‘The biggest scam’: This hated business fee might help protect SF’s budget from Trump

Businesses hate it. Restaurant customers are bewildered by it. Employees benefit from it.



Now, come budget time, an often-reviled city fee may help protect the city.



The San Francisco City Option program provides medical reimbursement accounts to help thousands of employees pay for health coverage every year. The fees that small businesses — in particular, restaurants — contribute to the program are so high, it’s akin to doubling their rent. Restaurants often pass some of that to customers, in the form of an “SF mandate” or “health fee” tacked onto the bill.



Ben Bleiman, a bar owner and president of the Entertainment Commission, said he pays roughly $350 per employee per month. For a restaurant or shop with a staff of 20, that’s $7,000 monthly — though most businesses enrolled in the program have far more workers than that.



“Don&#8217;t get me started, man. It&#8217;s just the biggest scam perpetrated on small businesses in the city,” Bleiman said. “It&#8217;s a massive expense.”



Roughly $200 million of that fund has gone unused by workers, according to a city report published at the end of March, and the excess will roll over into San Francisco’s general fund in April 2026. That’s just in time to serve as a cushion against the city’s budget deficit, as federal cuts loom.



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But amid complaints from business owners about the fees, city leaders are divided on how to use the money, if at all.



“We cannot paper over a $1 billion budget deficit with one-time funds, especially not funds that rightfully belong to San Franciscans,” Charles Lutvak, Mayor Daniel Lurie’s spokesperson, said in a statement. “Our administration is prepared to make the structural changes needed to close this $1 billion deficit, stabilize our city’s finances, and get back to investing in the workers and businesses of San Francisco again.”



The deficit, estimated at $820 million, could mean cuts in agencies citywide: street cleaning crews, homeless shelter staffers, pro-bono legal aid for low-income residents, and more. If President Donald Trump continues swinging a scythe at funding for healthcare, education, and other services, the deficit could <a href="https://sfstandard.com/2025/04/10/san-francisco-lurie-budget-trump-2-billion/">more than double,</a> officials estimate.



The San Francisco Board of Supervisors negotiates with the mayor’s office to approve the budget, giving them a say in how funding is used. Supervisor Rafael Mandelman, the board president, said the City Option dollars may come in handy at a time of great uncertainty.



“In that kind of environment, you&#8217;re looking for additional sources of reserve dollars,” Mandelman said. “But I think we&#8217;re not there yet, and there&#8217;s all these other elements of the conversation we have to have.”



However, the amount of unspent City Option money has led small business groups to question whether the program is needed. It was created two decades ago, long before the Affordable Care Act helped insure more San Franciscans, according to Laurie Thomas, executive director of the Golden Gate Restaurant Association.



“Many additional healthcare options are now available,” Thomas wrote. “Given the amount of unused funds paid into the city&#8217;s [medical reimbursement] account, we believe it is prudent to look to repeal this ordinance.”



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Small-business owners are pushing the city to repeal the program. Conversations to reform it are underway.



Many entities can make strong claims to the unspent dollars: the employers who paid fees to make it possible, the workers whom the fund was created to help, and unions looking to prevent layoffs.



Insiders said it may be easier politically to spend the spare funds on public health, instead of on general city costs. The federal government’s potential Medicare or Medicaid reductions, for instance, could cost the city roughly $900 million, according to the mayor’s office.



The city doesn’t have its hands on the money just yet. It sits in a $900 million Department of Public Health reimbursement account as part of Healthy San Francisco, the 2006 <a href="https://www.foundsf.org/index.php?title=Healthy_San_Francisco">brainchild of progressive Democrats</a> aimed at helping uninsured San Franciscans with medical care. The city anticipates the bulk of those funds will be used by workers.



Supervisor Connie Chan, the board&#8217;s budget chair and a leading progressive, said the healthcare fund should be reserved for workers.



&#8220;At a moment when Trump is attacking our sanctuary state where many, including immigrant workers, have taken roots and contributed for generations, it is unthinkable for anyone wanting to take away their health care, especially because this is not funded by any business but all San Franciscans who dine out and&nbsp;support our restaurants,&#8221; Chan said.



Chan said the current system should become more accessible to workers. She said she will demand that the city use a separate pot of money called the Health Security Fund as a bulwark against Medicaid cuts. That fund has about $240 million accessible.



Roughly 5,225 employers have opted into the San Francisco City Option program, which houses the healthcare reimbursement account. More than $500 million has been paid out in claims to workers since 2021, according to the Department of Public Health.



The city’s ability to reclaim unspent dollars is fairly recent. In 2022, the Health Commission approved a tweak to the healthcare reimbursement fund to bring it in line with state law. From then on, funds unclaimed in a three-year period would roll over to the city’s general fund.



“Closing accounts is the last resort,” a Public Health spokesperson said.



Mandelman said shrinking or eliminating the healthcare fee could “provide relief for some small-business owners,” and he’s taken part in meetings to figure out its future.



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City records show various meetings aimed at reforming the healthcare fund: a Feb. 26 meeting between Supervisors Danny Sauter, Joel Engardio, and Mandelman, as well as mayor’s office and city department staff. On March 27, a team from the mayor’s office met with the San Francisco Labor Council, and on Friday they are due to meet with the Golden Gate Restaurant Association.



Small businesses pay the smallest portion of the fund; groups that represent them argue that this is a reason to exempt them. Roughly 4% of contributions come from companies with 20-49 employees, but a whopping 79% comes from companies employing more than 500.



Even Democrats are pushing for change. Eric Kingsbury, a member of the San Francisco Democratic Party board, said he’s writing a resolution to put Democrats on record seeking to repeal the healthcare fund.



“It was a great initiative that did its work and no longer serves its purpose,” Kingsbury said.



The Department of Public Health has recognized the need to reach more workers so funds don’t go unspent. In September, the agency kicked off a splashy ad campaign on BART, Muni, and billboards to direct San Franciscans to an online tool where they could look up their healthcare reimbursement accounts.



This summer, the Public Health Department aims to issue debit cards so San Franciscans can more easily pay for medical expenses upfront, instead of seeking reimbursements later.



Bleiman, the bar owner, thinks most small-business owners want the fund scrapped. He said he hears from restaurateurs and bar owners who hate the fee “every goddamn day, dude. Every single day.”



“It&#8217;s so offensively unfair that it&#8217;s infuriating,” Bleiman added. “It&#8217;s exactly why San Francisco has a reputation of being the most unfair to small businesses in America.”

New SF public health chief was part of notorious McKinsey opioid-marketing operation

Daniel Tsai, Mayor Daniel Lurie’s choice to lead the Department of Public Health, has a blue-chip résumé: After studying at Harvard University, he landed a prestigious consulting gig before jumping into government, leading Medicaid programs in Massachusetts, then federally under former President Joe Biden.&nbsp;



Along the way, Tsai, in his capacity as an employee with McKinsey &amp; Company, helped to market a powerful painkiller called tramadol during the company&#8217;s years-long streak of pushing opioid sales. The company’s actions ultimately led to a criminal probe, more than $1 billion in settlements, and a public mea culpa over its role in fueling an overdose epidemic that has killed more than 500,000 Americans over 25 years.



Tsai’s actions at McKinsey are detailed in a tranche of documents that were released as part of a settlement with the consulting firm in which it was accused of accelerating opioid sales despite growing awareness of the risks.&nbsp;



The records show that Tsai — who worked for McKinsey from 2007 to 2015, according to his LinkedIn page — helped develop a marketing strategy for tramadol sold under the brand name Ultram ER, an effort that involved cultivating relationships with doctors who became prolific prescribers. The records are housed at the <a href="https://www.industrydocuments.ucsf.edu/opioids">UCSF-JHU Opioid Industry Documents Archive</a>.



In a March 2008 PowerPoint presentation, Tsai outlined a marketing strategy for the drug that included guidance on targeting “specific physician segments to grow high-prescriber group (i.e., physicians more sensitive to patient needs)” and an idea to introduce “coupons” for the drug as part of a pilot program.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1629" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?w=2500" alt="A booth with &quot;McKinsey &amp; Company&quot; in bright letters on a wooden panel. Two men stand nearby, one looking at a touchscreen display." class="wp-image-367908" srcset="https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg 4396w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=300,196 300w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=768,501 768w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=2500,1629 2500w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=1536,1001 1536w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=2048,1335 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">McKinsey &amp; Company has paid more than $1 billion in settlements related to its role in the opioid crisis.</figcaption></figure>



“We hope to be interviewing some high-prescriber physicians next week,” Tsai wrote in an email the same month, attaching a list of questions that could be used to screen doctors. 



Lurie’s office defended Tsai’s appointment as Public Health chief. In a statement, the mayor’s office wrote, “Nearly 20 years ago, Dan Tsai was a 23-year-old entry-level staffer assigned to conduct research for a project at work. He has spent nearly his entire two-decade career supporting those struggling with homelessness and addiction and helping tens of millions of our most vulnerable neighbors access critical medical care, and he will continue that work in San Francisco.”



Several drug and homelessness service providers in the city said they were disappointed by a lack of transparency surrounding Tsai’s appointment process. The revelation of his past role at McKinsey intensified those concerns, they said.&nbsp;



“You’d want a public health official of that caliber to articulate what his participation was in that role,” said Laura Guzman, director of the National Harm Reduction Coalition. “This is an important moment to bring in people with federal bureaucracy expertise. But if [Lurie] wants to address the lack of treatment, we need leadership with expertise in evidence-based interventions.”



Others were less diplomatic in their reaction to the news.



“Holy fucking shit,” said Liza Murawski, co-chair of the city’s Behavioral Health Commission, when told of Tsai’s role at McKinsey. “Why would he be the director? Why don&#8217;t you have someone in there who’s a mental health expert?”



It wasn’t immediately clear who Tsai’s client was when he was marketing Ultram ER. The brand, which has been discontinued, was developed by a Canadian company and licensed to a subsidiary of Johnson &amp; Johnson in 2005, <a href="https://pharmatimes.com/news/orthos_ultram_er_reaches_us_market_996469/">according to PharmaTimes</a>.&nbsp;



Experts say tramadol was initially thought to be less harmful than OxyContin, another product McKinsey marketed for Purdue Pharma. But that view has changed.&nbsp;



Tramadol is a Schedule IV drug — in the same category as Xanax, Valium, and Ambien — and has <a href="https://www.voanews.com/a/report-highly-potent-opioids-now-showing-up-in-drug-users-in-africa/7653980.html">more</a> <a href="https://www.bbc.com/news/world-africa-44306086">recently</a> <a href="https://www.occrp.org/en/news/un-report-tramadol-use-in-africa-is-increasing">been</a> linked to addiction in Africa. “It was seen as this alternative,” said Dr. Rachel Sussman, a South Bay-based addiction medicine specialist. “It is just as risky and just as dependency-creating as any other opioid medication.” In fact, the drug carries more complications than some other opioids, including a risk of seizure and negative interactions with antidepressants, said Sussman.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?w=2500" alt="Two men in suits stand near a podium. One is holding papers, and the other rests a hand on his shoulder. A calendar and TV are visible in the background." class="wp-image-366616" srcset="https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg 7510w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Mayor Daniel Lurie tapped Tsai to lead the city&#8217;s Public Health Department. The sprawling agency has a roughly $3 billion budget.</figcaption></figure>



Dr. David Juurlink, an expert on tramadol, called the drug a “minor player in the opioid crisis, but a player nevertheless.”



He added, “To the extent that McKinsey helped advertise it as a notionally safer opioid, I think they did a disservice in doing so. The main reason I say tramadol is a minor player is because it wasn’t prescribed like candy, like OxyContin was.&#8221;



McKinsey’s method of targeting high-volume prescribers was part of its playbook to juice opioid sales, despite mounting evidence that the drugs could be highly addictive. In other emails uncovered in the McKinsey documents, employees wrote excitedly about finding doctors who were willing to write opioid prescriptions. <a href="https://www.industrydocuments.ucsf.edu/opioids/docs/#id=hlmn0255">In one instance</a> in 2015, a McKinsey partner wrote, “The challenge which we need to start working on is to identify the sweet spot of docs so we can do targeting. … Fun be[g]ins on Monday!”



San Francisco’s fentanyl crisis is part of a broader trend of opioid overdoses <a href="https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html">that traces back to the 1990s,</a> when prescription opioids became popular among doctors for chronic pain management. Companies such as Purdue Pharma, which manufactured OxyContin, brought in consulting firms like McKinsey to help with sales strategies. After a Department of Justice probe and settlement, McKinsey <a href="https://www.justice.gov/usao-ma/media/1380236/dl">acknowledged that it knew</a> the dangers of OxyContin but continued working with Purdue Pharma — even after several of the drugmaker’s executives pled guilty in 2007 to misrepresenting addiction risks.&nbsp;



McKinsey, along with a slew of drug companies and pharmacies, agreed to pay billions in settlement funds over their roles in fueling opioid addiction. California received <a href="https://oag.ca.gov/news/press-releases/attorney-general-becerra-announces-573-million-nationwide-settlement-mckinsey">roughly $60 million</a> from the 2021 McKinsey settlement. San Francisco, <a href="https://www.sfcityattorney.org/2023/05/17/san-francisco-city-attorney-announces-230-million-settlement-with-walgreens-after-victory-in-opioid-litigation/">under the 2023 settlement</a> of an opioid-related lawsuit, was expected to receive about $230 million from Walgreens.



In both instances, the funds were slated to be used for opioid recovery efforts.



In 2019, McKinsey said it would no longer work on opioid-related businesses.&nbsp;Last year, McKinsey formally apologized for its Purdue Pharma work, <a href="https://www.mckinsey.com/about-us/opioidfacts">saying it was “deeply sorry”</a> for its role in selling OxyContin. “This terrible public health crisis and our past work for opioid manufacturers will always be a source of profound regret for our firm,” the company said in a statement.



At the San Francisco Department of Public Health, Tsai replaced Dr. Grant Colfax, who took the reins in 2019 and led the city through the pandemic <a href="https://sfstandard.com/2025/01/16/grant-colfax-resign-san-francisco-public-health/">before stepping down in January</a>. The role paid $546,133 in 2024, one of the highest city salaries.&nbsp;&nbsp;



On Monday, the San Francisco Health Commission unanimously nominated Tsai as director of Public Heath. Dr. Laurie Green, president of the commission, said the governing body conducted a “multi-hour” interview.



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“In the interview with Mr. Tsai, the Health Commissioners focused on his preparedness to address the current public health challenges facing San Franciscans and his ability to sustain the Department through a potential tumultuous time ahead,” Green wrote in a statement. “This includes his unique expertise in Medicaid funding and programs, in addition to healthcare innovations and transformation.”



Tsai is expected to work with <a href="https://sfstandard.com/opinion/2025/01/07/the-fresh-faces-in-luries-cabinet-will-have-vast-power-but-will-they-know-how-to-wield-it/">Kunal Modi</a>, another McKinsey alum, whom Lurie has tapped to lead the city’s response to health and homelessness. In a statement this week, Tsai highlighted&nbsp;the city’s opioid and homelessness crises and said he was looking forward “to partnering with stakeholders and individuals with lived experience to find new, data-driven approaches to tackling this important challenge.”



Representatives of McKinsey did not respond to a request for comment.



Richard Beal, director of recovery services at the Tenderloin Housing Clinic, said he appreciates Lurie’s early focus on the fentanyl crisis and remains optimistic about Tsai’s appointment. “Just like [Tsai] distributed the drugs, maybe he can distribute the solution to the drugs,” Beal said. “Hopefully, he can use the knowledge he has from helping to create the monster to figure out how to solve it.”

Nurse staffing measure Prop. I passed by voters

A relatively under-the-radar proposition on the November ballot could have huge consequences for the quality of health care in San Francisco, city nurses say.



Proposition I would beef up retirement benefits for over 1,000 nurses in the city, allowing workers to bank time spent as a per diem nurse toward their pension. The ballot measure would offer similar changes for 911 dispatchers, with the hope that the incentive will retain city workers. It needs a simple majority to pass.



“It is a small measure that goes a really long way,” said Brittany Hewett, a per diem nurse at Zuckerberg San Francisco General Hospital who works with the elderly.



<a href="https://develop.sfstandard.com/2024/11/05/san-francisco-election-results-november-2024/#local-measures">Early results</a> Tuesday night showed voters passing the measure with an overwhelming majority.



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Because so many nurses and other frontline health care workers consider their job a calling, burnout is widespread — and without more incentives to retain them, Prop. I proponents say, turnover will continue to drive staffing shortages.



“You can work yourself to death,” Hewett said. “And there are still going to be people who need help. It is really challenging.”



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2001" height="2001" src="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?w=2001" alt="A nurse in blue scrubs stands by a wooden bench, her name badge visible." class="wp-image-269965" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg 2001w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=150,150 150w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=300,300 300w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=768,768 768w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=1536,1536 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=180,180 180w" sizes="auto, (max-width: 2001px) 100vw, 2001px" /><figcaption class="wp-element-caption">Brittany Hewett speaks during a Health Commission in April. </figcaption></figure>



The proposition was introduced by city Supervisor Ahsha Safaí — who is also running for mayor — and the city’s healthcare unions poured hundreds of thousands of dollars into the measure to see it passed.&nbsp;



San Francisco’s health and emergency systems have struggled to keep pace since the pandemic, Prop. I backers say. Proponents say the city’s nurses are exhausted and leaving for private hospitals. They also contend that the staffing shortage is putting them in harm’s way. <a href="https://develop.sfstandard.com/2024/04/23/san-francisco-general-hospital-nurses-understaffing-assaults/">Last spring</a>, nurses testified before the city’s Health Commission about an uptick in physical and verbal assault. One nurse said a patient spat on her, and others told stories about skipping meal breaks.&nbsp;



Jennifer Esteen, a psychiatric nurse, said the staff turnover puts a considerable financial burden on the city and degrades the quality of medical care.



“The patients we serve need continuity of care,” Esteen said, “and a solid and stable workforce. Prop. I helps shift from a temporary workforce to a permanent workforce.”&nbsp;



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The city’s 911 dispatchers are dealing with the same issues, proponents say, claiming that a 20% staffing shortfall is forcing dispatchers to work up to 18-hour shifts to cover the gaps.&nbsp;



There are currently 1,400 per diem nurses eligible for the benefits change, according to a 2023 estimate from the city controller’s office. The office found the measure would similarly impact about 175 emergency dispatchers. <a href="https://www.sf.gov/sites/default/files/2024-08/Prop%20I%20-%20Nurses%20%20911%20Dispatchers%20Retirement%20-%20CON%20VIP%20Letter%20-%20Signed.pdf">Controller Greg Wagner estimates</a> that Prop. I would cost the city between $3.8 and $6.7 million annually to start and progressively increase year to year.&nbsp;



No significant opposition surfaced against the measure. Safaí managed to get it on the ballot with unanimous support from his colleagues on the Board of Supervisors. Unions threw over $850,000 toward the proposition, including $400,000 from the Service Employees International Union 1021, which represents the city’s nurses.



Prop. I was one of several retirement-related measures on the ballot.



Prop. F, introduced by Supervisor Matt Dorsey, would postpone retirement for police officers while offering sizable incentives. Then there’s Prop. H, which would lower the retirement age for firefighters to receive the maximum pension benefits and was introduced by Supervisor Catherine Stefani. The latter two have raised concerns about cost and about whether people could game the system and undermine the ostensible aim of fixing staffing shortages.&nbsp;

Nurses say they’re assaulted constantly at San Francisco public hospitals

City nurses excoriated Department of Public Health officials on Tuesday and warned that public hospital systems across San Francisco were struggling under the weight of severe understaffing that has led to a spate of troubling incidents, which include physical and verbal assaults from patients.



Nurses from both Zuckerberg San Francisco General and Laguna Honda hospitals, along with community clinics, reported a chaotic working environment that they said has jeopardized their ability to provide quality patient care.&nbsp;



“Our system is impacted with folks who need care,” said Jennifer Esteen, a nurse who has worked with the city for 14 years and specializes in helping those with severe mental health issues, in an interview. “The working conditions are tough.”



The complaints come as the nurse’s union, Service Employees International Union Local 1021, is in active contract negotiations with the city and is pleading with officials to beef up staffing.&nbsp;



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="2001" height="2001" src="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg" alt="A nurse in blue scrubs stands by a wooden bench, her name badge visible." class="wp-image-269965" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg 2001w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=150,150 150w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=300,300 300w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=768,768 768w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=1536,1536 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_006_9793a8.jpg?resize=180,180 180w" sizes="auto, (max-width: 2001px) 100vw, 2001px" /><figcaption class="wp-element-caption">Brittany Hewett speaks during a Health Commission meeting at San Francisco Department of Public Health (SFDPH) on Grove Street in San Francisco on Tuesday.</figcaption></figure>



Last week, over 20,000 workers <a href="https://develop.sfstandard.com/2024/04/15/san-francisco-city-unions-labor-deal/">struck tentative deals</a> with the city, winning pay bumps over three years despite a looming $800 million deficit. The clock is ticking to resolve the remaining unions that haven’t reached an agreement with the city; current contracts end on June 30.



The incidents cited during the city’s Health Commission meeting on Tuesday spanned from patients lashing out at workers after not receiving food, water or pain medication to one nurse being spat on by a patient.



Before speaking at the commission meeting, Esteen presented “four phone books worth” of paper that comprised thousands of pages of workers documenting unsafe working conditions.



The records, which were provided to The Standard, include incidents of assault.



“We are short staffed at 6, with 3 1:1 assault 3 patients, high acuity, no clerk,” one report from March 2022 at General Hospital said. “Entire staff was called to de-escalate 2 situations despite having deputies and sfpd present. There were not enough staff to ensure the rest of unit was safe, potentially leaving patients vulnerable.”



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="1965" height="1965" src="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?w=1965" alt="A person crosses a glass-walled bridge above a bustling outdoor terminal with passengers and a vendor cart." class="wp-image-269957" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg 1965w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?resize=150,150 150w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?resize=300,300 300w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?resize=768,768 768w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?resize=1536,1536 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/featuredl_hospital-11-1.jpg?resize=180,180 180w" sizes="auto, (max-width: 1965px) 100vw, 1965px" /><figcaption class="wp-element-caption">People enter and exit Zuckerberg San Francisco General Hospital and Trauma Center on Jan. 13, 2022.</figcaption></figure>



Members of the nursing union also presented their survey results, which found that many members have experienced assault while on the job. The questionnaire found nearly two-thirds had been assaulted more than 10 times. Over one-third have been injured in assaults.



SEIU Local 1021 represents about 2,300 nurses, according to union spokesperson Ella Sogomonian.&nbsp;



“They’re continuously missing meal breaks,” said Sogomonian in an interview. “They’re overworked. They’re exhausted.”



The union’s complaints coincide with similarly concerning incidents at the city’s jails.&nbsp;



Earlier this month, two of San Francisco’s jails were placed on lockdown after an increase in physical assaults on sheriff’s deputies and jail staff, a situation <a href="https://develop.sfstandard.com/2024/04/13/san-francisco-county-jails-lockdown-attacks-deputies/">that has been blamed</a> in part on inadequate staffing.&nbsp;



On Tuesday, <a href="https://develop.sfstandard.com/2024/04/23/prisoner-escapes-san-francisco-general-hospital/">an inmate was caught</a> after escaping a cell at General Hospital.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="3024" height="3024" src="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?w=2500" alt="A sheriff's car parked outside the Zuckerberg San Francisco General Hospital." class="wp-image-269958" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg 3024w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=150,150 150w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=300,300 300w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=768,768 768w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=2500,2500 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=1536,1536 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=2048,2048 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/zuckerberg-san-francisco-general-hospital-prisoner-02-1.jpg?resize=180,180 180w" sizes="auto, (max-width: 3024px) 100vw, 3024px" /><figcaption class="wp-element-caption">San Francisco Sheriff&#8217;s Office vehicles are stationed in front of Zuckerberg San Francisco General Hospital and Trauma Center on Tuesday.</figcaption></figure>



When asked about the nurse staffing conditions, Department of Public Health Director Dr. Grant Colfax walked away from this reporter and deferred questions to an agency spokesperson.



The city’s hospitals have also dealt with concerns around its policy surrounding illicit drug use. <a href="https://develop.sfstandard.com/2023/03/10/sf-general-hospital-claims-its-a-drug-free-zone-nurses-say-otherwise/">Last year, nurses told The Standard </a>that they were compelled, in certain circumstances, to return fentanyl and methamphetamine to patients. On Monday, <a href="https://develop.sfstandard.com/2024/04/22/drug-overdose-san-francisco-general/">The Standard reported</a> that a man had overdosed on fentanyl and died at General Hospital.



A statement provided by a health department spokesperson said the agency has made “significant progress” in hiring and retaining nurses. The department has added 135 new nursing positions since 2019 and has helped streamline hiring procedures, they said.



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="1126" height="2001" src="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_018_a00e0a.jpg" alt="A man in a blue blazer and white shirt, with a serious expression, sits with hands clasped in front of him." class="wp-image-269960" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_018_a00e0a.jpg 1126w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_018_a00e0a.jpg?resize=169,300 169w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_018_a00e0a.jpg?resize=768,1365 768w, https://content-develop.sfstandard.com/wp-content/uploads/2024/04/20240422-sfdphnursesphysicalassault_eg_018_a00e0a.jpg?resize=864,1536 864w" sizes="auto, (max-width: 1126px) 100vw, 1126px" /><figcaption class="wp-element-caption">Grant Colfax, Director of Health for the City and County of San Francisco, listens during a Health Commission meeting at San Francisco Department of Public Health (SFDPH) on Grove Street in San Francisco on Tuesday.</figcaption></figure>



The department also addressed concerns from the union about outsourc...

Speaker Emerita Nancy Pelosi’s chief of staff named vice chancellor at UCSF

Speaker Emerita Nancy Pelosi&#8217;s chief of staff—a longtime San Francisco resident and president of the city&#8217;s Health Commission—has been named vice chancellor of community and government relations at the University of California, San Francisco, according to the university.



Over his 25-year career in public service, Dan Bernal worked in health care policy on the local, state and federal levels, serving on the board of the San Francisco AIDS Foundation and in the White House for the political director under President Bill Clinton before working as Pelosi&#8217;s senior advisor during the HIV/AIDS crisis.



In his new role at UCSF, he replaces interim Vice Chancellor Ellie Rossiter, who was appointed to her position in February.



“I am deeply grateful to Speaker Emerita Pelosi for her barrier-breaking, life-changing leadership on health care, education, equity and justice and so much more,” Bernal said. “Personally, her solidarity with the LGBTQ+ community and work to fight HIV/AIDS has been so meaningful to me and to our city.”



Bernal, who has lived with HIV since 1990, has a long record of advocacy around HIV/AIDS issues. He also frequently collaborated with UCSF&#8217;s health experts in response to the Covid-19 pandemic.



That experience and the network he built over decades in public politics and policy laid a foundation for his new role, UCSF Chancellor Sam Hawgood said. 



“Dan’s experience at all levels of government and his productive relationships in the community are enormous assets as we pursue our core missions of research, patient care, education and public service,” Hawgood said in announcing the appointment. “He is committed to inclusivity and fairness to all people, and he knows the value that research can play in improving their lives. We have already been fortunate to work with him in government and know he will be a great fit for the UCSF community.”

San Francisco drug crisis commission doing nothing for lack of members

A commission in charge of holding San Francisco accountable for its response to the drug and mental health crises hasn’t been able to hold a proper meeting for more than seven months as the city’s elected leaders neglect to fill its seats.&nbsp;



There are currently only six active members on the 17-person Behavioral Health Commission, an oversight body with the power to draft policy and conduct reviews of programs run by the city’s Behavioral Health Department. The department has a $592 million annual budget and is responsible for providing mental health and drug treatment services.&nbsp;



Because there are fewer than nine active members, the commission lacks a quorum and hasn’t been able to wield much of its power or hold meetings since February.



The term of the commission&#8217;s co-chair, Balham Vigil, expired 10 months ago, but Vigil continues to serve; the city has failed to appoint a replacement. The commission is required by state law, and 16 of its 17 members are appointed by the Board of Supervisors.&nbsp;



A 17th seat is reserved for a member of the Board of Supervisors. But that seat has sat empty since January 2022. Supervisor Ahsha Safaí, who championed the creation of <a href="https://develop.sfstandard.com/2023/03/28/can-you-fight-bureaucracy-with-bureaucracy-this-new-commission-is-optimistic/">the Homelessness Oversight Commission</a>, was the last Board of Supervisors member to fill the seat before Behavioral Health Commission members said he abruptly stopped attending. Safaí didn’t respond to a request for comment.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2350" height="1567" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg?w=2350" alt="" class="wp-image-185328" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg 2350w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg?resize=300,200 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg?resize=768,512 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg?resize=1536,1024 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/1SupervisorsChambersPhotos07062023-23.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2350px) 100vw, 2350px" /><figcaption class="wp-element-caption">District 11 Supervisor Ahsha Safai during the San Francisco Board of Supervisors Meeting at City Hall in San Francisco on July 11.</figcaption></figure>



“The supervisors are just not appointing people,” said former commission member Geoffrey Grier. “You’ve got a lot of folks who want to be on the commission but they’ve got to wait a year? Nine months?”



Victor Young, a clerk for the Board of Supervisors, told The Standard there are eight people who have pending applications to serve on the commission. However, he said it’s difficult to find qualified members for the commission due to the types of experience needed for each seat.&nbsp;



Each of the 11 supervisors gets one appointee to the commission. The six other seats are appointed by the full Board of Supervisors, including the one seat designated for a member of the Board of Supervisors.



On top of that, there are other complicated rules. At least nine of the 17 commissioners are supposed to be mental health patients or family members of mental health patients. Two commissioners are supposed to be mental health “advocates,” two seats are designated for mental health professionals, and one seat is to be held by a person “serving the public interest.”&nbsp;



The commission currently has three seats occupied by mental health patients or their family members, two mental health professionals and one advocate.



The Behavioral Health Department is part of the Department of Public Health, the largest department in the city with a $3 billion budget. The Department of Public Health has at least four commissions overseeing its work.&nbsp;



Supervisor Matt Dorsey, who is chair of the rules committee, which evaluates commission applicants, said he’s working on legislation that would shrink the commission from 17 members to 11. He told The Standard the commission’s stringent eligibility requirements have imposed barriers for him and other supervisors to appoint commissioners.&nbsp;



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2560" height="1708" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-scaled.jpg?w=2500" alt="" class="wp-image-178021" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-scaled.jpg 2560w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-2500x1668.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-1536x1025.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-2048x1366.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-650x434.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-800x534.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-740x494.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-900x600.jpg 900w, https://content-develop.sfstandard.com/wp-content/uploads/2023/07/BreedPressConf062923_20-72x48.jpg 72w" sizes="auto, (max-width: 2560px) 100vw, 2560px" /><figcaption class="wp-element-caption">Supervisor Matt Dorsey speaks at a press conference in San Francisco on June 29. | Jeremy Chen/The Standard</figcaption></figure>



<h2 class="wp-block-heading" id="h-do-oversight-bodies-work-some-supervisors-are-skeptical-nbsp">Do Oversight Bodies Work? Some Supervisors Are Skeptical&nbsp;</h2>



In July, The Standard reported <a href="https://develop.sfstandard.com/2023/07/06/only-1-person-at-sf-city-hall-knows-the-answer-to-this-simple-question/">only one person working in City Hall</a> was able to figure out how many departments, boards, commissions and advisory bodies the city has. A representative from the City Attorney’s Office eventually counted 53 departments, 56 boards and commissions, and 74 more advisory bodies, bringing the grand total to 183 different entities.&nbsp;



The revelation frustrated many who said the city is plagued by too many overlapping bureaucracies.&nbsp;



Supervisor Rafael Mandelman, who is one of five supervisors with active appointees on the Behavioral Health Commission, said the city should fill the vacant seats but was skeptical whether it would move the needle on solving city issues.



“If oversight bodies led to good government, we would have the best government in the world,” Mandelman said.&nbsp;



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2560" height="1707" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-scaled.jpg?w=2500" alt="" class="wp-image-161645" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-scaled.jpg 2560w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-2500x1667.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-1536x1024.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-2048x1365.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-650x433.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-800x533.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-740x493.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-071-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-conte...

Only 1 person at SF City Hall knows the answer to this simple question

In the process of reporting a <a href="https://develop.sfstandard.com/politics/london-breed-mayor-san-francisco-drugs-homelessness-crime-economy-election/">long story about Mayor London Breed</a>, one seemingly routine question proved to be exceptionally difficult to answer: How many departments, commissions and advisory boards are there in San Francisco?



This seems like a straightforward question. Hardly.



Dozens of calls, emails and texts were sent asking the same question, but no one at City Hall was willing or able to give a definitive answer. Staff at the Mayor’s Office said they once knew the numbers—an intern apparently had been assigned the unenviable task of counting—but the report couldn’t be located.&nbsp;



Instead, the mayor’s team, a majority of supervisors and multiple city departments sent along a string of incomplete or <a href="https://sfbos.org/sites/default/files/Maddy_Act_Report_2023.pdf" target="_blank" rel="noreferrer noopener">regional reports</a> and suggested I give so-and-so a call, only to have that person send me the same reports and refer me back to the places from which I came.&nbsp;



Weeks went by without a single person at City Hall willing to offer hard numbers. For anyone who pays taxes in San Francisco, this may be a bit troubling considering it’s the equivalent of asking a parent how many children they have.&nbsp;



“Who, him? I think that’s Gary, number eight. Or is it nine?”



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2500" height="1668" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-2500x1668.jpg" alt="" class="wp-image-133148" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-2500x1668.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-1536x1025.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-2048x1366.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-650x434.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-800x534.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-740x494.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-900x600.jpg 900w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/PoliceCommision010323_920-72x48.jpg 72w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Commissioner Jim Byrne, right, and Paul Henderson, left, attend a Police Commission meeting at San Francisco City Hall on March 1, 2023. | Benjamin Fanjoy for The Standard</figcaption></figure>



It wasn’t until I circled back to the City Attorney’s Office that a knight in shining armor emerged. Jen Kwart, a spokesperson for the office, hand-counted city departments—based on statements of economic interest filed by department heads—to come to the conclusion that San Francisco has 53 departments, 56 boards and commissions, and 74 more advisory bodies, bringing the grand total to 183 different entities. And that doesn’t even include other informal groups created by the mayor and city agencies.



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If that seems like a lot, that’s because it is a lot <a href="https://develop.sfstandard.com/politics/city-hall/explanier-san-francisco-boards-and-commissions/">compared with other cities</a>. So much so that San Francisco currently has more than 180 vacancies for members of the public to serve across an array of boards, commissions and advisory bodies.



“San Francisco has so many commissions the number is almost farcical,” Joel Engardio, a first-year supervisor for the Sunset District, said in a text message. “There are probably 60 or 70 commissions the public has never heard of. Many of these commissions have vacancies or large numbers of absences, which means even the people who know about them don’t care enough to fill the seats or show up. We have to ask, &#8216;What’s the point of all these commissions if they’re only catering to a small group of political insiders talking to each other?&#8217;”



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2500" height="1667" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-2500x1667.jpg" alt="" class="wp-image-161673" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-2500x1667.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-1536x1024.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-2048x1365.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-650x433.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-800x533.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-740x493.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-900x600.jpg 900w, https://content-develop.sfstandard.com/wp-content/uploads/2023/05/05162023BOSRoundup-183-72x48.jpg 72w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Supervisor Joel Engardio speaks during a board meeting at San Francisco City Hall on May 16, 2023. | Justin Katigbak for The Standard.</figcaption></figure>



Engardio isn’t alone in admitting that San Francisco’s unique brand of participatory democracy has become unwieldy and expensive. Even though most of the commission and advisory board positions are unpaid, there is a cost to hunting down appointees and staffing them.



Of course, many commissions are established by the City Charter and make good sense. San Franciscans want citizen oversight for obvious things like <a href="https://sf.gov/departments/police-commission">police</a> and <a href="https://sfplanning.org/hearings-hpc-grid">historic preservation</a>. Getting rid of these or altering them would require voter sign-off to update the City Charter.



But critics of the vast number of advisory boards and oversight commissions say that, ironically, they lead to opacity instead of the transparency they’re meant to provide. Many groups have been created as the result of ballot measures being passed, which package taxes and updates to the law with task forces.&nbsp;



One City Hall insider suggested the work of a group like the Sugary Drinks Distributor Tax Advisory Committee could be overseen by the Health Commission, but <a href="https://ballotpedia.org/San_Francisco,_California,_Soda_and_Sugary_Beverages_Tax,_Proposition_V_(November_2016)" target="_blank" rel="noreferrer noopener">a 2016 ballot measure</a> that slapped a tax on sweet drinks—San Francisco’s attempt to take on Big Soda—created the committee. 



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="1790" height="1194" src="https://content-develop.sfstandard.com/wp-content/uploads/2023/03/1022723BOSRoundup-62.jpg" alt="" class="wp-image-132339" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2023/03/1022723BOSRoundup-62.jpg 1790w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/1022723BOSRoundup-62.jpg?resize=300,200 300w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/1022723BOSRoundup-62.jpg?resize=768,512 768w, https://content-develop.sfstandard.com/wp-content/uploads/2023/03/1022723BOSRoundup-62.jpg?resize=1536,1025 1536w" sizes="auto, (max-width: 1790px) 100vw, 1790px" /><figcaption class="wp-element-caption">President Aaron Peskin oversees the Board o...

San Francisco puts millions in Covid response funds on the chopping block

San Francisco’s nearly $14 billion budget presents an opportunity for a fair number of coins to slip between the cushions, but the city’s impending financial crisis may be exposing some bloat for one major city department.



Mayor London Breed recently called on agencies to propose additional cuts to make up for a <a href="https://develop.sfstandard.com/politics/city-hall/san-franciscos-deficit-swells-to-780m-in-latest-sign-of-budget-distress/">$780 million expected shortfall</a> over two years. At the Department of Public Health, which has a $3 billion annual budget, agency officials were tasked with slashing $100 million in potential costs.



While the department fell short of that goal—identifying $85 million in potential cuts—the city appears to be acknowledging that the ongoing pandemic is not as dire as some expected. Covid operations are a primary target for rollbacks, according to <a href="https://www.documentcloud.org/documents/23781371-dph-budget-memo" target="_blank" rel="noreferrer noopener">a memo going before the SF Health Commission</a> on Tuesday.



Jenny Louie, chief financial officer for the health department, proposed scaling down the budget for San Francisco’s Covid response from $57.5 million to $18.1 million in the 2023-24 fiscal year, which starts July 1. While the Department of Public Health’s previous budgets called for $25 million annually in ongoing Covid funding, the proposed cuts would reduce testing operations and eliminate unfilled positions.



In total, health officials identified 15 positions as superfluous and said that eliminating some temporary staffing could save $2.4 million. The department expects to save $7.5 million through the “liquidation of prior year contracted services and underspending in salary and fringe costs due to lower-than-expected hiring,” Louie wrote.



Louie also noted in her memo that interest accrued from the San Francisco City Option—an $850 million health care plan for employees—can be applied as cost savings thanks to in-house management of the plan that started in the fall of 2022. The health department said that using the City Treasury to administer the fund will save $20 million next fiscal year and $10 million annually going forward.



Health officials said they weren’t certain they had authority to use those funds until a recent review with the Controller’s Office.



Louie acknowledged in her memo that the Department of Public Health usually has around $4 million in unspent funds each year. The agency is now offering to give up $4.5 million this coming fiscal year and $4 million in 2024-25 “to recognize savings we usually realize at year-end and forestall service reductions.”



San Francisco <a href="https://develop.sfstandard.com/public-health/san-francisco-to-end-covid-emergency-declaration/">called off its pandemic public health emergency</a> at the end of February. While infections are still common, life has returned to pre-Covid routines for many people. The result has been a massive drop in residents seeking Covid tests.



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2500" height="1667" src="https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-2500x1667.jpg" alt="" class="wp-image-30163" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-2500x1667.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-1536x1024.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-2048x1365.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-650x433.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-800x533.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-740x493.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-900x600.jpg 900w, https://content-develop.sfstandard.com/wp-content/uploads/2022/01/color-07-3-72x48.jpg 72w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">A Covid testing site in San Francisco. | Sophie Bearman</figcaption></figure>



The Department of Public Health’s testing sites administered nearly 135,000 tests in the first quarter of 2022, but that amount dropped to fewer than 11,000 for the first three months of this year.



“This represents usage of less than 10% of current capacity, even as some of the larger sites have closed as part of the planned step-down of the program,” Louie said in her memo. “Most sites do not administer the minimum of 40 tests per day that is required to make the sites cost-effective, resulting in an untenably high cost per unit of service.”



The Department of Public Health identified other savings by closing out projects that will release funds, shifting contracts and tapping into reserves from the Mental Health Services Act, which taxes California residents who earn an income above $1 million.



However, the Department of Public Health fell $15 million short of meeting its new goal of $100 million in proposed cost savings over two years.



“Given the size of the target and the extremely short deadlines, staff were unable to identify proposals to meet the entire amount,” Louie writes in her memo. “We will continue to work with the Mayor’s Office and inform the commission if additional proposals are required.”



Mayor Breed’s office did not say whether her office received revised budget projections from each city department, but she is scheduled to introduce her finalized budget at the beginning of June.



“We are currently working with all of our departments to address our deficit,” said Jeff Cretan, the mayor’s spokesperson. “These are ongoing conversations with budget staff and will vary by departments, as will the avenues they take to reduce the funding they use from the general fund.”

Supervisors to kickstart dialogue on city’s reparations plan

The Board of Supervisors will hear a progress report on Laguna Honda Hospital’s rocky road to recertification Tuesday, as well as pass resolutions related to gun violence in the wake of <a href="https://develop.sfstandard.com/research-data/california-mass-shooting-deaths-incidents-trend-data/">several deadly mass shootings in the state</a>.&nbsp;



The supervisors will also schedule a hearing on the city’s African American reparations plan. As usual, wonks can find the whole kit and caboodle in this week’s <a href="https://sfbos.org/sites/default/files/bag013123_agenda.pdf" target="_blank" rel="noreferrer noopener">agenda</a>.



<h2 class="wp-block-heading" id="h-more-on-committees">More on Committees</h2>



Board President Aaron Peskin announced the <a href="https://sfbos.org/sites/default/files/Press_Release-New_Board_Of_Supervisors_Welcomes_New_Year_With_Committee_Assignments_Highlighting_Shared_Priorities.pdf" target="_blank" rel="noreferrer noopener">new makeup of board committees</a> during roll call last week, and the news here is both old and new. 



Under the new assignments, <a href="https://develop.sfstandard.com/politics/housing-tensions-simmer-as-supervisors-shift-focus-to-police-staffing-overdose-crisis/">moderates now dominate the Public Safety and Neighborhood Services Committee and will lead the Rules Committee</a>. Others remain mostly unchanged; and there will be a new committee addressing homelessness.&nbsp;



Notably, the Land Use and Transportation Committee is the same as last year, with Supervisor Myrna Melgar serving as chair alongside Peskin and Supervisor Dean Preston. Peskin also created a new Select Committee on Homelessness and Behavioral Health, with former budget chair Hillary Ronen at the helm and other members yet to be announced.&nbsp;



So far, freshman Supervisor Joel Engardio has been assigned to the Youth, Young Adult and Families Committee, and to the Public Safety and Neighborhood Services Committee, where he serves as vice chair.&nbsp;



As reported last week, the new committee assignments are effective Feb. 1.



<h2 class="wp-block-heading" id="h-resignation-gate-law-hits-rules">&#8216;Resignation-gate&#8217; Law Hits Rules</h2>



Meanwhile, the outgoing Rules Committee will review Preston’s legislation banning the practice of requiring commission appointees from signing predated resignation letters.



Preston introduced the bill in December in response to the “Resignation-gate” fracas <a href="https://develop.sfstandard.com/politics/whats-really-behind-the-mayors-spat-with-her-appointee-influence-over-sfpds-future-leadership/">uncovered by The Standard last fall</a>, where Mayor London Breed’s administration <a href="https://develop.sfstandard.com/politics/mayor-breed-resignation-letter-meena-kamala-harris/">had required nearly 50 commissioners</a> to sign undated letters of resignation. 



At <a href="https://develop.sfstandard.com/politics/supervisors-grill-mayor-breeds-chief-of-staff-for-answers-on-undated-resignation-letters/">a hearing last October</a>, Breed’s Chief of Staff Sean Elsbernd testified that the letters were requested from appointees “based on a subjective standard,” and as a backstop against misconduct or abandonment of duty.  City Attorney David Chiu determined that the practice was “inconsistent” with the City Charter, and Breed pledged to end the practice. 



If the new law passes muster at the committee, it will go on to the full board later in February.&nbsp;



This will be the last meeting of the Rules Committee under hair Peskin.



Supervisor Matt Dorsey, an ally of Breed, will chair the new Rules Committee along with fellow members Supervisors Shamann Walton and Ahsha Safaí. 



<h2 class="wp-block-heading" id="h-laguna-honda-progress-report">Laguna Honda Progress Report&nbsp;</h2>



The board will hold a special hearing on the recertification process at Laguna Honda Hospital on Tuesday.



Laguna Honda, the nation’s largest skilled nursing facility, <a href="https://develop.sfstandard.com/public-health/feds-cut-funding-to-laguna-honda-hospital-putting-future-in-doubt/">was decertified last April</a> by the Centers for Medicare and Medicaid Services (CMS) over alleged drug-related contraband and infection-control issues, among other other deficiencies in care. 



CMS ordered the hospital to close and discharge its patients, but after community outcry over the deaths of several transferred patients and threats of litigation, <a href="https://develop.sfstandard.com/politics/supes-roundup-next-steps-on-laguna-honda-and-more-scrutiny-for-commissioners-contractors/">it came to a settlement with the city</a> to allow the hospital to stay open for current patients at least until Feb. 2, when the status of the hospital will be reevaluated. 



The Department of Public Health submitted an action plan to CMS on Jan. 6 that included a significant number of proposed changes in care policy, which were under review at the Health Commission last week.&nbsp;



<h2 class="wp-block-heading" id="h-speaking-out-against-gun-violence">Speaking Out Against Gun Violence</h2>



Supervisors are also expected to pass resolutions urging a federal assault weapons ban as well as recognizing the first seven days of February as National Gun Violence Survivors Week. Supervisor Catherine Stefani, a longtime gun control advocate, introduced the resolutions in an emotional speech at last week’s board meeting.&nbsp;



California has experienced a Cruel January of gun violence, with six mass shootings so far, the most recent happening <a href="https://abcnews.go.com/US/6th-mass-shooting-13-days-rocks-california/story?id=96749605" target="_blank" rel="noreferrer noopener">Saturday in Beverly Crest</a>. Stefani’s speech reflected reactions to recent mass-casualty event shootings affecting the Asian community in Monterey Park and <a href="https://develop.sfstandard.com/politics/gavin-newsom-republicans-mass-shootings-america/">Half Moon Bay</a>.



California has among the strictest gun laws in the country, and more are coming: East Bay state Sen. Nancy Skinner co-sponsored a bill to <a href="https://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=202320240SB8" target="_blank" rel="noreferrer noopener">require gun owners to buy liability insurance</a>. Meanwhile, U.S. Sen. Alex Padilla urged stronger action on guns in Congress. 



<figure class="wp-block-embed is-type-rich is-provider-twitter wp-block-embed-twitter"><div class="wp-block-embed__wrapper">
<blockquote class="twitter-tweet" data-width="500" data-dnt="true">To everyone out there who is calling on Congress to take more action to curb gun violence, let me be clear: it is Republicans who continue to prioritize the profits of gun manufacturers over the lives of people. <a href="https://t.co/YIwBbdTiWd">https://t.co/YIwBbdTiWd</a>&mdash; Alex Padilla (@AlexPadilla4CA) <a href="https://twitter.com/AlexPadilla4CA/status/1619161909915443202?ref_src=twsrc%5Etfw">January 28, 2023</a></blockquote><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
</div></figure>



<h2 class="wp-block-heading" id="h-reviewing-reparations">Reviewing Reparations</h2>



The board is also set to pass a motion to hold a hearing next week on the city’s draft African American Reparations Plan, which has garnered national attention. 



The <a href="https://sf.gov/sites/default/files/2023-01/HRC%20Reparations%20Report.pdf" target="_blank" rel="noreferrer noopener">draft plan</a> includes, among other possible recommendations, giving Black residents of San Francisco who meet specific tenure criteria a one-time payment of $5 million to compensate for protracted “economic and opportunity losses.” The draft drew outrage in the <a href="https://www.foxnews.com/politics/larry-elder-takes-aim-san-frans-5-million-reparations-plan-when-do-we-stop" target="_blank" rel="noreferrer noopener">national conservative press</a>, and a hearing will kickstart the conversation locally on what it may ultimately amount to. 



Walton sponsored the legislation that led to the draft plan, and it passed the board in December 2020.

Supervisors mull preferences for women, minorities, veterans in city contracts

The San Francisco Board of Supervisors is taking much of this short week off, with no general meeting and many committee meetings canceled. However, other committees and commissions are taking up potentially sensitive matters ranging from equity in city contracts to long-troubled Laguna Honda Hospital. 



And with a <a href="https://develop.sfstandard.com/politics/in-shock-vote-peskin-elected-board-president-after-17-ballots/">newly elected board president</a> bringing fresh committee assignments soon, this relatively quiet week could be the calm before the storm. 



<h2 class="wp-block-heading" id="h-equity-in-contracting">Equity in Contracting</h2>



The Government Audit and Oversight Committee <a href="https://sfbos.org/sites/default/files/gao011923_agenda.pdf">meets Thursday</a> to consider <a href="http://sfgov.legistar.com/gateway.aspx?m=l&amp;id=39401">a resolution</a> asking the City Administrator&#8217;s Office to conduct a disparity study on San Francisco’s Local Business Enterprise (LBE) contracting program. 



That <a href="https://sf.gov/14b-local-business-enterprise-lbe-program">program</a>, which offers a leg up in the contracting process to local small businesses, supplanted minority-owned business programs after the passage of Proposition 209 in 1996, which banned affirmative-action contracting. 



“With the results of this study, I think that we, the mayor and our city departments will be better equipped to live up to our values and craft public policy that elevates women- minority- and veteran-owned small businesses,” said Supervisor Myrna Melgar when she introduced the resolution on Nov. 29. 



A <a href="https://equaljusticesociety.org/wp-content/uploads/2019/10/ejs-impact-prop-209-mwbes.pdf">2015 study</a> by the nonprofit <a href="https://equaljusticesociety.org/aboutus/">Equal Justice Society</a> found that minority- and women-owned businesses lost about $200 million a year in contracts in San Francisco since passage of Prop. 209.&nbsp;



A <a href="https://sfgov.org/cmd/sites/default/files/FY19-20%20Annual%20Report.pdf">2020 report</a> from the city’s contract monitoring division reported over 1400 participating businesses, 35% of which were minority-owned and 25% were women-owned.&nbsp;



In 2021, <a href="https://www.sandiegouniontribune.com/news/politics/story/2021-07-19/study-says-women-minorities-dont-get-their-fair-share-of-billions-in-san-diego-city-contracts">San Diego</a> completed a disparity study of its own programs that revealed businesses owned by women and/or minorities received only 19% of city contracts versus 31% demographic representation.



Last July, the San Diego City Council <a href="https://www.sandiegouniontribune.com/news/politics/story/2022-07-20/city-contracts-diversity-prop-209">voted unanimously</a> to seek “legally defensible policies” that provide preferences to women- and minority-owned businesses for contracting, despite warnings that they could run afoul of Prop. 209.&nbsp;



“Even though Prop. 209 ties our hands, we can certainly ask the question,” Melgar said.&nbsp;



<h2 class="wp-block-heading" id="h-laguna-honda-hearing-coming">Laguna Honda Hearing Coming</h2>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" width="2500" height="1667" src="https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-2500x1667.jpg" alt="" class="wp-image-50379" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-2500x1667.jpg 2500w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-300x200.jpg 300w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-768x512.jpg 768w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-1536x1024.jpg 1536w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-2048x1365.jpg 2048w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-650x433.jpg 650w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-370x247.jpg 370w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-800x533.jpg 800w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-450x300.jpg 450w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-20x13.jpg 20w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-185x123.jpg 185w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-740x493.jpg 740w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-400x267.jpg 400w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-1600x1067.jpg 1600w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-225x150.jpg 225w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-900x600.jpg 900w, https://content-develop.sfstandard.com/wp-content/uploads/2022/05/LagunaHondaEvictions-13-72x48.jpg 72w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Laguna Honda Hospital patients, residents and staff walk through the hospital and treatment center’s grounds in San Francisco. | Camille Cohen/The Standard</figcaption></figure>



At the board’s last full meeting on Jan. 10,&nbsp; Melgar requested a hearing on the status of Laguna Honda Hospital now set for Jan. 31. Supervisors <a href="https://develop.sfstandard.com/politics/supes-roundup-next-steps-on-laguna-honda-and-more-scrutiny-for-commissioners-contractors/">approved a settlement</a> with federal agencies that agreed to conditions for the recertification of the troubled facility on Nov. 1.&nbsp;



Laguna Honda <a href="https://develop.sfstandard.com/public-health/feds-cut-funding-to-laguna-honda-hospital-putting-future-in-doubt/">was decertified last April</a> by the Centers for Medicare and Medicaid Services (CMS) over what it identified as deficiencies in care, including drug-related contraband and infection-control issues. 



The upcoming hearing would be the last update the board receives before CMS decides whether to extend the current suspension on involuntary discharges and transfers of patients on Feb. 2.&nbsp;



Under the settlement, the facility continues to get federal Medicare and Medicaid funding until Nov. 23.



On Tuesday, the <a href="https://sf.gov/meeting/january-17-2023/january-17-2023-health-commission-meeting">Health Commission</a> will also hear a status update on the situation at Laguna Honda—and will likely approve <a href="https://sf.gov/sites/default/files/2023-01/Policy%20and%20Procedures%20for%20JCC%2012.13.22%20%281%29.pdf">a laundry list</a> of over 80 changes in care policies for the facility.&nbsp;



“As part of the Medicare and Medicaid recertification effort and in close collaboration with regulators, Laguna Honda has reviewed policies and procedures to ensure they meet best practices and current regulations, modifying where necessary,” said the Department of Public Health in a statement.&nbsp;



The health department submitted an action plan to CMS on Jan. 6 that included the proposed changes in care policy.  



<h2 class="wp-block-heading" id="h-final-act-of-elections-commission-drama">Final Act of Elections Commission Drama?&nbsp;</h2>



<figure class="wp-block-image size-full"><img loading="lazy" decoding="async" width="2000" height="1333" src="https://content-develop.sfstandard.com/wp-content/uploads/2022/12/FEATURED_ArntzFolo12052022.jpg" alt="" class="wp-image-100262" srcset="https://content-develop.sfstandard.com/wp-content/uploads/2022/12/FEATURED_ArntzFolo12052022.jpg 2000w, https://content-develop.sfstandard.com/wp-content/uploads/2022/12/FEATURED_ArntzFolo12052022.jpg?resize=300,200 300w, https://content-develop.sfstandard.com/wp-content/uploads/2022/12/FEATURED_ArntzFolo12052022.jpg?resize=768,512 768w, https://content-develop.sfstandard.com/wp-content/uploads/2022/12/FEATURED_ArntzFolo12052022.jpg?resize=1536,1024 1536w" sizes="auto, (max-width: 2000px) 100vw, 2000px" /><figcaption class="wp-element-caption">John Arntz, the director of San Francisco&#8217;s Department of Elections, saw his job status go into limbo after the Elections Commission voted last month to conduct a nationwide search. | Courtesy ABC7</figcaption></figure>



Depending on what happens this week, supervisors may finally be able to put the controversy over San Francisco’s Director of Elections to bed.



The Elections Commission meets Wednesday evening, and will likely reverse their much-maligned decision to fire Director of Elections John Arntz. The move <a href="https://develop.sfstandard.com/politics/messy-drama-san-francisco-elections-director-open-source-voting/">had been widely condemned by all political camps</a> in the city.&nbsp;



The decision not to renew Arntz’ contract was ostensibly based on equity concerns, with commissioners saying they wanted to open the job up to more diverse candidates. However, the real reason may have been animus toward Arntz, who has been in the role for 20 years, <a href="https://develop.sfstandard.com/politics/messy-drama-san-francisco-elections-director-open-source-voting/">over certain policy decisions</a>. Moreover, Arntz’ department was found in surveys <a href="https://develop.sfstandard.com/politics/elections-panel-falsely-claims-high-ground-in-racial-diversity-spat/">to be an equity leader</a> in hiring, worker retention and other areas. 



Supervisor Aaron Peskin, who has <a href="https://develop.sfstandard.com/politics/in-shock-vote-peskin-elected-board-presi...

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Abatement Appeals Board Commissioner 6

Abatement Appeals Board Commissioner 7

The Access Appeals Commission provides final reviews for a wide range of City permitting decisions. It ensures an efficient, fair, and expeditious permit issuance process through an impartial panel. The commission holds authority to make binding decisions on appeals related to City permits.

Access Appeals Commission

Access Appeals Commission Commissioner 1

Access Appeals Commission Commissioner 2

Access Appeals Commission Commissioner 3

Access Appeals Commission Commissioner 4

Access Appeals Commission Commissioner 5

The Adult Day Health Care Planning Council advises on the development and improvement of adult day health care services. It provides expertise in healthcare planning, policy recommendations, and program evaluation. Key responsibilities include assessing community needs and advising on service delivery enhancements.

Adult Day Health Care Planning Council

Adult Probation Department supervises individuals on probation and facilitates their reintegration into the community. It provides reentry and rehabilitative services, including victim restitution and financial assistance for crime victims. The department values public safety, offender rehabilitation, and community partnerships.

Cristel Tullock

The Advisory Committee of Street Artists and Crafts Examiners evaluates arts and crafts applicants and monitors program compliance. It conducts studio visits and public screenings to ensure adherence to established criteria. Members also revise program criteria and undertake additional tasks as needed.

Advisory Committee of Street Artists and Crafts Examiners

The Advisory Council on Human Rights advises on anti-discrimination laws and racial equity initiatives. It provides expertise on reparations and public policy impacts on Black communities. It guides efforts to establish partnerships with Historically Black Colleges and Universities in San Francisco.

Advisory Council on Human Rights

San Francisco Airport manages air traffic operations and ensures safe aircraft movement. It provides parking facilities and maintains airport infrastructure to accommodate travelers and staff. The department oversees ground transportation and coordinates with airlines for efficient passenger services.

Mike Nakornkhet

The Airport Commission oversees policy and strategic planning for San Francisco International Airport. It makes key decisions on airport development projects and financial management. It ensures compliance with regulations and collaborates on initiatives like terminal naming.

Airport Commission

Airport Commission Commissioner 1

Malcolm Yeung

Jose F. Almanza

Mark Buell

Susan Leal

Airport Director

Animal Care and Control Department manages animal sheltering, adoption, and emergency response services. It enforces animal-related laws and regulations, ensuring the humane treatment and safety of animals. The department also provides public education on responsible pet ownership and animal welfare.

Animal Care and Control Department

Virginia Donohue

Animal Care and Control Department, Director

The San Francisco Arts Commission oversees the integration of arts into city life and ensures public access to cultural experiences. It makes decisions on public art programs and allocates grants to support local artists and performances. The commission actively shapes policies affecting the arts ecosystem in San Francisco.

Arts Commission Commissioner 1

Arts Commission Commissioner 2

Arts Commission Commissioner 3

Arts Commission Commissioner 4

Debra Walker

Suzanne Ferras

Jessica Rothschild

Seth Brenzel

JD Beltran

Marcus Shelby

J Riccardo Benavides

Nabiel Musleh

Charles (Chuck) Collins

Lydia So

Arts Commission Commissioner 15

San Francisco Arts Commission invests in a vibrant arts community and shapes cultural policy. It enlivens the urban environment through public art programs and supports diverse artistic expressions. The commission facilitates meetings and discussions to engage the community in cultural development.

Ralph Remington

Arts Commission, Director of Cultural Affairs

The Asian Art Commission determines policy and administers the Asian Art Museum of San Francisco. It oversees museum operations and collaborates with the Asian Art Museum Foundation on fundraising efforts. Commissioners ensure the museum's strategic direction and financial sustainability.

Asian Art Commission

Asian Art Commission Commissioner 1

Asian Art Commission Commissioner 2

Asian Art Commission Commissioner 3

Asian Art Commission Commissioner 4

Asian Art Commission Commissioner 5

Asian Art Commission Commissioner 6

Asian Art Commission Commissioner 7

Asian Art Commission Commissioner 8

Asian Art Commission Commissioner 9

Asian Art Commission Commissioner 10

Asian Art Commission Commissioner 11

Asian Art Commission Commissioner 12

Asian Art Commission Commissioner 13

Asian Art Commission Commissioner 14

Asian Art Commission Commissioner 15

Asian Art Commission Commissioner 16

Asian Art Commission Commissioner 17

Asian Art Commission Commissioner 18

Asian Art Commission Commissioner 19

Asian Art Commission Commissioner 20

Asian Art Commission Commissioner 21

Asian Art Commission Commissioner 22

Asian Art Commission Commissioner 23

Asian Art Commission Commissioner 24

Asian Art Commission Commissioner 25

Asian Art Commission Commissioner 26

Asian Art Commission Commissioner 27

Asian Art Museum showcases Asian art and culture through exhibitions and educational programs. It offers diverse collections and hosts special events to engage the community. The museum fosters cultural appreciation and understanding by providing access to its extensive art collections.

Dr. Soyoung Lee

Asian Art Museum, Director

The Assessment Appeals Board #1 hears property tax assessment appeals in San Francisco. It evaluates evidence presented by taxpayers and the Assessor to determine property values. The Board has the authority to make final decisions on assessments regardless of property type or value.

Assessment Appeals Board #1

Assessment Appeals Board #1 Commissioner 1

Assessment Appeals Board #1 Commissioner 2

Richard Lee

Stephen Wasserman

Adena Gilbert

Paul Bellar

Quirina Mitchell

Hilary Winslow

The Assessment Appeals Board #2 adjudicates property tax assessment appeals for San Francisco taxpayers. It evaluates evidence presented by taxpayers and the Assessor to determine accurate property values. The Board exercises authority to render final decisions on residential properties and specific real estate assessments.

Assessment Appeals Board #2

Assessment Appeals Board #2 Commissioner 1

Assessment Appeals Board #2 Commissioner 2

Assessment Appeals Board #2 Commissioner 3

Claire Ervin Lee

Louisa Mendoza

Joyce Lewis

Nicholas Goldman

Michelle Domingo

The Assessment Appeals Board #3 provides a platform for San Francisco taxpayers to contest property tax assessments. It conducts hearings where evidence from both taxpayers and the Assessor is evaluated. The Board makes binding decisions on property assessments based on presented evidence.