In response to public outrage over a proposal to suspend 41 permanent mental health beds at the Zuckerberg San Francisco Hospital campus, the Department of Public Health on Friday announced that it will freeze planned changes to give city leaders time to address the issue.
For years, the 55-bed Adult Residential Facility (ARF) located within the hospital’s Behavioral Health Center has provided permanent beds for San Franciscans with severe mental health disorders who are unable to live independently. The San Francisco Examiner first reported in August that the department planned to suspend 44 of the ARF beds to allow for a 27-bed expansion of a shelter program offering short-term psychiatric respite in the same building.
Friday’s announcement comes on the heels of three pieces of legislation proposed in the past month by city supervisors urging the health department to reverse its plan, and after dozens of health department employees shut down a health commission hearing on Tuesday in an effort to “save the ARF.”
Frontline nurses who work with the 18 ARF patients who received 60-day relocation notices in August criticized the health department for destabilizing and displacing some of The City’s most vulnerable residents. On Tuesday, they presented a petition opposing the plan with over 1,200 signatures on it to the health commission, and denounced the department’s lack of transparency in making the decision to suspend the beds.
“We have chosen to pause changes at the Behavioral Health Center while the Mayor and Board of Supervisors have a conversation about how to proceed in a way that accomplishes our shared goals of patient safety, stability and expanded access to services,” health department Director Dr. Grant Colfax said in a statement posted to the department’s website on Friday. “We restate our commitment to ensure the long-term stability of board and care services, including the [ARF].”
The health department has cited staffing shortages and state regulatory issues related to “staff behavior” as reasons for reducing the unit to just 14 beds, and has stated repeatedly that none of the patients within the ARF would go homeless. Many affected patients were asked to relocate to another psychiatric unit reserved for elderly patients within the behavioral health center.
But opponents of the plan said that the city was not transparent in its decision making and argued that it jeopardized critical long-term care in exchange for temporary shelter beds. The nurses advocating to keep the beds open were also angered when the health department appeared to blame the decision to reduce services in the ARF on workers within the unit.
Continued tensions over the past weeks prompted city leaders to step in. Supervisor Hillary Ronen, who immediately denounced the ARF bed reductions upon learning about decision, called for a hearing on the issue, and along with Supervisor Matt Haney introduced an ordinance that would require the City to operate 55 residential mental health beds at all times and to develop an urgent hiring plan for the unit.
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.
Jennifer Esteen, a ZSFGH nurse who has spearheaded advocacy around keeping the ARF beds open and filling them to capacity, on Friday demanded that the health department rescind the patients’ relocation notices entirely, and pointed out that the department has not indicated “timelines or next steps beyond talking.”