A Code Tenderloin ambassador offers coffee or tea to people as they arrive at the triage center at 469 Stevenson St. on its first day open on Feb. 7, 2025.
Kunal Modi, chief of health, homelessness, and family services: “What we’ve been doing on 6th Street is informing what we want to see happen across The City, which is addressing public disorder and improving our street conditions.”
San Francisco Homeless Outreach Team members speaking to people living at a homeless encampment on Merlin Street off of Harrison Street in San Francisco during a sweep on Wednesday, Nov. 1, 2023.
A Code Tenderloin ambassador offers coffee or tea to people as they arrive at the triage center at 469 Stevenson St. on its first day open on Feb. 7, 2025.
Kunal Modi, chief of health, homelessness, and family services: “What we’ve been doing on 6th Street is informing what we want to see happen across The City, which is addressing public disorder and improving our street conditions.”
San Francisco Homeless Outreach Team members speaking to people living at a homeless encampment on Merlin Street off of Harrison Street in San Francisco during a sweep on Wednesday, Nov. 1, 2023.
A Code Tenderloin ambassador offers coffee or tea to people as they arrive at the triage center at 469 Stevenson St. on its first day open on Feb. 7, 2025.
More than 12,000 people have used San Francisco’s new Mobile Triage Unit, a makeshift panoply of social services Mayor Daniel Lurie launched that saw mixed results in its first 30 days of operation.
Opened at 469 Stevenson St. in February, the Mobile Triage Unit was initially envisioned as a place where people experiencing homelessness or addiction would be directed toward shelter, connected to treatment or taken to jail — depending on whether they arrived by choice or in handcuffs.
The center has since evolved and will continue to do so, though in precisely what form remains unclear, according to a memo the administration authored on the 30-day pilot program.
The center, established just days into Lurie’s term, was a clear signal from his administration that it would take risks and learn from mistakes as it endeavors to curtail open-air drug use and homelessness in San Francisco.
The memo, obtained by The Examiner, credited the Mobile Triage Unit for an effective clean-up of poor street conditions in the nearby neighborhood, and partly blamed it for shifting those conditions elsewhere in The City.
The report summarizing the Mobile Triage Unit’s operation was accompanied by several key data points, including 275 people placed into shelter or housing and more than 1,000 people directed into medical or behavioral-health treatment.
Perhaps most importantly, the center served as a nearby drug-free facility to which outreach workers and police could direct people they encountered on the street for everything from linkage to shelter to treatment for skin infections.
“What we’ve been doing on 6th Street is informing what we want to see happen across The City, which is addressing public disorder and improving our street conditions,” said Kunal Modi, Lurie’s chief of health, homelessness, and family services.
Kunal Modi, chief of health, homelessness, and family services: “What we’ve been doing on 6th Street is informing what we want to see happen across The City, which is addressing public disorder and improving our street conditions.”
Craig Lee/The Examiner
The site is fundamentally different from past city service hubs — such as former Mayor London Breed’s quickly opened and unceremoniously closed Tenderloin Center in 2022 — in that it is operated by the San Francisco Police Department, not public-health or emergency-management officials.
The police presence has helped ensure that the triage site is free from open drug use or other illegal activity, according to the administration. By contrast, the Tenderloin Center served as both a service directory and a de facto supervised-consumption site, where people could use drugs under the supervision of staff members trained in overdose reversal.
Under the police-led model Lurie’s administration has embraced, 349 people were arrested in the 6th Street corridor during the pilot program, compared to just 68 arrests tallied during the same time period and area in 2024. Three-quarters of the arrests during the pilot program were narcotics-related, according to the memo.
Dr. Terry Osback, the chief medical officer and a psychiatrist at the St. Anthony Foundation — located at 150 Golden Gate Ave., just a short walk from the triage center — said that police presence at such centers hasn’t always worked in the past, in his experience.
“It’s a delicate balance — how much police authority do you want to use?” said Osback, who has worked on similar models throughout his 40-year career in behavioral-health services. “Where’s the line between their civil rights to refuse treatment and potentially committing a crime?”
Initially, when the center was announced, it was described as a site at which people arrested for drug-related crimes could accept treatment, be taken to jail, or choose to leave The City. Ultimately, it was not used as a police processing facility.
Osback said this tactic to push people into treatment is not always successful, even though diversion programs are common, whether through court or jail.
“The major problem that most of them run into is that you can refer people, but you can’t force them into treatment,” he said. “There are often no consequences of people not receiving treatment, that they can show up at whatever the site is, the mental-health treatment center, the residential treatment center for substance use — but they can also just walk away.”
People gather on 6th Street at Mission Street in San Francisco on Friday, Nov. 1, 2024.
Craig Lee/The Examiner
Stricter enforcement of drug laws in and around the intersection of 6th and Mission streets sent some of its problems elsewhere, a consequence that the administration officials acknowledged.
That displacement is likely to continue as long as San Francisco continues to run up against a shortage of beds, both in mental-health facilities and shelters, that meet the needs of those who receive the offers.
For example, the City waitlist for a shelter bed stands at more than 600 names long. Of the beds were set aside for the pilot program’s use, 82% were utilized.
“This reinforces the need to expand shelter formats that best serve the needs of those on the street, including tiny homes, stabilization centers, recovery and sober housing, residential treatment, and other semi-congregate options,” the report states.
Osback said that since the launch of the triage center, Modi — who previously served on the foundation’s board — has chatted with him and St. Anthony’s CEO Dr. Larry Kwan about how to implement services “more coherently.”
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One of Osback’s main concerns has been the lack of beds available for those who want and need treatment that are coming to the center.
“Right now, it is still a bottleneck,” Osback said. “You can get people to an access center, but the next step is the most important one, which is getting them to a mediator and figuring out what that treatment should be.”
There just aren’t enough beds for people with different treatment needs, he said, which can itself be a barrier.
“You really need almost immediate access, or people bounce off and don’t get the services,” he said.
San Francisco Homeless Outreach Team members speaking to people living at a homeless encampment on Merlin Street off of Harrison Street in San Francisco during a sweep on Wednesday, Nov. 1, 2023.
Craig Lee/The Examiner
The administration recently restructured The City’s street-outreach teams in an effort to mitigate issues related to displacement as they pop up.
The new approach, outlined by Lurie last week, narrows The City’s nine separate outreach teams into six. The new teams will have a geographic focus, rather than a purpose-driven one, and will all fall under the umbrella of the Department of Emergency Management.
One aspect of the SoMa triage center that clearly fell short of expectations was its use of the Journey Home program, which offers paid bus tickets out of San Francisco for people experiencing homelessness and addiction.
Of the 90 people who were screened for the Journey Home program, only four were provided relocation assistance. The low rate of success was attributed to the need to first stabilize people with services such as detox; Journey Home was specifically designed by Breed’s administration to forego any requirements to offer people shelter or services before sending them out of San Francisco.
The tweaks to Journey Home that Lurie’s administration is pondering are likely a harbinger of what’s to come.
The throughline of the triage center report is a call to remain fast and flexible.
“Throughout this work, we remain committed to refining our systems, scaling what works, and continuing to bring urgency, compassion, and coordination to the street-level challenges we face,” the report states. “With a focus on transparency, we will also continue to track outcomes and share the takeaways.”
Del Seymour, the founder of Code Tenderloin, a local nonprofit that has been contracted to help staff the site, said he has noticed the difference as a private citizen walking the corridor.
“People, slowly by slowly, are going to get help and assistance and referrals,” he said. “That’s what the triage center appears to be doing.”
Osback said that he hopes the future of the center could look more like a day program similar to the Gubbio Project in the Mission District, which provides a range of services and resources for those struggling with homelessness and behavioral-health issues, such as clean clothes, food, computer access, a place to rest during the day and referrals to treatment.
“A place where you could pick people off the streets, where they might feel safe and might have some of their needs met,” he said.
Seymour said he hopes the main takeaway is to keep going.
“Go day by day,” he said. “Don’t wait two weeks and say, ‘Well, it’s not working. Shut it down.’ That’s what we’ve done in the past, and I don’t want to see that happen again.”
The triage center is just one facet of Lurie’s response to the crisis, and Seymour said that he sees all these efforts as part of a renewed attempt to see what works, and what doesn’t.
“Lurie’s throwing a lot of things up on the wall to see what’s going to stick,” he said. “There’s nothing wrong with that.”
