Tenderloin stuck in crisis as emergency initiative comes to an end

‘Drug dealing and use is as present as ever’ — Supervisor Matt Haney

As the 90-day mark for Mayor London Breed’s emergency declaration in the Tenderloin draws near, city leaders say that despite some incremental gains, conditions in the neighborhood are as dire as ever.

Breed — who was absent Tuesday from a public hearing probing the initiative — has signaled she will not renew the declaration but plans to continue the effort by maintaining operations set up during the emergency order. But data and observations aired at a recent hearing before the Board of Supervisors revealed the initiative is far from meeting its goals.

“We need more help, as much as ever,” said Supervisor Matt Haney, whose district encompasses the Tenderloin. “The conditions in the neighborhood have not changed. The health and safety issues in the neighborhood are as real and as urgent as ever. Drug dealing and use is as present as ever, if not as bad then worse than before.”

Breed announced a state of emergency for the Tenderloin on Dec. 17 with sweeping promises to make the neighborhood safer by cracking down on crime, outdoor drug sales and use, and decreasing homelessness and illegal vending.

At the hearing, supervisors lauded Breed for initially declaring the emergency and questioned why it would not be continued. They praised some of the work that’s been undertaken, but painted it as only the first step in what will be an arduous, lengthy effort to clean up the Tenderloin.

“We need to acknowledge that social services and harm reduction alone won’t help the people of the Tenderloin and neither would a law enforcement-centric approach,” said Department of Emergency Management Executive Director Mary Ellen Carroll. “We need them to be unified.”

Serving basic needs

The emergency move has allowed The City to bypass certain zoning laws and regulations to rapidly construct a homeless services center at United Nations Plaza called the Tenderloin Linkage Center. It is equipped with showers and provides hot meals, medication refills and assistance signing up for life-saving programs such as Medi-Cal, supportive housing and addiction treatment.

It also allowed San Francisco to quickly hire 100 behavioral health workers to staff the site, which would otherwise have taken months.

Some indicators hint at progress. At least 35 overdoses have been reversed at the Linkage Center since it opened in mid-January, and no overdose deaths occurred while supervised drug use has been taking place, weekly reports show.

Every day, the center serves three meals and 40 to 60 people use the showers, according to Dr. Hillary Kunins, director of behavioral health for the Department of Public Health. She said there have been more than 15,600 visits to the center overall, many of which have led to meaningful conversations about substance use treatment options — an important step in building trust and creating opportunities to provide care.

“The great majority of needs are seeking safety and to meet basic needs, and we provide this for our guests on a daily basis,” said Kunins. “We are also aiming to build relationships and trust with our guests and encourage them to get connected with treatment options.”

The linkage center has directly led to 66 placements into shelters, and 345 people have been moved off the street and into a shelter during the emergency order, according to data from the Department of Homelessness and Supportive Housing. More than 150 people have been added to the housing wait-list and 56 have moved into housing.

“This is much more than we are typically able to make available to people living outside,” said Emily Cohen, a spokesperson for the Department of Homelessness and Supportive Housing.

But it has been more challenging to link people to substance use disorder treatment and permanent housing. Eight individuals have been successfully connected with addiction treatment, and 18 were placed in clean and sober transitional housing, according to the weekly reports. Six people were able to get medication refills.

At the same time, data from the medical examiner’s office shows 46 people died of accidental drug overdose in January, a slight dip from the monthly average across 2021.

“Did we reduce overdoses in the Tenderloin as a result of this emergency?” said Haney. “This requires our urgent attention to what is very much still an emergency in our streets.”

Tackling crime

Breed’s plans to address drug dealers and crime in the Tenderloin also hasdrawn scrutiny. Supervisors expressed frustration over a lack of evidence about decreasing drug dealing from field operations.

“I’ve never seen drug dealing as abrasive and open and the numbers that are there as they are today. I don’t see the presence of police that was talked about,” Supervisor Ahsha Safaí said.

Breed pledged an aggressive approach, flooding the streets with police officers and refusing to allow open-air drug use. The broad goals included a reduction in illegal activities such as drug dealing, but there were no specific targets.

Overall crime — including violent and property crime — is down 14.4% in the Tenderloin this year compared to the same point in 2021, according to the San Francisco Police Department’s crime dashboard. That’s compared to a 6.3% increase in overall crime citywide during the same period. That data does not include drug crimes, however.

When it comes to open drug dealing, “there has been little if any improvement at all,” said Supervisor Aaron Peskin.

According to data compiled as part of the Tenderloin Emergency Initiative, police seized more than 1,000 grams of fentanyl each of the last four weeks through Feb. 27. That amount dropped to 424 grams in the week ending March 6.

“One of the frustrating things that I hear and quite frankly experience is how, regardless of individual efforts, there seems to be a vexing challenge to make a sizable dent,” said Police Captain Chris Canning.

Canning added that as of Monday the department had increased police presence in the Tenderloin area and would continue to do so.

In its latest report published Tuesday, The City acknowledged some streets in the Tenderloin are safer, but some problems have been pushed elsewhere. Safaí and other supervisors expressed concern that not only was the emergency initiative not having its desired impact, it was actively draining resources from other areas.

“Other areas in San Francisco are suffering,” said Board President Shamann Walton.

Supervisor Hillary Ronen echoed the sentiment, saying “conditions in the Mission have gone down to a degree that I haven’t seen since I started as a supervisor. I’m at a loss and I’m a little frustrated.”

The City also acknowledged in its report that while it has boosted the presence of community ambassadors, they are not a substitute for police. Those working at the linkage center said it is too soon to evaluate whether the initiative is a success or should change course.

“When we start up new programs it takes a while to attract participants, acknowledging the lack of data on reducing overdose deaths and housing placements,” said Kunins. “I really want to achieve and share those kinds of outcomes for us to know this approach is working and will continue to work.”



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