San Francisco Project Gives HIV/AIDS Homeless Shelter and Treatment, But in Unsafe Housing
A San Francisco program to place homeless people with HIV/AIDS in residential hotels has often placed its clients in buildings both unsafe and structurally dangerous, the San Francisco Chronicle reports. The Bridge Project, run by the not-for-profit Lutheran Social Services of Northern California, was implemented in 1996 with the backing of the federal Health Resources and Services Administration, which funds health care services nationwide, and the U.S. Department of Housing and Urban Development, which finances rent subsidies. Supported by a $3 million grant, the Bridge Project takes off the street HIV-positive homeless individuals who receive general assistance, make less than $640 a month and have "a history of substance abuse and/or mental illness." The project offers these clients medical, mental health and social services in order to "improve the quality of life, extend life expectancy, expand the use of services and reduce the cost of health care." Lutheran has placed 173 people in five hotels since 1996, and there are currently 50 Bridge Project clients living in these buildings. Yet the hotels in which the homeless are placed have had numerous safety code violations, including unsafe elevators, fire hazards, missing smoke detectors and broken plumbing. They are also "generally ... dangerous" because of violent crime and drug use. Dr. David Bangsberg, an assistant professor of medicine at the University of California-San Francisco and a "fan" of the project, acknowledged that the hotels "are abominable places for people to live." Richard Stahlke, Lutheran's president, said housing was "the weakest part of the project" and that the group was "limited to the least desirable hotels" because of a lack of funding. He added that Lutheran wants its clients to be able to afford the rent "on their fixed incomes after the subsidies ended." Bangsberg agreed that residency in the unsafe hotels was the best of a set of bad options. "Conditions in them are sad. But they're a whole lot better than living on the streets," he said. The Bridge Project is in its final year and its efficacy will be reviewed next year by a San Francisco research firm. According to Bangsberg, homeless Californians with HIV/AIDS face problems because they are able "to obtain $20,000 worth of medications a year under state and federal programs, but it's hard to get the financial help they need to keep a roof over their heads." The program also reduces the number of homeless HIV/AIDS patients who rely on costly emergency rooms for care. "The fundamental project is worthwhile and essential, and unfortunately, (a five-year study) is the only way we can demonstrate the fiscal importance of providing housing," Bangsberg said (Sullivan, San Francisco Chronicle, 10/27).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.