Treatment program in problem area
San Francisco is converting a vacant SoMa hotel into a transitional housing and treatment program for people involved in the criminal justice system who struggle with homelessness, mental illness and drug addiction — challenges that too often overlap in jail cells.
The 75-unit building at 509 Minna St., overseen jointly by the health and adult probation departments, will be an encouraged “sober living environment” where drug use is prohibited but medicationassisted treatment, such as methadone for opioid users, is provided.
Referrals will include people diverted before trial, as part of sentencing, or while on probation. Some participation could be court-ordered.
Dr. Lisa Pratt, director of the health department’s jail health services, said treatment and housing options for people coming out of jail have been piecemeal or not always immediately available. Those services are vital given that 41% of people in San Francisco jails were homeless last fiscal year. More than half of people in jail reported using substances and 12% had a serious mental health diagnosis.
“No one should have to go to jail to get treatment,” she said. “We will be able to support these people who have these needs coming out of jail in a way that we haven’t had the opportunity to over and over for many people. It’s an exciting — and will be a life-changing — opportunity.”
However, the location of the new program could pose challenges for those in it. Some addiction medicine experts and providers have expressed concerns about concentrating treatment programs in environments with drug dealing and use on the streets.
Near the part of Minna Street between Sixth and Seventh streets that will host the new program, a 16-yearold girl was found dead of a suspected overdose in suspi
cious circumstances earlier this year, and three people were shot there this month alone. On Tuesday, The Chronicle observed a couple of people smoking drugs and what appeared to be the exchange of money for drugs outside the vacant hotel.
When asked about concerns over the program’s location, Chief Adult Probation Officer Cristel Tullock said, “It’s important to build where the problem is.”
The city will fund nonprofit Tenderloin Housing Clinic to lease the hotel, which has been vacant for two years, and spend $4.6 million a year to operate it. The new program will bring the city’s new mental health and substance use treatment beds to 164 on the way to its goal of adding 400 beds.
The new beds were mandated under reform legislation MentalHealthSF, passed more than two years ago to fix the city’s broken behavioral health care system that leads to people cycling from the streets in and out of hospitals and jail.
City officials, including Supervisors Matt Haney and Hillary Ronen, who co-authored MentalHealthSF, praised the new beds.
“With this project we’re working to break the cycle of people with these challenges cycling from the justice system to the streets and back again, without receiving the type of care they need that could make a difference in their lives,” Mayor London Breed said in a statement. “With better coordination, more focused services, and housing options, we can hopefully improve this situation in San Francisco.”
While the city makes progress on adding treatment beds, it continues to struggle with street conditions, including drug dealing and use, in the Tenderloin and SoMa.
The health department has previously said a majority of its services are in those neighborhoods because that’s where the need is greatest.
Tullock pointed out that her department opened a drop-in center and smaller transitional living program earlier this year on Sixth Street, one block from the new program, that can serve people on the streets if they decide they are ready for change.
She also said the same level of drug activity on Minna doesn’t take place outside the existing center on Sixth Street, and the city hasn’t had its “imprint” yet on Minna.
Keith Humphreys, an addiction researcher and professor at Stanford University School of Medicine, said research shows that the sight of drugs, paraphernalia and sales “cue in addicted people pretty powerful physical and psychological effects . ... They do represent a risk for relapse.”
“You’re better off in a treatment environment away from all of that, but it’s very hard to obtain and then particularly so in cities that have allowed open-air drug dealing in neighborhoods,” he said.
Humphreys said, in general, he is glad to see the city creating this program, especially because it is using what he called national best practices of a sober living environment while offering medication-assisted treatment.
That’s different from another Adult Probation transitional living program opened last year for justice-involved men that promotes total abstinence. That model received pushback from harm reduction advocates and medical experts who said medication should be offered, but praise from people in recovery who want to see more treatment options in the city that encourage people to stop using drugs.
The new program will work with participants who relapse on a case-by-case basis to determine whether they need a higher level of care and how best to get them back on track, officials said.
After renovations, the building is expected to open in early May to some participants who are already in other programs. It will then expand to full services and new participants in the fall. Westside Community Services and Tenderloin Housing Clinic will operate the program. Services will include medicationassisted treatment, case managers, support groups, recreation and mental health services.
The program will open in a troubled area. On Tuesday outside the vacant hotel, the Chronicle observed four people holding drugs and exchanging money.
When a police car rolled down the alley, three dispersed, but a young man on a bicycle stayed. The two officers hopped out of the car and ordered him to put away the tinfoil he was using to smoke. They left, but he stayed.
The 23-year-old, who gave his name as Foe, said he lived in the now-vacant hotel at 509 Minna for about a year before he fell behind on payments, got evicted and is now homeless.
He said he started using drugs because of a back injury and currently smokes fentanyl. He said if the city were to start a treatment program in the troubled area, it had to make sure to “send people that want to change.”