San Francisco Chronicle - (Sunday)
S.F. sobering center provides a safe place, hope
In frantic desperation, 53year-old Kenneth Jacobs knocked on the door of an unassuming mission revival storefront in the South of Market neighborhood last year, unable to calm his brain after smoking meth a few blocks down.
Jacobs had spent the last 30 years smoking the stuff, along with crack cocaine and harsher drugs — though it’s always been about the uppers for him. For more than three decades, from Baltimore in the 1990s to San Francisco today, Jacobs had begged, borrowed and stolen just to get another hit.
But on that cold February day in 2022, beneath the three arches of San Francisco’s sobering center SoMa RISE — now more than a year into serving the neighborhood’s most needy — Jacobs had had enough. The years of smoking meth, homelessness and various stints in jail had taken their toll. He needed to rest his head. He needed a shower “real bad.” But he said he never imagined the place would also be his ticket to a new life.
“I was eating out of trash cans. I was tearing my body to pieces,” Jacobs said on a recent November day, eight months out of detox. “But I went from the garbage — from the gutter — to the top.”
The SoMa RISE sobering center where Jacobs found his path to recovery and eventually housing, employment and sobriety isn’t a be-all and end-all to the city’s drug crisis. But what it offers is often what unhoused people dealing with drug addiction need most: a place to sleep, a shower, a full meal, detox opportunities, referrals to treatment programs and willing helpers to guide them along the way.
Officials with HealthRight 360 and the city say demand for SoMa RISE’s services is so strong that the center sometimes has to turn people away so it will not exceed its capacity. HealthRight 360 has been criticized for running facilities with insufficient staff — and a supervisor has called for an audit of the city’s largest drug treatment provider over the issue — but officials
with the nonprofit say staffing is not a problem at SoMa RISE.
In 2019, the city designed the center after the results of a Methamphetamine Task Force found it could help to deal with the number of people who use that drug exhibiting concerning behaviors in public. Someone speaking to themselves or pulling at their clothes, or behaving in a more aggressive or threatening manner, can look like mental illness, but it could also be adverse effects of meth, which include paranoia and hallucinations. Since then, the center caters to all drug users, not just those addicted to meth.
In its first year of operation, the program cost $3.5 million. That grew to $5.2 million for the current fiscal year. The funds came from the Department of Public Health’s $3.19 billion estimated budget for the next two years.
Meth use in the city has increased over the past decades and has contributed to skyrocketing overdose deaths — the city is on track for a record number this year — and flooded San Francisco’s emergency rooms.
The center was intended to be a place for them to come down and have supervision while keeping emergency rooms clear for more serious situations.
With drug addiction raging among San Francisco’s unhoused population, SoMA RISE’s sobering center has become a place that could help to combat the city’s greater drug crisis, connect unhoused people to resources and get them into treatment.
On a recent tour, it was clear SoMA RISE hasn’t changed much since last year. Inside the low-lit sobering center, separated from the lobby by floor-toceiling glass dividers, several people snored, tossed and turned in twin-size plastic beds while one man sat by a table with board games beside him, eating lunch on a disposable plate.
In the darkest part of the room, there’s a glass box staff call the “private room” where people too paranoid to be with others can find brief solitude. Opposite the glass box, Melissa Chavez, the center’s nurse, walks out of her small, on-site clinic every 15 minutes or so to ask if she can
check out a bad cut, invite someone for a check-up or book them doctor’s appointments.
HealthRight 360 said it has found that when people aren’t worried about their next meal, or a place to sleep or rest for a few hours, they’re using substances less on average. And the longer they’re in the center and the more interactions they have with staff, the more likely they end up in treatment or detox, the nonprofit said.
“More of these (centers) would be places for people to land and you can find them again,” Chavez said, highlighting the difficulty street outreach teams sometimes face when offering someone help and then not finding them again on the streets.SoMA RISE has averaged 32 visitors a day, many of them staying about 14 hours, and the DPH said from January to June this year, 179 people from SoMA RISE subsequently entered withdrawal management via HealthRight 360’s Integrated Care Center. In the same time period, 79 people entered residential substance use disorder treatment.
The center has also successfully diverted by dozens a week the number of unhoused, drugaddicted people that flood the city’s emergency rooms every night. It has also been a good neighbor, said nearby business owners, many of whom were surprised the center didn’t attract more drug users to the area as initially expected.
Still, it’s clear SoMa RISE has been a key experiment in the city’s effort to curb its drug crisis, and it could offer a successful alternative or add-on to the controversial plan to open “wellness hubs” across the city that allow for supervised drug use.
Gary McCoy, spokesperson for HealthRight 360, which operates SoMa RISE, said he wants to see more places like it across the city.
“The longer somebody is in a place like this, they’re interacting with and working with our teams, they’re getting more stable, they’re coming down from whatever substances, and they’re offered services,” McCoy said. “That is time that they’re not out on the streets or in a doorway or in front of a business. It works not just because it’s a compassionate approach, but also for the neighborhood.”
But while SoMa RISE has been helpful to many people, it’s also bursting at the seams. In a statement to the Chronicle, the health department said the facility is frequently at capacity, and sometimes it has to turn away people being diverted from the emergency room by police or first responders.
Supervisor Catherine Stefani called for an audit of HealthRight 360 this year after she found out an unhoused person dealing with addiction to fentanyl had tried to enter treatment multiple times but was turned away because of a lack of treatment beds.
The nonprofit faces a staffing crisis, though SoMa RISE said it hasn’t had a problem with staffing the site since opening. But sometimes people who pass through SoMa RISE end up on waiting lists down the line. A recent hearing on the city’s Treatment on Demand mandate
found the nonprofit and others across the city and the state are dealing with a staffing shortage that likely won’t get any better unless more pay is offered or the state creates a pipeline of social workers and behavioral health professionals.
Jose Rios Chavez, who has run the center, said he hopes the city will commit to expanding SoMa RISE, especially in the Mission and Tenderloin districts. But there are things he can’t control: Most of the people who seek help at SoMa RISE ask for housing, and the center has no ability to place them into shelters or other housing units.
“That’s one of the main things,” Rios Chavez said. “Everybody asks for housing. All of San Francisco is asking for affordable housing, but we don’t have that. Even if we get someone to treatment … how can they be successful? Housing gives people stability. Without stability, you’re not able to be successful in many ways.”
DPH called SoMa RISE “a success” in a statement to the Chronicle.
“The program has proven very successful in providing a safe and accessible indoor space for people who are intoxicated with opioids, methamphetamines, other substances, or experiencing mental or behavioral drug-related crises to come in off the street and make connections to ongoing care,” the statement said.
Mayor London Breed’s office told the Chronicle in a statement that as the city looks ahead to expanding treatment and care facilities, “funding will remain a critical issue, as well identifying the kinds of beds we need to make our system work as efficiently and effectively as possible.”
“That is why the Mayor supported Gov. Newsom’s proposal in the legislature to move forward a Mental Health Bond and Mental Health Services reform work that will fund more beds across the state,” the statement says.
But for Jacobs, success is measured in every day he stays sober and keeps a job, a roof over his head and food in his belly. After visiting SoMa RISE a few times, Jacobs said he started listening to the SoMa RISE worker telling him every day that he should get into detox. One day, he decided to listen and filled out the form. After a few months, he graduated from detox and “stepped down” to a residential drug treatment facility on Haight Street, where he still lives.
Jacobs works for Urban Alchemy — the team of street ambassadors — patrolling an elevator at Civic Center, the same place he often found himself searching for more meth and crack. He said he deals a lot with homeless people who remind him of his old self, and he tries desperately to get people the help they need.
“If I can come off the streets after being homeless from the East Coast to the West Coast and doing all the stuff that has destroyed my life … if I can do it, I know you can do it,” Jacobs said. “You gotta just jump in the water. You can’t go swimming with one foot out. Take the chance and put both feet in.”