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Health Commission hears BERT six-month report and phased plan to replace deputy functions with behavioral response staff

San Francisco Health Commission · February 1, 2022

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Summary

Department leaders presented phased implementation of a Behavioral Emergency Response Team at Zuckerberg San Francisco General, hiring updates and data showing 96% successful interventions and 77% of emergent calls completed without law enforcement during the July'Dec 2021 review period.

San Francisco Department of Public Health staff briefed the Health Commission on implementation steps for a new safety-services staffing model centered on a Behavioral Emergency Response Team (BERT) that will phase in psychiatric nurses, licensed vocational nurses and psychiatric technicians to provide behavioral-health response across hospital campuses.

Mr. Price outlined a phased rollout at Zuckerberg San Francisco General with the goal of ultimately staffing 31.9 BERT FTEs to provide 24-hour coverage and reduce deputy involvement in clinical behavioral interventions. The phased approach starts with clinical rounding and a March-to-May training/hiring window; the reduction of deputy FTEs will follow once BERT staffing and training milestones are met.

Joan Torres presented a six-month BERT report (July'Dec 2021) showing 90 emergent BERT calls/activations and 205 rounding consultations during tracked operating hours; 96 percent of emergent interventions were judged successful and 77 percent (60 of 90) of activations were completed without law enforcement present. Torres described activation protocols (emergent activation, non-urgent consults and proactive rounding) and a multi-month training curriculum for new BERT members covering de-escalation, motivational interviewing, trauma-informed care, psychopharmacology and cultural humility.

Carrie Johnson reported hiring progress: psychiatric nurses have been selected and are onboarding, eight LVNs were selected and onboarding began, and several psychiatric technicians are in the onboarding pipeline; a Feb. 22 target start date was identified for cleared hires, with a March 5 orientation as the next onboarding date for those who miss the February class.

Commissioners questioned the May implementation target and sought clarification on cadet and non-cadet roles at Laguna Honda and in community clinics; staff said those timelines remain feasible but depend on training completion and clearances. Price and Torres said the changes are already associated with lower use-of-force incidents and will continue to be monitored as the BERT program scales.

The commission asked for follow-up reporting on hiring progress, training completion and measured outcomes including use-of-force incidents and patient-safety metrics.