Almost two years after approving a conservatory program for mentally ill residents with drug addictions who live on the city streets, San Francisco has only now brought the first person to justice.
In June 2019, the Board approved the controversial Housing Conservatorship pilot program, permitted under Senate Act 1045, approved earlier that year. However, the challenges of implementing the program, sponsored by Mayor London Breed and Supervisor Rafael Mandelman, have so far prevented anyone from staying. The pilot expires on January 1, 2024.
“It’s been almost two years since the board of directors debated fiercely and ultimately decided on SB 1045,” Mandelman said at a public safety and neighborhood services committee hearing on Thursday. “I said at the time that even if SB 1045 only helped one person, I believed it was worth doing. And I still believe that, but I didn’t think it would literally be just one person. “
He said the “purpose was to meet the needs of a relatively small population of unhodged people who cycle repeatedly through mental emergencies, our other emergency rooms, the prison, back on the road and again without ever having the longer-term assistance and support.” Get the care they need. “
Under the program, an individual with a mental illness and substance use disorder from The City can apply for a court-approved conservatory if they have a mental illness and substance use disorder for up to 72 hours for an emergency psychiatric evaluation.
Early last year city officials blamed the difficult process of establishing legal forms in the courts for the new program as the reason for the delay in implementation.
“In June 2020, the forms were finalized by the local courts so we could continue working on the cases,” Angelica Almeida, who oversees the health ministry’s outpatient treatment program and SB 1045 pilots, told the committee. “We weren’t able to move the cases forward until June 2020.”
Almeida said that by the end of January they had identified 63 people with double illnesses who had at least five 5150 in the past 12 months, of whom 16 had at least 8 and one was preserved.
She said she anticipated The City would eventually get “at least a handful more people” under the pilot.
Mandelman said SB 1045 was originally suggested as a solution to a certain type of problematic behavior he sees in his district.
“I know a number of these named people in my district who commit crimes, not because they are bad people, but because they have a mental illness associated with a substance problem, who are 5150 years old, maybe not eight times. but a lot, ‘said Mandelman. “One such person lit a fire in my district that burned three people from their homes last week.”
Jill Nielsen, assistant program director for the disability and elderly services department that oversees regulators, said the “eligibility criteria are way too tight” to get someone under the pilot. She noted that SB 1045 was originally introduced to allow a conservatory if a person had three 5150s within 12 months, not 8.
However, critics of the law have called for stricter protections against the conservatory under the pilot, including The City, which is doing more to provide volunteer services and housing “before we take away civil liberties.”
Nielsen said it remains to be seen what will happen if there is a controversial conservatory, but that the prosecutor “believes that a future controversial case could be quite complex and lengthy because of the” extensive requirements contained in the law ” .
“While we knew the housing conservation program would only serve a small number of people, it remains disappointing that we were unable to serve more vulnerable people at the time,” said Nielsen. “We are absolutely determined to expand the program and we remain committed to implementation and innovation to do whatever we can to ensure we use this tool.”
However, critics said the approach was still wrong.
“We know there are big problems with the Conservatory,” said Jessica Lehman, executive director of Senior and Disability Action. “It’s a major deprivation of civil liberties. We need to offer people housing and volunteer services sooner instead of having people in crisis for years and then say they haven’t made rational decisions.”
It refuted the characterization of 1045 supporters that the opponents of the bill had succeeded in making changes that made the pilot overly complex.
“It’s great that we have as many safeguards as we do,” said Lehman. “The people who have had multiple 5150s are disproportionately African-American men, and the city needs to work out a plan to eliminate these racial differences before proceeding.”
Dr. Grant Colfax, Head of the Department of Health, acknowledged the “multiple challenges” involved in implementing the pilot project, but stood behind them.
“DPH will continue to support the Housing Protection Agency,” said Colfax. “We need all the tools we have to help the most vulnerable in San Francisco.”
He promised improvements to the overall care system through Mental Health SF, a multi-year effort to reshape the city’s behavioral health system. The department recently appointed Dr. Hillary Kunins hired to lead the Mental Health SF.
“Our care system is expanding, lowering treatment barriers, and making it easier to access and move through the system,” said Colfax.
Mandelman said, however, that “expectations of SF mental health are very high” and he remains concerned that the city is “orders of magnitude away from responding to the fairly serious behavioral health and substance use problems on the street.”
Bay Area NewsHousing and HomelessnessPoliticssan Francisco News
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