, called “coordinated entry,” which takes into consideration, among other things, how long they’ve been homeless, if they have any mental or physical disabilities and if they’re addicted to drugs. Those who score highly by the city’s complex algorithm — in theory the most vulnerable — are marked “housing priority status,” and are then put on a waitlist for permanent supportive housing.
But actually getting off of the waitlist and into those units isn’t easy. The city’s software to track vacant units is error prone, unit maintenance problems take a long time to resolve, case managers quit and it can be impossible for people who have been living on the street to meet document requirements. (The homelessness department said that the city is currently working on the software and documentation issues, and has put a raise for case managers into its budget request for next year.)
On top of all that, the city’s response to the COVID-19 pandemic made getting housed harder by creating a system that gave top priority to those least likely to want to move in: those who suddenly found themselves living for free in shelter-in-place hotel rooms.
In spring 2020, as the city locked down and its housed residents stayed indoors, advocates raised concern for the thousands of homeless people living outside and in temporary shelters, many of whom had health conditions that increased their risk for severe COVID-19. Those fears were realized when 92 residents of a large one-room shelter contracted the illness just one month after the city shut down.
In response, San Francisco leased hotel rooms to help people experiencing homelessness quarantine indoors. It was always meant to be a temporary measure, and as the pandemic dragged on, the homelessness department strategized on how to wind the program down. The optics of sending anyone back to the street were not great, and the city created a policy of prioritizing residents of the shelter-in-place hotels for housing.
“I will be candid: It is both one of the biggest opportunities and one of the biggest challenges our city has faced in our homelessness space,” said Abigail Stewart-Kahn, then director of the homelessness department, during a Nov. 10, 2020, Board of Supervisors meeting at City Hall, where she justified the new policy. She added that the department would keep an eye on the data, and would “course correct” to ensure the process was successful. In subsequent interviews and email exchanges, the department did not respond to additional questions about why that policy was created and pursued.
The data over the past 15 months shows a gradually increasing crisis: In October 2020 there were 544 vacant units. A year later, vacancies had nearly doubled to 1,064. While units sat vacant, people living outdoors were waiting to get indoors. Any course correction has been slow to come.
From the get-go, the policy of reserving housing for people in hotels was difficult to implement. Although residents knew the hotels were temporary and could close at any time, many were reluctant to move from free, modern rooms with private bathrooms into small, older units with bathrooms down the hall, at a cost of 30% of their income. All of a sudden, one housing provider said, three applicants for housing had to be referred in order to fill one vacant room.
In the first seven months after the policy was implemented, supportive housing vacancies jumped 61%, from 600 units in November 2020 to 964 in June 2021, a period when the city was also adding new units. In February 2021, the homelessness department reported that 70% of shelter-in-place hotel residents who were offered a spot in the Granada Hotel, a newly purchased permanent supportive housing building, had rejected the placement.
When someone turned down an available housing unit, it sat vacant until a new referral appeared. Providers found themselves in a new position: having to offer incentives to persuade potential tenants to move in.
Georgetta Lovett, a property supervisor at DISH, oversees more than 300 units of permanent supportive housing. She said the organization now provides move-in benefits: free rent for the first month, free meals for three months and a free Muni transit pass.
Resistance to moving into permanent housing is not something Lovett experienced when showing units to people who had been living outside.
“People coming directly off the streets would take the place immediately,” she said. “We would be able to show them a room, they’d say, ‘Oh, this is nice.’ Most of them don’t come with a lot of stuff, and they were like, ‘I can move in today, or I can move in tomorrow.’ And normally we can make that happen right away.”
A Feb. 24, 2021, a budget hearing at City Hall on shelter-in-place hotels showed the homelessness department was aware early on that the policy was adding to the vacancy crisis in permanent supportive housing.
“We are noting that people who are not in shelter-in-place hotels are more eager to take permanent supportive housing placements,” Stewart-Kahn said, adding that it was “putting pressure on our system.” She said that the department was “reevaluating” the policy.
Three weeks later, Stewart-Kahn resigned, moving to a new role as an adviser to the city’s Department of Children, Youth, and Their Families. That same month, the city established an 18-person shelter-in-place hotel housing team. Their task: to more efficiently implement the policy and move everyone qualified for housing from shelter-in-place hotels into vacant units. As a result of the change, move-ins did increase. In the six months before the housing team was established, the city moved 325 people into permanent supportive housing. In the six months after its creation, that number grew to 488.
In an email exchange with the San Francisco Public Press and ProPublica in February, Megan Owens, who oversees much of the housing process of the city’s homelessness department, acknowledged that the policy “caused a huge delay” for adults living outside of the hotels.
In June, the department told the news organizations that it planned to open up a portion of permanent supportive housing vacancies to unhoused people living outside of shelter-in-place hotels. But the department offered no transparency about how units were being allocated.
Neither effort did enough to catch up to the growing supply. By September 2021, vacancies were at their height, with 1,064 permanent supportive housing units empty.
The delay in access to housing has been rough for people living outdoors. According to the official numbers, the current median wait time for a unit is 82 days.
But Owens admitted that the software the city uses doesn’t accurately track the time between being approved for housing and moving indoors. The city and federal government spent $8.5 million for that system over the past five years, but information on people trying to get indoors still isn’t recorded accurately.
For example, if someone doesn’t contact their case manager for 90 days, their spot on the waitlist expires. In acknowledgment of the long delays, at the start of 2021 the city automatically reinstated those applications, but the software then started the timeline over from scratch.
“The 300 people that expired off the queue and were reinstated in December and January are now listed as having waited 20 to 45 days, depending when they were reinstated, but their experience is that they’ve been waiting for months,” Owens explained.
That lack of clear data worries Nan Roman, president and CEO of the National Alliance to End Homelessness. People who are unsheltered “have very high needs, and they need to get into permanent supportive housing,” she said. “If you don’t keep good administrative data, you can’t track them. You can’t support them. You can’t find them. You can’t know what their situation is. It’s very important to have good data to make these programs work properly.”
Many of those who are waiting are living in city-sanctioned tent encampments in empty parking lots around the city.
That’s where Ladybird, ineligible for housing under the policy that prioritizes hotel dwellers, lived for 15 months. (She requested the use of her nickname for this story due to complicated family matters; her identity was confirmed by a member of the city’s health department.)
After years on the streets, Ladybird committed herself to finding a home. She said she took the coordinated entry assessment for housing three times — going through a mandatory six-month wait between attempts. She was finally approved in November.
“Six months is a long time,” she said about the time between applications. “You basically have to be sitting out here waiting to be raped every night.” (A University of California San Francisco study found that 32% of women living outdoors reported instances of sexual or physical assault.)
Research backs up Ladybird’s experience. “The impact of waiting weeks, months or years in a shelter or outside rather than a home has devastating consequences for a person,” said Chris Herring, an assistant professor of sociology at the University of California Los Angeles. “Homelessness for even short periods of time has negative impacts on people’s physical, behavioral and mental health, can strain familial and social relations, have lasting impacts on future employment opportunities, and can entangle people in the criminal justice system.”
In the city-owned parking lot where Ladybird lived during the last year, her cheap camping tent, which rested on a wooden platform in a parking lot, got moldy during a wet winter. She developed pneumonia, and said rats would run around at night, hiding under the pallet she slept on.
“I can’t be there anymore,” she said when interviewed in December. “Your body goes through a lot being homeless. I’ve had pneumonia for two months now, from black mold on my tent. My tent is literally killing me.”
While the city said it is taking steps to mitigate delays, months of living in a wet tent site took its toll on residents. In text messages sent late one night, Ladybird described the chaos that had ensued as one of her neighbors had a mental breakdown. “This situation is getting worse by the day, it’s more twisted than anything I’ve seen in my decade out here,” she said. “I would be better off on the streets.”
The situation felt hopeless. “This site hasn’t placed anybody,” Ladybird said. “Anybody who’s getting out of there is doing it on their own. There’s no social worker. It’s just a dead end.”
Paperwork Bottlenecks Stall the Process of Moving People Indoors
While the policies of the last two years left people like Ladybird living outdoors, those living in shelter-in-place hotels haven’t always fared better, with some of them waiting more than a year to be connected to a home.
Marquita Stroud is one of those. She said that she has been homeless for 15 years, but that about a month before the COVID-19 outbreak began in earnest, she was approved for permanent supportive housing. “God was on my side!” she said when interviewed in December.
In April 2020, she was relocated to the Hotel Whitcomb, a historic tourist hotel repurposed to allow people experiencing homelessness to quarantine safely. Stroud was one of 500 homeless people the city moved from large, warehouse-style shelters into 25 hotels around town.
Stroud is an optimist, high-energy and cheerful, who wears her hair tied up neatly in a scarf. “It’s wet!” she exclaimed on a rainy morning, as she strode confidently down Market Street with an umbrella in one hand, pushing a cart containing her small, fluffy dog, Blue, with the other. She headed straight to a corner of the public library, a place she knows well.
Under COVID-19-era rules, Stroud isn’t allowed visitors where she lives, so she meets people at their apartments, outside or in public places. The prohibition on guests didn’t bother Stroud too much when she first moved in. But she felt isolated and, as the months dragged on, no one contacted her about moving into her own place. Stroud watched her friends and neighbors — many of whom arrived in the hotel the same day she did — move into permanent housing. Her turn never came.
In large part, that’s because the homelessness department’s process for reviewing and selecting unhoused people for referral is slow. And in the period when Stroud was waiting, things were markedly worse. In October 2020, 32% of vacant units had no pending referrals for a resident. In January, that ratio had more than doubled, to 66% of available units, according to the city’s own data. The department did not respond to questions about why this might be.
Gary ran eight buildings through DISH. In February 2021, before he stepped down, he said the problem wasn’t new, but it was getting worse.
“Somewhere there is a bottleneck where the city is not sending us the housing application — that is, the documented representation of that person that we can process,” he said. “We report the vacancy to the city, and those vacancies languish for weeks to months without a referral of a real live human being who can be housed.”
At least part of the problem is a shortage of case managers, who are the crucial link between vacant units and the hundreds of people approved for housing. There is frequent turnover in the high-stress positions, and nonprofits struggle to fill new job openings.
Stroud said she has been assigned six case managers in two years. To figure out who is assigned to her, she regularly checks a piece of paper taped to a wall in her hotel, which lists the name of the case manager assigned to each floor. She describes calling her case manager repeatedly to set up an appointment and not getting through.
“They pretty much don’t go knocking on your door,” Stroud said. “You got to ask for them. If I see one in the hallway — like if I see a worker talking to a client in the hallway — I always ask, ‘Are you a counselor? Are you my counselor?’ Because they don’t tell you.”
Nearly two years after being approved for a housing unit, Stroud is still at the Hotel Whitcomb. Although she dreams of going back to school, publishing her journals and giving back to the homeless community, her reality is much different. She’s had items stolen from her room, and the building has fallen into disrepair. “When we first got to this hotel, it was so cute,” she said. “Now they got the bedbugs, the roaches, the mice. Every other day, the pipes are messing up.”
Recently she met a woman who had recently moved into the Whitcomb, but was already on her way out: She’d been assigned a housing unit.
“I was asking her, what did she do to get her housing that quick? And she said her counselor just came knocking on her door like, ‘You ready to go?’” Stroud said, clearly frustrated. “I haven’t talked to anyone about housing,” she said this month, as she approaches her two-year anniversary at the hotel. “I’m still here just waiting.”
As for Ladybird, she was approved for housing in November, but three months later, she is still without a home. In January, she left the tent encampment for a short-term residential hotel, but it comes with a time limit. “After 28 days, we get put out.”