San Francisco Health Commission adopts new public‑comment rules as residents clash over masking in health settings

The San Francisco Health Commission on March 7 announced new meeting procedures requiring commissioners to attend in person to participate and putting in‑person public comment first, followed by remote commenters who had requested disability accommodations and then other remote commenters, subject to a 20‑minute aggregate limit for the latter group.

Multiple public commenters used the forum to press the commission on recent changes to masking and to criticize the newly tiered remote‑comment process. Jessica Lehman of Senior and Disability Action said the decision to stop requiring masks in health care facilities and homeless shelters would “terminate safe access to healthcare” for seniors and people with disabilities and urged the commission to reverse it. “For many of us, that's untested,” Lehman said, adding that people with disabilities are being stigmatized by a system that requires them to request special accommodation to speak remotely.

Caller Elizabeth, who identified herself as immunocompromised, similarly said the two‑tier system was discriminatory and asked the commission to keep universal mask requirements. “If this is not an ADA violation, it should be one,” she said, urging the commission to “reverse this immediately and bring back the universal mask requirement in healthcare and homeless shelters.”

At the meeting Director of Health Dr. Grant Colfax and Health Officer Dr. Susan Philip explained the local orders the department issued to align with the end of state and local public‑health emergencies. Colfax said two new local orders require staff in hospitals, skilled nursing facilities and similar institutions to wear masks when interacting with patients, clients or incarcerated people, while masking requirements for the general public in those settings will end unless an institution chooses to be more restrictive.

Dr. Philip told commissioners that health systems can be more restrictive than the health‑officer orders and that the new local rules focus on preventing staff‑to‑patient transmission. “We really are moving to more of a phase of people being able to choose to use those masks, particularly members of the public,” she said, but added that staff should continue masking “at least in the short term” to reduce the risk of transmission to patients.

Commissioners asked whether DPH or the California Department of Public Health will issue guidance to help institutions explain their policies to the public. Dr. Philip said the state order remained in place until April 3 and that, for now, there is not a department plan to issue prescriptive guidance; she said health systems should decide how to notify visitors of their rules.

The commission did not take a formal policy vote on masking at the meeting; instead, the discussion clarified that staff masking requirements remain under local order in certain settings while public masking could be left to facility policy. Public commenters pressed the commission for clearer communication and for reconsideration of policies they said could hinder access to care for vulnerable residents.