Tag: Zuckerberg San Francisco General Hospital

ZSFGH Is Not Safe for Vulnerable Patients: Documented Safety Failures Affect Staff, Patients, and Visitors — and DPH’s Security Model Is Failing

Zuckerberg San Francisco General Hospital (ZSFGH) is a city within a city—a dense, vertical campus with constant foot traffic, high-acuity medicine, psychiatric emergencies, and complex social-service needs moving through the same corridors. Vulnerable inpatients can’t “opt out” of that environment. They can’t leave when violence erupts. They depend on the hospital’s security posture to be strong, visible, and fast.

ZSFGH has documented safety failures affecting staff, patients, and visitors—and the public record shows those failures are not hypothetical.

ZSFGH is a high-risk campus, not an outpatient clinic

ZSFGH is San Francisco’s only Level-1 Trauma Center and a major hub for psychiatric emergency care and high-risk patient volume. That reality alone demands a district-style security posture—the kind you would expect for a downtown transit node, a courthouse complex, or a busy police district footprint.

DPH’s own planning direction: reduce sworn presence, measure “success” by avoiding law enforcement

DPH’s security planning materials have repeatedly centered a policy goal of reducing the presence of law enforcement, and DPH has emphasized metrics framed around completing Behavioral Emergency Response Team (BERT) interventions without law enforcement present. SF Media

DPH’s own Environment of Care reporting also describes BERT as part of a broader strategy to reduce reliance on law enforcement—explicitly listing measures of “success” such as reducing law-enforcement interventions and “replacing” deputy positions with DPH security roles.

BERT may help in some situations. But a hospital campus does not become “safe” because sworn staff were avoided. It becomes safe when violence is prevented, contained quickly, deterred, and when vulnerable people are protected in real time.

The December 2025 Ward 86 killing: the public timeline shows warning signs — and the system still failed

In December 2025, a social worker at Ward 86 was fatally stabbed inside ZSFGH. Reporting after the killing describes long-standing safety concerns, prior warnings, and a security posture that did not stop a determined attacker. San Francisco Chronicle

Mission Local’s reported timeline (source: Mission Local)

Mission Local reported that the alleged attacker had been reported to security for abusive behavior and threats toward a doctor about two weeks before the attack, that there were plans to ban him, and that staff had tried to contact him leading up to the incident. (Mission Local also reports eyewitness accounts disputing the “within seconds” narrative and describes delays and gaps in control of access and response.)

That matters because it goes directly to a second issue:

DPH’s own Violence Risk Notification Policy: if a high-risk threat is identified, law enforcement notification is required

DPH’s Violence Risk Notification Policy contemplates situations where a threat is assessed and escalated, and it includes explicit notification requirements that involve law enforcement. The policy’s notification flow requires SFSO notification and indicates SFPD notification as part of the process when certain thresholds are met. 

If DPH leadership had credible notice of a specific, escalating, high-risk threat (as Mission Local reports), then the core question becomes unavoidable:

Did DPH follow its own violence-risk notification policy—early, formally, and fully—so that sworn resources could be deployed in a preventive posture (not merely reactionary)?

When a system trains itself—by policy design, incentives, and staffing—to treat sworn presence as something to be minimized, deputies risk being pushed into a reactionary role, and then blamed when the underlying security posture fails.

ZSFGH’s own security reporting shows serious crime and safety volume

DPH/SFHN security reporting for ZSFGH documents significant incident volume across categories that directly affect staff, patients, and visitors. In the FY 2023–2024 security annual report, ZSFGH reported hundreds of “crimes against persons,” along with property crimes and other categories (including increases compared to prior years in multiple areas).

This is not an abstract debate about ideology. It’s measurable security workload on a high-risk campus.

Documented theft, privacy loss, and property vulnerability — not just violence

Safety is not only stabbings. It’s also the predictable results of weak deterrence and insufficient patrol coverage in a “city-within-a-city” environment:

  • Attempted theft of emergency equipment from an ambulance at ZSFGH in September 2024 resulted in a paramedic injury during the incident. San Francisco Chronicle+1

  • A missing patient logbook containing sensitive information triggered security and policy review reporting in April 2024. SFist

And as our current article correctly emphasizes: we haven’t even fully touched the broader theft exposure—including the vulnerability of hospital-owned property, supplies, and equipment, and the diversion risk that grows when visible deterrence and real patrol saturation are reduced.

What a working, realistic fix looks like (short and operational — not a “theory document”)

ZSFGH needs district-style coverage that matches the threat environment, not a model optimized around avoiding sworn presence:

  1. Uniformed deputy foot patrols across corridors, stairwells, entrances, elevators, and transition points (deterrence + rapid response).

  2. Plainclothes deputies on campus in addition to assigned posts, focused on:

    1. catching theft and criminal activity without telegraphing presence, and

    2. co-responding with BERT when appropriate—while preserving immediate peace-officer capability when violence erupts.

  3. A posture that treats sworn staffing as preventive protection for staff, patients, and visitors—not a last-second backstop.

Bottom line

The public record now includes a fatal stabbing inside ZSFGH, documented concerns about long-running safety failures, and ongoing theft/property vulnerabilities. San Francisco Chronicle+2San Francisco Chronicle+2 Meanwhile, DPH’s own planning materials and internal reporting show a model and culture shift aimed at reducing law-enforcement presence and measuring “success” by minimizing law-enforcement involvement. SF Media

ZSFGH is not safe for vulnerable patients under the current posture—nor is it reliably safe for staff and visitors. The standard must be real protection and real outcomes—not metrics that celebrate how often deputies were avoided.

ZSFGH Is Not Safe for Vulnerable Patients: Documented Attacks and Thefts Show DPH’s Security Model Is Failing

Zuckerberg San Francisco General Hospital (ZSFGH) is a city within a city—a dense, vertical campus with constant foot traffic, high-acuity medicine, psychiatric emergencies, and complex social-service needs moving through the same corridors. Vulnerable inpatients can’t “opt out” of that environment. They can’t leave when violence erupts. They depend on the hospital’s security posture to be strong, visible, and fast.

ZSFGH carries an extreme ER burden and high-risk volume

Public reporting citing California health data has highlighted ZSFGH as one of the hospitals with a very high share of homeless ER patients (22% in 2023), and notes heavy recidivism in SF ER usage.

Whatever the exact percentages year to year, the operational reality is the same: ZSFGH is an intense, high-risk campus—not an outpatient clinic.

DPH’s own documents show the policy direction: “reduce law enforcement presence”

DPH materials presented to the Health Commission frame the security strategy around “prevention/equity” and reducing the presence of law enforcement.

DPH also reports performance using metrics like how often BERT interventions are completed without law enforcement present (e.g., 87% cited in staffing materials). 

BERT may help in some situations—but a hospital campus doesn’t become “safe” because law enforcement was avoided. It becomes safe when violence is prevented, contained quickly, and deterred.

Weapons are a daily reality, not a talking point

ZSFGH security reporting documents thousands of weapons/contraband confiscations through screening:

  • 3,394 in FY 2020–2021 

  • Nearly 4,000 in FY 2023–2024 

That is exactly why minimizing sworn presence as a goal is backwards on this campus.

Documented attacks, thefts, and injuries reported in the news

These aren’t hypotheticals. Recent public reporting includes:

  1. Fatal stabbing of a social worker inside ZSFGH (Ward 86) — December 2025
    A UCSF social worker was attacked and repeatedly stabbed inside the hospital; charges were later upgraded after the victim died. ABC News+2San Francisco Chronicle+2
    This incident has triggered major public scrutiny of ZSFGH safety conditions and security posture. San Francisco Chronicle+1

  2. Ambulance smash-and-grab / attempted theft of emergency equipment — paramedic injured — September 28, 2024 (ZSFGH campus)
    Police and news outlets reported an ambulance was broken into and equipment stolen; a paramedic was injured during the incident. NBC Bay Area+1

  3. Security failure involving missing patient logbook with sensitive information — April 2024
    News reports said a patient logbook containing personal/medical information went missing, prompting a security/policy review. CBS News+1

  4. High volume of reported workplace-violence incidents and regulatory scrutiny (context emphasized in reporting after the fatal stabbing)
    Major reporting after the December 2025 killing describes long-running safety concerns, workplace-violence incident volumes, and prior enforcement actions and warnings. San Francisco Chronicle

Bottom line: the public record shows violence and theft-type incidents are occurring at or tied to the ZSFGH campus and operations—and they’re not isolated “one-offs.”

It’s also a theft and property-loss vulnerability—and the risk is structural

DPH’s own security scope includes protecting equipment, supplies, and medications and investigating theft.

When visible deterrence and patrol coverage are reduced in a “city within a city,” the predictable result is more opportunity: theft, diversion risk, property damage, and repeat offenders who learn the gaps.

A working fix (short, operational, and realistic)

ZSFGH needs district-style coverage that matches the threat environment:

  1. Assigned posts in predictable high-risk locations.

  2. Uniformed deputy foot patrols across corridors, stairwells, entrances, and transition points.

  3. Plainclothes deputies on campus (in addition to posts and beats):

    1. to catch theft/crime without telegraphing presence, and
    2. to co-respond with BERT when appropriate—while preserving immediate peace-officer capability when violence erupts.

Bottom line

DPH’s own documents show a model optimized to reduce law enforcement presence, while ZSFGH’s own reporting shows weapons are constantly intercepted—and the news record now includes fatal violence, injuries, and theft incidents tied to the campus. San Francisco Chronicle+2NBC Bay Area+2

ZSFGH is not safe for vulnerable patients under the current posture. The standard must be real protection and real outcomes—not metrics that celebrate how often deputies were avoided.

Deputy’s Rapid Response at ZSFGH Likely Prevented Mass Casualty Stabbing — But Security Plan Still Keeps Deputies Out of Most Crises

FOR IMMEDIATE RELEASE

Deputy’s Rapid Response at ZSFGH Likely Prevented Mass Casualty Stabbing — But Security Plan Still Keeps Deputies Out of Most Crises

Deputy Sheriffs say DPH’s BERT model minimizes law-enforcement presence and relies on unarmed security in a vertical city of high-risk patients

Deputy Saves ZSFGH Ward 86 from Mass StabbingSan Francisco, CA — The San Francisco Deputy Sheriffs’ Association (SFDSA) is calling attention to the heroic actions of a Sheriff’s deputy at Zuckerberg San Francisco General Hospital (ZSFGH) and renewing its warning that the hospital’s current security model is designed to keep deputies out of most violent incidents while relying on unarmed security and clinical teams.

On December 4, 2025, a stabbing in Ward 86, ZSFGH’s HIV clinic, left UCSF social worker Alberto Rangel with multiple stab wounds. Despite rapid intervention and lifesaving efforts, Mr. Rangel later died from his injuries.

SFDSA President Ken Lomba says that while the deputy could not undo the initial wounds, his rapid intervention almost certainly prevented additional victims.

“What people aren’t being told is that our deputy didn’t just confront one dangerous situation — he likely prevented a mass-casualty stabbing inside that clinic,” Lomba said. “Ward 86 is a high-volume HIV clinic. If the assailant had been able to move freely down the hallway, we could be talking about multiple staff and patients stabbed. The only reason that didn’t happen is because a deputy was close enough to intervene within seconds.”

Unarmed security at the entrance, no fixed deputy post in the 80/90 complex

Under ZSFGH’s current security model, Building 80 – which houses the Ward 86 HIV clinic on the 6th floor – is part of the connected 80/90 complex, with its main public entrance on 22nd Street. According to our union members assigned to ZSFGH, that entrance is staffed by an unarmed private security guard seated at a desk, and DPH relies on additional private security guards who patrol the building’s interior. There is no fixed Sheriff’s deputy post in Building 80.

SFDSA later discovered, through its staffing records, that Building 80 previously had a Sheriff’s cadet post, but DPH eliminated that post in July 2025, leaving only unarmed private security at the public entrance and in the hallways.

In the connected Building 90, ZSFGH operates Ward 93, an Opiate Treatment Outpatient Program (OTOP) methadone clinic on the third floor. Public information lists Ward 93 as a methadone clinic serving adults with substance-use disorders, and our union members report that DPH assigns a private armed security guard inside Unit 93 who is not permitted to leave that unit. That means the one armed security presence in the 80/90 complex is effectively locked to a single clinic, while the rest of the building — including the path to Ward 86 — is covered only by unarmed guards and a greatly reduced number of deputies.

On December 4, a stabbing occurred in the 6th-floor Ward 86 hallway, where UCSF social worker Alberto Rangel was repeatedly stabbed and left in critical condition. An individual was later arrested on suspicion of carrying out the stabbing. Based on information from our members, the individual possibly moved past the unarmed security presence at the 22nd Street entrance and through the 80/90 complex to reach the 6th floor.

The only sworn law-enforcement officer in Building 80 at that time was a Sheriff’s deputy temporarily assigned there solely because DPH had requested protection for a doctor who had previously reported threats from the same individual. When the stabbing began in another area in a hallway, that deputy responded, intervened to stop the attack, helped secure the individual, and allowed medical staff to begin lifesaving care.

“This was not a building with a strong law-enforcement presence,” Lomba said. “It was an unarmed guard at the lobby desk, a handful of roving security guards, no fixed deputy post, and a deputy in Ward 86 only because a doctor had already been threatened. In the end, the only person who physically restrained the suspect and stopped the stabbing was a sworn deputy sheriff.”

A missed opportunity at City Clinic and delayed law-enforcement notification

San Francisco City Clinic, located at 356 7th Street in SoMa, is a DPH sexual-health clinic that does not have any assigned Sheriff’s deputy post. According to public news reports, on the same day as the Ward 86 killing, hours before the stabbing, the same individual went to City Clinic looking for a specific doctor he had been threatening. A clinic director hid the doctor, told the individual the doctor was not there, and then heard the individual say he would go to Ward 86 at ZSFGH to find that doctor later that day. The clinic and the hospital are roughly two miles apart, yet there is no public indication in those reports that either SFPD or the Sheriff’s Office was contacted at that point so law enforcement could attempt to locate or intercept the individual before he reached Ward 86.

Under DPH’s own Threat Management policy, multiple threats combined with a stated plan to go to a specific location to find a targeted provider appear to meet the definition of a “High Risk” case—the very category where the policy warns of imminent danger of serious injury or death and directs staff to notify both SFSD and SFPD. SFDSA is therefore asking DPH to explain why law enforcement was not called from City Clinic when staff had both credible threats and advance notice of the individual’s stated destination, and why the Sheriff’s Office was only brought in shortly before the attack instead of at the earliest warning.

Unanswered questions about DPH’s own threat policy

Through a public-records request under the California Public Records Act (CPRA), SFDSA’s counsel obtained DPH’s Threat Management flowchart, which outlines how threats are supposed to be classified and handled. According to that document, cases are classified as “High Risk” when there are multiple threats of violence and evidence of a violent plan directed at a specific person or location. In those situations, the policy says there is a high probability of imminent danger of injury or death, and the response should include contacting both the Sheriff’s Office and SFPD.

Public news reports about this case describe an individual who threatened staff over a period of time, went to San Francisco City Clinic looking for a specific doctor, told the clinic director he would go to Ward 86 at ZSFGH to find that doctor, and then later allegedly carried out a stabbing in Ward 86. Taken together, those facts appear to fit the very “High Risk” scenario DPH’s own Threat Management policy describes: multiple threats combined with a clear plan to seek out a targeted provider at a specific location.

DPH’s Threat Management flowchart, as produced to SFDSA, states that when a situation is classified as “High Risk,” both the Sheriff’s Office and SFPD should be notified. In this case, a doctor at Ward 86 had already reported threats from the same individual, and DPH specifically requested that a Sheriff’s deputy be assigned to protect that doctor on the day of the stabbing.

SFDSA is calling on DPH and its security leadership to answer two basic questions:

  1. How was this case formally classified under DPH’s Threat Management policy — Low, Medium, or High Risk?

  2. If it was treated as High Risk, were both SFSD and SFPD notified in accordance with that policy — and if not, why not?

“DPH’s own document, which we obtained through a CPRA request, says multiple threats plus a violent plan aimed at a specific person equals High Risk and should trigger calls to both the Sheriff’s Office and SFPD,” Lomba said. “The publicly reported facts about this case look exactly like that scenario. The public deserves a clear answer: did DPH follow its own High-Risk protocol before this attack — yes or no?”

A security model built to keep deputies out of the room

SFDSA says the tragedy in Ward 86 must be understood in the context of a security plan that intentionally reduced sworn staffing and routed most crises away from law enforcement.

In a series of plans and presentations to the Health Commission, the Department of Public Health (DPH):

  • Proposed cutting 11.4 deputy positions at ZSFGH, reducing deputies on the hospital work order from 30 FTE to 21 FTE.

  • Created a Behavioral Emergency Response Team (BERT) made up of psychiatric nurses and psych techs to respond to behavioral crises, perform de-escalation, administer medications, and manage restraints.

  • Chose to support BERT with non-uniformed cadets and private security personnel, rather than strengthening sworn coverage on high-risk units.

  • Reported that in the Emergency Department and other areas, over 80 percent of BERT activations now occur without any law-enforcement presence, and cited that as a success metric.

  • Stated that law-enforcement intervention could “have the unintended effect of escalating a situation” and described reducing the presence of deputies in DPH facilities as an explicit goal.

“DPH didn’t just trim numbers; they rewrote the model so that deputies are kept out of the room as much as possible,” Lomba said. “They built a system where psych staff, cadets, and unarmed guards are expected to handle the early, most dangerous seconds of an attack — and then deputies are supposed to show up later and clean up the aftermath.”

Not just one building — a vertical city of high-risk patients

The Association says this “response-only” approach is especially dangerous at ZSFGH because of how the campus is built and what it handles.

Zuckerberg San Francisco General is not a single hallway with a front desk. It is a dense, multi-building, multi-story campus of high-risk services:

  • San Francisco’s only Level-1 trauma center,

  • The City’s only 24/7 psychiatric emergency department, and

  • The primary safety-net hospital for many of the City’s most vulnerable residents, including people experiencing homelessness, serious mental illness, and substance-use disorders.

Multiple towers and specialty buildings — trauma and emergency, medical-surgical units, HIV and infectious-disease clinics like Ward 86, psychiatric emergency, acute psych, and high-risk outpatient programs — are stacked on top of one another and connected by elevators, stairwells, internal corridors, and secured passageways.

When a call comes in from an upper floor or a remote clinic, deputies must navigate multiple floors, secured access points, and crowded hallways before reaching the scene.

“On a campus like this, ‘response-only’ isn’t a theory problem; it’s a time-and-distance problem,” Lomba said. “Every minute of delay is more time for a stabbing, strangulation, or assault on staff to continue. When you cut deputies here, you don’t just pull them off one doorway — you thin sworn coverage across an entire vertical grid of trauma units, psych, and clinics all at once.”

Built on narrow statistics and flawed comparisons to LA and Alameda

DPH has repeatedly cited hospitals in Los Angeles County and Alameda County as models for its hybrid BERT and security approach. SFDSA argues those comparisons are fundamentally flawed:

  • LA and Alameda distribute trauma and psychiatric emergencies across multiple hospitals and trauma centers, with sheriff’s deputies and local police departments able to surge to incidents across a wide geographic area.

  • San Francisco concentrates most of that burden on one campus — ZSFGH — for roughly 1.5 million people in San Francisco and northern San Mateo County.

  • In the external systems DPH references, sworn law enforcement remains a core part of a co-responder model. At ZSFGH, the implementation has focused on reducing deputies and measuring success by how often BERT can operate without law enforcement present.

At the same time, DPH built its equity case on a narrow slice of data:

  • Internal memos and public statements highlighted that roughly half of use-of-force incidents in one reporting period involved Black patients, and that a high share of ED use-of-force involved Black patients compared to their percentage of ER visitors.

  • ZSFGH’s own annual reports, however, show that Black patients are about 12–15 percent of the hospital’s overall patient population, not 48–70 percent.

  • DPH has not publicly released the full breakdown of who is in the ED, PES, and psych units by race, or how many of those force incidents involved fights, weapons, or psychiatric restraints.

“DPH took a small number of high-risk incidents and used that percentage to argue deputies themselves were an ‘equity problem,’” Lomba said. “They never showed the full picture of who is in those units, why staff called for help, or how many times deputies prevented serious injury or death. That narrow statistic was then used to sell a plan that civilianized security and kept deputies out of the room.”

What SFDSA is demanding now

In light of the Ward 86 killing and the documented design of the ZSFGH security plan, SFDSA is calling for immediate changes:

  1. Restore and expand assigned deputy-sheriff posts on high-risk units and posts at ZSFGH, including Ward 86, the Emergency Department, Psychiatric Emergency Services, and critical inpatient floors, with a fully staffed sworn patrol presence on campus.

  2. End the experiment of replacing deputies with cadets, private security, and BERT-only responses in areas where staff routinely face weapons, severe psychiatric crises, and violent assaults.

  3. Publish a full, unit-level analysis of use-of-force and patient demographics, so the public can see the true denominators behind DPH’s equity claims, including ED/PES/psych race breakdowns and the reasons staff call for help.

  4. Establish an independent safety and equity review of the ZSFGH security model, including BERT, cadets, private security, and deputy staffing, with full participation from frontline unions representing deputies, nurses, physicians, social workers, and other hospital staff.

  5. Adopt a true co-responder model in which BERT clinicians and deputies respond together to the most dangerous situations, instead of sending clinicians and non-sworn staff in first and treating law enforcement as a last resort.

“The deputy in Ward 86 did everything right and likely prevented more people from being stabbed,” Lomba said. “What failed that day was not the deputy — it was a security plan that deliberately kept most deputies away from high-risk units in the first place. That plan has to change before we lose anyone else.”

Media Contact
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Phone: (415) 696-2428

Internal DPH Memos Show ZSFGH Security Plan Was Built to Keep Deputies Out

FOR IMMEDIATE RELEASE

Internal DPH Memos Show ZSFGH Security Plan Was Built to Keep Deputies Out

Deputy Sheriffs’ Association says DPH cut sworn staffing, misused equity data, and spent more on an unproven BERT / private-security model before fatal stabbing of UCSF social worker

San Francisco, CA — The San Francisco Deputy Sheriffs’ Association (SFDSA) is releasing internal Department of Public Health (DPH) documents showing that security changes at Zuckerberg San Francisco General Hospital (ZSF GH) were deliberately structured to keep law enforcement out of most patient crises — even as weapons seizures, assaults, and workplace-violence incidents remained high.

On December 4, 2025, a UCSF social worker was fatally stabbed multiple times in Ward 86 at ZSF GH. A nearby deputy intervened, disarmed the attacker, and allowed staff to begin life-saving measures, but the victim later died. SFDSA President Ken Lomba says this tragedy is the predictable outcome of a policy that treated deputies as a problem to be reduced, not a safety partner to be strengthened.

“DPH used the language of ‘equity’ and ‘best practices’ to justify a security experiment that removed deputies from high-risk units and posts and replaced them with BERT clinicians, cadets, and unarmed guards,” said Lomba. “Their own memos brag that almost nine out of ten behavioral emergencies now happen with no law enforcement present. On Ward 86, we saw the real-world result of that decision.”

DPH’s own memos: cut deputies, keep them out of the room

In a June 14, 2021 Safety Services Staffing Plan Proposal, DPH proposed to:

  • Reduce Sheriff’s deputies at ZSF GH by 11.4 positions (about 14.5 FTE including backfill), and
  • Add 31.9 FTE of Psychiatry Nurses and Licensed Psychiatric Technicians, plus 2.5 FTE Care Experience Health Workers, to form a Behavioral Emergency Response Team (BERT).

The same plan specifies that non-uniformed cadets would provide clinical support in patient intervention, function as “healthcare ambassadors,” and conduct campus patrols.

A later August 28, 2023 Security Staffing Plan Update to the Health Commission reports that:

  • The plan would reduce deputies by 11.4 FTE and add 29.4 FTE of BERT staff to create a 24-hour BERT program in the Emergency Department.
  • DPH proposed supporting BERT with non-uniformed cadets trained as “healthcare ambassadors,” not with additional deputies.
  • By early 2023, BERT was fully implemented and, instead of calling law enforcement, staff were calling BERT to thousands more “risk behavior” events than the Sheriff’s Office, with over 80% of BERT activations — and nearly 90% of Emergency Department BERT activations — occurring without any law enforcement present.
  • In July 2023, the 11.4 FTE of deputies was officially removed from the ZSFGH work order, reducing deputies from 30 FTE to 21 FTE.

At the same time, the update memo notes that 46.5 FTE of “healthcare trained private security officers” were installed as hospital ambassadors at ZSFGH campus entry points.

“At the one campus that handles most of San Francisco’s stabbings, shootings, and psychiatric emergencies, DPH chose to send BERT and cadets into the room and push sworn deputies farther away,” Lomba said. “That is not a co-responder model — that’s a model designed to keep law enforcement out of the picture until after violence has already occurred.”

An expensive experiment, not a safety upgrade

DPH has sometimes framed these changes as modernization or rationalization of security. Their own FTE and cost figures tell a different story.

According to DPH’s Safety Services plan and subsequent updates:

  • At ZSFGH, DPH proposed to reduce the Sheriff work order by 11.4 deputy positions (about 14.5 FTE), while adding 31.9 FTE of BERT psych nurses/techs and 2.5 FTE care workers.
  • By August 2023, 29.4 FTE of BERT positions were funded, and 46.5 FTE of contracted “healthcare trained private security officers” were in place at ZSFGH campus entry points.
  • In their own cost comparisons, DPH shows that a small number of deputies and cadets account for several million dollars in annual cost, while dozens of private security officers are added on separate contracts, illustrating that DPH shifted money away from sworn and cadet roles toward a much larger private-security footprint.

At Laguna Honda Hospital, DPH’s example of “efficiency” makes the trade-off clear:

  • 8.4 FTE of deputies cost significantly more than 34.6 FTE of private security officers, who were then used to provide 24-hour monitoring in multiple locations.

Taken together, these documents show that DPH did not simply “save money by replacing deputies.” The department reduced sworn coverage and then layered on:

  • Dozens of BERT clinical positions,
  • Dozens of contracted private security officers, and
  • Cadets or other non-sworn “ambassador”-type roles.

From SFDSA’s perspective, this amounts to an expensive and unproven security experiment: one that trades sworn patrol and rapid response for a more complicated mix of clinical teams and unarmed guards, while leaving fewer deputies immediately available when violence erupts.

The Association is calling on the City to disclose the full annual cost of the BERT-plus-private-security model at ZSFGH and explain why that funding was not instead used to fully staff a sworn patrol division and fixed-post deputies in the highest-risk units and posts at the hospital.

Misusing equity data to justify cutting deputies

DPH also relied on a single statistic to justify reducing deputies: that about 46% of use-of-force incidents against patients in one reporting period involved Black/African American patients.

SFDSA does not dispute that racial disparities are real and serious. However, the way the data are presented raises concerns:

  • The figures in DPH’s materials do not provide the racial breakdown of patients in the specific high-risk areas (ED, PES, inpatient psych) where most force is recorded.
  • The same Safety Services plan acknowledges that deputies assisting with patient restraints and defending staff against attacks drive a large share of force incidents, yet this context is not clearly presented when the “46% Black” figure is cited.

Despite these limitations, DPH used this disparity as one of the key reasons to reduce the Sheriff’s work order and expand BERT and non-sworn roles.

“If DPH truly wants equity, the answer is not to quietly pull deputies out of high-risk units and hope the numbers look better,” Lomba said. “The answer is to be honest about what is driving these incidents and to fix it in partnership with staff, patients, and the communities we serve.”

ZSFGH is not comparable to LA or Alameda

In its own Security Model responses, DPH repeatedly cites Alameda Health System and Los Angeles County hospitals as “comparable” to ZSF GH and as justification for its hybrid BERT / non-sworn model.

SFDSA believes this comparison is misleading:

  1. One overloaded campus vs. multi-hospital systems
    • Alameda and LA counties distribute trauma and psychiatric emergencies across multiple hospitals and trauma centers, with sheriff’s deputies and city police departments available to surge to calls.
    • San Francisco relies on one safety-net campus — ZSFGH — as the City’s only Level-1 trauma center and only 24/7 psychiatric emergency department for roughly 1.5 million people in San Francisco and northern San Mateo County.
  2. Co-responder vs. “keep deputies away”
    • DPH’s own descriptions of Alameda and LA highlight hybrid security models that include healthcare security officers and county sheriff’s deputies as partners.
    • At ZSF GH, by contrast, DPH cut deputies by roughly one-third and used BERT plus cadets and unarmed private security to handle most risk-behavior incidents, with success measured partly by how often law enforcement is not present.
  3. Existing record of violence at ZSF GH
    • ZSFGH’s own annual reports emphasize that healthcare workers are almost four times more likely than workers in most other industries to experience workplace violence and that the hospital has had to invest in BERT and security upgrades to address persistent safety issues.

Not just one building — a vertical city of high-risk patients

Not just one building — a vertical city of high-risk patients
When DPH reduced deputy positions at ZSFGH, they did not simply pull deputies off “one hospital building.” They thinned coverage across what is effectively a vertical city of high-risk patients.

ZSFGH is a dense hilltop campus made up of multiple multi-story towers and specialty buildings — trauma, medical-surgical units, HIV and infectious-disease clinics, psychiatric emergency, acute psych, and high-risk outpatient programs — all stacked on top of each other and connected by elevators, stairwells, skyways, and long interior corridors. Nearly all of San Francisco’s Level-1 trauma care, 24/7 psychiatric emergency, and safety-net inpatient care is concentrated on this single site.

When a call comes in from an upper floor or a remote ward, deputies have to navigate multiple floors, secured access points, and crowded hallways before ever reaching the scene. On a campus like that, “response-only” policing is not a theory problem, it is a time-and-distance problem: every minute of delay is more time for a stabbing, a strangulation, or an assault on staff to continue.

Cutting deputies in that environment does not just mean fewer uniforms in one lobby. It means fewer sworn officers available to cover an entire vertical grid of vulnerable units — from the Emergency Department to Ward 86 to psych and ICU floors — at the same time. That is the reality DPH chose to ignore when it redesigned security around BERT, cadets, and unarmed guards.

“You cannot treat a single, overloaded trauma and psych emergency hospital in San Francisco like just another line on a spreadsheet next to Alameda and LA,” Lomba said. “Those systems built co-responder models with deputies and clinicians together. DPH’s implementation at ZSFGH went in a different direction: fewer deputies, more complexity, and more distance between sworn officers and the highest-risk units.”

What SFDSA is demanding now

In light of the internal memos, equity data, cost figures, and the fatal Ward 86 stabbing, SFDSA is calling for:

  1. Immediate restoration and expansion of assigned deputy-sheriff posts on high-risk units and posts at ZSFGH, including Ward 86, ED, PES, and critical inpatient floors, with a fully staffed sworn patrol presence on campus.
  2. An independent safety and equity audit of ZSFGH’s security model — including BERT, cadets, private security, and deputy staffing — with full participation from frontline unions representing deputies, nurses, physicians, social workers, and other hospital staff.
  3. Transparent incident reporting, including detailed breakdowns of workplace-violence events and use-of-force by unit, incident type (crime-related, psychiatric, medical), clinical factors, and who requested the response, so that decisions are based on full context rather than partial statistics.
  4. A true co-responder model, where BERT clinicians work with trained, equipped deputies on the most dangerous calls, rather than being sent in instead of law enforcement.

“These memos show that the stakes at ZSFGH were always high: concentrated trauma, psychiatric emergencies, and a vulnerable patient population,” Lomba said. “What changed was DPH’s decision to move deputies out of the way and measure success by keeping law enforcement out of the room. After this tragedy, the City cannot pretend that model is working.”

Media Contact
San Francisco Deputy Sheriffs’ Association
Phone: (415) 696-2428

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San Francisco Deputy Sheriffs’ Association responds to stabbing of social worker at Zuckerberg San Francisco General Hospital

FOR IMMEDIATE RELEASEF

San Francisco Deputy Sheriffs’ Association: Stabbing of Social Worker at Zuckerberg San Francisco General Was Predictable — and Preventable

Union calls on City leaders to restore deputy sheriff staffing on high-risk units after years of documented assaults and ignored warnings

San Francisco, CA — On December 4, 2025, a 31-year-old UCSF social worker was repeatedly stabbed by a patient in Ward 86 at Zuckerberg San Francisco General Hospital (ZSFGH) and left in critical condition and has since died from his injuries.. The San Francisco Deputy Sheriffs’ Association (DSA) says this tragedy is exactly what deputies and staff warned would happen when the Department of Public Health (DPH) cut deputy sheriff positions and shifted to a “response-only” security model.

“This was not a random, unforeseeable incident,” said DSA President Ken Lomba. “ZSFGH’s own data show years of serious assaults and weapons on campus. Deputies, nurses, and social workers told DPH that pulling deputies off high-risk units/posts and replacing them with unarmed cadets and distant response teams would get someone seriously hurt or killed. On December 4, that prediction came true.”

A uniquely high-risk safety-net hospital

Zuckerberg San Francisco General is San Francisco’s only Level 1 trauma center and the city’s only 24/7 psychiatric emergency department, serving roughly 100,000 patients a year and treating nearly 4,000 severely injured trauma patients annually, including gunshot wounds, stabbings, and other violent assaults.

Unlike Los Angeles County or Alameda County, which spread trauma and psych-emergency patients across many hospitals, San Francisco relies on one safety-net campus for residents of San Francisco and northern San Mateo County. That means gunshot victims, stabbing victims, high-risk psychiatric emergencies, and people in severe crisis all converge on a single crowded hospital, placing an unusually heavy safety burden on deputies and clinicians working there.

ZSFGH’s own internal data show that violence has been a persistent problem:

  • Between January 1, 2020 and September 30, 2021, ZSFGH recorded 748 workplace violence events, including 303 incidents in the Emergency Department and 215 in psychiatry units alone.

  • The hospital’s Security Annual Report for FY 2020-2021 notes that deputies responded to 13,339 patient-related security calls, confiscated 3,394 weapons and contraband at Emergency Department screening, and investigated 23 moderate or high-risk workplace-violence threats.

  • ZSFGH’s FY 2024-2025 Annual Report shows that even after new training and prevention initiatives, the hospital still averaged six physical assaults with injury each month across just five high-risk areas, barely below the prior-year baseline of seven assaults with injury per month and far above the hospital’s target of fewer than four.

Despite these red flags, DPH moved forward with a restructuring that reduced deputy sheriffs on campus and clinics, expanded unarmed cadet roles, and relied more heavily on distant response teams and behavioral-health staff to manage escalating violence.

December 4, 2025: Exactly what staff warned would happen

On December 4, 2025, hospital staff had already raised safety concerns about a patient and requested deputy protection for a doctor at Ward 86 who had received threats. While the deputy was in a nearby room providing security for the threatened doctor, he heard a disturbance and saw the same patient in the hallway repeatedly stabbing a 31-year-old UCSF social worker with a kitchen knife, inflicting multiple wounds to the neck and shoulder.

He immediately went into the hallway, restrained the suspect, and allowed medical staff to begin CPR and lifesaving measures.

Research on close-range knife attacks (often summarized as the “21-foot rule”) shows that an assailant can cover about 21 feet in roughly 1.5 seconds—about the same time it takes a trained officer to perceive the threat and react—meaning a determined attacker can deliver multiple stab wounds in the one to two seconds before even a nearby responder can physically intervene. In a response-only model where deputies are stationed elsewhere on campus, that delay is far longer. By the time help arrives from another building or floor, a victim may already have sustained fatal injuries.

“This is exactly why we opposed a ‘civilian roving response team’ model for a hospital like ZSFGH,” Lomba said. “Knife attacks happen in seconds. If a deputy is on the opposite side of the campus when an employee is attacked on an upper floor, the response time is so long that the employee could be dead before help arrives. On December 4, a deputy happened to be close enough to intervene—and even then, the social worker suffered life-threatening wounds.”

The deputy who saved a life

The DSA recognizes the responding sheriff’s deputy as a hero for his actions on December 4. While providing security for a threatened doctor in Ward 86, he heard a disturbance, saw the social worker being repeatedly stabbed, and immediately intervened, restraining the attacker and securing the scene. His rapid response allowed medical staff to begin CPR and other lifesaving measures within moments, giving the victim a fighting chance to survive injuries that could easily have been fatal.

“This is exactly what deputy sheriffs are supposed to do on high-risk units: be close enough to stop an attack in progress and protect frontline healthcare workers,” Lomba said.

DPH was warned in 2022

In 2022, during a video-conference meeting with DPH and ZSFGH leadership, DSA President Ken Lomba objected to Security Director Basil Price’s plan to reduce deputy sheriffs and rely more heavily on cadets and civilian staff paired with social workers.

Lomba explained that the proposed security model was copied from Los Angeles County and would not work in San Francisco’s environment, where there is only one Level 1 trauma and psych-emergency hub and far fewer sworn officers available across the city. In contemporaneous notes and texts summarizing his comments to DPH leaders, Lomba warned that reducing deputies would:

  • Turn ZSFGH into a “reaction-only” scene,

  • Leave staff and patients exposed during the first critical seconds of an attack, and

  • Create scenarios where “if a deputy is on the opposite side of campus and an employee gets attacked or stabbed on an upper floor or roof of SFGH, the response time would be so long the employee could be dead.” 

Lomba’s concerns echoed what deputies and security staff had been documenting in workplace-violence and crime reports for years: moving deputy sheriffs off units and treating ZSFGH as a campus that can be secured by unarmed cadets and roaming response teams would increase response times and leave employees unprotected during the most dangerous moments of an attack.

Nonetheless, DPH proceeded with a model that reduced deputy sheriffs on campus, leaving fewer deputies responsible for a large hospital campus and stationed farther away from high-risk wards—including Ward 86—while publicly emphasizing new training, behavioral-health teams, and technology upgrades.

ZSFGH’s own reports acknowledge ongoing assaults

In recent annual reports, ZSFGH acknowledges that workplace violence “continues to be a serious challenge” and that healthcare workers are nearly four times more likely than workers in most other industries to experience workplace violence.

The hospital highlights a campus security assessment, weapons detection systems, de-escalation training, the Behavioral Emergency Response Team (BERT), and an Assault Governance Task Force, and sets a goal of reducing assaults with injury in high-risk areas.

Yet the FY 24-25 data show that even after these initiatives, staff are still suffering, on average, six assaults with injury every month in just five high-risk areas—a level of violence that underscores the need for immediate, on-scene protection, not only after-the-fact response.

What must change now

The San Francisco Deputy Sheriffs’ Association calls on DPH, the Health Commission, and the Mayor to take the following immediate steps:

  1. Restore and increase deputy sheriff positions on high-risk units, in behavioral-health settings, vehicle/foot patrol and in HIV/positive-health clinics, rather than relying on distant response teams and unarmed cadets.

  2. End the experiment of replacing deputies with unarmed cadets and civilian staff in roles that routinely face violent, armed, or unstable patients. Cadets and civilians can play a valuable supportive role, but they cannot safely substitute for trained, sworn law-enforcement officers in high-risk environments.

  3. Convene a joint hospital safety task force that includes deputies, nurses, social workers, physicians, and patient advocates to design a security model grounded in real-world response times, the physics of close-quarters attacks, and the hospital’s own workplace-violence and crime data.

  4. Fully integrate workplace-violence and security metrics into hospital governance, including transparent reporting on assaults, weapons confiscated, and use-of-force, and clear accountability when staffing or policy decisions increase risk.

“ZSFGH’s own reports show a hospital that has been struggling with workplace violence for years while trying to manage an extraordinarily high-risk patient population,” Lomba said. “Our deputies are proud to protect this campus, but they cannot do it from across town or across campus. The City must put deputy sheriffs back where the danger is—on the units, in the clinics, and at the front doors—before another nurse, doctor, or social worker pays the price.”

Until ZSFGH recognizes that violence can unfold in seconds and structures security around prevention and immediate intervention—not delayed response, frontline staff and patients will remain at unacceptable risk.

Editor’s note: This statement was originally issued while the victim was still in critical condition and was updated December 7th after his death was confirmed.

Media Contact:
San Francisco Deputy Sheriffs’ Association
415-696-2428 • SanFranciscoDSA.com 

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Cost Neutral Sign On Bonus Program: The Smart Way to Cut Recruitment Costs

In the fast-paced world of law enforcement, we’re all too familiar with the challenges of securing top-notch talent while balancing the books. As we navigate this landscape, one tactic gaining traction is the introduction of cost-neutral lateral officer signing bonuses tailored to recognize the value of all ready trained Deputy Sheriffs and Police Officers. By cutting out the costs tied to academy training, wages, and benefits, often stretching over 6 to 9 months, we can redirect these savings into an enticing signing bonus program for lateral officers which have all ready been trained and have experience, boasting an impressive $75,000.00 similar to Alameda’s Police Sign On Bonus.

Skipping the expenses typically associated with conventional academy training, including instructor fees, equipment purchases, and administrative overhead, frees up a significant chunk of the agency’s budget. Not to mention, bypassing the need to pay wages and benefits to new recruits during their training phase adds to the pot of saved resources. This move acknowledges the skill set and know-how of experienced officers, making long-drawn training periods obsolete and, as a result, bringing in substantial savings for the agency.

By funneling these funds into an attractive signing bonus package, our law enforcement agency positions itself as a competitive and appealing career destination for seasoned professionals. This $75,000.00 sign-on bonus stands as a testament to our recognition of the expertise and dedication of our lateral officers. It’s a powerful motivator for experienced officers to consider making the shift to our team. Their inclusion not only fortifies our operational capabilities but also nurtures a dynamic and diverse work environment brimming with specialized knowledge and honed skills.

With a firm commitment to fiscal responsibility and the nurturing of a high-caliber workforce, the strategic introduction of cost-neutral signing bonuses signals a significant shift in our recruitment approach. By shrewdly redirecting savings from omitted training costs, we demonstrate our unwavering dedication to attracting top-tier talent and bolstering our operational prowess, all in the service of upholding the highest standards of public safety and community well-being.  San Francisco needs to implement Sign On Bonuses Now!

San Francisco’s Criminal Justice System: A Balancing Act with Limited Resources and the Mayor’s Funding Failure

San Francisco’s criminal justice system is grappling with a multifaceted crisis, characterized by a significant imbalance in resource allocation, challenges in monitoring pretrial diversion and electronic monitoring, and the persistent issue of outstanding warrants. A critical element that exacerbates this problem is the Mayor’s apparent failure to adequately fund the Sheriff’s Office, which is tasked with managing these critical aspects of the criminal justice system. This article delves deeper into these issues, highlighting the impacts of inadequate funding on the functioning of the system.

A Strain on Sheriff’s Office Resources

San Francisco’s Sheriff’s Office plays a pivotal role in overseeing pretrial diversion programs, electronic monitoring, and the apprehension of individuals with outstanding warrants. However, the Sheriff’s Office has been grappling with resource shortages that severely hamper its effectiveness.

Electronic Monitoring Oversight

Perhaps one of the most glaring issues is the overwhelming caseload faced by a mere one to two deputy sheriffs per shift responsible for monitoring 500 individuals on electronic ankle monitoring. This stark imbalance between the number of offenders and the personnel assigned to oversee them has several consequences:

  1. Inadequate supervision: The limited number of personnel makes it exceedingly difficult to ensure effective supervision and compliance with the terms of electronic monitoring. This raises concerns about the potential for offenders to exploit these conditions or reoffend without proper oversight.
  2. Rehabilitation and reintegration: The objective of electronic monitoring programs, which is to support rehabilitation and successful reintegration into society, becomes questionable when the sheer caseload makes individualized attention and support nearly impossible.

The Overburdened Warrants Service Unit

The Warrants Service Unit, tasked with actively seeking out and apprehending individuals with outstanding warrants, operates with just five deputies. The implications of this understaffing are far-reaching:

  1. Limited apprehension capacity: With a minimal workforce, the unit struggles to locate and arrest individuals with outstanding warrants in a timely manner. This undermines the credibility and effectiveness of the criminal justice system.
  2. Accumulating warrants: The challenges faced by the Warrants Service Unit contribute to the mounting number of outstanding warrants, leaving many individuals unaccounted for and the public at risk.

Mayor’s Failure to Fund

2023 San Francisco budget

It is imperative to address the core issue: the Mayor’s apparent failure to allocate adequate funding to the Sheriff’s Office. This funding deficiency exacerbates the problems within the criminal justice system, resulting in an imbalanced workload for deputies, an ever-increasing number of outstanding warrants, and the erosion of public trust.

The implications of this funding shortfall are clear:

  1. Reduced public safety: Inadequate funding of the Sheriff’s Office directly impacts the safety of San Francisco’s residents. Insufficient resources hinder the effective supervision and apprehension of offenders.
  2. Strain on law enforcement: Deputies are faced with insurmountable caseloads, making it nearly impossible for them to fulfill their responsibilities effectively. This, in turn, affects the quality of rehabilitation programs and the timely apprehension of individuals with outstanding warrants.

San Francisco’s criminal justice system grapples with severe challenges, primarily due to the lack of funding for the Sheriff’s Office. The Mayor’s failure to address this issue has far-reaching consequences, leading to imbalanced workloads, a growing number of outstanding warrants, and a loss of public trust. Addressing this problem requires a fundamental reevaluation of resource allocation and a commitment to bolstering the Sheriff’s Office’s capabilities. It is crucial to bridge this funding gap to ensure that the criminal justice system can meet its core objectives while safeguarding the interests of the community.

San Francisco Deputy Sheriff Perez Prevents Suicide due to an Eviction

When San Francisco Deputy Sheriff Diego Perez, of the Sheriff’s Civil Unit Eviction Assistance, noticed that an elderly evictee he was counseling had stopped making eye contact with him.  This concerned Deputy Perez and the evictee’s body language raised a red flag to him.  The man had fought the eviction through the Rent Board and the courts.  He had won two stays of execution. But he had just learned that his third request for a stay was denied and he would have to leave the apartment that had been his home for more than 20 years.  Now that the eviction was inevitable, he wanted to know what would happen to his pets and his property if he could not move them out in time. Continue reading “San Francisco Deputy Sheriff Perez Prevents Suicide due to an Eviction” →

San Francisco Deputy Sheriff stops Robbery Attempt near City Hall

In June of 2015, an attempted robbery was thwarted by a quick-acting San Francisco Sr. Deputy Sheriff V. Chew when he observed a subject fleeing and others giving chase several blocks from the scene of a robbery.

The robbery, unbeknownst to Sr. Deputy Chew, originated outside the Civic Center headquarters of the San Francisco Public Utilities Commission. Sr. Deputy Chew, who was driving in an unmarked vehicle, was able to catch up to and detain the subject. Kudos to Sr. Deputy Chew!

The San Francisco Sheriff’s Department (SFSD), officially the City and County of San Francisco Sheriff’s Department, is the sheriff’s department for the City and County of San Francisco. The department has 850 deputized personnel, and support staff.

The primary function of the SFSD is to operate the system of county jails where there is an average population of 1,200 inmates, and a number of individuals on supervised release programs.

The SFSD also provides law enforcement and security services in the following locations in San Francisco:

  • the civil and criminal courts
  • City Hall
  • the Emergency Communications & Dispatch center
  • Zuckerberg San Francisco General Hospital, Laguna Honda Hospital, the Public Utilities Commission, the MTA  and several public health clinics

The current sheriff is Vicki Hennessy, the first female sheriff in the city-county (and the second in the nine-county Bay Area, after Virginia Clark of nearby Santa Clara County, as well as the fifth female sheriff in California, joining Margaret Mims [Fresno County], Laurie Craig [Glenn County] and Sandra Hutchens [Orange County]).

The SFSD is a separate organization from the San Francisco Police Department. However, SFSD deputies and SFPD officers have all attended a POST-mandated police academy, and are duly sworn California peace officers enforcing state laws and San Francisco Municipal Ordinances.

SF Deputies Saved a Zuckerberg San Francisco General Hospital Employee’s Life

On April 18th, 2015 the San Francisco Sheriff’s Department took great pride in honoring four of our own at the Lion’s Club 52nd Annual Peace Officers, Firefighters and Sheriffs Awards Banquet. Up for accolades for acts above and beyond the call of duty are Sgt. Restauro, Sr. Deputy Clauzel, Deputy Li and Deputy Simms.

In February of 2015, San Francisco Sheriff’s Sgt. Restauro and San Francisco Sheriff’s Sr. Deputy Clauzel intervened to save the life of a Zuckerberg San Francisco General Hospital (SFGH) employee.  The employee, who was depressed and suicidal, went missing after brandishing a razor.  During their search, Sgt. Restauro and Sr. Deputy Clauzel contacted law enforcement departments from as far away as Arizona, utilized ingenuity in following up on various investigative leads, and worked closely with the employee’s family.

As a result of their efforts, Sgt. Restauro and Sr. Deputy Clauzel located and took the employee to a psychiatric care facility.