100 hired fast to boost therapy in Tenderloin
Under Mayor London Breed’s Tenderloin state of emergency, San Francisco quickly hired 100 public health workers to fill vacant positions that have hindered reform of the city’s mental health and substance use disorder care system.
The city said Tuesday it plans to hire 100 more workers by the end of the 90-day emergency. The hiring, usually at least a six-month process, was completed in two months.
“The expedited hiring of these behavioral health workers is proof that when we cut through bureaucracy and aggressively address our City’s most pressing needs, we can make real, tangible change and deliver services faster,” Breed said in a statement Tuesday.
The human resources department sped up the timeline by choosing candidates from qualified lists of people who had already taken a civil service exam, which is required for city employment, for a similar position, instead of creating a unique test for each new role. The department also accelerated the onboarding process, including running a new employee’s fingerprints and getting them an ID, to a single day instead of weeks or a month.
The city is spending $607 million this fiscal year on a behavioral health system that serves around 20,000 people. The city put out a news release touting progress in hiring before the Board of Supervisors held a hearing on the emergency during Tuesday’s board meeting.
A week before Christmas, Breed announced the emergency in the Tenderloin to respond to overdose deaths, while also pledging a hard-line police response against drug dealing and use in the neighborhood, which critics said was the wrong approach to dealing with the neighborhood’s problems. Two supervisors voted against authorizing the emergency because of the mayor’s push for more policing. Last month, Breed said police presence in the Tenderloin has not increased because of pandemic staffing and budget constraints.
But other supervisors, while disagreeing with the police response, supported public health action to make yearslong reform of the city’s behavioral health care system a reality. The city found two years ago it has 4,000 homeless people who are struggling with mental illness and addiction.
More than two years ago, Supervisor Hillary Ronen and Matt Haney co-authored Mental Health SF, legislation that planned to expand and streamline the city’s disjointed system that led to people in crisis cycling in between services and the streets.
Some aspects of the legislation have come to fruition. The city created teams of mental health professionals that respond to people in crisis instead of police and has added 89 out of 400 new treatment beds. But officials said the plan to bring together a disjointed system with an office to coordinate care and a mental health service center were slowed by the city’s bureaucratic hiring process.
But Breed’s emergency cut red tape to make progress. The city last month opened a linkage center in U.N. Plaza that brings together basic services including food and hygiene and a one-stop-shop for referrals to city treatment and housing, similar to the mental health service center. And slashing bureacracy in hiring has filled critical staff positions in a fraction of the time.
Ronen said the health department had hundreds of funded but unfilled positions for years.
“The biggest challenge to implementing Mental Health SF has been the limited clinical staff to run all parts of the system of care,” she said in a statement Tuesday. “Thanks to the Emergency Declaration in the Tenderloin, we will save years of red tape and have the team in place that we need to get individuals off the streets and into the proper level of care to treat their mental illness and addiction.”
Positions were long vacant because of growth in the budget coinciding with the pandemic that reduced the city’s ability to hire and led to more employee turnover and leaves, the health department said. Civil service exams were backlogged for seven months. The positions targeted for expedited hiring include: psychiatric physician specialists, behavioral health clinicians, health program coordinators, pharmacists, epidemiologists, program managers and analysts.