Homelessness is not a Money Problem. It’s an Ideas Problem.
San Francisco has one of the largest populations of unsheltered homeless residents in the country.
9,800 homeless according to the last biennial survey. 4,600 living in shelters. Leaving over 5,000 unsheltered people on any given day.
While politicians have given up and said that homelessness “may not be solvable”, evidence disagrees. There are communities that have eliminated chronic homelessness and achieved functional zero — a dynamic, sustained state where homelessness is rare and brief for a population.
Take Rockford, Illinois — a city that struggled to reduce homelessness for 12 years. But in 2015 rearchitected their approach, and eliminated veteran homelessness in 15 months. 2 years later, they also successfully eliminated chronic homelessness.
How did they do it?
The Built for Zero system. A system that rearchitects government, deploys data-driven frameworks, and personalizes care to every individual. It has worked in 14 US cities across the country, and it can work in San Francisco.
It will take investment. But we don’t have a money problem in San Francisco. We’re spending $1.1 billion over the next two years. We have an ideas problem.
The current approaches aren’t working.
A Housing Success Story
First a story.
I met Scotty T. last year, a resident of San Francisco who had previously been suffering with homelessness and addiction.
Scotty sought help for years. But the challenge was stable housing. He was on housing lists for 8 years. Any shelter he went to only let him stay for 30 days. Not enough time to curb urges or “kill the pain of being in the streets” as he told me.
But it went further than that. They also provided combined case programs that coordinated to help him personally 1:1. They gave Scotty three meals a day. Hosted him at collaborative group meetings. And helped him with career services and job training.
Scotty has now been sober for 3 years.
Why did it work? Because he had a conglomerate of resources across public/private sectors helping him. Stable shelter. Personalized treatment.
These are the components key to scaling success. And lessons we can draw from to build a holistic solution to solving homelessness, modeled on the Built for Zero system.
Step 1: Integrated Command Team
The core of the Built for Zero system is that eliminating homelessness must be a top priority for the government and community. Not just in terms of money, but also time and attention.
An integrated cross sector approach, that breaks down silos and is able to coordinate across stakeholders — city and state, public and private — must be established.
To do this, we need to create an integrated command team — the Homeless Emergency Management Agency (HEMA) — with the sole purpose of achieving functional zero. It will guide an integrated task force that collaborates across local government agencies, federal Veterans Affairs, and nonprofit service providers. It can also integrate existing efforts of the California Interagency Council on Homelessness (Cal ICH) and existing funding from the Homeless Emergency Aid Program (HEAP).
The authority of HEMA will expand on existing efforts to operate on an outcomes driven framework. HEMA will set quarterly targets on the number of unhoused individuals, available shelter beds or supportive housing units. It will mandate weekly meetings between the public and private partners in the command team, review operational data, and select the most effective interventions per cycle. If any metrics are lagging, HEMA will have emergency statewide powers and authority to cut any red tape holding back the meeting of those respective milestones.
This will consolidate siloed departments, unspent capacity and capital. To achieve functional zero, silos must be broken down and converted towards a performance based structure that incentivizes rapid iteration towards outcomes.
Step 2: Real Time Data
To monitor its outcomes, and translate those outcomes to the individual, HEMA needs real time data on every unhoused individual.
Because the unhoused are individuals.
Each individual experiences homelessness in different ways — from eviction to job loss to addiction. We must get to know everyone experiencing homelessness by name, to enable us to understand why each person is experiencing homelessness, and provide solutions that meet their needs.
The second element of the Built for Zero framework accordingly is what’s called a “By-Name List” — a comprehensive list of every person in the city experiencing homelessness. The information is collected and shared with consent, with each person on the list having a file that includes their name, homeless history, health, and housing needs.
The list is also updated in real-time, via census canvassers. The real time data collection enables us to reveal what housing resources and interventions are needed to drive the greatest reductions in homelessness. Without it, cities can dramatically expand housing supply without reducing homelessness, because they did not address the specific needs of the individual that were prohibiting access (e.g. addiction).
The data also is essential to HEMA’s ability to monitor its progress and rapidly iterate towards achieving its outcomes on shelter and recovery.
Step 3: Guaranteed Shelter
With a foundation of real-time data to guide interventions and track outcomes, and the authority to cut the red tape that may be blocking progress, HEMA can enable every unhoused person to secure stable, permanent housing and address any co-occurring needs, such as physical and mental health challenges, substance use disorder, and under- or unemployment.
That journey often starts with immediate access to temporary shelter while working towards securing permanent housing.
In San Francisco, we simply do not have enough shelter beds. It’s estimated we have 5000 beds with 9800 chronically homeless. For every two individuals seeking shelter there is literally only one bed.
The real-time data on every unhoused individual can help us evaluate where shelters need to be built, how many need to be built, and are we on pace to meet them.
Often laws like CEQA are used to block shelter projects under the guise of environmental review — HEMA would have the authority to execute by-right development of such projects, in the scenario that a region is not meeting its individual : supportive housing ratio requirements.
There is precedence for this with affordable housing legislation like CA SB 35 — which enables streamlined development for affordable housing units if a region is not meeting its RHNA housing targets. Similarly, if a region is not meeting HEMA’s mandated individual : shelter or supportive housing requirements, HEMA would have the authority to intervene and enable by right development of emergency shelters and affordable housing units.
Because only if individuals are housed, can they have the stability to move forward to recovery.
Step 4: Personalized Care
The real-time data foundation enables HEMA to not just build the necessary housing, but also to customize treatment to the individual.
HEMA will deploy taskforces that work through the By-Name List database, developing a detailed understanding of the unique reasons why an individual is experiencing homelessness.
Again, individuals are unhoused due to a variety of experiences — family conflict, eviction, job loss, mental health, addiction. They need customized plans to help them get back on track.
HEMA taskforces will effectively work as a cross-functional case team to provide every individual with a personalized treatment. While homeless services typically involve just one case manager within one organization — HEMA taskforces will gather cross-stakeholders across each representative public-private partner (federal, state, nonprofit) across shelter, healthcare, and recovery services.
The cross-functional case team meets weekly to work through the By-Name List, dynamically brainstorming solutions and removing barriers for each homeless person to secure housing and address other needs.
For example, if a person is suffering homelessness due to job loss, the case manager can help pair them with career services. If the primary concern is addiction, they can help them navigate recovery services.
The important facet is that the real-time data + personalized counseling helps ensure that we treat individuals as human beings and not a monolith. Preserve their dignity, ensure their safety, and meet their needs. This system can and should be trauma informed, designed with principles of racial equity,LGBTQ+ competency, and access — especially considering that a disproportionate number of unhoused individuals are people of color, LGBTQ+, and/or disabled.
This is a system that works.
A centralized command center, real time data, guaranteed shelter, and personalized care. A system that breaks down government silos into an emergency command center. A command center that leverages real-time data to set individual : shelter targets, and is granted the authority to intervene if cities do not meet those targets. A realtime data framework that allows us to personalize care to every individual to meet them where they’re at.
14 US cities have already solved chronic homelessness using this system.
It’s time to bring it to San Francisco.
Bilal Mahmood is a Candidate for CA State Assembly in San Francisco, former policy analyst in the Obama Administration, neuroscientist and entrepreneur