Homelessness in San Francisco: Lived Experience and Solutions from the Frontlines

February 13, 2026

Nearly 200 community members gathered at UC Law San Francisco for Homelessness in San Francisco: Lived Experience and Solutions from the Frontlines, a town hall convened by St. Anthony Foundation to foster honest dialogue around dignity, relationship, and long-term care. 

The evening was moderated by Keith Humphreys, Ph.D., Stanford University Professor and former Senior Drug Policy Advisor, with opening remarks from Kunal Modi, Chief of Health & Human Services, City and County of San Francisco. The conversation was rooted in a shared understanding that trust and stability are built over time and require collective responsibility. 

Panelists included:

• Larry Kwan, Chief Executive Officer, St. Anthony Foundation
• Dr. Jim O’Connell, President, Boston Health Care for the Homeless Program
• Daniel Tsai, Director of Public Health, City and County of San Francisco
• Beth Stokes, Chief Executive Officer, Episcopal Community Services
• Kevin Fagan, former San Francisco Chronicle homelessness reporter; author, The Lost and the Found

Beginning with Lived Experience 

The forum opened with Ranjit Brar, a former St. Anthony guest and now Dining Room Volunteer Coordinator. His journey reflects what accompaniment makes possible. Once on the receiving end of care, he now helps welcome volunteers and ensure that thousands of neighbors receive meals with dignity and respect. 

His story grounded the evening in what St. Anthony’s has practiced for 75 years. Transformation happens when people are met with compassion and walked alongside consistently over time. 

Housing Is Essential, but Not Sufficient 

Throughout the discussion, panelists emphasized the complexity of homelessness and the limits of single-solution thinking. 

Kunal Modi stated clearly, “Housing is essential. But when the door closes, the real work begins.” 

Housing is a critical milestone. Yet many individuals moving into supportive housing are living with serious medical and behavioral health conditions. Stabilization, recovery, and rebuilding trust require sustained care and coordination across systems. 

Daniel Tsai, Director of Public Health, City and County of San Francisco reflected on that systems challenge, noting, “We have incredible resources here, but they don’t always function as a seamless system of care.” 

San Francisco has strong programs and deep expertise. The ongoing work lies in aligning those programs so individuals can move through care effectively, particularly when they are ready for treatment or additional support. 

The Human Reality Behind the Headlines 

Journalist Kevin Fagan, who spent decades reporting on homelessness, offered a perspective that resonated deeply with the audience. 

“No one really wants to be homeless,” he said. 

He continued, “Inside every single homeless person you see is the child that had all the hope in the world.” 

These reflections echo St. Anthony’s Franciscan belief in the dignity of every person. Behind statistics and policy debates are human beings carrying trauma, loss, resilience, and inherent dignity. 

Dr. Jim O’Connell of Boston Health Care for the Homeless Program underscored the medical realities. Mortality rates among people experiencing homelessness remain alarmingly high. Complex health conditions, mental illness, substance use disorders, and untreated trauma intersect in ways that require integrated, long-term care. 

The panel acknowledged the difficulty of the work and the need for humility. No single organization or agency has all the answers. 

Compassion and Accountability 

In a climate where frustration around visible homelessness is rising, the forum addressed how leaders balance compassion with expectations. 

The conversation made clear that compassion and accountability are not mutually exclusive. Effective responses require both. They require policies that uphold dignity while creating pathways to recovery and stability. 

Dr. Larry Kwan grounded the discussion in St. Anthony’s tradition of accompaniment. Trust and stability are built through relationship, consistency, and presence. Lasting solutions require time. 

The Work Continues 

For 75 years, St. Anthony Foundation has stood in solidarity with neighbors experiencing homelessness, poverty, or addiction. Each day, more than 2,500 meals are served in the Dining Room. Medical care is provided to those who need it most. Clothing, recovery support, job training, and community are offered through a model rooted in dignity and long-term relationship. 

The challenges discussed at the town hall were complex. The need for sustained commitment was clear. So was the importance of collective responsibility across sectors. 

Watch the full recording of the town hall here.

St. Anthony’s continues this work every day in the Tenderloin, grounded in our Franciscan tradition of accompaniment and belief in the inherent worth of every person we walk alongside every day. Join us in that work and make a gift today.