Supervisors hear city departments on updating overdose prevention policies; one resolution continued

The Public Safety and Neighborhood Services Committee on July 24 continued a resolution urging the Police Department and the Department of Emergency Management to designate all 911 calls reporting drug use or suspected drug activity within 1,500 feet of parks, playgrounds and schools as Priority A, and held a hearing soliciting city department input on potential updates to the 2021 ordinance (administrative code section 15.17) that requires annual overdose prevention policy reports.

On the resolution (agenda item 3) — sponsored by Supervisor Sherrill with Supervisor Danny Sauter listed as a cosponsor in committee remarks — Supervisor Sauter moved to continue the item to the call of the chair to allow additional work with SFPD and DEM; the committee voted 3-0 to continue the resolution.

Committee members then heard a substantive presentation from Department of Public Health (DPH) Deputy Medical Director for Substance Use Services Dr. Kristi Soren and partner presenters from the Department of Homelessness and Supportive Housing (Deputy Director Emily Cohen), Human Services Agency (Principal Administrative Analyst Perry Weisberg) and the Department of Emergency Management (Deputy Director Adrienne Bechelli). The panel described how the 2021 ordinance requires DPH, DEM, HSH and HSA to submit annual overdose prevention policies addressing: treatment access; posting and access to resources including naloxone and syringe services; agency overdose response procedures; staff and grantee training on overdose recognition and response; and grantee implementation processes.

Presenters described citywide efforts since 2021 across the continuum of care. Highlights presented by DPH and partners included: - DPH’s e‑learning opioid overdose recognition and response module has had more than 7,500 completions since it launched in August 2022, and a frequently updated DPH resource page provides treatment and overdose prevention information to staff, grantees and the public. - Admissions to Drug Medi‑Cal residential treatment programs rose about 35% in the most recent fiscal year compared with the prior year; DPH said it has added roughly 400 new behavioral‑health beds over the past five years and has about 70 new substance‑use and dual‑diagnosis beds in the pipeline. - DPH announced an expansion of 21 withdrawal management and residential treatment beds at Salvation Army earlier in July and reported a 35% increase in people accessing buprenorphine in 2024 vs. the prior year and a 16% increase in people engaging in methadone treatment. - The city has expanded contingency management programs to 12 sites with two additional programs expected to open by year‑end; recovery housing expanded in 2024 with the addition of 70 residential step‑down treatment beds on Treasure Island and another 68 recovery beds expected this fall. - HSH has incorporated overdose prevention requirements into contracts with providers, requires submission of harm reduction and overdose response plans, has added an on‑site naloxone access protocol in the 2024 policy, and expanded the Permanent Housing Advanced Clinical Service (FACS) to all permanent supportive housing sites. - HSA described a county adult assistance program (CAP) treatment program launched in January: presenters said the CAP effort has identified 179 clients for referral to more intensive services and that 116 of those 179 had achieved at least 30‑day retention in services as of the presentation. - DEM explained its role coordinating interdepartmental street‑response work through the Healthy Streets Operations Center (HSOC) and said it will update its policy in 2025 to reflect new programs such as neighborhood street teams and community safety ambassadors; DEM reiterated naloxone accessibility and annual training requirements across coordinated operations.

DPH staff presented several recommendations for legislative updates and administrative changes: they suggested removing the requirement that departments submit policies through a Board resolution annually and instead aligning policy submissions with the Treatment on Demand report timing; they recommended removing language that requires posting a static list of specific services (syringe access, naloxone locations) in favor of ensuring departments have timely access to full continuum information; and they requested continued collaboration to incorporate Recovery First principles into overdose prevention policies so the policies better reflect treatment and recovery across the continuum.

Public comment included multiple speakers with lived experience and provider organizations. Matthew Valls, a Code Tenderloin outreach worker who said he is in recovery, told the committee that ‘‘recovery is possible’’ and thanked supervisors for making recovery a priority. Other commenters — including leaders of recovery nonprofits and medical society representatives — praised the collaborative approach and urged sustained attention to workforce and provider shortages.

After discussion, Chair Matt Dorsey moved that the hearing be considered "heard and filed." The committee voted 3-0 to hear and file the report. Separately, the committee voted 3-0 to continue the Priority‑A 911 resolution to the call of the chair to allow further coordination with SFPD and DEM.

Ending: Departments will continue work with the Board on potential ordinance updates; DPH recommended procedural changes to reporting and posting requirements and invited further collaboration to align overdose prevention reporting with Recovery First principles.