All DAH sites are service-enriched, offering tenants access to voluntary on-site support tailored to their needs. On-site support service staff actively engage residents and attempt to help individuals make choices that reduce their physical, psychiatric, and social harm. For residents unable or unwilling to accept offered services, staff continue to engage them in dialogue, continually reminding residents of available services.
On-site support services staff generally consist of several on-site case managers supervised by an on-site director. Most case managers are bachelor’s level social workers, though some have advanced degrees and others are formerly homeless peer advocates. Site directors are generally master’s level or licensed social workers or registered nurses. Case managers help residents access and maintain benefits; provide one-on-one substance use, mental health, life skills and family counseling; access medical and behavioral health treatment (e.g., mental health and substance abuse treatment); secure food and clothing; and interface with property management to aid in eviction prevention.
All DAH tenants may access primary and psychiatric care through the Housing and Urban Health Clinic (HUHC), as needed. A Federally Qualified Health center, the HUHC logs approximately 1,000 encounters each month, 10% of which are bedside home visits at the supportive housing site; all other appointments take place at the HUHC. In addition to preventive, medical, and psychiatric care, HUHC offers medication management, diabetes education, traditional Chinese medicine services, and ophthalmology services via the University of California, San Francisco Eye Van.
DAH provides permanent supportive housing to formerly homeless adults—and, in some cases, adults at-risk of homelessness—most of whom have concurrent mental health and substance use issues and/or chronic medical conditions. The DAH definition of “homeless” includes living on the streets or in abandoned buildings, living in emergency or domestic violence shelters, hospital or forensic programs, institutions, transitional and/or substance abuse treatment programs as well as other emergency and transient situations. DAH tenants must be San Francisco residents who are “extremely low-income” as defined by the U.S. Department of Housing and Urban Development (HUD)(2). DAH residents must also, prior to lease-signing, agree to pay a portion of their income toward rent via an approved third party rent payment provider(3).