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New DPH director outlines street outreach, telehealth prescribing and mayoral directive to expand access to treatment
Summary
Department of Public Health Director Mark Tsai described street-team telehealth prescribing pilots, efforts to streamline pathways into treatment and a mayoral executive directive emphasizing access to treatment, beds and connections to syringe services during his first weeks on the job.
Department of Public Health Director Mark Tsai used his director’s report on Monday to summarize observations from his first two weeks and to describe several operational efforts the department is pursuing, including street-team telehealth prescribing, efforts to make treatment pathways clearer and a mayoral executive directive with citywide implications.
Tsai said he had spent time with street navigation teams and night navigators and that the department has initiated an on-the-street telehealth prescribing program able to connect people directly to prescribers for buprenorphine initiation. "We're able to get someone, even at all hours of the night, on the phone with a prescriber and able to, in that moment, prescribe buprenorphine to really lower the barriers to providing access to that really evidence based life saving potentially intervention," he said.
He described a recurring challenge that while clinicians can initiate treatment in the field, the harder task is helping people remain engaged after the first days: "How we help someone when they're able to initiate treatment, actually continue to stay plugged in," Tsai said, noting the need for counseling, social work and other supports beyond initial prescribing.
Tsai also flagged a mayoral executive directive released the same morning calling for easier entry into treatment, expanded appropriate bed capacity, and a recommitment to longstanding harm-reduction interventions (including sterile syringe access) paired with more intentional referral into treatment. He told the commission the department would work with community partners and city agencies over the next one-to-two weeks to determine policy implications and operational steps.
Commissioners responded with support and questions about monitoring and integration. Commissioner Christian praised the department’s street-based work and asked for regular updates; Commissioner Chao asked whether street teams have a sense of which interventions generate the most enthusiasm among people they meet. Tsai and commissioners discussed coordination with hospitals and shelter systems in the city to facilitate step-down connections and discharge options for people engaged on the street.
No formal commission action was taken on the director’s report, but commissioners asked for frequent updates and asked staff to brief the commission on how DPH plans to track engagement beyond initiation.
