Establishing health and hygiene standards of care in city-funded shelters in San Francisco

At present in San Francisco, homeless shelters lie outside of city, state, and federal regulations of health and hygiene. This lack of a rudimentary standard is potentially deleterious to the overall health and quality of life of the estimated 1165 nightly shelter residents and estimated 290 shelter staff in the city. A need for legislation that clarifies standards of care in homeless shelters was identified in San Francisco by shelter advocates, the city government-affiliated Shelter Monitoring Committee, along with the Department of Public Health staff. Causal risk factors for ill-health were initially identified by reports from homeless advocate groups, shelter clients, and government sponsored shelter monitoring groups. Individuals at the Department of Public Health subsequently verified these causes of mortality and morbidity though on-site assessments, as well as focus groups with shelter staff. Existing standards of health and hygiene were identified though conference with disparate elements of the Department of Public Health including: environmental health, occupational health and safety and infectious disease. Representatives from the Department of Public Health were then integrated into a consensus-based work group with government agencies, advocate groups, service providers, and shelter residents to assemble the necessary requirements for shelters to be a safe, humane, and healthy environment. By incorporating all the aforementioned involved groups into the formulation of health, operation, and facility standards for all shelters, the ultimate proposed legislation proved agreeable to all parties involved.