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Bay Area’s Housing Shortage Is Fanning The Flames Of Yet Another Crisis

In 2017, San Diego was hit with a hepatitis A epidemic that killed 20 and infected 600 people, many of whom were homeless. Mass vaccinations were issued and the city had to face its growing homelessness crisis head-on before the epidemic spread even more.

In San Francisco, where rents average about $3,700, growing encampments and a lack of shelter beds could push the city to the brink of a similar healthcare crisis. Unsanitary conditions can lead to a rapid spread of hepatitis A and other health maladies.

HealthRIGHT 360 President and CEO Dr. Vitka Eisen and DPR Construction healthcare core market leader George Hurley

“Until the city makes a financial commitment to develop low-income housing for people, we are at risk of other healthcare epidemics,” HealthRIGHT 360 President and CEO Dr. Vitka Eisen said during Bisnow’s The State of San Francisco Healthcare event Wednesday.  

People who live outdoors or in large encampments and have no other place to go typically have poor health outcomes, said Eisen, whose nonprofit organization focuses on providing healthcare to low-income and homeless individuals.

The need for housing is only getting greater in San Francisco. Thousands of people are on the waitlist for beds in navigation centers in San Francisco, she said.

Kaiser Permanente Senior Vice President Ron Groepper, UCSF Chief Operating Officer James Bennan, View Dynamic Glass Vice President of Business Development Zachary Gentry, HealthRIGHT 360 President and CEO Dr. Vitka Eisen and DGA Planning | Architecture | Interiors senior associate and senior medical planner Melinda Lin

San Francisco is already in the middle of tackling the opioid epidemic, which is sweeping through the homeless population. Housing homeless people could be the best way to keep them healthy, Eisen said.

The opioid epidemic is hitting the country hard and 72,000 people died from a drug overdose in 2017. That is more than the 35,000 people who died during the height of the AIDS epidemic in 1994, Eisen said.

Laws like AB 186 that allow for supervised injection sites can help provide a sterile safe place for people who may also receive counseling for recovery services. San Francisco recently opened a safe-injection demonstration site at Glide Memorial Church to show how these facilities would work.

“While supervised injection sites are not the only answer, housing people is one of the ultimate answers,” Eisen said. “Not doing that is a huge contributor to health costs and to people’s misery.”

Los Angeles passed a sales tax increase in 2017 to support transitional and permanent housing for homeless residents. Since then, the city has noticed a 20% reduction in the cost of prisons, hospitals and emergency rooms, Eisen said.

How Health Systems Are Tackling The Problem

Kaiser Permanente Vice President of Real Estate Terry Wood, Senior Vice President Ron Groepper, Executive Director of Real Estate Ethan Sullivan and Cammisa+Wipf principal Paul O'Connell

Health systems have been funding programs to help address homelessness and helping build more infrastructure to care for more patients in need.

Kaiser Permanente committed $200M earlier this year for affordable housing and addressing homelessness in the Bay Area, Kaiser Permanente Senior Vice President Ron Groepper said. Kaiser and Sutter Health previously provided funding for Tuff Shed shelters in Oakland to help house homeless individuals.

“The problem is a complex problem. It can’t be solved by the goodwill of people. It has to be done in a systematic approach,” Groepper said.

Emergency rooms have been the front line for care and often treat the same people over and over. UCSF has been working with the Salvation Army to provide people with supportive housing placement services in the ERs as well as offer immunization programs, UCSF Chief Operating Officer James Bennan said.

Treating people who are mentally ill and homeless also has increased demand for care at behavioral health facilities across the region. Many people with acute mental illness don’t need hospital inpatient care, but require some level of care in a behavioral health facility, Bennan said.

To address the growing need for behavioral health beds, UCSF joined a partnership with San Francisco General and the Department of Public Health to help fund a mental health facility managed by Crestwood at St. Mary's Medical Center.

The need is so great that the 54-bed facility filled up right away, he said.

“We could build 10 more of them, and they would fill up right away,” Bennan said.