The Board of Supervisors voted unanimously to expand withdrawal‑management services by adding 44 detox beds in downtown San Diego, a change sponsors said would create access for an estimated 2,700 people per year.

Supervisor Montgomery Step, the item sponsor, framed the action as a response to continuing countywide crises in homelessness and substance use: “Nearly 10,000 people sleep without shelter each night. And last year alone, 293 of our neighbors died from drug or alcohol related causes.” She said the county currently has only two withdrawal‑management beds in District 1 and called for beds located close to where people live.

Why it matters: Advocates and service providers told the board that detox (withdrawal management) is often the required step to enter long‑term treatment; providers said long waits and geographically distant bed locations prevent people who are ready for recovery from starting treatment. Father Joe’s Villages said last year 300 people living on the streets died from overdose and supported downtown capacity to reduce wait times for treatment slots.

Public comment: The board received 15 in‑person speakers and multiple written comments. Providers including Father Joe’s Villages and clinicians from service agencies described the shortage of downtown beds and urged the board to expand capacity. Some callers argued the plan was a short‑term “band‑aid” without additional community‑based recovery investments.

Board action and next steps: Supervisors said withdrawal management must be paired with warm‑handoffs to treatment and housing supports. The motion to approve the expansion passed with all supervisors present voting aye. The county will proceed with implementation steps through the department identified in the board letter; staff said the item also contemplates coordination with Medi‑Cal providers and case managers to ensure equitable access for people experiencing homelessness.

Source material: Staff presentation and public remarks at the Nov. 4 meeting; quotes above come from the sponsor’s remarks and from providers who testified (transcript).