As another anecdote, I encountered some fairly aggressive panhandling in Nashville. I was there for a convention but got out into the city a bit. At the crosswalk near music row toward the river, a man asked for change and heckled me until the light changed and I crossed. In east Nashville, I definitely saw things that reminded me of home (in SF): very ill, almost certainly addicted people wandering around, attempting to stop me and ask for "five dollars", with a bit of menace thrown in.

This was a year ago. It was not as bad as SF by a long shot, but absolutely present.