Cops may be replaced at city hospitals

The number of sheriff ’s deputies who guard public hospitals and clinics in San Francisco would be dramatically reduced under a plan proposed Tuesday by city health officials who want to hire more psychiatric nurses and other mental health staff to respond to crises.

The Department of Public Health presented a plan to the Health Commission at its Tuesday meeting to drop the number of deputies from 29 to about 18 at San Francisco General Hospital and replace around seven more at Laguna Honda Hospital and four community clinics.

The department would add around 30 psychiatric nurses and technicians to San Francisco General’s existing Behavioral Emergency Response Team, whose members are trained to prevent crises, verbally deescalate and physically intervene, administer medications, and use restraints if necessary.

As protests over policing and racial justice roiled the country last summer, the role of deputies at the city’s health care facilities stirred debate. A Black midwife at San Francisco General went on strike to protest deputies’ treatment of people of color, igniting a movement for the health department to “divest” from the sheriff. The action led to an opposing petition to keep deputies that garnered thousands of signatures.

Basil Price, the health department’s director of security, said Tuesday that the presence of law enforcement officers has traumatized some patients, and that last fiscal year, 91% of useofforce incidents were against patients and 46% of the subjects were Black. In 34% of incidents, deputies assisted with patient restraints.

“Law enforcement is not always the appropriate response for addressing these situations,” Price said.

At San Francisco General, deputies or cadets screen people entering the emergency room for weapons and are stationed inside, staff said. Others guard patients who

have been arrested or jailed. Most patrol campus on regular rounds and respond to calls from an onsite command center.

Assistant Sheriff Tanzanika Carter said the sheriff is “on board and willing and wanting to work together to make sure we can offer safety and security at your hospitals.”

Some hospital and clinic staff criticized law enforcement Tuesday and shared stories of trauma at their hands while others said they depended on deputies to quell violence in San Francisco General, which was cited last year for workplace safety violations.

At Laguna Honda, four deputies would be replaced with eight cadets and three psychiatric nurses. Communitybased organizations would provide safety staff at four clinics instead of the sheriff.

More than a dozen doctors, nurses and community members spoke in support of the proposal during the meeting, although some said it didn’t go far enough since it still relied on cadets and some deputies. Multiple people spoke about traumatizing experiences where deputies used force against patients.

A UCSF medical student on rotation in the psychiatric emergency services at San Francisco General described an instance where staff called deputies when a patient who wanted to leave, but was on a psychiatric hold, started banging his head on the wall. He said he watched deputies punch the patient until he was bleeding with a broken wrist. When other patients started fighting, he saw another staff member’s hand hover over the call button, debating what to do, before she summoned deputies again.

“The vast majority of instances that sheriffs were called by staff, because it’s the only option they felt for support, led to escalation of these situations, lack of a compassionate response, sometimes assault of patients, and criminalization and arrest primarily of people of color in need of medical care,” said Dr. Jessica Bloome, a doctor at San Francisco General.

Sheriff ’s Office spokesperson Nancy Crowley said in a statement that the department “has embraced, encouraged and trained deputy sheriffs and sheriff ’s cadets in deescalation tactics to avoid using force whenever possible.” Assistant Sheriff Carter said she was disheartened to hear of any reports of potential misconduct and encouraged staff to file whistleblower reports.

Some San Francisco General staff, particularly in the emergency and psychiatric emergency departments, said they depend on deputies for their own safety. Last year, the state’s workplace safety watchdog cited the hospital for failing to provide violenceprevention training and other issues after a patient assaulted a nurse.

Christa Duran, an emergency room nurse for seven years, quit her job in February and said the change in security staffing was a big reason why.

“More psych staff (are) not going to decrease assaults in the emergency department,” Duran said.

The incoming staff will cost less than deputies, but because of added positions, the plan will still require $1.4 million in the fiscal year starting in July and an additional $1.8 million in the next fiscal year.

The department is requesting that the proposal be submitted with the mayor’s budget to the Board of Supervisors in June. If it is approved, hiring would start in August.