A healthy compromise
Ballot measures are San Francisco’s favorite substitute for responsible policymaking. Rather than hash out differences and come to a consensus, the city’s politicians are all too quick to go to the initiative process and force voters to do their jobs for them.
The city’s response to the mental illness crisis on its streets was headed in that direction until this week, with Supervisors Hillary Ronen and Matt Haney preparing for a ballot battle with Mayor London Breed. By reaching a compromise instead, both camps did a service for the voters and, let’s hope, the San Franciscans who need help.
The outlines of the program introduced Tuesday strike a healthy balance between the supervisors’ ambition and the mayor’s pragmatism. While the supervisors initially proposed pieinthesky universal care even for the privately insured, they narrowed their focus to the crisis at hand. The compromise reflects that shift and the mayor’s preference for prioritizing treatment of the estimated 4,000 homeless people suffering from mental illness and drug and alcohol addiction.
Breed proposes funding about $100 million in annual operating costs by adjusting existing business taxes instead of introducing a new one favored by Ronen and Haney. The mayor is also seeking a bond measure next fall to fund onetime capital costs, including a renovation of existing facilities in place of the new construction the supervisors proposed.
The compromise realizes the supervisors’ push for a new program with new bureaucracies: an Office of Coordinated Care to ensure that patients aren’t pointlessly bouncing in and out of treatment and an Office of Insurance Accountability to advocate for insured patients who aren’t getting adequate care.
Any familiarity with San Francisco’s street scene supports Ronen’s contention that the city needs “big, bold, systemic change” in its approach to mental health — along with the housing shortage that, though most supervisors are loath to acknowledge it, leaves more and more vulnerable people without shelter. The mayor, meanwhile, was right — and, as the city’s chief executive, had the right — to insist that public resources support the most needy. With another Breed rival just elected to the board, this should serve as a model for resolving the inevitable differences ahead.