Resource Center

Public policy academics Pamela Herd and Don Moynihan have an interesting brief in Health Affairs on how administrative burdens can harm the health of low-income people. Herd and Moynihan quite literally wrote the book on administrative burdens, so their work on the subject is always worth a look.

Much of BHHI’s work is rooted in a simple premise: The solution to homelessness is housing. While lack of a permanent home is not the only challenge facing most unhoused people, it is the one challenge they all have in common. And whatever other challenges they may have—whether they include persistent unemployment, physical disability, mental illness, or none of the above—are significantly harder to manage for people who are simultaneously dealing with the stress of homelessness. Giving people homes creates the conditions necessary for them to heal and flourish.

Welcome to the introductory blog post of the Benioff Homelessness and Housing Initiative, which describes what to expect from future posts.

This brief, based on our analysis of Census Pulse Data and a survey administered by BHHI and partners at UC Berkeley and UC ANR Nutrition Policy Institute, includes recommendations for how public and nonprofit entities in California can improve emergency rental assistance uptake among low-income renters. Because many survey respondents said they were not aware of the emergency rental assistance program's existence, our core recommendation is that various entities engage in public outreach to renters who are likely to be eligible for assistance.

San Francisco is buying hotels to house people experiencing homelessness, but some neighborhoods are resisting supportive housing efforts. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, said, "The usual opposition forces who really don’t want to be part of the solution have had time to mobilize and that’s going to be a problem not just in San Francisco, but other cities."

UCSF BHHI director Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, says solving homelessness shouldn’t be just one neighborhood or community’s responsibility. “Everyone wants homelessness solved but people are worried. They have concerns and to be honest, neighborhoods block the things they most need, which is if they had housing in their neighborhood they would have fewer people facing homelessness,” Dr. Kushel said.

Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, is among the panelists discussing how the partnership between UCSF scientists, government officials, advocacy organizations, and media has changed the way older adults experiencing homelessness received support from the City of Oakland. The film highlights how structural inequities can be addressed through influencing and widely scaling local policies and programs.

This brief on the Home Safe program summarizes key findings from the UCSF Benioff Homelessness and Housing Initiative’s (BHHI) interim evaluation of the program. It includes a brief description of the program, an overview of the evaluation’s design, and an assessment of the Governor’s 2021-22 budget proposal to expand Home Safe eligibility.

The UCSF Benioff Homelessness and Housing Initiative collaborated with the California Homeless Coordinating and Financing Council and the California Health Care Foundation to create resources to help homelessness response systems with COVID-19 vaccination planning. The second in a series, these materials detail key lessons learned from the early rollout of COVID-19 vaccination events for sheltered or service-connected people experiencing homelessness.

The homeless population is aging and people experiencing homelessness are at a heightened risk of experiencing physical and sexual victimization. This study examined whether homelessness is independently associated with experiencing physical or sexual abuse. Researchers found that older homeless adults experience high rates of victimization.

The San Francisco Department of Public Health implemented the Coordinated Care Management System (CCMS) in 2007. The CCMS is used to develop High Users of Multiple Systems (HUMS) tp identify individuals with the highest use of emergency medical services. Researchers described the HUMS scoring system and the characteristics and service use of the highest scoring 100 individuals. Researchers found that nearly all of the individuals had a history of homelessness in SF, and over half were unsheltered at their last point of contact.

With cities implementing new camping bans and conducting new removals, advocates and homelessness experts are troubled by the new wave of enforcement around homelessness. In addition, temporary shelter still falls short of what is needed to move people off the street for good. “The goal should be to get everyone into permanent housing,” said Ned Resnikoff, policy manager at the University of California, San Francisco Benioff Homelessness and Housing Initiative. “If getting them sheltered doesn’t get you closer to that goal, then you actually haven’t solved anything.”

Several shelter-in-place hotels, where people with medical vulnerabilities have safely quarantined since the pandemic broke out, will close by the end of August, and the city’s largest congregate shelter has paused intakes for weeks due to positive COVID tests from residents. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, “Non-congregate shelter is a really important intervention. It has been throughout the pandemic and with the virulence of the delta variant is, arguably, more so now. Getting people into safety is important for all.”

In this podcast, Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, explains the country’s rise in homelessness and the critical impact of housing on the health needs of vulnerable populations.

In this article about Project Homekey, Margot Kushel, MD, director of the University of California San Francisco's Benioff Homelessness and Housing Initiative, described how the goal is to make sure even the “hardest-to-house” people will come inside. To that end, Dr. Kushel said Homekey gets the most important part right: providing permanent supportive housing, not temporary shelter. “Some people need services that go along with that housing, and some people don’t. But the really essential thing is that without the housing, the services don’t work,” she said.

An event in San Francisco called “Public Health is Public Safety,” brought together a dozen experts from homelessness services, policy, research, and jail health services backgrounds. Margot Kushel, MD, director of the UCSF Benioff Homelessness and Housing Initiative, discussed a successful “housing first” study conducted in Santa Clara, which found that simply providing housing to people who most needed it helped reduce emergency room visits and allowed people the chance to get mental health services.

Although the majority of San Francisco residents have been vaccinated against the coronavirus, people experiencing homelessness may still face barriers to vaccination. By walking the streets and offering immunizations on the spot, Code Tenderloin has collaborated with UCSF and Glide to try to overcome those barriers. Margot Kushel, MD, who directs the UCSF Benioff Homelessness and Housing Initiative, said UCSF health workers asked Code Tenderloin to take the lead in the outreach work, "I can’t emphasize enough how much our efforts were led by Code Tenderloin, who really in the Tenderloin is seen as a very trusted entity. They know the community. They’ve been there, they get it."