Dear sf.citi Members,
I am writing to you today with updates regarding the CEO Tax. As you likely heard, yesterday, Supervisors Ronen and Haney introduced the anticipated CEO Tax, supported by Supervisors Walton, Mar, and Brown. As anticipated, this tax would be a 0.1% surcharge on companies that have an Executive Pay Ratio of 100:1 or more, which is defined by if a company’s highest paid employee earns 100x more than the median compensation paid to employees based in San Francisco. This would be an additional gross receipts tax in the amount of 0.1%. Further, as reported on previously, if the highest paid employee earns 200x the median employee’s pay, the tax would be at 0.2%, and so on. Intended for the November ballot, this legislation would need a 2/3 majority vote as the resources would be specifically directed for an expansion of mental health services in San Francisco.
As reported on previously, the CEO tax will be the primary mechanism to fund the Mental Health SF program, which has also been proposed for the November ballot and will require 50+1 percent of voter support. If the Mental Health SF ordinance passes without the CEO Tax passing, the program will be implemented on a significantly smaller scale without its primary revenue tool. Alternatively, though it would be unlikely, if the CEO Tax passes without the Mental Health SF ordinance passing, the tax will be implemented and funds will be directed to general mental health service funding.
Prior to introducing the legislation, sf.citi and other advocacy organizations held a meeting with Supervisors Ronen and Haney to discuss and collaborate on this issue. Additionally, we met again today with Supervisor Haney. We look forward to collaborating with both Supervisors Haney and Ronen to suggest amendments where needed, if at all, and will keep you up to date with information as it comes our way. I have attached the legislation and highlights for both measures for your review.
Please provide any feedback, questions, or thoughts on the legislation below. As requested by their office, we will be sharing this feedback with Supervisor Haney’s team, as we work through this legislation and continue this conversation.
Thank you for your continued membership and support. Enjoy the warm weather.
Jen
– –
[Initiative Ordinance – Administrative Code – Mental Health SF]
Ordinance amending the Administrative Code to establish Mental Health SF, a universal mental health program designed to provide access to mental health services, substance use treatment, and psychiatric medications to all San Franciscans; and to establish the Mental Health SF Implementation Working Group to advise the Mental Health Board, the Department of Public Health, the Health Commission, the San Francisco Health Authority, and the Board of Supervisors on the design and implementation of Mental Health SF.
The proposed ordinance also would require that the City expand the following services to meet need: case management, intensive case management, residential treatment, respite care, detoxification services, PES beds and other secure placement options for individuals who are a danger to themselves or others, long-term housing.
Mental Health SF would serve two populations:
Core Patients – who are individuals who: lack health insurance; are enrolled in Healthy San Francisco; are enrolled in a Medi-Cal managed care plan and receive mental health services from the Department’s Community Behavioral Health Services under California’s Medi-Cal Specialty Mental Health Services Waiver; or are released from the County jail, prior to their enrollment in Medi-Cal; and
Bridge Patients – who are individuals who have health insurance, except for those individuals who are enrolled in a Medi-Cal managed care plan and receive behavioral health services from the Department’s Community Behavioral Health Services under California’s Medi-Cal Specialty Mental Health Services Waiver.
The design and implementation of Mental Health SF would be guided by the following governing principles:
Low-barrier;
Services first;
Customer service;
Harm reduction;
Integrated services;
Coordinated services;
Cultural competency; and
Treatment on demand.
Mental Health SF would operate a Mental Health Service Center that would serve as a centralized hub for Core Patients and Bridge Patients who seek access to voluntary services and medications.
The Mental Health Service Center would be a physical location near other City-funded services, and would be open seven days per week, 24 hours per day.
It would be adequately staffed to ensure that wait times do not exceed three hours.
Staffing would include, at a minimum, nurse practitioners, psychiatrists, and peer counselors.
The Mental Health Service Center would offer triage, psychiatric assessment and treatment, 24-hour pharmacy services, psychosocial assessment and services, crisis stabilization, transportation to services that are located in other buildings, and a team to conduct outreach to individuals in crisis on the streets.
The proposed ordinance would also require Mental Health SF to operate an Office of Coordinated Care to oversee the seamless delivery of mental health care and substance use services across the City’s behavioral health systems, and to ensure that Mental Health SF is accountable and proactive in how it delivers care. The Office of Coordinated Care would be responsible for:
Conducting and maintaining an up-to-date inventory of available space in all City-operated and City-funded mental health and substance use programs;
Ensuring a continuum of care for all consumers in San Francisco’s City-funded and City-operated programs by providing and supervising case managers who are responsible for monitoring compliance with individual treatment plans and identifying appropriate housing placements, as needed, with the goal of securing long term permanent housing;
Coordinating the care of patients who are exiting the County Jail system or General Hospital’s Psychiatric Emergency Services (“PES”) unit;
Tracking and evaluating a variety of data to examine the effectiveness of Mental Health SF; and
Producing bi-annual reports to the Board of Supervisors on all tracked data, and on the extent to which Mental Health SF has operated in compliance with its governing principles.
The ordinance would provide that a Mental Health Service Emergency shall exist when two of the following three conditions exist at the same time:
the Department’s PES unit is under diversion for at least two days for three consecutive weeks;
the wait time for placement in a transitional residential treatment program exceeds two weeks;
the wait time for assignment to intensive case management services exceeds two weeks.
After confirming that a Mental Health Service Emergency exists, the ordinance would require DPH to notify the Health Commission, the Board of Supervisors, and the Mayor of such emergency in writing. Upon receipt of the notice of Mental Health Service Emergency, the Health Commission would be required to schedule a hearing on the Mental Health Service Emergency.
Lastly, the proposed ordinance would establish the Mental Health SF Implementation Working Group (“Implementation Working Group”), which would be charged with advising the Mental Health Board, or any successor agency, the Health Commission, the Department of Public Health, and the Board of Supervisors on the design and implementation of Mental Health SF. The Implementation Working Group may also advise the San Francisco Health Authority on Mental Health SF.
The Implementation Working Group would consist of eleven members appointed by the Board of Supervisors. Members would serve two-year terms, except that the term of the initial appointees in seats 1, 3, 5, 7, and 9 would be one year. Appointees would have the following qualifications:
Seat 1 would be held by a person with expertise working on behalf of healthcare workers.
Seats 2 and 3 would each be held by a person who identifies as having a mental health condition or identifies as having a mental health condition and substance use condition (“dual diagnosis”), and who has accessed mental health or substance use services in San Francisco.
Seat 4 would be held by a person who identifies as having a substance use condition or a dual diagnosis, and who has accessed mental health or substance use services in San Francisco.
Seat 5 would be held by a person with expertise in substance use treatment and harm reduction.
Seat 6 would be held by a psychiatrist with experience working with vulnerable communities.
Seat 7 would be held by a behavioral health professional with expertise providing services to transitional age youth in San Francisco.
Seat 8 would be held by a person with experience in the management or operation of residential treatment programs.
Seat 9 would be held by a medical professional with expertise in working with dually diagnosed persons.
Seat 10 would be held by a person with experience providing supportive housing in San Francisco.
Seat 11 would be held by a person with experience in health systems or hospital administration.
The Implementation Working Group would terminate on March 1, 2026, unless the Board of Supervisors extends its term by ordinance.
[Disproportionate Executive Pay Tax]
Disproportionate Executive Pay Tax – Sponsors: Supervisor Ronen, Supervisor Haney
Amending the Business and Tax code by adding “Article 33: Mental Health Gross Receipts Tax” (MHGRT) Ordinance
Article 33 shall be known as the “MHGRT Ordinance” and shall impose the “MHGRT” – an additional gross receipts tax on businesses with a ratio of the compensation of the business’s highest-paid employee to the median compensation paid to the business’s employees based in the City that exceeds 100:1, to fund mental health services; and increasing the City’s appropriations limit by the amount collected under the additional tax for four years from November 5. 2019.
Beginning on or after January 1, 2021, the City will impose an annual MHGRT on any person doing business in San Francisco if the Executive Pay Ratio for the tax year exceeds 100:1.
Definition of Executive Pay Ratio: The ratio of the annual Compensation of the person or combined group’s Highest-Paid Employee for a tax year to the median Compensation paid to the person or combined group’s full-time and part-time employees based in the City for that tax year. An employee is based in the City for a tax year if the number of the employee’s working hours in the City during the tax year exceeds the number of the employee’s working hours in any other City or municipality during the tax year.
Definition of Highest-Paid Employee: Person or combined group’s individual employee or officer that received the most Compensation for a tax year.
Calculated in the following manner:
- 0.1% of the person or combined group’s taxable gross receipts for a tax year if the Executive Pay Ratio is greater than 100:1, but less than or equal to 200:1; or
- 0.2% if the Executive Pay Ratio is greater than 200:1, but less than or equal to 300:1; or
- 0.3% if the Executive Pay Ratio is greater than 300:1 but less than or equal to 400:1; or
- 0.4% if the Executive Pay Ratio is greater than 400:1, but less than or equal to 500:1; or
- 0.5% if the Executive Pay Ratio is greater than 500:1, but less than or equal to 600:1; or
- 0.6% if the Executive Pay Ratio is greater than 600:1
Every person engaging in business within the City as an administrative office shall pay an annual “Mental Health Administrative Office Tax” if the Executive Pay Ratio exceeds 100:1. The Mental Health Administrative Office Tax shall be considered part of the MHGRT.
Measured by the persons/business’ total payroll expense that is attributable to the City. If the person is a member of a combined group, then its tax is measured by the total payroll expense of the combined group attributable to the City.
Such person or combined group shall pay only the Mental Health Administrative Office Tax, and not the tax imposed by other subsections of this ordinance
The Mental Health Administrative Office tax is calculated as follows:
- 0.4% of the person/combined group’s total payroll expense attributable to the City if the Executive Pay Ratio is greater than 100:1, but less than or equal to 200:1;
- 0.8% of the person/combined group’s total payroll expense attributable to the City for the tax year if the Executive Pay Ratio is greater than 200:1, but less than or equal to 300:1;
- 1.2% of the person/combined group’s total payroll expense attributable to the City for the tax year if the Executive Pay Ratio is for that tax year greater than 300:1, but less than or equal to 400:1;
- 1.6% of the person/combined group’s total payroll expense attributable to the City for the tax year if the Executive Pay Ratio is for that tax year greater than 400:1, but less than or equal to 500:1;
- 2.0% of the person/combined group’s total payroll expense attributable to the City for the tax year if the Executive Pay Ratio is for that tax year greater than 500:1, but less than or equal to 600:1;
- 2.4% of the person/combined group’s total payroll expense attributable to the City for the tax year if the Executive Pay Ratio is for that tax year greater than 600:1
All money collected from the MHGRT shall be deposited into the “Mental Health Fund” and used for the following purposes:
Up to 2% of the proceeds of MHGRT for the administration of the MHGRT and Mental Health Fund
Refunds of any overpayments
If measure creating “Mental Health SF” passes in November, all remaining monies shall be used for such Mental Health SF, including the administrative costs
If measure creating “Mental Health SF” does not pass in November, all remaining amounts shall be used for mental health facilities, services, and programs including the cost of administering the programs.
The BOS may amend or repeal by ordinance without a vote of the people
“Mental Health Fund” will be a category four fund
This ordinance shall become operative on January 1, 2021.
Comments are closed.