A city performance audit of San Francisco’s various homeless outreach and response teams found a lack of coordination among teams, inconsistent goal tracking and poor contract oversight, among other issues.
The four departments that operate street teams use at least eight different data-collection systems, the report says, but are unable to easily share or link data across teams or departments.
Limited data access and sharing practices make it challenging for street-team members to understand a client’s full history and connect them to resources on the ground, the report found. It also means the city cannot analyze longitudinal data about the outcomes and effectiveness of the street teams.
Following the release of the audit, Supervisor Dean Preston, who commissioned it, called for a hearing on its findings.
“Our City’s street teams are essential for responding to crises, and connecting people to the help they need,” said Preston. “We should be making sure that the City is setting these teams up for success by providing the necessary oversight, management, and ensuring that we have adequate treatment beds, shelters, and other services available for referrals.”
The audit covers 11 teams that respond to emergencies and intervene with people on the street, largely helping those who are experiencing a substance-use or mental-health crisis with a goal of getting treatment or care.
The audit, conducted by the Board of Supervisors Budget and Legislative Analyst’s Office, examined all 11 teams over a five-year period, from fiscal year 2018 to 2022.
The report came to seven findings and 20 recommendations on management across teams, goals and performance evaluation, contract oversight, data access and sharing, resource-referral capacity, team-member availability and staff support.
Over the five years analyzed in the audit, there have been nine contracts with six organizations involved in the street teams, the report found. The departments that manage these contracts, particularly the Department of Public Health, are not providing adequate oversight of the contractors, it said.
For example, two of the health department’s contractors, HealthRight 360 and RAMS, had not generated any formal contract monitoring reports after more than two and a half years of operation.
“Inadequate contract monitoring is a risk for the City, and for the street teams,” the audit report said. “It is also a risk for the street teams that rely heavily on contractors to meet the goals of the teams, and is particularly concerning for newer teams.”
Some contractors have only inconsistently met the expectations outlined in the contracts, while some contracts did not contain adequately specific scopes of work. For example, one of the street teams, Harm Reduction Therapy Center, was working for the health department — without a signed, executed contract in place — for more than 18 months.
When street teams are out on the streets, many resources are not immediately available, the report found.
On average, 13 percent of the time, according to fire department data, a requested service was unavailable. Eighty four percent of these are due to lack of shelter capacity, the report showed.
Street teams also face staffing issues: Dispatched street teams, which respond to 911 and 311 calls for service, have fewer units available to respond than originally planned when the teams launched.
When team members are on leave, for example, not just anyone can fill in. Street teams usually require staffing and collaboration from at least two and sometimes three agencies: Fire Department for community paramedics, DPH for contracted peer counselors and Department of Homelessness and Supportive Housing for contracted Homeless Outreach Team members.
On staffing, the report also found that support for relationship-building among team members has decreased, which increases the risk of burnout, turnover and job dissatisfaction for street team members across departments.
No longer, for example, is there support for post-call debrief sessions or informal social gatherings.
All four city departments that run the street teams, including the Department of Emergency Management, Department of Public Health, Fire Department, and Department of Homelessness and Supportive Housing, largely agreed with the recommendations and said they are working to implement the recommendations.
San Francisco faces many challenges in mounting an effective response to homelessness. A shortage of resources is not one of them.
Thank you Supervisor Preston for calling for this much needed hearing. This lack of coordination among city teams, teams from city departments each with multi-hundred million dollar budgets is troubling. This needs to be examined much much more closely. Resources are being wasted. Those suffering on the streets are not getting the help or referrals they need. This needs to be fixed.
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David Elliott Lewis
The time is now for this Mayor and the city departments she controls (via the budget and by her decree) to get their act together. 8 different systems to the City’s system with none of them interfacing!?@%!!§ Dept of Health, Dept of Homelessness, Dept of Emergency Response ALL ARE UNDER BREED’s CONTROL. The buck stops with London Breed and her appointees.
Preston commented on KTVU that his office had to spend resources coordinating the actions of several of these homeless departments to squeeze an effective response from the Mayor.
Ronen claims that she’s spending her time bird dogging the departments to squeeze a response on vending and homelessness. Assume for a moment that Hillary is not lying.
What if this “dysfunction” is by design, an intentional effort to deprive supervisors of services in their district so that they they waste their scarce resources and time getting the Mayor’s departments to do the job that supervisors specify and fund, the job that they should get for free, that the mayor could order by fiat?
This ends up depriving residents of these districts of effective representation as supes are being led around by rings in their noses by the Mayor to address public realm problems that the Mayor’s political operation hypes as the responsibility and failure of supervisors.
A supe that is being led around by the mayor is a supe who is not legislating to solve the district’s and city’s problems, both for time and for fear that the mayor will not deliver services unless they play ball.
There needs to be systems in place and accountability to track the performance of these organizations. Many are so-called non-profits, but I bet the executives of many of these organizations draw a good salary. The city should not be hiring a ragtag patchwork of nonprofits to tackle its most pressing problem. There should be a Department of Homelessness, with officials and employees tasked with cracking this vexing problem.
Maybe the AI hackathon should have focused on that instead of potentially making the process of complaining to 311 incrementally more efficient.
The city’s 2023 budget for the homeless: “includes $423 million for Permanent Housing, $244 million for Mental Health services, $58 million for Shelter and Hygiene programs, and $120 million for Homelessness Prevention programs.” And how many are homeless? “Under the 2022 PIT Count, 7,754 people were experiencing homelessness in San Francisco. Of those people, 3,357 were staying in shelter.” That’s roughly $109,000 per person for 2023. I think an audit was in order.
i think every homeowner or tenant renter should be forced to take in the homeless. a new city department should seek out the unhouses and put them on a waiting list and as it flows, the tenter/dweller would be placed in somebody’s resident. Classes on equity, diversity, inclusion and gender acceptance would certainly go far in making a proper fit.
The problem is one of basic philosophy, and this Board is not going to address it, but voters might.
All of us agree homelessness is the city’s biggest challenge.
However, this Board of Supes interprets that to mean we need to spend endless resources to make sure every homeless junkie who shows up from another state has cash, food and shelter.
Whereas myself, and a lot of other San Francisco voters, want to see the city do something to encourage the junkie tourists to go be homeless somewhere else.
People who really lose their homes in SF due to economic circumstances should get all the support we can give them. Unfortunately nobody at the city is distinguishing between these homeless people and the junkie tourists. Thus we will never reduce our homeless population because our generosity to the junkie tourists keeps attracting more.