In 2017, San Francisco (SF) implemented Law Enforcement Assisted Diversion (LEAD), a program Beckett described as harm reduction policing. Through a process and outcome evaluation of LEAD SF, this paper demonstrates the positive impacts of harm reduction policing, on those who use drugs and/or engage in sex work. When law enforcement officers used their discretion to divert individuals into LEAD rather than arrest, those individuals had significantly fewer felony and misdemeanor arrests and felony cases, in comparison to a propensity score matched group. The focus group and interview data describe that the collaboration, the warm handoff, and LEAD’s harm reduction principles were mechanisms of success. However, obtaining officer buy-in was a key challenge. Despite that obstacle, LEAD SF’s harm reduction policing reduces offending, improves the wellbeing of people who use drugs and engage in sex work, and allows the police to carry out their mandate to protect and serve.

In 2016, San Francisco (SF) implemented the Law Enforcement Assisted Diversion (LEAD) program, a harm reduction–based pre-booking diversion system for people who violate drug laws and/or are engaged in sex work. LEAD is set apart from existing diversion programs, as it uses police as point of entry. Prior LEAD studies indicate some success in reducing recidivism and improving life outcomes. However, less is known about program implementation, including barriers and facilitators. Relying on policy documents, interviews, and focus groups, this study describes the LEAD SF’s development, operations, adaptations, and challenges. It also identifies the unique context of LEAD SF that led to implementation barriers and facilitators. Results show that SF experienced success in collaboration, relationship building, and client connections to services but experienced challenges in securing and maintaining police officer buy-in and keeping clear and open lines of communication regarding LEAD goals, objectives, policies, and procedures. This led to the termination of LEAD SF in 2020.