SF to launch expanded conservatorship program

State legislation allows city to compel mentally ill, substance users into treatment

The City will begin implementing state law that allows San Francisco to force people into treatment if they are suffering from mental health and substance use issues, officials said Monday.

With the passage of conservatorship legislation — Senate Bill 1045 last year, and Senate Bill 40 this year, which Gavin Newsom signed into law last week — The City will start asking the courts to conserve those who are now eligible, Mayor London Breed announced Monday at a 100-unit supportive housing site in the South of Market area.

Breed was joined by State Sen. Scott Wiener, who authored the state bills, and Supervisor Rafael Mandelman, who helped pass the local law to participate in the program.

Breed, as Wiener pointed out, was the only candidate in last year’s mayor’s race to support the effort. She is up for re-election in November and is expected to win, facing no serious opposition. But Breed has vowed to address mental health and substance use among the homeless on the streets and has asked voters to judge her based on her success.

Breed said this is “not trying to hide people or move them off the streets because we don’t want to see it, this is about trying to help people.”

The City estimates there are between 50 and 100 people who meet the criteria for conservatorship. In order to qualify, they must have a dual-diagnosis of mental illness and substance use disorder and have been placed at least eight-times in a 12-month period under an involuntary 5150 emergency hold.

Those conserved will be represented by the Public Defender’s Office, while The City Attorney ‘s Office is in charge of petitioning the court to compel treatment.

“We are currently working with stakeholders to implement the new type of conservatorships authorized in Senate Bill 40,” City Attorney Dennis Herrera said in a statement. “We welcome this new tool to help people suffering from mental illness and substance abuse to turn their lives around. We will ensure that our implementation follows the law, including due process.”

The law requires The City to establish a working group to oversee the program and evaluate it. The group meets first on Oct. 21 and ultimately will submit a report to the State Legislature by January 1, 2021.

The mayor gets three appointments to the group, which she announced Monday: Simon Pang, Captain of the San Francisco Fire Department’s EMS-6 Team; Rachel Rodriguez, co-founder and director of the Community Payee Partnership, and Kelly Dearman, executive director of the San Francisco In Home Supportive Services Public Authority.

The expansion of The City’s conservatorship powers was strongly opposed by homeless advocates who argued for increased voluntary services before taking away people’s civil liberties.

“I acknowledge that there are people that have concerns,” Wiener said. “I am very mindful of the civil liberties implications. That is why this legislation is very focused.”

But he noted that “in the legislature, honestly, this was overall not a controversial bill.”

“It was controversial in the advocacy community and we respect our advocates and work with them, but this is a bill last year and this year that got almost unanimous bipartisan support,” Wiener said.

He blamed a lack of state and federal support for the challenges seen on the streets.

“This is a problem that has been many, many, many years in the making,” Wiener said. “It has to do a lot with statewide and national failures around our mental health and eviction safety nets around housing and having enough of it.”

He said that two-thirds of homeless people have no mental health or substance abuse issue, but “for a small percentage of our homeless population voluntary services are not enough.”

Mandelman praised Breed and Wiener for having “backbones of steel” for politically pushing the proposal. He said if Breed didn’t threaten to take it to the ballot, the board wouldn’t have passed legislation to authorize program.

He said the “intensity and vehemence of the opposition to it was unwarranted and I think wrongheaded.”

One of their arguments was that The City should focus on adequate and effective voluntary services, but Mandelman said, “It’s not an either-or, it is a both-and.”

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