A New Triage Center Opened in San Francisco, but Questions Remain

Alex Crafton stood at the corner of Sixth and Jessie streets in San Francisco’s South of Market neighborhood, holding a cup of coffee. A few weeks ago, police arrested the 26-year-old for drug possession outside his former SRO at the same corner, releasing him within 24 hours.

He’s currently living with a friend in the Mission, but he came back to the area recently to check out San Francisco’s latest experiment to address the fentanyl crisis, something he knows first-hand through struggling with addiction for several years.

“The cops have been cracking down more lately, but it’s a lawless city,” Crafton said after exiting a new triage center Mayor Daniel Lurie and other city agencies, including the San Francisco Police Department and Public Health Department, opened this month on 469 Stevenson St. in a fenced-off corner of a former Nordstrom parking lot. “I don’t know if I agree with forcing people to go into rehab because that generally doesn’t work.”

On a recent Tuesday, workers at the triage center offered free water, coffee and snacks, and helped visitors sign up for government IDs and other programs like emergency shelter and Journey Home, which offers bus tickets out of the city for people looking to reunite with loved ones.

John DaRosa, who lives in his car near Sixth and Jessie, stopped by the triage center to find a place to stay that night and a cup of coffee. While staff connected with him, he left, still unsure about a place to sleep.

“They were very welcoming,” he said. “I’d like to get help.”

They are some of the people that Lurie is hoping to reach with the space he envisions as a walk-in center where people can get connected with health and social services, as well as a drop-off point where law enforcement can bring people who have been arrested for processing.

The triage center opened to the public on Feb. 7, but details about how law enforcement will operate during the 30-day pilot remain scant.

In its first week, the site was primarily a few picnic tables and white tents. Spokespersons from both SFPD and the mayor’s office declined to say when police operations would start but noted that site outcomes and local conditions will be evaluated after 30 days.

“I can’t sit by, so we are trying this and demand that people move from the street into the triage center, a place where they can get a cup of coffee, they can be seen by somebody,” Lurie said on KQED’s Forum. “We’re going to try something new, and that’s what the triage center is doing.”

On Feb. 12, Lurie signed his first major piece of legislation into law, which aims to expedite hiring and contracting by limiting the Board of Supervisors’ approval for certain programs addressing the fentanyl crisis, an opioid about 50 times stronger than heroin that has been associated with the most overdose deaths in San Francisco in recent years.

The same day, Lurie announced a second site will open this spring in the Tenderloin at 822 Geary St. for law enforcement, paramedics and street outreach teams to place people experiencing mental health or substance use crises. The Tenderloin facility is a tenet of Lurie’s plan for his first six months in office, along with opening 1,500 shelter beds, which he’s acknowledged the city lacks enough of to direct people to at the drop-off sites.

“The center will be staffed by medical professionals,” he said at a press conference. “It will divert people from the emergency department at places like SF General (Hospital), and it will accept patients dropped off by police, paramedics and street crisis response teams. This will free up essential hospital and first responder resources.”

It’s not the first time that the city has tried a pop-up-style center aimed at improving street conditions and connecting people to drug treatment.

In 2022, as part of Mayor London Breed’s Tenderloin Emergency Initiative, the city opened the Tenderloin Center, a temporary site that operated at United Nations Plaza and offered food, hygiene services and connections to health and social services. Unlike Lurie’s new sites, it allowed supervised drug consumption. Medical professionals there reversed more than 300 overdoses, with no lives lost.

However, the Tenderloin Center faced scrutiny from residents and local businesses for its location in the heart of the Civic Center, where it often drew hundreds of people daily.

“What was really great about that program (Tenderloin Center) is that with all of the many overdoses they encountered there, not a single life was lost,” said Crafton, who visited the Tenderloin Center during its 10-month run. “That was a good thing.”

Law enforcement, along with leaders from the public health and emergency management departments, expressed support for the city’s latest fentanyl response.

“This center will be a tremendous help to our officers who are working hard to enforce the law and improve street conditions in San Francisco,” SFPD Chief Bill Scott said in a statement. “I want to thank Mayor Daniel Lurie for moving swiftly to address this crisis and empowering our entire city in the effort.”

As of Monday, police have not yet used the triage center for any arrest processing or drop-offs, according to a spokesperson from the mayor’s office. He said police have so far been able to process arrests directly on the street and have not yet utilized the new command center in the SoMa parking lot.

The site was closed all Presidents Day weekend due to inadequate staffing, according to the mayor’s spokesperson.

But addiction experts like Vitka Eisen, CEO of HealthRIGHT 360, the city’s largest nonprofit drug treatment provider, remain skeptical. While HealthRIGHT has been asked to set aside additional beds for drop-offs at its SoMa RISE sobering center, the broader strategy of the drop-off sites remains unclear.

“I don’t think the solution to people’s drug use on the streets — the solution doesn’t come from law enforcement,” said Eisen, as multiple people could be seen bent over using drugs openly in the recently power-washed alleyway near the triage center. “I’m not entirely clear on the intent of what’s been open on Jessie Street.”

Neighborhood residents like Byron Carter, who lives about a block from the site at Hotel Henry, are skeptical about the triage center’s long-term goals. He’s noticed cleaner streets during the day since it opened, but said drug dealing, public drug use and other dangerous activity resume after the center closes for the night.

Meanwhile, people like Crafton are still trying to navigate the new services. On his way out, he said the triage site could help anyone unaware of available resources. But the help he’s seeking — a place he can afford as he tries to get off fentanyl — wasn’t available.

“They have the HOT (Homeless Outreach Team) team there, the people who refer you to different programs like housing or getting public benefits like food stamps. You know, just pointing you in the right direction,” Crafton said. “But I pretty much knew about all those things, and I’m all good. I just wanted a cup of coffee.”