S.F.’s Tenderloin Center for people on the streets was a mystery for months. A tour only raised the curtain a little

2022-09-02 19:12:57 By : Ms. Angela Li

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A sharps container on a table in the overdose prevention space at the Tenderloin Center.

Jayvon Muhammad, CEO of mental health group RAMS, and Miguel Leyva of RAMS take part in a Tenderloin Center tour.

Donna Hilliard (left), Code Tenderloin chief executive officer, speaks during a tour of the Tenderloin Center.

Juliana McNeil, a Tenderloin Center guest, answers questions during an interview at the outreach facility in U.N. Plaza.

The best way for government officials to avoid confusion and skepticism about their work is to be transparent about what they are doing.

That’s not what’s happened at the Tenderloin Center — formerly known as the Linkage Center — in United Nations Plaza since Mayor London Breed hastily opened the service facility in January as part of her pledged crackdown on crime and drugs in the Tenderloin. The center, obscured behind tents and a tarp-covered fence, provides basic needs including showers and food, while aiming to connect people to services and housing.

On Thursday, after months of requests, Breed’s Department of Public Health finally flung open the center’s doors to members of the media — sort of. It provided a brief tour, but only before the facility opened to guests.

So journalists could see the offices, furniture, computers and harm reduction supplies, but they were unable to observe any interactions between staff and people in need.

And that’s too bad, because a lot of good work appears to be happening inside the Tenderloin Center. City officials and nonprofit workers should be proud of what the center is trying to accomplish instead of secretive about it.

They should also understand that the public demands accountability over how money is spent dealing with the city’s most crucial and high-profile challenges and whether the city is successfully connecting people to long-term care.

The center, which seems to be staffed by well-intentioned people offering valuable help, is not the problem. The problem is Breed, the police and the rest of city government providing an inadequate response to the miserable street conditions prompting so many people to need the center in the first place.

As I interviewed staff outside the center Thursday after the brief tour, a barefoot, filthy woman hustled down the sidewalk, sobbing. Another woman screamed threats at the top of her lungs. Drug dealing, fencing of stolen goods and fentanyl smoking went on as usual in the plaza as people rushing to work tried to ignore the devastation.

Here’s what I can tell you: The center is open from 8 a.m. to 8 p.m. every day — except Thursday, when it doesn’t open until 11 a.m. for staff meetings. Visitors enter on Market Street, where they briefly check in at a front table, telling a staff member their preferred name, what they’re seeking and whether they’re housed.

They can leave their belongings safely monitored and then visit the rest of the building, no questions asked. They can eat healthy food, do laundry, take showers and talk to counselors.

There’s a row of offices where city staff can connect people to housing and treatment, as well as contact their probation or parole officers. There’s also a living room with couches, art supplies and computers.

Outside, in a patio surrounded by tarp-covered fencing and covered in tents, sits an area that’s garnered controversy: a circle of plastic chairs where people can use drugs, as well as 10 plastic tables where people can inject drugs. Boxes for the safe disposal of needles sit on the tables, and a cart full of harm reduction supplies rests to the side.

When the center opened, the city didn’t share publicly that there would be a drug-use area. It was only discovered when Michael Shellenberger, an author-turned-gubernatorial candidate who has criticized the center, jumped the fence and spread the word.

City officials would have been far smarter to follow the lead of New York City and open a real supervised consumption site indoors and in a clinical setting. At the sites in New York, the first two in the country, journalists, neighbors and others can tour the sites and talk to anyone who’s willing to share their stories.

After all, saving lives is something to be proud of — not something to be hidden away. The Tenderloin Center, too, is saving lives — and reports reversing scores of overdoses, which is essential in a city that sees a body or two taken to the morgue every day, struck down by drugs.

Donna Hilliard, executive director of Code Tenderloin, one of the nonprofits staffing the Tenderloin Center, said city officials should be more open with the media and the public about what’s going on at the center. She said she’s frustrated by the secrecy and wished the media could see the center when it’s open and serving guests.

Asked why it’s taken city officials so long to grant such a limited tour, she said, “I don’t know, but it’s been driving me crazy! Just let them in! Then they’ll see what’s going on.”

So what is going on? As Hilliard described it, a lot of heart-breaking, yet essential, work.

She said about 500 people use the center each day, many of them staying for several hours. She described the patio as loud, but not chaotic, and a place where people can discard shame about their drug use and form connections with staff who can help them.

She’s seen people of all ages and races use the space, as well as veterans, seniors, disabled people and women who are victims of human trafficking. She said that in a city with far too few treatment beds, emergency room doctors are releasing people with mental health issues and drug addictions to the center in hospital gowns and bracelets.

She said she’s seen women arrive at the center naked after being raped on the streets or fleeing their pimps. Others show up in extreme distress after not sleeping or eating for days.

While Hilliard doesn’t have a problem with the fact that people are using fentanyl, heroin, meth and crack cocaine on the patio, she said she doesn’t understand why city officials take such a hands-off approach to the open-air drug markets dotting the area, with dealers occupying corners 24/7.

“You can travel anywhere else in the world, and you don’t see it like you see it in San Francisco,” she said. “It’s crazy.”

While it’s easy for fentanyl dealers to prey on people with addictions, it’s much harder to connect people to help. In the center’s first five months, more than 49,000 visits have taken place, but there have been just 53 connections to substance-use treatment. And just 21 connections to mental health services. It’s unclear if there’s overlap in those groups.

Services include methadone treatment, psychiatric care, therapy, crisis stabilization beds and other forms of help, said Alison Hawkes, a spokesperson for the Department of Public Health. The center doesn’t track whether the connections are successful and long-term.

The center has also made 900 placements into shelters and 150 placements into permanent supportive housing, said Emily Cohen, a spokesperson for the Department of Homelessness and Supportive Housing. That doesn’t mean 1,150 people have received beds, Cohen pointed out, since some people might get multiple short-term shelter placements in the course of five months or receive a shelter bed and then a permanent room.

Almost all of the visitors have received basic necessities like food, showers, laundry and a place to rest.

Also squishy is just how much this center costs. The Chronicle has tried for weeks to nail down an exact figure, but even the city controller’s office hasn’t been able to definitively provide one. On Thursday, Hawkes said the mayor’s new budget includes $10.6 million to fund the center for the second half of this year. It’s still unclear how much the first six months cost.

Supervisor Hillary Ronen, chair of the board’s budget committee, said the board has approved a $75,000 monthly lease on the space through the end of 2022, but hasn’t yet approved funding the services. She said she’s glad so many people are accessing basic services, but she hasn’t yet seen proof that will lead to long-term help for drug addictions and mental illness.

She said she’s worried the money and attention has been pulled from Mental Health SF, legislation passed three years ago to reform the city’s broken mental health care system that included a far more robust treatment center. That center still doesn’t exist.

“I feel like we have a problem in this city that we don’t just create a vision and stick with it and fully implement it,” she said. “We’re constantly changing directions.”

Krista Gaeta, interim director of the center, said it takes time to build relationships to move beyond providing meals and showers to something more life-changing. But she thinks the Tenderloin Center will get there.

“It’s about giving people hope there’s something on the other side,” she said.

I could see hope inside the center. It’s the despair on the other side — past the tarp-covered fence — that needs fixing.

Heather Knight is a San Francisco Chronicle columnist. Email: hknight@sfchronicle.com Twitter: @hknightsf

Heather Knight is a columnist working out of City Hall and covering everything from politics to homelessness to family flight and the quirks of living in one of the most fascinating cities in the world. She believes in holding politicians accountable for their decisions or, often, lack thereof - and telling the stories of real people and their struggles.

She co-hosts the Chronicle's TotalSF podcast and co-founded its #TotalSF program to celebrate the wonder and whimsy of San Francisco.