Conservatorship Vote Moves to Full Board — But Will It Pass?

The June 4 vote could be tight — and if the Board opposes it, the issue of how coercive S.F. should be around its mental health treatment may head to the ballot.

The discussion around how coercive San Francisco should be in managing its homeless mentally ill population is heading to the full Board of Supervisors for a vote June 4 — and if it fails there, may be put to voters in an upcoming election.  On Monday, the Board of Supervisors’ Rules Committee — consisting of Supervisors Hillary Ronen, Shamann Walton, and Gordon Mar — declined to support Senate Bill 1045, but did vote to forward the legislation to their colleagues for a vote.  

The bill, drafted by state Senator Scott Wiener, would increase the list of qualifications for someone to be involuntarily institutionalized, otherwise known as conserved. Currently, people can be conserved if they’re a chronic user of alcohol and suffer from severe mental illness. Under the new law, conservatorship could be applied to those who are chronic users of drugs, and people who have been taken to Psychiatric Emergency Services (5150d) eight times in one year. 

Opponents to SB 1045 — which include a vast range of organizations from the ACLU to HealthRight 360 — argue that the city is failing to provide adequate voluntary services. Data has shown that there was a $40 million cut in behavioral health care between 2007 and 2012.

“Our goal is to move people away from coerced treatment,” explains Vitka Eisen, president and CEO of HealthRIGHT 360. “Over 90 percent of our clients live outside prior to entering residential addiction treatment — 30 years of experience tells us that if we can demonstrate that substance use treatment will be accompanied by long term supports and a path out of homelessness, people will access services voluntarily.”

For the supervisors on the Rules Committee, concerns ranged from the overall feasibility of the legislation in getting people help to a lack of data on how many people of color are currently conserved. 

“SB 1045 is unworkable and doesn’t make sense,” Ronen said. “I think that I have shown and proven that 1045 is just a really poorly written law. It is unworkable as it is currently drafted. It doesn’t make any sense internally. There is not a system of care where people move from one step to another with a case manager. How — without these services — can we force individuals into services they don’t want without a system in place to support them along the way?”

Walton reiterated his concern over police violence and our racist criminal justice system. 

“We can’t look at all the steps we’ve taken on police reform and the 272 steps from the Department of Justice … and then, in turn, support further negativities with police contact,” he said, referencing the fact that police are commonly the ones dropping off mentally-ill people to Psychiatric Emergency Services. “I’ve heard nothing about mitigating the possibility of Black people and people of color being disproportionately affected by SB 1045,” he added.

Mar stated that we need more robust voluntary services before we can conscionably move forward with a law expanding the city’s ability to lock people up. 

“There’s just been a lack of enough information to ensure that voluntary services are going to be available to the individuals that would be served by this pilot program,” he said. 

While opposition to SB 1045 was strong among the members of the Rules Committee, it’s still a toss-up how the full Board will vote on June 4. With the mayor already supporting the measure it only needs six votes to pass. Supervisors Rafael Mandelman (who introduced SB 1045), Catherine Stefani, and Vallie Brown are on board with the law, meaning there are only three more supervisors needed. That leaves Supervisors Sandra Lee Fewer, Matt Haney, Aaron Peskin, Norman Yee, and Ahsha Safai as wild cards.

“I’m still meeting with frontline providers and experts about it,” Haney told SF Weekly when we inquired how he would vote. “Our city’s mental health system is fundamentally broken, incoherent and disjointed.  We need sweeping, comprehensive changes to fix that problem, so that’s where my focus has been.”

If the Board of Supervisors does not vote to support SB 1045 Mandelman has threatened to take the legislation to the ballot, to let voters decide — despite explicit wording in the bill stating that the Board of Supervisors is the authorizing body. 

To learn more about SB 1045, read our cover story Mental Health, Homelessness and Civil Rights: S.F.’s Crisis of Conscience from March 20, 2019. 

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