Three months into San Francisco's RESET Center, the Sheriff's office isn't just defending the drug-sobering site — it's defending the fact that a for-profit company runs it. A leading homelessness advocate says that's exactly what should worry the city.

RESET, the Sixth Street facility where police drop people arrested for public intoxication instead of taking them to a hospital or jail, has now admitted 1,269 people since opening in May, with 433 accepting referrals to treatment or support services, according to figures the San Francisco Sheriff's Office gave KRON4. Those numbers are the city's headline. The quieter fight is over who profits from the operation — and whether a payment structure that rewards a contractor for occupancy is the right way to run a place meant to help people in crisis.

RESET — Rapid Enforcement, Support, Evaluation and Triage — is the centerpiece of Mayor Daniel Lurie's "Breaking the Cycle" drug-policy agenda. When officers pick someone up for public drug use or intoxication, they bring them to the center on Sixth Street rather than to an emergency room or a jail cell. The Board of Supervisors approved a $14.5 million, 26-month contract with Connections Health Solutions, an Arizona-based for-profit operator, to provide the care.

To the Sheriff's office, the for-profit structure is a feature, not a bug. Chief Deputy James Quanico told KRON4 the contractor's pay is tied to hitting the standards written into the contract. "They get paid on assuring that they meet the standards that are acquired in the contract, and I think that's a huge plus, whereas going with a non-profit sometimes you don't see that," he said. Quanico also offered a broad endorsement of the direction the city is heading: "Night and day from 2018 to driving around the city today, you can see the improvement, the collaboration."

That confidence is not universal. Jennifer Friedenbach, executive director of the Coalition on Homelessness, told KRON4 that paying a company to run a facility that provides sobering care — but not medically assisted treatment for addiction — builds in the wrong incentives. A for-profit operator, she argued, "would have an incentive not to call an ambulance because the money sign is clicking, tick, tick, tick." She added: "More and more money the longer they keep people, so that's really not good." Friedenbach said she would rather see the money go toward "restore" beds, where people with addiction get longer-term treatment.

The critique lands on a specific gap. By the Sheriff's own tally, roughly one in three people admitted has accepted a referral — the hand-off toward actual treatment. What happens after that referral is not something an admission-and-referral count captures.

The Dissent has reported before that the metrics the city touts — people processed, referrals offered — don't measure whether anyone got better. The debate Quanico and Friedenbach are having sharpens that question into a structural one: when the operator's revenue is a function of how many people move through the doors and how long they stay, the incentives of the business and the interests of the person in the chair don't automatically point the same way.

Neither the Mayor's office nor Connections Health Solutions has publicly detailed how the contract's performance standards are defined or measured, or whether they reward outcomes — people who stay in treatment — rather than throughput. Until that's on the table, the city is asking residents to take the profit motive on faith.