Public Safety and Neighborhood Services Committee Hearing on PES and Vision Zero - July 28, 2022
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Public Safety and Neighborhood Services Committee Hearing on PES and Vision Zero - July 28, 2022
On July 28, 2022, the San Francisco Public Safety and Neighborhood Services Committee, chaired by Supervisor Gordon Maher, held a hybrid meeting to discuss two items: a hearing on the conditions at the Psychiatric Emergency Services (PES) unit at Zuckerberg San Francisco General Hospital and private psychiatric emergency services, and a resolution to amend the city's Vision Zero traffic fatality protocol to include a public town hall within two weeks of a traffic fatality. The committee was joined by Supervisors Raphael Mandelman and Dean Preston (substituting for Supervisor Melgar for item two).
Public Comments & Testimony
- Item 1 (PES Hearing):
- Public commenters included frontline healthcare workers and advocates. Heather Bollinger (SEIU RN chapter president) described severe staffing shortages, with nurses forced to work 16-hour shifts without breaks, and cited over 50 assignment despite objection forms submitted in four months. She noted that the city offers no sign-on bonuses, unlike other institutions, and that ancillary staff shortages (no clerks, techs, or security) worsen conditions. Two emergency physicians (Scott Chang, Julie) recounted repeated assaults on staff, with patients requiring sedation and restraint, and called for more conservatorships for frequent utilizers. A community member (Patricia Boyd) highlighted the lack of transportation for non-emergency mental health services and urged restoration of the MAP program. HealthRIGHT 360’s Alex Boiter stressed pay parity issues for nonprofit workers, which exacerbate staffing shortages and limit discharge options from PES.
- Item 2 (Vision Zero Resolution):
- Public commenters supported the resolution. Richard Waffman cited multiple fatal pedestrian crashes with no action from SFMTA, such as at 38th and Geary and 37th and Falcon. Joaquin Kira Laguna described organizing rapid-response protests at fatality locations and noted that neighbors feel hopeless after years of unheeded safety requests. Parker Day called San Francisco’s Vision Zero efforts a failure, arguing that parking and driver convenience are prioritized over human life.
Discussion Items
- Item 1: Hearing on Psychiatric Emergency Services (PES) Conditions
- The hearing focused on capacity, staffing, and system pressures at PES, the only dedicated psychiatric emergency service in San Francisco. Dr. Hillary Cunnins (DPH Behavioral Health Director) and Dr. Mark Leary (ZSFG) presented data: PES has been “condition red” (diverting patients to the ED) 100% of the time during the pandemic due to COVID screening, but was open 82% of the time for immediate transfer from the ED. In 2022, 65% of PES patients were discharged with outpatient referrals, 18% were admitted to acute inpatient care, and 5% each went to hummingbird respite or DOOR urgent care. 72 patients were released by court order against medical advice between August 2021 and March 2022. Dr. Cunnins highlighted new initiatives: SCRT teams (226 clients in June 2022, <15% transported to hospital), Soma Rise (330 clients served in first weeks), and progress toward 400 new beds (250 opened by end of summer 2022). Staffing: 2 RN vacancies in PES, with 23.5 RN FTEs and a 1:4 ratio, but frontline staff reported chronic understaffing, high acuity, and lack of ancillary support. Lieutenant Mario Molina (SFPD) described a decline in police 5150 detentions (from 3,426 in 2019 to 1,132 in the first two quarters of 2022), attributing it to better training and increased use of DOOR clinic and Westside Clinic, but noted that substance-induced psychosis often precludes a 5150. He called for better data-sharing and collaboration between agencies. April Sloan (SFFD Street Crisis Response) reported that five high-utilizer individuals had 1,781 ambulance transports over five years, costing $4 million, with two now deceased. UCSF’s Dr. Maria Raven noted that 485 behavioral health patients were seen in Q1 2022, with average ED length of stay of 25.7 hours, and 35% were admitted to inpatient medicine due to lack of psychiatric bed placement. Supervisor Mandelman expressed concern that despite many new facilities, the system still lacks a clear plan for severe methamphetamine users cycling through PES.
- Item 2: Resolution on Vision Zero Traffic Fatality Protocol
- Supervisor Preston presented the resolution, noting 19 traffic fatalities in 2022 (15 at introduction, 4 more since) and a lack of public communication after each death. Current protocols involve internal coordination (SFPD, SFMTA, DPH) but no standard public briefing. City Traffic Engineer Ricardo Olea outlined proposed improvements: a standardized public report within 30 days (including incident details, SFMTA rapid response actions, and DPH crisis response), quarterly reports to the SFMTA board, and on-site posting at fatality locations. He estimated costs for posting at $150,000 and for community outreach at $300,000 annually. Supervisor Maher emphasized the need for proactive neighborhood engagement, referencing a January 2022 fatality in his district at 46th and Lincoln where community requests for a stop sign were denied for years. Commander Walsh (SFPD) explained that some information is withheld during criminal investigations (e.g., stolen vehicle cases). The departments proposed the report and quarterly updates as alternatives to a town hall, citing concerns about logistics and the potential for misinformation. Supervisor Preston pushed for direct outreach, noting that a pilot outreach program in 2019 was discontinued due to funding, and asked for cost details and a timeline for implementation.
Key Outcomes
- Item 1: The committee continued the hearing to the call of the chair. Supervisor Mandelman requested a future visit to PES and further details on the crisis diversion unit plan and its expected impact on PES demand.
- Item 2: The committee continued the resolution to the call of the chair. Supervisor Preston will work with departments to finalize the standardized public report, on-site notification, and community outreach components, including securing funding for the outreach program. The item will return to committee after further negotiations.
Meeting Transcript
Good morning. The meeting will come to order. Welcome to the Thursday, July 28, 2022 meeting of the Public Safety and Neighborhood Services Committee. I am Supervisor Gordon Maher, the chair of this committee, and I I'm joined by Supervisor Raphael Mandelman and later Supervisor Dean Preston. Thank you to Alisa Samara, the committee clerk for staffing this meeting. And I'd also like to thank SFGUB TV James Kawana for staffing as well. Madam Clerk, do you have any announcements? Yes, Mr. Chair, the Board of Supervisors and its committees are now convening hybrid meetings that allow in-person attendance and public comment while still providing remote access and public comment via telephone. The board recognizes that equitable public access is essential, and we will be taking public comment as follows. First, public comment will be taken on each item on this agenda. Those attending in person will be allowed to speak first, and then we will take those who are waiting on the telephone line. For those watching our cable channels or sfgovtv.org, the public comment call in number is streaming across the screen. The number is 415-655-0001. Once connected, enter the meeting ID 2489-275-0650, then pound and pound again. When connected, you will hear the meeting discussions, but you will be muted and in and in listening mode only. When your item of interest comes up and public comment is called, those joining us in person should line up to speak, and those on the telephone should dial star three to be added to the speaker line. If you are on the telephone, please remember to turn down your TV and all listening devices you may be using. Alternatively, you may submit public comment in writing in either of the following ways. You can email them to myself at Elisa A-L-I-S A. Sumara S O M E R A at SFGO V dot org. If you submit public comment via email, it will be forwarded to the supervisors and also included as part of the the official file. You may also send your written correspondence to via U.S. Postal Service to our office at City Hall One. Dr. Carlton B Goodlok Place, Room 244, San Francisco, California, 94102. Finally, items acted upon today are expected to appear on the Board of Supervisors Agenda of September 6, 2022, unless otherwise stated. Mr. Chair. Thank you, Madam Clerk. And I did want to note that we we are in receipt of a presidential act or two presidential action memos. One um uh designating Supervisor Mandelman as a substitute for Supervisor Stephanie for today's committee meeting, and then also um another one designating Supervisor Preston as a substitute for Supervisor Melgar for item number two. Um Madam Clerk, um I would like to make a motion that we excuse uh supervisor Stephanie and Supervisor uh Melgar from today's meeting. On the motion to excuse Supervisors Melgar and Stephanie from today's PSNS meeting. Member Mandelman. Mandelman, I Chair Mar. Aye. Mar either, two eyes. Great, thank you. Madam Clerk, can you please call item number one? Yes, item number one is a hearing on the conditions at the Psychiatric Emergency Services Unit at San Francisco General Hospital and Private Psychiatric Emergency Services and requesting the Department of Public Health, SEIU 1021, Straight Crisis Response Team, Police Department, and Hospital Council to report members of the public who wish to provide comment on this hearing may line up to speak. Or if you are joining us remotely, please call the public comment number 415-655-0001. Enter the meeting ID 2489-275-0650, then pound and pound again. Once connected to the meeting, you'll press star three to enter the speakers line. Assistant prompt will indicate that you have raised your hand. Please wait until we had take public comment on this item. And when the system indicates that you have been unmuted, that will be your cue to begin your comments. Mr. Chair. Thank you, Madam Clerk.
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