- Six Sigma frameworks used in Managing and Using Information Technology to solve Homelessness in San Francisco Project

1. Frameworks
City of San Francisco
MGT 120
Team Four
June 11th, 2020

2. Problem Statement One
The City of San Francisco is home to 9,700 homeless people, 42% of which have a form of mental
illness, and 95% of those with mental illness have self-reported substance abuse issues. The city has
failed to remove drugs and other substances from the homeless population, specifically those with mental
illnesses, which can be seen in measures such as Prop 47.
Nearly 80% of San Francisco veterans left the military without a job, and two in five have reported
homelessness in the past year. Most veterans are unprepared for the transition back to normal life, and
San Francisco veterans have reported not knowing how to access resources, and if they were able to,
difficulty scheduling appointments and long wait times.
In 2019, there were 208 families in San Francisco, consisting of 631 people, suffering from homelessness.
94% of these families are in shelters or transitional housing programs, however 60% of homeless families
in San Francisco have been homeless for a year or longer.
How can we rethink the current processes in place to fit the needs of each specific type of homelessness
to ultimately reduce the population, while also attempting to prevent individuals from becoming homeless
in the first place?

3. Problem Statement Two
Many of the resources/programs are deemed ineffective to “re-entering” homeless individuals. In 2018,
homeless-related requests for services via SF311 declined by 33%. There are currently 7 Navigation centers
(Funded by the city of SF) in SF, whose sole purpose is to focus on re-entering homeless individuals into
society, and to assist them with finding jobs and housing. They have served over 5000 individuals/families
with a reported success rate of 46% (14% move on to permanent housing, 4% to temporary housing, and
28% are reunited with friends and family). However, out of the 54% not re-entered successfully: 30% exit by
choice, 14% end their timed stay of 30 days, and 10% are denied services. Additionally, the high cost of
living in San Francisco adds to the difficulty of re-entering the homeless into society. The average rent in the
city is $3,629, and the estimated cost of living is $5000 monthly, which is much higher than the national
average. Homeless individuals often can only secure minimum wage jobs, and the minimum wage of $15 is
simply not enough to cover these costs.
How can we improve the process of re-entering substance abuse homeless individuals into society, while the
city of San Francisco ensures its Navigation Centers effectively assist in providing the homeless with
housing and jobs?

4. Problem Statement Three
Due to San Francisco’s rising homeless issue, the city passed Proposition C in 2018, increasing
taxes by 0.5 percent for local businesses with annual revenue exceeding $50 million, bringing in
up to an additional $300 million for the city to address homelessness. A separate tax of 1.5%
applies to companies’ administrative expenses. This tax applies to about 400 San Francisco
businesses to help pay for buildings, such as three navigation centers (temporary homeless
shelters), with annual operating costs of $33,000 to $38,000 per bed. This tax on businesses is
estimated to create a loss of 725 to 875 jobs while homelessness continues to rise.
How can the City of San Francisco create a strategic partnership with businesses that includes
incentives for hiring homeless individuals, while still funding efforts to help the homeless
population re-enter society?

5. Triple Constraint
People (20%)
- Homeless Individuals
- Program Volunteers, Employees, and Officials
Process (70%)
Provide transitional housing, navigation
centers, and other health services
Technology (10%)
Any technology used to help automate
programs and policies, using resources
provided by the city
Within the Triple Constraint, the people element is twenty percent, and involves the homeless individuals as well
as the volunteers and employees that work at homeless programs, and the government officials that implement the
policies. The process element is seventy percent, and is the transitional housing, navigation centers, and other
health and homeless services that support homeless individuals. Technology, which is ten percent of the
constraint, involves anything that allows the program employees and government officials to execute their
programs and policies.

6. Trade-Offs Fast
Turnaround
Temporary
Solutions
Permanent
Solutions
The tradeoffs for the city of San Francisco include Fast Turnaround, Temporary Solutions, and Permanent
Solutions. The city has chosen to prioritize fast turnaround and temporary solutions, rather that taking the time to
invest in permanent solutions. San Francisco has consistently utilized temporary solutions that do not address the
root cause of homeless issues.

7. Three Questions
What are we trying to accomplish?
➔ Establish an effective process to provide homeless individuals with opportunities to recover and re-enter society
➔ Incentivize businesses to hire homeless individuals
➔ Create more subsidized housing to accommodate the increasing homeless population
➔ Work upstream to prevent individuals from becoming homeless
How will we know when a change is an improvement?
➔ The number of individuals already homeless begins to decrease
➔ Less people are becoming homeless
➔ More businesses are hiring homeless individuals
➔ More subsidized housing is available to homeless individuals
What changes can we make that will result in an improvement?
➔ Improve and alter San Francisco’s process for addressing the homeless population
➔ Implement new policies to incentivize businesses to hire homeless individuals
➔ Build more subsidized housing
The San Francisco homeless population will not decrease if the policies and processes in place are not
altered to be more effective. There also needs to be incentives for businesses to hire homeless individuals
in order to increase job opportunities, an increase in subsidized housing, all while working upstream to
prevent homelessness in the first place. (Please see painpoints and capabilities for more changes)

8. Five Whys
Five Whys Output
Why is the San Francisco Homeless population
increasing?
While many homeless individuals are re-entering into society, many more
individuals are becoming homeless simultaneously, causing the population to rise.
Why are more and more homeless individuals
becoming homeless?
The City of San Francisco’s current process for addressing homelessness is not
working.
Why is the City’s current process not working? The city’s process involves temporary solutions, and not permanent solutions.
Why do the city’s temporary solutions not work?
The temporary solutions are not working because they do not focus upstream to
address any preventative measures for before individuals become homeless.
Why does San Francisco need to focus upstream?
Focusing upstream will allow the city to prevent individuals from becoming
homeless in the first place, therefore lowering the homeless population.
The City of San Francisco needs to work upstream in order to effectively decrease the homeless population. Although
there are some individuals re-entering into society, the amount that is becoming homeless is much larger. The city has
focused its resources towards temporary solutions that do not address the root cause, so if they want to fix the issue they
need to move towards permanent solutions that are focused upstream.

9. Change Curve
Denial
➔ Despite the increase in
homelessness each year, the
San Francisco government
refuses to change its failing
policies
Resistance
➔ The city has policies and
processes in place, however they
are only temporary solutions and
do not address the root cause
Exploration
➔ Raise spending each year to
compensate for the lack of
effective programs
Commitment
➔ Address the symptoms of
homelessness instead of the
cause
In the denial stage, San Francisco does not address its failing policies by implementing change, and instead continues to
use the same process for “solving” homelessness year after year. In the resistance stage, the city has policies and
processes in place, however they are not addressing the true cause of the issues. The next stage, exploration, is where the
city attempts to improve its disappointing services by significantly increasing spending for each service. The last stage is
where San Francisco has committed to continue treating the symptoms of homelessness, instead of putting effort towards
changing their process to treat the cause of the issue.

10. Flexibility Matrix
Flexibility
Constraint Least Somewhat Most
Schedule
Scope
Resources
Resources are the least flexible constraint, as the resources are the most essential component to reducing homelessness. With the
proper programs in place, like rehabilitation centers designed for the substance abuse homeless population, we can make efforts
towards decreasing the homeless population. Our scope is somewhat flexible. Right now we are focused on veterans, substance
abusers, families, and mentally ill homeless, but given our future process and policies this may be subject to change. The most
flexible is our schedule, because as long as the homeless population is reduced in the long run with quality programs in place, the
timeline to implement our processes does not matter as much in the short run.

11. Strategy
The City of San Francisco’s current strategy includes clear tradeoffs and tailored
activities that fit together in an integrated system. The tradeoffs are between temporary
solutions, permanent solutions, and fast turnaround, and the city has prioritized the first
two. The tailored activities include the programs, resources, and other assistance the city
offers to homeless individuals. Additionally, while the city also has continuity of
position, they do not have consistent improvement. The city of San Francisco needs to
reevaluate their current strategy to account for the increasing homeless population. If
they alter the strategy, then the city will be have a better advantage for pursuing a
smaller homeless population.

12. Ladder of Inference
Residents of San Francisco
Actions I look down on the homeless and do not offer my help
Beliefs Homeless people don’t want to turn their lives around
Conclusions Homeless people are lazy and dirty and are degrading my city
Assumptions The homeless are degenerates, drug users, etc.
Interpret This makes my city appear filthy and overrun
Select There are many homeless people in my home of San Francisco
San Francisco Residents are impacted by their city’s homeless issue every day. They have experience interacting with
homeless people in their own neighborhoods, businesses, and other places throughout the city. Residents believe that the
homeless are addicted to drugs, do not want to improve their lives, and do not have a problem with overrunning the
streets of San Francisco. In their eyes, homelessness is detrimental to their quality of living, and they do not want to
continue to enabling them.

13. Ladder of Inference
Visitors of San Francisco
Actions My opinion of San Francisco is now clouded and I will strongly consider not returning
Beliefs The city enables homelessness
Conclusions San Francisco is ridden with homelessness and the city is not doing anything to help
Assumptions They do not have a home, or resources to improve their situations
Interpret They are degrading homes, places of business, and most streets
Select I see an abundance of homeless people on the streets
Many tourists who visit San Francisco are shocked by the city’s homeless problem. They interpret the impacts of
homelessness by seeing how prevalent it is in daily life. This leads visitors to assume that the government has either not
implemented effective programs, or any programs at all. Visitors then leave the city with the belief that the City of San
Francisco enables homelessness, causing them to rethink their opinion of the city and question if they will ever return.

14. Ladder of Inference
Aid Programs in San Francisco
Actions Implement shelters, foodbanks, and other services for the homeless
Beliefs Aid programs can offer the essential help that homeless people need to improve their situations
Conclusions Homeless people do not have the means to help themselves and therefore are in need of aid programs
Assumptions They do not have the necessary skill sets to find and maintain a job
Interpret They do not have jobs or sources of income
Select We see homeless people on the streets of San Francisco
While the aid programs in San Francisco recognize that the homeless need their help, there is a disconnect with reality
since the programs offered do not include any rehabilitation services. These programs may be helpful for other types
of homelessness, however for the substance abuse homeless population, these resources are not enough for these
individuals to recover and eventually end their homelessness (they need more help than just a temporary shelter).

15. Ladder of Inference
Veterans
Actions Avoid aid programs and remain homeless
Beliefs Housing prices will remain high and aid programs do not work
Conclusions We do not have the means to help ourselves and aid programs have not been able to keep us afloat
Assumptions The housing prices have made us homeless and unable to find minimum wage work
Interpret Our time in the armed forces has not given us the skills to find sustainable work
Select We are not able to afford housing and suffer from mental health disorders such as PTSD and anxiety
Veterans who served time abroad suffer from PTSD and anxiety disorders that have made it hard for them to
acclimate to society. Upon returning from overseas, aid programs have not been put in place to help them cope with
their mental health issues. In the Bay Area, housing prices continue to rise and these veterans cannot find work to
house themselves because of their mental health issues and lack of a permanent residence.

16. Ladder of Inference (Families)
Homeless Families
Actions Take advantage of aid programs for as long as they last and continue being homeless
Beliefs
Aid programs will not fix our situation and housing prices will continue rising. We cannot escape
homelessness
Conclusions Aid programs have not been able to help us find permanent housing
Assumptions The housing prices have made us homeless and unable to find minimum wage work
Interpret We do not have the necessary skill set to maintain a sustainable job and support our family
Select We are not able to afford housing and have children to feed
Aid programs in the Bay Area try their best to help homeless families support their children and stay housed.
However, the rising housing prices make these aid programs temporary and families have to continue going back to
get the support they need. Due to this, families develop the belief that aid programs only provide support for a short
period of time before they will be homeless again and do not provide the necessary aid to make these families
independent.

17. Ladder of Inference (Mentally Ill)
The high rent in San Francisco causes individuals to live on the streets. The high cost of living, in combination with
mental illness, makes it extremely difficult for homeless individuals to find and maintain jobs, so their chances of re-
entering effectively are even lower. Additionally, these individuals generally find communities while they are homeless,
and would rather remain a member of the community than re-enter and abandon the community.
Homeless Individuals with Mental Illness
Actions We will continue to stay homeless
Beliefs We do not want to re-enter because we have made communities along our homeless journey
Conclusions It is easier to stay homeless than go through the system and attempt to re-enter
Assumptions The City of San Francisco does not have enough resources to address our needs
Interpret Due to our mental disabilities, it is difficult for us to find and maintain jobs
Select We cannot afford housing, therefore we live on the streets

18. Ladder of Inference (Substance Abuse)
The rent in San Francisco is skyhigh even people that hold a job with minimum wage are not able to afford the cost of
living in the city. Homeless individuals eventually become addicted to drugs and/or alcohol, losing their hope and
motivation of going back to normal life because they believe the crisis they’re going through is out of their hand.
Additionally, it is easy for homeless individuals to access drugs and there is little to no penalty for using drugs.
Homeless Individuals with Substance Abuse Issues
Actions We will continue to abuse substances
Beliefs Drugs and alcohol allow us to cope with our situations
Conclusions Drugs and alcohol are easy to access / penalty free
Assumptions The government does not care if we use drugs or alcohol on the streets
Interpret There is not enough availability in rehabilitation programs
Select We cannot afford housing, therefore we live on the streets and use drugs / alcohol

19. SIPOC (Entire Homeless Population)
Suppliers Inputs Process Outputs Customers
-City of San
Francisco
($364 million
in 2019)
-Federal Grants
from the US
Government
($4.45 million
in 2019)
-Homeless
Shelters
(currently
1,203 beds)
-Housing
-Food and Meals
-Health Care
(SFHCHP)
-Safe injection kits
(4.45 million $
annually)
-Therapists
-Job Opportunity
Programs
-Resident
Aftercare and case
managers
-The city builds homeless shelters
and programs
-They give homeless people a
temporary place to stay (typically 90
days)
-Provide shelter for emergency
situation (84% of people in shelters
are there for emergent situations)
-Providing homeless people, both in
the shelters and on the streets, with
food, health care, and other basic
necessities
-Once the 90 day stay is complete,
homeless individuals must leave the
shelter and live elsewhere
-Homeless individuals don’t have a
permanent place to live and build a
life
-Homeless people continue to take
advantage of the handouts given to
them by the city
-Homeless from other areas are
attracted to SF’s handouts and migrate
to the city (homelessness has
increased 17% since last year)
-Homeless people lack a motivation to
recover, and reenter society, since
they are receiving plentiful support
from the government
-Homeless
individuals (9,702
in total)
-Residents of San
Francisco, who are
exposed to
homelessness
(888,305 in total)
-San Francisco
Tourists (25 million
annually)
The City of San Francisco has provided numerous programs for its homeless population. The city’s current process is to provide a
place for food and shelter, however this is for a limited time, while also providing safe injection sites and kits. This process results in
poor results, as seen in the outputs section, where there is no improvement in the decrease in the substance abuse homeless population.
In fact, San Francisco’s policies almost encourage the substance abuse homeless individuals by having a lack of resources /
insufficient resources that do not meet the needs of this homeless population.

20. SIPOC (Programs & Services)
Suppliers Inputs Process Outputs Customers
-Navigation
Centers
-HSH (Dept of
Homeless and
Supportive
Housing)
Outreach team
-ERT
(Encampment
Resolution Team)
-Housing
-Food and Meals
-Health Services (SFHCHP)
-Help access/obtain
Identification papers, DMV
info, and Social Security
cards
-Job Opportunity
Programs/Social Work
-Resident Aftercare and
people to manage cases
-Protected by security and
multiple staff workers (High
staff to client ratio and 24/7
Staff)
-HSH Outreach team and ERT
identify and refer vulnerable
individuals, specifically around
Navigation Center Locations (3,606
homeless have been referred from
2015-2019)
-Navigation Centers provide
housing/beds (7 centers with a total
of 495 beds)
-Campus Managers assess
individuals and refer them to the
many provided services
(Rehabilitation, Employment,
Housing Rental Vouchers, Medical
Care)
- Navigation centers have
46% success rate
-If discharged
successfully:
• 14% permanent housing
• 4% temporary housing
• 28% move w/loved ones
-If discharged
unsuccessfully:
• Return to the streets
-Homeless
individuals (9,702
in total, out of
which only 495
can stay at a time)
*Insight in slide notes

21. Suppliers Inputs Process Outputs Customers
-Federal Grants, $5.3 million was
given this year to aid homeless
veterans
-US Department of Veteran Affairs
(VA)
-US Department of Housing and
Urban Development (HUD)
-SSVF (Supportive Services for
Veteran Families)
-Donations from various SF
businesses and families that support
smaller veteran programs, like
Swords to Plowshares
-Housing search & placement
assistance
-Eviction prevention
-Rental assistance
-Utility payments
-Security deposit & first month’s rent
-Move-in expenses assistance
-Childcare expenses assistance
-Transportation assistance
-Application for SSI and SSDI support
-Money Management services
-Health Care and Psychological Care
-SSVF veterans can
contact for assistance
with many services
(previously listed in
inputs)
-Collaboration between
HUD and VA provide
rental assistance
vouchers
-Swords to Plowshares
Program provides
veterans with a multitude
of services
-SF’s population of
homeless veterans
has decreased 4%
from last year, but
has increased 31%
since 2016
-Veterans use the
resources provided
to them
-Homeless
veterans in SF
(656 in 2019, 12%
of the total
homeless
population)
-Residents of San
Francisco,
exposed to
homelessness
(888,305)
SIPOC (Veterans)
Veterans have a plethora of services available to them for assistance with homelessness. Government Funding and different
organizations aim specifically to assist veterans with their basic needs, like housing and the costs of living in general.
However, with so many different processes, there is a lack of a connection between them all. This makes it difficult for
homeless veterans to navigate through the different systems, and get the help that they need. However, the population of
veterans is slowly declining year over year, but not significantly (only by 4%).

22. Suppliers Inputs Process Outputs Customers
-Department of
Homelessness and
Supportive Housing
(HSH)
-Hamilton Families
-Compass Family
Services
-US Department of
Housing and Urban
Development (HUD)
-Donations from various
SF businesses and
families that support
smaller programs
-Housing/Shelter
-Meals and food
-Medical Services
-Rental Vouchers
-Children and Youth
enrichment services
-income planning
-legal assistance
-temporary rent
assistance
-job search assistance
-parenting services
-substance abuse services
-Homeless families or
families that are at risk
of becoming homeless
reach out to one of
several programs for
assistance
-Family Coordinated
Entry: families have to
apply and if they’re
eligible, they are
provided with
emergency shelter, or
given resources they can
utilize
-Homeless families have
difficulties finding housing
for their entire family
-Not all families are eligible,
because there is a large
demand for
housing/assistance, but only a
limited supply
-Many families aren’t able to
get the help they need, and
continue to struggle
-Homeless families
in San Francisco
-there are over 3,000
homeless children in
SF
-San Francisco
Residents who are
affected by
homelessness
SIPOC (Families)
Homeless families are at a disadvantage when it comes to finding housing. It’s difficult enough to find single-occupancy housing, and
adding more individuals into the picture makes it even harder. There are several services that solely cater to homeless families, such as
Hamilton Families and Compass Family Services. The services provided by these programs rely on government funding, and public
donations. It is very costly to house entire families, which makes qualifications difficult to meet, and decreases the chance of families being
able to be housed together. There are over 3,000 homeless children in SF, indicating how many families are in need of housing.

23. SIPOC (Substance Abuse)
The City of San Francisco has provided numerous programs (S.B. 1045) for its homeless population. The city’s current process is to
provide a place for food and shelter, however this is for a limited time, while also providing safe injection sites and kits. This process
results in poor results, as seen in the outputs section, where there abuse of the policies put into place to combat substance abuse. In
fact, San Francisco’s policies almost encourage the substance abuse homeless individuals by having a lack of resources / insufficient
resources that do not meet the needs of this homeless population.
Suppliers Inputs Process Outputs Customers
-City of San
Francisco ($364
million in 2019)
-Federal Grants
from the US
Government
($44.5 million in
2019)
-Homeless
Shelters (currently
1,203 beds)
-Housing
-Food and Meals
-Health Care
(SFHCHP)
-Safe injection kits
(4.45 million $
annually)
-Therapists
-Job Opportunity
Programs
-Resident Aftercare
and case managers
-San Francisco provides
questionable help (including
free needles, food, shelter, etc.)
(homelessness has increased
17% since last year)
-State law SB-1045 allows
homeless individuals to be
forcefully put into treatment
-Props M and N allowed
citations to homeless and funnel
offenders with substance abuse
to treatment
-$1 million per year to hire
cleanup crew for needles
-Homeless people continue to
take advantage (66% of homeless
use free meals and 44% use
shelter services)
-Homeless stop cycle of drug use
while held in confinement
-Plentiful government support
leads to lack of motivation to
recover, reenter society (use of
health services has increased by
25%)
-Homeless
individuals (9,702
in total)
-Residents of San
Francisco, who
are exposed to
homelessness
(888,305 in total)
-San Francisco
Tourists (25
million annually)

24. SIPOC (Mentally Ill)
The City of San Francisco has provided numerous measures to combat homelessness, most notably SB-1045 and Props M
and N. The city’s current process took a big leap with the passing of S.B 1045 as it allowed health professionals retain
homeless to treat them for mental illnesses. However, some argue that it is unlawful as it allows for de facto detention or
extended holdings that are against civil rights of people. Unlike substance abusers, it seems mentally ill homeless are not
abusing San Francisco’s policies but are simply not using them leading to forceful treatments.
Suppliers Inputs Process Outputs Customers
-City of San
Francisco ($364
million in 2019)
-Federal Grants
from the US
Government ($44.5
million in 2019)
-Homeless Shelters
(currently 1,203
beds)
-Housing
-Food and Meals
-Health Care
(SFHCHP)
-Therapists
-Job Opportunity
Programs
-Resident Aftercare
and people to
manage cases
-State law SB-1045 allows
homeless individuals to be
forcefully put into treatment
-Props M and N allowed
citations to homeless and
funnel offenders with
mental/physical disabilities
to treatment
-Homeless Individuals must
leave the shelters when they
have extended their stay
-Update of SF conservatorship
program to contemplate needs of
people with substance abuse
-De facto detention of mentally
ill homeless
-39% of homeless have self-
reported psychiatric problems
-Longer-term support to patients
who are mentally ill
-Homeless
individuals (9,702
in total, 4,000 which
have mental
disabilities)
-Residents of San
Francisco (888,305
in total)
-San Francisco
tourists (25 million
annually)

25. Root Cause Analysis (Job Incentives)
Business
Impact
Lack of
Incentives
Timeline
Impacts
People
A strategic partnership
with the city and
businesses needs to be put
in place in order to hire
homeless individuals
➔ The Howard Jarvis
Taxpayers Association is
against Prop C
➔ Plan to appeal the
proposition due to the
need of a two-thirds
majority to institute new
taxes
➔ This has caused the city
not to spend the funds due
to the fear of a possible
ruling against the law
➔ Delay associated with Prop C
➔ The City is collecting tax
revenue from companies, but
can’t spend it until the
litigation challenging its
validity is resolved.
➔ If the measure is invalidated,
the money currently being
collected would be returned
➔ Officials estimate it would take
3 years for the litigation to be
resolved
➔ Higher costs for the business
➔ 22% of homeless individuals
often lack education and skills
which in return enforces business
to spend more resources on
training them
➔ Increased business taxes
➔ Due to Proposition C
businesses with annual
revenue of over 50M gets
taxed more by up to .5%
➔ Loss of 725 to 875 jobs
*Insight in slide notes
⇒ Many businesses do not want to
hire homeless individuals since
they would have to spend more
resources to train them, and they
could instead hire other individuals
with the necessary skills.

26. Root Cause Analysis (Veterans)
ProcessPeople
Policy
Reducing
Homelessness
within Veterans
➔ Landlords do not want to rent to
veterans: City of SF spent $364
million dollars on homeless
services (2019-2020)
➔ SF avg. rent is 3,629
➔ Rental Assistance Vouchers for
Veterans: San Francisco has
received $343,723
➔ Swords to Plowshares Program:
Serve 59 new homeless & at-risk
veteran clients each month. Helps
increase income by avg. 34%
➔ 22% report job loss as the reason for
being homeless
➔ Job training is absent in SF’s process
➔ 656 in 2019, 12% of the total
homeless population
➔ Nearly 80% of San Francisco
veterans left the military without a
job
➔ 30% of SF Homeless Veterans
were incarcerated in the last year
(higher than the non-veteran
homeless rate)
*Insight in slide notes
Culture
➔ Veteran homelessness has increased
31% since 2016
➔ Over 50% of San Francisco veterans
have PTSD and nearly ⅔ likely have
depression
➔ 46% of SF Veterans at risk for suicide

27. Root Cause Analysis

28. Root Cause Analysis (Families)
Process
People
Reducing
homelessness
within families➔ 51% of families receive
CalFresh (food stamps)
➔ 23% TANF; Temporary
Assistance for Needy Families
(TANF)
◆ “suffering the special
need of shelter due to
homelessness
➔ Living in SROs
◆ coordinated entry actually acts as a barrier to accessing services.
◆ 40 percent of the rooms in San Francisco SROs are currently
occupied by four or more people
◆ you don’t have your own bathroom, kitchen etc; → sharing this 8-
by-8 square foot room with four, five, six people
◆ SRO families would more than quadruple the total count of
homeless families in San Francisco if counted
➔ The HAP program helps families eligible for Aid to Families with Dependent
Children (AFDC) in need of shelter by providing emergency or transitional
assistance
➔ Public shelters serve 90% of
homeless families in the United
States → much higher than other
homeless demographics in the US
➔ The average monthly cost of child
care in SF for one child is $1,955
→ compared to the median rent in
San Francisco which is $3,629
➔ 33% of all people experiencing
homelessness are families.
➔ 21% of families said loss of job
caused their homelessness
➔ 17% stated it was due to
eviction
◆ 14% said it was due to
the landlord raising
their rents
*Insight in slide notesCulture
Environment
➔ Average rent is $3,629, compared
to the national average of $1,476
➔ A family of 2 adults and 2
children in SF needs to earn on
avg $148,440 per year, or $12,370
a month, to live comfortably
➔ It is estimated that one adult’s
livable wage is $20 in SF, but
minimum wage is only $15
Policy

29. Root Cause Analysis (Substance Abuse)
Process
People
Reducing
Substance Abuse
HomelessnessNeedle Exchange Program:
➔ Dept Of Public Health
distributes 4.45-4.8
syringes annually
➔ 85% of injection drug users
utilize this service
➔ Public Works pick up
12,500 needles from street
every month
Reduction in Drug Treatment Admission:
➔ Admissions to treatment programs dropped by 20%
➔ Lack of available beds in some programs, and 6 month waiting
lists
➔ 42% of homeless population suffer from substance abuse
BART:
➔ SF BART stations have buses that transport the homeless to
different parts of the city during the end of operating hours of
BART, such as the Tenderloin. Which accounts for 56% of drug
related crimes in SF
Drug Trade in SF:
➔ Fentanyl and Meth are
taking over opioids and
cocaine
➔ Increase in Organized
Crime, drugs pour into
SF from Oakland,
Hayward, LA, and
Mexico
People/Departments/Programs:
➔ Lack of coordination from
Mayor London Breed office,
Dept of Homelessness and
Supportive Housing, Dept of
Public Works, SFPD
➔ Lack of city support to combat
the real issue at hand: people
living on the streets
*Insight in slide notesCulture
Technology
Use of Data:
➔ Through Public Health Data,
Mayor Breeds initiative identified
4000 individuals suffering from
substance abuse and mental
Health
➔ 230 out of 4000 individuals, were
the “most vulnerable” and placed
into permanent housing
immediately
Policy

30. Root Cause Analysis (Mental Illness)
Difficulties finding
Affordable permanent
housing
Cost of Treating
Mentally Ill
Lack of Beds in
Mental Health
Institutions
Lack of
Transitional
housing after
rehab
Reducing
Mentally Ill
Homeless
Population
➔ Costs $109,00 to operate
each bed, meant to house
only for a couple of weeks
➔ Provides slight
independence but still
includes on-site services
➔ Supply is not meeting demand
➔ Operating one bed in a nursing home or
psychiatric institution costs $85,000 to
$800,000 a year
➔ Nursing home owners make more
money selling the homes than caring for
the mentally ill
➔ 400 psychiatric beds available, but only
150 beds are in the City, the remaining
250 are in nearby counties
➔ Average rent is $3,629, compared
to the national average of $1,476
➔ Estimated monthly cost of living
is $5000
➔ It costs $50 million a year
to treat mentally ill
homeless in SF or
$150,000 each individual
*Insight in slide notes

31. System Map (Veterans)
Drivers
Mainstays
Enablers
Mental Health:
80% of homeless veterans
suffer from mental health
challenges
No Job Support:
22% report job loss as
the reason for being
homeless
No Affordable Housing:
Average rent is $3,629,
compared to the national
average of $1,476
Navigation
Centers
Reduce unsheltered
homelessness and
connecting guests
to services and
housing assistance
(46% Success Rate)
Veterans
Coordinated Entry
Program
Connects households
with previous active
military service to
appropriate housing
interventions based on
need
Swords to
Plowshares Program
Serve 59 new homeless
& at-risk veteran clients
each month and increase
their health, wellness,
and stability, and
increased income by
34%
Rental
Assistance
Vouchers for
Veterans
San Francisco
has received
$343,723 (21
vouchers)
Funding
City of SF
spent $364
million dollars
on homeless
services (2019-
2020)
Employees
Employees
& volunteers
are essential
to help run
the programs
Available
Housing
Limited housing
drives up costs
while preventing
more individuals
from being housed
(SF avg. rent is
$3,629)
Program
Accessibility
Many programs
do not have a
streamlined
process, and
strict
qualifications
Mental Health
Services
80% of
homeless
veterans suffer
from mental
health
challenges
Job Availability
The more jobs
available, the easier
it will be to connect
homeless
individuals to work
(job availability has
declined 23% in the
last year)
Government
The SF
government
implements
and regulates
the policies
regarding
homelessness
*Insight in slide notes

32. System Map (Families)
Drivers
Mainstays
Enablers
Finding Affordable
Homes
Average rent is
$3,629,
Earning Livable Income
Families in SF need to earn
on avg $148,440 per year
to live comfortably
High Cost of Childcare
The average monthly cost
of child care in SF for one
child is $1,955
Navigation Centers
Reduce unsheltered
homelessness and
connecting guests to
services and housing
assistance (46%
Success Rate)
Family Coordinated
Entry
Connects households
experiencing
homelessness to
available community
resources, whether
shelter or housing
Shelters for
Families
94% of
homeless
families are
in shelters
Steady Jobs
Connecting
individuals
with jobs will
allow them to
re-enter with
more success
Funding
City of SF
spent $364
million dollars
on homeless
services
(2019-2020)
Employees
Employees
& volunteers
are essential
to help run
the programs
Available
Housing
Limited housing
drives up costs
while preventing
more individuals
from being housed
Program
Accessibility
Many programs
do not have a
streamlined
process, & strict
qualifications
Job Availability
The more jobs
available, the
easier it will be
to connect
homeless
individuals to
work
Child Care
The average
monthly cost of
child care in SF
for one child is
$1,955
Job Loss
21% of homeless
families reported
job loss
*Insight in slide notes

33. System Map (Substance Abuse)
Drivers
Mainstays
Enablers
Drug Treatment Availability
Most treatment centers have a
lack of beds and waitlists of 6
months
Accessibility to Drug
Treatment
Admissions to treatment
programs dropped by 20%
Lack of Safety
56% of drug related
crimes in SF solely on
BART
Gov. Syringe
distribution:
4.45 million $
annually
Harm Reduction
Centers:
4-9% of syringe related
disease over last 10 years
Temp.
Shelters:
44% use shelter
services
Navigation
centers:
Operating costs of
$33,000 to $38,000
per bed & 6 month
waitlists
Local
Community
66% of homeless
use free meal
services
Standard of
Living
Minimum wage-
$15
Cost of living-
$20
Gov.
Funding
$44.5 in federal
funding for SF
Program
Accessibility
see notes
Rehabilitation
programs:
Lack of available beds
in some programs, and
6 month waiting lists
Drug
market
Only 60% of
needles get
returned
Job
Availability
SF Homeless
Employment
Collaborative
*Insight in slide notes

34. System Map (Mentally Ill)
Drivers
Mainstays
Enablers
Access to Mental Health
institution:
Operating one bed in
psychiatric institution costs
$85,000 to $800,000 a year
Lack of Affordable
housing:
Average rent is $3,629,
Transitional housing after
rehab:
Costs $109,00 to operate
each bed, meant to house
only for a couple of weeks
SFHCHP: 19,000
patients and provided
over 100,000 medical
visits
Job Opportunities:
2017: 13 percent of respondents
reporting part or full-time
employment
Mental health Services:
9,702 in total, 4,000 which have
mental disabilities
Navigation Centers:
46% success rate
Program
Accessibility
see notes
Funding
$364 million on
homeless services
2019-2020
SB-1045
Pilot programs
for
conservatorship
Therapists
/Physiatrist
400 physiatrists beds
are available
Normal Shelters:
Costs $109,00 to operate each
bed, meant to house only for a
couple of weeks
Government
$44.5 in federal
funding for SF
*Insight in slide notes

35. 35
System Map
DRIVERS
MAINSTAYS
ENABLERS

36. Balance Scorecard (1/4)
Operational Effectiveness Target Actual Status
Rehab/Psychiatric Facilities
Increase the number of beds in psychiatric facilities to
400 in the city
There are only 150 beds in psychiatric
facilities in SF
Subsidized Housing
Increase the number of subsidized housing to 2190
units (50%)
There are currently 1460 units of subsidized
houses
Navigation Centers Increase success rate of permanent housing to 30%
14% successfully re-enter to permanent
housing, 54% unsuccessful in re-entering
society
Transitional Housing
Allow for extended length stays, to provide an
adequate amount of time for transition back into
society
Current shelters limit homeless individuals
to typically 90 day stays, after which many
individuals return right back to the streets
SRO's Increase the numbers of SROs to at least 1060
There are currently 530 SRO hotels in SF,
but they are increasingly being converted to
condos

37. Balance Scorecard (2/4)
Upstream Target Actual Status
Military Training
Implement programs to provide every officer basic
strategies for maintaining adequate mental health
US Military officers do not receive
any training to help sustain their
mental health while in duty
PTSD programs for veterans
Enact constant checkups after the first 5 months of
serving
80% of homeless veterans currently
suffer from PTSD
Domestic Abuse Support
Implement educational programs to women in low
income families on how to properly use the resources
in the event they experience domestic violence
SF has domestic abuse resources,
but often individuals aren't properly
educated on how to navigate them

38. Balance Scorecard (3/4)
Community Development Target Actual Status
Educational Clinics
Ability to host reproductive health
education programs once a month to
educate women on family planning and
reproductive services
No such programs in place
Mental Health Outreach Teams
Ability to implement an additional team of
10 healthcare providers to increase
accessibility
No team in place
Health Clinic Use
50% of Homeless individuals use health
services
25% of Homeless individuals use health
services
Incentives to increase Job Availability
Offer tax breaks, utility rebates, etc. to at
least 10% of businesses in San Francisco
0% of business are receiving incentives to
hire homeless individuals

39. Balance Scorecard (4/4)
Security and Technology Target Actual Status
BART Security
Decrease crime rate by 50% in the next
two years by increasing BART PD
security in every BART station
Have 4000 surveillance cameras but
very low visible presence by BART police
Database System
Integrate widespread database to track
the progress of the homeless
integrating into society
No such system in place