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SF supervisors call on health department to 'pause' planned relocation of mental health patients
San Francisco Examiner - 9/18/2019
San Francisco supervisors Hillary Ronen and Matt Haney are urging health officials to hold off on relocating more than a dozen mental health patients as legislators wrangle over alternatives to cutting beds in the facility that currently houses them.
Last month, some 18 patients living the Adult Residential Facility on the Zuckerberg San Francisco General Hospital campus received 60-day relocation notices informing them that the department planned to repurpose 41 of the 55 beds in that unit as temporary shelter beds. The residents were asked to relocate to another unit reserved for seniors in the hospital's Behavioral Health Center by October 19.
Nurses at the hospital are opposing the change, arguing that it jeopardizes long-term beds in exchange for short-term care, and have said that the impending relocation has destabilized ARF clients, all of whom are suffering from severe mental illness. Ronen and Haney on Tuesday introduced a resolution that would direct the health department to rescind the relocation notices, and to "meet and confer" with "all unions representing affected employees" prior to repurposing the beds.
The health department would also be required to consult with the community impacted by the ARF bed reductions, including the residents.
Health department officials have told the San Francisco Examiner that the department stopped admitting patients to ARF about a year ago due to understaffing in that unit, as well as state regulatory issues related to "staff behavior" that the department is working to resolve.
"The decision to close the ARF was abrupt and reckless, done without any consultation with the workers there or the patients. It has caused incredible anxiety and put many patients in dangerous situations that could lead them to be back out on the street," said Haney on Tuesday, adding that the health department "needs to press pause on this abrupt decision."
Per the resolution, "residents began showing signs of anxiety and decompensation upon receiving the notice to relocate."
"Last night, we heard directly from staff that people in the facility are filled with extreme anxiety due to the impending date of this displacement," said Ronen, who called the resolution introduced Tuesday a "stop gap" measure to prevent patient displacement.
Supervisors Gordon Mar and Sandra Fewer have already backed the resolution, which will likely move before the full board of supervisors next week. It is the third piece of legislation to address the bed reductions within the ARF.
Earlier this month, Supervisor Rafael Mandelman introduced an ordinance that would require the health department to open and fill all 55 ARF beds by June 30, 2021, among other things.
But Ronen and Haney took issue with that time frame, and followed up with a separate ordinance that would require The City to operate no less than 55 residential treatment beds for mental health clients at all times and to create an "urgent hiring" plan to sufficiently staff the facility. That ordinance is scheduled to be heard at the full board on Oct. 17.
Both ordinances must still go through the legislative process, which can be time consuming. The resolution introduced Tuesday aims to immediately protect the ARF residents by stopping the transfer of patients while officials work out long-term solutions, Ronen said,
"These are people with the most severe mental illness — stability is key to their wellbeing," said Ronen. "This resolution is about the wellbeing of staff and patients, while we as an elected body and the department are having a debate and disagreement over how we should be investing money and providing leadership on this issue."
Tensions run high at health commission hearing
A health commission hearing scheduled later in the afternoon on Tuesday was shut down by health department employees who stormed the room to demand that the department rescind the relocation notices.
The workers said they supported Ronen and Haney's resolution, and collected more than 1,200 signatures on a petition to "save the ARF," which they had planned to deliver to the department's director, Dr. Grant Colfax.
Colfax was not in attendance at Tuesday's hearing due to a prior engagement, according to a health department spokesperson, who told reporters at the scene that none of the current ARF residents would go homeless as a result of the bed closures.
"The administrators at the ARF told the staff to keep [the plan] a secret from the people who live there," said ZSFGH nurse Jennifer Esteen, who works closely with ARF staff and patients, addressing the commission.
As seen in this slideshow, more than two dozen people, including nurses employed at ZSFGH, chanted "shame" as the commissioners attempted to quiet them down.
After some 20 minutes, the meeting was adjourned by the commission's president, James Loyce, who squared off with several protesters as he left the room.
"I can't do business under these conditions," said Loyce, who added that he was unaware of Ronen and Haney's resolution and had not yet had a chance to review the protester's petition, but was "more than willing" to hear from them.
"We will re-calendar this and have an opportunity for the community to speak to us in a more orderly fashion so that everyone can be heard," he said.
Commissioner Edward Chow said he understood the "passions that the public has."
"We will continue to look into and make sure that everyone who needs to is taken care of," said Chow.
A discussion over the plan to close down the ARF beds was scheduled at the Mental Health Board on Wednesday, but was cancelled as of Tuesday, the Examiner has learned.