Annie Gaus

Matt Charnock

San Francisco policymakers are coalescing around the idea of “safe consumption sites”—sanctioned facilities for drug addicts to use under medical supervision—as one solution to the city’s drug overdose crisis. But actually opening any such sites seems to be a remote prospect, and how the sites would work in San Francisco and other jurisdictions remains an open question.&nbsp;

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San Francisco policymakers are coalescing around the idea of “safe consumption sites”—sanctioned facilities for drug addicts to use under medical supervision—as one solution to the city’s drug overdose crisis. But actually opening any such sites seems to be a remote prospect, and how the sites would work in San Francisco and other jurisdictions remains an open question.&nbsp;

The Board of Supervisors plans to vote on a resolution Tuesday urging Mayor Breed to declare a state of emergency over the city’s opioid crisis and to “immediately” implement overdose prevention sites, another term for safe consumption sites. The medical examiner recorded 511 overdose deaths between January and September of this year, with fentanyl involved in 367 of those deaths, putting the city on track to meet last year’s historic total of accidental overdoses.&nbsp;

The Board of Supervisors plans to vote on a resolution Tuesday urging Mayor Breed to declare a state of emergency over the city’s opioid crisis and to “immediately” implement overdose prevention sites, another term for safe consumption sites. The medical examiner recorded 511 overdose deaths between January and September of this year, with fentanyl involved in 367 of those deaths, putting the city on track to meet last year’s historic total of accidental overdoses.&nbsp;

Supervisor Matt Haney, who introduced the resolution at the Board of Supervisors, told Here/Say that he hopes the resolution—which is non-binding and not legally enforceable—will put the city on “steadier legal ground” when it comes to implementing safe consumption sites. But for now, the sites remain strictly illegal at the state and federal levels, and Breed is unlikely to act on opening any sites until that changes.&nbsp;

Supervisor Matt Haney, who introduced the resolution at the Board of Supervisors, told Here/Say that he hopes the resolution—which is non-binding and not legally enforceable—will put the city on “steadier legal ground” when it comes to implementing safe consumption sites. But for now, the sites remain strictly illegal at the state and federal levels, and Breed is unlikely to act on opening any sites until that changes.&nbsp;

One state bill to legalize safe consumption pilots in San Francisco, Oakland and Los Angeles, <a href="https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB57">SB 57</a>, passed the Assembly earlier this year but was stalled until next year by the state Senate. An earlier version of the bill passed through the entire legislature but was vetoed by former Governor Jerry Brown, who likened safe consumption sites to “enabling” and questioned the effectiveness of such sites in reducing addiction.&nbsp;

One state bill to legalize safe consumption pilots in San Francisco, Oakland and Los Angeles, <a href="https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202120220SB57">SB 57</a>, passed the Assembly earlier this year but was stalled until next year by the state Senate. An earlier version of the bill passed through the entire legislature but was vetoed by former Governor Jerry Brown, who likened safe consumption sites to “enabling” and questioned the effectiveness of such sites in reducing addiction.&nbsp;

“The purpose of these sites is to provide a clean, safe place for people to use substances out of the public eye where they can be supervised to ensure that if anything negative happens, that there&#8217;s someone there to help,” said Peter Davidson, a professor of medicine at the University of California at San Diego and an advocate of safe consumption sites.

“The purpose of these sites is to provide a clean, safe place for people to use substances out of the public eye where they can be supervised to ensure that if anything negative happens, that there's someone there to help,” said Peter Davidson, a professor of medicine at the University of California at San Diego and an advocate of safe consumption sites.

“The purpose of these sites is to provide a clean, safe place for people to use substances out of the public eye where they can be supervised to ensure that if anything negative happens, that there&#8217;s someone there to help,” said Peter Davidson, a professor of medicine at the University of California at San Diego and an advocate of safe consumption sites.

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“You take the organizations that are already working with this population&#8230;and you authorize them to set up a room in their building to do this particular add-on service,” Davidson added. “That&#8217;s that&#8217;s all it is.”

“You take the organizations that are already working with this population...and you authorize them to set up a room in their building to do this particular add-on service,” Davidson added. “That's that's all it is.”

“You take the organizations that are already working with this population&#8230;and you authorize them to set up a room in their building to do this particular add-on service,” Davidson added. “That&#8217;s that&#8217;s all it is.”

Catie Stewart, aide to SB 57 author State Sen. Scott Wiener (D-San Francisco), said that Wiener’s office is confident that SB 57 will be heard in committee next year but that its ultimate prospects are still “up in the air.” If the bill were passed and signed by Governor Newsom, it would make California one of the first states to legalize safe consumption sites. The earliest the law would go into effect would be January 2023.&nbsp;

Catie Stewart, aide to SB 57 author State Sen. Scott Wiener (D-San Francisco), said that Wiener’s office is confident that SB 57 will be heard in committee next year but that its ultimate prospects are still “up in the air.” If the bill were passed and signed by Governor Newsom, it would make California one of the first states to legalize safe consumption sites. The earliest the law would go into effect would be January 2023.&nbsp;

Operators of sites would still be exposed to liability under federal law, and a spokesperson for Breed’s office said it was too soon to say under what circumstances the city would be willing to shoulder the legal risk. The Biden administration has not stated a position on safe consumption sites.

Operators of sites would still be exposed to liability under federal law, and a spokesperson for Breed’s office said it was too soon to say under what circumstances the city would be willing to shoulder the legal risk. The Biden administration has not stated a position on safe consumption sites.

For local policymakers, a comparable effort in Rhode Island may prove instructive. Rhode Island recently approved a two-year pilot of safe consumption sites in the state and plans to open them in March 2022. However, operators have yet to codify rules around running the sites or sort out details of the operations, such as securing insurance and ongoing funding.&nbsp;

For local policymakers, a comparable effort in Rhode Island may prove instructive. Rhode Island recently approved a two-year pilot of safe consumption sites in the state and plans to open them in March 2022. However, operators have yet to codify rules around running the sites or sort out details of the operations, such as securing insurance and ongoing funding.&nbsp;

Safe consumption sites are found in just 10 countries in the world at this point, amounting to around 120 sites globally. They’re part of a spectrum of harm reduction services that seek to minimize the harm of drug use by giving users safe supplies or a safe venue to use and offering access to social services. Wiener’s SB 57 would require that sites provide referrals to medical treatment.&nbsp;

Safe consumption sites are found in just 10 countries in the world at this point, amounting to around 120 sites globally. They’re part of a spectrum of harm reduction services that seek to minimize the harm of drug use by giving users safe supplies or a safe venue to use and offering access to social services. Wiener’s SB 57 would require that sites provide referrals to medical treatment.&nbsp;

The sites have passionate advocates in positions of influence—as well as skeptics who believe that resources may be better spent elsewhere.

The sites have passionate advocates in positions of influence—as well as skeptics who believe that resources may be better spent elsewhere.

Gary McCoy of Healthright 360, a major contractor with the Department of Public Health that has urged the opening of safe consumption sites, staged <a href="https://twitter.com/HereSayMedia/status/1422630557175877634?s=20">a hunger strike</a> over the summer to urge the city to open the sites.&nbsp;

Gary McCoy of Healthright 360, a major contractor with the Department of Public Health that has urged the opening of safe consumption sites, staged <a href="https://twitter.com/HereSayMedia/status/1422630557175877634?s=20">a hunger strike</a> over the summer to urge the city to open the sites.&nbsp;

“With over many of these sites operating around the world, there have been zero overdose deaths,” McCoy told Here/Say, estimating that the sites could save millions in public health costs.&nbsp;

“With over many of these sites operating around the world, there have been zero overdose deaths,” McCoy told Here/Say, estimating that the sites could save millions in public health costs.&nbsp;

Keith Humphreys, a professor of psychiatry at Stanford University who studies addiction, told Here/Say that the public ought to temper expectations on safe consumption sites as a salve for an escalating overdose epidemic locally and nationwide.

Keith Humphreys, a professor of psychiatry at Stanford University who studies addiction, told Here/Say that the public ought to temper expectations on safe consumption sites as a salve for an escalating overdose epidemic locally and nationwide.

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“If they were spread all over, [safe consumption sites] might touch one percent of all injections in the United States,” said Humphreys. “Each year it gets enormous, outsized attention and debate. What doesn&#8217;t get debate is that millions of people with addictions of all sorts in this country have no health insurance and get no care at all&#8230;that’s a much bigger issue.”

“If they were spread all over, [safe consumption sites] might touch one percent of all injections in the United States,” said Humphreys. “Each year it gets enormous, outsized attention and debate. What doesn't get debate is that millions of people with addictions of all sorts in this country have no health insurance and get no care at all...that’s a much bigger issue.”

“If they were spread all over, [safe consumption sites] might touch one percent of all injections in the United States,” said Humphreys. “Each year it gets enormous, outsized attention and debate. What doesn&#8217;t get debate is that millions of people with addictions of all sorts in this country have no health insurance and get no care at all&#8230;that’s a much bigger issue.”

Despite political push, prospects for safe consumption sites in San Francisco remain vague

David Sjostedt

When Mayor London Breed announced the opening of the Tenderloin Linkage Center in January, she touted it as “a safe, welcoming space for those ready to access San Francisco&#8217;s health and human service resources easily and quickly.”&nbsp;

When Mayor London Breed announced the opening of the Tenderloin Linkage Center in January, she touted it as “a safe, welcoming space for those ready to access San Francisco's health and human service resources easily and quickly.”&nbsp;

When Mayor London Breed announced the opening of the Tenderloin Linkage Center in January, she touted it as “a safe, welcoming space for those ready to access San Francisco&#8217;s health and human service resources easily and quickly.”&nbsp;

The idea, Breed and other city officials said, was to create an easy path for people suffering from drug addiction or mental illness to be “linked” to services.

The idea, Breed and other city officials said, was to create an easy path for people suffering from drug addiction or mental illness to be “linked” to services.

But four months later, city officials have <a href="https://sf.gov/location/tenderloin-linkage-center">quietly</a> dropped the word “linkage” from the title, <a href="https://sf.gov/location/tenderloin-linkage-center">according to the facility’s dashboard</a>, and now call it simply the Tenderloin Center.

But four months later, city officials have <a href="https://sf.gov/location/tenderloin-linkage-center">quietly</a> dropped the word “linkage” from the title, <a href="https://sf.gov/location/tenderloin-linkage-center">according to the facility’s dashboard</a>, and now call it simply the Tenderloin Center.

The change is about much more than a word. From the very start, many of those involved in creating the facility viewed it primarily as a place where people could consume drugs in relative safety—an “overdose prevention site” or “safe consumption site,” to use the parlance.&nbsp;

The change is about much more than a word. From the very start, many of those involved in creating the facility viewed it primarily as a place where people could consume drugs in relative safety—an “overdose prevention site” or “safe consumption site,” to use the parlance.&nbsp;

City data indicates that few people have been linked to services. Journalists have been barred from the center, but in interviews with The Standard, guests who had visited the site confirmed that they had witnessed or partaken in illegal drug use there. Some <a href="https://sfstandard.com/public-health/linkage-centers-first-month/">weren’t even aware</a> that drug rehabilitation services were offered at the linkage center, seeing it primarily as a safer and more private place to use drugs.&nbsp;

City data indicates that few people have been linked to services. Journalists have been barred from the center, but in interviews with The Standard, guests who had visited the site confirmed that they had witnessed or partaken in illegal drug use there. Some <a href="https://sfstandard.com/public-health/linkage-centers-first-month/">weren’t even aware</a> that drug rehabilitation services were offered at the linkage center, seeing it primarily as a safer and more private place to use drugs.&nbsp;

The Tenderloin Center’s emergence as a de-facto safe consumption site puts the city in a tricky legal position; federal and state laws prohibit such facilities. And San Francisco voters have mixed views on whether they should be allowed, according to <a href="https://sfstandard.com/politics/san-francisco-standard-voter-poll-june-2022/">The Standard’s Voter Poll</a>, with many residents opposing the idea as one that condones drug use rather than combating it.

The Tenderloin Center’s emergence as a de-facto safe consumption site puts the city in a tricky legal position; federal and state laws prohibit such facilities. And San Francisco voters have mixed views on whether they should be allowed, according to <a href="https://sfstandard.com/politics/san-francisco-standard-voter-poll-june-2022/">The Standard’s Voter Poll</a>, with many residents opposing the idea as one that condones drug use rather than combating it.

The legal situation could soon change. The U.S. Department of Justice is weighing a possible legal path forward for supervised consumption sites, and engaged the mayor’s office on the question of “appropriate guardrails” for such sites this year. It’s unknown what those guardrails would look like, but harm reduction advocates expect a decision to come down in the next few weeks.

The legal situation could soon change. The U.S. Department of Justice is weighing a possible legal path forward for supervised consumption sites, and engaged the mayor’s office on the question of “appropriate guardrails” for such sites this year. It’s unknown what those guardrails would look like, but harm reduction advocates expect a decision to come down in the next few weeks.

In the meantime, the city is in an awkward position. It <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">has a plan</a> for a full-blown safe consumption site at a different Tenderloin location, but in the meantime has to explain its interim solution.&nbsp;

In the meantime, the city is in an awkward position. It <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">has a plan</a> for a full-blown safe consumption site at a different Tenderloin location, but in the meantime has to explain its interim solution.&nbsp;

“I don&#8217;t think we would characterize the linkage center as the same thing as an overdose prevention site,” said Jen Kwart, a spokesperson for the city attorney’s office, in an April 25 interview.

“I don't think we would characterize the linkage center as the same thing as an overdose prevention site,” said Jen Kwart, a spokesperson for the city attorney’s office, in an April 25 interview.

“I don&#8217;t think we would characterize the linkage center as the same thing as an overdose prevention site,” said Jen Kwart, a spokesperson for the city attorney’s office, in an April 25 interview.

Breed’s Announcement Sparks a Scramble

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<h2 id="h-breed-s-announcement-sparks-a-scramble">Breed’s Announcement Sparks a Scramble</h2>

The idea for a “linkage center” first emerged as part of Mayor Breed’s Dec. 17 <a href="https://sfstandard.com/public-health/breed-declares-state-of-emergency-in-the-tenderloin/">emergency declaration</a> to crack down on <a href="https://sfstandard.com/public-health/this-shouldnt-be-normal-tenderloin-parents-grapple-with-neighborhood-woes/">drug overdoses and drug-related crimes</a> in the Tenderloin district. As part of a “robust, aggressive plan” to address the crisis, Breed said that the city would open a center to connect those struggling with substance abuse and other problems to the services they need. &nbsp;

<p id="h-the-idea-for-a-linkage-center-first-emerged-as-part-of-mayor-breed-s-dec-17-emergency-declaration-to-crack-down-on-drug-overdoses-and-drug-related-crimes-in-the-tenderloin-district-as-part-of-a-robust-aggressive-plan-to-address-the-crisis-breed-said-that-the-city-would-open-a-center-to-connect-those-struggling-with-substance-abuse-and-other-problems-to-the-services-they-need">The idea for a “linkage center” first emerged as part of Mayor Breed’s Dec. 17 <a href="https://sfstandard.com/public-health/breed-declares-state-of-emergency-in-the-tenderloin/">emergency declaration</a> to crack down on <a href="https://sfstandard.com/public-health/this-shouldnt-be-normal-tenderloin-parents-grapple-with-neighborhood-woes/">drug overdoses and drug-related crimes</a> in the Tenderloin district. As part of a “robust, aggressive plan” to address the crisis, Breed said that the city would open a center to connect those struggling with substance abuse and other problems to the services they need. &nbsp;

Mayor London Breed talks with a homeless man on Castro Street as she takes a neighborhood walk on Monday, Aug. 13, 2018. | Getty Images

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/05/GettyImages-1321764258-3-2500x1667.jpg" alt="" class="wp-image-49662"/><figcaption>Mayor London Breed talks with a homeless man on Castro Street as she takes a neighborhood walk on Monday, Aug. 13, 2018. | Getty Images</figcaption></figure>

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<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/05/GettyImages-1321764258-3-2500x1667.jpg" alt="" class="wp-image-49662"/><figcaption>Mayor London Breed talks with a homeless man on Castro Street as she takes a neighborhood walk on Monday, Aug. 13, 2018. | Getty Images</figcaption></figure>

In the following days and weeks, employees of multiple city agencies, including the Department of Emergency Management, Department of Public Health and the Department of Homelessness and Supportive Housing, scrambled to pull together a plan, according to emails obtained through public records requests.

In the following days and weeks, employees of multiple city agencies, including the Department of Emergency Management, Department of Public Health and the Department of Homelessness and Supportive Housing, scrambled to pull together a plan, according to emails obtained through public records requests.

The emails show a disconnect between how the site was discussed among a small group of top public health officials and how it was discussed more broadly, both with other city agencies and in communications with the public.

The emails show a disconnect between how the site was discussed among a small group of top public health officials and how it was discussed more broadly, both with other city agencies and in communications with the public.

In a Jan. 7 email to Andrea Tenner, the Department of Public Health’s head of emergency preparedness, an official at a HealthRIGHT 360, a nonprofit with a key role in the center, referred to it as the “Tenderloin Overdose Prevention Site,” or TOPS for short. The email from Britt Miazgowicz, vice president of contracts for HealthRIGHT 360, <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/T.Rivera_emails_Redacted.pdf">detailed the challenges</a> of having to redirect staff from another planned drug crisis response center.&nbsp;

In a Jan. 7 email to Andrea Tenner, the Department of Public Health’s head of emergency preparedness, an official at a HealthRIGHT 360, a nonprofit with a key role in the center, referred to it as the “Tenderloin Overdose Prevention Site,” or TOPS for short. The email from Britt Miazgowicz, vice president of contracts for HealthRIGHT 360, <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/T.Rivera_emails_Redacted.pdf">detailed the challenges</a> of having to redirect staff from another planned drug crisis response center.&nbsp;

Another Jan. 3 email from HealthRIGHT 360 CEO Vitka Eisen, addressed to Tenner along with DPH head of behavioral health Hillary Kunins and other top public health officers, <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/D.BorneEmails_Redacted-5.pdf">urged the parties</a> to host the overdose prevention site in an outdoor tent rather than inside to “manage smokers.”&nbsp;

Another Jan. 3 email from HealthRIGHT 360 CEO Vitka Eisen, addressed to Tenner along with DPH head of behavioral health Hillary Kunins and other top public health officers, <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/D.BorneEmails_Redacted-5.pdf">urged the parties</a> to host the overdose prevention site in an outdoor tent rather than inside to “manage smokers.”&nbsp;

“For a host of reasons, HR360 would strongly prefer to offer harm reduction/overdose prevention services in an outdoor/tented structure,” said Eisen, citing the pandemic and the nonprofit’s expectation that it would be servicing smokers. HealthRIGHT 360, which specializes in addiction services, has received more than $53 million in payments from the Department of Public Health in the current fiscal year.

“For a host of reasons, HR360 would strongly prefer to offer harm reduction/overdose prevention services in an outdoor/tented structure,” said Eisen, citing the pandemic and the nonprofit’s expectation that it would be servicing smokers. HealthRIGHT 360, which specializes in addiction services, has received more than $53 million in payments from the Department of Public Health in the current fiscal year.

The city relied on a collection of nonprofits as it raced towards the center’s Jan. 18 opening date. According to a document laying out assigned roles, HealthRIGHT 360 was responsible for “medical, behavioral and mental health support” for guests along with “overall harm reduction and monitoring.” Another nonprofit, Urban Alchemy, was responsible for “general staffing” and de-escalation. Other organizations set up at the site to act as service liaisons.&nbsp;

The city relied on a collection of nonprofits as it raced towards the center’s Jan. 18 opening date. According to a document laying out assigned roles, HealthRIGHT 360 was responsible for “medical, behavioral and mental health support” for guests along with “overall harm reduction and monitoring.” Another nonprofit, Urban Alchemy, was responsible for “general staffing” and de-escalation. Other organizations set up at the site to act as service liaisons.&nbsp;

Grand Opening Draws Scrutiny

<h2 class="wp-block-heading">Grand Opening Draws Scrutiny</h2>

<h2>Grand Opening Draws Scrutiny</h2>

After the linkage center opened, it didn’t take long for things to veer off course.&nbsp;

After the linkage center opened, it didn’t take long for things to veer off course.&nbsp;

On Jan. 20, author and gubernatorial candidate Michael Shellenberger <a href="https://michaelshellenberger.substack.com/p/san-francisco-government-is-secretly?s=r">published an article</a> claiming that he had witnessed guests smoking fentanyl in an outdoor area at the linkage center. Breed, for her part, appeared to flip-flop on whether drug use was permitted at the facility, a fenced-off and partially tented area at United Nations Plaza.&nbsp;

On Jan. 20, author and gubernatorial candidate Michael Shellenberger <a href="https://michaelshellenberger.substack.com/p/san-francisco-government-is-secretly?s=r">published an article</a> claiming that he had witnessed guests smoking fentanyl in an outdoor area at the linkage center. Breed, for her part, appeared to flip-flop on whether drug use was permitted at the facility, a fenced-off and partially tented area at United Nations Plaza.&nbsp;

A man named Virgil, last name not given, lines up for services at the Tenderloin Center, formerly known as the Linkage Center at Civic Center in San Francisco, Calif. on Tuesday, May 10, 2022.  | Camille Cohen

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/05/TenderloinLinkageCenter-6-2500x1667.jpg" alt="" class="wp-image-49656"/><figcaption>A man named Virgil, last name not given, lines up for services at the Tenderloin Center, formerly known as the Tenderloin Linkage Center at Civic Center in San Francisco, Calif. on Tuesday, May 10, 2022. | Camille Cohen</figcaption></figure>

In December, Breed made sharp statements that the city would no longer “let someone use [drugs] in broad daylight.” But in late January, after the center opened, she appeared to <a href="https://sfstandard.com/public-health/linkage-center-update-drug-use/">walk back that statement</a>, asserting at a press conference that the city “cannot control who does or does not use drugs in any given location.” In February, Breed told Fox KTVU in a live interview that drug use is not “authorized” at the linkage center.

In December, Breed made sharp statements that the city would no longer “let someone use [drugs] in broad daylight.” But in late January, after the center opened, she appeared to <a href="https://sfstandard.com/public-health/linkage-center-update-drug-use/">walk back that statement</a>, asserting at a press conference that the city “cannot control who does or does not use drugs in any given location.” In February, Breed told Fox KTVU in a live interview that drug use is not “authorized” at the linkage center.

Staff at the Department of Public Health meanwhile were fretting about possible legal liability.

Staff at the Department of Public Health meanwhile were fretting about possible legal liability.

In a <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/DebBornetexts-3.pdf">text message conversation</a> on Jan. 22, DPH medical director Deborah Borne expressed concern that she could be held culpable after Shellenberger’s article on drug use at the site published.

In a <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/DebBornetexts-3.pdf">text message conversation</a> on Jan. 22, DPH medical director Deborah Borne expressed concern that she could be held culpable after Shellenberger’s article on drug use at the site published.

“The mayor is going to need to defend us,” Borne said to Paul Harkin, director of harm reduction services at HealthRIGHT 360. “If DPH throws me under the bus, please vouch for me when I’m looking for a new job.”&nbsp;&nbsp;

“The mayor is going to need to defend us,” Borne said to Paul Harkin, director of harm reduction services at HealthRIGHT 360. “If DPH throws me under the bus, please vouch for me when I’m looking for a new job.”&nbsp;&nbsp;

Linkage Center Yields Few Links

<h2 class="wp-block-heading">Linkage Center Yields Few Links</h2>

<h2>Linkage Center Yields Few Links</h2>

From the start, it was unclear whether “linkages” were actually happening. An initial report published on the city’s website showed 33 completed linkages in the first week. But because the category grouped together medical treatment, behavioral health care, substance use treatment, shelters, food security programs and housing into a category called “completed linkages,” it wasn’t possible to tell how many people were connected to drug treatment.&nbsp;

From the start, it was unclear whether “linkages” were actually happening. An initial report published on the city’s website showed 33 completed linkages in the first week. But because the category grouped together medical treatment, behavioral health care, substance use treatment, shelters, food security programs and housing into a category called “completed linkages,” it wasn’t possible to tell how many people were connected to drug treatment.&nbsp;

To date, despite thousands of visits per week, the site has only reported 31 completed linkages to addiction treatment.&nbsp;

To date, despite thousands of visits per week, the site has only reported 31 completed linkages to addiction treatment.&nbsp;

In response to a Feb. 15 inquiry from The Standard seeking clarity on visitor outcomes at the linkage center, Zoe Harris, a spokesperson from the Department of Public Health, wrote to a group of city officials that she hoped to redirect reporters from their “focus on linkages.”&nbsp;

In response to a Feb. 15 inquiry from The Standard seeking clarity on visitor outcomes at the linkage center, Zoe Harris, a spokesperson from the Department of Public Health, wrote to a group of city officials that she hoped to redirect reporters from their “focus on linkages.”&nbsp;

Other questions arose around the site’s use of “meaningful engagements” as a metric of success. According to February email exchanges, HealthRIGHT 360 reported hundreds of “meaningful engagements” that did not square with observations of other staffers and led to an artificially high count.&nbsp;

Other questions arose around the site’s use of “meaningful engagements” as a metric of success. According to February email exchanges, HealthRIGHT 360 reported hundreds of “meaningful engagements” that did not square with observations of other staffers and led to an artificially high count.&nbsp;

Pedestrians and unhoused individuals stroll past the Tenderloin Center, formerly known as the Linkage Center at Civic Center in San Francisco, Calif. on Tuesday, May 10, 2022.  | Camille Cohen

<figure class="wp-block-image size-large"><img src="https://content.sfstandard.com/wp-content/uploads/2022/05/TenderloinLinkageCenter-1-2500x1666.jpg" alt="" class="wp-image-49653"/><figcaption>Pedestrians and unhoused individuals stroll past the Tenderloin Center, formerly known as the Linkage Center at Civic Center in San Francisco, Calif. on Tuesday, May 10, 2022. | Camille Cohen</figcaption></figure>

A <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/A.Tenner_Batch1_Redacted-5-1.pdf">Feb. 8 email </a>from Department of Public Health special project coordinator Robert Hoffman speculated that Gary McCoy, the vice president of policy and public affairs for HealthRIGHT 360, was “making up numbers” in light of confusion about seeming sharp discrepancies in statistics about linkages week over week.&nbsp;

A <a href="https://content.sfstandard.com/wp-content/uploads/2022/05/A.Tenner_Batch1_Redacted-5-1.pdf">Feb. 8 email </a>from Department of Public Health special project coordinator Robert Hoffman speculated that Gary McCoy, the vice president of policy and public affairs for HealthRIGHT 360, was “making up numbers” in light of confusion about seeming sharp discrepancies in statistics about linkages week over week.&nbsp;

In an interview, McCoy said that HealthRIGHT 360’s involvement with the linkage center happened “with almost no notice” and pointed to the last-minute scramble as a reason for the center’s struggle to produce coherent data.&nbsp;

In an interview, McCoy said that HealthRIGHT 360’s involvement with the linkage center happened “with almost no notice” and pointed to the last-minute scramble as a reason for the center’s struggle to produce coherent data.&nbsp;

“There were a lot of ideas from the higher-ups on how we should provide metrics for this type of program,” McCoy said. “There was certainly not enough time to ramp up or redeploy staff from other programs.”&nbsp;

“There were a lot of ideas from the higher-ups on how we should provide metrics for this type of program,” McCoy said. “There was certainly not enough time to ramp up or redeploy staff from other programs.”&nbsp;

Despite all the problems, the center may indeed be saving lives as an overdose prevention facility: Since its January launch, 78 overdoses have been reversed there, among 982 reversed citywide by emergency personnel.

Despite all the problems, the center may indeed be saving lives as an overdose prevention facility: Since its January launch, 78 overdoses have been reversed there, among 982 reversed citywide by emergency personnel.

Hopes for a Change Under Biden&nbsp;

<h2 class="wp-block-heading">Hopes for a Change Under Biden&nbsp;</h2>

<h2>Hopes for a Change Under Biden&nbsp;</h2>

The confusion surrounding the linkage center’s primary purpose mirrors a lack of clarity around what “overdose prevention sites” or “safe consumption sites”–terms often used interchangeably–ought to entail.

The confusion surrounding the linkage center’s primary purpose mirrors a lack of clarity around what “overdose prevention sites” or “safe consumption sites”–terms often used interchangeably–ought to entail.

The term safe consumption site has a broad meaning and is used to describe any facility that provides supervision for drug use. Overdose prevention site is a phrase more commonly used to describe a social gathering place for people to use drugs with supervision and access to overdose-reversing drugs.

The term safe consumption site has a broad meaning and is used to describe any facility that provides supervision for drug use. Overdose prevention site is a phrase more commonly used to describe a social gathering place for people to use drugs with supervision and access to overdose-reversing drugs.

All such facilities remain illegal under the federal Controlled Substances Act. But New York City has forged ahead anyway, opening two safe consumption sites in November and no deaths have occurred at those facilities. City officials in San Francisco have <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">said</a> they want to move ahead, too, with the Board of Supervisors approving a purchase in December of two buildings in the Tenderloin to serve as SF’s first sanctioned safe consumption site.

All such facilities remain illegal under the federal Controlled Substances Act. But New York City has forged ahead anyway, opening two safe consumption sites in November and no deaths have occurred at those facilities. City officials in San Francisco have <a href="https://sfstandard.com/public-health/safe-consumption-controversy/">said</a> they want to move ahead, too, with the Board of Supervisors approving a purchase in December of two buildings in the Tenderloin to serve as SF’s first sanctioned safe consumption site.

A bill to legalize safe consumption sites under state law is now making its way through the legislature. The author of the bill, state Sen. Scott Wiener, <a href="https://sfstandard.com/public-health/drug-overdose-death-safe-consumption-site-scott-wiener/">told The Standard</a> in January that “if San Francisco decides to move ahead of the state and open up a safe consumption site before SB 57 passes, that’s a decision for San Francisco.”&nbsp;

A bill to legalize safe consumption sites under state law is now making its way through the legislature. The author of the bill, state Sen. Scott Wiener, <a href="https://sfstandard.com/public-health/drug-overdose-death-safe-consumption-site-scott-wiener/">told The Standard</a> in January that “if San Francisco decides to move ahead of the state and open up a safe consumption site before SB 57 passes, that’s a decision for San Francisco.”&nbsp;

The U.S. Department of Justice, meanwhile, is considering carving out an option that would allow overdose prevention sites to operate under some set of conditions.&nbsp;

The U.S. Department of Justice, meanwhile, is considering carving out an option that would allow overdose prevention sites to operate under some set of conditions.&nbsp;

That’s because the justice department is nearing a settlement with a Philadelphia-based nonprofit called Safehouse, which it sued in February 2019 over plans for a safe consumption site. That settlement is expected to set terms that could allow Safehouse to operate legally, and a judge this week extended a deadline to determine the terms of that settlement until June 23.&nbsp;

That’s because the justice department is nearing a settlement with a Philadelphia-based nonprofit called Safehouse, which it sued in February 2019 over plans for a safe consumption site. That settlement is expected to set terms that could allow Safehouse to operate legally, and a judge this week extended a deadline to determine the terms of that settlement until June 23.&nbsp;

In San Francisco, longtime recovery advocates and some policymakers say they’re supportive of overdose prevention sites and other harm reduction practices, but hope to see those techniques balanced with more services for people seeking sobriety and abstinence from drugs and alcohol.&nbsp;

In San Francisco, longtime recovery advocates and some policymakers say they’re supportive of overdose prevention sites and other harm reduction practices, but hope to see those techniques balanced with more services for people seeking sobriety and abstinence from drugs and alcohol.&nbsp;

Providers at the linkage center are missing a “golden opportunity” to provide a productive environment for people who want to stop using, said Richard Beal, a recovery advocate and a director at Tenderloin Housing Clinic.

Providers at the linkage center are missing a “golden opportunity” to provide a productive environment for people who want to stop using, said Richard Beal, a recovery advocate and a director at Tenderloin Housing Clinic.

“They do a lot of good work, but what about the people who need to be in a different modality,” Beal said. “They’re doing a great job meeting people where they’re at, but they’re doing them a disservice by leaving them there.”

“They do a lot of good work, but what about the people who need to be in a different modality,” Beal said. “They’re doing a great job meeting people where they’re at, but they’re doing them a disservice by leaving them there.”

Annie Gaus contributed to this report.

Annie Gaus contributed to this report.

Corrections: This story has been updated to delete an inaccurate paraphrase of a comment from Gary McCoy of HealthRIGHT 360, and to reflect that Paul Harkin is director of harm reduction services at HealthRIGHT360.

Corrections: This story has been updated to delete an inaccurate paraphrase of a comment from Gary McCoy of HealthRIGHT 360, and to reflect that Paul Harkin is director of harm reduction services at HealthRIGHT360.

Much-touted ‘Tenderloin Linkage Center’ morphs into a safe consumption site for drug use, despite legal risks

Josh Koehn

It was only the second of four elections this year to represent San Francisco in the state Assembly, but it will almost certainly prove to be the decisive one as Supervisor <a href="https://sfstandard.com/politics/elections/matt-haney-district-6-supervisor-on-why-hes-running/">Matt Haney</a> scored a dominating victory Tuesday over <a href="https://sfstandard.com/politics/elections/david-campos-former-supervisor-and-longtime-party-leader-on-why-hes-running/">David Campos</a> in a special election.&nbsp;

It was only the second of four elections this year to represent San Francisco in the state Assembly, but it will almost certainly prove to be the decisive one as Supervisor <a href="https://sfstandard.com/politics/elections/matt-haney-district-6-supervisor-on-why-hes-running/">Matt Haney</a> scored a dominating victory Tuesday over <a href="https://sfstandard.com/politics/elections/david-campos-former-supervisor-and-longtime-party-leader-on-why-hes-running/">David Campos</a> in a special election.&nbsp;

Results for the Assembly District 17 runoff—<a href="https://sfstandard.com/politics/elections/campos-haney-april-election-results/">near-final returns</a> had Haney taking 63.3% of the vote—suggest the District 6 supervisor’s ideological shift over the last year, as he rebranded himself from a San Francisco progressive to something more moderate, was a savvy strategy. But it’s unclear if that change represented a genuine evolution of thought, particularly on the issue of housing, or a calculated plan to mirror the path others have taken to political prominence.

Results for the Assembly District 17 runoff—<a href="https://sfstandard.com/politics/elections/campos-haney-april-election-results/">near-final returns</a> had Haney taking 63.3% of the vote—suggest the District 6 supervisor’s ideological shift over the last year, as he rebranded himself from a San Francisco progressive to something more moderate, was a savvy strategy. But it’s unclear if that change represented a genuine evolution of thought, particularly on the issue of housing, or a calculated plan to mirror the path others have taken to political prominence.

The Standard spoke with almost a dozen sources at City Hall and the Capitol—including people close to both Haney and Campos’ campaigns, community organizers in San Francisco and longtime Bay Area political consultants—to get a sense of what San Franciscans should expect from its next assemblymember, and whether the results of this race are indicative of a less progressive electorate in San Francisco.&nbsp;

The Standard spoke with almost a dozen sources at City Hall and the Capitol—including people close to both Haney and Campos’ campaigns, community organizers in San Francisco and longtime Bay Area political consultants—to get a sense of what San Franciscans should expect from its next assemblymember, and whether the results of this race are indicative of a less progressive electorate in San Francisco.&nbsp;

While the low voter turnout makes it difficult to foreshadow the future of political races in the city, there is no doubt that the multiple crises San Francisco is facing—an intractable housing crunch, the opioid epidemic in the Tenderloin, and growing anxiety over public safety—played a huge role in how Tuesday’s race shook out.&nbsp;

While the low voter turnout makes it difficult to foreshadow the future of political races in the city, there is no doubt that the multiple crises San Francisco is facing—an intractable housing crunch, the opioid epidemic in the Tenderloin, and growing anxiety over public safety—played a huge role in how Tuesday’s race shook out.&nbsp;

Haney has been described as a friendly, studious, inoffensive ally, but one who has&nbsp; also ruffled feathers with political opportunism. Many forget that it was Haney’s attempt at being woke while serving on the Board of Education that created the school renaming mess that contributed to three board members being recalled in February.&nbsp;

Haney has been described as a friendly, studious, inoffensive ally, but one who has&nbsp; also ruffled feathers with political opportunism. Many forget that it was Haney’s attempt at being woke while serving on the Board of Education that created the school renaming mess that contributed to three board members being recalled in February.&nbsp;

“He has run away from his super-left record,” said David Latterman, a Bay Area political consultant with two decades of experience. “While it is true that he is kind of the amorphous blob that he is, he’s not a dyed-in-the-wool progressive. He’s been able to say enough things to moderates and the housing folks and the young people to make them happy.”

“He has run away from his super-left record,” said David Latterman, a Bay Area political consultant with two decades of experience. “While it is true that he is kind of the amorphous blob that he is, he’s not a dyed-in-the-wool progressive. He’s been able to say enough things to moderates and the housing folks and the young people to make them happy.”

Haney’s victory Tuesday in some ways is a testament to his ability to distance himself from his own record in 2018, when he easily won a seat on the Board of Supervisors despite opposing Sen. Scott Wiener’s SB 35 housing bill and offering limp support of development projects outside of District 6. His more recent about-face on housing helped him secure the support of <a href="https://yimbyaction.org/2021/">YIMBY Action</a> and other pro-housing groups in the city, a crucial step in differentiating himself from Campos.

Haney’s victory Tuesday in some ways is a testament to his ability to distance himself from his own record in 2018, when he easily won a seat on the Board of Supervisors despite opposing Sen. Scott Wiener’s SB 35 housing bill and offering limp support of development projects outside of District 6. His more recent about-face on housing helped him secure the support of <a href="https://yimbyaction.org/2021/">YIMBY Action</a> and other pro-housing groups in the city, a crucial step in differentiating himself from Campos.

“It took [Haney] a while,” said Laura Foote, the executive director of pro-housing group YIMBY Action, which endorsed Haney after working with him during his three-plus years as a supervisor. “He had to go through the experience of seeing all the roadblocks to building housing in San Francisco.”

“It took [Haney] a while,” said Laura Foote, the executive director of pro-housing group YIMBY Action, which endorsed Haney after working with him during his three-plus years as a supervisor. “He had to go through the experience of seeing all the roadblocks to building housing in San Francisco.”

Haney’s campaign also made a smart move tactically by having him move closer to the center to fend off an unexpectedly strong challenge from third-place primary finisher Bilal Mahmood. That maneuver set Haney up to absorb much of Mahmood’s supporters following a post-primary endorsement.

Haney’s campaign also made a smart move tactically by having him move closer to the center to fend off an unexpectedly strong challenge from third-place primary finisher Bilal Mahmood. That maneuver set Haney up to absorb much of Mahmood’s supporters following a post-primary endorsement.

Haney, who did not make himself available for an interview for this story, not only had a bigger campaign war chest than Campos, but he also benefited from $1.7 million in spending by independent expenditure committees over the course of the primary and runoff. That avalanche of outside spending shouldn’t be discounted. A torrent of mail propped Haney up on housing while taking Campos to task for everything from his work history with <a href="https://sfstandard.com/criminal-justice/chesa-boudin-recall/">District Attorney Chesa Boudin</a>, who is facing a recall, to votes Campos cast a decade ago when he served on the Board of Supervisors.

Haney, who did not make himself available for an interview for this story, not only had a bigger campaign war chest than Campos, but he also benefited from $1.7 million in spending by independent expenditure committees over the course of the primary and runoff. That avalanche of outside spending shouldn’t be discounted. A torrent of mail propped Haney up on housing while taking Campos to task for everything from his work history with <a href="https://sfstandard.com/criminal-justice/chesa-boudin-recall/">District Attorney Chesa Boudin</a>, who is facing a recall, to votes Campos cast a decade ago when he served on the Board of Supervisors.

“Haney has run a better campaign,” Latterman said. “He has more money (than Campos), but Haney and his team have run a decent campaign. He’s done a pretty good job not ticking anybody off.”&nbsp;

“Haney has run a better campaign,” Latterman said. “He has more money (than Campos), but Haney and his team have run a decent campaign. He’s done a pretty good job not ticking anybody off.”&nbsp;

Of course, it didn’t hurt that Campos ran a campaign that most observers considered to be anachronistic and even grating at times. In many ways, he relied on the same progressive playbook that led him to a similar Assembly race defeat in 2014: not taking money from corporations, focusing on identity politics and framing the discussion on housing in binary terms in which affordable homes are mostly pitted against luxury condos.&nbsp;

Of course, it didn’t hurt that Campos ran a campaign that most observers considered to be anachronistic and even grating at times. In many ways, he relied on the same progressive playbook that led him to a similar Assembly race defeat in 2014: not taking money from corporations, focusing on identity politics and framing the discussion on housing in binary terms in which affordable homes are mostly pitted against luxury condos.&nbsp;

If the Asian American vote was truly as sacrosanct in this race as both candidates have acknowledged in recent months, the absence of the late Chinatown boss Rose Pak probably hurt Campos more than his campaign initially realized. Pak spearheaded a get-out-the-vote operation on Campos’ behalf in a close Assembly loss in 2014 to David Chiu, whose resignation last year to become San Francisco’s city attorney prompted this year’s race.

If the Asian American vote was truly as sacrosanct in this race as both candidates have acknowledged in recent months, the absence of the late Chinatown boss Rose Pak probably hurt Campos more than his campaign initially realized. Pak spearheaded a get-out-the-vote operation on Campos’ behalf in a close Assembly loss in 2014 to David Chiu, whose resignation last year to become San Francisco’s city attorney prompted this year’s race.

Campos also has a well-established reputation for irritating the very people who would seem to be his obvious allies. Only one of the city’s two major LGBTQ+ organizations endorsed Campos, who is openly gay, and Equality California—the state’s largest LGBTQ+ group—decided to sit out the race entirely, a red flag considering how outspoken the group has been on behalf of Sen. Wiener and other out legislators.

Campos also has a well-established reputation for irritating the very people who would seem to be his obvious allies. Only one of the city’s two major LGBTQ+ organizations endorsed Campos, who is openly gay, and Equality California—the state’s largest LGBTQ+ group—decided to sit out the race entirely, a red flag considering how outspoken the group has been on behalf of Sen. Wiener and other out legislators.

Campos’ focus on being corporate-free might have resonated in the days when Bernie Sanders had liberal arts majors swooning, but the pandemic and issues the city is facing this very moment have superseded noble gestures on campaign cash.

Campos’ focus on being corporate-free might have resonated in the days when Bernie Sanders had liberal arts majors swooning, but the pandemic and issues the city is facing this very moment have superseded noble gestures on campaign cash.

Perhaps the most glaring example of Campos failing to read the room occurred just two days after mail-in ballots went out to voters last month, as he told a group of supporters at the Bernal Heights Recreation Center that his campaign was “<a href="https://sfstandard.com/politics/gross-san-franciscans-react-to-campos-comparison-to-ukrainians/">fighting and running like Ukrainians</a>” in an effort to defeat Haney.&nbsp;

Perhaps the most glaring example of Campos failing to read the room occurred just two days after mail-in ballots went out to voters last month, as he told a group of supporters at the Bernal Heights Recreation Center that his campaign was “<a href="https://sfstandard.com/politics/gross-san-franciscans-react-to-campos-comparison-to-ukrainians/">fighting and running like Ukrainians</a>” in an effort to defeat Haney.&nbsp;

If that seemed ill-advised, the rest of this year’s electoral calendar could inspire even more groans.

If that seemed ill-advised, the rest of this year’s electoral calendar could inspire even more groans.

In an interview earlier this month, Campos told The Standard that winning is his only focus—even if that means he needs to challenge Haney again in June when voters will be forced to weigh in once again on who should represent AD 17 for a full term spanning 2023 to 2024. The top-two finishers in that race are guaranteed to advance to a runoff in November, regardless of whether voters feel emotionally equipped.

In an interview earlier this month, Campos told The Standard that winning is his only focus—even if that means he needs to challenge Haney again in June when voters will be forced to weigh in once again on who should represent AD 17 for a full term spanning 2023 to 2024. The top-two finishers in that race are guaranteed to advance to a runoff in November, regardless of whether voters feel emotionally equipped.

New district lines, which were redrawn last year to include the city’s southwest side, suggest that the races this summer and fall will feature an even larger bloc of moderate voters, adding to Haney’s advantage as an incumbent. And yet, Campos pulled papers to run last year and is giving every indication he is determined to grimly carry on.

New district lines, which were redrawn last year to include the city’s southwest side, suggest that the races this summer and fall will feature an even larger bloc of moderate voters, adding to Haney’s advantage as an incumbent. And yet, Campos pulled papers to run last year and is giving every indication he is determined to grimly carry on.

Tuesday’s victory will give Haney the rest of the year to find his footing in Sacramento and essentially cast roll call votes on the state budget. As one of 80 assemblymembers, his vote will frequently land with the rest of the Democrats, who hold a supermajority in the Legislature.&nbsp;

Tuesday’s victory will give Haney the rest of the year to find his footing in Sacramento and essentially cast roll call votes on the state budget. As one of 80 assemblymembers, his vote will frequently land with the rest of the Democrats, who hold a supermajority in the Legislature.&nbsp;

His legacy will largely depend on his ability to follow through on his newly crafted image and author transformative policy to address California’s housing crisis.

His legacy will largely depend on his ability to follow through on his newly crafted image and author transformative policy to address California’s housing crisis.

Analysis: Haney dominates Campos by shrewdly following shifting political winds

Anna Tong

Two dozen of San Francisco’s top YIMBYs gathered in a spacious Bernal Heights backyard in September to discuss the movement founder’s latest venture: a $1 million cash reserve to take San Francisco to court should it stymie any new housing projects.

Two dozen of San Francisco’s top YIMBYs gathered in a spacious Bernal Heights backyard in September to discuss the movement founder’s latest venture: a $1 million cash reserve to take San Francisco to court should it stymie any new housing projects.

YIMBY founder Sonja Trauss, who led a group discussion about the annals of housing policy while soothing her newborn baby, likened the Sue San Francisco Fund to a denial-of-service (DoS) attack on the city, referring to a type of cyber strike that paralyzes its target by blitzing it with an overwhelming number of requests.

YIMBY founder Sonja Trauss, who led a group discussion about the annals of housing policy while soothing her newborn baby, likened the Sue San Francisco Fund to a denial-of-service (DoS) attack on the city, referring to a type of cyber strike that paralyzes its target by blitzing it with an overwhelming number of requests.

“The denial-of-service portion is because we could send threatening letters for every single missed housing deadline,” Trauss said, describing the money as <a href="https://sfstandard.com/housing-development/woman-stockpiling-cash-to-sue-sf-over-housing/">ready-to-go ammunition</a> to sue San Francisco over housing deadlock.

“The denial-of-service portion is because we could send threatening letters for every single missed housing deadline,” Trauss said, describing the money as <a href="https://sfstandard.com/housing-development/woman-stockpiling-cash-to-sue-sf-over-housing/">ready-to-go ammunition</a> to sue San Francisco over housing deadlock.

Despite political push, prospects for safe consumption sites in San Francisco remain vague

Much-touted ‘Tenderloin Linkage Center’ morphs into a safe consumption site for drug use, despite legal risks

Analysis: Haney dominates Campos by shrewdly following shifting political winds

YIMBYs ate the world—except for SF. Now its founders are up to new tricks

This weekend: Noise Pop approaches, Marquis Hill, Chinese New Year Parade and more

Search Results for: bill scott

Despite political push, prospects for safe consumption sites in San Francisco remain vague

Much-touted ‘Tenderloin Linkage Center’ morphs into a safe consumption site for drug use, despite legal risks

Analysis: Haney dominates Campos by shrewdly following shifting political winds

YIMBYs ate the world—except for SF. Now its founders are up to new tricks

This weekend: Noise Pop approaches, Marquis Hill, Chinese New Year Parade and more