Board holds public hearing on appointment of county health officer; director and acting officer testify

The San Francisco Board of Supervisors convened a special public hearing on April 6 to consider the county health officer position and to hear from Department of Public Health leadership about the role’s duties and independence.

Director of Health Grant Colfax and acting health officer Susan Philip described the legal authority of the health officer under state law, the office’s responsibilities during communicable‑disease events and the department’s decision‑making process through clinical policy and legal counsel.

Why it matters: The health officer has statutory authority to issue orders and take measures to protect public health; during the COVID‑19 pandemic the office has been a central decision‑maker for masking, business restrictions and school safety. Supervisors sought clarity about how the role will operate in San Francisco’s unusual city‑and‑county governance structure (mayor plus Board of Supervisors) and whether the health officer can act independently of political authorities.

Key testimony and oversight questions Dr. Colfax told the board the health officer is an agent of the state vested with broad authority for communicable disease and acute public health hazards and that California requires each county to designate a physician as local health officer. He said San Francisco’s public health leadership and legal teams have worked closely throughout the pandemic and that it is typical for directors and the health officer to align on science and policy.

Acting health officer Dr. Susan Philip, who has overseen the department’s communicable disease response during the pandemic, described the clinical policy meetings, legal review and interagency inputs that inform orders. Philip told supervisors she consults with the department’s experts, legal counsel, academic partners and state and federal public health agencies and then signs orders when required by statute.

Board members asked how the health officer ensures independence from political pressure, how decisions are made (who has the final authority for reopening or for school‑related guidance) and whether the department keeps a formal decision‑making chart identifying participants and inputs. Dr. Philip described a regular structure of clinical policy meetings, legal review and interagency consultations and said the health officer has the authority to sign orders consistent with state law.

Schools, vaccination and reopening Supervisors pressed the department about school reopenings, the role of the health officer in offering forceful public guidance, and the department’s use of CDC and state guidance. Philip said the department had issued forceful statements — for example after the CDC adjusted distancing guidance — and that accumulated evidence from schools that have reopened gives the department more confidence in strongly supporting safe in‑person learning.

Outcome and next steps The board did not take a formal appointment vote at the hearing. Supervisor Mark Peskin said he would bring the administrative resolution forward in Rules Committee with an amendment adding Dr. Philip’s name and any required residency waiver; that process would return a formal nomination or appointment to the full board for a subsequent vote. President Walton and several supervisors said publicly they support an independent, physician‑led health officer who follows science and is accessible to the board.

Provenance: Colfax’s overview and Philip’s description of the clinical policy process were presented during the special order public hearing on the appointment of the public health officer (special order called at 3:00 p.m., item introduced at the start of the special order).