Two women discussing a chart

A collaborative model for improving community healthcare

San Francisco’s only public acute care hospital has developed a ground-breaking approach to help patients dealing with mental and behavioral health issues as well as homelessness and other barriers

San Francisco has long been known as a place where creativity and hard work combine to create opportunity, from its early dominance in Pacific Rim trade and the California gold rush to today’s dynamic technology economy. The city is renowned for its sweeping vistas, considerable wealth and sky-high housing prices.

But opportunity has not been distributed equally among its residents. San Francisco is faced with serving people experiencing homelessness and housing insecurity, often accompanied by mental health issues. An estimated 20,000 San Franciscans experience homelessness over the course of a year,footnote1 according to the city's Department of Homelessness and Supportive Housing, and the department’s annual survey of this population found that 52% of those reporting health conditions have substance abuse problems, while 36% report psychiatric or emotional conditions.footnote2 It’s a crisis that echoes in many U.S. cities.

Stepping into the breach is Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG), which has a well-earned reputation for addressing citywide health emergencies with inventive solutions and empathetic care. The hospital has historically been ground zero for the city’s health issues, from the devastating earthquake and fire of 1906 to the AIDS/HIV crisis in the 1980s. “As a human right, we believe that everybody deserves dignity, respect and high-quality healthcare,” says Susan Ehrlich, CEO of ZSFG.

To address the present situation, ZSFG looked beyond the traditional practice of offering psychiatric and medical care in isolation. Four years ago, with support from the San Francisco General Hospital Foundation, ZSFG introduced an interdisciplinary approach to delivering mental health and addiction care to hard-to-reach populations. The Transform Mental and Behavioral Health Fund brings together a number of departments across the hospital — including addiction care, social medicine, inpatient psychiatry and the city’s only 24/7 dedicated psychiatric emergency department — to develop holistic treatment plans for each patient.

This initiative is funded in part by Bank of America, which has supported ZSFG for more than two decades. As San Francisco General Hospital Foundation CEO Kim Meredith puts it, “Bank of America’s shared commitment to equity brings critical support to our mission of supporting excellence in patient care at our city’s only public hospital.”

In the program, specialists with the Addiction Care team help patients secure residential treatment and arrange support in the community in addition to recommending best-practice medication-assisted treatment for substance use disorders. The Social Medicine team addresses potential contributors to poor health – such as nutritional deficiencies, housing issues and lack of transportation – with solutions that include food and transportation vouchers, prepaid phone cards and housing assistance. Teams are devoted to improving mental health treatment for a range of patients, including those in a violent relationship with a partner, women who are pregnant or postpartum, and children in crisis.

Patient Navigators, who help link patients to care and community services, have recently been added to many of the programs, thanks to the support from the foundation. “These are culturally sensitive professionals who understand patients’ lived experiences, which helps build trust,” Meredith says. The Transform initiative also applies sophisticated technological approaches to managing care, including greater use of electronic health records and uniform patient data collection, which helps identify and address gaps in care.

“We pride ourselves on our compassionate approach of caring for a population that is often difficult to reach, and on building programs that meet patients where they are in life,” says Ehrlich. “By bringing together a diverse network of specialists and caregivers within the hospital, we are supporting holistic, patient-centered care.”

Adds Elizabeth Minick, San Francisco-East Bay market executive at Bank of America and a hospital foundation board member, “Partnering with the San Francisco General Hospital Foundation on initiatives like mental health support allows us not only to provide critical healthcare services to the community, but also to come together as neighbors as we work toward a better San Francisco and East Bay.”

The support for the San Francisco General Hospital Foundation is an example of Bank of America’s commitment to help advance racial equality and economic opportunity in local neighborhoods around the country.

San Francisco Department of Homelessness and Supportive Housing, “Point-in-Time and Housing Inventory Counts,” accessed May 2023.


San Francisco Department of Homelessness and Supportive Housing and Applied Survey Research, “San Francisco Homeless Count and Survey: 2022 Comprehensive Report,” August 2022.


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