San Francisco behavioral health leaders outline state-led plan, overdose response and new treatment capacity

San Francisco Department of Public Health behavioral health leaders presented a wide-ranging update to the San Francisco Health Commission on Sept. 22, saying new state requirements will require counties to submit a three‑year Behavioral Health Services Act integrated plan and budget and that the city is expanding overdose prevention and addiction‑treatment capacity.

The integrated plan required under the Behavioral Health Services Act (Prop 1) covers fiscal years 2026–29 and, officials said, for the first time must account for all payer and revenue sources used for specialty behavioral health services. “The plan must be informed by local stakeholder input,” Behavioral Health Director Dr. Coonens told commissioners, and counties must submit drafts for state review in March 2026 with final plans due June 30, 2026.

Why it matters: the change demands that local agencies inventory and report all funding streams—beyond the Mental Health Services Act—and tie them to measurable service outcomes. Department officials said the requirement is a substantial operational lift for program, finance and personnel teams but could create clearer, more transparent reporting on what services are being paid for and where gaps remain.

On Medi‑Cal and new billing authorities, DPH staff described state plan amendments that let counties bill Medi‑Cal for…