Mayor Mark Farrell May 29, 2018

City Hall, Room 200

1 Dr. Carlton B. Goodlett Place
San Francisco, CA 94102

Dear Mayor Farrell,

As you approach the conclusion of your tenure as mayor of San Francisco, we, the undersigned,
thank you for your service and your commitment to our city.

In these final days, we ask you to make an administrative policy change that will have lasting
impact on the lives and futures of some of the poorest of the poor in our city. By improving their
lives, you will improve the social fabric of our city for all of us.

San Francisco has a largely invisible homeless population—pregnant women. And because of a
gap in San Francisco’s emergency housing policy those women are frequently homeless
throughout pregnancy.

More than one woman has given birth on our streets in San Francisco, other pregnant women are
living in tent encampments. Many are sleeping in cars, even doorways.

For the first four and half months of 2018, Homeless Prenatal Program has seen 229 pregnant
homeless women. In the last two months, Catholic Charities outreach case workers at Access
Point in the Bayview saw 25 homeless pregnant women living in their cars, on the streets, and in
encampments. The Gabriel Project, a Roman Catholic outreach to pregnant women, almost
solely serves homeless women in San Francisco.

Each of those unborn children is at risk if they don’t get the care in that first trimester. All
homeless pregnant mothers are “high risk” for preterm birth, for miscarriage, for developmental
delays or other physical problems in their children if they don’t get good care early in pregnancy.

Yet San Francisco’s Department of Homelessness and Supportive Housing only qualifies
pregnant women for family shelter before the third trimester if they are shown to be medically at
risk, with certification. Few qualify, according to the Coalition on Homelessness and the
Homeless Prenatal Program.

And qualifying for shelter may still mean a wait of an average of 121 days which would mean
AFTER the baby is born, according to the Coalition on Homelessness.

Instead, the city says those women can either line up daily for a spot in single adult shelters,
sleeping on a mat in a large congregate setting, which also has long waits and no specialized
care for pregnant women—or they can stay on the streets.

We are asking the city to change the way it classifies pregnant women so that they can qualify
for family shelter in their first trimester.
The earlier a pregnant woman gets prenatal care, the healthier her baby will be. Most housed
women know this and run to the doctor's office as soon as they get a positive pregnancy test.
Why don't we insist on the same opportunity for homeless expectant mothers? By the third
trimester the major organs – heart, lungs, brain, etc. have already been formed. Babies born to
homeless women deserve to be born as healthy as possible and a stable place to rest is a
prerequisite for that opportunity.

We can help make this happen.

Those expectant mothers need healthcare, and they also need a safe and secure place to rest, to
sleep, to nourish themselves and their unborn child. If not, they are at risk of miscarriage, pre-
term labor and a host of other risks that will have real negative impacts on the child’s
opportunity to thrive and succeed in school and in life.

A recent study has shown the rates of miscarriage and preterm birth are high among women in
these situations, unsurprisingly. The 2017 report, “Housing, Pregnancy & Preterm Birth in San
Francisco: A community-academic partnership for research, policy & practice,” was conducted
under the auspices of San Francisco State University and with the UCSF Preterm Birth Initiative,
Benioff Community Innovators, and other partners. It found a pregnant woman’s health is
undermined by housing loss, multiple moves and fear and stress of eviction. In addition, the
study found the women experience extreme stress that damages their health, well-being and the
health of their babies.

Attached are two documents that explain the Department of Homelessness and Supportive
Housing policy:
1. The December 2017 minutes of the Local Homeless Coordinating Board in which an
official states that women in their third trimester qualify for family housing but before
that qualify for adult shelter system (pages 9-11, with additional comments by the
Coalition on Homelessness executive director on page 12)
2. The San Francisco Homeless Family Triage Process sheet dated Feb. 15, 2017 which
states one characteristic to qualify for family housing is “… one or more adults in
household with a person who is in third trimester or high risk 5+ month pregnancy.”

We are asking the city of San Francisco to think about the future and take care of homeless
pregnant women and their unborn children. They are worth our investment in their lives and their
futures.

There is much more to be done, but allowing homeless pregnant women to qualify for the list for
family housing in their first trimester--a simple change to a city policy--is a good start.

We would like to meet at your earliest convenience. Someone will contact you or you can reach
Martha Ryan, executive director and founder of Homeless Prenatal Program at 415-875-7320 or
email martharyan@homelessprenatal.org.

Sincerely,
Abu Qadir Al-Amin Jennifer Friedenbach
Imam Executive Director
SF Muslim Community Center SF Coalition on Homelessness

Marsha Attie His Eminence Metropolitan Gerasimos

Cantor Greek Orthodox Metropolis of San Francisco
Congregation Emanu-El
Deacon Michael Ghiorso
Rabbi Ryan Bauer Director
Congregation Emanu-El Permanent Diaconate Ministry and Life
Archdiocese of San Francisco
Rev. Greg Bonfiglio, SJ
Pastor The Rev. Mary Carter Greene
St. Ignatius Church Director of Children, Youth and Family
Ministry
The Rev. Dr. Ellen Clark-King Grace Cathedral
Executive Pastor and Canon for Social Justice
Grace Cathedral Diane Gutierrez
Gabriel Project Angel
Archbishop Salvatore J. Cordileone St. Ignatius Church
Archdiocese of San Francisco
Deacon Eddy Gutierrez
Kelley Cutler St. Ignatius Church
Local Homeless Coordinating Board
Ellen Hammerle
Deacon Rory Desmond Division Director
Archdiocese of San Francisco Homelessness and Housing Services
St. Stephen Parish Catholic Charities

Jane Ferguson Flout, D.Min. Janet Healy

Director Coordinator
Strategic and Community Partnerships SF Gabriel Project
Catholic Charities
The Rev. Mark W. Holmerud
Rev. Paul J. Fitzgerald, S.J. Bishop
President Sierra Pacific Synod,
University of San Francisco Evangelical Lutheran Church in America

Kathy Folan Father Michael Hurley, OP

Director of Family and Youth Ministries Pastor
St. Dominic’s Catholic Church St. Dominic’s Catholic Church
Bishop Emeritus William Justice
Archdiocese of San Francisco
Rev. Ronald Kobata
Resident Minister
Buddhist Church of San Francisco
Martha Ryan
Founder and Executive Director
Homeless Prenatal Program
Deacon Christoph Sandoval
Cathedral of St. Mary of the Assumption

R Arik Luck Valerie Schmalz

Ben and A. Jess Shenson Cantor Director
Congregation Emanu-El Office of Human Life & Dignity
Archdiocese of San Francisco
Dolores Meehan
Co-Chair Rabbi Jonathan Singer
Walk for Life West Coast Senior Rabbi
Congregation Emanu-El
Lorena Melgarejo
Executive Director Rabbi Beth Singer
Faith in Action Bay Area Richard and Rhoda Goldman Senior Rabbi
Congregation Emanu-El
Jilma Meneses
Chief Executive Officer Joe Wilson
Catholic Charities of San Francisco, Marin Executive Director
and San Mateo Counties Hospitality House

Rabbi Sydney Mintz

Congregation Emanu-El

Eva Muntean
Co-Chair
Walk for Life West Coast

Nancy Nielsen, Deputy Director

Lutheran Social Services

Michael G. Pappas, M.Div.

Executive Director
San Francisco Interfaith Council

Mario Paz
Executive Director
Good Samaritan Family Resource Center