Matt Dorsey: 'Recovery Housing First' offers urgent alternative

When the California State Legislature first enacted our statewide “Housing First” policy in 2016 to address homelessness, it defied federal guidance from the Obama Administration that strongly encouraged state and local governments to adopt a Housing First strategy that “addresses the housing needs of people at all stages of recovery” from addiction and alcoholism.

Instead, California effectively prohibited state funding for recovery-oriented housing.

In fact, the legislature’s absolutist approach — still on the books today — requires that state-funded housing for formerly unhoused adults be exclusively drug-permissive. California law requires :

Tenant selection and screenings to “promote accepting applicants regardless of their sobriety or use of substances.”Lease provisions stating “use of alcohol or drugs in and of itself, without other lease violations, is not a reason for eviction.”And services that are “informed by a harm-reduction philosophy that recognizes drug and alcohol use and addiction as a part of tenants’ lives.”

The guiding principle of the homeless policy strategy we call Housing First is a good one: connecting individuals and families experiencing homelessness to permanent housing as quickly as possible, without needless barriers to entry, and with supportive services aimed at maximizing housing stability.

Yet with few factors more reliably predicting housing instability than untreated substance-use disorders , it never made sense to abandon recovery community members asking for the supportive-housing options they need when they seek to exit homelessness.

As a person in recovery from addiction and alcoholism myself, I identify personally with the pleas of recovery community members asking for drug-free housing options.

Few challenges in life are more daunting than to face down one’s demons and commit to doing the hard and humbling work necessary to overcome a powerful addiction. We do recover; millions have. With time and an enduring commitment to one’s recovery journey every day, it eventually even gets easier.

But long-term success in recovery is impossible without short-term success during the most vulnerable stages of early sobriety. Drug-permissive housing mandates push those who have made the brave and difficult choice to get and stay sober into unsupportive and unsafe living environments.

Eric G. Holt has made the brave choice to embark on his recovery journey. A constituent of mine on Treasure Island, he recently completed a union apprenticeship program to work in the construction trades.

As he approaches the end of his time in a short-term residential step-down program along with others in recovery programs, he wrote to tell me their next step will involve being “moved into an SRO or small space in the Tenderloin, which is essentially back where we came from.”

“With no structure or accountability, in a problematic neighborhood, without the support of like-minded people who are also in recovery, it seems we are being set up for failure when we are still in early recovery,” he wrote.

Another San Franciscan courageously forging a successful path forward in recovery from alcoholism is Danica Gutierrez. A mother of three and constituent of mine living in SoMa, she wrote to tell me that “the stark reality of living in permanent supportive housing where active drug use is allowed is incredibly distressing,” adding that “it creates an unsafe and unstable environment for families like mine.”

“Daily exposure to drug-related nuisances is bad enough for those of us who are adults in recovery,” she said. “But I’m especially worried about the damage drug-permissive housing inflicts on young children like mine, who have already endured the emotional, physical, and psychological traumas of homelessness.”

Eric and Danica are why recovery housing is so desperately needed. Thankfully, San Francisco Assemblymember Matt Haney is championing legislation in Sacramento to expand state funding for needed recovery housing.

Together with new funding options made possible by Proposition 1 — which California voters passed in March — and local funding that’s unencumbered by the drug-permissive mandates of state law, San Francisco has an unprecedented opportunity to finally deliver on the true promise of Housing First — by addressing the needs of people at all stages of recovery from addiction and alcoholism, exactly as former President Barack Obama’s HUD originally urged in 2015.

That’s why Supervisor Rafael Mandelman and I have proposed legislation that will prioritize drug-free, recovery-oriented housing within San Francisco’s portfolio of site-based permanent supportive housing. Entitled “Recovery Housing First,” what our proposed legislation seeks to do is straightforward:

Whenever available funding requires drug-permissive housing models, it should be used for drug-permissive housing models.But whenever funding allows for recovery housing, it must be used for recovery housing — at least until San Francisco reaches a modest 25% target of drug-free permanent supportive housing in its citywide portfolio.

Other provisions of our proposed legislation include the following:

It would require the Department of Homelessness and Supportive Housing, in coordination with the Department of Public Health, to promulgate local rules and regulations for recovery housing. These would be based on well-established federal policies and best practices from the Substance Abuse and Mental Health Services Administration

and the National Alliance for Recovery Residences.It would include a low-barrier recovery housing option, which would simply mandate lease provisions prohibiting the use of illicit drugs. Residential eligibility would be wholly voluntary and not require a substance use disorder diagnosis.It would specify that restrictions on illegal drug-use would never bar residents from medication-assisted treatments such as buprenorphine, methadone, or naltrexone.It would adhere to strict federal standards on relapses and returns to illicit drug use, assuring that relapses would not be treated as automatic cause for eviction — and that recovery housing would offer support in relapse prevention.

It would require that discharges from recovery housing would only occur “when a participant’s behavior substantially disrupts the welfare of the recovery community in which the participant resides,” in alignment with federal standards.

It would enable discharged residents to remain fully eligible to reenter drug-free programs, “if they express a renewed commitment to living in a housing setting targeted to people in recovery with an abstinence focus.”It would guarantee residents of recovery housing who decide that they are no longer interested in abstinence-based programs access to other housing and service options, “including options operated with harm reduction principles,” as prescribed by federal HUD policies.

And it would assure that all drug-free and recovery-oriented permanent supportive housing programs abide by all local and state landlord-tenant laws governing grounds for residency and eviction.

Our proposed legislation reflects a strong conviction Supervisor Mandelman and I share with recovery community members who were united in

voicing their strong support for Recovery Housing First

at a recent City Hall rally: No one exiting homelessness should be forced to choose between their recovery and a home that continually endangers it.

“Recovery Housing First” will add a desperately needed new choice that every unhoused San Franciscan deserves: recovery-oriented supportive housing, free of illegal drug use, if that’s what the resident wants. Against the backdrop of the deadliest drug crisis in San Francisco history , there is no excuse for further delay.

Matt Dorsey represents District 6 on the San Francisco Board of Supervisors.