Behavioral health oversight body looks for new start — and staff — after mismanagement

Members of an oversight body for San Francisco’s behavioral health programs said Monday that their work has suffered due to...

Members of an oversight body for San Francisco’s behavioral health programs said Monday that their work has suffered due to an unusual structure that relies on staffing from a city-contracted nonprofit.

But now that structure is expected to change.

The Board of Supervisors Rules Committee approved legislation Monday that was introduced by Supervisor Catherine Stefani to have the Department of Public Health provide the administrative staff for the commission.

It would eliminate the decades-old relationship between the San Francisco Mental Health Education Fund and the Behavioral Health Commission. Currently, The department’s Behavioral Health Services division contracts with the nonprofit to provide the oversight body with staffing and support. The commission, previously called the Mental Health Board, is a state law requirement for counties throughout California.

Questions about the commission, however, have come as the demand for effective behavioral health services has increased and The City has committed to invest more in programs and reform the existing system under an initiative known as Mental Health SF.

Earlier this year, Stefani stepped down from the commission amid concerns the nonprofit’s executive director, who also is the executive director of the commission, was mismanaging the organization, including failing to submit invoices for expenses on time. And those concerns only intensified when the nonprofit applied for and secured a federal Paycheck Protection Program loan to help with salaries even tough it is contracted with The City.

The head of the nonprofit, Helynna Brooke, has since retired from her position, but she has argued the nonprofit gives the commission independence from the department it’s supposed to oversee. No other Mental Health Board in the state has such an arrangement, however.

The legislation also staggers the terms of those appointed to the board so they do not all expire at the same time.

Marylyn Tesconi, chair of the commission for the past three years, said the legislation is “the best hope of restoring relevancy and credibility to the commission.”

Tesconi said she sees no “convincing value” to keep the structure as is, noting that in her experience the “commission’s effectiveness and credibility has declined.”

She said by cutting ties with the nonprofit the commission will get back on track and resume “one of our most important duties, the review of local behavioral health facilities.”

Terry Bohrer said she considered it an honor to be appointed to the commission twice, but lamented that “unfortunately as I look back I do not have very much to be proud of.”

She said she participated in meetings and wrote resolutions and reports, did some site visits, but “none of what I did, changed the behavioral health system, a system, as you all know, that is in need of great change.”

“Our commission should not have to concentrate on mismanagement of funds, sloppy bookkeeping, out of date documents, bylaws and manuals that are 20 to 30 years old,” Bohrer said. “This commission has great potential to advise the Board of Supervisors and the mayor and make a difference in the lives of people with behavioral health needs.”

David Elliott Lewis, a former member of the Behavioral Health Commission who sits on the San Francisco Mental Health Education Fund board, supported the legislation.

“I am sorry to say that this board has underserved the commission and the current process has underserved the commission,” Lewis said. “We are not getting our money’s worth. And we are not really helping the city.”

Lewis said the new structure would address the “many failures.”

“One of the most significant is the failure to really do program reviews,” Lewis said. “We are supposed to do, by contract with The City, five per year. In 2019, we only did two program reviews.”

Stefani said that the department is “currently auditing the contract and a federal investigation into the status of the PPP loan is underway.”

“None of this information is meant to malign anyone who has ever served on this body,” Stefani said. “In my opinion they and the residents of San Francisco have been poorly served by a structure that undermines their efforts.”