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To Fix Homelessness, San Francisco First Has to Clean Up Its Data Mess

For years, the city and its dozens of nonprofit partners have operated in the dark. That’s finally starting to change.

 

“Have you seen the TV show The Wire?” Jeff Kositsky, the head of San Francisco’s Department of Homelessness and Supportive Housing, asks.

In the show, he explains, police captains use a database called ComStat to understand how their department is doing. They round up the rank-and-file to discuss arrests, stops, and other stats. Kositsky, who has salt-and-pepper hair, a genial face, and glasses better suited to an architect than a public servant, dreams of his own version of ComStat. Like a police captain, he would gather his program managers around him each week to dive into the data. How many people did we house last week? How many people do we need to house this week? How are we doing housing people with psychiatric disabilities? In his mind, the lack of a ComStat-like system is, along with a dearth of available housing, perhaps the greatest obstacle to reducing the number of homeless San Franciscans.

“I would tell you that it’s the only missing component in the system. I mean besides the fact that we need more of everything,” Kositsky says wryly, swiveling in his desk chair. “We have such incredibly high-quality service providers in this city. They just don’t work in concert, and that’s not their fault.”

At present, Kositsky’s department and its city and nonprofit partners use approximately 15 different databases, with virtually no data sharing—let not thy left hand know what thy right hand doeth. Because of these siloed systems, people working to combat San Francisco’s swelling homelessness problem (according to this January’s official count, the population, at 7,499, decreased half a percent since 2015) have had a “very fragmented” picture of the clients they serve, Kositsky says. Creating a shared data system for all providers has been one of his goals since he became the department’s first director last June—and it’s finally coming to fruition.

Several weeks ago, the department’s Homeless Outreach Team began using a new database called Online Navigation and Entry (ONE) System, which will be rolled out over the course of the summer to social workers, case managers, peer advocates, and others at the city and nonprofit agencies that work with the homeless. It will give the city a much more accurate sense of how many people are homeless, although it won’t replace the federally mandated point-in-time count. The new database is also critical to the city’s “coordinated entry” strategy, in which case managers, outreach workers, and others run new homeless clients through a standard assessment to quickly identify needs and match them with a bus ticket home, temporary housing, mental health care, and other services. For people already in the system, providers will be able to find clients by name, see the last time they went to the ER or were arrested or had stable housing, and also identify which benefits they’re eligible for.

“What ONE System gets you is the ability to see what people are experiencing. Only by knowing where they’re interacting in the system can you really effectively serve them,” says Rachel Metz, director of policy for Tipping Point Community, the politically connected nonprofit which recently funded two positions in the department, including a data analyst, as part of a $100 million, five-year commitment to halving chronic homelessness in San Francisco.

Until now, city departments have famously struggled to share data. Between privacy laws like HIPAA, which restrict how and with whom data can be shared, and what Metz describes as a general level of skittishness within city bureaucracies about handing over data to other city bureaucracies, there’s long been a lack of cooperation among the agencies trying to treat homelessness. But that looks likely to change: Kositsky’s department has volunteered to become a HIPAA-covered entity under San Francisco’s Department of Public Health, which would allow specific staffers within both agencies to access data. “So if [Public Health] has a client who’s in the hospital, they’ll be able to look up and see what shelter they’ve been staying in, who their case manager is,” Kositsky explains. 

The hope is that through communication, data sharing, and collaboration between entities, the city will be able to use its resources more efficiently and reduce time on waiting lists. Metz also sees the benefit of using data to funnel people into different levels of care based on their needs. “By allocating all our resources to the most vulnerable it will have kind of a ripple effect of opening up other systems for people so that we’re really able to overall increase the number of people we serve,” she says.

ONE System, along with training and support, will roll out for free this summer to all agencies and the department’s 70 nonprofit partners. But Kositsky estimates it won’t be fully used as a means of rationing resources until next year. Helping get it to that point will be the work of the data analyst, a temporary department employee paid with funding from Tipping Point, who will shepherd the project for the next two years. 

Larkin Street Youth Services, one of the city’s nonprofit transitional housing partners, is eagerly awaiting the arrival of ONE System, says Ilsa Lund, senior director of operations. Currently, when a homeless young person walks into Larkin Street’s Lark-Inn emergency shelter, Larkin staff might have no information on him or her; at best, if that particular youth has ever used the city’s adult shelter system, caseworkers can see basic biographic data. “We really need that real-time, widely accessible data that is available to all stakeholders on who is in housing at any time and where there’s housing availability citywide,” Lund says. As it stands now, anything else a caseworker would want to know—records relaying whether the youth uses drugs, has a disability, or has been in foster care or the juvenile justice system—must be self-reported, since databases from other departments and providers are siloed. ONE System, with its data sharing between a wide range of agencies, could eliminate the need for clients to recount the story of how they became homeless to every single service agency, which “can be a traumatizing thing, especially for a young person,” Lund says.

While Lund is excited and optimistic about the changes ONE System will bring, she hopes it won’t become duplicative and burdensome. Larkin Street, like many nonprofits, has its own robust data infrastructure. ONE System will be most successful if it can become “an added value,” and integrate with the systems nonprofits already rely on, Lund says. “We are pushing the city to allow and plan for our systems to talk to each other,” she says. “We have a lot of confidence that the city is invested in that process of doing it with provider input.”

She, Metz, and Kositsky acknowledge that ONE System, even if functioning perfectly, is not a silver bullet. “We need the data system, but the data system is nothing if you don’t attach the right types of interventions to it,” Metz says. For his part, Kositsky recognizes that ONE System won’t house people or feed them or counsel them—it will simply point him and his staff to areas where the department can improve.

But where homelessness is concerned, even incremental adjustments can have outsized impacts. Kositsky will be happy just to be able to see stats he can’t now: how many people are newly homeless, what the housing-placement rate is, when someone in housing slides back to the street, and how many people manage to exit homelessness on their own. “Even a five percent change in each one of those places is a 25 percent reduction of homelessness,” he says. “So this is how you get the job done.”

 

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