SAN FRANCISCO (KPIX 5) — A San Francisco program that helps the severely mentally ill stay off the street by housing them in small group homes is quietly disappearing, taking away a vital safety net that no one seems to be trying to save.
For decades the group of homes in San Francisco has been a place of refuge for some of the city’s most vulnerable citizens. Its residents suffer from severe mental illness. The residents who live there are among the lucky few who have managed to escape the vicious cycle of homelessness and endless trips to jails and hospitals.
“I used to sleep in Chinatown. It’s terrible. You have to sleep in the streets you cannot take a shower,” said resident Sonia Hernandez. She came to the Aurora Board and Care Home from San Francisco General Hospital.
“I want to stay here because we have a nice place to live, Aurora treats us very nice,” she said.
Lori Loo was placed at Aurora by her family. “I like this place a lot,” she said.
So was Isabel Santos. “Its very pleasant. I mean the food is good, very steady,” said Santos.
Her brother Mel Santos visits her weekly.
“It’s not just the food and the shelter that everyone needs. Because of her mental condition, she needs her medication administered in a professional way. And that is what she gets here,” her brother said.
But changes are afoot that are casting a shadow on all the residents’ futures. Aurora and Frank Rosario, who have run the board and care homes for 40 years, say they can’t afford it any more.
“We have been using our retirement money to cover operating expense, and we can’t keep doing that,” said Frank Rosarios.
The $1,000 social security check they get from each resident — plus a meager $19 a day supplement from the city — is no longer enough. The Rosarios have closed two of their five homes already and might soon be forced to close the rest.
There’s been an upward trend of homes like these closing. In the past five years, 23 residential care facilities in San Francisco shut down. 11 more are expected to close this year.
“It would be difficult enough to uproot anyone from their living environment. But you take a patient with mental illness and they are very fragile,” said Steven Protzel, a pharmacist at Daniel’s Community Pharmacy. He has been working with mental health clients as a pharmacist for 42 years.
“My concern for clients as a pharmacist is that many may become non-compliant. Many may become combative. Many may not want to take their meds and require much more work and much more help. I’ve seen it happen,” said Protzel.
“I think it’s sad. I don’t know if I would call it a crisis,” said Kelly Hiramoto, who oversees the placement of mental health patients for the city’s Department of Public Health. “Right now, we’ve been able to house everyone that’s left a facility that’s closed in another facility.”
Hiramoto says the Aurora homes only take in the highest functioning mental health clients and would have to take on more acute cases to qualify for more money from the city.
“The only other alternative is, if you increase everyone’s rates, you decrease the number of beds. And then you’re in the dilemma of what happens to the people you’re not going to place,” explained Hiramoto.
She predicts the board and care home model may soon be a thing of the past.
“What will be left standing in the end is going to be much larger facilities, which have much larger of a feel. It’s not the same as walking into a six-bed house,” said Hiramoto.
Protzel sees that as a step backward to the days when San Francisco residents with mental illnesses were warehoused at Laguna Honda Hospital 20 years ago.
“They may be more in an environment that is a so called sterile environment , more of a locked environment, or regimented environment, regimentation for mental health clients is not a good thing,” said Protzel.
And though the Department of Health has a legal obligation to find new homes for displaced clients, Protzel says many will opt out.
“They have a right of refusal. I would say that there is a good percentage of patients that will just fall through the cracks and end up on the street,” explained Protzel.
Hiramoto says for some homeowners, shutting down these care facilities and selling their homes has become all too tempting. But Aurora Rosarios says she doesn’t want to do that, and worries shutting down will put her long standing residents at risk.
“If there is anything we should be doing for mental illness is having them stabilized. Give them a home, a decent home, good homes. Which was my goal; to make a difference in their life, which I have accomplished and shown. But they don’t care about that,” said Aurora.
Sonia, Lori and Isabel hope the city can do something that will allow them to stay right where they are.
”I think I am going to sleep under the freeway. And I don’t have a place to go,” said Sonia.
“I don’t want to be in a homeless shelter,” said Lori.
“You can’t just ignore us, you can’t just throw us away,” said Isabel.
The city says it plans to begin outreach to encourage more homeowners to run residential care facilities, but it is not offering any extra financial incentive.