San Francisco, CA — Today the Board of Supervisors voted unanimously in favor of Mental Health SF, which is an overhaul of San Francisco’s mental health system and guarantees mental health care to all San Franciscans who lack insurance or who are experiencing homelessness. Mayor London N. Breed, Supervisors Hillary Ronen, and Supervisor Matt Haney co-sponsored the legislation.

“With the passage of Mental Health SF, we can keep moving ahead to address the serious mental health and substance use challenges on our city’s streets,” said Mayor Breed. “As we work to reform our entire mental health system, we’ll continue prioritizing the most vulnerable people, and providing targeted services to those who are experiencing homelessness, mental illness, and substance use disorder.”

Mayor Breed is committed to fast tracking implementation of the legislation and will prioritize the hiring of a new Director of Mental Health SF by next summer. Additionally, a 13-person implementation working group will be impaneled to begin the process of developing recommendations on how best to reform and expand the City’s mental health services.

Prior to introducing the Mental Health SF legislation, Mayor Breed and Supervisors Ronen and Haney had submitted separate initiatives for the March 2020 ballot. Talks between the Mayor’s office, the Supervisors, community stakeholders, and union leaders representing front-line workers led to a compromise proposal focused on those most in need, allowing both previous versions to be withdrawn from the ballot. Mental Health SF prioritizes people experiencing homelessness, includes a central access location for behavioral health services, and creates a new Office of Private Insurance Accountability.

“Supervisor Haney and I began this work to reform our mental health care system two years ago, in partnership with nurses and front-line mental health care workers,” said Supervisor Ronen. “I am thrilled that Mayor Breed has now joined us as a co-sponsor of Mental Health SF, and that the Board unanimously passed this legislation today. This is a concrete plan that will help vulnerable people who are suffering from mental illness and substance abuse. It’s long past due for City Hall to take action on our mental health crisis and I’m so pleased that we were able to come together to make it happen.”

Prioritizing People Experiencing Homelessness

Mental Health SF will focus first on serving people who are homeless with serious mental illness or substance use disorders and will prioritize getting people off the street and into care. The program is also open to the uninsured and those who the Department of Public Health already serves. The system improvements targeting the homeless population will extend to the broader populations served as well.

Mental Health Service Center

Mental Health SF calls for the creation of a Mental Health Service Center that will serve as a central access portal for uninsured and homeless San Franciscans seeking access to mental health care. Mental Health SF will expand a centralized drop-in center for people in need of immediate behavioral health care, including those who come in voluntarily and providing another drop-off destination for first responders and the jail, strengthening coordination with law enforcement partners. The Center will provide expanded capacity for several levels of care, including pharmacy services and care coordination.

Office of Private Insurance Accountability

The Mental Health SF legislation creates an Office of Private Insurance Accountability that will advocate for insured people with mental illness to make sure that they receive the care to which they are legally entitled.

“Passing Mental Health SF is a huge step forward, but we still have a long way to go,” said Supervisor Haney. “Supervisor Ronen and I are committed to working with the Mayor, our colleagues, and stakeholders to ensure that Mental Health SF is fully implemented and fully funded. We will not rest until every component of this program is up and running. The crisis on our streets continues to have a devastating impact on our residents and neighborhoods, and Mental Health SF is the solution we urgently need.”

Mayor Breed and Supervisors Ronen and Haney have committed to working together to secure the approximately $100 million annually needed for Mental Health SF’s implementation. The City will continue making investments immediately and in the upcoming budget to meet the goals of Mental Health SF, however, several elements of Mental Health SF will be dependent on identifying new revenue sources. Mayor Breed and Board of Supervisors President Norman Yee have asked the Controller to convene a process to reform the City’s business tax, which could provide a new revenue stream for Mental Health SF. The City Administrator and the Capital Planning Committee are also looking at moving up a Public Health Bond for the November 2020 election to help pay for capital improvements. 

As the Mayor and Supervisors work to identify funding for the longer-term elements of Mental Health SF, the City will continue providing mental health and substance use treatment services to as many homeless individuals as possible. This immediate action includes continuing to prioritize healthcare and housing for the most vulnerable of the 4,000 who are experiencing homelessness, and have both a mental illness and a substance use disorder, as identified by the Department of Public Health.

The City will continue to expand treatment capacity and reduce administrative barriers to eliminate wait times for services. This will include adding new behavioral health treatment beds, creating new meth sobering centers and managed alcohol facilities, expanding access to existing City services, and ensuring there are navigators and case managers to help people get into care. These improvements will be folded into Mental Health SF as the new program becomes operational.

“Mental Health SF is an opportunity to come together and do great things—this time for San Franciscans experiencing homelessness, mental illness and substance use disorders,” said Dr. Grant Colfax, Director of Health. “An initiative of this magnitude promises to help transform our behavioral health care system. With the support of Mayor Breed and the Board of Supervisors, the expertise of the Department of Public Health, and the wisdom of our community, we can make a difference and save lives.”

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