Compromise reached to save Adult Residential Facility, which mayor and Health Department had moved to gut

The 55-bed Adult Residential Facility — which had been willfully kept largely empty for months, prior to the mayor and Department of Public Health in August sparking a firestorm by proposing to essentially do away with it — will be preserved.

“We are feeling relieved. We are feeling empowered,” said Connie Truong, a city activity rehabilitation worker, regarding the deal, which was reached on Oct. 11 and announced Monday afternoon. The deal to preserve the long-term residential center for the seriously mentally ill was reached after negotiations between several unions, the mayor’s office, the Department of Public Health, and the offices of Supervisors Hillary Ronen and Matt Haney.

“There is hope with these changes.”

That’s a far cry from the mood in the summer, when the mayor and health department proposed moving the lion’s share of the 32 remaining Adult Residential Facility patients upstairs to the Residential Care for the Elderly facility, and folding 41 ARF beds into the Hummingbird homeless respite center, also on-site at the San Francisco General Hospital campus.

That push to replace permanent housing with temporary shelter met a quick and organized resistance from the mental health workers on-site and members of the Board of Supervisors; two different ordinances were proposed.

The rationale for liquidating the Adult Residential Facility — that it was largely empty during a visible and acute homeless and mental health crisis — only sparked more outrage and prompted more questions. Admissions had been frozen for more than a year at the ARF; it turned out that 23 beds were empty here and 22 more were empty on the second floor Residential Care for the Elderly facility. The locked Mental Health Rehabilitation Center on the third floor, meanwhile, was operating at 10 to 12 beds below capacity — meaning that only a shade over 100 of the 161 licensed beds here at the “Behavioral Health Center” were filled.

This, again, in a city with a visible and acute homeless and mental health crisis.

Per the deal, however, the Adult Residential Facility should be caring for 41 patients by April of next year — with the ultimate goal of expanding back to 55 long-term care beds. In the meantime, those 14 beds will be filled by the Hummingbird respite center. “But we are guaranteed to get them back,” says Amy Wong, a mental health treatment specialist on-site.

DPH director of health Dr. Grant Colfax credited all sides on reaching a deal that finds “a path that puts patients first, continues to provide services, and lays out long-term stability for the residents of the ARF board and care.”

This deal will be formally announced tomorrow at a noon press conference at the Adult Residential Facility hosted by Ronen, workers, and residents. And it may begin the process of repairing this relatively small facility — that was hard not to view as a microcosm of the city’s larger problems administering to the mentally ill.

All of the following happened here at the Behavioral Health Center in recent weeks and months:

• The Department of Public Health initially explained the empty beds by stating that 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; materials in October produced by the DPH at Ronen’s insistence revealed that it requires between 210 and 220 days to hire a nurse — and 419 to land a behavioral health clinician. The hiring process has no fewer than 34 steps.
• 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. 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;”
• In an above-the-fold A1 story in the San Francisco Chronicle, DPH special projects manager Kelly Hiramoto claimed 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.”
• Court transcripts obtained by Mission Local revealed that, after 11 mental patients had languished in jail for up to nine months, the Department of Public Health hurriedly moved all of them into residential facilities — only when subpoenaed and forced to explain the delay in court.

In addition to preserving the Adult Residential Facility and keeping most of its 32 current residents on-site, key points of this deal will be additional training for staff; the hiring of more staffers — and higher-level staffers more capable of administering medications — and the formation of a working group populated by both management and workers from the Behavioral Health Center to report to the Board of Supervisors.

Workers told us they were thrilled to have a carved-out place at the table, and the additional oversight of the Board: “This is a check-and-balance,” Wong said. “We are going to be able to have actual front-line staff working with management to ensure there’s going to be proper training and proper staffing and adequate measures.”