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Budget office audit finds gaps in San Francisco behavioral‑health system; supervisors press for targeted follow‑up
Summary
A Budget & Legislative Analyst report identified underperforming civil‑service clinics, a shortage of intensive case‑management capacity and weak transitions from psychiatric emergency services; supervisors and the Department of Public Health agreed to a follow‑up focusing on roughly 2,200 high‑use individuals who drive a disproportionate share of emergency costs.
The city’s Budget and Legislative Analyst (BLA) told the Government Audit and Oversight Committee on Dec. 5 that San Francisco’s behavioral‑health system has several weaknesses that limit its ability to prevent repeated crisis care use.
Latoya McDonald, the BLA project manager, said the office reviewed five fiscal years of Behavioral Health Services (BHS) data and identified eight findings and 15 recommendations. “So when we talk about behavioral health, we’re referring to mental health and substance use disorder services,” McDonald said in her presentation, noting BHS served about 23,000 to 25,000 adults annually in the audit period and that system costs run in the hundreds of millions of dollars a year.
The audit’s main conclusions were that (1) city civil service clinics scored lower on the BLA’s performance metrics than community‑based organizations and lack formal corrective‑action procedures; (2) intensive case management (ICM) capacity has not kept pace with demand,…
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