HSH outlines mayoral directive to expand interim housing, integrate street teams; DPH pairs safer‑use supplies with treatment referrals

The San Francisco Department of Homelessness and Supportive Housing outlined a mayoral executive directive in April 2025 that directs coordinated city action to address homelessness and behavioral health, including a citywide effort to add 1,500 interim housing beds and to reconfigure street outreach into integrated neighborhood teams.

The directive, HSH Executive Director Shereen McSpadden said, sets short-, medium- and long-term steps to "implement a system that helps people achieve lasting stability, provide cleaner and safer sidewalks for all members of the community, and to provide more responsible governance and more accountable services." McSpadden said the city plans immediate changes in the next 100 days to form "street teams" that integrate enforcement, service and treatment to get people into care, and to deploy emergency hotel vouchers as part of interim housing expansion.

Why it matters: The directive signals a shift toward a large interim-housing expansion combined with tighter integration among police, public health and other city departments. HSH staff described the plan as a combined operations and service model designed to speed placements into shelter and treatment while improving accountability.

HSH—s presentation listed specific actions: merging Journey Home and Homeward Bound programs to improve reconnecting people to supportive contacts outside San Francisco; expanding interim housing capacity by 1,500 beds over six months (including hotels, transitional housing, stabilization centers, sober housing and residential treatment); improving case management and contracting standards; and maximizing Medi-Cal/CalAIM and Proposition 1 capital funding. Gigi Whitley, HSH chief of administration and finance, said CalAIM community supports could bill managed care plans for housing navigation, deposits and stabilization services but cannot be used for shelter operations.

The directive also reorganizes outreach into five neighborhood street-team units plus a citywide coordinating team, McSpadden said. HSH said the first two integrated teams deployed March 24 in the Tenderloin and the Mission, with a citywide coordinating team launched March 31. McSpadden said SF HOT (San Francisco Homeless Outreach Team) will continue to focus on relationship-building, shelter placements, on-street assessments and case management while working alongside public safety and emergency-management partners.

Department of Public Health policy shift: McSpadden reported a separate DPH policy, effective April 30, that requires distribution programs receiving city funds to pair safer-drug-use supplies with proactive treatment counseling and service referrals. The policy, she said, "mandates that any distribution of supplies be paired with proactive treatment counseling and connections to care requiring distribution programs to provide treatment referrals and on-site engagement to enable entry into services" and prohibits distribution of smoking supplies in public spaces. McSpadden said DPH will monitor overdose rates and infectious-disease indicators to ensure public-health goals are met.

Funding questions and next steps: Commissioners pressed HSH staff about funding sources for the 1,500-bed goal. Whitley said HSH is billing for CalAIM services that currently bring about $6 million a year and could eventually scale; she said Prop 1 funds are capital-only and that Medicaid-related operational funds are managed primarily by DPH. McSpadden said the mayor—s office is developing a funding plan and that HSH expected to present site-level and cost details in a future meeting.

Public comment: Service providers and advocacy organizations welcomed additional interim capacity but urged parallel investments in exits to permanent housing, population-specific beds and stronger case-management and prevention services. Marnie Regan of Larkin Street/HESPA said adding beds must be accompanied by ‘‘multiple well-coordinated pathways out of homelessness——and population-specific services." Flo Kelly and other commenters urged the city to prioritize a safe-parking strategy for people living in vehicles.

HSH said it will continue cross-departmental planning, start a multi-year re-procurement of services to improve performance tracking and report back with additional details on funding and sites at upcoming meetings.

Ending note: HSH framed the directive as an operational pivot combining outreach, enforcement and care to move people off the streets more quickly while pursuing longer-term funding and procurement changes intended to improve outcomes.