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San Francisco Again Tries to Deal With Chronic Alcoholics

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San Francisco is beginning two novel criminal justice programs aimed at steering chronic offenders into different sorts of treatment. Although there is some overlap between the Serial Inebriate Program and the chronic offenders program, the efforts are aimed at different populations.

Serial Inebriate Program

The Serial Inebriate Program, which strives to break the streets-to-drunk-tank cycle for homeless alcoholics, was slated to start May 1. SIP uses the threat of criminal sanction to coax habitual street drinkers into long-term treatment. San Francisco’s program is modeled on a 13-year-old effort in San Diego, which is being replicated in police departments across the nation.

A man is taken away after failing a sobriety test. (Justin Sullivan/Getty Images)
A man is taken away after failing a sobriety test. (Justin Sullivan/Getty Images)

“To leave folks unattended in a condition where they’re absolutely unable to care for themselves and they refuse to accept services is akin to a death sentence,” San Francisco Police Chief Greg Suhr said. “We’re trying to get the first olive out of the jar, trying to help those people who are most unable to care for themselves.”

San Diego police Officer John Liening, an 18-year veteran, helped create SIP in 2000. He said he and his sergeant were frustrated by putting chronic street alcoholics in jail just so they could be released and continue drinking.  And when officers didn’t make arrests, it was paramedics who responded, taking severely intoxicated people to the emergency room.

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“What we were doing at the time wasn’t working,” Liening said.

San Francisco District Attorney George Gascón estimates costs from those kinds of emergency room visits and other services are in the millions yearly, with the cycle often repeating.

But Liening also knew the police department couldn’t solve the problem on its own. So the department started coordinating with other stakeholders, including the county mental health department, the city’s public defender and prosecutors.

San Francisco’s plan uses the same model as San Diego’s. Police start tracking how many times they pick someone up for public drunkenness. The sixth offense triggers a misdemeanor charge, and offenders then have a choice between a jail sentence and some form of treatment.

Completion of 180-day treatment has consistently been three times the national average for SIP clients, according to Deni McLagan, program manager of San Diego County's mental health service provider.

In San Francisco, the police department, public defender and district attorney are all on board, along with mental health service providers. But Suhr said any more than 10 SIP candidates could stretch current resources. San Francisco’s population of chronic homeless alcoholics is certainly more than that, he noted.

McLagan said she hears about similar issues in cities across the country, where she often travels to help start a program. She said chronic homeless alcoholics need to be separated from other addicts who have housing, families and jobs. Otherwise, they end up feeling worse about themselves than when they started.

She cited a survey one mental health department was using that asked questions such as, “Have you ever had a DUI?” or “How often do you drink before work?" These questions are not necessarily applicable to a homeless population.

“We had to change the questions to things like, ‘If you made $3 panhandling, would you use it to buy food or booze?’ ” she said. “Once we modified care, then we had buy-in from the clients.”

Despite his concern about program capacity, Suhr said the city has some time after May 1 before the first SIP candidates would rack up their sixth contact with police. He added that it’s a program the city desperately needs.

“I walk Sixth Street myself at least once per week,” Suhr said, “and I have never walked up Sixth street and not come across somebody who would be a candidate for the SIP program.”

Chronic Offenders Program

Suhr and other San Francisco officials said there’s been some confusion between SIP and a project originated by the district attorney called the chronic offender program, which has had two difficult beginnings.

Most recently, Gascón asked police to find a man who had 22 outstanding citations for what are often referred to as quality-of-life crimes, like sleeping in the park or possessing an open container of alcohol. The man had consistently failed to show up to court and answer for his citations, so Gascón charged him with 22 counts of failure to appear, a misdemeanor.

Suhr said the man was not hard to find, and he stood before the San Francisco Superior Court on April 18. But he was released on his own recognizance and ordered to reappear on May 22, which frustrated Gascón.

“Can the court do this?” Gascón said. “Obviously they can. The judge in this particular case did so. Is it appropriate? Is it good public policy? I would argue not.”

Liening, the San Diego police officer, said judges always have the discretion to release low-level defendants after arraignment, but most SIP candidates have many previous infractions that makes it unlikely. Both SIP and the chronic offenders program rely on the threat of jail time to coerce people into treatment, but the charges, treatments and targets are different.

“It’s two different populations.” Suhr said. “One of these populations is the chronic person who is cited over and over again and is basically a scofflaw. There isn’t a lot of crossover between chronic offenders and serial inebriates.”

As a prosecutor, Gascón doesn’t like people flouting the law, but he also thinks that many candidates for the chronic offenders court could benefit from mental health services or addiction counseling, and they would be diverted away from jail and into those programs.

The San Francisco public defender’s office challenged a previous version of the court that relied on the civil charge of contempt to hold chronic offenders. That court was ruled unconstitutional by California's 1st District Court of Appeal in January.

Matt Gonzalez, chief attorney in the public defender's office, said he doesn’t think this iteration of Gascón’s court poses the same due process challenges as the last one. But he thinks it’s still a poor use of money that will collapse under its own weight.

“This program is not going to survive because of the tremendous amount of public resources that will be expended against people that haven’t committed any kind of serious offense,” Gonzalez said. “When we have law enforcement officials embark on a program to arrest people to see what services they need, I don’t think people are going to stand for that.”

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Gascón said he will try again soon to charge another chronic offender with failure to appear. Next time he’s hoping the judge is on board.

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