The ever-controversial implementation of Senate Bill 1045 — to expand forced treatment for San Francisco’s unhoused mentally ill — might die before it reaches the full Board of Supervisors for a vote. At a Rules Committee hearing at City Hall Monday morning Supervisors Hillary Ronen, Gordon Mar and Shamann Walton appeared skeptical that the law would adequately protect those who it aims to serve. The vote has been continued to next week, but it’s not looking like it will pass.
Put simply, the legislation would expand the current requirements for conservatorship — involuntary mental health treatment in a locked ward — to include people who use drugs, and anyone who has been dropped off at Psychiatric Emergency Services (otherwise known as being “5150d”) more than eight times in one year. Although as written it may only affect a dozen people citywide, disability rights advocates have raised the alarm about the legislation, arguing that involuntary treatment is ineffective and that taking away someone’s civil rights — including access to their bank account and choices about their treatment — is a major civil rights violation.
After months of forums, protests, and articles, the decision over whether not to enforce SB 1045 in San Francisco finally fell in the hands of politicians. The response was lackluster from the get go.
“Abandoning mentally ill people to wander the streets … is morally wrong and it’s dangerous,” stated Committee Chair Ronen as the hearing began. “It’s way past time we build a modern care system for people with mental illness and substance use disorders.
“But I have been very skeptical about a brand-new conservatorship model like 1045, and am not yet convinced it’s workable at all, or even a useful law to address the people suffering from mental health and substance use issues on our streets,” she added.
Specifically, Ronen grilled the Department of Public Health on the steps of each process and what a treatment plan would look like. In the past few months, she’s visited a number of places that serve people experiencing mental health crises, including the city’s Psychiatric Emergency Services, Progress Foundation, and HealthRight360.
“Not one of the professionals at any one of the places — not a single person told me we need to reform our conservatorship law,” she said. “Every single person said ‘we do not have enough residential treatment beds in the program’.”
In his time as supervisor, Walton has come out strongly against the city’s current criminal justice system, helping to pave the way for the eventual closure of Juvenile Hall. At Monday’s hearing, he clearly voiced his disproval of any law that would make it easier to lock people up.
“As a person of color there is always concern anytime there is a system of incarceration, or taking away someone’s liberties to be free, it typically disproportionately affects Black people and typically disproportionately affects people of color. That’s one of the biggest reasons why … I’m not excited about this.”
Mar played his hand close to his chest until the end, asking a few questions of speakers like how many people eligible for conservatorship are in jail (three), and how much it would cost to conserve somebody for a year (no one had an answer).
“You’ve made a good case for careful and thoughtful expansion for conservatorship here in San Francisco,” he said to Supervisor Rafael Mandelman — who introduced the legislation — after the hearing was over. “I do want to say that I’m not going to be able to support this moving forward today because I feel there are still too many unanswered questions.”
Mandelman fired back at his colleagues. “Even with its imperfections, SB 1045 is worth moving forward with,” he said. “We do have an urgent crisis and we should be using every tool. It sends a terrible message to the state to say we’re not interested in moving forward with SB 1045 … and it sends a terrible message to our constituents. It would be a terrible mistake not to move forward with SB 1045.”
While it’s followed the legal process, in many ways this bill has taken an odd route. Watered down significantly in Sacramento, it picked up support from Mayor London Breed and Supervisor Rafael Mandelman only to end up in the hands of three local politicians who appear strongly against it. The decision on whether to pass it or not was extended a week, to the May 20 Rules Committee meeting.
If it fails there, which seems fairly likely, then Mandelman says he will employ a seldom-used tactic to pull the legislation out of committee and put it in front of the full Board for a vote. He’ll need the signatures of three other supervisors to allow that to happen.
“It’s got a difficult path ahead,” he said after the vote. “If we to pull it out of committee because they don’t want to move forward I hope we can find six votes on the Board of Supervisors. We have some support, we have some noncommitted. We’re increasingly getting clear on who the opposition is.”
But even there it’s a toss-up; Mandelman supports it, as do Supervisors Catherine Stefani and Vallie Brown. Mandelman would still need three more to support it, or else it would not pass.
“I’m going to work on everybody,” he said. “I’ll even work on Supervisors Walton and Mar because I believe their opposition is wrongheaded and inconsistent with the views of their voters.”
San Francisco is the only county of three that have pursued implementation of SB 1045. As drafted, Wiener’s bill would have allowed Los Angeles and San Diego to expand their conservatorship laws as well, but neither has taken steps to do so.