Mayor London Breed last week urged the Board of Supervisors to pass legislation that would allow city officials to compel some mentally ill homeless people into treatment. “Please take action. No more delays,” she told the Board at Tuesday’s meeting. (Kevin N. Hume/S.F. Examiner)

Showdown looms over ‘contentious’ proposal to compel homeless into treatment

Unclear if Conservatorship legislation has votes to win approval by the Board of Supervisors

San Francisco’s proposal to expand The City’s power to compel the medical treatment of homeless who are mentally ill and substance users advanced Monday to the Board of Supervisors.

The full board is now scheduled to vote June 4 on the “contentious” legislation introduced by Supervisor Rafael Mandelman and Mayor London Breed to enact the pilot conservatorship program under Senate Bill 1045.

It remains unclear, however, if there are six votes on the board to pass the legislation.

The board’s Rules Committee postponed a vote last Monday on the legislation. A day later, Mayor London Breed slammed the board’s delay when she appeared during a meeting for question time.

“This is one solution to the challenges that you all know we are dealing with every single day and after six months we get opposition and additional delays? Enough already,” Breed said last week. “People in San Francisco want us to take action. You all see what we see on the streets every day with people suffering from mental illness.”

“Please take action. No more delays,” she concluded.

The three members of the board’s Rules Committee — Supervisors Hillary Ronen, Gordon Mar and Shamann Walton — said Monday that they did not support the legislation, but voted to forward it to the full board anyway, but without any recommendation on how the board should vote.

“Let the full board weigh in,” Walton said.

Breed’s spokesperson Jeff Cretan called on the board Monday to approve the measure.

“The Mayor was clear in her desire to move this public health measure forward, so it’s positive that it moved out of committee today,” Cretan said in an email. “Now the full board needs to approve the legislation so the City can provide care for those suffering on our streets who cannot help themselves.”

Opponents of the measure include homeless and disability advocates who argue The City shouldn’t take away people’s civil liberties and should instead focus on voluntary services and supportive housing. They also argue that voluntary services are the most effective treatment and The City has failed to provide them adequately.

“This is a highly contentious issue and it is highly contentious for a reason,” said Jennifer Friedenbach, executive director of the Coalition on Homelessness.

She said Senate Bill 1045 is a “radical change” that subverts the “longstanding agreement that you only take away people’s civil liberties when there is a safety issue.”

Instead, she said it relies on “an absolutely random eight 5150s decided on by the police.”

“When folks are more interested in personal political wins than addressing the true need of folks and engaging with people with lived experience it is going to be contentious,” she added.

Under the measure, if someone is held on a 5150, an emergency psychiatric hold, eight times in a year, The City can seek to obtain a court-ordered conservatorship of the person for a year if they meet certain criteria, including if they suffer from substance abuse and mental health illness.

A public defender would represent the person throughout the process. Ronen pointed out that if the person is eligible for the court-ordered treatment and they are already unwilling to obtain services, it is unlikely the person will go to court to face possibly being conserved by a judge.

“I have shown and proven that 1045 is just a really poorly written law,” Ronen said. “It is unworkable as it is currently drafted. It doesn’t make any sense internally.”

A pending state bill, Senate Bill 40 would fix this by allowing The City to impose a temporary 28-day hold on the person at the eighth 5150.

“It doesn’t put the priority where we need right now, which is to create a workable system that is getting people the services that they need,” Ronen added.

Walton said he opposed the measure since it would result in “further possibilities of negative police contact” at a time when the Police Department is implementing reforms to address bias. He added, “I have heard nothing about mitigating the possibility of black people and people of color being disproportionately affected by SB1045”

Mar said he continued to question how the “small step” proposal fits into a larger strategy.

“There is not enough information to ensure that voluntary services are going to be available or have been available to the individuals which will be served by this pilot program and more importantly to the broader range of community members that really need those services,” Mar said.

Mandelman had previously threatened to pull the proposal from the committee with four signatures if it didn’t advance, a rarely used procedure. There is also a possibility that if the board doesn’t approve the measure, supporters could take it to the ballot.

After the hearing, Mandelman said he hoped that wasn’t necessary.

“Given the scale of the program, we have spent far too much time on it already. It should have been passed months ago,” Mandelman said. “We need to see it through.”

He said that he is “ cautiously optimistic” he can convince his colleagues to support the measure. The measure is backed by Mandelman and Supervisors Vallie Brown and Catherine Stefani.

“There is going to be a conversation over the next couple of weeks about making sure that we really do have the services to meet the needs of this population and the broader population of mentally ill and substance using folks,” Mandelman said.

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