THE SAN FRANCISCO Board of Supervisors decided Tuesday to delay taking a vote on legislation to make new permanent supportive housing facilities drug-free after a local medical association pushed back against the proposal.
The Board was set to consider Supervisor Matt Dorsey’s drug-free housing legislation. The ordinance would prevent the city from funding new “site-based” permanent supportive housing that prohibits eviction solely due to on-site drug use. Site-based permanent supportive housing is subsidized rental housing where all of the units are for those with a history of homelessness.
On-site illicit drug use would be grounds for eviction, with exceptions for alcohol and marijuana.
Most of San Francisco’s permanent supportive housing, or PSH, follow the state’s “Housing First” model, which states that drugs or alcohol on the premises cannot be a sole cause for eviction. Funding conditions for PSH under the Housing First policy do not allow for evictions on the basis of drug use.
Dorsey has said his legislation is intended to provide an alternative funding pathway to get more drug-free housing in San Francisco.
Medical group raises alarms
But the San Francisco Marin Medical Society, an association representing thousands of doctors and medical professionals in San Francisco and Marin counties, wrote a letter to Dorsey outlining its issues with his ordinance. The letter, dated April 21, was sent two days before the legislation was heard in the Board’s Public Safety and Neighborhood Services Committee.
The letter stated that SFMMS would oppose the legislation unless amendments were made. The letter viewed the ordinance as restrictive in its funding requirements and criticized the legislation’s provisions for responding to residents who use drugs on-site.
“While SFMMS agrees with the goal of adding and prioritizing sober-living options in the city’s PSH portfolio, we have several concerns with the ordinance as currently drafted,” the letter reads.
Dorsey blasted the letter in his own 16-page written response, saying that the society made “advanced material mischaracterizations of my legislation that, if left unaddressed, risk misleading Board members and the public about its intent.”
At Tuesday’s meeting, Dorsey asked the Board if it could give him one week to try and reach a compromise with SFMMS. Additionally, one of the legislation’s co-sponsors — Supervisor Bilal Mahmood — was absent.
“I would like to make a motion to continue this item for one week,” Dorsey said to the Board. “Apart from one of my co-sponsors being unavailable today, I also am encouraged by conversations I’ve had with recovery community allies in the medical community who believe that there is still common ground to find with the San Francisco Marin Medical Society.”
In SFMMS’s letter, the association said that the ordinance would add barriers to securing funding for PSH sites that do not evict for drug use.
“Individuals with an SUD evicted from supportive housing because of relapses should be moved to a setting with more intensive services, not relegated to an unknown setting with less support and possibly homelessness.”
San Francisco Marin Medical Society
“Mandating exclusive funding for recovery housing, and creating obstacles to override that mandate, reduces the city’s ability to meet other housing needs as they arise,” reads the letter sent by SFMMS in April.
Dorsey pushed back, saying that state-funded PSH in the city would be exempt from requiring abstinence from drugs. He added that the ordinance contains a provision stating that the restriction can be overridden by simple majority vote from the Board if deemed necessary.
“SFMMS’s charge of inflexibility is not a difference of opinion,” Dorsey wrote in his response letter. “It is flatly incorrect.”
SFMMS also criticized what it sees as inadequate measures to continue supporting individuals with substance use disorder, or SUD, who are evicted from drug-free PSH sites for on-site drug use.
“Individuals with an SUD evicted from supportive housing because of relapses should be moved to a setting with more intensive services, not relegated to an unknown setting with less support and possibly homelessness,” the letter from SFMMS reads. “As currently written, the ordinance fails to ensure this important outcome.”
Dorsey defends safeguards
Dorsey responded by saying in his letter that his legislation “provides important guardrails.”
The legislation outlines that a single relapse would not lead to an automatic eviction unless the resident’s behavior “substantially disrupts” the community where the resident lives. Residents who do relapse and are not disruptive would first be offered resources for support, and that the Department of Homelessness and Supportive Services would “use its best efforts to provide alternative housing or shelter,” according to the proposed ordinance.
Dorsey has previously worked with SFMMS on other issues including advocating for adequate supplies of buprenorphine , a medicine used to reduce cravings for opioid addicts, in retail pharmacies across the city. He and SFMMS also worked together to help enact the city’s “Recovery First” ordinance that stated that abstinence and substance-free living were primary goals of the city’s drug policy.
“SFMMS recognizes that Supervisor Dorsey is addressing serious and complex issues pertaining to substance use disorders in San Francisco,” the association wrote in a response to Dorsey’s letter. “SFMMS remains focused on core aspects of this ordinance, which we continue to believe can be improved.”
Despite the distinctions in opinion on the legislation, Dorsey is hoping he can reach an agreement.
“I am proud to have stood with this organization over the years,” Dorsey said at Tuesday’s meeting. “I’m going to do everything I can in the week that we have to find common ground.”
The legislation is expected to return to the Board at next week’s regular meeting Tuesday.
