Armed with state law backing, San Francisco is moving forward with a plan that will require mental health and substance abuse treatment for some of The City’s most vulnerable residents. Although conservatorship, essentially judge-appointed guardianship, is somewhat controversial, officials hope their expanded power will help those who need it most.
Senate bills 1045 and 40, both authored by Sen. Scott Wiener, were signed into law by Gov. Gavin Newsom last week, allowing The City to conduct a five-year pilot program to conserve people who meet specific criteria through the court system.
Mayor London Breed, joined by Wiener, announced Monday at a permanent supportive housing complex in the South of Market neighborhood, that city officials are in beginning stages of the law’s implementation.
Breed said it was time for The City to find new solutions in their effort to help those among the homeless population who struggle with both mental health illness and substance abuse disorders.
“The reality is sad. It’s a repeating cycle with people who are in and out of our jails and hospitals and in the same areas that they once were with no help and no plan insight.”
The mayor added that the biggest challenge in helping those who suffer from mental health and substance abuse issues is the refusal of service The City offers.
“It’s not humane to just say that someone has the right to be on the streets dealing with the same challenges over and over again.”
It is estimated that 50 to 100 people would be targeted for the expanded conservatorship program.
Eligibility requires that people are at least 18 years of age, diagnosed with a mental health illness and substance use disorder, be incapable of taking care of themselves, have eight or more 5150 detentions in a one-year period, have been given opportunities to engage in voluntarily treatment, do not meet criteria for assisted outpatient treatment and that conservatorship be the least restrictive protective option.
The City Attorney’s Office will make the court request to conserve individuals and the Public Defender’s Office will represent each person through the conservation process.
Wiener said he understands opposition from advocacy groups because a conservatorship ultimately takes away a person’s right to make decisions for themselves.
“I am very mindful of the civil liberties implications. That is why this legislation is very focused.”
Wiener added that it is unacceptable to sit back and watch severely ill people unravel and die on the streets.
“It’s not good enough to say we have voluntary programs that people can accept.”
The City will form a working group tasked with evaluating the program’s success. The group is scheduled to meet for the first time Oct 21.
Breed announced her seat appointments at the press conference, which include Kelly Dearman, executive director of the San Francisco In Home Supportive Services Public Authority, 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 .
Supervisor Rafael Mandelman, who was instrumental in the passage of local law that enables The City’s participation in the pilot program, credited Breed and Wiener as advocates.
“We are not going to get there if we ignore the sickest people on the streets. The folks who do not know that they need help. Those people, in fact, have to be our highest priority.”