San Francisco Considers a Measure to Screen Welfare Recipients for Addiction

The Democratic mayor of San Francisco is pushing a pair of controversial public safety proposals on the March 5 ballot, including one that would require single adults on welfare to be screened and treated for illegal drug addiction or else lose cash assistance.

Mayor London Breed also supports a ballot measure that would grant police more crime-fighting powers, such as using drones and surveillance cameras. In November, she’ll face cranky voters in a competitive reelection bid.

San Francisco is in a struggle to redefine itself after the pandemic left it in economic tatters and highlighted its longstanding problems with homelessness, drugs and property crime. Opponents say both ballot measures are wildly out of step with San Francisco’s support for privacy and civil liberties and will only hurt the marginalized communities the city prides itself on helping.

But Breed, the first Black woman to lead San Francisco, said at a January campaign stop that residents from poorer, Black and immigrant neighborhoods are pleading for more police, and recovery advocates are demanding change as more than 800 people died of accidental overdose last year — a record fueled by the abundance of cheap and potent fentanyl.

“They said San Francisco makes it too easy for people to access and to use drugs on the streets of the city, and we need to do something a lot more aggressive,” Breed said at Footprint, an athletic apparel and shoe store that has been repeatedly burglarized.

While Breed’s name isn’t on the presidential primary ballots going out now — San Francisco uses a method where residents rank mayoral candidates by preference a single time in November — the two measures she’s pushing are. They serve as an opening salvo for her reelection campaign as she faces off against fellow moderates who say her approach to the city’s problems has been weak.

Violent crimes are low in San Francisco, but the city has long struggled with quality-of-life crimes.

Breed said rates of retail theft and auto smash-ins have declined recently, thanks in large part to strategic operations by city police. Similarly, police have stepped up enforcement of drug laws, including by issuing citations to people using drugs in public as a way to disrupt the behavior and an opportunity to persuade the person cited to seek help.

But she said San Francisco needs to do more.

If approved by voters, Proposition F would offer another way to compel treatment by allowing the city to screen single adults on local welfare for substance abuse. People found to be abusing illegal drugs would be required to enroll in treatment if they want to receive cash assistance from the city, which maxes out at just over $700 a month.

Opponents say coercion doesn’t work and homelessness may increase if the measure passes. Drug addicts are not criminals, they say, and there are not enough treatment beds and counseling services as it is.

A crackdown on drugs is reminiscent of the failed war on drugs that disproportionately harmed Black families, said Chris Ballard, co-executive director of Coleman Advocates, which pushes for improvements for Black and Latino youth in San Francisco.

“There are more ethical ways to address the issue aside from punitive measures, and that’s the proper way to take care of a community, to show true support,” he said.

Yet Trent Rhorer, executive director of the San Francisco Human Services Agency, which provides cash assistance and employment services to low-income residents without dependent children, said the current situation conflicts with the agency’s mission: to improve lives.

“To give someone who’s addicted to fentanyl $700 a month, I don’t think it helps improve their lives,” he said. “In fact, I think it does the opposite.”

Compelling treatment has become more acceptable in Democratic California, despite angst over the potential loss of civil liberties, as visible signs of homelessness and mental illness, fentanyl addiction, and unsafe street behavior surge.

Last year, several counties rolled out an alternative mental health court created by Democratic Gov. Gavin Newsom, former mayor of San Francisco, to fast-track people with untreated schizophrenia and related disorders into care, and in March, voters will take up a statewide mental health proposition, that some say will increase involuntary treatment.

Rhorer said the welfare program for single adults — which serves about 9,000 people per year — already asks applicants about substance abuse, with about 20% self-reporting an issue. A data check with the Department of Public Health revealed that almost one-third of recipients have been diagnosed with a substance use disorder, he said.

The ballot measure would replace that question with a more rigorous screening test that an addiction specialist would verify. If substance abuse is found, Rhorer said, the specialist and applicant would agree on treatment options that include residential care, a 12-step program, individual counseling and replacement medication.

There is no requirement that the person be sober, only that they make good-faith efforts to attend their program, with the hope that “at one point a light bulb will go off,” Rhorer said.

The measure calls for the city to pay the rent of those accepted into the program for 30 days or longer to avoid eviction. About 30% of the people who fatally overdosed in 2023 were homeless, and more were living in subsidized city housing.

Besides authorizing drones, cameras and other modern technologies, Proposition E would reduce paperwork so police have more time to patrol. It would also allow police to pursue more suspects by vehicle, not just in cases of a violent felony or immediate threat to public safety — a policy store owner Michael Hsu learned of the hard way.

Hsu has had his Footprint store broken into multiple times since he took over in 2020, most recently on Jan. 1. Police arrived as the suspects were leaving but could not pursue them because no lives were at risk. Hsu, who lost about $20,000 in merchandise and damage, called that discouraging.

“You’re sending the wrong message to these criminals,” he said.