Targeted outreach and consistent care will provide San Franciscans in need of behavioral health services with a far more robust and proactive support system so they can avoid a cycle of crisis
SAN FRANCISCO — Mayor London N. Breed and the San Francisco Department of Public Health (SFDPH) on Friday, May 6 announced the opening of the Office of Coordinated Care (OCC) as part of the unprecedented expansion of mental health and substance use services in San Francisco.
A key component of the 2019 Mental Health SF legislation, the OCC assigns case managers to people who are disconnected from behavioral health services, or who are making transitions in care from one setting to another. Case managers proactively support people to successfully access and remain in care so they can avoid falling back into a cycle of crisis. Previously, people had little follow-up care and experienced fragmented, or insufficient support and many times lacked a clear pathway to entering the behavioral health system. Mayor Breed worked in partnership with Supervisor Hillary Ronen and then-Supervisor Matt Haney to craft the Mental Health SF legislation.
The launch of the OCC is part of an expansion of behavioral health resources in process over the last year, including the addition of 400 mental health and substance use treatment beds and the deployment of the Street Crisis Response Team, which responds to calls for emergency services for those struggling with mental illness and addiction. This is all part of San Francisco’s strategy, including the Mayor’s Homelessness Recovery Plan, to provide services for those in need and improve the conditions on the streets.
“We are working to fix a system that simply has not worked well for so many of those we see struggling in our city every day,” said Mayor Breed. “This requires both new resources but also reforming how we deliver services around mental health and substance use disorders. We want people to get the consistent support they need to heal and thrive, not to endlessly cycle through the emergency room, jail, or the streets. The Office of Coordinated Care will help get us on a better path.”
Although the San Francisco Department of Public Health (SFDPH) has been developing the OCC for more than a year through pandemic-related delays, it was the Emergency Declaration in the Tenderloin in December that provided the expedited hiring path needed to complete the staffing required to launch the OCC. The inaugural Director of the OCC, Heather Weisbrod, has been a SFDPH employee for 16 years and most recently served as the Director of Transitional Aged Youth (TAY) System of Care. She now leads a team of 20 staff members that will expand to 40 by this summer. OCC staff include behavioral health clinicians, registered nurses, health workers, and peer specialists with lived experience with mental health and/or substance use disorders.
When fully expanded, the OCC expects to manage the cases of 4,000 individuals annually who have mental health and/or substance use disorders, and who have been historically underserved by the healthcare system because of trauma, homelessness, racism, and other social determinants of health.
“The Office of Coordinated Care is a central part of our efforts to make our care and services user-friendly, low barrier, and culturally congruent,” said Director of Health, Dr. Grant Colfax. “The OCC will make sure that the process of entering care and treatment is supportive of the person, rather than an impediment to their progress.”
The OCC will follow clients transitioning between systems of care, including those leaving jail, Zuckerberg San Francisco General Hospital’s Psychiatric Emergency Services (PES), and the hospital’s emergency department. These transitions are a time of vulnerability, and the OCC ensures clients stay engaged with the health care system, including accompanying clients to appointments when needed rather than simply making a referral. The OCC’s efforts can improve health equity by lowering the barriers to care and by utilizing a diverse staff who have language capacity and are reflective of communities in San Francisco.
Additionally, the OCC will carefully follow people who receive 5150s, an involuntary hold due to a mental health challenge, so that it can scale interventions as needed. This could include in-person outreach if the person is not connecting to care. And the OCC supports incoming calls to the City’s 24/7 Behavioral Health Access Line where people can call for information on accessing care (415-255-3737 or 888-246-3333). In addition to case management and behavioral health access programs, the OCC will also provide enrollment services and connect uninsured San Franciscans to Medi-Cal and Healthy SF.
“Although we have some of the best mental health and substance use programs in the nation, you would not know it because of the chaos you see on the streets every day. Finally, with the launch of the Office of Coordinated Care, we will see the level of coordination between programs which has the been the missing link in our broken system of care. I am excited and hopeful these changes will bring relief to so many critically ill people in our city and bring change to our unacceptable street conditions that we are all desperate to see,” said Supervisor Hillary Ronen.
Opening the OCC has been a multi-phase effort beginning with a pilot that launched in April 2021 to provide follow-up case management for individuals seen by the Street Crisis Response Team (SCRT). In March 2022, the OCC team was actively working with 72 individuals identified through a SCRT crisis contact to support and connect them to ongoing care.
SFDPH is also expanding its most intensive case management support for the people who are already within the system of care and have the most complex needs. More than 100 individuals are currently on a wait list for the Intensive Care Management program and need additional supports or risk falling out of care. Expansion of that case management program is in process, and in coordination with the OCC will stitch together an effective network of case managers for people at all stages of care.
Mental Health SF is focused on serving people experiencing homelessness. For more information on Mental Health SF, go to: sf.gov/information/mental-health-sf. (SF Mayor’s Office Release)