When the Mayor announced the Tenderloin Emergency Plan on December 14, 2021, the Department of Emergency Management ("DEM") was tasked with coordinating the City's multi-agency response. The initial stage of the Tenderloin Initiative was seen as the crisis operations phase, during which the priority was on quickly launching and coordinating the City's programs. On July 3, the crisis operations phase came to a close, and the Tenderloin Initiative transitioned to the sustained operations phase. With this transition to sustained operations, overall coordinating responsibility transferred from DEM to the Planning Department.
As the City considers how to adjust the Tenderloin Initiative during the sustained operations phase, we have prepared this evaluation of the Initiative's results during the crisis operations phase, from December 2021 through July 3, 2022. How effective was the Tenderloin Emergency Initiative at accomplishing its goals?
Reduce Drug Sales and Violent Crime
When the City launched the Tenderloin Initiative, supporters hoped the effort would significantly reduce drug sales and crime, while critics feared excessive police action against drug users. Neither outcome has come about. The data shows modest levels of arrests for drug sellers, but not drug users, which is consistent with the stated focus on reducing drug trafficking. However, the data is too limited to evaluate the City’s real progress.
First, the City hasn’t released data on the final disposition of these arrests. How many arrests led to convictions, and how many arrested suspects returned to the streets? Drug dealing in the Tenderloin won’t decline until arrests have consequences.
Second, arrest and conviction rates are only proxies for what we really care about – the prevalence of open-air drug dealing. To demonstrate success, the City needs to create a more direct measure of drug dealing, for example by recording observations of street activity or even through public opinion polling.
Reduce Homelessness and Street Sleeping
As of July 3, the City had successfully helped 1,253 people exit street sleeping since the start of the Tenderloin Initiative. The vast majority of those people – 1,055 individuals – were initially moved to shelter, which means that they still need to find permanent housing. The City achieved significant results during these six months. At the same time, more information would allow a deeper assessment of the City’s efforts.
First, we do not know how many people are currently unsheltered in the Tenderloin and the rest of the City. The results of the Point-in-Time count from February are just now being released, but that data will only be accurate as of a single night in February. The City does not conduct regular counts of unsheltered people, which means that we do not know how many people currently remain on the streets.
Second, we know that the biggest obstacle to helping people move off of the streets is the lack of sufficient shelter and housing. While the City is expanding its shelter capacity, we need to know how many people are currently on the streets in order to determine how much more shelter and housing the City should provide.
And third, the City’s tent counts show that while the number of tents is declining in the Tenderloin, the number of tents is increasing in the rest of the City. This data suggests that some of the positive results in the Tenderloin may reflect the displacement of unsheltered people to other neighborhoods in the City.
Eliminate Widespread Public Drug Usage
The City’s main strategy for reducing public drug usage in the Tenderloin is to offer the Linkage Center as a safe consumption site where people can safely use drugs off of the city streets. Through July 3, the Linkage Center had a total of 62,733 visits, representing 2,614 weekly visits. This data doesn’t actually measure what we care about – the extent of public drug usage. Are visits to the Linkage Center reducing public drug usage? To evaluate real progress on this goal, the City needs a more direct measure of public drug usage such as structured observations or even an indirect measure such as public opinion polling.
Reduce Fatal and Non-Fatal Overdoses
One of the main justifications for launching the Tenderloin Emergency Initiative in December 2021 was to reduce the high level of accidental drug overdose deaths seen in the Tenderloin. Based on the reported data, the City appears to be relying primarily on the use of Naloxone to reverse overdoses. What we’re not seeing is evidence of the City trying to prevent overdoses by reducing substance abuse. The reported data on this goal does not include any data on treatment programs. Moreover, the data for the separate goal of increasing connections to care shows that the City is connecting very few people to drug treatment programs.
Before the launch of the Tenderloin Initiative, from September to December 2021, the Tenderloin saw an average of 9 accidental overdose deaths per month. During the Emergency Operations Period, accidental overdose deaths in the Tenderloin increased to 11 per month. While these figures may have been worse without the City's efforts, it's clear that the City did not achieve one of its primary objectives of reducing overdoses.
Increase Connections to Care
Many Tenderloin residents, especially unhoused residents, have significant physical and behavioral health needs. Unfortunately, the data shows that the City has so far had shockingly limited success connecting people to care. Through July 3, the Linkage Center reported 62,733 visits but only made 532 referrals for behavioral health services, representing just 0.8% of total visits.