Increasing connections to care for people in the Tenderloin

Data about people in the Tenderloin connecting to health and social services.

The Tenderloin Center closed December 4, 2022.  The center, part of San Francisco’s Tenderloin Emergency Initiative, was planned as a temporary site to reduce overdose deaths and increase connections to services, as well as to collect data for future sites and services. SF Public Health is supporting people seeking and receiving services by facilitating their transition to trusted providers in the neighborhood, who offer similar services as the TLC.

In addition to ongoing field outreach, San Francisco opened the Tenderloin Center (TLC) in January 2022 as part of a larger system of care. The TLC welcomes guests in need of services or treatment. The TLC strives to meet the basic needs of guests and provides a safe space for anyone to easily and quickly access San Francisco health and human services. This page describes visits to the TLC, activities that occur on-site, requests made by guests, and referrals and linkages to services.

The Tenderloin Center and other teams supporting the Tenderloin Emergency Initiative increase connections to care for people in the Tenderloin in five primary categories of service.

Dignity Services

Dignity services include providing showers, laundry, and food.

Behavioral Health

Behavioral health services include counseling, medication, and out-patient and residential treatment. Treatment can occur in a variety of settings, take different forms, and last for different lengths of time. Guests at the TLC come with a range of needs and readiness for engagement in treatment services.

Housing and Shelter

Housing and shelter services include housing services related to housing assessments, housing placements, and referrals and connections to shelter programs offered by San Francisco agencies, including both the Department of Homelessness and Supportive Housing as well as the Adult Probation Department.

Physical Health

Physical health services include prescriptions, urgent and primary medical care, vision, dental, and hearing services, medical appointment support, HIV and Hepatitis C testing, and other medical services.

Social Services

Social services include public benefits, job training services, food and nutrition services, and legal support.

More data about other types of services may be included over time. See the page for Reducing homelessness and street sleeping for data about homelessness services delivered by street teams and the TLC.

Visits to the Tenderloin Center

The Tenderloin Center (TLC) is part of San Francisco’s Tenderloin Emergency Initiative. It strives to meet the basic needs of guests and provides a safe space for anyone to access San Francisco health and human services.

Services at the TLC contribute to several strategic goals including reducing homelessness and street sleeping, increasing connections to care, reducing drug overdose deaths, and reducing widespread public drug use.

The following chart shows the average number of unique guests visiting the TLC each day. Results are summarized by week. Each week is represented by an operational period (OP), which begins on Monday and ends the following Sunday.

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

Anotaciones y fuentes de lo datos

Anotaciones y fuentes de lo datos

Guests might visit the Tenderloin Center (TLC) multiple times each day or week. Guests are counted only once each day. If a guest visits on multiple days, they may be counted multiple times during that week.

This data is reported by staff at the TLC each week. Staff members fill out an intake form with each guest at the start of their visit. Guests are not required to complete an intake form to enter the TLC, so these results may underreport the number of visits.

Data gathered before March 18, 2022 may not be a complete count due to changing data gathering practices. Data reflects a daily average using weekly visits and assuming the TLC is open 7 days each week. In weeks where the TLC experienced a closure for a day, the average will be an undercount. 

Services requested at the Tenderloin Center

Guests at the Tenderloin Center (TLC) are asked what services they are seeking when they arrive. These services include dignity services such as food and water, access to toilets, showers and other hygiene services, as well as a safe space, social space, harm reduction supplies, linkage to housing and other social services, linkage to medical care, and linkage to behavioral health services.

The following dashboard shows the cumulative number of services requested by guests at the TLC. A service request does not necessarily mean that a service was provided.

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

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Basic necessities include food, water, showers, hygiene supplies, and access to toilets. This data is provided by the Department of Public Health and is updated weekly. Service request tracking started on February 28, 2022. Guests can request multiple services in a single visit.

Dignity services provided through the Tenderloin Center

The following dashboard shows the cumulative number of meals, showers, and loads of laundry provided at the Tenderloin Center since the initiation of data tracking for each measure.

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

Anotaciones y fuentes de lo datos

Anotaciones y fuentes de lo datos

This data is provided by the Department of Public Health and is updated weekly.

Service activities, referrals, and linkages made at the Tenderloin Center

Guests at the Tenderloin Center (TLC) may engage in several activities while on-site, and can be referred and linked to a variety of services. These activities and services include mental health and substance use treatment, medical care, housing assessments and placement, food and nutrition services, and social services such as benefits enrollment, assistance with getting an ID, and veteran, employment and legal support.

On-site activities

These include a guest receiving a service at the TLC, including completing a housing assessment or benefits application, being navigated to an on-site service, attending a support group or a one-on-one therapy session, getting an HIV test, or receiving an essential item such as clothing, wound supplies, or a hygiene kit. On-site activities related to dignity services (meals, showers, and food) are reported in the section above.

Referrals

These occur when staff initiates a process for someone to access a service off-site. This may include a service navigator helping a guest set up a primary care appointment or enroll in an employment training course, or providing information and supporting a guest to access a specific health or social service.

Linkages

These occur when a guest is confirmed as having connected to a service. Connections include confirmed enrollments in a public benefit such as Medi-Cal, confirmed move-in to a housing or shelter program, or confirmed engagement in a health service following a TLC referral. Linkages are only tracked by the TLC when they can be confirmed. There may be additional referrals resulting in linkage that are not included in this dashboard.

Activities, referrals, and linkages dashboard

This dashboard shows the cumulative number of on-site activities, service referrals, and service linkages provided to guests at the TLC, as well as bar charts showing the number of on-site activities, referrals, and linkages by the four service categories: Behavioral Health, Housing & Shelter Support, Physical Health, and Social Services. Results are a cumulative count of on-site activities, referrals, and connections since the initiation of data tracking for each measure.

Referrals and linkages to housing and shelter are shown and counted on both this dashboard and those shown on the Reducing homelessness and street sleeping in the Tenderloin page. Behavioral health on-site activities from Naloxone kits distributed at the Tenderloin Center is also shown and counted on both this dashboard and that shown on the Reducing fatal and non-fatal overdoses in the Tenderloin page. See the data notes below for more information.

On-site activities related to supporting guests to apply for public benefits are shown and counted on both this dashboard and that shown on the “Increasing enrollment in public benefits at the Tenderloin Center” section on this page. See the data notes below for more information.
 

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

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Anotaciones y fuentes de lo datos

This dashboard shows the number of on-site activities, referrals, and linkages made for guests visiting the Tenderloin Center (TLC). Definitions for on-site activities, referrals, and linkages were updated as of May 13, 2022 to improve reporting consistency across the various providers offering services at the TLC. Due to changed definitions of on-site activities, referrals, and linkages, data reflected in this dashboard may vary from previous reports of this information on this webpage and/or on prior Situation Reports posted to the Tenderloin Emergency Initiative webpage. Some data gathered prior to this date has been cross-walked to new definitions when possible. Data aligned to the current definition for referrals and linkages is available from Operational Period 12, which started on February 28, 2022. Data aligned to the current definition for on-site activities is available from Operational Period 23. Data for prior periods may be cross-walked and added in the future. The cards at the top of the dashboard show the total number of on-site activities, referrals, and linkages for the time periods stated in the dates below them. The bar chart shows this information broken out by type of service. Data is manually updated and refreshed on a weekly basis.

The number of Housing & Shelter Support referrals and linkages includes some from the Tenderloin Center completed by the San Francisco Homeless Outreach Team. The “Shelter placements” dashboard on the Reducing homelessness and street sleeping in the Tenderloin page shows “Placements from the Tenderloin Center”—these numbers are counted as linkages in the dashboard above. The “Housing assessments, prioritization, and placements at the Tenderloin Center” dashboard on the Reducing homelessness and street sleeping in the Tenderloin page shows “Individuals referred to housing” and “Individuals placed in housing” when you click on the “Housing referrals and placement” radio button at the top of the dashboard. “Individuals referred to housing” are counted as referrals and “Individuals placed in housing” are counted here as linkages in the dashboard.

The number of Behavioral Health on-site activities includes some from the Tenderloin completed by public health outreach teams. The “Naloxone distributed to community members” dashboard on the Reducing fatal and non-fatal overdoses in the Tenderloin page shows the number of Naloxone kits distributed to guests. These numbers are also included as on-site activities in the dashboard above.

The number of Social Services linkages includes some from the Tenderloin Center completed by the San Francisco Human Services Agency. The “Increasing enrollment in public benefits at the Tenderloin Center” dashboard on this page shows “CalFresh Enrollees,” “Medi-Cal Enrollees,” and “CAAP enrollees”—these numbers are counted here as linkages in the dashboard. The “Housing assessments, prioritization, and placements at the Tenderloin Center” dashboard on the Reducing homelessness and street sleeping in the Tenderloin page shows “Individuals referred to housing” and “Individuals placed in housing” when you click on the “Housing referrals and placement” radio button at the top of the dashboard. “Individuals referred to housing” are counted as referrals and “Individuals placed in housing” are counted as linkages in the dashboard above.

Increasing enrollment in public benefits at the Tenderloin Center

An important role for the Tenderloin Center (TLC) is supporting guests to apply for and successfully enroll in public benefits. Public benefits include:

  • CalFresh, a food assistance program 
  • Medi-Cal, health care benefits
  • County Adult Assistance Programs (CAAP), income assistance for adults

Enrollment in these benefits can lead to improved outcomes for clients, including stable medical and behavioral health care options, food security, and enrollment in housing programs.

The dashboard below shows the total number of applications submitted for one of these three benefits programs.  A client may represent an individual or a family. When a client visits the TLC, a staff member from San Francisco's Human Services Agency (HSA) supports the client to complete the applications. The dashboard also shows the total number of clients who become approved program enrollees. Not all applications will be approved in the same month as the application was submitted, as approval may occur 45 days after the date of application submission.

An individual receiving application support by an HSA staff member may also be tracked in the prior dashboard as an “on-site activity.” Confirmed enrollment in one or more public benefits is a “linkage,” but due to the delay in confirmation of the enrollment, linkages to public benefits are only displayed in the dashboard below and not in the section above.
 

We've changed the way the data is presented: Data collection and posting has been discontinued as of December 4, 2022.

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After a client’s application is submitted, HSA staff verify that they are eligible. For example, a client may already be enrolled in a benefits program in another county and would therefore be ineligible.  Each enrollee represents an individual or a family who has been approved to participate in a benefits program. A client is allowed to enroll in multiple programs at once—such as CalFresh for food assistance and Medi-Cal for health care benefits. When a client submits an application for CAAP, the system automatically submits applications for CalFresh and Medi-Cal, even if the client is already receiving those benefits, is not eligible, or chooses not to participate in those benefit programs. This automatic submission of applications may account for a portion of the gap between the number of applicants and the number of enrollees for CalFresh and Medi-Cal.