A wave of new policies and rhetoric aimed at San Francisco’s overlapping mental health, homelessness, and drug crises in 2024 culminated in one of this year’s central questions: is SF becoming less liberal?
Whatever the consensus, voters showed they are fed up with a status quo that’s made a seemingly negligible dent in the suffering on city streets. To make progress, Sup. Rafael Mandelman told The Frisc in October that the city’s permissiveness needed a shakeup: “It’s pretty important for progressive politicians and cities to separate ourselves from the idea that disorder is somehow progressive.”
The impact of a year of new policies and laws have yet to shake out. Addressing homelessness remains one of SF’s biggest challenges. The year began with a Jan. 30 citywide tally, known as the point-in-time count, that found just over 8,000 people living on streets, in vehicles, or in shelters, according to the Department of Homelessness and Supportive Housing.
It’s essentially the same amount as 2019, counted one year before the pandemic shut down the city. In between, the 2022 total dipped about 7 percent. That count showed fewer people on the streets and more in shelters and temporary housing, which advocates attributed to funding from a business tax boost approved by voters in 2018.
Despite spending hundreds of millions of dollars a year, however, SF hasn’t reduced the total number of people living in vehicles, shelters, or on the streets because “for every person HSH is able to exit from homelessness, approximately three people become homeless,” as HSH noted in its 2024 count summary.
The US Supreme Court’s June ruling in the Grants Pass case gave cities the green light to force people living on the streets to move. Such sweeps were previously blocked by a 2022 lower court injunction, which said cities couldn’t move people without having shelter beds available for them. Mayor London Breed embraced the new powers, stating that those who refuse help or shelter would not be allowed to remain on city streets. It’s unclear if city workers are following local rules to store, or “bag and tag,” the belongings of people swept off the street.
The city also gave notice to people living in vehicles. Despite promises, the city never expanded beyond a single site where people could park RVs and temporarily live. The one site, at Candlestick Point, was recently shuttered. Meanwhile, SF’s streets agency enacted an overnight parking ban, promising to roll it out slowly. The Board of Supervisors overturned the ban in December, agreeing with advocates who said it would force people, many of them Spanish-speaking families, onto the streets.
For years, city officials have debated which is more useful: more overnight or congregate shelters or more permanent supportive housing (PSH) which often comes from converting old hotels.
Adding more overnight or “congregate” shelters is a faster way to put roofs over people’s heads, but it’s often hard to convince people to stay in them, with their strict rules and crowded conditions. Advocates say PSH is better for ending the cycle of homelessness, but there’s no guarantee conditions there will be friendlier for residents – or neighbors, as The Frisc reported earlier this year.
In September, Breed directed HSH to amend its five-year plan to double the goal for shelter and temporary housing as a result of accelerated investments in homelessness. In October, the state awarded SF a $44 million grant to fund more shelters. During the campaign, Mayor-elect Daniel Lurie promised to provide 1,500 new emergency shelter beds during his first six months in office and 2,500 temporary housing units in his first year.
Fentanyl’s shadow
Lurie’s promise of both kinds of housing to get people off the streets comes as another debate ratchets up, fueled by the drug overdose crisis. As of Dec. 11, 589 people died from accidental drug overdose deaths, mostly from fentanyl. There’s a glimmer of good news: the figure is 23 percent lower than the same period in 2023 after years of SF setting grim records.
Of this year’s deaths, over three-quarters of them happened at a fixed address. With people dying inside apartment buildings, some critics questioned the city and state’s gold-standard “Housing First” policy, which holds that people on the streets first need a roof over their heads before addressing issues like drug and alcohol use. Sobriety is not a box required to check to move in. (Privately funded recovery facilities, like the Salvation Army, can set their own sobriety rules.)
Housing First goes hand in hand with harm reduction, a policy to let people use drugs more safely with tools like overdose reversal, because forcing sobriety upon them doesn’t lead to better outcomes. But some officials, researchers, and recovery advocates say fentanyl has changed the equation, and they’re demanding more sober living options.
So far, these calls have been unsuccessful. Assemblymember Matt Haney of San Francisco couldn’t get a bill through the state legislature that would have set aside 25 percent of state PSH funds for sober living. This fall, Sups. Matt Dorsey and Mandelman introduced a bill to require up to 25 percent of SF’s PSH units to be drug- and alcohol-free, but it gained little traction.
(During the debate, HSH director Shireen McSpadden wrote to Dorsey that “HSH agrees that San Francisco should have more sober living options for people coming out of treatment programs or in recovery,” but she pushed back against the bill’s funding mandates.)
SF lawmakers did pass a bill to pay methamphetamine addicts $100 a month for passing drug tests, an expansion of a method that has evidence of success. But several other bills that could be seen as more “tough-on-crime” moved forward. In March, SF voters easily approved two Breed-backed measures to give police more power and require drug screening for welfare recipients. In November, San Franciscans threw their support behind California’s Prop. 36, which increased punishments for repeat offenses of theft and drug use.
Amid the votes for Lurie, a law-and-order candidate, and tougher rules, SF also said yes to funding more affordable housing and senior rent subsidies, and it denied the police a sweeter pension deal.
City health officials are also hopeful about CARE Court — a mandated treatment program for people with specific mental health diagnoses — despite opposition from many mental health experts and advocates because they say it’s either coercive or underfunded.
Potential voters said crime and safety were the top priority of the mayoral election. Lurie won the election with a vow of crackdowns (declaring a “fentanyl state of emergency,” which might not be possible) and more resources. The resources might not be possible, either; the budget deficit could hit a whole new dimension if a Trump White House decided to punish the city.
Most San Franciscans would vow they want to reduce the suffering on their streets. The push and pull over how to do it will certainly continue next year.