SF supervisors grill health dept. on 400 mental health treatment beds promised in 2021

SAN FRANCISCO (KGO) -- The San Francisco Board of Supervisors budget and finance committee on Wednesday questioned the health department on the effectiveness of their planned treatment bed expansion plan.

For two hours, San Francisco supervisors questioned the city's public health department for two hours mostly asking where the treatment beds were.

"It sounds like for most of the beds for people with severe behavioral health needs - those are 'as needed' beds and we have no idea. In school they talk about butts in seats. We have no idea based on the numbers we are looking at today, how many San Franciscans with several health needs are in those 'as needed' beds?," said Supervisor Rafael Mandelman during the budget and finance committee on Wednesday.

In 2021, San Francisco announced a plan to add 400 new treatment beds for mental health and addiction treatment. On Wednesday, the city's health department said they expansion has led to a total of 2,550 treatment beds, but Supervisor Mandelman said their numbers may not be accurate.

"They had a plan to add 400 additional beds. They believed and they are telling us that they are close to having added those beds but they have some key foot notes that are concerning to us. One is 15-20% of those beds may be unavailable because of staffing challenges," said Supervisor Mandelman.

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The public health department said the staffing shortage is part of a nationwide staffing crisis for mental health professionals.

"In terms of the intersection between impact of staffing on 'as needed' beds - we don't know that. Meaning we apply for a placement. The facility accepts or doesn't accept and we don't track if they are not accepting," said Hillary Kunins, director of San Francisco's Behavioral Health Services during the meeting.

When it comes to getting treatment beds San Francisco competes with other counties for access.

"Particularly for the highest levels of beds the competition is fierce. We have never replaced the state mental health hospitals that have been closed. There are these private facilities that are sort of providing but there are not nearly enough beds for the needs of all the counties, and San Francisco has a lot of need," said Supervisor Mandelman.

The Salvation Army's Harbor Light Center has 136 beds. The city funds 65 of those beds. They are urging the public health department to pay for more treatment beds within the city.

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"We have basically 50 to 60 beds open that the city can purchase today," said Adrian Maldonado, director of the Salvation Army's detox facility, called the Harbor Light Center.

Luz Pena: "You are saying they are empty?"

Adrian Maldonado: "They are empty. If they chose to do thatm we can then fill up harbor light. If people stop using dope, they are not in crisis in the street. They don't go to the emergency room. They don't have the police coming to arrest them."

Supervisor Mandelman wants the city to change its plan for treatment beds

"I think we need to own more of those buildings ourselves and if we have excess we share them with other counties," said Supervisor Mandelman.

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The need for treatment beds in San Francisco is climbing and according to experts mental illness among the unhoused population across California is as high as 80%.

"I talk to my colleagues across the country and we are seeing really substantial demand for resources that include medical but go well beyond medical particularly those who are experiencing homelessness. Those who are experiencing behavioral issues and even more so perhaps when they overlap," said Dr. Christopher Colwell, chief of Emergency Medicine at Zuckerberg SF General Hospital.

After Wednesday 's committee meeting, supervisors are planning to request a follow up with the department of public health for more clarity.

We asked the San Francisco Public Health Department how many beds are "empty." In an email, they said:

"To view bed capacity and availability for someone seeking substance use or mental health treatment, please visit at: https://findtreatment-sf.org/.

The majority of beds are utilized. However, Behavioral Health staffing challenges are a federal, state, and local issue and we know that staffing has intermittent impacts on service availability. However, we have seen increases in clients served in our bed expansion in a number of areas including substance use disorder residential, substance use disorder residential step-down, and in withdrawal management, psychiatric respite, drug sobering programs and facilities."

In their presentation, the health department broke down the bed expansion:

"Additional bed expansion projects in progress include:

- Additional Enhanced Dual Diagnosis (18 beds)

- Transition-Age Youth Residential (10 beds)

- Crisis Diversion (16 beds)

- Dual Diagnosis Women's Therapeutic Residence for Justice-Involved

- Women (33 beds)

- SUD Stabilization (20 beds)

- Other projects pending approval of Behavioral Health Bridge Housing spending plan"

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