Commission begins work on resolution declaring incarceration a public health issue; staff to return with revised roadmap

The San Francisco Health Commission spent the meeting27s largest block of time considering a draft resolution that frames incarceration as a public health issue and directs the Department of Public Health to develop a roadmap for integrated services, improved data collection and community-engaged recommendations.

Presenter (committee staff) said the resolution grew from the jail re-envisioning project and the MacArthur grant process and has been revised after committee review. "Out of that process, there was acknowledgement by the department that we had some issues in terms of improving our data collection as well as integrating our services," the presenter said.

Dr. Lisa Pratt, who directs Jail Health services, told commissioners that jail-health data come from a homegrown electronic medical record with limited analytics and that differences in counting explain apparent discrepancies in racial figures: the system shows about 38% African Americans among those booked into jail, while on any given day the in-custody population may be 44-48% African American because those who remain tend to have different offense profiles and legal statuses. "The difference is who's arrested and who stays," Pratt said.

Community speakers urged the commission to strengthen the resolution. Kate Monaco Klein (San Francisco Taxpayers for Public Safety) read comments submitted by a UCSF sociologist and recommended an amendment to single out cis and trans women for gender-focused services. Roma Guy urged inclusion of transitional-age youth (18-25) and stronger stakeholder engagement and offered suggested redline language. Michelle Loya Talamantes (Public Health Justice Collective) and Daniel Madrigal (Public Health Institute) asked the commission to adopt measurable objectives, resist any proposals that would expand jail capacity, and prioritize investments in housing, behavioral-health treatment and alternatives to incarceration.

Commissioners broadly supported the resolution27s intent but flagged several edits: add a whereas clause to define the scope of "incarceration" beyond county jail, include clearer language on family impacts and children, explicitly reference partner processes (the MacArthur grant and jail-reenvisioning work), and ask the department to specify the investments required to carry out the roadmap. Commissioners asked staff to seek greater data-sharing with the sheriff27s office and other criminal-justice partners to reconcile numbers.

The commission directed staff to return a revised resolution incorporating community and commissioner feedback for a vote on March 19. The presenter said the roadmap would be developed with internal stakeholders, community input and may include consultants or subject-matter interviews.

Key claims and status: Dr. Pratt described data limitations and a difference between "booked" populations (38% African American) and daily in-custody figures (44-48%); community speakers characterized incarceration as tied to homelessness, violence and structural inequities and requested targeted language for women and transitional-age youth. Commissioners requested that the resolution avoid overreliance on a single statistic and instead emphasize actions and measurable objectives.

Next steps: staff will revise the draft to add clarifying whereas clauses, integrate suggested amendments where legally appropriate, and return the resolution for the March 19 meeting with a proposed roadmap and a plan to document data-sharing steps.