Healthy Streets Operation Center Local Homeless Coordinating Board November 20, 2019
Cri risis is in Sa n San n Fr Franc ncisco isco Homelessness • 8,011 people experiencing homelessness on any given night in San Francisco • 17% increase in homelessness in the HUD PIT Count • 19% increase in unsheltered homelessness Public Health Crisis • 69% of people experiencing homelessness report having a disability • 4,000 people experiencing homelessness are duel diagnosed with mental illness and a substance use disorder • ~24,000 injection drug users in San Francisco • Since 2008, the meth overdose mortality rate has risen from 1.8 to 11.5 per 100K San Franciscans Calls for Service • Between 3,000 - 4,000 311 calls for service monthly to HSOC • Between 3,000 - 4,000 911 calls for service monthly to HSOC 2
In San Francisco 4,000 (1 in 5) individuals experiencing homelessness have a history of co-occurring psychoses and substance use disorders… 80% 95% 35% 74% used have a history of identify as have a serious medical condition urgent/emergent alcohol use Black/African care services in disorder American 12% HIV/AIDS FY1819 65% utilized the ED Blacks outnumber 65% CHF 223 individuals but only 6% utilized Whites in this 35% used over 24 the Sobering population Hypertension 4% Renal Failure services Center 40% 22% 28% 40% are 50+ years of had involuntary had at least one have cycled in age psychiatric holds county jail and out of homelessness for interaction The average age 3% are currently more than 13 in FY1819 of death for conserved years homeless adults The average number 11% are currently 29 died in FY1819 is 51 of incarcerations is assigned an 2.3 113 individuals intensive case are 18-24 years of manager age 3
Bloo oombe berg rg Ha Harv rvard rd City Le Leade ders rship hip Ini nitiative iative • HSOC has brought multiple city departments together in an unprecedented collaboration to address the crisis of unsheltered homelessness and unhealthy street behavior. • Despite the level of collaboration, HSOC could be more effective at achieving its goals. • HSOC will receive support from the Bloomberg Harvard City Leadership Initiative over the next six months: • Refocus HSOC • Define the strategies and tactics to achieve our goals 4
HSOC Charter Controller’s Office 5
Overv rview The Healthy Streets Operations Center (HSOC) launched in January 2018. HSOC uses a unified command structure and a collective impact model to coordinate the efforts of City agencies involved in addressing street homelessness and behaviors that affect quality of life. Note: HSOC is only a portion of individual departments’ overall responsibilities.
HS HSOC Vision on & G Goa oals Vision: ion: San Francisco’s 1. Increase in people connecting with appropriate health and social services streets are healthy for everyone and those 2. Reduce the number of highly vulnerable people on the streets experiencing homelessness, 3. Reduce the number of tents and marginally housed, or vehicles inhabited by people experiencing homelessness in need of social connections and 4. Increase the City’s responsive to community concerns healthcare have access to the 5. Increase the safety and cleanliness of appropriate resources San Francisco’s streets and services.
HSOC Activ HS tivities ities Connecting Planned, People to Proactive Care Engagements Responding Coordinating to Service across Requests Departments 8
Con onne necting cting Peop ople to C o Care re Goals ls Sample mple of Activities vities 1. Ensure that everyone living 1. Training of field staff unsheltered on the street is 2. Daily triage and weekly case assessed and connected to conferencing of referrals by appropriate health and social DPH, HSH and EMS-6 services. 3. Shared Priority List 2. Ensure that the most vulnerable individuals are expedited to 4. Placements by SFPD and HOT services and housing. into temporary beds 3. Reduce the number of deaths of 5. Health fairs and other outreach homeless individuals through activities by HOT and DPH enhanced planning, care coordination and service linkage. 9
Plann nned d and nd Pro roactive active Eng ngage ageme ments nts Goals ls Sample mple of Activities vities 1. Use data to proactively, 1. ERT/VERT conducts multi-week collaboratively, and urgently outreach in advance of address encampments and encampment resolutions. locations where behaviors of 2. Quarterly tent and vehicle count community concern and/or to identify areas needing criminal activity are creating outreach and resolution. unsafe and unsanitary conditions. 3. Special collaborative operations to address behavioral health 2. Maintain a city free of large needs. encampments, and reduce the overall number of tents, improvised structures, and inhabited vehicles throughout the city. 10 10
Respo pond nding ng to Se o Serv rvice ice Requ quests ts Goals ls Sample mple of Activities vities 1. Improve the quality and 1. Co-located dispatch with DEM, consistency of the City’s SFPD, Public Works and HOT response to service requests consulting on responses. about encampments and street 2. Consolidated routing from 911 conditions. and 311. 3. Customer call-backs to gather detail and improve response. 11 11
Coo oord rdinating nating acro ross ss Depa partme rtments nts Goals ls Sample mple of Activities vities 1. Enhance the effectiveness and 1. Operational and planning efficiency of the City’s response meetings to identify areas of through collaboration, data need, share departmental sharing, and transparency information, and coordinate between departments. responses. 2. Case conference meetings to plan client-centered interventions. 3. Data working group meetings to review trends, identify operational issues, and plan improvements. 12 12
Recent HSOC Policy Changes Department of Emergency Management 13 13
Recent nt HS HSOC Pol olicy icy Cha hang nges 1. Discontinued the use of 7-day beds for the HSOC set asides. These 15 beds are now time-limited beds with a minimum stay of 30 days. 2. Launched the Joint Priority Project 3. Piloting a new police encounter tracker 14 14
HS HSOC OC Re Response sponses s to to LH LHCB CB Questions uestions Enforcement (Q. 11-13) SFPD 15 15
Enf nforceme orcement nt • SFPD is responsible for ensuring the overall safety of the public in San Francisco and enforcement is at times a part of those efforts. • When responding to public safety issues, the SFPD leads with services with a focus on diverting individuals into care. • If there is an immediate safety risk, SFPD will assess the situation take appropriate action. 16 16
Enf nforceme orcement nt • When interacting with people experiencing homelessness, SFPD leads with services to connect individuals with shelter and services, depending on availability and interest. • SFPD calls upon HSH and DPH for additional support and services. • SFPD uses enforcement strategies as needed to address illegal activity on the streets, including: • Blocking a sidewalk after being offered services • Addressing a public nuisance that can not be resolved with services • Assessing situations in which an individual poses a threat to themselves or others 17 17
SFP FPD Data a on Quali lity ty of Life Citati ations ns & B Booking ng (Q (Question tion 11) ALL SFPD QUALITY OF LIFE CITATIONS & BOOKING Quality of Life Citations Quality of Life Bookings • Quality of life citations and booking fluctuate 215 overtime. • Only 3.1% 1% of calls to HSOC resulted in citation. 190 • Only 0.5% 5% of calls to HSOC 131 resulted in an arrest. 898 601 490 2017 2018 2019 ** 2019 Includes Q1, Q2, and Q3 Data** 18 18
All SFPD Quality of Life Citations (Question 13) SFPD “Quality of Life” Citations: 2017 - 2019 1000 900 898 800 700 600 601 500 490 400 300 200 100 0 2017 2018 2019 ** 2019 Data Includes Q1, Q2, and Q3 Data** 19 19
SFPD Data Regarding Citations & Bookings (Question 12) 2019 SFPD “Quality of Life” Citations & Bookings Citations Bookings 42 47 42 231 162 97 Q1 Q2 Q3 20 20
Services Offered by HSOC Officers Since August 2019, HSOC officers from SFPD have engaged over 6,290 people living on the streets, largely in response to 311 calls, and have made the following service referrals & connections: Service ice Referr erred ed Conne nect cted ed Navigation Center 547 385 Shelter 414 14 CASC 1099 220 Sobering 63 33 SFHOT 608 NA DPH 80 NA EMS-6 2 NA LEAD 57 15 Other 10 1 21 21
HS HSOC OC Re Response sponses s to to LH LHCB CB Questions uestions Bag & Tag (Q. 14) Public Works 22 22
Bag and Tag Data ( Question 14) 2019 Public Works Bag & Tag Data Occurr rrences Occurr rrences Where ere Visits its to the Month th Bag & Tag Even ents Items ms Receiv ived ed Wher ere e No Items ems Items ms Were e Found d Yar ard Were Found and d Ret eturned ed Januar ary 90 198 18 1 17 Febr bruar ary 70 140 12 6 6 March 54 240 9 5 4 April il 65 213 5 0 5 May 98 238 9 0 9 June 72 169 19 7 12 July 18 13 70 146 5 August st 6 3 48 111 3 Septembe ber 8 4 64 138 4 Octobe ober 12 3 61 207 9 Total tal 709 2104 116 42 74 23 23
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