Deal reached over shutdown of long-term mental health beds

San Francisco Mayor London Breed and public health leaders have agreed to walk back a controversial decision made earlier this summer to suspend 41 long-term care beds for mental health patients at Zuckerberg San Francisco General Hospital.

Scaling down the hospital's Adult Residential Facility [ARF] in exchange for a 27-bed expansion at the hospital's Hummingbird Place, a short-term psychiatric respite program, would have required the relocation of 18 ARF clients with severe mental illness. The move was vehemently protested by nurses and mental health workers workers.

In a deal reached Friday, 14 of the 41 beds that would have been suspended within the 55-bed facility will be repurposed into temporary shelter beds at the Hummingbird Place, a psychiatric shelter program where clients stays average 19 days, for a six-month period.

After that, the ARF beds will be returned to their original use as long-term residential treatment beds, officials said Monday. None of the ARF's current residents will be forced to move from the facility, where some have lived upwards of 15 years.

Additionally, a working group comprised of health department staff and management will be created for the first time to work collaboratively on hiring, training, and other issues within the facility. The agreement was reached between city leaders and the unions representing workers at the hopstial, including SEIU 2021 and IFPTE Local 21.

"The new plan includes more staff, more comprehensive and effective training, and a workgroup of staff and management [which] are all steps in the right direction to improve care and accountability at the facility," said Theresa Rutherford, regional vice president of SEIU 1021, in a statement.

"We want to continue to work with the leaders of the [DPH] to fix persistent understaffing, restore cuts to supportive mental health programs, and invest in comprehensive, integrated services that address the complex mental and physical health needs of our residents," she said.

The deal is expected to be announced on Tuesday at a joint press conference between Supervisor Hillary Ronen, who in recent months authored two pieces of legislation to reverse the health department's proposal, hospital workers and ARF residents.

It follows a resolution introduced by Ronen and Supervisor Matt Haney last month directing the health department to rescind the 60-day relocation notices that ARF residents received in August.

In a separate effort, Ronen worked with nurses and mental health workers to introduce an ordinance requiring the City keep the Adult Residential Facility open and at full capacity. Both pieces of legislation were scheduled for a hearing at the Government Audit and Oversight Committee on Thursday.

Supervisor Rafael Mandelman also introduced an ordinance requiring the health department to open and fill all 55 ARF beds by June 30, 2021.

Workers at the hospital objected, however, insisting that immediate action was needed and that the proposed reductions to the ARF would jeopardize The City's already shrinking inventory of permanent mental health beds. They also warned that the relocation notices had destabilized some ARF clients.

The San Francisco Examiner first reported on the proposal to reduce capacity within the ARF, which health department officials said was chronically understaffed and plagued by issues, including with state regulatory issues, related to "staff behavior."

Frontline workers at the hospital said they were not to blame for problems within the ARF, and called out the health department for making the decision without a public process at a time when San Francisco is struggling to reform its mental health system.

The deal follows months of protests, during which hospital workers shut down a health commission meeting. A petition with more than 1,200 signatures on it was delivered to the commission to protest the ARF bed suspensions.

"I am so grateful to the mental health workers and nurses who alerted my office to what was happening, and who do so much every single day to fight for their patients' rights, health and safety," said Ronen in a statement. "It's because of them that we can celebrate this victory today, where no resident will be forcibly removed from their home, and where the City's critical long-term beds for mentally ill residents will be protected."