San Francisco supervisors probe gaps in housing, care and training for LGBT seniors

Supervisors and dozens of residents told the Government Audit and Oversight Committee on Thursday that lesbian, gay, bisexual and transgender seniors in San Francisco are at growing risk of losing housing, access to culturally competent medical and long‑term care, and the social supports that allow them to age in place.

The hearing, called "to explore the needs of lesbian, gay, bisexual, and transgender seniors," featured city officials and community providers who urged the board to convert the discussion into an action plan that addresses affordable housing, coordinated services and mandatory cultural‑competency training for city contractors and long‑term care facilities.

Supervisor David Campos opened the hearing by saying the discussion was only a beginning and by citing an estimate that "there are about 25,000 LGBT people who are 60 years of age or older" in San Francisco, a cohort that he and other speakers said will grow as baby boomers age. Anne Hinton, executive director of the Department of Aging and Adult Services, described the department’s work to fund targeted programs and the Alzheimer’s strategic plan and said city planning, contracts and program design can affect seniors’ ability to remain independent.

Seth Kilborn, executive director of Open House, told the panel that Open House provides case management and social programs to hundreds of LGBT seniors and is developing 110 units of affordable senior housing at 55 Laguna Street. "Our ability...to get from lines on a paper to a shovel in the ground will depend entirely on the city's decision to prioritize this critical project," Kilborn said, noting uncertainty from federal and redevelopment funding losses.

Daniel Redmond of the National Center for Lesbian Rights described documented incidents of mistreatment in long‑term care — including staff refusing care or using residents’ birth names against their wishes — and cited a study he said found that "80 percent of LGBT elders...would not feel safe to be out in a nursing home." He and other witnesses urged the city to expand monitoring of facilities, coordinate outreach so elders know their rights, and consider a kinship registry to protect visitation and decision‑making for families of choice.

Multiple public commenters recounted personal experiences of discrimination in SROs and nursing homes, warned that Ellis Act evictions and TIC conversions are pushing seniors out of the city, and asked the board to restore or reallocate funds to housing modification and eviction‑prevention programs. Speakers from the Institute on Aging, Transgender Law Center, AIDS Housing Alliance and other organizations emphasized that transgender elders, seniors living with HIV and low‑income LGBT people face layered risks and often avoid care because of fear of mistreatment.

On the question of training, the Department of Public Health said cultural‑competency requirements are included in some contracts and are monitored by contract compliance units, but several supervisors and advocates argued that voluntary training is insufficient. "We should actually require people to provide that [training] if they're going to get city funding," Supervisor Campos said during the exchange.

Speakers identified near‑term actions they want the city to pursue: prioritize funding for the 55 Laguna project and other affordable units, expand and require cultural‑competency training for city‑funded facilities (including paramedics and long‑term care staff), reestablish small housing‑modification funds to help elders age in place, improve data collection on LGBT seniors, and form a working group or task force to move recommendations from reports into implementation. Several organizations offered to participate in a coordinated planning effort and to supply client‑satisfaction measures or training curricula.

The committee took the procedural step of continuing the call to the chair to schedule follow‑up work and adjourned after public comment concluded. Members said next steps would include determining budget implications during the city's budget cycle and discussing a possible working group to translate findings into an implementation plan.

The hearing produced multiple concrete proposals (mandatory training for contractors, a kinship registry, a prioritized funding track for 55 Laguna, and reestablishing modest housing modification/eviction‑prevention funds) but did not result in immediate legislation; supervisors and stakeholders left the meeting with a commitment to return with a work plan and budget options.