San Francisco supervisors press DPH on case manager vacancies, data sharing and housing coordination

San Francisco — The Board of Supervisors’ Homelessness and Behavioral Health Select Committee on July 28 took an in-depth look at the Department of Public Health’s behavioral health case management system, focusing on staffing shortfalls, service intensity and barriers to information sharing.

Supervisor Hillary Ronan, chair of the committee, opened the hearing by saying case managers are central to connecting people with mental illness and substance-use disorders to treatment and housing. “Case management is extremely hard work,” Ronan said as she introduced the Department of Public Health presentation.

Imo Momo, director of managed care at the Department of Public Health, told the committee the city’s intensive and linkage case management programs have about 221 budgeted full-time equivalents and a roughly 28% vacancy rate — about 63 funded but unfilled positions — and serve close to 4,000 individuals. Momo said caseloads vary by intensity: low-intensity case managers may carry up to 50 clients (1:50), intensive case managers about 1:17, and the most intensive “linkage/stabilization” managers about 1:12.

Momo emphasized contact frequency also varies: for high-acuity clients, case managers aim to interact one to four times per week, while…