Committee forwards San Franciscos 20202023 MHSA integrated plan to full Board, backs $4.2M innovation project

The San Francisco Board of SupervisorsBudget & Finance Committee on Sept. 16 voted to forward the citys Mental Health Services Act (MHSA) three-year integrated plan for fiscal years 20202023 to the full Board with a positive recommendation.

Theresa Yu, who until recently served as interim MHSA director at the Department of Public Health, told the committee the plan is required for counties to access state MHSA funds and was developed with consumers and stakeholders following a 30-day public comment period earlier this year. "The purpose of today's presentation is to present you our San Francisco mental health services act fiscal year 2020 to 2023 three year integrative plan," Yu said.

Why it matters: MHSA is a dedicated funding stream that supports a range of behavioral-health services in San Francisco. Yu said MHSA represents about 9% of Behavioral Health Services funding, currently funds 84 programs and served roughly 50,000 unduplicated individuals in fiscal year 201819. The plan packages existing programs, updates priorities, and proposes new initiatives the County must adopt before submitting to the state.

Among the initiatives highlighted was a proposed innovation project aimed at developing culturally congruent services for Black and African American communities. Yu described the project as a pilot of up to five years with a total budget of $4,200,000 that would fund a community needs assessment, culturally adaptive outreach and interventions, peer workforce engagement, and a manualized curriculum that could be adapted for other populations. "Once we have Board of Supervisors approval for this innovation project, we will seek mental health services oversight and accountability commission approval before we can begin expending innovation funds," Yu said.

Committee members pressed staff on language access, service capacity for children and teens, and workforce development. Yu and other BHS staff said MHSA-funded programs include multilingual staff and that services are available in Spanish, Cantonese, Mandarin, Vietnamese and that programming is expanding to Mongolian; a peer in the Tenderloin was reported to provide Arabic-language services but broader Arabic-language capacity is not yet in place. On youth inpatient and mental-health beds, presenters and committee members agreed that a shortage persists and that regional collaboration with other counties is being discussed.

On workforce issues, presenters described MHSA-supported workforce education and training, a new online learning management system for professional development, and regional loan-assumption partnerships with Alameda, Contra Costa and Santa Clara counties to encourage therapist retention.

Public comment included an objection from caller William Shafillier, who alleged that a Behavioral Health Commission hearing cited in the plan did not meet quorum and said a certificate stating compliance with Welfare & Institutions Code Section 5848 was "false." Committee staff responded that the plan had a posted 30-day public comment period, that comments were received and summarized in the report, and that the department would continue to work with oversight bodies. The allegation raised by the caller was recorded in the public record and was not resolved during the committee meeting.

The committees action: Chair Sandra Lee Feuer moved to forward the MHSA plan to the full Board with a positive recommendation; roll call recorded three ayes (Supervisor Shamone Walton, Supervisor Rafael Mandeman, Chair Feuer) and the motion passed.

What happens next: The item will be considered by the full Board of Supervisors. If the Board approves the plan, the county may submit the adopted MHSA plan to the state to access MHSA funds and, for the innovation project, seek subsequent oversight commission approval before expending innovation funds.