Report 2019-119 Recommendation 7 Responses
Report 2019-119: Lanterman-Petris-Short Act: California Has Not Ensured That Individuals With Serious Mental Illnesses Receive Adequate Ongoing Care (Release Date: July 2020)
Recommendation #7 To: San Francisco Department of Public Health
To ensure that it connects patients who have been placed on multiple short-term holds to appropriate ongoing treatment, San Francisco should, by no later than August 2021, adopt a systematic approach to identifying such individuals, obtaining available mental health history information about these individuals, and connecting these individuals to services that support their ongoing mental health.
6-Month Agency Response
Mental Health SF legislation creates an Office of Coordinated Care (OCC) to oversee behavioral health services and was discussed in our previous report. The OCC continues to be a priority for planning and implementation. While not fully implemented, DPH is hiring OCC staff specifically to support a new Street Crisis Response Team (SCRT).
SCRT launched November 2020 and is in progress of launching a second team February 2021. These teams provide a non-law enforcement response to behavioral health emergencies in public spaces and divert individuals away from emergency rooms and criminal justice settings into behavioral health care. Each team includes a community paramedic, a behavioral health clinician, and behavioral health peer. Each team provides coverage in a specific geographic area with a goal of 24/7 city-wide coverage Spring 2021. In addition to diverting individuals from emergency rooms who may have otherwise been placed on an involuntary psychiatric hold, SCRT will likely be engaging with individuals who have previously been placed on a 5150WIC. Collaboration with the OCC will allow for enhanced data on supporting individuals who are at risk of psychiatric hospitalization.
As discussed, DPH has spoken to one of our largest private hospitals regarding obtaining alerts when individuals with frequent involuntary psychiatric holds are treated at their site. This is in process and will inform future collaborations. We also look forward to seeing State and/or legislative changes as recommended in the original audit to support the sharing of information both within and across counties.
- Estimated Completion Date: TBD
- Response Date: January 2021
California State Auditor's Assessment of 6-Month Status: Partially Implemented
60-Day Agency Response
Mental Health SF legislation creates an Office of Coordinated Care (OCC) to oversee mental health and substance use services. The OCC is responsible for 1) Maintaining an up-to-date inventory of available space in all City operated and funded mental health and substance use programs; 2) Providing and supervising case managers responsible for monitoring compliance with individual treatment plans and identifying appropriate housing placements; and 3) Coordinating the care of patients who are exiting the County Jail system or General Hospital's Psychiatric Emergency Services. Funding for the OCC has been budgeted pending mayoral approval, and includes a Bed and Patient Tracking System; Jail and PES Linkage Support; Crisis Linkage Support; and more positions for Case Management, Intensive Case Management, and Critical Care Management.
SF-DPH recently reached out to the Manager of Community Health of one of our largest private hospitals asking to discuss the feasibility of obtaining alerts when individuals are admitted for involuntary detention who have had multiple prior involuntary detentions. By working through the details of such a data sharing agreement, we hope to establish a workflow that could be replicated in our other Designated Receiving Facilities.
A Street Crisis Response Team is being developed which will provide a non-law enforcement response to behavioral health emergencies and divert individuals in crisis away from emergency rooms and criminal justice settings into behavioral health treatment facilities. Each team will include a paramedic from the Fire Department, and a behavioral health clinician and behavioral health peer from the Department of Public Health.
- Estimated Completion Date: August 31, 2021
- Response Date: September 2020
California State Auditor's Assessment of 60-Day Status: Pending
Agency responses received are posted verbatim.