"SF is a city of compassion, but we also need accountability," Mayor London Breed said on Tuesday, announcing a new proposed policy of withholding cash assistance payments to addicts unless they agree to undergo drug treatment.
The three individuals likely to be the primary trio vying for the mayor's office in San Francisco next year, incumbent London Breed, Supervisor Ahsha Safai, and wealthy philanthropist Daniel Lurie, all made proposals today regarding how to deal with the perennial challenges of the city's streets. Safai was on KPIX early this morning talking about putting more police on foot and bike patrols on the street. Lurie made some vague suggestions about "commission reform" and compelling more mentally ill people into treatment. And Breed unveiled a new policy proposal as well.
Breed's suggestion is to add a provision to the rules around cash assistance that is given out under the County Adult Assistance Program. As the Chronicle notes, all California counties have assistance programs like this for the homeless and indigent, though San Francisco's may be one of the better funded — with $30 million handed out in 2022 in monthly grants to approximately 5,200 individuals.
Homeless individuals receive just $105 per month under the program, while those with steady housing can receive $697 per month. Two decades ago, then-Mayor Gavin Newsom got a new ordinance approved by voters which was nicknamed Care Not Cash, and it was under that program that cash payments to the homeless decreased — with shelter beds and other services offered instead.
Breed is proposing adding drug screening to the assistance approval process, which some supervisors are going to balk at when this comes up for a vote — and perhaps this will be something we'll be seeing on the 2024 ballot if they do.
"We will continue to support those struggling with addiction who are seeking help, and those who refuse to enroll in services should no longer receive county-funded cash assistance," Breed said in a statement on X.
Speaking to the Chronicle, Breed said, "We need to make a significant change. No more 'anything goes' without accountability, no more handouts without accountability."
Supervisor Matt Dorsey, a Breed ally, tells the paper that such "coercive interventions can work," while Board of Supervisor President Aaron Peskin characterizes the proposal as Breed "grasping for a political lifeline."
As KPIX reports, Supervisors Catherine Stefani and Raphael Mandelman have expressed their early support for the proposal. Breed made the proposal announcement a press conference Tuesday, also attended by Dorsey and Trent Rhorer from the San Francisco Human Services Agency, which distributes the assistance grants. ABC 7 has some footage from that event.
Peskin also gave a quote to KPIX as well saying, "If she can't find the way to prevent several hundred brazen criminals from selling deadly drugs — how does she think she will find the resources to drug test thousands of welfare recipients?"
Breed's proposal, which is likely to stir up controversy, comes at a time when the city is on track to see 850 overdose deaths this year, or around 70 per month. It also comes months after a policy of arresting drug users for public intoxication and drug possession has reportedly failed to get many — or any — people into drug treatment programs.
But while this could spell a political win for Breed, as Care Not Cash did for Newsom way back when, it's not likely to have the support of addiction and treatment professionals.
One expert in addiction medicine, Ryan Marino, who is an assistant professor at Case Western Reserve University, tells the Chronicle, "The evidence says coercive 'treatment' (forced treatments, incarceration, etc.) of substance use — after almost a century of study — is literally worse than doing nothing at all for people who use drugs. They are more likely to die if you force them into treatment than if you let them keep using."
Breed gave a defiant response to these criticisms, saying to the Chronicle, "Everyone’s going to have an excuse for why we shouldn’t do this. And at the end of the day, at this point, as far as I’m concerned, we’re going to do everything we can to move forward and to get people into treatment, controversial or not."
So, in all likelihood, we can expect to see something like this proposal on the ballot when it comes time to vote for mayor in November 2024.