Board and Care Facilities Get a $1M Boost

In the past five years S.F. has lost half of its contracts with residential facilities that house people with physical and mental disabilities.

Residential care facilities — commonly known as “board and cares” — tend to get overlooked in San Francisco’s affordable housing discussion. Often sandwiched between old Victorians on residential streets, they’re easily mistaken as senior homes, and some are. But the facilities, which range in size from just a handful of beds to dozens, provide an important service: Long-term housing and support for people who need ongoing mental or physical care.

San Francisco’s Department of Public Health has long seen the value in board and cares. Five years ago, the city held contracts with 70 of them, guiding people with unstable housing into the facilities. But a sharp drop in funds from the state and federal government has halved that number; today, the city only works with 37, which house around 350 residents. Fewer contracts mean fewer beds, and with our current housing crisis, that means more people suffering from dementia, mental illnesses, or physical disabilities living on our streets.

Without those city contracts, privately-owned board and cares have a hard time making ends meet, and a number have shuttered as a result. But on Monday, news broke that board and cares may get a little bit of a break. Mayor London Breed proposed amendments to the budget that would grant $1 million in operational support to board and care facilities.

“San Francisco is expensive and for many operators, it has been hard to hang on,” says Health Director Barbara Garcia. “While DPH currently invests approximately $2.5 million per year to help make up the difference between the cost of services and the current level of funding, this additional investment is critical to bridging the remaining gap in San Francisco.”

Two new supervisors — Rafael Mandelman and Vallie Brown — flanked Breed as she discussed the funding at a press conference at Victorian Manor, a 90-bed facility in Western Addition.

“We don’t spend enough time talking about prevention,” Breed said. “When you think about the amount of money it takes, whether it’s wages for an employee, whether it’s an increase in what it costs to feed people, whether it’s additional services like physical therapy, social services… the costs are going up. They can’t take care of all the clients they have. A budget shortfall means they could go from 90 beds to 80 beds… Where are we going to put 10 people that might be displaced because of the lack of funds? We have to make sure we keep every single bed.”

It’s a noble cause, but it remains to be seen how much of a difference $1 million can make — Breed herself calls it a “down payment,” implying that future funds will be dedicated to this cause. The Board of Supervisors will vote on the budget amendment on Tuesday. 

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