Health Commission hears expanded behavioral health plan: 100 hires, new office of coordinated care, SCRT and overdose interventions

Department of Public Health leaders presented a broad update on behavioral health programs and the city’s overdose prevention strategy, highlighting accelerated hiring, new care coordination structures and community‑facing crisis response teams.

Dr. Hillary Conins, director of Behavioral Health Services/Mental Health SF, said behavioral health services treated roughly 20,000 people in fiscal year 2021 and provided prevention and early‑intervention services to more than 20,000 people. She said the Tenderloin emergency declaration has permitted expedited hiring: the department has onboarded about 100 behavioral health staff and aims to hire 200 total under the emergency authorization that shortens some civil‑service constraints.

Conins described the creation of an Office of Coordinated Care (OCC) with an operational center at 1360 Mission, expanded behavioral health access‑line hours (from 45 to 69 per week), and new care coordination teams that follow up with people after a Street Crisis Response Team (SCRT) contact. Dr. Angelica Almeida reported on SCRT operations: since its November 2020 launch the program now fields six fully operational teams providing citywide 24/7 coverage, with a seventh team planned for June or July. Almeida said SCRT diverted 42% of calls away from law enforcement cumulatively and 61% in December, with average response times around 15–16 minutes. Outcomes at the time of crisis included ~15% hospital transports, ~14% to social/behavioral settings, and involuntary holds in roughly 5% of responses; follow‑up contacts reached 63% of individuals in December.

On overdose prevention, Conins said preliminary 2021 data from the medical examiner indicate an estimated ~650 overdose deaths in 2021 versus more than 700 in 2020. She said fentanyl remains a primary driver of overdose fatalities and that racial disparities persist: Black/African American residents are dying at about four times the rate of other residents. Services described included a Street Overdose Response Team (SORT) that has handled more than 700 calls as of December 2021, expansion of behavioral health pharmacy hours (33 to 61 hours weekly), and a projected distribution of approximately 28,000 naloxone kits per year to DPH clinics and community partners. Conins said the department has received over $8 million in federal (SAMHSA) funding targeted to primary, secondary and tertiary prevention, with specific programs to be procured via RFPs and community partnerships.

Commissioners praised the hiring drive and program development and asked about metrics and targets. Vice President Lori Green asked when the department will develop baselines and meaningful percentage targets for key performance indicators; Conins said she expects an initial set of operational metrics by spring or early summer and emphasized that establishing baselines is a first priority before setting improvement targets.

DPH said it will continue to post weekly metrics on sf.gov and the department’s bed dashboard and return with progress updates to the commission.