SAN FRANCISCO -- Only a few days into his new job as San Francisco's homeless czar, Bevan Dufty already has big ideas.
The former Castro District supervisor and erstwhile mayoral aspirant is pushing a plan for "wet houses," homeless shelters that don't force severely alcoholic residents to go cold turkey. Instead, drinking is permitted and monitored by staff members, who provide addiction counseling.
Wet houses share an underlying premise with needle exchange programs: If addicts are going to engage in self-destructive behavior no matter what, it's better they do it in a supervised environment, where some detrimental effects can be mitigated.
"The staff who gravitate to these types of facilities are ones who have specialties dealing with chronic alcoholism," Dufty told The Huffington Post.
Wet houses theoretically would woo hardcore alcoholics, now mostly outside the city's network of homeless services, into the system. They also would save taxpayers money. A study by the city Health Department found that San Francisco spends around $13.5 million per year caring for its top 225 chronic public inebriates.
"That means that we're spending money on emergency services, ambulances, shelters and jails, all of these ways that we're spending money that are not really productive and not having good outcomes," Dufty told CBS San Francisco.
Establishing wet houses in San Francisco has long been a priority for Dufty. He began talking up the shelters while still a member of the city Board of Supervisors, and the idea was a plank in his campaign platform during last year's mayoral contest.
The exact shape wet houses in San Francisco could take is still up in the air. Programs in other parts of the country either provide alcohol directly, hand out regular stipends that can be used to purchase whatever residents desire or simply allow outside alcohol to be brought onto the premises.
However, Dufty would likely model San Francisco's wet houses on a program Seattle began in 2006, offering permanent residences to severe alcoholics.
The Seattle program is widely regarded as successful because almost all participants cut their drinking significantly. Residents averaged 20 drinks per day at the time of their intake, and within two years, that number fell to 12.
A study of the program published in the Journal of the American Medical Association found that the average individual in a Seattle wet housing program, such as the 1811 Eastlake facility, cost the city more than $4,000 per month prior to their intake, but only $958 per month afterwards.
The Seattle program began with controversy. CNN reports:
There was a lot of opposition in Seattle when the residence was first proposed in 1999. A legal challenge led by a prominent businessman delayed the opening of 1811 Eastlake for six years.
"A lot of the rhetoric that their attorney used was that it would be a party house, a free-for-all," said Nicole Macri, administrative director for Seattle's Downtown Emergency Center, which oversees the residence. "It really has more of a feel of a convalescent home than a party house."
Dufty visited Seattle facilities last year and said he was excited by what he saw. However, he admitted to San Francisco Chronicle columnist C.W. Nevius that he was slightly taken aback by "big Rubbermaid tubs with the patient's name on them ... And inside is a case of Old Milwaukee."
Jennifer Friedenbach, executive director of Coalition for Homelessness San Francisco told The Huffington Post that Seattle's situation greatly differs from how San Francisco handles drug and alcohol use inside city-sponsored housing.
"In Seattle, they have strict sobriety requirements for entry into their housing programs," said Friedenbach. "Here, we already engage in 'harm reduction' strategies and, because of tenants' rights, the city can't just bust into someone's room and tell them what they're allowed to drink just because they're poor."
As recently as the late 1990s, most shelters in San Francisco were clean and sober. Many dropped strict requirements because severe alcoholics were dying from injury in the streets, as alcoholism prevents blood from clotting.
Friedenbach said she thinks wet houses will entice hardcore alcoholics off the street. "The idea is that you engage people in services as a way to get them into the system," she said. "For a lot of severe alcoholics, the only contact they have with any support network is at the hospital. You can bring them in with the wet house and then start to help them."
"With the exception of some of the usual suspects, the response I've gotten to the idea has been very positive," said Dufty, who remembered the blowback from residents when he helped set up the Castro Young Adult Housing Collaborative as a residence for homeless young people on a harm-reduction model similar to the one applied in Seattle's wet houses.
Dufty explained that he convinced doubting neighbors by inviting them to see the benefits of harm-reduction, compared with zero-tolerance. He said he hopes to make a similar pitch to San Francisco Mayor Ed Lee, the man who appointed him homeless czar, by getting Lee to visit Seattle wet houses.
"I think it would have a huge effect," Dufty told the Chronicle. "People see the same people on the street over and over and wonder why something isn't happening. If we took 50 of them off the street, how much nicer would the neighborhood be?"