RescueSF Tenderloin Emergency Dashboard

The purpose of the RescueSF Tenderloin Emergency Dashboard is to evaluate the City’s progress in achieving the priorities of the Tenderloin Emergency Plan. Instead of presenting all of the metrics from the City’s weekly reports, this dashboard includes only those metrics that most clearly relate to the overall goals.  Like most government data, the weekly reports reveal what the City has been doing, but the data provides only limited insight into whether the City is making an impact.

Key Takeaways

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.  A separate analysis has previously shown that most people arrested for drug dealing in San Francisco quickly return to the streets after serving little jail time.  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

  • The City has successfully helped 807 people exit street sleeping since the start of the Tenderloin Initiative.  The vast majority of those people – 708 individuals – were initially moved to shelter, which means that they still need to find permanent housing.  The City has achieved impressive results in just four months.  At the same time, we need more information to make a full assessment of the City’s results.

  • 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 January will be available soon, but that data will only be accurate as of a single night in January.  The City does not conduct regular counts of unsheltered people, which means that we do not know how many more people 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 trying to expand its shelter capacity, it would be helpful to understand the City’s actual pipeline for new shelter.  The City should clarify its shelter plans so that we can determine whether the City will have sufficient space for all of the unsheltered people who need it.  

  • 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 is to offer the Linkage Center as a safe consumption site where people can safely use drugs off of the city streets.  The City has averaged 2,508 weekly visits to the Linkage Center, and the Center had 3,038 visits during the week of April 24.  This data shows increasing numbers of visits to the Linkage Center, but it 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 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.

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.  According to the data up to April 17, the Linkage Center was averaging only 4 mental health referrals and 19 substance use referrals per week.  Since the start of February, the Linkage Center had made a total of 45 mental health referrals and 212 substance use referrals.  This means that out of the total 35,108 visits to the Linkage Center, the City had made only 257 behavioral health referrals, representing only 0.7% of total visits.  

Each week, we publish a blog post with commentary on that week's updated dashboard.  For background on the Tenderloin Emergency Plan and an evaluation of the City's weekly reports, visit our first blog post on the dashboard.

Below, we present commentary and data on each of the eight goals of the City's Tenderloin Emergency Initiative.

1. Reduce Drug Sales and Violent Crime

  • Since the start of the Tenderloin Initiative, total calls for police service have declined from 1,336 for the week ending January 23 to 1,135 for the week ending April 24, representing a drop of 15%.  Since the start of January, the police have averaged 10 booked arrests for drug sales or possession with intent to sell in the Tenderloin.  With arrests on a downward trend for the past month, the police made only 4 booked arrests during the week ending April 24.  

  • Since the start of January, the police have made a total of 174 booked arrests, but there is no data regarding the final disposition of these cases.  Since the start of January, the police have on average seized 1,434 total grams of narcotics each week, including 876 grams of fentanyl.  During the week of April 17, the police seized only 423 grams of narcotics, including 192 grams of fentanyl.  To put these figures in context, it would be helpful to have even a sense of the total amount of narcotics sold in a typical week.  Are these drug seizures making a difference?

Figure 1. Calls for Service During Tenderloin Initiative, 2022 (2).png
Figure 2. Arrests for Drug Sale and Possession for Sale During Tenderloin Initiative, 2022

Cumulative Booked Arrests:  174

Figure 3. Drugs Seized During Tenderloin Initiative, 2022 (3).png

2. Reduce Homelessness and Street Sleeping

  • Since the start of the Tenderloin Initiative, the City has helped 807 people exit street sleeping by placing 708 people into shelter and 99 people into housing.  On average, each week the City has placed 19 people into shelter and 8 into housing.  During the week of April 24, the City placed 42 people into shelter and none into housing.  

  • The City is also reporting periodic data on tent counts.  The data shows a slight decline in the total number of tents in the Tenderloin before the start of the initiative, from 77 in June 2021 to 60 in November 2021, while tents in the rest of the city increased from 310 in June 2021 to 466 in November 2021.  Tents in the Tenderloin declined from 60 in November 2021 to 35 in March 2022, while tents in the rest of the city increased from 466 in November 2021 to 566 in March 2022.  In other words, the launch of the Tenderloin initiative saw a reduction of 25 tents in the Tenderloin but an increase of 100 tents in the rest of the city.

Figure 4. Weekly Placements to Shelter During Tenderloin Initiative, 2022 (1).png

Cumulative Shelter Placements:  708

Figure 5. Weekly Placements to Housing During Tenderloin Initiative, 2022 (1).png

Cumulative Housing Placements:  99

Figure 6. Total Tents and Structures Before and During Tenderloin Initiative, 2022 (1).png
Figure 7. Change in Tents and Structures Before and During Tenderloin Initiative, 2022 (1)

3. Eliminate Widespread Public Drug Usage

  • Since the launch of the Linkage Center, the site has had 35,108 total visits.  The Center has averaged 2,508 weekly visits, with 3,038 visits during the week of April 24. 

Figure 8. Total Weekly Visits to Linkage Center During Tenderloin Initiative, 2022 (1).png

4. Increase Safe Passage and Accessibility 

  • Up until April 10, the City reported the number of streetlight repairs and curb and sidewalk repairs completed each week.  Since then, the City has been reporting the number of new service requests filed each week and the percent of service requests closed within seven days.  This new data is unhelpful because the City is no longer revealing basic data on the number of repairs City staff are completing each week.  

  • The previous data series revealed that, as of April 10, the City on average was repairing 10 streetlights and 6 curbs and sidewalks, each week.

  • This data shows what the City is doing to improve accessibility, but it doesn’t demonstrate that the City is actually succeeding.  Are the Tenderloin’s streets safer and more accessible?  To answer this question, the City would need a more direct measure of safe passage and accessibility, such as structured observations, or even an indirect measure, such as public opinion polling.

Figure 9. Infrastructure Repairs During Tenderloin Initiative, 2022 (7).png

5. Cleaner Sidewalks and Streets

  • To ensure cleaner sidewalks and streets, the City removes trash and conducts power washings.  Each week, the City removes an average of 200 tons of waste and conducts 110 power washings, although the results for recent weeks have fallen below these averages.  

  • This data records the City’s activities, but, as with other goals, it does not show whether the City is succeeding.  To know whether the streets are actually cleaner, the City would need to measure street cleanliness, either by recording qualitative observations or by conducting a public opinion poll.

Figure 10. Waste Collected During Tenderloin Initiative, 2022 (5).png
Figure 11. Power Washings During Tenderloin Initiative, 2022 (5).png

6. Reduce Fatal and Non-fatal Overdoses

  • According to the data, the City’s emergency medical services (EMS) staff each week are reversing an average of 29 overdoses in the Tenderloin and 22 in the rest of the City.  Since December, EMS staff have reversed a total of 820 overdoses – 465 in the Tenderloin and 355 in the rest of the city.  Since the start of January, the City has distributed 1,678 doses of Naloxone.

  • Has the City been successful in reducing the number of overdose deaths?  Before the start of the Tenderloin Initiative, during the last three months of 2021, on average there were 9 overdoses per month in the Tenderloin and 43 in the rest of the city.  After the launch of the Tenderloin Initiative, since the start of January 2022, on average there have been 10 accidental overdose deaths in the Tenderloin and 37 in the rest of the city.

  • Therefore, according to the data, accidental overdose deaths have slightly increased in the Tenderloin and have fallen in the rest of the city since the start of the Tenderloin Initiative.  What we don’t know is what these numbers would have been without all of the additional effort to reduce overdoses.  For example, the number of overdose deaths could have been much higher.

Figure 12. Emergency Medical Services Overdose Reversals During Tenderloin Initiative, 202

Cumulative EMS Overdose Reversals in Tenderloin:  465

Cumulative EMS Overdose Reversals in Rest of City:  355

Figure 13. Overdose Reversals in the Tenderloin During Tenderloin Initiative, 2022.png
Figure 14. Naloxone Doses Distributed During Tenderloin Initiative, 2022 (2).png

Cumulative Naloxone Doses Distributed:  1,678

Figure 15. Accidental Overdose Deaths Before and During Tenderloin Initiative, 2021-22.png
Figure 16. Average Monthly Accidental Overdose Deaths Before and During Tenderloin Initiat

7. Eliminate Widespread Street Vending

The weekly report does not contain data measuring progress on reducing illegal vending.

8. Increase Connections to Care

  • The numbers on connections to behavioral health treatment programs are so low that the weekly report no longer breaks out the data for mental health care and substance use treatment. Starting with the report for the week ending April 24, the City’s report only shows an aggregate number for behavioral health referrals.  In this last week, the City made only 3 total behavioral health referrals.  This lack of transparency is disappointing and not helpful.  For example, it is very useful to know the number of referrals to substance use treatment to assess the City’s efforts to reduce overdoses.  The new figures make this analysis impossible.  

  • We strongly urge the City to resume the previous practice of reporting the separate data on referrals to mental health care and referrals to substance use treatment.  The City has the data, and there is no reason not to report it.

  • Disturbingly, the data suggests that connecting people to care has actually not been a high priority.

  • The City also reports connections to care from Felton Institute’s Street Team and Community Health Equity Team.  The reported data aggregates medical, mental health, and substance use referrals, making it impossible to identify the number of behavioral health referrals.  We suggest that the City disaggregate the data to show the number of referrals to mental health care and to substance use treatment.

  • And finally, all of this data is even less clear because of the vague definition of “referral.”  At present, the City defines a referral as a conversation about connecting someone to a service.  The City cannot confirm that the individual actually received the service.  

  • To show success on this important goal, the City needs to report how many people were actually connected to a specific medical or behavioral health service.  All of the service teams – whether operated by the City or an outside organization – should use the same definitions and report comparable data.

Figure 17. Connections to Care from the Linkage Center During Tenderloin Initiative, 2021-

Cumulative Linkage Center Behavioral Health Referrals:  257

As Percent of Total Visits to Linkage Center:  0.8%

* Note:  The new reporting as of 4/24 shows only 219 total behavioral health referrals.  The reason for the discrepancy is unclear.

Figure 18. Connections to Care from Service Providers During Tenderloin Initiative, 2021-2

* Note:  Referrals are for medical, mental health, and substance use treatment.