The streets are home to dozens of chronic alcoholics who are clogging the emergency medical system and the city jails.
For example Paul Sanchez, a self described drunk, ABC7 met a few years ago had been arrested 128 times and hospitalized 50 times.
San Francisco Supervisor Bevan Dufty thinks they're might be a better approach -- so-called "wet housing" modeled after this project in Seattle where homeless alcoholics are allowed to live and keep on drinking.
"Providing a medically supervised safe living environment in which the chronic inebriates have the ability to live safely but also don't drain public resources," he said.
A three-year study by the San Francisco's Health Department found 225 of the worst offenders accounted for more than 1,900 EMS pickups and spent more than 2,000 days at SF General Hospital. In all, their treatment cost taxpayers $13.5 million annually.
Dr. Eugene Schoenfeld has worked in the field of addiction medicine for more than 40 years.
"The best solution would be to have them hospitalized involuntarily if necessary, and have them de-toxed," he said.
He believes the wet houses allows for severe alcoholics to keep killing themselves.
San Francisco Mayor Gavin Newsom supports Seattle's concept.
"At least this gets people thru the door and then you can start saying, 'hey, we are here for you.' Right now, you've got people that aren't going thru any doors, they are all out on the streets and sidewalks and it's hard to pull them in. This way really, we help save lives and reduce the cost to the taxpayer," he said.
Seattle officials say their program saved $4 million the first year alone and a study by the Journal of the American Medical Association verified cost savings as well as a drop in alcohol consumption by the homeless. Supervisor Dufty will head there for a look next week.