Updates on our demands for safety & transparency at SF Department of Public Health facilities and UC San Francisco
Written safety protocol for situations of escalation in DPH clinics, including which security personnel and staff are responsible for direct intervention, escalating complaints and threats, and handling violent scenarios.
Taking a clinic-by-clinic approach in setting the various protocols for the unique needs of each workplace.
A threat escalation hotline, available to all DPH-affiliated staff, with a single phone line that connects to a human being 24/7 who can provide a resolution or direction within 20-30 minutes. Having on-site building security managers available at all times to address urgent workplace violence and threat situations.
Physical workplace changes at all settings owned, rented, or operated by DPH, including:
Evolv weapons systems detection, with system settings adjusted for threats at clinics. Adding lockers and security ambassadors to explain the changes to staff and patients.
Working security cameras.
Working duress buttons and review of who is notified when staff send duress signals.
Review of access issues with respect to locked doors, admitting areas, and entrance/egress.
Daily clinic staff huddles on safety to review changes and protocols and gather staff input.
Site-specific safety committees to which all affiliated UC staff can nominate themselves to regularly meet and provide feedback on ongoing safety measures in DPH settings.
Through direct advocacy by staff at San Francisco General Hospital and Trauma Center’s HIV Clinic at Ward 86, UPTE social workers met with Daniel Tsai, Director of the San Francisco Department of Public Health, along with members of the University of California’s (UC) labor leadership. At the meeting, workers gave Director Tsai feedback on the safety measures the Department of Public Health (DPH) plans to implement. Ward 86 social workers provided key insights into patient and staff safety, emphasizing that current safety concerns stem from longstanding systemic failures. They also made clear that UC leadership must apply these measures equally to all UC workers in DPH settings. Director Tsai is committed to implementing the following changes across all settings where DPH operates:
These steps describe planned changes, but plans alone are not enough. What matters is real implementation that frontline workers can see and feel in their day-to-day work. We will track implementation and provide updates as they are available. We will continue to hold UC accountable for ensuring frontline staff are genuinely included in the rollout—because the people who do the work every day are best positioned to identify what patients need and prevent avoidable disruptions in care.
We will also intensify our call to end the two-tier system of behavioral health compensation. A pay structure that undervalues some workers, fuels turnover and vacancies, deepening the recruitment and retention crisis. That instability directly affects patient care: it reduces timely access to services, increases wait times, breaks continuity with trusted clinicians, and can compromise clinic safety when teams are chronically short-staffed.
Finally, we will elevate the demands of Ward 86 staff for increased leave and meaningful mental health support in the wake of the tragic loss of our colleague. Caring for caregivers is not optional—it is essential infrastructure for patient care. When staff have the time and support to heal, clinics are safer, teams are stronger, and patients receive more consistent, compassionate, high-quality care.
Read UPTE’s demands on safety & transparency
Recently, an UPTE member was stabbed and killed while working at Zuckerberg San Francisco General Hospital and Trauma Center (ZSFGH) UCSF HIV Clinic at Ward 86. This was a severe workplace violence incident with profound impacts on staff across units. Although the incident occurred at Ward 86, the safety concerns and infrastructure failures implicated UCSF Campus programs operating at San Francisco General Hospital, including outpatient, inpatient, and crisis-response teams.
Workers have repeatedly raised concerns about the absence of basic safety infrastructure, including a lack of metal detectors or equivalent screening procedures, inconsistent security presence, and no standardized protocols for high-risk patients or regular safety huddles. We have also continuously raised concerns about safe staffing levels, as our behavioral health workers play a direct role in risk assessments for our clients. We understand that leadership has indicated safety changes will be implemented. We expect those changes to be concrete, timely, compliant with Cal/OSHA’s workplace violence prevention requirements, and clearly communicated to staff.
We are formally requesting (tap each item to see an expanded view of the demand):
-
A clear threat assessment and security plan for all UCSF Campus workplaces where social workers and clinicians provide care — including programs located at San Francisco General Hospital as well as UCSF Campus clinics and offices off hospital grounds where similar safety risks exist.
Concrete changes to physical security, such as metal detectors or equivalent screening at patient entrances, controlled access points, functional and tested panic buttons, updated duress systems, and cameras.Clear protocol on limiting access to animals in clinics.
A written protocol for identifying and managing high-risk patients and visitors, including criteria for when security or sheriff involvement is required and when services may be limited, paused, or redirected to preserve safety.
Immediate institution of medical emergency contingency plans, including providing crash carts and other necessary emergency equipment in all clinics. A review of emergency response times and barriers to providing life-saving care.
-
A clear plan to address the ongoing crisis of recruitment and retention impacting behavioral health workers performing front-line community-based services.
Additional behavioral health staff support in-unit for all teams that provide risk assessments as part of their role.
-
Paid administrative leave or equivalent for staff who are directly impacted, traumatized, or who do not feel safe returning while a comprehensive safety plan is still being developed.
Clear assurance that no employee will be penalized or required to use their own accruals due to a workplace violence incident.
-
On-site or readily available trauma-informed counseling available within 24 hours, crisis support, and facilitated debriefings within 24 on work time.
Options for temporary reassignment, schedule flexibility, or remote or alternative duties for those who do not feel safe returning to the same work area at this time.
-
Regular, scheduled safety meetings or huddles that include frontline behavioral health staff and union representatives, with a clear timeline on implementing proposed mechanisms.
Mandatory, paid training on workplace violence prevention, de-escalation, and emergency response for all patient-facing staff.
Transparent incident reporting and follow-up processes, including timely communication to staff when serious safety events occur in their areas.
Furthermore, UPTE expects a system-wide security assessment covering every UCSF behavioral health unit, including Hyde Street and Stanyon Hospitals, with immediate, concentrated review and mitigation planning for all campus-based worksites. To ensure transparency and timely action, we request:
A joint meeting including hospital leadership, security, risk management, impacted social workers, and union representatives.
A written response by Thursday, December 11, 2025, outlining all immediate and planned safety actions, including timelines for implementation.
The above requests reflect concerns that staff have raised over many years, and especially in the aftermath of this incident. The requested changes reflect the needs of staff across units who face similar conditions. Many social workers and clinicians continue to work under conditions similar to those in which this incident occurred, and immediate intervention is required to ensure safety.
Our members have a right to a safe workplace. Asking staff to continue providing care without meaningful, clearly communicated changes after a violent incident of this magnitude is unacceptable. We are committed to working collaboratively on solutions and expect tangible commitments and timelines from hospital leadership.