What Would It Take to Keep People Housed in the Bay Area?

What Would It Take is a series of short-form, podcast-style recorded conversations with problem-solving change agents committed to putting science to work for society. 

Our pilot season explores projects aimed at improving health outcomes. Episode 1 features Vivian Wan, CEO of Abode Services, and SIL's Kate Green Tripp discussing the question What Would It Take to Keep People Housed in the Bay Area?

We invite you to listen to the recorded conversation or read the transcript below.

Episode 1: Transcript

Kate Green Tripp: Welcome to episode one of What Would It Take – a conversation series from Stanford Impact Labs designed to expose and explore what it looks like to tackle social problems with a solutions-focused orientation and a dedication to partnership. I’m your host, Kate Green Tripp.

Today we are joined by Vivian Wan to take a closer look at housing insecurity in San Francisco and help us consider the question: what would it take to keep people housed in the Bay Area?

Vivian is the Chief Executive Officer of Abode Services, an agency built on the principles of Housing First. Abode implements innovative programs to end homelessness across seven Bay Area counties, serving more than 15,000 people each year.

Vivian, welcome. Thank you so much for being with us today.

Vivian Wan: Thanks for having me, Kate. I'm really excited to talk with you today.

Kate: The deeply layered issue of housing insecurity is, of course, an incredible stressor for many people in the U.S. and in particular our state of California. When we zoom in and focus on the Bay Area in particular, what does the data tell us about the scope and scale of the problem?

Vivian: So the data tells us that housing insecurity is getting worse in the Bay Area, that fundamentally we are not housing people quickly enough to adjust for the people falling into homelessness. So depending on which county you're really looking at, 1.5 to 3.5 people fall into homelessness for every person that we end homelessness for.

We're trying to really figure out how to keep people in their homes to prevent homelessness and also to make sure that those that are falling into homelessness get houses as quickly as possible and stay housed because housing isn’t enough. We really focus at Abode on housing sustainability, that short term solutions typically aren't enough, that we really need to think about getting people housed and sustaining that housing with them.

Kate: I'm hearing you focus in on the concept of staying housed, and I know that a lot of your work also really listens to the lived experience of being on that edge. I'm wondering if you can share more about what is working and what is needed when it comes to that?

Vivian: Absolutely. I mean, what is working, is over the past several years, you speak of our partnership with people with lived experience and making decisions about people without people is not okay. Right. So really a focus on including people with lived experience in the decision-making, in the programming, and the policy. As you mentioned when you so kindly introduced me, we do serve about 15,000 folks each year, most of them in housing solutions.

And that gives us a tremendous voice right, to amplify people with lived experience in making sure that they're providing feedback not only on what should be done, but what is being done right. So I think that's what's working. Historically, there's been a paternalism about housing programs, frankly, and there still is, to be quite honest with you.

And that's what's really exciting about one of the partnerships I want to talk to you about today that we’re actually embarking on with Stanford University and the Lab for Economic Opportunities at Notre Dame and that we're really taking a thousand folks who have experienced homelessness already. They're in a program that helps them for a year, two years, depending on the program, and we're trying to attach money with them in a cash transfer or some people call it UBI, Universal Basic Income, but really giving people money in their own hands at the end of that program just to help them sustain housing, post housing programs.

So historically, agencies that work with the government like Abode, we give money to landlords to help pay rent, which is tremendous, right? People can't afford rent in the Bay Area, but this flips it on its side. And instead of giving money to landlords, giving money to people so they can make their own decisions because, fundamentally, people make decisions in the best interest of their family, right? So instead of giving it to landlords and all of the bureaucracy that goes along with that, just give it to people and see what they can do with it. And many Universal Basic Income, Guaranteed Basic Income, and Cash Transfer Programs have shown that people use it for what they need.

People pay for housing, they pay for medications, school supplies, food, and the things that we need to do to survive. And that's a lot of it coming from the voices of the people in our programs, like can you stop doing things for me and just give me money so I can do it myself?

Kate: Abode clearly is going to come to a partnership like this with a set of on-the-ground areas of expertise. Given all that you do and the reach that you have across the Bay Area, and then you're partnering with academic researchers to bring their piece to the table. Can you share more about what it is Abode may gain from that academic side of things joining into this problem-solving effort?

Vivian: We're an agency that really drives solutions to end homelessness. So, you know, we are fundamentally doers, we're practitioners. But it's not enough for us to practice. It's really important to me as a leader in the agency, in the field, to influence the field, right. To actually move us along, to use evidence to support new and better interventions.

And this is specifically a randomized controlled trial. So there are about a thousand households. And so half of them will get the intervention and half of them will not. It's a large enough study that it has a real potential to influence policy. There are lots of pilots out there, great pilots that really help the people in them for guaranteed basic income, universal basic income, cash transfers. But they're usually really, really small. They're not statistically significant enough to really further the field and they don't, they aren’t as trusted as a large-scale study that we can really pick out, how does housing work, period? How does giving more people work, period? But also digging into some of the questions on how race and ethnicity play in the housing market, how age, how family status, because it's a large enough sample size to actually ask those questions.

And absolutely it will help our work. I mean, if I have less work because there aren't as many people to house, fantastic! There's all sorts of social problems that we can solve together.

Kate: Vivian, I'd love it if you could help us understand what it means when we say Housing First?

Vivian: People have been practicing Housing First for 20, 30 years now and Housing First really means that we eliminate any barriers to housing that might not otherwise be imposed on someone who's not homeless. So that means that when I apply for an apartment, they don't ask me if I have an addiction problem. They’re not allowed to ask.

But oftentimes they'll say, have I gone through a program to solve my addiction problem? Right? They don't ask any of that. And when I move into housing as just a renter, they don't say, okay, you need to follow X rules, right? They just remove any barriers. And if you pay your rent on time, if you're a good neighbor, you can live there indefinitely.

So really, that's the core of Housing First. We put people in housing without making them go through 15 other steps before we prove that they're ready for housing. Right? That we put them in housing first and then we provide whatever services they need to sustain housing. For some people, that's just rent, and maybe connection to the local schools or, you know, a resource.

For some people it's full scope really needing to connect with mental health services or other food resources. Oftentimes it's reconnecting people with their informal network, friends and family, and loved ones. But we don't do all that first, as we say, fundamentally, housing ends homelessness. So let's get you housed and then provide the support that we need to keep you housed.

Kate: And as I understand it, it isn't simply just the issue of the housing itself. It's all of the related outcomes for an individual or a family. I'm curious if you can help us understand some of those really critical realms.

Vivian: Housing is health, right? So, as a prime indicator for all of our programs, we look on housing success; how quickly are they getting housed, what type of quality housing and how long they're staying housed. But really, what we also know through the research is people who are housed are more healthy.

They can access doctors, they can access medication, they can more easily get their kids to school, they can more easily get to work. So all of these other economic and health indicators really play into housing and that, through 20 years of research on Housing First, has been proven over and over again.

I really think of it from an ethical standpoint. It's better for everyone, for the community that we serve, for the people who are experiencing homelessness, the neighborhoods that homelessness is happening in, which is more and more. And then, of course, the resources available to all of us if people are inside.

People who are living outside have higher rates of comorbidity. They have higher rates of not only things like depression, but chronic health conditions, diabetes and other conditions that really impact our quality of life.

I talked to lots of colleagues who are in the health field, doctors, and I don't know how many times they told me, I wish I could write a prescription to housing because all of the prescriptions that I'm writing, I know isn't going to be enough because they are back in the ERs, they’re landing back in their offices over and over again because they're living outside.

Kate: It feels like an important moment to reinforce what I've come to understand about you and your role here in this work. It sounds like you've been doing this work for a decade plus—16, 17 years, and that currently at Abode, you're responsible for the design, operation and evaluation of a pretty extensive portfolio of programs for both individuals and families, which, as you use this term “inside”, can mean many things.

It sounds like your programs include permanent supportive housing, rapid rehousing subsidy programs, site-based permanent housing, property management services, clinical and supportive services, as well as the kind of shelter and emergency services type of things (which often is what may be conjured as an image when people think about housing folks who are experiencing homelessness). 

So given all of that, I'm really curious just about you, Vivian, and how you come to this work, the perspective you bring, and how you enter this giant puzzle of really critical importance.

Vivian: You know, I enter into it as uniquely as we all are as humans, right? I mean, and that's sort of the Abode spirit. Like we just really look at the region's housing inequities from every lens, right. From meeting people where they're at on the streets and in shelters to managing and building places they’ll call homes.

And I come to the work specifically as a person who hasn't experienced homelessness, as a person who has extreme privilege in this society, and coming out of a place of curiosity. I just think that we can't rest with what we think has been helpful for years and years.

We always have to look critically at what we're doing and how we're doing it. And, through a quality improvement perspective. And like, okay, is this working for everyone? Is it working for some people? Is it working well enough? Are we targeting deeply enough? Are we targeting too deeply? So all of these questions, I think, for me as a place of someone who just believes in equity, who believes that fundamentally housing should be a human right.

And I just see the amazing resilience of people. People that just have such survival skills. And then I think, well, why do we have to make them be resilient? Right? There's plenty of suffering that everyone has. You know? Why are we putting people through this pain? And only through sort of evidence and research do I feel like we can really push the envelope on policy to change really how we think about people who are suffering.

Kate: Speaking of that, and speaking of evidence and research and circling back to what you've shared with regard to the RCT underway with Notre Dame's Lab for Economic Opportunity and Stanford University as well, I'm curious about the impact this collaboration is really aiming at.

Vivian: What I hypothesize will come of it is that people who receive the cash transfers will show greater housing stability and health outcomes, economic outcomes, and ability to achieve educational and work related goals because the stressors of paying for rent will be reduced. 

This isn't rocket science. People who have more money can afford more rent. I think that people will do better and I think that they'll do better longer even after the cash transfer ends. One of the reasons that we're targeting this set of folks and again, these are people who are leaving the rapid rehousing program because it’s over that’s time limited, and usually rapid rehousing is a model in which the lease is directly with the tenants, with the participants in our programs.

So they're paying for rent and usually they pay more and more rent as the program ends. And at the end, they're paying all of their rent. What that means in the Bay Area is if we're lucky, and I do say if we're lucky, at the end of the program, they're paying about 50% of their income towards rent.

And the sort of affordability rule is 30% of income, right? If you're paying 30% of your income towards rent, you're able to afford it and still buy groceries and do the things that we need in life. So for rapid housing, if you're lucky, 50%. Sometimes it's 80% or 90% of the income is going to rent because that's what we call the high rent burden.

So that's, you know, we hope to move that needle a little bit so that they're not actually having that high rent burden, they don't have that pressure of every time that rent is owed, am I going to lose my housing?

How do we actually amplify our learnings beyond this study? That's the hope and the dream. It'll be great for the 500 households, particularly those that receive the extra support but ultimately I'm hoping that it has an exponential impact on those in the future.

Kate: So, Vivian, with all of what you've shared today and given your years of experience, immersing yourself in this question, what does it take to keep people housed in the Bay Area?

Vivian: So I think that it takes a few things. One, it takes resources, but not as many resources as you might think, right? I think it takes resources like we're talking about, giving people more money or if we want to continue to give it to landlords. We do have housing in the community, but oftentimes our programs put additional barriers to housing them, saying, well, this program, because it's coming from the federal government, can't pay for more than $2,000 rent, whereas they can rent to someone working at Google or Stanford for $3,500.

So if we're going to play in a market-based housing economy, we have to actually provide market-based housing resources. So paying for quality housing for folks, giving people enough income to be able to afford housing and to reduce the stigma that homelessness is often saddled with. 

We have to understand that people are part of communities, and there's a lot of wealth and support that comes from those communities. So shipping people off doesn't work. And we don't want communities that lack diversity in all spheres: age and race and economic diversity. We want really rich communities and to do that, we're going to have to put our money where our mouth is and make sure that we can support people to live in the communities that the market has driven so high that it's really hard to live here.

So I think that's what's going to take.  An open mind, and dollars to make it happen. And following the evidence. I ask folks to really follow the evidence. And Housing First is one of those. The other piece, time and time again: the quality of housing has a direct correlation to the success of people in that housing and the economic mobility of those folks.

So, really: high quality housing that people can stay in and afford creates vibrant, healthy communities where we all want to live. That's what it would take.

Kate: Vivian, thank you so much for your time. It's been such a pleasure to have you here.

Vivian: Thank you so much, Kate. Pleasure's mine. And any time you want to talk more about how to end homelessness, you have my number.

Kate: Thanks for listening to What Would It Take – a conversation series from Stanford Impact Labs. To learn more about Stanford Impact Labs and how we partner with communities to put social science to work for society, please visit impact.stanford.edu.