Committee recommends contract amendment for Epiphany Center amid calls for better outcomes data

The Homelessness and Behavioral Health Select Committee voted May 12 to forward to the full Board of Supervisors an amendment to the Department of Public Health’s agreement with Mount Saint Joseph / St. Elizabeth (the Epiphany Center) to continue residential and outpatient behavioral‑health services for women, children and families and extend the contract through June 2027.

Max Fruscher, director of Systems of Care at Behavioral Health Services, told the committee the contract funds three program types at Epiphany: short‑term residential treatment for substance use disorder, residential step‑down services and an outpatient program for children and youth. Fruscher said the residential treatment programs systemwide have a capacity of about 245 beds and that stays can range from 30 to 120 days.

BLA materials presented to the committee show this contract line is roughly $2.7 million per year, about one‑third funded by the city’s general fund. The BLA noted some performance shortfalls in the last fiscal year tied to staffing constraints and low units of service during COVID; according to the department those concerns have since been addressed. The BLA analyst recommended approval while highlighting a policy question about whether to move back from COVID‑era cost‑reimbursement arrangements to fee‑for‑service payment models in order to better tie payment to performance.

Supervisors pressed DPH for clearer outcome data, asking how many clients are homeless on entry and where people go after completing residential treatment. DPH said it will follow up with more complete bed‑flow and exit data and noted a beds‑optimization study and evaluation scheduled to conclude in late September.

Public comment included calls for stronger clinical supports and better data collection. One public commenter alleged the contract could be fraudulent and urged scrutiny; no departmental rebuttal appears in the hearing record. The committee sent the item on to the full board as a committee report with a unanimous vote.