After much shouting, perhaps it's time for talking about San Francisco's failing Behavioral Health Center. Photo by Joe Eskenazi

You can say this about the nurses staffing the imperiled Adult Rehabilitation Facility on the campus of San Francisco General Hospital: They’re punctual.

At the crack of 4 p.m., the starting time for today’s Health Commission meeting, chants of “Save the ARF” rang out in the halls of the Department of Public Health headquarters at 101 Grove Street. A virtual conga line of several dozen nurses, mental health workers, medical students, union leaders, homeless activists and at least one resident of the Adult Residential Facility paraded in. Loudly.

“SAVE THE ARF!” they bellowed while marching about the room. Whenever they momentarily quieted down, commission president James Loyce, Jr. went on the microphone and urged everyone to take a seat. “Please come to order,” he said. “We will hear each and every…”

But Loyce’s words were like Gatorade for the protesters on a hot summer day. That perked them up more than anything else could, and they began chanting and marching anew.

At issue are plans, announced by the mayor and Department of Public Health last month, to fold 41 permanent housing beds for the mentally ill at the Adult Residential Facility into the Hummingbird homeless respite.

The notion of converting permanent housing into temporary shelter has not gone over well in many quarters of this city. Nor has the DPH rationale that this was a prudent move as, in a city with a mental illness and homeless crisis, 23 permanent housing beds meant to house such people were being kept empty at the Adult Residential Facility, along with 22 more unused beds upstairs at the Residential Care for the Elderly facility.

Why do this? Several explanations have been proffered. As we wrote earlier this week:

  • The Department of Public Health first said it had been unable to expediently make hires to staff the facilities properly. Staffers, however, told us of open positions languishing for more than a year. A quick Sept. 12 search on the DPH’s job portal shows only two open jobs here — and both are earmarked for lateral transfers, not new workers. What’s more, Janel Holland, who ran the Adult Residential Facility from 2009 to 2015, says she warned higher-ups about understaffing a decade ago. In 2013, 14 beds were added to the facility and, she says, she was told to make do without any additional staff;
  • Mental health workers here — and we have spoken to well more than a dozen — say they were told by management that new patients could not be admitted because the facilities were “on probation” from the state licensing board. The Department of Public Health confirmed that management did tell staff this. But it’s not true. And, in fact, three days after Mission Local’s Sept. 2 article about management’s “probation” claims, state licensing personnel dropped by Potrero Street unannounced and “explained” to top managers “that the facility is not on probation and not restricted to not admit residents;”
  • Finally, in an above-the-fold A1 story in the San Francisco ChronicleDPH special projects manager Kelly Hiramoto last week said it was the “unprofessional conduct” from workers that led to a freeze on admissions (citations, as you can see here, have been amassing over the years). DPH director Dr. Grant Colfax added that the facility was “not performing to our standards.”
Marcus Huiseman, a resident of the Adult Residential Facility, urges city residents to “stop discriminating against the mentally ill.” Photo by Joe Eskenazi.

Colfax yesterday sent a letter highlighting department efforts to every DPH employee. The protesters today tore it to shreds and left the confetti on the floor.

Loyce, frustrated, told the demonstrators that “we can’t work this way,” and stormed out of the room. But that was exactly the point. After 20-odd minutes of parading and shouting and letter-tearing, the meeting was canceled. “This, to us, is easy organizing,” one unionist said while demonstrators marched about the room. “We can do this every week.”

For good measure, the Mental Health Board preemptively nixed its scheduled Wednesday meeting.

“Do not displace our clients. Do not displace our workers,” nurse Jennifer Esteen, a DPH psychiatric nurse and SEIU 1021 member who has been leading the efforts to preserve the Adult Residential Facility, told the commissioners. “We have a simple request: Rescind the 60-day eviction notices” for facility residents.

These notices were not rescinded. And the meeting was not resumed.

After shutting down the day’s event, the demonstrators gathered in the lobby. Theresa Rutherford, the SEIU 1021’s vice president, predicted victory: “It is the right fight, and a righteous fight.”

Adult Residential Facility resident Marcus Huiseman said his current home is the best one he’s lived in since he arrived in San Francisco a dozen years ago from Seattle. “This city needs to stop discriminating against mentally ill people,” he said. “It’s easy for them to put us into the streets. It blows my mind to pieces.”

A city worker told him she was proud that he came out to demonstrate. He thanked her, but added, “please don’t pity me, ma’am.”

All the while, SEIU organizer Nato Green buttonholed a dozen San Francisco State nursing students who had no idea what they were in for when they attended today’s Health Commission meeting as part of their studies.

“This,” Green told them, “is patient advocacy. Patient advocacy goes from the bedside all the way to City Hall.”

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Managing Editor/Columnist. Joe was born in San Francisco, raised in the Bay Area, and attended U.C. Berkeley. He never left.

“Your humble narrator” was a writer and columnist for SF Weekly from 2007 to 2015, and a senior editor at San Francisco Magazine from 2015 to 2017. You may also have read his work in the Guardian (U.S. and U.K.); San Francisco Public Press; San Francisco Chronicle; San Francisco Examiner; Dallas Morning News; and elsewhere.

He resides in the Excelsior with his wife and three (!) kids, 4.3 miles from his birthplace and 5,474 from hers.

The Northern California branch of the Society of Professional Journalists named Eskenazi the 2019 Journalist of the Year.

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  1. Whoever thinks that temporary respite is what mentally ill people need must have failed their psychology exam.

    1. So you’re saying that bringing someone in of off of the streets for a three months of psych stabilization so that they might make the sane decision to get off of the streets and into stabilized housing in a plece like Oroville (or maybe go back to the streets) or do “homeward bound” once stabilized is a bad idea?

      It seems like a rational trade-off to me.

  2. Thank you, joe for putting this piece out there. It’s tragic to hear how residential treatment facilities continue to close with no plan in place for people who require this level of care. I really hope that the arf remains open as I feel like this will color how future facilities handle their folks with the most need. Please keep putting these articles out there so people see what’s going on.

    Former San Francisco case manager And current therapist at a psych facility.

    1. Scott, Residents of the ARF pay $1058.37 each month out of their own pockets, and that is to most always to be sharing a small to average size bedroom with another person whom you don’t know. Please don’t say it’s free. They are left with $136 per month to pay for hygiene supplies, medication copays, transportation, all clothing, cigarettes, haircuts, any sort or phone/reading/entertainment, copays for podiatry and dental partially covered by medi-cal, any extra snacks or food they may buy out…Every and anything. It’s a very rough choice that folks with significant disabilities make to accept care and support in a residential care facility. It is never one they seek out for comfort or to somehow get over on public benefits. It is avoided by most until it is absolutely the only safe option, and their lives are dramatically improved in many ways while becoming quite challenging and different in others.

      1. Where do residents of the ARF get $1058.37 plus a spare pittance for expenses every month?

        The need to get people in psych crisis off of the streets for stabilization, if even temporary, is greater than the need to retain those already stabilized in situ.

        That need is greater both professionally and politically.

        If the City is willing to constrain its policy attentions to the most vulnerable, leaving most San Franciscans high and dry, then the City should apply the same logic to those in crisis on the streets relative to those stabilized in beds who could be relocated elsewhere.

  3. !2 years ago he came from Seattle and thinks he deserves free life time housing. No wonder this city is fucked up and lousy with bums.