San Francisco homelessness. Housing First model.

3. Shelter AccessWorkgroup
Participatory Action Research (PAR)
Participants= Mayors office, service providers, community
members, shelter residents, people who are homeless, etc.
 Diagnose the situation (focus groups/brainstorming)
 Recommendations to Improve/Action Plan
 Research to Assess Effectiveness
*Branom, C. (2012). Community-Based Participatory Research as a Social Work Research and Intervention
Approach. Journal Of Community Practice, 20(3), 260-273. doi:10.1080/10705422.2012.699871

4. Presenting Problem
 6,544 — Population of homeless people in San
Francisco (Others report about 15,000 homeless
and LSYS reports 4,105 youth served in ‘12)
 1,134 — Total beds in single adult shelter system
funded by taxpayers
 75% — Percentage of homeless people with a
chronic medical ailment
 55% — Percentage of shelter clients reporting a
disabling condition
 12 to 14% — Percentage of beds used by clients
aged 60 or older (3/09 to 3/11- increased)
 ONLY 9 CASE MANAGERS!!!!!!!
*Sources: San Francisco Human Services Agency, Department of Public Health

5. PhaseTwo of the Shelter AccessWorkgroup focusing
on improving outcomes in the Adult Shelter system.
Recommendations address
3 categories.
Improving Health
Outcomes in Shelters.
Cultural Competency /
Special Populations.
Access to and quality of
case management and
service connection.

6. Intervention/Analysis
Shelter Recommendations:
 Increase accessibility and education for residents about
available services.
 Improve staff training and increase staffing resources.
 Improve shelter conditions.
 Provide medical and mental healthcare services on-site.
 Permanent housing, employment, & DIGNITY!
Building more shelters is NOT the answer!

7. Housing First, Consumer Choice, and Harm
Reduction for Homeless Individuals With a
Dual Diagnosis

8. Provider Perspective: Housing 1st
vs.Traditional Programs
This study revealed that providers working within
Treatment First programs were consumed with the pursuit
of housing, whereas Housing First providers focused more
on clinical concerns since clients already had housing.
 How programs position permanent housing has very
different implications for how providers understand their
work, the pressures they encounter, and how they
prioritize client goals.
*Henwood BF, StanhopeV, Padgett DK.The role of housing: a comparison of front-line provider views in housing first and
traditional programs. Adm Policy Ment Health. 2011 Mar;38(2):77-85. doi: 10.1007/s10488-010-0303-2.

9. Think Out of the Box- Wet House
San Francisco spends around $13.5 million per year caring
for its top 225 “chronic public inebriates.”
The average individual in a Seattle wet housing program
cost the city more than $4,000 per month prior to their
intake, but only $958 per month afterwards.
 Residents averaged 20 drinks per day at the time of their
intake, and within two years, that number fell to 12.
*Larimer ME, Malone DK, Garner MD, Atkins DC, Burlingham B, Lonczak HS,Tanzer K, Ginzler J, Clifasefi SL, Hobson WG,
Marlatt GA. Health care and public service use and costs before and after provision of housing for chronically
homeless persons with severe alcohol problems. JAMA. 2009 Apr 1;301(13):1349-57. doi: 10.1001/jama.2009.414.
PubMed PMID: 19336710.

10. *Stuart, R. (2012). Practicing Contemplation for Healthy Self-care. Chaplaincy Today, 28(1), 33-36.
*White, M. L., Peters, R., & Schim, S. (2011). Spirituality and Spiritual Self-Care: Expanding Self-Care
Deficit Nursing Theory. Nursing Science Quarterly, 24(1), 48-56. doi:10.1177/0894318410389059
Regular spiritual practice &
incorporating contemplation
into ones daily routine
is an antidote to stress.
Healthy self-care not only helps prevent compassion fatigue,
but also helps one relax and clear one's mind of thoughts
and feelings, and experience warmth, love and goodness.