Discord in SF City Hall over ambitious mental health system overhaul – Mission Local

Like the boulders of Clinton Park being rolled off the sidewalk, put back on, taken off again and now perhaps replaced with bigger boulders the political tug-of-war between a faction of the Board of Supervisors and Mayor London Breed over reforming San Franciscos mental health system draws on, as people continue to suffer on the street.

Supervisors Hillary Ronen and Matt Haney on Tuesday announced a revised version of a proposed March 2020 ballot measure that would overhaul San Franciscos mental health system, a proposal they withdrew in July pending more outreach to the Department of Public Health and the unions.

But Breed has given no indication she will support the revised proposal after officially walking away from negotiations on Sunday.

The plan, called Mental Health SF, would no longer provide round-the-clock mental health services to every San Franciscan, as Ronen and Haney initially proposed. Rather, it would now provide these services to adult San Franciscans on public health plans, with no insurance at all, or in immediate crisis, even if privately insured.

The plan would nonetheless cost the city $100 million annually, underwritten by a proposed tax on companies whose CEOs earn 100 times more than its ordinary employees. Heres some of what that would pay for:

Supervisor Hillary Ronen (left), Matt Haney (center), and Jennifer Esteen held a press conference on Mental Health SF on Oct. 1, 2019, at City Hall. Photo by Julian Mark.

Ronen and Haney said their $100 million annual cost estimate would add to the $400 million the city already spends on mental health services. Ronen said she believes that the city is currently wasting a large portion of existing expenditures due to logjams in the system.

Ronen added that spending more on the front end could curb the number of people forced onto the streets due to their mental illness. Right now, she said, the system is hamster-wheeling people in and out of services, which is a waste of money.

Every time you get someone stabilized and they decompensate again, she said, its that much harder to get them stabilized that second and third and fourth and fifth time around.

She said she and Haney are currently working with the Controllers Office for official cost estimates. Ronen said she expects the controllers analysis to match her and Haneys estimates, but if they are more than $100 million, we are committed to tweaking the legislation so that it costs less.

The two supervisors say the revenue will be raised through so-called Excessive CEO Salary Tax, a separate ballot measure that would appear on a November 2020 and, if passed with a simple majority, tax companies whose high-paid employees earn 100 times the salaries of their rank-and-file workers.

We believe we addressed the concerns [the Mayors Office] brought up during our many meetings, Haney said. we havent heard from them yet. We were prepared to present these amendments to them but they left the talks unexpectedly.

Breed, indeed, sent Ronen and Haney a letter dated Sept. 29, explaining that she believed the two sides had fundamental policy differences in approach and who we are trying to serve.

Namely, the mayor believed the initiative should not serve the privately insured at all. She also had reservations about the proposed low-barrier services center, explaining that a similar building already exists at 1380 Howard Street. I am committed to supporting and expanding the services provided there, she said.

Breed also opposed the supervisors insistence on taking the initiative to the ballot, instead of being shaped legislatively within City Hall. My door remains open to having discussions around the future of behavioral health services in our city, Breed wrote, but until the proposed Mental Health SF program addresses these fundamental differences in policy approach, we will no longer be engaging in these meetings.

In response to questions regarding whether the mayor is willing to resume talks in light of the amendments, Breed spokesman Jeff Cretan said that the mayor and the Department of Public Health are implementing a plan to help 4,000 people who are homeless and living with mental illness and addiction on the streets.

These are our most vulnerable residents who are in crisis that need help today, he said, giving no indication either way on the mayors opinion of Mental Health SFs current version.

But Jennifer Esteen a Department of Public Health psychiatric nurse and member of SEIU 1021, which supports the initiative said at Tuesdays press conference that the Health Department and Mayors Office have been too focused on short-term solutions, mentioning Navigation Centers and the halted plan to replace permanent mental health beds with temporary shelter beds.

So if we take someone off the street for a day or two, or even two weeks, and we offer them access to treatment thats wonderful, Esteen said. But after that then what?

The legislation will be voted on at the Board of Supervisors Rules Committee on Oct. 30 at 1 p.m.

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Discord in SF City Hall over ambitious mental health system overhaul - Mission Local