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More than two years into the city attorney’s S.M.A.R.T program, which connects people who have a string of misdemeanor arrests with addiction treatment and housing, only a handful of clients have graduated and the city has struggled to expand the program despite significant investment. City attorneys say the outcomes reflect the challenges of an especially vulnerable population.
In 2014, California voters passed Proposition 47, and law enforcement officials have complained ever since that they have fewer options to confront people caught possessing drugs.
The new law may have helped alleviate prison overcrowding but police and prosecutors say reducing many drug charges to misdemeanors deprived them of the chance to force people into recovery programs.
The San Diego city attorney’s office responded in late 2016 by launching a program to connect people who have a string of misdemeanor arrests with addiction treatment and stable housing.
More than two years in, only a handful of clients have graduated from the San Diego Misdemeanants At-Risk Track program and the city has struggled to expand the program despite significant investment.
In 2017, the city bought a South Bay hotel to house up to 84 people while they are enrolled in the program. The plan to expand in Nestor is now on hold after a Superior Court ruling late last year. More than two-thirds of clients who enrolled in the program have walked away at least once.
Nine of the 53 clients who have enrolled in the program since September 2017 have graduated from substance abuse treatment and five have moved into permanent homes.
Through mid-March, 37 of those 53 clients exited the program at least once, according to an analysis from SANDAG, the regional planning agency tracking the outcomes of program. Some left the program multiple times.
City attorneys and public defenders have worked with health and substance abuse treatment nonprofit Family Health Centers of San Diego and housing provider Rooted Life on the program.
Despite the setbacks, the city is working to double the S.M.A.R.T. program’s capacity by June – increasing the number of beds at independent living homes in the College Area and Logan Heights from 20 to 44.
City attorneys say the program’s initial two years reflect the struggles of an especially vulnerable population. They have often watched S.M.A.R.T. clients repeatedly cycle through the justice system as they wrestle with addiction and homelessness.
“I think one of the most important things about our program is that we remove judgment from this because we know that these individuals are the most difficult for us to reach and we expect that they will fall off the wagon from time to time,” City Attorney Mara Elliott said.
At least a few who left the program returned and found success.
One was David Moncada, who said he racked up many arrests for erecting a tent on city sidewalks over four years on the street. He also struggled with alcoholism.
Moncada said he enrolled in the S.M.A.R.T. program in early 2017 and then walked away a few months later for reasons he said he can’t entirely explain.
“I wasn’t ready yet. I thought I might be able to change something by doing the same thing over and over again,” Moncada said. “I ended up picking up unhealthy behavior.”
Moncada said he signed on again after a warrant arrest that September tied to his departure from the S.M.A.R.T. program. Family Health Centers staffers visited him in jail and persuaded him to give S.M.A.R.T. another try.
Now, after graduating from treatment and participating in a culinary training program, Moncada is working as a cook at an Italian restaurant in Kensington. He’s continued to live at a S.M.A.R.T. home in Logan Heights while he saves to buy a car and rent an apartment.
“It’s amazing where I’m at now,” Moncada said.
Elliott said the S.M.A.R.T. program recognizes that clients who have struggled with homelessness and addiction won’t be overnight success stories.
“We saw this as an opportunity to throw a lifeline to individuals who really need it,” Elliott said. “Instead of showing them the revolving door into our criminal justice system, we’re finding them real solutions.”
Elliott and staffers who work on the program say it was developed with the assumption that clients would likely relapse and built to allow them to recommit to the S.M.A.R.T. program after that happens. The program follows the harm reduction model, meaning clients commit to sobriety when they are at the S.M.A.R.T. facilities but aren’t booted from the program if they struggle.
Clients get multiple shots to succeed – even if they leave the program more than once.
Hilary Nemchik, a spokeswoman for Elliott, said one client wrestling with methamphetamine addiction has enrolled in the S.M.A.R.T. program four times. He agreed to try S.M.A.R.T. again last summer and has since stuck with treatment for more than six months.
Now he’s on a waiting list for permanent housing, Nemchik said.
But many other clients have not returned. Officials said they would welcome them back again.
“We don’t give up on people, and I think our clients know that,” said Bob Lewis, who oversees Family Health Center’s efforts to provide treatment and health care to S.M.A.R.T. clients.
The S.M.A.R.T. program was a recognition that repeated arrests or tickets can do more to complicate the lives of homeless San Diegans battling addiction than inspire them to seek help.
A few years ago, San Diego officials saw a boom in misdemeanor cases and received the largest influx of requests statewide for reduced sentences following the passage of Prop. 47.
Then-City Attorney Jan Goldsmith and other law enforcement leaders openly grappled with how to cope. The found it more difficult to compel low-level offenders to seek addiction treatment after Prop. 47. At the same time, street homelessness was spiking.
After a series of conversations with public defenders and the local ACLU chapter, Goldsmith and his team debuted the S.M.A.R.T. pilot program.
The idea was to offer people who’d been repeatedly arrested for drug and quality-of-life offenses such as trespassing or public urination both treatment and transitional housing for up to two years, typically in lieu of jail time. If clients fell out of S.M.A.R.T., they could end up in jail. If they graduated from the program, charges against them could be expunged.
City attorneys noted that a similar initiative in Seattle more than halved criminal-recidivism rates for a group of low-level drug offenders in that city.
San Diego’s program started with 10 beds operated by nonprofit Second Chance and substance abuse treatment provided by Family Health Centers.
Then, more than two years after Prop. 47 passed, state officials invited cities and counties to apply for grant funds to support substance abuse and mental health treatment programs for people with criminal histories.
San Diego city and county leaders teamed on an application that scored first in the state’s initial funding round. They were collectively awarded $6 million over a few years.
Part of the proposal was to bolster the S.M.A.R.T. program to serve 70 clients a year.
With the promise of state Prop. 47 funds, the county expanded an existing contract with Family Health Centers, which runs health clinics across the county, to provide substance abuse treatment, mental health care and other services to more clients through the S.M.A.R.T program. The agency has also committed to try to link clients with permanent housing after they graduate from substance abuse treatment in its contract for nearly $1.7 million over four years.
Family Health Centers also agreed to oversee a new contract with housing provider Rooted Life, which receives $38 a day per client to provide housing.
City officials later revealed even more significant plans to expand the program. The City Council voted in July 2017 to spend about $11.2 million to buy and rehabilitate a Super 8 Motel in Nestor, which borders Imperial Beach, amid warnings the state Coastal Commission could oppose the project.
A lawsuit from a group of neighbors, Citizens for South Bay Coastal Access, has since stymied those plans. The group alleged the city failed to conduct proper environmental reviews and should have sought a coastal development permit to convert the hotel into longer-term housing.
In a ruling late last year, Superior Court Judge Joel Wohlfeil ordered the city to seek a coastal development permit but dismissed the lawsuit’s other claims.
The city has since appealed Wohlfeil’s ruling and argued it should be allowed to proceed with its plans for the hotel while the court fight continues.
City Councilwoman Vivian Moreno, who represents the area, and neighborhood activists have argued the city should seek another site for S.M.A.R.T. program.
Michael Ruiz, who supervises the public defender’s misdemeanor unit, considers the court battle a setback for the program. The city and its partners had envisioned having dozens more S.M.A.R.T. beds by now.
For now, Ruiz said, there aren’t always open slots when city attorneys and public defenders want to steer clients toward the program.
With more beds, Ruiz said he’s hopeful attorneys and police officers can offer the program as an option to more clients before charges are filed against them – rather than when they are already in jail or in the court system.
“We have the demand,” Ruiz said. “We just don’t have the capacity.”
Despite the program’s early challenges, UCLA psychologist and professor Steve Shoptaw, who for years operated a housing program for people grappling with addiction, mental illness and HIV/AIDs, commended S.M.A.R.T.’s initial outcomes.
Shoptaw, who reviewed data on the program at VOSD’s request, noted that those who stuck with it typically spent almost six months in treatment, a significant time period for its vulnerable target population.
“For the people who it works for, it works pretty well,” Shoptaw said.
He said only a small percentage of people who need substance abuse treatment pursue it but that S.M.A.R.T. operators should study why many reject the program or abandon it.
Barbara DiPietro, senior director of policy for the Nashville-based National Health Care for the Homeless Council, also emphasized the need for persistence in aiding S.M.A.R.T. clients.
“It’s very hard to build into your program expectations, and also build into your community partnership expectations, that this is gonna be a long slog for a lot of people and we have to accept it,” DiPietro said. “There has to be a patience and a compassion and a perseverance and dedication to outcomes.”
Elliott says she’s committed to the S.M.A.R.T. program and that her office will continue to encourage homeless San Diegans battling addiction and misdemeanor charges to give it a chance.
“This is a population that has been turned down from other programs, or has not had successes in other programs, and so often times we find that they’re less likely to say yes in the beginning,” said Chief Deputy City Attorney Angie Law, who helps oversee the S.M.A.R.T. program. “But when you continue to come back and continue to offer and continue to offer and continue to offer, they realize that there is some hope in this type of program.”