Inside San Francisco's Tenderloin Center, Which Serves Hundreds Every Day

The Tenderloin Center, formerly known as the Tenderloin Linkage Center, opened in January as part of San Francisco Mayor London Breed's emergency declaration to reduce overdose deaths in the neighborhood. Members of the media have not been allowed inside the Civic Center Plaza facility, which offers food and showers along with referrals for housing, jobs, drug treatment and a range of other services.

That changed on Thursday, with a morning press tour of the offices where housing referrals are made, the living room where guests come to relax and the outdoor area where people play games and do their laundry.

The tour wasn't the full picture, because hundreds of people access the site's services every day, and the space was closed to guests when the media tour occurred. But it offered a glimpse into how the city is tackling issues around poverty, homelessness and drug use in the Tenderloin.

Juliana McNeil greeted reporters in what's known as the living room, a tranquil space with yellow walls where people use computers, read books and unwind.

She was there as a kind of ambassador for the visitors who come in regularly, and had glowing reviews of her experience at the Tenderloin Center.

McNeil said she had been sleeping on the streets in Oakland before she arrived at the site. She said staff helped her find housing, mental health support and mentors.

"Places like this need to exist in other counties because when you're homeless, you feel like you have nothing," she said. "They got me not only a hot meal, they gave me a hygiene kit, clothes. They basically linked me back up to where I'm building myself again, my trust with people."

Donna Hilliard, executive director of Code Tenderloin, took reporters to the courtyard.

"What we tell people is, 'Welcome to grandmother's backyard,'" she said.

She pointed toward a mobile shower and laundry station.

"You can come in smelling like pee, but guess what, we have a shower, and we're going to give it with care," she said.

Hilliard nodded toward the game area and where guests can get coffee, and gray-and-blue reclining chairs arranged in a circle where people wait for services or nap.

Then reporters were escorted to what staff called "the overdose prevention area."

The area is pretty basic. Plastic tables and chairs are set up for people to use drugs with relative privacy, while staff are nearby to reverse overdoses.

"There are people we don't see in treatment, people who leave treatment and have reoccurrence of drug use. And for those people, we believe we have an obligation to care for them so they don't die of a drug overdose," said Vitka Eisen, president and CEO of HealthRIGHT 360, a nonprofit health provider that offers harm-reduction services at the Tenderloin Center.

Naloxone, the drug used to reverse overdoses, and clean needles are at the ready. No one has fatally overdosed at the Tenderloin Center, and staff have reversed over 90 overdoses since the site opened in January, according to data from the San Francisco Public Health Department.

Eisen disagreed that the site is a safe consumption site, however, and preferred to call it an overdose prevention site.

"The safe consumption sites are typically indoors. They have nursing staff, a medical model, and this is outdoors in a tent," she said. "It's rugged."

Alex Kral, an epidemiologist with RTI International, said the distinction between safe consumption sites and overdose prevention sites is less important than what happens there.

"They're providing services for people who use drugs," he said of both kinds of site. "[Staff] are prepared to help them out in case there's an overdose or other kind of medical emergency."

But spaces where drug use is allowed and staff are reversing overdoses are still limited in the staff they can bring on until the state legalizes them, Kral said.

A bill from State Sen. Scott Wiener (D-San Francisco), SB 57, would set up a pilot program to allow certain cities, including San Francisco, to open supervised consumption sites. It passed a California Assembly committee this week, and now heads to the full Assembly.

But regardless of the bill's fate, the Tenderloin Center will stay open until at least the end of the year. Hundreds of people continue to show up daily, and many use drugs.

So far the site has reported zero overdose deaths.