San Francisco has seen a 15% reduction in drug overdose deaths this year with 462 people dying in the first eight months of 2024. That is still an “alarmingly high” mortality rate and it may increase again, said Dr. Grant Colfax, the city Department of Public Health director.

Nevertheless, when asked at an overdose awareness day event in August what happened to the department’s plan to open safe consumption sites, Colfax said: “What our focus is right now is continuing to make sure that people have access to treatment.”  That’s despite research showing such facilities — also known as overdose prevention centers — save lives, reduce drug use in public, increase access to life-saving treatment and care and reduce public spending on emergency services.

Instead, the Department of Public Health is relying on a new 24-hour-a-day outreach initiative that provides unhoused drug users with the opioid dependency medication buprenorphine.

This “Civic” episode goes inside an overdose prevention center run by OnPoint NYC to hear from staffers and people who have received help with treatment for substance use disorders and other challenges associated with addiction.

Meanwhile, more cities and states are embracing overdose prevention centers. Last February, the Providence City Council in Rhode Island approved a state-sanctioned overdose prevention center. In April, Minneapolis nonprofit Minnesota Overdose Awareness opened a safe injection site thanks to legislation signed in 2023 by Gov. Tim Walz, presidential candidate Kamala Harris’ running mate. And in June, the Vermont Legislature overrode the governor’s veto of a bill to sanction an overdose prevention center in Burlington, an addiction hot spot.

But San Francisco appears to have abandoned the strategy, despite previously having the support of Mayor London Breed and city supervisors. Talk of overdose prevention centers has not come up in any meaningful way during election campaigning. And elected officials did not reply to calls and emails in August requesting an update.

At a mayoral candidate debate in June, Breed suggested city attorneys could face disbarment for enabling the launch of an overdose prevention center because of prohibitions under state law. But in New York City, the nonprofit organization OnPoint NYC worked with the city to skirt legal liability and opened two centers in November 2021. Their efforts have cleaned up surrounding neighborhoods and reversed more than 1,500 overdoses in less than three years with no deaths, according to OnPoint.

[Read and listen to our previous reporting on San Francisco’s overdose crisis and ongoing prevention efforts.]

A study published in the New England Journal of Medicine in April found that the centers kept people alive and kept them from consuming drugs in public. And a 2022 study published in the Journal of the American Medical Association found that the centers did not increase crimes recorded by police or calls for emergency services in the surrounding neighborhoods.

OnPoint’s efforts are also improving lives, said Sam Rivera, the organization’s director.

“The anecdotal things around reunification with children and reunification with families and becoming employable again — these are things that would never have happened for these folks,” Rivera said.

The success is in large part due to OnPoint’s dedication to treating each client with dignity, said Susan Spratt, OnPoint’s associate director of clinical services.

“We’re seeing people who are often not seen, they’re stepped over, literally, in the streets,” Spratt said. “This has been said to me more than once, to me and to multiple staff members in our clinic: ‘I feel like you’re really listening to me. I haven’t been listened to in a long time. So, thank you.’”

The post Overdose Prevention Centers — Nonstarter in SF, Despite Success in NYC appeared first on San Francisco Public Press.

For Supervisor Connie Chan, who announced her proposal at a Tuesday press conference and represents District 1, which includes the Richmond District, the cuts would reduce her annual salary by $16,819, to $151,355. 

With mounting deficits, the Board of Supervisors will be asking departments to do more with less, she said. Through her proposal, city leaders would set an example and demonstrate how severe the situation is.

“The message today is that business cannot go on as usual,” Chan said. She warned that, in the long run, the city must reduce its rate of spending commensurate with revenue. Chan, who chairs the city’s Budget and Appropriations Committee, said supervisors will soon “be forced to make some draconian cuts to city staffing, city services and community services.” 

The proposal would set aside the money, totaling an estimated $1.5 million, for a reserve fund that could be used to help protect some essential services, which could be pared back if lawmakers approve a budget plan by Mayor London Breed.

At least at first, the fund would be much too small to fully address the budget’s critical condition — the city faces a nearly $790 million shortfall over the next two fiscal years. Chan said she intends to soon announce other ways to fill the reserve fund.

City Hall has faced increasing budget shortfalls since the COVID-19 pandemic, which hobbled the downtown office real estate market, disrupting a major source of tax revenue. Local officials and media outlets have long warned that dwindling public coffers would cause a reduction in city services. Some supervisors and local social service providers have bristled at Breed’s budget plan, saying that it endangers essential services intended to help low-income renters and increase public safety, among other things.

The post SF Lawmaker Pitches Pay Cuts for Top Officials to Ease Budget Woes appeared first on San Francisco Public Press.

Bystanders might wonder how to summon help from the city — and what will happen if they do.

We created a flow chart to answer those questions, though it does not capture all possible outcomes. Scroll down or click here to find it.

Cases traverse a tangle of pathways, through handoffs between dispatchers and myriad public workers. The person in crisis might spend days or weeks tumbling through the criminal justice system or health care facilities. They might get a reprieve from the outdoors in a sobering center or a communal recovery setting, where they can access food and information to help them seek social services. Their path depends on many factors, like the availability of the Street Crisis Response Team, what the bystander tells city personnel and whether responders can calm them.

Often, the person returns to where they started: the streets.

San Francisco emergency dispatchers can receive tens of thousands of calls per year about mental health incidents, including suicide attempts. According to a recent study by a city working group, there were nearly 13,700 recorded involuntary psychiatric detentions in the fiscal year that ended in 2022 — a conservative tally as the analysis did not include some facilities in San Francisco. The study found that African American residents were detained at disproportionately high rates, and unhoused people were frequent users of psychiatric emergency services.

(Click the link below the chart to see a version that allows you to zoom in.)

The San Francisco Public Press spent months investigating how people can be detained involuntarily due to mental health crises and what happens to them afterward. The psychiatric detentions are commonly called “5150” holds, a nod to the section of state code that defines the criteria for this intervention. We examined hundreds of pages of call records, department procedures and training documents, and interviewed staff at numerous city departments directly involved in crisis response to map the city’s system of care.

A single phone call about an incident can trigger responses from multiple departments. Major responders include the Department of Emergency Management, Fire Department, Police Department, Sheriff’s Department, Department of Homelessness and Supportive Housing, and Department of Public Health.

People witnessing a crisis generally request help by calling either 911, the city’s emergency line, or 311, for general services and assistance. Dispatchers do their best with the information the caller provides to quickly determine whether the distressed person poses an immediate danger to themselves or others.

Calls about mental health crises often ping-pong between 911 and 311 as details emerge, said Burt Wilson, president of the union chapter that represents the city’s emergency dispatchers.

Many unhoused people carry weapons to defend themselves at night, and they might struggle with drug addiction or be mentally unstable, Wilson said.

“I don’t know how you differentiate, on the phone call, who to transfer to 311 and who to transfer to the police,” Wilson said. “Most of the 311 calls end up coming back to our call center because 311 just has to say a certain trigger word like, are they ‘aggressive?’ And then it comes right back to us.”

The Department of Emergency Management dispatches police in cases of calls about people threatening violence or wielding weapons; that doesn’t include people who are merely yelling, said Officer Robert Rueca, a spokesperson for the San Francisco Police Department.

But what qualifies as “violence?” The Department of Emergency Management could not say.

“‘Violent’ is not something we have a concise definition for,” a spokesperson said. “It will vary based on circumstances and the level of information the reporting party is providing.”

And a “weapon” is broadly defined as “anything that can be used as a weapon,” according to department guidelines. For many types of small weapons, such as pocket knives, possession alone is not considered a threat.

If a person is in severe crisis, police and medical personnel can put them on a 5150 hold.

But involuntary hospitalization can be harmful, said Sarah Gregory, a senior attorney at Disability Rights California. The organization advocates for community-based services for people with mental health disabilities, as an alternative to forced stays in hospitals or psychiatric wards.

Gregory called it a “traumatic” experience when someone “who’s already having a mental health crisis calls for help, and then receives a response that takes away the person’s rights.”

“Client after client says, ‘I came out of there worse than I went in,’” Gregory said, referring to places where patients were involuntarily detained.

When a person in mental distress is not an immediate threat, the call goes to medical personnel like the Street Crisis Response Team, Fire Department or paramedics. The crisis team is one of many created in recent years as San Francisco and other cities have shifted away from a law enforcement response following high-profile police killings, including those of Mario Woods, Tony Bui and George Floyd, in which the officer was convicted of murder.

The San Francisco Police Department “would never be dispatched to a medical call” even if the Street Crisis Response Team or an ambulance were unavailable, said the spokesperson for the Department of Emergency Management. The police were the crisis team’s backstop in its early years, but that stopped in June 2022, they said.

The team uses de-escalation strategies to calm a person in distress, like speaking softly, asking questions to get to know them, and offering snacks or water. When the person regains composure, the team might connect them to treatment or follow-up care with the Office of Coordinated Care, Homeless Outreach Team or Post Overdose Engagement Team, the spokesperson said.

The team might also simply leave the scene once the person is no longer in distress.

People who engage with the city’s crisis-response system might benefit most from having long-term case managers who can help them fully resolve problems with their health or living situations, said Mark Salazar, chief executive officer of the Mental Health Association of San Francisco. The organization provides case management and peer support services at courts, jails and Zuckerberg hospital after someone is released from a 5150 hold.

“But the shortage of support and funding is really a challenge,” Salazar said. “Without having continued support after being 5150’d, or [receiving] forced treatment, you’re just setting up someone for more failure.”

Support for people struggling with their mental health

San Franciscans struggling with their mental health can call many local and national hotlines. To learn about the resources that are available, and potentially speak with counselors, reach out to the organizations below. 

Mental Health Association of San Francisco: Talk to a peer about your feelings and get information about available mental health services.

• Warm line is open 24/7
• Call or text 855-845-7415

San Francisco Behavioral Health Services: Find local mental health or substance use services that meet your needs.

• Clinicians are only available Monday-Friday from 8 a.m. to 7 p.m., and Saturday-Sunday from 9 a.m. to 4 p.m.
• Behavioral access helpline is open 24/7
• Call 415-255-3737 or 888-246-3333

Harm Reduction Therapy Center: Speak with someone if you are experiencing homelessness and seeking peer counseling or harm reduction services.

• Community helpline is open Monday-Friday, from 10 a.m. to 8 p.m.
• Call 415-863-4282

San Francisco Night Ministry: Speak with counselors trained in trauma-informed care, interfaith spiritual support, suicide prevention and crisis management.

• Care line is open every day from 8 p.m. to 2 a.m.
• Call 844-467-3473

Mobile Crisis Team: Speak with clinicians who can help someone experiencing a crisis. The team may visit the person to assess whether they meet the criteria for involuntary psychiatric detention, and they can request support and transportation by paramedics or police.

• Helpline is open 24/7
• Call 628-217-7000

SF Suicide Prevention Hotline: Speak with a counselor if you or your loved one are considering suicide. Counselors can provide referrals for mental health, HIV and addiction services.

• Hotline is open 24/7
• Call 415-781-0500 or text 415-200-2920

Other resources

California Peer-Run Warm Line

• Warm line is open 24/7
• Call or text 855-600-WARM (9276)

California Suicide Prevention Lifeline

• Hotline is open 24 hours
• Call 988

Crisis Text Line

• Crisis counseling is available 24/7
• Text HOME to 741741
• Visit their website to connect via online chat or WhatsApp

Like many media organizations, the San Francisco Public Press is experimenting with artificial intelligence (A.I.) tools that aid the creation of images for use in some stories. Nearly all our visual content is produced by humans.

The Public Press is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity and newsrooms in select states across the country.

See our related article, The Often Vicious Cycle Through SF’s Strained Mental Health Care and Detention System

The post You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next appeared first on San Francisco Public Press.

Uncertain what to do, we dialed 311, San Francisco’s non-emergency helpline. Seventeen minutes later, a red van arrived, carrying members of the city’s Street Crisis Response Team. Jay told them he was schizophrenic. The paramedic recognized him from previous calls and greeted him. Looking at Jay’s digital records, a member of the group realized his prescription had been refilled about two weeks prior, but Jay didn’t remember picking it up.

As they spoke, it became clear that Jay had previously been placed under involuntary psychiatric detention, also called a “5150 hold.”

That fall day, Jay asked to be detained again.

[ Read also: “You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next” ]

That was how he had gotten a dose of Benadryl, one of two medications he used to manage his condition, he said. Benadryl is among the antihistamines that can help control anxiety. Schizophrenia requires lifelong treatment, even when symptoms have subsided.

“They give me my pill with a 5150,” he said.

The paramedic bristled. “That’s a lot of resources just to get one pill.”

Jay was one of thousands of people last year who fell into San Francisco’s complex, reactive, strained system for treating severe mental health and drug-related crises. As with many of the people who enter that system — including those who are unhoused or are detained without their consent following a call from an alarmed observer — Jay had received temporary care, entailing multiple involuntary psychiatric holds, that failed to address his long-term problems. That left him back on the streets to fend for himself or, with the help of passersby, try again to get the help he needed.

Since the start of the COVID-19 pandemic, much of the public discussion about homelessness and mental health in San Francisco has focused on the people who desperately need care, but who reject it. Jay’s story diverges from this common narrative.

“When’s the last time you were at Gen?” the paramedic asked, referring to the emergency room at Zuckerberg San Francisco General Hospital and Trauma Center, the facility in the city with the highest number of beds for people on 5150 holds.

“Today,” Jay said. He had gone there seeking medication, then waited in a hallway for four hours before staff gave him a dose of Risperdal, an antipsychotic that he did not usually take. It had not been effective.

Who responds to mental crisis calls

Emergency service providers may not legally turn people away. For many San Franciscans, this is their only option for accessing medical care.

City officials have made recent efforts to improve the crisis care system. A few years ago, police might have been dispatched to Jay’s call and that would divert them from situations they might be better trained to handle. Today, the city routes mental health-related calls to other teams instead when there is not an immediate safety threat, said a spokesperson with the Department of Emergency Management.

One alternative is the Street Crisis Response Team. It was created in late 2020 and aims to offer trauma-informed care to people facing mental health crises or minor medical issues, potentially reducing unnecessary emergency room visits.

When team members arrive on the scene, they address the person’s immediate needs first — for example, food or a warm blanket — and might connect them with other services and take them to a shelter, sobering center or health clinic.

The many units that respond to the city’s increasingly visible street-level crises cost millions of tax dollars each year: The Street Crisis Response Team’s budget will be $12.3 million for the fiscal year ending in 2025; the Homeless Outreach Team’s budget for the same year will be $8.9 million; and the Homeless Engagement Assistance Response Team was authorized last year to receive one-time funding of $3 million.

City dispatchers must decide which team to send — they might send more than one — relying on the caller’s description of the scene. Calls about mental health crises often ping-pong between 911 and 311 as details emerge, said Burt Wilson, president of the union chapter that represents San Francisco’s emergency dispatchers.

“It’s a huge amount of resources,” Wilson said.

Involuntary detention’s disproportionate impacts

Dispatchers received at least 24,000 calls about mental health crises or attempted suicides in 2023, including calls from bystanders as well as police, based on a Public Press analysis of government records. In many cases, responders couldn’t find the people in crisis.

In the most serious instances, crisis responders put people in 5150 holds, named after the section of California’s Welfare and Institutions Code that defines this procedure. The law permits police and trained medical personnel to detain someone for up to 72 hours if their mental health disorder is making them a danger to themselves or others, or it leaves them unable to provide for their basic needs.

The city recorded nearly 13,700 psychiatric holds for the year that ended June 2022 — but that figure, the most recent available, captures a fraction of the total situation. The number was calculated in a report by a city working group, which found that not all hospitals reported detentions and that the available data did not allow for robust analyses of patient characteristics like race, gender or housing status.

Some people were put on 5150 holds multiple times at Zuckerberg hospital. Using data from that facility in its analysis, the working group found that 425 people received at least two psychiatric holds, 86 had at least four holds and 13 had eight or more. African Americans, despite making up only 6% of the city’s population at the time, accounted for over 42% of people detained four or more times.

Most people who received emergency psychiatric services from the hospital, including 5150 holds and voluntary visits, had experienced homelessness in the prior year.

Numerous service providers told the Public Press that people are more likely to cycle repeatedly in and out of crisis-care facilities when they don’t have access to preventive or non-emergency care, because small problems can become larger ones that require hospitalization.

Experts said also that it’s vital for people to receive culturally competent care — for example, when the health worker speaks the patient’s language or knows which medical guidance will conflict least with social norms.

Underfunded care system

San Francisco has seven designated psychiatric facilities with a total of 187 beds for patients on psychiatric holds, according to the California Department of Health Care Services, which approves facilities for this use.

But not everyone on a 5150 hold gets a bed. The crisis care system is notoriously underfunded, with inadequate capacity and staff. When no bed is available, someone is detained in an emergency room for up to 24 hours.

The 2023 passage of state Senate Bill 43 might further strain the system. The law modified the eligibility criteria for 5150 holds for the first time in decades, making it possible to detain people gravely disabled due to substance use. In response, San Francisco has acquired additional beds. Many other counties are waiting to implement the policy, saying they need more guidance and resources from the state to comply.

Meanwhile, Proposition 1, a separate package of state policies that voters approved by a razor-thin margin in March, could add treatment beds to the system, including those for 5150 holds. The proposition forces counties to redirect a large portion of their mental health spending to housing programs, many of which must benefit unhoused people and veterans. A coalition of mental health organizations and disability advocates opposed the ballot measure, fearing it would cause cuts to vital community-based programs. 

Among its many mandates, Proposition 1 authorized the sale of $6.4 billion in government bonds. Of the total bond revenue, $4.4 billion is slated to pay for building behavioral health facilities. Gov. Gavin Newsom, who campaigned for Proposition 1’s passage, has said it will enable adding more than 11,150 behavioral treatment beds.

For people who are able to get beds, their problems are far from solved.

“There’s a perception that if you put someone on a hold, something good will happen for them, like something miraculous,” said Dr. Maria Raven, chief of emergency medicine at the University of California, San Francisco. People might think that an intervention by psychiatric workers would set in motion a process that leads to long-term treatment or, for those experiencing homelessness, permanent housing, she said.

“That doesn’t really happen,” Raven said. Instead, “you just put someone where there’s a bed.”

[ Read also: “Mental Health Advocates Call for Voluntary Treatment as Spears Conservatorship Ends” ]

Back on Market Street, the Street Crisis Response Team was trying to find help for Jay in this overburdened system. As they made phone calls to locate a facility that could fill Jay’s medication, one team member tried to comfort him with snacks and water, which he was hesitant to accept.

“Every time I drink something, bad stuff happens,” Jay said.

“You can drink it,” the paramedic told him calmly. “We’re not going to leave you.”

After about 15 minutes and at least four unfruitful calls to multiple agencies, the paramedic suggested that the outreach workers try the Westside Crisis Clinic. They checked its operating hours but found conflicting information online. A call revealed that it was closed for the day.

“It’s very unfortunate that the city runs on banking hours,” another team member said.

Finally, the team found a bed at the Dore Clinic, which provides psychiatric urgent care. Jay could stay there for up to a day. He would have a bed and access to a shower and a phone. That would enable him to call his sister, who could pick him up and help him obtain his medication.

“You can get all your meds tomorrow, something that we can all look forward to,” the paramedic said.

Like many media organizations, the San Francisco Public Press is experimenting with artificial intelligence (A.I.) tools that aid the creation of images for use in some stories. Nearly all our visual content is produced by humans.

The Public Press is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center, The Center for Public Integrity and newsrooms in select states across the country.

See our related article You Report an Unhoused Person in a Mental Health Crisis. This Is What Happens Next

The post The Often Vicious Cycle Through SF’s Strained Mental Health Care and Detention System appeared first on San Francisco Public Press.

Algunas personas recitan una oración de agradecimiento por el tiempo que pasaron en la cárcel del condado de San Francisco. Entre ellos está un hombre del Área de la Bahía al que llamaremos Carlos para respetar su solicitud de anonimato. 

“Gracias a Dios que yo me salí,” Carlos dijo, 29. “Busqué una mejor vida porque me acerqué a buenas personas, me acerqué a personas que me orientaron, me acerqué a personas que querían en realidad verme triunfar en la vida.”

Esas personas eran proveedoras de programas en español en las cárceles del condado. Carlos es de Honduras y llegó a San Francisco por un trabajo prometido que nunca se materializó. En cambio, vendió drogas.

Todo eso cambió cuando fue encarcelado en la cárcel del condado de San Francisco por cargos relacionados con drogas hace casi cuatro años. Cuando era encarcelado, conoció a un trabajador hispanohablante de ReSET Justice Collaborative – una de las organizaciones comunitarias que trabajan con el director de los programas de la cárcel para brindar capacitación vocacional, cursos educativos, tratamiento de trastornos por uso de sustancias, clases de manejo de la ira, actividades culturales, clases de inglés y observancias religiosas.

“Ellos fueron a visitarme a la cárcel. Y desde ahí ellos me suscribieron a lugares donde podían ayudarme,” Carlos dijo.“Luego de que salí me ayudaron a conseguir un trabajo que aún todavía lo tengo. Tengo dos años trabajando en este trabajo acá. No volví a regresar nunca más, nunca más a mezclarme con ventas de droga. … No me he vuelto a meter al Tenderloin y me ha servido mucho porque le he traído más tranquilidad a mi familia.”

Pero desde entonces, los programas ofrecidos en español en la cárcel del condado de San Francisco se han vuelto prácticamente inexistentes porque los cierres de rutina causados ​​por la escasez de personal han hecho prácticamente imposible impartir clases. Incluso con los diputados trabajando en turnos obligatorios de 16 horas, no hay suficientes para acompañar a las personas que administran sesiones de rehabilitación y otros programas de capacitación a las cárceles. El 2 de febrero, numerosos proveedores de servicios sociales para la población latina encarcelada imploraron a la Junta de Supervisión del Departamento del Sheriff en su reunión que los ayudará a obtener acceso a la cárcel.

Parecía que el liderazgo de la cárcel respondió al llamado público la semana siguiente anunciando un nuevo programa de recuperación del uso de sustancias y una clase de arte terapia ofrecida en español; sin embargo, un portavoz de la cárcel dijo que han estado planificando las clases desde octubre pasado. Sin embargo, algunos trabajadores carcelarios que llevan mucho tiempo expresaron dudas de que los programas durarían más de unas pocas semanas.

La falta de programación en español es un problema crecientemente grave ya que el encarcelamiento de latinos ha aumentado desde el lanzamiento el junio pasado de una ofensiva policial contra las drogas en los vecindarios de Tenderloin y sur de Market.

Según datos del Departamento del Sheriff, del 1 de junio al 10 de noviembre de 2023 (el más nuevo disponible), el 42% de las personas ingresadas en la cárcel del condado de San Francisco por cargos relacionados con drogas eran latinas, en comparación con el 30% que eran personas negras y el 28% que eran personas blancas. Y como Carlos vio hace años, algunas personas necesitan comunicar su necesidad de ayuda desesperadamente.

“Hay personas ahí que tienen hasta problemas mentales, problemas mentales que no pueden lidiar. ¿Y cómo se los van a contar a alguien que hable inglés y no entiende?” Carlos dijo. 

El año pasado, la policía también se dirigió a personas por simple consumo de drogas para motivarlos a recibir tratamiento para el trastorno por uso de sustancias, según funcionarios municipales y oficiales. Sin embargo, desde entonces, el programa de tratamiento de la cárcel, Road to Recovery, ha estado disponible sólo en inglés, a pesar del interés expresado por parte de la población latino.

Según datos del Departamento de Salud Pública de la ciudad, de septiembre de 2022 a septiembre de 2023, los Servicios de Salud Penitenciario evaluaron que 380 pacientes latinos encarcelados tenían un trastorno para consumir opioides. De ellos, 209 buscaron tratamientos a través de medicamentos como buprenorfina o metadona.

No está claro cuántos de ellos no recibieron programación de tratamiento porque eran monolingües de español, ya que no rastrean datos sobre preferencias de idioma.

Pero en un caso en octubre pasado, la proveedora de servicios Joanna Hernández del Latino Task Force, una asociación con sede en San Francisco de más de tres docenas de organizaciones comunitarias, dijo que fue testigo de un grupo de hombres en el programa del Road to Recovery en la cárcel del condado No. 3 en San Bruno. Hernández dijo que de los 46 hombres en el programa, 20 hablaban español y apenas podían entender la clase.

“A veces, simplemente se sientan y entienden algunas de las palabras, pero si no, simplemente van a sus celdas,” dijo Hernández en inglés. “Y luego me lo comprobé con el personal y me dijo: ‘No tengo personal que hable español y apesta porque siguen poniendo a personas que no hablan el idioma en este módulo del programa.’

“Es algo que pasa mucho dentro de las cárceles. Entonces, la gente está volviendo al mismo lío, volviendo al mismo comportamiento – si no volviendo peor, porque fueron confinados y arrancados de su familia, de sus hijos, de su religión, de todo.”

Ali Riker, directora de programas del Departamento del Sheriff, dijo que estaba consciente de que los hispanohablantes van a Road to Recovery, el programa en inglés. Dijo que cree que esto sucedió porque sabían suficiente inglés como para solicitar acceso al programa.

“No prohibimos la participación a las personas que lo solicitaron,” dijo Riker. “Sé que no es lo ideal. Estamos haciendo nuestro mejor esfuerzo. ¿Es suficiente? Ya sabes, necesitamos más. Definitivamente necesitamos más recursos.”

La Cárcel #3 del Condado de San Francisco en San Bruno es uno de los lugares donde los que son encarcelados pueden ir al programa Road to Recovery, un programa de rehabilitación para trastornos por uso de sustancias. El programa no se ofrece en español.

Read this story in English.

Hernández se unió a los otros proveedores de servicios sociales latinos en la Junta de Supervisión del Departamento del Sheriff el 2 de febrero. Dijo que ha experimentado el caos causado por la escasez de personal.

“Cuando llegas a facilitar tu clase, te dicen: ‘Lo siento, no llegamos al mínimo, el programa está cancelado’,” dijo Hernández. También dijo que descuidar las oportunidades vocacionales y de rehabilitación en la cárcel es contraproducente para los objetivos declarados de la ciudad.

“Sé que la gente quiere seguridad pública,” ella dijo. “Y sé que la gente quiere que cese la venta de drogas y que les roben o les golpeen los coches. ¿Pero qué hacemos encarcelando a la gente y no reciben ninguna rehabilitación?”

Los efectos negativos a largo plazo son especialmente tristes para los jóvenes encarcelados. Del 1 de junio al 10 de noviembre, hubo 10 veces más latinos de entre 18 y 24 años ingresados ​​en cárceles de San Francisco que las personas blancas o negras entre la misma edad. Y los defensores dicen que los más jóvenes necesitan especialmente programas de reinserción social, ya que los antecedentes penales les impiden adquirir habilidades laborales, avances profesionales y oportunidades económicas.

Los representantes del grupo comunitario dijeron a los comisionados de supervisión que ellos y otros proveedores de programas están en la mejor posición para ayudar a cambiar estas vidas.

“Somos culturalmente competentes,” dijo Bianca Sánchez, administradora de casos de Bay Area Community Resources. “Implementamos un enfoque centrado en la sanación y tenemos una perspectiva informada sobre el trauma, lo que nos hace más equipados para brindar servicios y apoyo dentro de las cárceles. Como profesionales capacitados, podemos brindar servicios efectivos de intervención, tratamiento y rehabilitación para romper los ciclos de encarcelamiento.”

Julie Soo, presidenta de la junta de supervisión, dijo que la solicitud estaba en consonancia con una legislación municipal de décadas de antigüedad, que ella ayudó a escribir,que garantiza el derecho a la igualdad de acceso a los servicios de la ciudad para todos los residentes de San Francisco, incluidos aquellos que saben poco el inglés. Sin embargo, dijo, un presupuesto “muy conservador” del Departamento del Sheriff requerirá “establecer prioridades.”

Llegan nuevos programas pero persisten las dudas

Menos de una semana después de la reunión de la junta de supervisión, se lanzó una nueva clase de recuperación del abuso de sustancias en español llamado Living in Balance; También se lanzó una clase de arte terapia en español.

Riker dijo que es optimista de que las clases programadas se mantendrán estables porque desde hace unos meses, el Departamento del Sheriff ha realizado programas ininterrumpidos de 9 a 11 a.m. en el anexo de la cárcel, donde recientemente han sido transferidos un gran número de reclusos que hablan español.

Otros no son tan optimistas como Riker. Hernández dijo que las dos horas para programas compiten con el tiempo al aire libre, llamadas y visitas a abogados, entre otras actividades, y está muy lejos de las seis a siete horas diarias de programación de tratamiento de adicciones que recibían los reclusos en el pasado. Y un trabajador que ha trabajado en la cárcel durante mucho tiempo, que habló bajo condición de anonimato, dijo que cree que el nuevo plan de estudios es para impresionar.

“Hacen cosas, ya sabes, para las cámaras, y luego, cuando termina, cuando nadie mira, todo vuelve a ser como era”, dijo el trabajador, y agregó: “Le doy dos semanas.”

Sylvie Pagan de NoVA, el No Violence Alliance Program, que atiende a personas que regresan a la comunidad después de estar en la cárcel por un delito violento o múltiples arrestos, dijo a la junta de supervisión el 2 de febrero que su organización también estaba lanzando un programa para latinos en la cárcel la semana que viene. Pero, dijo, “esto es sólo una semilla en un gran balde de muchas necesidades que necesitamos para la comunidad”.

Riker dijo que espera trabajar con más organizaciones comunitarias y, con los recursos escasos a su disposición, está implorando a grupos externos aun más ayuda.

Riker alentó a cualquier organización comunitaria enfocada en brindar servicios a hispanohablantes a enviar un correo electrónico a William Cooper, gerente de servicios de rehabilitación del Departamento del Sheriff, a william.cooper@sfgov.org.

Presupuesto de la alcaldesa da prioridad a la policía

La población carcelaria creció de 800 personas en junio a más de 1.100 hoy debido a la ofensiva policial contra las drogas. La situación exacerbó un nivel ya crítico de escasez de personal en la oficina del sheriff que, según los informes últimos, necesita contratar a 207 personas para dotar de personal a su contingente de 920 puestos. El año pasado, la abogada de derechos civiles Yolanda Huang demandó a San Francisco en nombre de personas encarceladas que afirmaban haber sufrido problemas de salud graves por la falta de luz solar después de años en confinamiento. Esa cuestión aún está en litigio, dijo Huang.

“La solución es que, si la alcaldesa quiere encarcelar a la gente, y no estoy hablando de si debería o no debería suceder, entonces tiene que pagar por ello,” dijo Huang. “Ella tiene que dotar de personal completo a la cárcel. Y si no va a dotar de personal completo a la cárcel, entonces no es necesario que encarcelen a estas personas. Es muy simple. Si los vas a alojar y controlarlos, entonces tienes que hacerlo bien. Y no lo son.”

Y no sólo las cárceles están sufriendo. La oficina del Defensor Público de San Francisco demandó al Tribunal Superior del Condado de San Francisco por retrasos en los juicios, alegando que infringía el derecho de sus clientes a un juicio rápido. El tribunal dijo que los retrasos en los juicios se deben a que la oficina del sheriff está extendida demasiado en las cárceles y el Salón de Justicia.

Sin embargo, la alcaldesa de San Francisco London Breed recortó el presupuesto del sheriff en $8 millones para 2023-24, dando al departamento un total anual de $292 millones. Pero sí aumentó el presupuesto del Departamento de Policía de San Francisco en $61 millones para 2023-24 y otros $11 millones el año siguiente fiscal para un total de $786 millones. Esos fondos se destinarán a la contratación de 500 funcionarios más, horas extras y salarios más altos negociados bajos un nuevo contrato sindical.

Además, en junio pasado, los supervisores de la ciudad respaldaron una resolución del supervisor Matt Dorsey solicitando que el Departamento de Recursos Humanos de la ciudad redactara una política de bonificaciones para los policías recién contratados que competiría con otras agencias policiales en el norte de California. El 16 de enero, Breed y el jefe de policía, Bill Scott, emitieron un comunicado de prensa conjunto promocionando sus éxitos. El comunicado anunció que en febrero y mayo se graduaron tres clases de la academia de policía con un total de 60 reclutas. El logro se debió a un salario inicial más alto y procesos de prueba y contratación simplificadas, según el comunicado. No se mencionó ninguna bonificación de contratación.

Mientras todo eso, supuestamente hay miedo en Departamento del Sheriff que las bonificaciones para firmar en otras agencias podrían atraer aun más diputados, incluyendo un bono de firma ampliamente publicitado de $75,000 del Departamento de Policía de Alameda para nuevos reclutas o contrataciones laterales de otros departamentos de policía.

Sylvie Sturm informó esta historia mientras participaba en la beca de datos 2023 del Centro Annenberg de Periodismo de Salud de la USC, que brindó capacitación, tutoría y financiación para apoyar este proyecto.

The post Proveedores de Servicios Exigen Acceso a Reclusos Latinos appeared first on San Francisco Public Press.

Numerous drug policy experts and addictions specialists from across the country — as close as UCSF and as far away as Rhode Island — publicly oppose a San Francisco ballot measure that would compel adult welfare recipients to undergo drug screening before collecting cash benefits.

And efforts to publicize the measure have brought specialists who don’t always agree about addiction treatment practices to the same side of the debate.

Keith Humphreys, Stanford professor of psychiatry and behavioral sciences, has said San Francisco has been too permissive with people with substance use disorder. 

That led a local Proposition F campaigner to believe that he was an ally, Humphreys said.

“It was sent to me by someone in politics in San Francisco asking me, you know, do I want to endorse this?” he said. “And the answer is no.

“Being poor is not a crime. If this is something that is important to do, we should be doing it with people who threaten public safety, and not people who need this money to eat and pay their rent.”

Mayor London Breed’s Proposition F — Illegal Substance Dependence Screening and Treatment for Recipients of City Public Assistance would require single adults aged 65 and under who have no dependent children and receive County Adult Assistance Program benefits to participate in drug screening, evaluation and treatment to be eligible for cash benefits.

Recipients who decline screening or treatment would be ineligible for monthly cash benefits of $105 for people experiencing homelessness and $697 for housed residents. Benefit recipients who lack housing would receive 30 days of guaranteed shelter access. Those in housing would receive 30 days of rent paid directly to a landlord, with potential extensions for eviction prevention.

Proposition F has the backing of some wealthy donors in the tech sector, most notably Chris Larsen, a tech billionaire best known for co-founding Ripple and a major donor to political groups Neighbors for a Better San Francisco, Progress SF and GrowSF. 

Larsen has spent nearly $1 million on this election, including $250,000 on Proposition F, donations to various Democratic County Central Committee candidates running against incumbents, and $100,000 in one San Francisco Superior Court contest to unseat an incumbent judge.

Larsen is also a personal champion of Breed and her agenda.

“You’ve got a Board of Supervisors that doesn’t work with the mayor, that’s a huge problem,” Larsen said in an interview with Bloomberg News last fall. “And unfortunately, that can only be addressed in the ’24 election.”

A Failed Strategy

Breed said threatening to rescind cash benefits would compel low-income residents with substance use disorder into treatment. She announced the strategy last September after a plan to coerce people into treatment through arrests failed.

“The arrests that we’re making for public intoxication, people are not accepting help,” Breed said. “And so now it’s time to make sure that we are cutting off resources that continue to allow this behavior to occur without the accountability, without someone involved in a treatment program that could lead to a better life.”

According to retired Redondo Beach Police Lt. Diane Goldstein, the mistake San Francisco’s and other cities’ leaders make is that they don’t adequately fund programs that would effectively support public health, public safety and mental health.

Instead, she said, they “wait until things are so bad that they call the cops to fix the problem with the wrong set of tools.” 

Goldstein is now executive director of the Law Enforcement Action Partnership, a group of police, prosecutors, judges and other criminal justice professionals focusing on drug policy and criminal justice.

“Frankly, I just don’t know if the public is ever going to understand it,” Goldstein said. “Because they don’t understand that law enforcement should have never been tasked with enforcing a public health issue going back years. But the reason we do is, we’re the only people that answered the phone in the middle of the night.”

Goldstein said there are positive ways to involve police officers in helping more people access substance use disorder treatment programs. For example, the San Francisco Police Department was involved in a program in 2017 that brought law enforcement officers, street teams, case managers, public health clinicians and justice system professionals together to enroll repeat low-level drug offenders into community-based health and social services as an alternative to jail and prosecution. But that was short-lived.

The Law Enforcement Assisted Diversion — aka LEAD and now called Let Everyone Advance with Dignity — was launched in 2011 by Seattle-based Purpose Dignity Action, then called the Public Defender Association, which responds to public safety issues by facilitating inter-agency coordination. It has since expanded throughout the country.

In 2017, San Francisco received $6 million to implement LEAD from the Board of State and Community Corrections. But it stumbled after two years despite showing significantly lowered rates of misdemeanor and felony arrests, and felony cases among enrollees. 

One of the main problems was getting buy-in from law enforcement officers, according to an evaluation by the California State University, Long Beach, School of Criminology.

It was a major shift to go from arresting people to diverting them into social programs, according to interviews with officers and court personnel quoted in the report. As one officer said, “I’ve been around…cops for almost 30 years, and it’s not going to be like — it’s not going to be, push a button or snap your fingers and everybody is going to go, ‘Okay, we’ll do it different.’”

San Francisco Police Chief Bill Scott expressed willingness to revisit the program at a Police Commission meeting last June, but it’s unclear whether there have been efforts to revive it. The Police Department did not respond to inquiries about this subject.

Lisa Daugaard, co-executive director of Purpose Dignity Action, said leaders can no longer ignore the fact that coercing people into treatment for substance use disorders is counterproductive because it doesn’t address underlying circumstances.

“It comes from an understandable impulse to help people get better. That is not how people get better,” Daugaard said. “Imagine what happens if they don’t do that thing. So now you have people in an even more miserable situation than they are right now who definitely are going to be turning to the illicit economy to get their income. And that’s not good for anybody.”

She said she understands the pressures city leaders face regarding visible drug sales, use and addiction.

“The problem that we’ve got is that public officials under public pressure need something to point to that seems like action,” Daugaard said. “They don’t know how people get better, and that impulse to quick action can be very, very destructive.”

She said that’s why her organization “spends a ton of time” ensuring that their inter-agency approach visibly improves the situation on the streets for retail businesses and that police are satisfied with their recommendations.

Relapse Not Considered

San Francisco Human Services Agency Executive Director Trent Rhorer said last September that about 20% of the 5,200 people who collect County Adult Assistance Program benefits self-disclosed last year that they were suffering from substance use disorder. 

“It’s a population that has not availed themselves of treatment,” and this measure would lead to a “positive change” in their lives, Rhorer said.

Brandon del Pozo, an assistant professor of medicine and public health at Brown University, where he conducts research on the drug epidemic and its intersection with policing and criminal justice, said Proposition F does not account for the fact that addiction is an inherently relapsing disease, even among those who willingly enter medically assisted treatment. 

“The clinical odds of someone getting on the medication and staying on the medication are very low without repeated attempts,” del Pozo said.

He also applied his perspective as a 19-year veteran of the New York City Police Department and the former chief of police of Burlington, Vermont, where he organized the city’s response to the opioid crisis.

“The cop in me says that if you could get them to stay on for five years, and that’s the facts, try it. That is just not the world,” he said. “People will fail out of this and lose their assistance, lose what they need to survive.” 

Addiction specialists agree that the measure does not address the circumstances surrounding harmful substance use.

Dr. Marlene Martin, UCSF associate professor and founding director of the addiction care team at San Francisco General Hospital, was among four medical professionals who gathered for a Feb. 2 press conference to speak out against Proposition F.

She said her patients have told her they use substances because of housing instability, trauma, poverty, discrimination and untreated mental illness. She added that threatening to halt or cut city benefits will erode the trust it takes for recipients to disclose their substance use and seek addiction treatment.

“I have seen addiction and overdose worsen when people lose support systems, and that is what Proposition F threatens to do,” Martin said.

Laura Thomas, senior director of HIV and harm reduction policy at the San Francisco AIDS Foundation, said at the Feb. 2 press conference that Proposition F does not increase access to substance use disorder treatment. And while her organization provides a path to recovery for numerous clients every year, she said, the city is reducing its funding.

“If the Human Services Agency wants to connect people to treatment, I highly recommend that instead of putting this wasteful and cynical initiative on the ballot, that they add a couple of linkage counselors to connect people to medications for opioid use disorder including buprenorphine and methadone,” Thomas said.

Legal Troubles on the Horizon

The measure could bring the city legal troubles. Mission Local reported Feb. 20 that attorney Kerianne Steele representing Service Employees International Union Local 1021 sent a letter to the city attorney claiming that Proposition F violates the Meyers-Milias-Brown Act, which mandates that an employer confer with union employees on matters related to employment conditions.

Steele says Proposition F would adversely affect employees since it would lead to increased workloads at a time when the mayor is calling for budget cuts despite staff shortages across the Human Services Agency. The letter states also that there could be an increase to threats against staff as recipients are denied benefits, yet the measure includes no provisions for increased security.

And, while the measure anticipates enrolling an estimated 1,700 new clients into treatment, the SEIU letter states that, as of its writing, San Francisco had only 46 treatment beds available, according to the city’s tracking system. Meanwhile, the mayor’s budget proposes to cut city funding for drug treatment and mental health services.

The letter demands that the Proposition F be removed from the ballot. But the deadline to do that passed in November, according to the San Francisco Department of Elections.

The post Drug Policy, Addictions Specialists Oppose Prop F Tying Welfare to Drug Tests appeared first on San Francisco Public Press.

Some people recite a prayer of gratitude for the time they spent in San Francisco County Jail. Among them is a Bay Area resident we’ll call Carlos to respect his request for anonymity.

“Thank God,” said Carlos, 29. “I sought a better life because I got close to good people who guided me. I got close to people who really wanted to see me succeed in life.”

Those people were Spanish-language county jail reentry program providers. Carlos came to San Francisco from Honduras, pursuing promised work that never materialized. Instead, he sold drugs.

That all changed nearly four years ago when he was booked into San Francisco County Jail on drug violations. Once incarcerated, he met Spanish-speaking staff from the ReSET Justice Collaborative — one of myriad community organizations that work with the jail’s program director to provide vocational training, educational courses, substance use disorder treatment, anger management counseling, cultural activities, English classes and religious observances.

“They went to visit me in jail, and from there they signed me up to the places where they could help me,” Carlos said. “Because of how much they taught me, after I left, they helped me get a job that I still have. I have been working in this job here for two years. I never went back to being involved with drug dealing again. I have not gone into the Tenderloin again, and it has helped me a lot because it has brought more peace of mind to my family.”

But Spanish-language programming at San Francisco’s County Jail has since become virtually nonexistent as routine lockdowns caused by staff shortages have made it practically impossible to hold classes. Even while deputies work mandatory 16-hour shifts, there aren’t enough of them to escort people who administer rehabilitation sessions and other training programs into the jails. On Feb. 2, numerous social service providers for the Latinx incarcerated population implored the Sheriff’s Department Oversight Board at its monthly meeting to help them gain access to the jail.

It appeared that jail leadership responded to the public call-out the following week by announcing a new Spanish-language substance use recovery program and art therapy class, however a jail spokesperson said the classes had been in the works since last October. Nevertheless, some longtime jail workers expressed doubt that the programs would last for more than a few weeks.

The lack of Spanish-language programming is an increasingly dire problem since Latinx incarcerations have been on the rise since last June’s launch of a police crackdown on drugs in the Tenderloin and South of Market neighborhoods.

According to Sheriff’s Department data, from June 1 to Nov. 10, 2023 (the most recent available), 42% of people booked in San Francisco County Jail on drug-related charges were Latinx compared with 30% who were Black and 28% who were white. And as Carlos witnessed years ago, some people desperately need to communicate their need for help.

“There are people there who have mental problems, mental problems that they cannot deal with, and how are they going to tell that to someone who knows only English and doesn’t understand?” Carlos said.

Last year’s police crackdown also targeted people for simple drug use as a means of encouraging them into substance use disorder treatment, according to city and law enforcement officials. Yet since then the jail’s treatment program, Road to Recovery, has been available only in English, despite an expressed interest in treatment from the Latinx population.

According to city Department of Public Health data, during the 12 months that ended in September 2023, Jail Health Services assessed 380 incarcerated Latinx patients as having an opioid use disorder. Of them, 209 sought treatments through medications such as buprenorphine or methadone.

It’s unclear how many of them lost out on treatment programming because they were monolingual Spanish speakers, since the data don’t track language preference. But in one instance last October, service provider Joanna Hernandez of the Latino Task Force, a San Francisco-based association of more than three dozen community-based organizations, said she witnessed a “pod” — a group of men assigned to a small congregation of cells — attending Road to Recovery at County Jail No. 3 in San Bruno. Hernandez said of the 46 men attending, 20 were Spanish speakers and could barely understand the curriculum.

“Sometimes they just sit and kind of understand some of the words but if not, they’ll just go to their cells,” Hernandez said. “And then I checked in with the staff, and he told me, ‘I don’t have Spanish-speaking staff and it sucks because they keep putting people who don’t speak the language in this program pod.’

“It’s something that happens a lot inside the jails. So, people are coming back to the same mess, back to the same behavior — if not coming back even worse, because they were confined and ripped from their family, their children, their religion, like everything.”

Ali Riker, director of programs for the Sheriff’s Department, said she was aware that Spanish speakers attended the English-language Road to Recovery program. She said she speculated that this happened because they had enough English proficiency to request access.

“We weren’t, like, barring people from participating who requested it,” Riker said. “I know it’s not ideal. We’re doing our best. Is it enough? You know, we need more. We definitely need more resources.”

Hernandez joined the other Latinx social service providers at the Sheriff’s Department Oversight Board on Feb. 2. She said she’s experienced the chaos caused by short staffing.

“When you get there to facilitate your class, you’re told, ‘Sorry, we’re not at our minimum, program is cancelled,’” Hernandez said, adding that neglecting jail vocational and rehabilitation opportunities is counterproductive to the city’s stated goals. 

“I know that people want public safety,” she said. “And I know that people want drug sales to stop, their cars being robbed or bipped. But what are we doing locking people up and they’re not receiving any rehabilitation?”

Long-term negative effects are especially dismal for incarcerated youth. Latinx people aged 18 to 24 represented 10 times more drug-related bookings in San Francisco jail from June 1 to Nov. 10 than either their Black or white counterparts. And advocates say younger people especially need reentry programs since criminal records inhibit them from gaining work skills, career advancements and economic opportunities.

The community group representatives told the oversight commissioners that they and other program providers are best positioned to help turn these lives around.

“We are culturally competent,” said Bianca Sanchez, a case manager at Bay Area Community Resources. “We implement a healing-centered approach and have a trauma-informed lens, making us more equipped to provide services and support inside the jails. As trained professionals, we can provide the effective intervention, treatment and rehabilitation services to break the cycles of incarceration.”

Julie Soo, president of the oversight board, said the request was in keeping with decades-old city legislation enshrining the right to equal access to city services for all San Franciscans, including those with limited proficiency in English — legislation that she helped draft. But, she said, a “very conservative” Sheriff’s Department budget will require “setting up priorities.” 

New Programs Arriving but Doubts Remain

Less than a week after the oversight board meeting, a new Spanish-language version of a substance abuse recovery class called Living in Balance was launched as well as a Spanish-language art therapy class.

Riker said she’s optimistic that class scheduling will remain stable since the Sheriff’s Department has delivered programs uninterrupted from 9 to 11 a.m. in the jail annex — where a large number of Spanish-speaking inmates have recently been transferred — for a few months now.

Others are not as optimistic as Riker. Hernandez said the two hours a day compete with outdoor time, phone calls and lawyer visits, among other activities — and it’s a far cry from the six to seven hours a day of addiction treatment programming that inmates used to get. And a longtime jail worker speaking on condition of anonymity said they believe the new curriculum is just for show.

“They do stuff, you know, for the cameras, and then when it’s over with, when nobody’s looking, it goes back to how it was,” the worker said, adding, “I give it two weeks.”

Sylvie Pagan of NoVA, the No Violence Alliance Program, whose participants return to the community after serving time for a violent offense or multiple arrests, told the oversight board on Feb. 2 that her organization was also launching a Latino program in jail the next week. But, she said, “this is just a seed in a large bucket of many, many needs that we need for community.”

Riker said she’s eager to partner with more community organizations, and with the meager resources at her disposal, she’s imploring outside groups for even more help.

Riker encouraged any community-based organizations focused on providing volunteer services to the newcomer Spanish-speaking population to help by emailing William Cooper, rehabilitation services manager with the Sheriff’s Department, at william.cooper@sfgov.org.

Mayor’s Budget Prioritizes Police

Last year’s police crackdown on drugs caused the jail population to balloon from 800 people in June to more than 1,100 today. The situation exacerbated an already critical level of staff shortages at the sheriff’s office, which, according to the latest reports, needs to hire 207 people to fully staff its contingent of 920 positions.

Last year, civil rights attorney Yolanda Huang sued San Francisco on behalf of incarcerated people who claimed they suffered serious health problems from lack of sunlight after years of lockdowns. That issue is still being litigated, Huang said.

“The solution is, if the mayor wants to put people in jail — and I’m not talking about whether or not it should or should not happen — then she has to pay for it,” Huang said. “She has to fully staff the jail. And if she’s not going to fully staff the jail, then they need to not put these people in jail. It’s real simple. If you’re going to house them and control them, then you have to do it right. And they’re not.”

And it’s not just jails that are suffering. Gaps in duties normally assigned to sheriff’s deputies led the San Francisco Public Defender’s office to sue San Francisco County Superior Court over trial backlogs, claiming it infringed their clients’ right to a speedy trial. The court said trial delays were due to the sheriff’s office being overextended at the jails and the Hall of Justice.

Nevertheless, Mayor London Breed slashed the sheriff’s budget by $8 million for 2023-24 giving the department an annual total of $292 million. She did, however, increase the San Francisco Police Department’s budget by $61 million for 2023-24 and another $11 million the following fiscal year for a total of $786 million. That funding will go toward hiring 500 more officers, overtime and higher salaries negotiated under a new union contract.

Also, last June, city supervisors endorsed a resolution by Supervisor Matt Dorsey requesting that the city Human Resources Department draft a policy of hiring bonuses for police department recruits that would compete with other law enforcement agencies in Northern California.

On Jan. 16, Breed and Police Chief Bill Scott issued a joint press release touting their successes. The release announced that three police academy classes totaling 60 recruits were scheduled to graduate in February and May. The achievement was thanks to a higher starting pay and streamlined testing and hiring processes, the release stated. There was no mention of hiring bonuses.

Meanwhile, there are reportedly fears at the Sheriff’s Department that signing bonuses at other agencies could entice away even more deputies — like a widely publicized signing bonus of $75,000 from the Alameda Police Department for new recruits or lateral hires from other police departments.

UPDATED 2/14/2024: The story was updated with additional information from a jail spokesperson who said that jail leadership last October began organizing the Spanish-language programming that was recently announced.

Sylvie Sturm reported this story while participating in the USC Annenberg Center for Health Journalism’s 2023 Data Fellowship, which provided training, mentoring and funding to support this project.

The post Service Providers Demand Access to Latinx Jail Inmates appeared first on San Francisco Public Press.

Proposition F asks voters whether the city should be allowed to screen single adult welfare recipients for drug dependency and require those identified as suffering from substance use disorder to enter treatment to continue receiving cash assistance through the County Adult Assistance Program.

A “yes” vote supports requiring that single adults aged 65 and under with no dependent children who receive county public assistance benefits and are reasonably suspected to be dependent on illegal drugs participate in screening, evaluation and treatment to be eligible for cash benefits. A “no” vote opposes adding that requirement for County Adult Assistance Program participants. The measure requires more than 50% affirmative votes to pass.

If the ordinance is approved, county assistance recipients who decline drug screening, evaluation and treatment will be considered noncompliant and ineligible for benefits.Discontinued recipients would get 30 days of housing through guaranteed shelter access or rent paid directly to a landlord, with potential extensions for eviction prevention. State law requires every county to provide public assistance programs for poor, single adults aged 65 and under.

San Francisco currently distributes County Adult Assistance Program funds to about 5,200 single adults aged 65 and under — $109 a month to unhoused residents and $712 a month to housed residents. From 2018 to 2020, about 20% of recipients reported having a disabling substance use disorder, according to the city Human Services Agency, which administers the program. And the rate is likely higher among recipients who are experiencing homelessness.

What the screening process would entail is vague. The measure’s lead proponent, Mayor London Breed, has denied that recipients would be tested for drugs, but Trent Rhorer, Human Services Agency executive director, said at a press conference that screening could include drug testing.

The measure could have disproportionate consequences for the city’s Black residents, who account for 6% of the total population but make up the highest percentage of County Adult Assistance Program recipients whose race is known — 18% — as well as more than one-third of the city’s unhoused population and nearly one-third of overdose deaths so far this year. (Nearly half of county assistance recipients were listed as having unknown races or ethnicities in the latest Human Services Agency demographics report.)

The Department of Elections received an opponent argument submission from Roma Guy and Diane Jones, a celebrated San Francisco couple with a long history of social justice activism that was depicted in the 2017 television series “When We Rise.”

Jones, a registered nurse, and Guy, a medical social worker who served for 12 years on San Francisco’s Health Commission, argued that the measure would worsen homelessness and have “deadly results.”

“Research by public health experts shows indisputable evidence that proposals such as Prop F lead to increased rates of return to substance use, overdose deaths, and suicide,” they wrote.

Breed initially announced the proposal at a Sept. 26 press conference as a strategy to compel low-income residents with substance use disorder into treatment. “No more anything goes without accountability, no more handouts without accountability,” Breed said. “So, in order to get resources from our city, you will need to be in a substance use disorder program and consistently seeking treatment.”

Supervisor Matt Dorsey — a Breed collaborator who is open about his struggles with substance abuse — proposed the measure to the Board of Supervisors as legislation, arguing that it would inspire people at high risk for substance use disorder and overdose death to enter treatment. It had the support of Supervisors Rafael Mandelman and Catherine Stefani. But six supervisors rejected the idea.

A coalition of more than two dozen community advocacy groups responded by launching a “No on F” campaign. In a Nov. 30 letter addressed to the mayor and Board of Supervisors, they wrote that the measure would worsen homelessness, jeopardize the health and stability of Black, Latinx, Indigenous and low-income people, contribute to the stigma, and create discrepancies in treatment services and accessibility.

Board President Aaron Peskin also opposed the proposal, describing it as Breed “desperately grasping for a political lifeline.” He added that the city could not fund the routine drug testing of thousands of welfare recipients.

According to City Controller Ben Rosenfield, the measure would have a “moderate impact on the cost of government.” The annual cost of administering the program is estimated at between $500,000 and $1.4 million, which would be partially offset by discontinued public assistance funding. If the measure passes, savings from discontinued benefits could range from $200,000 to $4 million in the first year to $100,000 to $2 million in subsequent years, Rosenfield wrote. But, he added, the measure doesn’t account for additional residential treatment, withdrawal management, or residential step-down treatment programs — a cost that would depend on the number of assistance recipients who choose to participate.

For context, the city spends about $12,000 per person for a 90-day treatment stay. If all 20% of CAAP recipients who said they suffered from disabling drug dependency enrolled in such a program, it could cost the city about $12.5 million.

The measure has also been panned by several political groups including the San Francisco Democratic Party and the San Francisco Tenants Union.

“This is just another in a long line of bad faith stunts by desperate politicians leveraging our homelessness crisis in an election cycle,” Róisín Isner, director of activism and operations for the SF Tenants Union, wrote in a statement.

According to campaign finance filings, the measure has received $330,000 so far from supporters, including a $100,000 contribution from Chris Larsen, a tech billionaire best known for co-founding the peer-to-peer lending firm Ripple. Larsen also donated $250,000 toward Proposition E — Police Department Policies and Procedures.

Larsen has spent a small fortune influencing San Francisco’s trajectory over the last few years. He partnered with San Francisco’s police union to attract recruits to the Police Department, spending $600,000 on an advertising campaign that aired last year during college basketball’s March Madness Final Four. And in 2021, he gave $1.7 million in COVID-19 pandemic recovery aid to 50 neighborhood and small business groups across the city through his nonprofit, Avenue Greenlight.

The measure also has the support of Safer SF — a lobbying firm that successfully campaigned to recall former District Attorney Chesa Boudin over policies it deemed overly progressive. The Department of Elections lists Eric Kingsbury as the proponents’ measure’s primary contact. Kingsbury is a member of Safer SF and secretary of the Marina Community Association, a nonprofit neighborhood group in San Francisco’s Marina District.

The post Proposition F — Illegal Substance Dependence Screening and Treatment for Recipients of City Public Assistance appeared first on San Francisco Public Press.

While these kinds of disasters wreak havoc across all populations, the U.S. Environmental Protection Agency warns that some people, including older adults, are at heightened risk due to pre-existing conditions, weakened immune systems, restricted mobility and other health challenges.

San Francisco has already seen extreme weather conditions threaten the well-being of older residents, especially in neighborhoods like Chinatown, which city analysis has shown is particularly vulnerable to these threats.

In the past several years, smoke from wildfires and rainstorms have caused health and other problems for Chinatown’s older residents. Community organizations worry that the systems in place in the neighborhood are not enough to protect older populations, in part because of the challenges of accessing climate-resiliency funding.

“Climate change definitely affects our seniors’ quality of life as well as their health,” said Anni Chung, president and chief executive officer of Self-Help for the Elderly, a nonprofit providing an array of services for older adults in Chinatown and beyond since 1966.

Shao Ao Situ, an 81-year-old tenant of a single-room occupancy building in Chinatown, said he experienced eye irritation, fatigue and coughing when smoke from wildfires that raged across California and the Pacific Northwest in 2020 drifted through his neighborhood.

As COVID-19 was taking a disproportionate toll on older adults that year, the skies above the western United States turned an eerie orange, and the air filled with ash and toxic particles.

“I was severely affected,” said Situ, who speaks Taishanese and Cantonese.

Residential rooms in Situ’s building are dense and compact, measuring about 8 by 10 feet. A bunk bed, a table, a dresser and shelves take up most of Situ’s space, leaving little room to walk. His clothes hang over a single, long window. When smoke covered San Francisco that year, he said, he drew the window almost all the way down, allowing a small gap for ventilation.

“When the smoke concentration from the wildfires was high, I felt discomfort in my throat when breathing,” he said. Situ said his cough made it difficult for him to sleep at night. He looked for resources to cope with the situation. 

“I heard on TV that N-95 masks are the best at preventing dust and pollution particles, so we bought two boxes at that time,” Situ said, adding that government and community groups should provide more direct education to older people on how to stay safe.

He said his health problems persisted even after the smoke subsided.

[See photo essay: “For Chinatown’s Older Residents in SROs, Climate Disasters Pose Greater Risks”]

There are around 193,800 residents in San Francisco who are 60 and older. From 2010 to 2060, the city expects to see a 159% surge in its 60-plus population, according to the California Department of Aging. Meanwhile, the frequency and intensity of climate change-driven weather disasters are expected to increase.

Climate and health hardships that older residents like Situ in Chinatown and those in other parts of the city have confronted and will encounter in years to come have been on the city’s radar for over a decade.

In 2010, San Francisco’s Department of Public Health, with funding from the Centers for Disease Control and Prevention, was one of the first agencies in the nation to launch a program to investigate climate change’s effects on the health of residents and draw up contingency plans.

Since then, detailed assessments conducted by the department in collaboration with other agencies have outlined numerous health impacts San Francisco neighborhoods could face from air pollution, heatwaves, wildfire smoke, flooding and other hazards. Those reports noted that besides Chinatown, Bayview-Hunters Point, South of Market, Civic Center and Visitacion Valley could bear the brunt of the climate crisis.

In a system the department developed to gauge each neighborhood’s climate resiliency, Chinatown received the lowest overall score. “The elderly residents of Chinatown are especially at risk due to the neighborhood’s high residential density, overcrowded living conditions, and urban heat island vulnerability,” the department’s environmental health experts wrote in a report published in 2014.

The climate resiliency scorecard for Chinatown developed by San Francisco’s Department of Public Health.

Hidden health harms

Kinchiu Fung, 65, lives in a single-room occupancy building in Chinatown. Fung said his breathing was affected when wildfire smoke cloaked San Francisco in 2020. He said he was able to manage on his own. But some of his older neighbors expressed concerns about leaving the building during extreme weather, he said.

“The government should help the elderly if it has resources,” said Fung, who speaks Taishanese and Cantonese. He said more volunteers are needed to help older tenants with limited mobility during rainstorms.

Bifang Kuang, 84, who lives in a single-room occupancy unit in Chinatown, said she stayed in her room during torrential rainfall that pelted the Bay Area last January. “I did not get my medicine when it was raining,” said Kuang, who primarily speaks Taishanese.

Supplementing the city’s research into how climate change impacts health, universities across the Bay Area are examining both obvious and subtle impacts of extreme weather.

During heavy rainfall, older adults could break a hip or long bone if they slip on sidewalks, and the steep slopes of Chinatown and other hilly neighborhoods could worsen the impact, said Dr. Andrew Chang, a cardiologist and fellow at the University of California San Francisco’s Advanced Echocardiography program.

Extreme weather events can also affect diet. Some older adults who live alone and cannot obtain fresh fruits and vegetables during severe weather might turn to pantry staples or frozen foods that are high in salt, fat, oil and processed sugar, Chang said. Because older adults tend to have pre-existing conditions that make their bodies sensitive to sodium load, consuming salt-heavy products could trigger heart failure, high blood pressure or fluid retention, he said. 

Weihong Wu, 53, lives with her husband in a single-room occupancy building in Chinatown. During the 2020 wildfire season, she said, if she opened the window, she didn’t feel well, and if she didn’t open the window, the room became too stuffy. “It’s like, we can’t breathe,” said Wu, who speaks Taishanese and Cantonese.

“No one knocked on our door and asked if we are OK,” she said.

Wu said that during the rainstorms earlier this year, she couldn’t go out, so she didn’t have any food in her home. She said her older neighbors in the building “really needed someone to deliver groceries to them because they are unable to go grocery shopping themselves.”

Inclement weather can also deter people from seeking medical care. “Not only people who are getting sick from air pollution, but also people who probably normally should be seeing the doctor or getting medical care for certain conditions are choosing not to go be seen because they don’t want to go out when it looks so frightful outside,” Chang said.

Another concern in single-room occupancy residences and other older buildings is accessibility.

In 2022, San Francisco’s Aging and Disability Affordable Housing Needs Assessment highlighted accessibility problems like steep stairs and malfunctioning elevators in the city’s publicly funded single-room occupancy housing stock.

Compromised access intensifies risks for older residents in those buildings. For example, tenants experiencing exhaustion or other symptoms from excess heat or wildfire smoke might struggle to walk down several flights of steep stairs to reach a cooling or air respite center.

Housing experts say people who experience such health or mobility challenges should have a say in what would help them most.

“I think you need to engage the seniors themselves,” said Leslie Moldow, a principal at Perkins Eastman architectural firm, where she specializes in senior living design, and an adjunct professor at the University of San Francisco. “Have them be part of the solution for what they want.”

Financial barriers

In 2021, Mayor London Breed released the latest iteration of the city’s Climate Action Plan with an overarching goal for San Francisco to reach net-zero greenhouse gas emissions by 2040. While the plan focuses on emission reductions, it also emphasizes related health benefits, noting that walking and biking boost physical well-being, green spaces improve air quality and eradicating fossil fuel use in buildings protects against chronic ailments like asthma.

Breed this year announced $2 million in grants for organizations working on removal of greenhouse gas emissions from buildings, waste prevention and environmental justice. But many of the plan’s long-term goals come with sky-high costs, and officials say San Francisco can’t go it alone.

“External support, from state and federal governments, is needed more than ever,” city officials wrote in the Climate Action Plan.

A funding analysis for the Climate Action Plan by researchers at the University of California, Berkeley’s Center for Law, Energy and the Environment, estimated that the overall cost of reducing emissions across sectors that the plan targets ­could reach $22 billion.

The financial analysis of San Francisco’s Climate Action Plan prepared by researchers at the University of California, Berkeley.

That analysis is used “to make a case that much more funding will be needed in the future to fully implement the plan” said Richard Chien, senior environmental specialist at the San Francisco Department of the Environment.

Louise Bedsworth, the executive director of UC Berkeley’s Center for Law, Energy and the Environment, is one of the authors of the funding analysis. Bedsworth said her team is exploring the barriers to moving projects from planning to implementation.

“I think funding remains the biggest challenge,” she said, partly because the way funds for climate adaptation are distributed is compartmentalized.

“People don’t live in silos, and communities don’t operate in silos,” she said. “But that tends to be how our funding is still rolled out.”

In July, San Francisco released a Heat and Air Quality Resilience Plan, which proposed pathways for city agencies, community groups and other stakeholders to help San Franciscans cope with extreme heat and wildfire smoke.

Officials noted in the report that $12.1 billion in federal funding is available for home energy efficiency and weatherization projects through the Inflation Reduction Act and the Infrastructure Investment and Jobs Act. And $444 million is devoted in California’s budget this year to extreme heat mitigation initiatives. This is in addition to funding available from other government and private grants and programs.

Bedsworth said one of the challenges for small nonprofits in accessing funds from state programs and the federal Inflation Reduction Act is the complex and competitive nature of these initiatives.

The Chinatown Community Development Center, which owns and manages single-room occupancy buildings and other affordable housing, faces such hurdles. Nearly 1,900 seniors live in properties managed by the organization.

For years, the nonprofit, which also engages in tenant advocacy, youth leadership and other community work, has tried to improve the sustainability of its buildings and the Chinatown neighborhood. It has worked with local nonprofits to provide some tenants with climate-resiliency tools such as air filtration devices.

Malcolm Yeung, the center’s executive director, said the resources in Chinatown are “absolutely not” sufficient to support older adults in single-room occupancy housing during extreme weather events, adding, “But it’s not to say that there aren’t efforts underway.”

In 2017, the organization, in collaboration with San Francisco’s Department of the Environment, Planning Department and philanthropic groups, published a comprehensive assessment called “Sustainable Chinatown” that laid out strategies for improving sustainability and climate-resiliency while maintaining housing affordability.

Yeung called it a “mixed success.” Some goals were met, but others stalled for lack of funding, he said. The organization has explored creative approaches to make sustainability improvements that are less resource-intensive.

For example, when it was taking over public housing from the city’s Housing Authority to rehab and operate as affordable housing, staffers saw that tenants had installed unauthorized, energy-draining washing machines and clothes dryers, because they feared robberies and violence in communal laundromats in their building. The nonprofit removed the appliances, bolstered security and implemented community policing in collaboration with the San Francisco Police Department to alleviate residents’ concerns, he said.

That was “the single largest sustainability improvement in that building, and it was primarily because of operating changes,” Yeung said.

Yeung said whenever his organization is rehabilitating or constructing a building, it works with sustainability consultants to identify ways to improve operating efficiency and climate resiliency. However, finding funding for those upgrades, he said, is a hit-and-miss process.

The Chinatown Community Development Center sees the Inflation Reduction Act as a potential funding source to complete upgrades systematically. “We have not secured funds, but the initial process is rolling,” Yeung wrote in an email.

A number of large affordable housing and climate justice intermediary organizations are submitting applications to distribute funds through the act’s Greenhouse Gas Reduction Fund, Yeung said. The Chinatown Community Development Center has shared its sustainable rehabilitation recommendations with three of those applicants.

Yeung echoed Bedsworth’s earlier point that smaller organizations struggle with navigating the complexities associated with applying for this kind of federal funding.

“Communities of color typically don’t have anchor organizations that have the resources to kind of engage on that level,” Yeung said.

Policies determining funding

San Francisco has 110 publicly funded single-room occupancy buildings. Many others are operated by private owners or other entities. There are at least 19,000 rooms for tenants overall. Residents typically share a kitchen, living area, bathrooms and laundry facilities.

Many of the buildings don’t have cooling systems, adequate insulation and ventilation, or other mechanisms to cope with extreme weather.

The Mayor’s Office of Housing and Community Development oversees 1,021 affordable housing units in Chinatown that are managed by three organizations, including the Chinatown Community Development Center. Data for 942 households supplied to the agency revealed that 519, or 55%, have at least one senior tenant, the department reported.

“Seniors and SRO families are probably the two populations I worry a ton about because the vulnerabilities are very unique for each,” said Eddie Ahn, executive director of Brightline Defense, an environmental justice nonprofit.

Brightline Defense, in collaboration with its community partners, surveyed residents of single-room occupancy buildings in the city in 2020 and 2021. Of the 255 people across 54 buildings who responded, around 79% did not have access to N-95 masks and 73% did not have air filtration systems in their rooms. More than half the respondents said they had respiratory or other health effects during the wildfires.

Ahn, who is also president of San Francisco’s Commission on the Environment, said Brightline Defense worked with the Chinatown Community Development Center a few years ago to distribute about 100 air filtration units in Chinatown, the Tenderloin and other neighborhoods.

“But it only goes so far,” he said. “Part of the reason why our nonprofit exists is to affect policy change. It’s not just about, you know, 50 units here, 100 units there; it’s hopefully trying to increase access to thousands of units at a time.”

One policy the organization is focusing on involves CalEnviroScreen, a mapping tool that uses environment, health, socioeconomic and other data to determine which census tracts are most affected by pollution and other environmental hazards, and classifies those areas as “disadvantaged communities.” The California Environmental Protection Agency and other entities use it to determine where to implement programs and target investment. According to the tool’s standards, Chinatown is not designated as a “disadvantaged community,” which Ahn considers an incorrect assessment.

“It’s very clear that there’s a history of incidents in Chinatown and in the Mission District to have racial discrimination, disinvestment,” he said. “And overall, there are unique environmental injustices that are being suffered in each community, too.”

Ahn said his organization filed an advocacy letter with other community organizations, calling for improvements to the CalEnviroScreen tool.

“Population characteristics including poverty, housing burden, education and especially linguistic isolation exceed the 99th percentile in all of Chinatown’s census tracts,” wrote the letter’s signers. “Chinatown also suffers from serious pollution burdens.”

Letter sent by a coalition of nonprofits, calling for Chinatown to be recognized as a community needing investment by the CalEnviroScreen mapping tool.

Brightline Defense has installed monitoring sensors to gather neighborhood-level data on air pollution.

“So, if you have massive climate change events like wildfires, for instance, that are pouring smoke into cities, our most vulnerable are low-income households and families that can’t afford an air filtration unit,” Ahn said. “And that is typically an SRO tenant, for instance, or an SRO family. So, that’s the kind of targeting I think we need to demand of our environmental justice mapping tools.”

Community response

One nonprofit at the forefront of disaster preparedness for Chinatown residents, including older adults, is the NICOS Chinese Health Coalition.

Michael Liao, director of programs, said NICOS coordinates with community organizations to do periodic resource inventories to assess which groups can offer cooking facilities, emergency shelters, communication tools, transportation supplies and other resources during climate-related emergencies and other catastrophes.

“Over the years, we’ve also developed emergency communication protocols with multiple layers of redundancies, so that we could communicate with each other before the city is able to effectively and adequately respond to all of our needs,” he said.

In the past, the disaster preparedness initiative’s funding has come mostly from private foundations, like the Fritz Institute and the Walter and Elise Haas Fund, Liao wrote in an email. During his 18 years at NICOS, he said, the initiative has received government funding from San Francisco once and from California once. Apart from those times, it has continued either unfunded or covered through the organization’s unrestricted funds, he said.

“Although the government regularly touts us — Chinatown — as a neighborhood, that is one of the most prepared, there hasn’t been a lot of investment, in terms of financial investment, to kind of help make that happen,” Liao said. “It really came from a lot of sweat, blood and tears from volunteers of the community who were able to put in their time and resources.”

Liao said the neighborhood’s support systems were weakened during the pandemic. “Funding is always an issue, and now even more so than before,” he said.

Self-Help for the Elderly is also pursuing climate-resiliency interventions for older residents. This year, through the city’s Extreme Weather Resilience Program, an initiative by the Department of Emergency Management, the nonprofit and other groups will receive devices like air filters and portable air conditioners. “That’s really good news,” said Chung, who leads Self-Help for the Elderly, noting that her nonprofit will use the items in its senior centers.

But more systemic solutions are needed, Chung said: “We’re doing only a patch-up here, like a band-aid right now.”

On Lok, which pioneered the Program of All-Inclusive Care for the Elderly, also provides medical and social services to low-income older adults in Chinatown and beyond. It offers comprehensive services by combining primary health care and long-term care, so members with chronic illnesses or other conditions who might otherwise have to move to a nursing home can remain at home, said Dr. Ben Lui, the organization’s chief medical officer.

When climate disasters happen, Lui said, On Lok can activate its network of social workers, drivers and others to check in on its members. On Lok also helps operate federally funded housing for older residents.

For residents in those housing units, “we can actually do even closer monitoring, so we can even have our caregivers check on them to make sure they have the windows open during hot weather,” he said. “We can make sure that they are hydrated.”

Lui said the organization groups members by health risk, “so that when disasters or these extreme weather events happen, we can start with the highest-priority,” he said. 

City response

Various city departments have initiated programs, sometimes working with community-based groups, to support older adults and other vulnerable populations during extreme weather.

“I think that we are more prepared now than we were in 2020,” said Adrienne Bechelli, the deputy director of San Francisco’s Department of Emergency Management. “In 2020, we were more prepared then than we were in 2017, when we had our first major heatwave over that Labor Day weekend.”

San Francisco considers anything above 85 degrees to be an extreme heat event, and during Labor Day weekend in 2017, temperatures soared to 106, which likely led to the deaths of three older residents.

Even before the 2017 heat wave, there were indications that San Franciscans could be particularly susceptible to this threat. A study examining a 2006 California heat wave found that emergency department visits and hospitalizations rose across the state. Researchers noted that children up to 4 years of age and people 65 and older were at highest risk.

“This pattern suggests an important role for acclimatization and for factors related to the built environment,” researchers wrote in Environmental Health Perspectives. “In San Francisco, for example, housing stock is less likely to have central air conditioning both because of its age and because of the cooler climate.”

Bechelli said the city will face challenges in any kind of emergency response.

“I think that anyone who says, ‘We’re fully prepared and we’re ready to take on this hazard, no problem,’ is probably, unfortunately, mistaken,” she said.

The San Francisco Human Services Agency’s Department of Disability and Aging Services also manages care coordination for older adults, and during extreme weather events, staffers call high-risk residents to check for symptoms of dehydration, heat stroke and other medical emergencies, Joe Molica, the agency’s senior communications manager, wrote in an email. The department also shares safety information with community centers to broaden its reach, he added. 

The San Francisco Department of Public Health’s Emergency Preparedness and Response team has worked with NICOS to offer trainings in English and Cantonese at health fairs in the Richmond neighborhood, Tal Quetone, the agency’s public relations officer, wrote in an email.

In the past four years, the team has worked with companies that manage single-room occupancy buildings in the South of Market neighborhood to offer training on climate change, he added. In one instance, it collaborated with other departments to research the impact of heat for a building managed by the John Stewart Co., which prompted the owner to buy air conditioners for all 98 units, Quetone wrote.

But these programs don’t cover all older adults who face health risks during extreme weather, and city officials said social isolation is a challenge. The Department of Public Health is exploring how to work on emergency preparedness messaging with specialists and organizations that support older adults.

“One of the things we’re looking at right now in the Heat and Air Quality Resilience project is how can we identify first points of contact for vulnerable populations,” which might include clinicians, residential caregivers and building managers, said Matt Wolff, the department’s Climate and Health Program manager.

Emotional ramifications

While researchers continue to study the consequences of extreme weather on the physical health of older adults, they are also looking into how it affects mental health. Clinicians with the Climate Psychiatry Alliance, a network of mental health professionals, say they have noticed post-traumatic stress disorder, depression and other mental health conditions among older adults, especially those whose lives have been upended by disasters like wildfires and floods.

For some older residents of Chinatown, the anti-Asian hate crimes that occurred concurrently with extreme weather and health emergencies intensified their emotional anguish.

“We were particularly concerned during the pandemic of this kind of triple-whammy effect for our Chinatown seniors with not only the pandemic but also a lot of the climate change-related issues such as extreme heat and air quality issues,” said NICOS’ Liao. “On top of that, a lot of seniors were afraid to go out because of the rise in anti-Asian hate.”

Liao said fears about anti-Asian hate crimes remain.

“As we come out of the pandemic into endemic for COVID, there’s still a lot of the lingering isolation, mental health and loneliness issues that our seniors struggle with,” he said.

Liao said NICOS conducted a focus group, part of a study funded by the National Institutes of Health, in partnership with the University of California, San Francisco, with Chinese seniors in single-room occupancy buildings to understand what might contribute to resilience. The organization found that some older residents were doing due diligence when it came to verifying health information they received on WeChat and other platforms. This also could be a critical step in protecting themselves during climate disasters when misinformation and disinformation can be rampant.

“I know a lot of times we focus on more of the negative aspects — what are some of the deficits and the needs — but I think it’s also important to highlight that within the Chinese community, there’s a lot of resilience,” Liao said.

Yesica Prado edited the photos for this story. Zhe Wu translated the interviews with residents in single-room occupancy housing in Chinatown who spoke Taishanese and Cantonese.

About the Project

Older adults are among those most at risk during climate change-driven weather disasters. This series examines the physical and mental health effects of these events on older people and explores how these challenges are unfolding in San Francisco’s Chinatown, a neighborhood considered by the city as particularly vulnerable to the hazards of climate change.

• Q&A with Dr. Andrew Chang on the physical toll of climate change on older adults
• Q&A with Dr. Robin Cooper on the emotional toll of climate change on older adults
• Q&A with Eddie Ahn on how Brightline Defense takes on air pollution and environmental justice concerns
• Long-form story: Protecting Chinatown’s Older Adults From Climate Change Disasters Requires More Funding, Nonprofits Say
• Photo essay: For Chinatown’s Older Residents in Single-Room Occupancy Buildings, Climate Disasters Pose Greater Risks

This project was produced with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations and the Archstone Foundation.

The post Protecting Chinatown’s Older Adults From Climate Disasters Requires More Funding, Nonprofits Say appeared first on San Francisco Public Press.

The agency has taken a multifaceted approach to determine which neighborhoods will be disproportionately affected by conducting heat and flood vulnerability assessments, creating community resiliency scoring systems and collaborating with local nonprofits to gather temperature and humidity data.

Those investigations have revealed that Chinatown could be particularly vulnerable during periods of extreme weather due to a range of socio-economic factors as well as the built environment. Within the neighborhood, older adults living in single-room occupancy buildings are among populations at heightened risk. Reasons for this include physiological changes related to aging and financial barriers associated with making climate-resiliency adaptations to older buildings.

The San Francisco Public Press this summer interviewed residents in single-room occupancy buildings in Chinatown about their experiences during extreme weather events in recent years. The residents, who spoke Taishanese and Cantonese, which have been translated below, described hardships they experienced and steps they took to protect themselves, and offered ideas for support that could be beneficial for them and their neighbors in the future.

As droughts, wildfires, storms, floods and other catastrophes become more frequent and aggressive, each neighborhood, city and state will face its own set of adversities and health inequities. The story of how these challenges are unfolding in Chinatown offers a glimpse into how they could play out for older residents in other climate-vulnerable places.  

[Read more: “Protecting Chinatown’s Older Adults from Climate Disasters Requires More Funding, Nonprofits Say”]

Since the founding of San Francisco’s Chinatown, the oldest and largest in North America, its residents have experienced natural disasters that have threatened their lives and well-being. In the early years, the deadly 1906 earthquake caused widespread devastation. More recently, extreme weather conditions have caused suffering for some residents, especially those who are older and living in buildings that aren’t equipped to protect them from these hazards.

Shao Ao Situ, 81, has been living in a single-room occupancy building in Chinatown for about 30 years. He has experienced several extreme weather events, including the wildfires in the western parts of the U.S. that engulfed San Francisco in smoke in 2020. “The wildfires and resulting haze have a significant impact, especially on us as elderly people, because they affect our respiratory system,” Situ says. He says he had eye irritation, cough and fatigue due to the toxic air.

The building where Situ lives has individual rooms for each tenant. Residents on each floor share bathrooms, laundry facilities, a kitchen and a living room. Situ often watches television with his wife in the living room. He says one strategy that city officials and community groups could adopt to educate residents about climate disasters would be to reach out to multicultural media outlets that residents typically watch, such as KTSF. “We often get information through TV,” he says. “I hope more people can share this type of knowledge there. I tend to remember information better after seeing that on TV.”

When San Francisco was blanketed in wildfire smoke in the summer and fall of 2020, Situ says he mostly stayed indoors. He says he did not receive any support during that time or during other crises. “Where can we go for help?” he says. “We had absolutely no such advice made available to us.”

Units in Situ’s building measure about 8 by 10 feet, which is typical for single-room occupancy buildings. Inside Situ’s room are a bunk bed, a table, a dresser and shelves holding his belongings. There is a single window where he hangs his clothes.

When smoke and toxic particles from wildfires in neighboring regions drifted into San Francisco in 2020, Situ says he kept his window mostly closed, leaving a small opening for ventilation. He says he put up a piece of cardboard to cover the gap, demonstrating how he does that even today.

Situ keeps a stock of surgical masks and sanitizer. During the wildfires, he says he bought N-95 masks. “I heard on TV that N-95 masks are the best at preventing dust and pollution particles, so we bought two boxes at that time,” he says. “Not with government money. We paid out of pocket. The N-95 masks were very effective.”

Situ’s neighbors are also older. He says they would benefit from more education from community groups and government agencies on how to protect themselves during wildfires. “I think governments can do a better job,” Situ says. “One is publicity and guidance, such as holding lectures to introduce smoke and haze prevention matters and methods. I believe it will be of great help to residents, especially the elderly.”

Bifang Kuang is one of Situ’s neighbors. Kuang, 84, says she has been living in the single-room occupancy building for about 10 years.

During the severe rainstorms in the Bay Area this past winter, Kuang says she did not go out to get medications or groceries until the downpour lessened. When asked what support she had during the rain, she holds up an umbrella.  

For older residents in Chinatown, especially those who have trouble with mobility, walking up the hills in their neighborhood to get food, medications and other supplies could be dangerous during heavy rains. One single-room occupancy tenant told the Public Press that arranging grocery deliveries for older neighbors during those times would be helpful. Community organizations and city agencies report that scaling up support services and creating climate-resiliency infrastructure continues to be difficult due to funding constraints.

Yesica Prado edited the photos for this piece. Zhe Wu translated the interviews with residents in single-room occupancy housing in Chinatown who spoke Taishanese and Cantonese.

About the Project

Older adults are among those most at risk during climate change-driven weather disasters. This series examines the physical and mental health effects of these events on older people and explores how these challenges are unfolding in San Francisco’s Chinatown, a neighborhood considered by the city as particularly vulnerable to the hazards of climate change.

• Q&A with Dr. Andrew Chang on the physical toll of climate change on older adults
• Q&A with Dr. Robin Cooper on the emotional toll of climate change on older adults
• Q&A with Eddie Ahn on how Brightline Defense takes on air pollution and environmental justice concerns
• Long-form story: Protecting Chinatown’s Older Adults From Climate Change Disasters Requires More Funding, Nonprofits Say
• Photo essay: For Chinatown’s Older Residents in Single-Room Occupancy Buildings, Climate Disasters Pose Greater Risks

This project was produced with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations and the Archstone Foundation.

The post For Chinatown’s Older Residents in SROs, Climate Disasters Pose Greater Risks appeared first on San Francisco Public Press.