International Journal of Drug Policy - 2014

Volume 25 Issue 3 May 2014

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Page 125 of 153

626 P.J. Davidson, M. Howe / International Journal of Drug Policy 25 (2014) 624–632 By the early 1990s, San Francisco had become a central loca- tion to another social and economic phenomena, the first dot-com boom. The Haight, like much of San Francisco, experienced skyrock- eting property and rental prices throughout the 1990s and 2000s. As a consequence, newly arrived residents tended to be consider- ably wealthier than those who had moved to the area in earlier decades, and as with the middle-class house buyers of the 1880s, these newer arrivals were also drawn to the area by the close prox- imity of Golden Gate Park, as well as by the once again fashionable Victorian architecture. However, despite this partial return to gen- tility, the commercial strip along Haight Street remains a chaotic and internationally famous destination for both tourists and home- less young people seeking some vestige of the Summer of Love. As in the 1930s and 1960s, the adjacent Golden Gate Park has con- tinued to provide shelter to a sizeable homeless population, who pursue economic activities such as panhandling (begging) and drug sales along the commercial strip alongside faux hippie-style stores and newer high-end boutiques. Needle exchange in the Haight In common with many other areas in the United States affected by the arrival of HIV in the 1980s, the distribution of clean needles to people who inject drugs in the Haight-Ashbury neighbourhood began as an illegal service conducted by drug users and those close to them. By the late 1990s the City Government had developed legal mechanisms to allow the City to fund needle distribution, and the individuals running the underground exchange serv- ing the Haight arranged for the exchange to become an official service of the abovementioned Haight Ashbury Free Medical Clinic (HAFMC), with the Clinic receiving grant money from the City to provide needle exchange services. By 2005 the needle exchange service had functionally merged with the Clinic's youth outreach program, which continued the Clinic's historic mission of providing homeless youth with support with drug use, legal, education, employment, health, and housing issues. Outreach and case management operated five days a week, and needle exchange operated three evenings a week, with both services being conducted out of the same store-front located on Haight street. In early 2007 the joint youth program/needle exchange separated from HAFMC and became its own non-profit entity called the Homeless Youth Alliance (HYA), which contracted directly with the City to provide case management and needle exchange to street-based youth in the Haight-Ashbury neighbour- hood. Relationships with HAFMC remained cordial, and HAFMC continued to sublet the store-front premises at the same monthly rate previously budgeted when the program was an internal program. Planning to relocate a needle exchange and youth service In mid-2007, disputes between HAFMC and the owners of the building from which HYA provided services led to legal action between the owners and HAFMC. Due to the inherent instability associated with being housed in a building in which the master tenants were in legal conflict with the owners, in a neighbourhood in which commercial rents are far higher than the program could afford, HYA began exploring the possibility of finding a new loca- tion. Hamilton United Methodist Church, located approximately 150 m away on Waller Street, parallel to and one block south of Haight Street (see Fig. 1) expressed a willingness to house the program. The space offered by the Church also had additional benefits from a service provision perspective, such as an outside area not directly connected to the street, allowing (for example) service users somewhere to smoke without blocking the sidewalk or alarming commercial neighbours and tourists. In San Francisco, a voter-approved ordinance (the "Citizen's Right-to-Know Act of 1998" (City and County of San Francisco, 1998) requires that ser- vices receiving more than USD$50,000 (D 37,500) per year in city funding must notify surrounding residents of any plan to begin or move a program into their neighbourhood. Notification usually takes the form of a posted sign on the proposed new premises, and can also include notification by mail or leaflet. The notification must give details of the program, and give a date and time for a 'commu- nity meeting' to discuss the proposed move. Any outcome from the meeting has no legal force—all the ordinance requires is that the meeting be held. By August 2007 the negotiations between HYA and the Church were sufficiently advanced that the two organiza- tions decided to call the necessary meeting (known colloquially as a 'Prop. I' meeting', after the ballot Proposition which had authorized the ordinance). Methods This paper draws on ethnographic field notes and other textual sources derived from events that took place in the leadup to and following the 'Prop. I' meeting mentioned above. The two authors were active participants in these events—the first author (David- son) was the Chair of the Community Advisory Board of HYA and the second author (Howe) was and is the Executive Director of the program. The first author was at the time a doctoral student at the University of California, San Francisco, and had participated in research and service delivery activities involving needle exchange in Australia and the United States for approximately ten years. The second author had run the needle exchange and later the youth program for several years before HYA was formed, and had her- self been homeless in San Francisco for several years during the previous decade. Data for this paper were drawn from a wide range of sources. These included field notes made by the authors during or imme- diately following community meetings; at HYA staff meetings; after interactions with community members; after interactions with San Francisco Department of Public Health officials; and after interactions with the media. Additional data included meet- ing notes and agendas provided by the San Francisco Department of Public Health; email exchanges between community mem- bers and HYA; public email mailing lists and blogs created by community members organizing to oppose the move; flyers and other printed materials distributed through the community by HYA and by various ad-hoc community groups; and from media reports. These data were analysed using a modified version of narra- tive analysis (Czarniawska, 2004; Riessman, 2008). In brief, this involved an iterative three stage process. In the first stage, we read through our field notes and other gathered texts several times, mak- ing preliminary notes as we went. In the second stage, we coded these texts for themes encapsulating issues which were central to the reaction of the community to the proposed relocation of the needle exchange. In the third stage, we wrote memos on our emer- gent themes in order to elaborate the properties and meanings of these themes, returning repeatedly to the original data sources to further refine these codes and themes. Housed community response to the proposed relocation After posting the required signs for the Prop. I meeting, the second author almost immediately began hearing about potential opposition to the move. In particular, a group of housed community residents began attempting to organize their immediate neigh- bours to attend the Prop. I meeting en-masse, with the intention of presenting a united front opposing the move. This organizing

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