The word shelter connotes protection, refuge, safety. A shelter is meant to be a sanctuary from the harsh conditions of the outside world, especially for those without homes who must not only brave harsh climates living outside, but also ruthless treatment by police officers, insensitive remarks from people walking down the streets, unmonitored violence, and the constant worry of having what little they own stolen. The shelter system in San Francisco tries to offer people this sanctuary; only a handful succeed in providing a livable space for residents. Though all of the shelters in San Francisco offer relief from harsh nights on the streets by giving people a place to sleep, this should not necessarily be considered an amazing service, but rather the most basic level of care. Is merely a bed or a mat inside for the night enough? Can the City, the Human Services Agency (HSA), and the shelter system claim that they have truly provided shelter to the homeless population when only one third of those shelters meet average health and hygiene requirements? When there is an apparent lack of training for staff? When there is a blind eye turned to the needs of populations such as seniors, women, and the disabled who often need the most support?

Health and Hygiene Deficiencies

The Shelter Monitoring Committee, created to provide the Mayor, the Board of Supervisors, the Local Homeless Coordinating Board, the public, and any other appropriate agency with accurate, comprehensive information about the conditions in and operations of shelters, released its quarterly report at the end of January. The report includes information from site visits to all 19 existing single, family, and interfaith homeless shelters conducted between November 25 and 30, 2006. During these site visits, the Committee used a checklist of six criteria to evaluate hygiene at each site (see box). Only six out of nineteen sites met these criteria—less than one third.

In its report, the Shelter Monitoring Committee notes the extreme importance of hand-washing, especially in the shelter system: “It is essential for clients to have access to these necessities in order to maintain proper hygiene and prevent the spread of communicable and infectious diseases, such as Hepatitis A, germs that cause the flu, SARS, and many kinds of diarrhea, amongst clients and staff.” Both the Center for Disease Control and the National Health Care for the Homeless support these ideas, further claiming that hand-washing and proper hygiene, “[are] the most effective and least costly way to reduce the spread of infections.”

The Committee has continually documented a lack of access to soap, toilet paper, paper towels or dryers, and towels for those who use showers on sites.

Although bringing hygiene up to code seems like a simple change to improve the conditions of homeless shelters, the fact that the reports issued by the Committee have been repeatedly disregarded is very telling of a problem that goes beyond a lack of soap and towels. The Committee submits these reports to the Mayor’s Office, the Board of Supervisors, and the HSA on a quarterly basis. Despite the concrete evidence of deficiencies in basic health and hygiene requirements provided by the report (which includes not only written observations, but also photographs), the HSA continues to neglect these concerns: “HSA staff verifies that the shelters are stocked with ample supplies to serve the needs of all shelter clients and visually confirm the availability of all necessary shelter supplies, including toilet paper and assorted toiletries.”

During an unannounced site visit at Sanctuary Shelter, the staff barred the inspectors from documenting the conditions of the bathrooms on site.

Treatment of Residents

The negligence in some of the San Francisco shelters is not only related to maintaining hygienic standards of living, but also appears in the way in which staff members treat those staying in the shelters. The Committee’s report notes that it, “continue[s] to receive complaints about disrespectful staff,” and that, “clients feel that they will be retaliated against for speaking to the Committee or attending meetings of the Committee.” This means that there are probably quite a few more incidents of disrespect and harassment that have not been reported at all.

The report strongly recommended that better training be provided to the staff. During the site visit at Multi-Service Center South, some of the staff had not read the Shelter Training Manual. At Sanctuary, none of the staff knew about the Homeless Outreach Team. On top of this, one of the staff members at Sanctuary completely disregarded one of the clients right in front of the Committee during the inspection. The report states, “one of the staff interrupted and talked over a trans-gendered female client who was talking with us. Her manner toward her was insulting and dismissive.” At Compass Family, there were no staff members on site during the visit.

Lack of training for shelter staff is cited as a major concern of the Committee and it recommends education pertaining to the shelter grievance policy, de-escalation training, and a working knowledge of each site’s policies and procedures before new staff can work on the floor with clients.

However, this training requires that sites receive additional money. Although we could point fingers at individual shelters or individual staff members, this would not solve the overall problem plaguing some of the most at-risk shelters. According to one shelter resident staying at 150 Otis, staff members that he had encountered were extremely kind and generous, even toward people who had gotten out of hand. However, he stated that he could understand how hard it might get for staff in facilities such as McMillan, where there are high numbers of residents with mental health problems or fighting drug addiction. He stated that there were, “very limited resources for mental health,” and that, “there [was] no place for [people with drug addictions].”

It is not only one person who has noted the lack of mental healthcare available to clients; another shelter resident spoken to by the Committee said that, “Mission Mental Health used to let a client see a psychiatrist monthly and now it [is] every six months.” Without training and without proper healthcare for the residents at these shelters, it is no wonder that staff seem overwhelmed and sometimes desensitized to the conditions of people that need the most help: The staff receives no help. It is for this reason that the Committee also recommends creating a crisis team to offer support to shelter staff and clients when a crisis occurs in a shelter. Unfortunately, without the same accountability that employees at other types of organizations have, staff members are allowed to continue to mistreat people without any consequences, and without proper documentation of that treatment.

And while specific services are lacking at many shelters, basic services are decreasing system-wide: There has been an approximate 370 sleeping-unit loss in San Francisco’s shelter system from 2004-2005 to the present. A large number of women who utilize the shelter system are escaping domestic violence situations. There are currently only 71 beds available in domestic violence shelters according to the Department on the Status of Women. The Shelter Monitoring Committee estimates a 25% reduction in shelter beds available to single women since the 2004-2005 fiscal year.

A Matter of Standards

If only one third of workplaces in the Bay Area were up to code on health and hygiene procedures, there would be an outcry concerning working conditions and an immediate response demanding that work areas be properly maintained. However, because the people staying in these shelters come in off the streets, there seems to be a general consensus among policy-makers, some staff, and even some shelter residents that sub-par living conditions are acceptable.

Lance Caples, a shelter resident and member of the Street Sheet Workgroup, stated that, “shelters… provide miraculous service for people who would otherwise be on the street.” Most people would agree with this statement: shelters do provide an extremely important service. Many of them—the Committee’s report recognizes 150 Otis, the Mission Neighborhood Resource Center, Tenderloin Health, Hospitality House, and Hamilton Family Shelter—even do this well, providing great models for the way in which shelters should be run.

However, the quality of all shelters should meet those standards. It is not enough just to have shelters. Without the same accountability that workplaces have to maintain proper levels of hygiene, shelters fall below expectations and are, in essence, placed outside of the average scope of societal standards. We cannot get caught up in only analyzing which shelters need soap and which need towels, but we must rather look at the lack of dignity and value; the lack of personhood and humanity that this neglect represents, because it does not just end with hygiene. As W.E.B. Dubois writes in The Souls of Black Folk:

“It is easy for us to lose ourselves in details in endeavoring to grasp and comprehend the real condition of a mass of human beings. We often forget that each unit in the mass is a throbbing human soul. Ignorant it may be, and poverty stricken… yet it loves and hates, it toils and tires, it laughs and weeps its bitter tears, and looks in vague and awful longing at the grim horizon of its life,—all this, even as you and I.”

The problems that have arisen in the shelter system cannot be traced to any root cause besides a general lack of concern and lack of funds from San Francisco policy-makers at multiple levels. How can we as a city declare that we are doing our best to end homelessness when we cannot even provide people with a clean and safe environment in which to live until the problem of housing access is solved?

Katy and Jonathan

This entry was posted on Thursday, March 1st, 2007 at 12:07 pm and is filed under Shelter System. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.