Supervisors move to restore psychiatric beds at San Francisco General as Progress Foundation delays opening

Supervisor Ross Mirkarimi asked the Budget and Finance Committee on Nov. 14 to restore inpatient psychiatric capacity at San Francisco General Hospital after learning the Progress Foundation’s alternative-bed program will not be ready this fiscal year. The committee voted to forward the ordinance adding 12.9 positions in the Department of Public Health to the full Board with a recommendation.

Dr. Mitch Katz, Director of Health, told the committee the Progress Foundation has secured a site and applied for a conditional use permit but now expects the program to open in July or August of the next fiscal year. "They are applying for conditional use permit...the site will then require additional work on the permit, and that facility will open July or August of the new fiscal year," Katz said. He asked that the ordinance be amended to allow the department to move the same amount of psychiatric-bed funding to the hospital for the remainder of the fiscal year so that there would be no cut to existing hospital psychiatric beds while the Foundation completes start‑up work.

Katz said he does not have authority to reallocate general‑fund appropriations on his own and needs Board action to shift position authority and funding. He described staffing and census pressures at San Francisco General: the department's budgeted census was reported at 323 while actual census has run above 350 and, at times, near 380, straining inpatient capacity.

Speakers from labor and health‑care groups urged the Board to fund both the Progress Foundation program and inpatient beds at San Francisco General. Testimony from nurses, social workers and advocates described long waits in psychiatric emergency services (one nurse said patients wait up to 80 hours for a bed), staffing shortages and transfers out of county for care. Tim Paulson of the San Francisco Labor Council and SEIU representatives urged prompt action to preserve hospital beds while the community program is established.

Budget Analyst Ken Bruce told the committee that restoring funds may trigger Charter Section 9.113, which requires a two‑thirds vote by the Board of Supervisors for certain restorations. Bruce also said approximately $545,000 remains in one‑time startup costs for the Progress Foundation, reducing the immediate operational need while leaving one‑time obligations.

Monique Zamuda of the Controller’s Office said the funds appropriated to the Progress Foundation have not yet been spent and the controller can administratively move those appropriated amounts to maintain hospital program positions in the short term; she cautioned, however, that there is not enough money to run both programs simultaneously without additional funding.

Supervisor Mirkarimi moved item 5 (the ASO) to restore position authority and requested the committee forward the ordinance to the full Board with a recommendation; Supervisor Bevan Dufty was listed as a cosponsor. The committee agreed to forward item 5 and continue item 6 to the call of the chair.

The ordinance and related amendments will now go to the full Board, where restoring funds subject to Charter Section 9.113 may require a two‑thirds vote. The controller and budget analysts said they will provide detail and any needed implementation language for the Board’s consideration.