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Committee forwards plan to replace clinic deputies with community‑based client safety teams

June 21, 2021 | San Francisco County, California


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Committee forwards plan to replace clinic deputies with community‑based client safety teams
The Budget and Appropriations Committee voted on June 21 to forward to the full Board a Department of Public Health proposal to change clinic safety staffing at four primary care and behavioral health clinics: the department proposes to replace full‑time sheriff deputies at those clinics with community‑based client‑safety teams trained in de‑escalation and patient navigation.

Greg Wagner, chief operating officer for DPH, described the proposed model as tested in other sites and focused on de‑escalation and patient engagement rather than law enforcement. Hallie Hammer, DPH director of ambulatory care, said the department has experience with the model at a medical respite/sobering center and at Curry Senior Center in the Tenderloin and characterized the client safety workers as embedded, trusted members of clinic teams.

The Controller’s Office explained that this change requires a Prop J notification (a labor/contracting requirement flagged in the packet) because it alters the staffing model for services previously provided by deputies.

Supporters who called into the hearing included a representative from Curry Senior Center and the SFPUC Citizens Advisory Committee (on a different item), who described the approach as peer‑based and effective at de‑escalation. Dave Kanago from Curry Senior Center said the client safety staff, many of whom are formerly unhoused, reduced the center’s need to escalate incidents.

The committee voted to forward the DPH Prop J item and related resolution to the full Board with a positive recommendation; the Board will consider the contracting change for the clinics at its July 13 meeting.

What’s next: DPH expects to return with procurement details and a request to contract with community‑based organizations for client safety services if the Board approves the Prop J certification.

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