Haven for Hope CEO Discusses San Antonio's Response to Rising Homelessness

Welcome to Big City, Small Town, the weekly podcast all about San Antonio and the people who make it go and grow. I'm your host, Bob Rivard, and this week's guest is Rhonda Munhenk, who is the president and CEO of the Haven for Hope. Rhonda, welcome to the podcast. Thank you, Bob. Happy to be here. And welcome to San antonio because you're 10 months into your position at the Haven for Hope and your arrival in San Antonio from Austin, and we're happy to have you here. Thank you. I'm delighted to be here. What have you found so far? Tell us all about it. Good breakfast tacos. That's a great start. Particularly lots of rain, which I understand is unseasonable. I had a great, great basketball team, so it's a good time. Are you a Spurs fan? I am. Well, coming from Austin, you might have been a Spurs fan. Yes. Where were you before Austin? Rhonda, tell us a little bit about your yourself and your life and what, what formed you and led you into the work you're in today. Yeah, great question. So I grew up overseas. I was born in Vietnam. I was raised in Papua New guinea, which is the island above Australia in the South Pacific. My father is a linguist, so that is the most linguistically diverse place in the world. So that's how we ended up there. And I grew up in a subsistence village 5,000ft up in the mountains. No power, no running water. I had to engineer all of those systems. So very, very different way to grow up. And very impactful, I think, in terms AM today. Came back to, well, went to high school in Penang, Malaysia, and then came back to the States for college in Santa Barbara, then went to law school in Chicago. Chicago stuck, which surprised me because initially I did not care for the weather. But I stayed in Chicago about 13 years, developed my career there, went straight into health care from law school, was in all manner of health care. So just about everything that you can think about in healthcare. I probably done and moved from Chicago for a job in Austin, Texas, at a large federally qualified health center, which is a big part of the safety net system that the United States has, and stayed in Austin again for another 13 years and then had the opportunity to come down to San Antonio. And in between the FQHC and San Antonio, I did a stint in healthcare startups, which was very interesting work. That's an incredible resume and global path. You're a world citizen. Yeah. And one with deep Asian roots. Really interesting that our former mayor, Ron Nirenberg, has Malaysian roots too, in his family. I don't know if the two of you have had a chance to compare nose. No, have not yet. He'll be our next amazing. He'll be our next county judge. And maybe you can use that to get a boost in your budget from them. I will certainly do that. Maybe I will take him some good Malaysian food. Well, your background though, is not in homeless services per se, it's more in healthcare. So that's an interesting transition. And I wonder, number one, how the people looking for Kim Jeffries successor found you and number two, how you were drawn out of healthcare into your current position. Yes, that's an interesting story and has a lot of serendipity in it. So I was working for startups, as I mentioned, I was working for a startup called Harbor Health. It is a really innovative insurance product. So an insurance company paired with a clinical delivery system out of Austin, Texas. And so it was the last thing I sort of really wanted to learn in healthcare was the insurance side of the equation, the reimbursement side. And I hadn't had an opportunity to do that. And I was approached by the individuals who were starting the company to be their inaugural chief operations officer. And I decided that was my chance to do that. Healthcare startups tend to go in equity cycles, so you have decisions to make every call it three to five years around whether or not you're going to stay and do a new round of equity or whether you're going to exit the company at that point. And so I had gotten to the stage where I thought I wanted to exit the company at that point in time. I had learned what I wanted to learn on the insurance side. We had just launched our first insurance product. Very proud of that company and very proud of the work that they're doing. So but it was time for me to think about sort of what was next to do. And in that deliberation, I received a call from a recruiter who normally wouldn't have had the impact that she had on me, but she had approached me with the job five years earlier, which was during COVID And so I was familiar with Haven for Hope. I had researched it, I had researched the position and was interested, but just knew that it wasn't the right time. Healthcare executives scampering off during COVID like not a good idea at the end of the day. And so it was something that I elected not to pursue at that point. But it was always there in the back of my mind as a thought or as something that had sort of passed me by that I didn't get a full opportunity to explore. And so it was the right moment. I was able to come down and meet the board of directors and everything else. Everything just sort of clicked, and all the arrows started pointing in the direction of San Antonio. And it's really the way I live my life. I feel like things are moving in a direction and everything's aligning. Then I think that's the next thing for me to do. So that's how I got here. Well, that's great. We could do a whole program on insurance and reimbursements, but we won't go there because we're here to talk about something else. And you do have, by the way, a formidable board. Yes. Incredible leadership. I was reacquainting myself with that this morning just to see who serving. And it's a very strong board and a strong backup of a board of community advisors that you have. You know, we spend more money and attention, in my opinion, in San Antonio than almost any other major city and sort of comprehensively addressing homelessness and as a condition as opposed to a problem. The Haven for Hope is a network of nonprofits that are all part of your campus. It's very comprehensive. And yet any survey of community people, city council surveys, whatever, people always put homelessness up at the top of their concerns, along with crime and streets and sidewalks. And I just wonder how you deal with that sort of contradiction. That on the one hand, we seem to be investing more energy resources and money than many other cities to take a more comprehensive approach to addressing the issue. And at the same time, people seem to be unhappy about it and concerned about it in every corner. Yeah, there's a lot wrapped up in that one, I think goes to the first point that you made, which is when you think about homelessness as a condition versus a problem, a condition is something that is so. At least that's the distinction in my mind. It is. And it is at a certain level. Sometimes conditions can rise to the level where they become very apparent to sort of the general public, and they start to become perceived as a problem as opposed to a condition. And I think this is where homelessness has sort of landed, not only here in San Antonio, but sort of across the United States. There's a lot of reasons for that. There's been a dramatic increase. There's been a spike in homeless populations across the nation for several years straight now, with people are estimating sort of a slight decline or holding steady here in 2025. But it's on an Upward trend. And then obviously the second issue is that many cities have chosen to deal or not deal with this problem. And if you choose not to deal with this problem, then you get a very visible, very evident population in particular areas of your city that then citizens, everyday citizens start to point to and say, you know, there's the issue. So I think there's two things. Yeah, there's an increase that's occurred over the point of the past several years. And then there's been several cities that have elected to do not much about people who are living, particularly people who are living unhoused. So living on the streets, obviously visible to the general citizenry. And those folks have really raised the profile of this issue with individuals changing it from a condition to a problem. So you haven't been here quite a year yet, but how do you assess things on the ground in San Antonio compared to what your observations were when you took the job? Is it a situation that's under control, getting better, getting worse, population growing? How do you see, I don't know, the distinction between the services we offer and the community need that's out there? That's a great question. So when you talk about the population in general, the way that we account for a city or a metro area's population in general is sort of on one single night, volunteers go out and they count the number of people they can find. So it's a snapshot, it's a point in time which makes sort of year over year comparison can be challenging. But what we know about that snapshot is that homelessness has been increasing in San Antonio. And in particular, unsheltered homelessness or people who are living on the streets has also been increasing over this time, making it obviously a far more prevalent issue for the general citizenry. So the question is, why is that occurring? And I think you have to back it into what are the larger sort of confluence of economic events that's causing that to occur. And the biggest story is that economic vulnerability, low income families are increasingly becoming economically vulnerable to homelessness. And the vast majority of people that you see come through the homelessness system are going to be those people who are economically vulnerable. What does that mean? That simply means that you are living with such a narrow margin in terms of your savings or whatever, all else, that one calamitous event sort of pushes you over the edge and into homelessness. And so the underlying story of all of this, if there is one underlying story, is poverty. And we know in San Antonio that almost one in five of our neighbors are living below the federal poverty level. So there's particular vulnerability with this population. And then you have a number of economic influences that are making it harder and harder for those families to make ends meet. It can be overwhelming when you think about the situation getting worse for so many people that are living below the poverty line. And I think many people have a stereotype of a homeless person as somebody that's mentally meal or has addiction issues, is pushing a grocery cart around a center city block. But the fact is, the vast majority of the people that you're dealing with are people that want to be housed and should be housed, and they're just facing daunting economic and social circumstances. That's two completely different populations. So on the one hand, you have more people demanding or needing your services that if they avail themselves of them, and they will, they can be on a path back toward a more stable living environment. And then you have that hardcore smaller population. But it's the most visible part of the population, perhaps the kind of population that gets people politically agitated the most that we see in these surveys and so forth. So how do you divide up your approach to those two very different populations? Great question. I can speak to. I know your readers can't see it, but you have an executive summary of the Blueprint for Hope there. What it does is it is a 15 year study of the work that Haven has done since inception with this population in San Antonio over the course of that 15 years of the organization's history. So what is different about this? It's not a snapshot in time. This is a longitudinal look at a population in the sixth largest city in the United States. That makes it important. What the blueprint discovered, with respect to the question that you asked, are two distinct groups. One, are these sort of economically vulnerable people? It's about 2/3 of the folks who came through Haven one time during the organization's 15 year tenure. And for those people, those 2/3 of people who came through the system one time and one time only stayed for about 90 days, they exit the system, they don't ever come back to Haven, and they don't come back anywhere else to any of the other members of the continuum in the San Antonio metro area. So effectively, what can we say with that population? We can say that their homelessness was resolved, they have gone on. And this is something in their review mirror with respect to then the third that remain. Again, the interesting thing about those individuals over that 15 year period is they again subdivide into two groups. There's a Group that come twice to Haven and then they too disappear into the ether and you don't hear from them again at Haven and you don't hear from them again throughout the homelessness system. So that's somebody who had to take a couple of tries at it, but then was able to gain their feet and move out back into the community, hopefully reunification with family, all the things that we look for at Haven. So then you have the last half of those 9,000 people in the 15 years, or think about it as about 600 people a year. Those are the folks that you're the chronically homeless folks. They have a much higher degree of recidivism. They're coming back to the system about every year and four months. So a much more volatile cycle, not really able to establish themselves in the community and maintain housing and continuously turning back, not surprisingly, far more likely to have substance use related issues, behavioral health conditions and disability as factors that they need to overcome. And so for these individuals, as a person that comes out of health care, we understand that there's a completely different set of services that need to be wrapped around those individuals in order for them to be successful. Would you agree that that's where our city has a resource deficit in terms of short term, not just beds, but people should realize that along with those beds come a lot of expensive wraparound services, therapists, prescription medications that are needed, all kinds of things that need to either be in place or you're not going to be able to help those people. And even then helping them is a challenge. And there's some people that think the police should just be responding, that put them in jail, whatever. What do you think that we need the most in a city that we lack right now in terms of resources to address that, you know, helping that population? Yeah, thanks for the question. So law enforcement is always one policy solution that people grab for. And the simple question that I'd ask this audience is do we treat any other disease by calling law enforcement? Because if we don't, you're not going to treat the root causes of what puts somebody in that position that we all desperately want them not to be in and to be doing something else at the end of the day. So I mean, the answer for conditions and diseases is treatment. And to your point, we've struggled with this population and there's two primary reasons for that. The first is typically there are over half are uninsured. So there's no payer, there's nobody that's going to pay for those services that these individuals need. So that's the first thing. There needs to be a reimbursement mechanism. That was one of the reasons why I wanted to do my last healthcare startup job, was really to understand that sometimes you have to reset or re engage the reimbursement mechanism in order to get the thing that you want in healthcare services. And this is very much one, number one, a reimbursement problem. There needs to be a reimbursement for these services. The second issue is then once you have reimbursement, it needs to be adequate enough to encourage healthcare institutions to develop the types of services that these individuals need. And then there probably needs to be some healthcare policy reform in terms of things that can be reimbursed under your sort of government payers that these individuals need. There's something less than hospitalization and more than just I'm hanging out in a shelter or at home and I can access healthcare services as needed. That's called outpatient or ambulatory as opposed to inpatient. There's levels in between this that are definitely needed for this population that aren't well understood, that aren't well reimbursed and that require development. Defining when you talk about reimbursements for a population that's basically uninsured, are we talking about Medicaid spending and the issue of how the state of Texas declines to take the full portfolio of federal funding that it qualifies for because it doesn't want to put matching state dollars into it? That's part of it, right? Is that the Medicaid program is smaller in Texas than it is in other states, have obviously expanded Medicaid. There is a little bit of a silver lining here in that if you think about this population, many of the conditions that they suffer from, sort of the severe mental illnesses and disability, there are pathways through both Medicaid and Medicare that can get these people health insurance. The process is arduous. And so some of the things that would be nice from a policy based perspective is being able to streamline some of these applications and be able to turn them over more quickly so that these individuals could actually receive the benefits that frankly, because of their diagnoses and conditions, they're entitled to. But the process of obtaining them can be very difficult, particularly when somebody's had a very fragmented history and past and you're trying to dig up all the medical evidence that you need to substantiate and support your application. So speaking of reimbursements, let's talk about your budget just a little bit, which off Camera, you told me is about $30 million a year now. That's correct. And we were talking about the fact that earlier in the 15 year progression of the Haven for Hope, there was a larger percentage of private dollars, particularly thanks to Bill Greehey and Valero and his vision. But now it has come over to where I think it's a healthier 60% public funding, 40% philanthropic private sector funding. What do you worry about? Given the Trump administration's continuing effort to cut social spending and we now have both in Bexar county and the city of San Antonio, we have local government facing budget deficits. They're, they're debating tax increases versus a cut in services. So are you in a vulnerable moment right now? I think any social service organization is in a vulnerable moment when you are cobbling together really your business model from multiple different funding streams that are all under duress for various reasons. You have to be concerned about how you're going to put it all together. Almost every social service organization, if you think about sort of the component revenue structure, it's a patchwork quilt and it really is. You're trying to find, oh, I need a star for this particular part of the quilt or oh, I need a square to match the pattern here. And so it all works as currently set. But if that quilt is upset and you haven't sewed all the pieces together, then you need to sort of re establish where all of those patterns are going to go. You sometimes need to shift one program to another, what it is that you're going to do. And in a worst case scenario, in order to survive, you're going to need to eliminate surfaces. So I think all social service organizations are in what I would call a very dynamic policy environment and now obviously a very dynamic economic environment as well. And so all of these things sort of come together to forge markets of poor uncertainty. And anything else where you're trying to be planful and trying to figure out where you need to go and what you need to do. Uncertainty is a major problem right now. I want to ask you after 10 months what your thoughts are about your campus. And maybe you can describe that for people that have never been over there. But you're on the near west side. And the Haven for Hope is a multi acre campus that not only encompasses your direct organization, but all of your partner organizations. And on the one hand that creates a economy of scale, I would say, having everybody working together and also just a more efficient and productive way of approaching services. On the other hand, when you look at The Bexar County Jail complex and all of the associated bail bond activity, and you look at the Haven for Hope and the underutilized Cattleman Square. People on the west side that are interested in economic and social development over there say that it's all serving to block them from the kind of increased prosperity that the south and east side and of course the north side enjoy with their connections to downtown. So tell me what your thoughts are about the campus, good and bad, after working there for a period of time. The good thing about the campus is it's adjacent to downtown. If the desire is really to develop strongly the downtown corridor, then this is proximate to the downtown corridor in a manner that people can take advantage of and have access to. So I think that's important. I think the second thing is that because of the intersection of sector work that Haven does, so Bexar County Jail incarceration, obviously either can precipitate homelessness, or after one is released and has a record, can create homelessness. There's causal pathways between being justice involved and homelessness. And again, having a program that's able to interact with Bexar County Jail in that regard is certainly helpful to help people transition back to communities. So I think when you look at these big sector movements and interventions, when you look at EMS utilization and you look at having one place where people can be assessed before they're sent by ambulance to emergency rooms, there's a major contribution of savings to the healthcare system by having a campus where people can be located and have that initial triage done on campus and the like. So I think when you think about these things, sector level interventions, it's very helpful to have a campus and it's very helpful to have a group of people who you can find. That's the other thing. When you're dealing with problems related to unhoused individuals, your ability to solve a problem is one day, unless they have a roof over their heads. That consolidation does create economies of scale. It's much more difficult to fund continuously scattered site developments because obviously you spend a lot of your time traveling potentially to those different locations and creating sort of outcrops of services. So consolidating services allows you to serve a much greater group of people. Now, we certainly understand that for some of our neighbors, the surrounding milieu of unhoused folks creates problems for the community. And, you know, we understand that we spend time with the neighborhood associations ensuring that we're doing what we can. Obviously, haven isn't the only precipitator of those issues, you have all of the major publicly available substance use and behavioral health treatment services, again, immediately located within that area. So there are a number of things that create sort of an outflow of individuals to these streets. We're working with the Cattlemen Square group that's looking to develop things, redevelop things to decrease the number of individuals who are using public areas and areas not fit for human habitation in the Cattleman Square area to live. So there's a big effort, joint effort going on between all of the continuum of Care organizations led by Close to Home alongside that development. And I think that's the way that these things should be thought about. We've had the leadership of Close to Home on the podcast, and we've had the leadership of Corazon Ministries. So there is a homeless services ecosystem that's developed over the 15 years along with the Haven for Hope, and it seems to be working in concert these days, in my view, compared to past years. But how do you describe that ecosystem and how do you interact with these other groups? And, you know, when we talk about some of the issues, the campus issues that you just articulated, it isn't all the Haven for Hope. There's other entities that are operating in the same sphere as you are. Yeah, absolutely. I mean, homelessness is a complex problem. It's not going to be solved by one organization. So the continuum is really necessary because it pulls in all parties that sort of have a role within the system, and it allows us to dialogue with each other and figure out what the best course forward is. So there's a lot more coordination that you're seeing coming from that continuum of care. In terms of policymakers, there's a lot more conversation between the policymakers to align their plans. So there really is a concerted effort to drive towards the same outcomes and good outcomes within the community. As a newcomer, I don't know how long that has been functioning vis a vis less functional space that you described, but for as long as I've been here, it is a very good mechanism of sharing what people are planning to do and then also trying to align resources with needed services. And that's really a critical piece of this, is you have to understand what resources you need in order to be able to address the population that you're caring for. One of the new things that we're really working on at Haven is really trying to understand that calibration of services to what it is that people need in healthcare, we would call that utilization. So, for example, when a hospital goes through planning A hospital would say, well, we need a cath lab and we need X number of cardiologists and we need X number of. And they're looking at a huge area and they're basically describing the services that are needed to match the population. So I think there's also really a concerted effort to understand services and their utilization better by the different subgroups that utilize the system. So you mentioned the chronically homeless. They're going to have a completely different set of services that are needed than somebody who's economically vulnerable. And everybody's sort of cuing in on that and thinking about how can my organization add to that understanding? Because once you calibrate your systems to your population and their utilization, that's how you get the most efficient continuum of care. So I would say that there's still, all of that is still being learned. We understand best the different types of housing that are needed for the population. And that's certainly something that at the planning level is articulated. So you must hear a lot from economically vulnerable clients, as opposed to the hardcore homeless, of how much the housing crisis has contributed to their current circumstances. I know that you aren't involved in permanent supportive housing or affordable housing, but we're nearing the end of a cycle of $150 million bond that the city voters passed in 2022 to support more housing initiatives. And is that what you're generally. If you take economically vulnerable population that you're trying to get back into housing, get back on their feet. Is the cost of housing the number one issue that they're facing? Absolutely. So if you think about a low income household, and there are varying degrees of low income household that we should talk about here. But if you think about moderate to low income households, the number one expenditure in a month is going to be their rent. So housing immediately jumps to the top of the list as you talk about what is it that's squeezing moderate to low income families? Any sort of change in housing market conditions that produces an outcome where minimum rents are more than people can afford precipitates homelessness. Anything less than that that squeezes them creates a real scramble around how they're going to spend their resources. So when you think about affordable housing, you think about it at different levels of income. And you know, San Antonio has been very successful at sort of that workforce mid range development that's been. They've exceeded their plans for the number of units that are required there. I think it's something just over 1,700 units that they were trying to produce in the last bond and they've done that. What does that say? It says that the economic deals that can be struck are right in that range of sort of workforce development housing. When you get below workforce development housing to people who are 30% of AMI or below that area is really, really challenging for developers. And why is that? It's because they have so little that they can put on the table to actually fund their rent. So there's two things that have to happen there. You have to come in with capital subsidy to get the developments built, but then you have to come in with deep, deep operational subsidy in order to be able to keep those units running. And so that's where I think this next bond. Obviously I think there's going to be some focus and some thought there. These deep subsidies are typically as well, federal vouchers. So federal rent programs at the end of the day, and there's questions about how those are going to fare in the 26 budget as well. How do they work now in your opinion? That's been an issue for Mayor Gina Jones. You know, given her military background, she's had a really strong position on whether or not landlords are accepting vouchers from veterans. And apparently I don't know if it's the time that it takes to collect the money or what the issue is, but clearly people that are on the landlord side of this, they don't like voucher programs. I'm not exactly sure why, but there seems to be a disconnect between the voucher holder and the voucher, you know, recipient. Yeah, several different kinds of vouchers. So the one you're talking about is a Section 8 voucher or housing choice voucher where a private landlord can elect to accept payment from an individual who's holding the voucher that requires housing in the private market. My understanding, not an expert in this area, but my understanding is that some of the landlord inspections and just the administrative process sort of gets in the way of folks interest. And it makes sense any sort of. Again, if you're a market landlord and there's friction in the process of renting to a tenant and you have plenty of other tenants that you can rent to, you're going to be less inclined to deal with somebody who's like, you've got a what? You've got a. Now I need to figure out how to deal with this. So I think there's a natural economic incentive to have a frictionless exchange. You give me money, I give you an apartment and I keep my landlord covenants and you keep your tenant covenants. That's something that everybody's comfortable with who signs a lease. But housing vouchers are a different beast. And so one, you have to have somebody who, that's, that's willing to explore that. There are many other kinds of housing vouchers that attach to the properties themselves. And these are the types that typically go with permanent supportive housing and some of these other things. The way to think about permanent supportive housing, which is sort of the intervention for these folks who are chronically homeless that will require wraparound services and a number of other supports to maintain their housing and community. The way that you think about them is their sort of the lowest annual median income. So if you think about that 30% and below, they're the lowest of that group. And not only do they require the capital subsidy to build the projects, the rent subsidy in terms of the vouchers, but then you also need to find a way to fund these wraparound services. So when you think about that, it is the most intensive, deepest subsidy group that you can think about. And then think about the number of stars that have to align to produce one of these programs so that it can function and you understand why it's so hard. Those are expensive to get those people off the streets. Expensive. And multiple different policymakers, right, having to come together at the right moment to support a development, and so very, very challenging to create long standing business models that work for permanent supportive housing. Rhonda, you have a hard job. How do you find joy in your job? Yeah, you know what, it's the human spirit that's. It's really easy for me to say it is watching a kid who doesn't even know where they are, you know, playing the playground and just the resiliency of like really little kids. It's watching, you know, families be able to get back on their feet. It's watching people beat the odds, always favored the underdog. So it's really easy for me to find a lot of joy not only seeing people sort of overcome their human being frailty, but get on to their new lives and just watch what they're able to do. So most people probably in our audience will never visit the haven for hope. I wish they could. I know that on the many occasions when I've gone there, particularly there's some very festive occasions, like what you do during the holidays. It's always remarkable how many women and children that you see availing themselves of your services and that are not the stereotypical homeless person that most of us have in our mind. And it's, it's people struggling to get back onto their feet. But it is a very different world where you see that people are just a couple of steps away from being back on their feet if they can get the right support. That's the incredible thing. I mean, it's a good story for the vast majority of people who fall into these circumstances. If you provide for their basic needs for an average of 90 days and you create readily available services, frictionless services for them to take advantage of, they will find their way out of this and not look back. And that's a really, really good story. All right, well, thank you for coming on to Big City Small Town. Rhonda, we appreciate that and we appreciate your service. Thank you so much, Bob. I had a great time. All right, y', all, thanks for listening to this episode of Big City Small Town. If you enjoyed the conversation, please do share it with friends and colleagues who might find it interesting. You can also keep up with our newsletters, Bob Rivard's Midweek and my own San Antonio Something. You can find those linked up@bigcitysmalltown.com Our show, Big City, Small Town, is made possible by Westin Urban building a city our children want to call home. Geekdom, where startups are born and smart ideas become businesses. And now swbc, the San Antonio based financial services company that has been putting clients first for decades, serving individuals, businesses and financial institutions across insurance, investments, payments and more. If you're part of a business or organization that believes in strengthening San Antonio's media ecosystem and you'd like to explore a partnership with us at Big City Small Town, we'd love to hear from you. You can reach out through our website or connect with us on social media. All right, y', all, thanks for being here. We'll see you next time.