Voters in San Francisco approved a measure on March 5 requiring some welfare recipients to take drug tests and enter treatment to receive cash payments, but some are wondering if the new law will be effective at curbing overdose deaths and addiction issues.
Some believe such is needed to address the record 806 overdose deaths recorded in the city in 2023—a nearly 25 percent jump from the year before. According to the coroner’s office, fentanyl was responsible for more than half of last year’s incidents.
“Addiction is complicated and there are no easy paths, but fentanyl is so deadly that we need more tools to get people into treatment,” Ms. Breed posted on March 6 on X, formerly known as Twitter. “Prop F is part of that change.”
If recipients test positive for certain drugs—to be defined later by the executive director of the city’s Human Services Agency—and professional evaluation determines that treatment is needed, participation in drug abuse programs will be required to keep receiving cash payments.
Such payments average $712 per month for housed recipients and about $109 monthly for the homeless, according to the proposal.
“We can’t just keep giving people money to overdose and die on our streets,” Ms. Breed wrote on X. “We have to do more.”
While participation in treatment programs will be mandatory, individuals will not have to stop using drugs to remain eligible for benefits. Supporters have argued that sobriety is a goal, not a mandate. Instead, cash assistance recipients will be asked for “good-faith efforts” to stop abusing drugs.
“Although reasonable participation in treatment programs will be required, sobriety of participants will not be,” the text of Prop F reads. “Perfection isn’t the goal; improved health and life outcomes is.”
Critics argue that a lack of incentive for drug abusers to change their behavior could inhibit the proposal’s effectiveness.
A lack of consequences for destructive behavior is, in part, to blame for the current drug abuse situation, and without such consequences, real change is unlikely, he suggested.
“There’s no teeth to it; there’s no follow-through,” Mr. Hall said. “And that’s typical San Francisco.”
Also, broad language defining treatment is meant to provide flexibility to those in need, according to supporters.
“Prop F ensures individuals are paired with the right treatment option, instead of mandating a one-size-fits-all treatment plan for everyone,” supporters wrote in the city’s voter guide on the issue.
Treatment programs are defined as residential medical detoxification, in addition to outpatient programs.
“There is no one answer,” the text of the proposal reads. “What matters is that people get into treatment and try to improve their lives.”
Costs associated with the program, including those to test and treat individuals suffering from addiction, are yet to be determined.
The city controller’s office estimated—before the proposal passed—that up to $1.4 million annually would be offset by savings of $100,000 to $2 million from cash recipients who forfeited their eligibility by refusing to participate.
“It would have a moderate impact on the cost of government,” Ben Rosenfield, city controller, said in the election material accompanying the proposition. “Increased costs will be dependent on operational ... and budget decisions.”
Unknown variables include how many will need treatment and the number that fail to comply. Such will determine the amount saved and the funding needed, with the latter expected to increase significantly if more beds are needed than are available, according to the controller.
The measure takes effect January 1, 2025. However, the Service Employees International Union, representing city workers employed by the city’s Human Services Agency, is challenging the proposal with letters to the city and the labor board, calling for the law to be voided because the group alleges that it will change the nature of contracts it has with the city.
Tasked with administering and overseeing the implementation of the new law, the Human Services Agency is still unclear how program services will be provided and by which agency or organization.
