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DPH says conservatorship pilot underway; committee to receive further update in September
Summary
San Francisco DPH told supervisors it has begun engaging individuals under the SB 1045/SB 40 housing conservatorship pathway and is working with several people who may become petition candidates in the coming weeks; public comment included both calls for more conservatorship and concerns about racial disproportionality and lack of evidence that housing had been offered.
The Public Safety & Neighborhood Services Committee on July 23 heard an update from the Department of Public Health and the Office of the Public Conservator on the city’s housing conservatorship pilot, a pathway authorized by the state conservatorship bills referenced in the record (SB 1045/SB 40).
Angelica Almeida, Director of Forensic and Justice-Involved Behavioral Health Services at DPH, said staff have started "serving individuals" under the statutory pathway that triggers consideration after repeated 5150 detentions (the 5th through 8th 5150s). Almeida told the committee "we have not yet submitted paperwork for an individual to move forward with housing conservatorship," but said several people are on the precipice and that staff "anticipate" moving forward with petitions in the coming weeks for at least a few cases.
On questions about the notice process and racial patterns, Almeida said the City Attorney’s Office drafted notification documents that the Public Defender’s Office and the courts have reviewed; notices inform individuals when they have reached their fifth 5150 and explain how many additional holds would be needed to make conservatorship a potential pathway. She said that, for the immediate pool of people the department is preparing to serve, "most of the individuals who are on that immediate more potential pathway are Caucasian," while acknowledging the committee’s request for a more complete demographic breakdown.
Supervisors and many callers raised questions about whether voluntary services and housing offers have been made before conservatorship is pursued. Rayna Small of Senior and Disability Action told the committee the preliminary data "does not show whether people with multiple 5150 holds have been offered housing," and urged withholding expansion until housing offers and other voluntary interventions were demonstrably available. Other callers argued that conservatorship is necessary to protect public safety and to get people into care.
Members of the committee emphasized legal and ethical limits: a representative from the Office of the Public Conservator explained the law requires showing to a court that "every other possible intervention has been attempted" before a conservatorship is authorized. DPH described assisted outpatient treatment as a less-restrictive option the city considers before conservatorship.
The committee did not vote to initiate conservatorship petitions; instead it voted unanimously (3-0) to continue the conservatorship hearing to the committee’s regular meeting on September 10, 2020 to receive another update and additional data. DPH committed to providing more detailed demographic and program-offer information ahead of that meeting.
Public commenters on both sides urged urgency — some callers pressed for more aggressive conservatorship use and immediate funding for conservatorship and crisis response teams; others called for expanded voluntary services, housing-first approaches, and scrutiny of disproportionate impacts on Black residents.
The committee’s continuation preserves oversight and asks DPH to return with more detailed data and operational clarity by the September hearing.
