San Francisco Expands Access to In-Home Supportive Services for Formerly Homeless Older Adults and People with Disabilities in Permanent Supportive Housing

News Release

San Francisco, CA — Mayor London N. Breed, the Department of Homelessness and Supportive Housing (HSH), and the Human Services Agency (SFHSA) today announced the launch of a pilot program to enhance In-Home Supportive Services (IHSS) for older people and adults with disabilities who live in Permanent Supportive Housing (PSH) sites. IHSS serves low-income (Medi-Cal eligible) older adults and people with disabilities who are at risk for pre-mature institutionalization, providing help with daily tasks like dressing, bathing, preparing meals, and house cleaning that helps residents to remain in independent living situations.

The Collaborative Caregiver Support Team (CCST) pilot grew out of the two agencies’ ongoing work together and builds on the success of their innovative programming during the pandemic. Both agencies are seeing a growing need to support formerly homeless San Franciscans with home care who often have complex health needs that can put their housing at risk. CCST aims to help stabilize these residents’ living situations in PSH sites, prevent a reoccurrence of homelessness, and improve their health outcomes by making it easier to enroll in IHSS and increasing connections to vital home care support.

The pilot launched on November 1st in a supportive housing site in the South of Market neighborhood and will expand to an additional site in early January, with more buildings coming online throughout the coming year. The pilot program is made possible because of San Francisco’s innovative use of the IHSS program and its partnership with Homebridge, a nonprofit organization that provides and coordinates caregiver services. San Francisco is the only county in the state that formally structures its services on a tiered continuum of support, with Homebridge’s agency-based service model available for IHSS recipients who cannot coordinate their own care.

“During the pandemic, HSH collaborated closely with SFHSA’s Department of Disability and Aging Services (DAS) to provide IHSS access to guests in SIP hotels who needed a higher level of support,” said San Francisco’s Department of Homelessness and Supportive Housing Executive Director, Shireen McSpadden. “This partnership was very successful in providing people with additional services needed to stabilize. This is one of the lessons learned from the SIP hotel program that HSH is looking to bring into its larger housing portfolio.”

IHSS services promote both housing stability and the overall well-being of formerly homeless residents in PSH sites. These residents often have complex health needs, and IHSS assistance allows them to remain in independent living situations. One of the greatest challenges for PSH providers is room habitability. IHSS is a critical support in helping these residents keep their units clean and livable, assisting them to maintain their units and therefore prevent potential eviction. Currently, IHSS serves roughly 30 percent of the City’s approximately 8,000 adult PSH residents.

“We are proud to work with our colleagues in HSH and to incorporate lessons learned from the pandemic so we can serve additional older adults and those with disabilities in need,” said Kelly Dearman, Executive Director of the Department of Disability and Aging Services. “This is an example of the City working together to innovate in order to help keep formerly homeless individuals housed, and thanks to Mayor Breed’s leadership, we are able to expand this pilot program.”

The pilot will provide a specialized team of IHSS social workers to connect with and support clients relocating from SIP hotels, staying in shelters, or moving into new PSH sites. This specialized team will also be able to more closely coordinate with other service providers supporting these residents, particularly on-site case managers, to ensure needs remain met as client circumstances change. The goal of the pilot program is to tailor services to meet the needs of PSH residents and play a pivotal role in preventing formerly homeless individuals from experiencing eviction and becoming homeless again.

“Providing a personalized level of support to our fellow citizens as they transition from homelessness is a critical step in addressing the homeless crisis among older adults and people with disabilities,” said Mark Burns, Executive Director of Homebridge. “This powerful program shows what is possible through partnership and collaboration designed to meet the complex realities individuals face on a daily basis.”

At present, this is a small pilot program, but has already had success in its first few weeks. A formerly homeless tenant in PSH had resisted cleaning his unit and was at risk of eviction. After engaging with the CCST team, he agreed to enroll in IHSS and accepted heavy cleaning services that helped him pass room inspection and made his room habitable. He is now accepting ongoing IHSS services from Homebridge to maintain the cleanliness of his unit. The collaborative and flexible service model facilitated this shift and the tenant is no longer at risk of eviction. The pilot hopes to build on this success while it grows to serve nearly 1,000 people over the next year.

About the San Francisco Human Services Agency

SFHSA serves as the foundation for three City Departments, each with a unique role in supporting San Franciscans. Together we build well-being in our communities by offering programs that make children and adults feel connected, valued, and supported. From financial assistance to nutrition, health care coverage, employment, and protective services, our dedicated professionals are here to lend support for all in need.

About the Department of Disability and Aging Services

As one of the departments within SFHSA, the Department of Disability and Aging Services (DAS) offers essential programming to maximize the well-being, safety, and independence of all adults with disabilities, older people, and veterans in San Francisco. The DAS Benefits and Resource Hub streamlines access to services by providing information and making connections to services throughout the City. We are working toward a San Francisco where people with disabilities and older adults are valued, engaged, and living with dignity.

About the Department of Homelessness and Supportive Housing

San Francisco is a national leader in homeless services and at the forefront in providing supportive housing as a permanent exit from homelessness. The Department of Homelessness and Supportive Housing (HSH) seeks to lead in the movement to end homelessness through its’ coordinated, client-focused Homelessness Response System, consisting of six core components: Outreach, Problem Solving, Coordinated Entry, Shelter, Housing and Housing Ladder. HSH oversees housing and shelter for approximately 13,000 individuals through a system of care that demonstrates the department’s values of compassion, common sense, courage and equity. Additionally, HSH’s Problem Solving program Homeward Bound has helped more than 10,000 individuals return to stable housing with family and friends. The department strives to make homelessness rare, brief and one time.



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