​​​​Our History and Mission

The Shelter Clinic was formed in 1991 by a group of UCSF medical students who recognized the unmet health needs of people experiencing homelessness in San Francisco. The students established a partnership between UCSF and the San Francisco Department of Public Health to provide health care to people staying at the Multi-Service Center South homeless shelter.

     For nearly 30 years, the Shelter Clinic has delivered urgent health care and referral services to shelter residents. In addition to our original biweekly General Clinic, we have increased the scope of our services to include Dermatology, Ophthalmology, Pharmacy, and Dental clinics, as well as Women’s Support, Women’s Health, and Men’s Support groups. In addition to our service mission, we are dedicated to educating a new generation of healthcare providers about the medical needs of homeless people. We currently accept student volunteers from UCSF schools of Medicine, Nursing, Pharmacy, and Dentistry as well as undergraduates from the University of San Francisco.We offer a Fall elective which teaches students about the socioeconomic roots of homelessness, relevant policies and interventions, the unique medical needs of this population and the hands-on skills needed in our clinic. Homelessness is a prominent part of life in San Francisco so it is critical that healthcare providers are well trained to provide high-level care to this population.

Finally, we recognize that homelessness is the manifestation of widespread political and economic dysfunction that will not be solved by medical intervention alone. We introduced a new Advocacy Director position into our leadership board to support policies that benefit our patients.

 

What is MSC-South?

The Multi-Service Center South is Northern California’s largest shelter for individuals experiencing houselessness. The shelter is located in the SoMA district of San Francisco at 5th St. & Bryant. The MSC-South provides food, shelter, and other services to approximately 45 women and 335 men each night, while also providing drop-in services to another 70 individuals a day

Multi-Service Center : South - Website Link

Address: 525 5th St (at Bryant St.) San Francisco, CA 94107

 

Homelessness in San Francisco

     Homelessness in San Francisco is very common, very harsh and is rapidly getting more severe. According to the US Department of Housing and Urban Development’s 2019 point-in-time count there are over 8,000 people living on the street or in shelters in San Francisco. This is a 17% increase from 2017. On the other side of the Bay, Alameda County also counted over 8,000 people experiencing homelessness, which marks a 43% increase since 2017.

     While Los Angeles and New York have larger total numbers, San Francisco has the highest rate of homelessness of any American city. Homelessness in San Francisco is not only very common, it is exceptionally brutal. Efforts to “fix the homeless problem” often rely on police intervention or strategic denial of basic services. After noting the lack of access to water, toilets and sanitation in Bay Area encampments, United Nations Special Rapporteur Leilani Farha said,"The idea that a government would deny people those services when they have nowhere else to go suggests a kind of cruelty that is unsurpassed. It's an attempt to erase people. Worse than erase — I can only use the word annihilate. It is a denial of someone's humanity."

Health Consequences of Homelessness

     People experiencing homelessness have higher rates of acute and chronic illnesses than the housed population (Schanzer et al., 2006 Brown et al., 2017).Their average life expectancy is approximately 25 years less than those in stable housing (ARS, 2017). Management of acute and chronic conditions in the homeless population is complicated by lack of secure storage for medications, unstable access to nutritious food, inability to get adequate rest, chronic exposure to stress, trauma and violence, harassment by police, increased substance and drug use, and lack of medical insurance and access to primary care services (Katz et al., 2017). The high cost and complexity of our safety net and health system encourages homeless people to rely on emergency services for all medical care, which generally leads to poor disease management and increased morbidity and mortality rates (Ku et al., 2010).

The Causes of Homelessness (CSAC, 2016, Gaetz, et al., 2013)

  1. poverty from lack of living-wage job opportunities and unemployment
  2. critical shortage of affordable, safe, and stable housing,
  3. racial discrimination, increased criminalization, and mass incarceration that impede access to employment, healthcare, and housing,
  4. inadequate state support for mental health and substance abuse treatment services,
  5. insufficient safety net services
  6. personal crisis  

The California Housing Crisis

California has the most expensive housing market in the United States, with one in three Californians paying more than 50% of their income on housing (CAHCD, 2017). Additionally, California poverty rate (16.4%) and unemployment rate (5.5%) are above the national averages of 14.5% and 4.9%, respectively (CSAC, 2016). The growing discordance between California’s high housing costs and low minimum wage is especially burdensome for low-income and vulnerable populations who may experience other compounding barriers to housing stability (CAHCD, 2017).

 

UCSF Shelter Clinic 1991