Supervisor Shamann Walton speaks during a hearing on conservatorships for homeless people during a meeting of the Board of Supervisors Rules Committee at City Hall on Monday, May 13, 2019. (Kevin N. Hume/S.F. Examiner)

Plan to push homeless, mentally ill substance users into treatment meets with resistance

Supervisors question impact, lack of resources in proposal

Supervisor Rafael Mandelman said his colleagues were making a “terrible mistake” Monday after his legislation to compel homeless people who are mentally ill and substance users into treatment met with a lack of support in committee.

The Board of Supervisors Rules Committee postponed to next week a vote on the proposal, which was introduced with Mayor London Breed, after its three members raised a number of concerns about costs and the adequacy of resources for the program. Committee members also questioned whether forced treatment works and whether the proposal would have a disproportionate impact on people of color.

The legislation, introduced in November 2018, would implement state Sen. Scott Wiener Senate Bill 1045. That bill, which became law last year, allows San Francisco, San Diego and Los Angeles to implement a five-year pilot program allowing someone to be placed under a court-ordered conservatorship after eight emergency psychiatric holds, or 5150s, in a year.

The board would have to approve the legislation to launch the program, but Mandelman has only two other co-sponsors in Supervisors Catherine Stefani and Vallie Brown. Opponents include homeless and disability advocates who argue involuntary treatment is ineffective and The City should not take away people’s civil liberties.

Rules Committee members Supervisors Hillary Ronen, Gordon Mar and Shamann Walton all expressed concern about the legislation and supported a postponement. The committee is scheduled to vote on the proposal next on May 20.

“Abandoning mentally ill people to wander the street without care or medication is morally wrong and it is dangerous,” Ronen said. But she said that “I have been very skeptical about a brand new conservatorship model. I am not yet convinced that it is workable at all or even a useful law to address the people suffering from mental illness and substance addiction on our street.”

After the hearing, Mandelman said: “‘I’m glad they didn’t kill it. I am disappointed that they didn’t pass it on with a positive recommendation.”

But Mandelman said if he can’t get the support from the committee he may turn to a rarely used board procedure to pull the legislation out of committee with four supervisor signatures, in order to bring it to a full board vote. Still, he would need to secure six votes at the full board.

Mandelman acknowledged he is still working to try and gain the support of the board’s majority. “It’s got a difficult path ahead,” he said.

During the hearing he appealed to his colleagues to support it. “We do have an urgent crisis that should be seizing every tool,” Mandelman said, adding that it would be “a terrible mistake not to move forward as quickly as we can.”

Ronen expressed concern about approving the legislation when there is a current bill pending approval in the state legislature, Senate Bill 40, that would fix some of the challenges identified with SB 1045.

Among them is the need to have a SB 1045 candidate held for a “temporary” conservatorship for 28 days following a 5150 to ensure the person remains within treatment and available for proceedings for a longer conservatorship.

Another provision in SB 40 will allow The City to waive a requirement that The City must first try to help the person with assisted outreach treatment or Laura’s Law if it finds that the person is deemed an unsuitable fit for that program. This provision had limited the number of people in The City eligible for conservatorship to as few a five. If SB 40 passes, the number impacted would likely be about 50.

Walton argued that the most effective treatment is voluntary treatment.

Mandelman responded that “we could double the availability of voluntary services tomorrow, and we should, and I still do not believe we would reach the population 1045 seeks to bring into care.”

Walton also said he was concerned about impact on Black residents.

“As a person of color, there is always a major concern of anytime we put any system in place of incarceration or taking away someone’s ability to be free typically disproportionately affects Black people and typically disproportionately affects people of color,” Walton said. “ That is … one of the biggest reasons why I am not excited about this.”

Mar said that the proposal lacked details on how it fits into a more comprehensive strategy.

“I am not going to be able to support this moving forward here today because I feel like there are still too many unanswered questions,” Mar said.

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