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Supervisors back amended response to civil grand jury27s behavioral health staffing report
Summary
The Government Audit and Oversight Committee heard the civil grand jury27s findings on behavioral health services, received departmental responses on hiring bottlenecks and information access, and voted to recommend an amended Board response acknowledging recent reorganization and targeted hiring steps.
The Government Audit and Oversight Committee on Dec. 3 heard the San Francisco civil grand jury27s report "Strengthening Our Behavioral Health Services" and recommended an amended response to the full Board of Supervisors.
The grand jury foreperson Jaime Guandique and lead author Dr. Patricia Levenberg outlined three priority concerns: lengthy hiring timelines that delay care, high executive turnover in behavioral health leadership, and challenges in public information and directories. "We issued 3 findings and 2 recommendations directed at reducing staffing shortfalls," Levenberg said.
Department of Public Health acting behavioral health services director Marla Simmons told the committee the department has prioritized vacancies and is taking steps to fill clinical roles. "Currently behavioral health services has a 113 vacancies," Simmons said, adding that DPH has prioritized 90 positions and expects to onboard new clinicians, including intensive case managers, in January.
DPH and DHR officials described structural constraints. Karen Hill, DPH director of staffing, said pandemic-era flexibilities allowed faster hiring for nursing staff and the department is trying to retain those gains: "We have civil service processes in place that, create, you know, a barrier," Hill said, but noted recent interim changes that sped hiring during the emergency. Acting Human Resources Director Eisen added that many hiring steps are governed by civil service rules and that some reforms require meet-and-confer or other city-level actions.
The grand jury had recommended a stretch goal that, by June 2021, the department should fill 50% of intensive case manager vacancies within 21 days; presenters acknowledged that 21 days was ambitious and that current DPH data indicated much longer timelines. The report also cited a provider-to-client ratio the jury labeled problematic (reportedly 1 to 17 versus a 1 to 10 target for intensive case management).
Supervisor Matt Haney moved to amend the board27s responding resolution to note that DPH had reclassified the behavioral health services director position and to mark certain recommendations as already implemented or addressed through reorganization. The committee voted unanimously to adopt the amendment, recommend the amended resolution to the full Board and to file the hearing.
The committee directed departments to continue work on hiring data tools, retention and workforce development, and improved public navigation of DPH resources. The amended response will be considered by the full Board on Dec. 15.
