For four months last year, Jessica Hassen-Whitson, 45, was a prisoner in her home, a permanent supportive housing unit in a hotel on Turk Street in San Francisco assigned by the city’s homelessness department. The elevator and doorways were too narrow for her plus-size wheelchair and she couldn’t get over the unit’s front steps. Her partner, Jason Davis, 33, had broken his leg and could no longer carry her.
During that time, she left the apartment only twice, for doctor’s appointments. Since she couldn’t step into the bathtub, she took sponge baths. As the weeks dragged on, Hassen-Whitson grew increasingly depressed.
“It was a nightmare,” she said. “I was ready to have a nervous breakdown.”
Hassen-Whitson needed a wheelchair-accessible unit. Instead, she twice got housing that was unusable for her, despite having a doctor’s letter on file and qualifying as a high priority candidate for support.
She is one of many homeless San Francisco residents who can’t get the services they need — and are entitled to — because of breakdowns in the city’s system for allotting housing and other support services.
Known as Coordinated Entry, the adult system was ushered in five years ago with a bold promise: to streamline the pathway to housing for those suffering the most on the street, and to tailor services to their needs. The program, which has served more than 49,000 unhoused people, has largely failed to deliver.
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Rather than accelerate the process, it has added bureaucracy and reduced visibility, say homeless service providers, who described the program as a black box. Unhoused residents bear the consequences. Many find the process confusing and stressful. Others face long waits that, in extreme cases, last years. Limited housing stock and a disorganized database make bad housing matches commonplace. People involved with the system have known about these problems for years, but they remain unsolved. Most unhoused people who go through the system stay homeless.
“Has it accomplished what it was supposed to? I would say resoundingly no,” said Jennifer Friedenbach, executive director of the Coalition on Homelessness. “It did the opposite.”
On average, it takes a homeless San Franciscan about 330 days to move into housing from the day the person applies, according to data from this fiscal year in the city’s homeless records system, provided to the Chronicle by a nonprofit service provider that contracts with the city. A spokesperson for the city’s Homelessness and Supportive Housing department said the agency calculates wait time as the period between being put on a wait-list and housing placement, which this fiscal year has averaged 154 days.
Coordinated entry is mandated by the federal government, which provided the city’s homelessness agency more than $53 million in federal funds last fiscal year. However, San Francisco designs its own system within federal parameters.
Some homeless service workers tempered their criticism with acknowledgement that the system is still young and that reforms are in the works. The city’s homelessness department has assembled a redesign working group that includes nonprofit homeless service workers, including system critics interviewed for this story. Still, they worry the problem is urgent and solutions are not coming fast enough.
More than a half dozen others who spoke with the Chronicle requested anonymity because they feared endangering their organization’s working relationship with the city.
Case workers say the new system, which uses an algorithm to calculate housing eligibility, is more complicated and impenetrable than the old one, where a referral was a matter of a phone call between people plugged into the ecosystem.
Housing someone requires consideration of their needs, the providers say. Someone who uses a wheelchair will need a building with an elevator, for instance. But often, they don’t get one.
Jessica Hassen-Whitson and her partner, Jason Davis, have fought to get housing that meets their basic needs through the city’s coordinated entry system.
Courtesy of Jessica Hassen-Whitson
For Hassen-Whitson, it has happened repeatedly. She resisted moving into the Gotham Hotel apartment that couldn’t accommodate her wheelchair, but she said her housing navigator at the city-contracted nonprofit Episcopal Community Services pressured her to accept it. The shelter-in-place hotel she lived in was closing and there wasn’t other housing available. It was that unit, or a group shelter, she recalled the case worker telling her.
According to city policy, coordinated entry applicants are entitled to three housing offers, but Hassen-Whitson only got one. She didn’t want to go to a shelter and she had received assurances that the city would relocate her to suitable housing, so she took it.
“We don’t have enough resources for everybody, which is really heartbreaking,” said Shireen McSpadden, executive director of the Department of Homelessness and Supportive Housing. “With something as basic as housing, we should be able to say to people who are homeless, ‘We may not have the resources you need right now, but we will have that for you, and we will be working with you on your housing plan all along on the way.’ And it hasn’t been like that in the past.”
Episcopal Community Services declined to comment, citing client confidentiality.
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Prior to coordinated entry, case workers drew on their nuanced knowledge of clients’ needs to match them with available units. Now two teams at the city’s homelessness department — coordinated entry and housing — handle that work without input from the case workers. The change was supposed to remove case workers’ personal opinions from the equation and distribute housing more equitably, according to the agency.
But too often the department offers homeless applicants housing options that don’t meet their needs and more community input would in fact make for better matches, said a longtime service provider, who spoke anonymously out of fear of reprisal.
Technology shortcomings worsen the problem. The city’s data system that keeps information about homeless people can’t pull health information from enough administrative systems. That means homelessness department workers can’t always see crucial information such as the need for a private bathroom due to sexual assault trauma or the need for wheelchair access that could help them allocate services.
The city is aware of its data mismanagement, but it said sometimes a poor match is the only one available.
“Mismatches happen, which is why we’re taking the time to really get the right people in the room to discuss how to have an inclusive system,” said McSpadden. “There’s an ebb and flow to this whole system and that’s what we have to work with.”
Jessica Hassen-Whitson still does not live in an apartment where she can bathe herself without assistance because the bathtub is not wheelchair-accessible.
Courtesy of Jessica Hassen-Whitson
San Francisco is building a new records system, modeled off a pandemic pilot, to integrate cross-departmental health information. The upgrades will draw from state dollars and may launch in about a year, according to the city’s homelessness agency. The effort is part of a broader push to integrate the city’s many disparate databases.
Improvements in technology and data systems are helpful, but they only work in conjunction with reducing documentation requirements, increases in affordable housing stock, incentives for landlord participation, and policy improvements, according to Gabi Remz, Assistant Director of Research and Writing at the Harvard Kennedy School Government Performance Lab.
For now, Hassen-Whitson has settled for getting most of her needs met. Last December, she finally moved to a newly-constructed apartment in Mission Bay. After going months without an update on her transfer date, she got a text message from her case worker the night of Dec. 29 notifying her the move would happen Dec. 31, according to a complaint she filed with the city. When she arrived at the new building, no one was aware she needed a wheelchair accessible unit and told her there were none left.
Hassen-Whitson took an available unit anyway. It was comfortable enough. The doorways and elevators were wide enough for her wheelchair. She was also tired of fighting. She and Davis settled in, covering the fridge with anime stickers and hanging gothic decorations on the walls.
To this day, she still doesn’t live in an apartment where she can bathe herself.
Reach Audrey Brown: audrey.brown@sfchronicle.com
