Supervisors send $248.6 million DPH substance-use services agreement back to Budget & Finance for vetting over Baker Places

The San Francisco Board of Supervisors voted unanimously on Nov. 1 to send a proposed Department of Public Health (DPH) agreement for substance use disorder services back to the Budget & Finance Committee for further review.

Item 27 on the agenda would have retroactively authorized an agreement between the city and the California Department of Health Care Services to provide Medi-Cal reimbursable substance-use-disorder services over a five-year term through June 30, 2027. DPH described the contract amount as approximately $248,600,000 for the full term.

Supervisor Ahsha Safai moved to send the item back to committee after members said they had received a list of potential service providers the day before and saw that Baker Placesa local nonprofit that operates detox and other programswas listed to receive more than $4.5 million. Safai said some supervisors had since been told Baker Places was ‘‘going out of business," and she asked for additional vetting on which organizations would receive the funds and how services would be sustained if a listed provider cannot operate.

DPH staff told the board that some presenters originally scheduled to answer budget questions were not available at the meeting. Anna Valdezic, a DPH staffer, joined remotely and said she was attempting to get the appropriate presenters to sign in; the department said Budget & Finance had requested the provider list and the list was delivered the previous day.

Supervisor Rafael Mandelman said his understanding was that Baker Places was being forced to close some facilities and that the board should ensure funds would not be directed to organizations unable to deliver services. Mandelman and other supervisors said they want more detail on which programs would be funded and how continuity of care would be maintained.

After a brief discussion, the board adopted the motion to refer the item to the Budget & Finance Committee. The roll-call vote was unanimous.

What the item would do: DPH described the contract as an intergovernmental agreement that allows San Francisco to receive and administer state funds for substance-use disorder treatment programs and to enter into subcontracts with service providers. The department said the funds would support programs already in place and help expand substance-use services across the city; the agreement also allows DPH to amend subcontracts as needed.

Why supervisors referred the item back: Members said the late delivery of the provider list and uncertainty about the status of at least one proposed provider made it inappropriate to approve the resolution without further review. Supervisor Safai specifically asked for committee-level vetting of how the department plans to spend the funds, which providers will be paid, and contingency plans if any listed organization cannot deliver services.

Next steps: The item will return to Budget & Finance for additional review and a fuller presentation by DPH staff on provider selection, funding allocations, and contingency planning. DPH said delays in the board vote would defer final sign-off of the intergovernmental agreement and could delay receipt of state reimbursements.

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"Because of the size and magnitude of this contractthis is money coming down from the statewe wanted to know which providers were identified by the Department of Public Health as potential recipients," Supervisor Ahsha Safai said on the record.

Ending

The boardwithout approving the contractvoted unanimously to send the item to Budget & Finance to allow DPH and supervisors more time to review the provider list and funding details before final approval.