Nearly two-thirds of San Francisco voters surveyed say they would vote for a ballot measure that will require those suspected of suffering from substance abuse while receiving cash handouts from the city to submit to drug tests and accept treatment.
Introduced by San Francisco Mayor London Breed and slated for the March 5 primary ballot, Proposition F will ask voters if the city should change the rules for those receiving cash aid from the County Adult Assistance Program—serving adults under 65 years old with no dependents.
Conducted in November by EMC Research— a national opinion research firm—the survey asked 500 San Franciscans if they would vote for such a measure, with 66 percent saying yes and 31 percent saying no, according to Ruth Bernstein, the company’s president and CEO.
With decades of polling experience in the area, a strong majority in favor of the plan was not entirely unexpected by researchers.
“Given the amount of work we do in San Francisco ... I was not really surprised to see that level of support,” Ms. Bernstein told The Epoch Times on Dec. 21. “Voters are concerned right now about crime, open-air drug use ... substance abuse and people being able to get treatment.”
Criminal activity and drug abuse on the streets are impacting the quality of life for many residents, with the goal of the initiative to incentivize treatment options, according to the mayor.
“I realize these changes are a tad bit controversial, but we’re trying to get people into treatment,” Ms. Breed said during a press conference in September introducing the initiative. “This will not be easy, but it’s necessary.”
Approximately 5,700 individuals in San Francisco received monthly cash payments in fiscal year 2022–2023, according to the city data.
If the ballot measure is approved, those who refuse drug screenings or treatment will lose access to cash benefits. Housing assistance, including access to shelters or direct payments to landlords, would continue for at least 30 days, according to its text.
“We need to make sure that we are cutting off resources that allow this behavior to occur without accountability,” Ms. Breed said. “We can’t say we want to see change and not be willing to make the hard decisions to get there.”
About 20 percent of those receiving cash assistance are homeless and qualify for about $100 per month plus food and shelter space. Those with housing receive about $700 monthly, including approximately 1,700 formerly homeless, according to Trent Rhorer, executive director of the city’s Human Services Agency.
Using the lure of cash payouts to urge individuals into mental health programs to address substance abuse disorders could prove beneficial, he said during the press conference.
“There are a significant number of people receiving $700 that are suffering from substance abuse disorders,” Mr. Rhorer said. “We have the treatment resources ... and if they choose not to participate, they will no longer receive cash aid.”
Some supervisors took exception to the plan and suggested such would be detrimental to drug addicts.
“Do we really think the best way to get people better is by kicking them more when they’re down?” Supervisor Hillary Ronen asked during a September board meeting when the idea was introduced.
Another official suggested the plan is better suited for a county in Texas and said she was adamantly opposed.
“There is no reason we have to test people to get the help they need and deserve,” Supervisor Connie Chan said during the meeting. “It is just unacceptable.”
While the measure was met with stiff debate and opposition from some supervisors when introduced, in October, the mayor added the proposal to the ballot, with one official saying he steadfastly supports the plan.
“It will better incentivize treatment for a population that is widely at risk of addiction and drug overdose fatalities,” Supervisor Matt Dorsey said during the press conference. “We’re facing an unprecedented loss of life in San Francisco, and we also know that coercive interventions work.”
Citing evidence from the National Institute of Drug Abuse showing the benefits of involuntary treatment programs, he said the measure could bring meaningful changes.
“This will not only save lives but give one a chance at a better life,” Mr. Dorsey said.
Before casting her vote in support, Supervisor Catherine Stefani said that city leaders need to be cognizant of the dangers associated with giving drug addicts access to easy money.
“Giving people money to do the drugs that might kill them might be a problem,” she said during the meeting.
In preparation for the coming election, city officials prepared cost estimates related to the issue including the number of people that will lose eligibility due to noncompliance.
The San Francisco controller’s forecast shows that the measure, if approved, would cost the city between $500,000 and $1.4 million annually for those who agree to drug treatment, which would be offset by estimated savings of between $100,000 and $2 million a year.
The numbers vary so widely, the controller said, because of the fluctuating nature of drug abuse and the unpredictability of users.
Supporters of the initiative say costs should be measured against the number of lives impacted by the changes.
According to the city and county office of the medical examiner, there have been 752 overdose deaths in just the first 11 months of 2023—the most on record.
“Proposition F definitely comes with new costs for the city, but the savings in emergency care, not to mention the lives saved, could outweigh the costs,” Grow SF—a nonpartisan public policy advocacy group—wrote on its website regarding the measure. “If Proposition F can save even a fraction of those lives and prevent future drug-related expenses, it will be a good deal.”
Acknowledging the opposition and the difficult nature of the process, one supporter said it’s time for everyone to be held accountable, including voters, lawmakers, and those receiving aid.
“We’re doing this with love and kindness, but at some point, the people of San Francisco and on the streets have to take accountability for our actions and our consequences,” Cedric Akbar, co-founder of Positive Directions Equals Change—a local nonprofit focused on rehabilitation and recovery services—said during the September press conference.
