Health director backs state pilot to expand pharmacologic treatment in jails, announces billing reforms

The San Francisco Department of Public Health told the Health Commission it supports Assembly Bill 1557, a state bill described in the directors report as creating an "opt-in pilot program" to provide state funding for pharmacologic treatment of substance use disorders in incarcerated populations.

Health Director Grant Colfax also announced Mayor London Breeds appointment of Dr. Nagoosa Bland as director of mental health reform, a newly created role that will review how the city provides mental health and substance-use services to people who are homeless or at risk of homelessness.

On hospital billing, the department said it has halted patient balance billing and is developing a three-part plan to strengthen patient protections: expand eligibility for charity care and sliding-scale discounts, set an out-of-pocket maximum for patients at all income levels, and bring a formal recommendations package to the commission on April 16. Director Colfax noted the citys safety-net hospital provided "$61,000,000 in charity care in 2017 alone," and said the department aims to align billing practices with departmental values.

Commissioners asked for follow-up on dental outreach (including Chinatown-focused efforts) and raised concerns about a reported uptick in tuberculosis diagnoses among newer arrivals to the city; the director acknowledged increases in some populations and described improved diagnostics and screening as mitigation efforts.

The director framed the AB 1557 support as consistent with the departments interest in expanding access to medication-assisted treatment for populations with high substance use disorder prevalence, noting the bill will go to the Assembly Health Committee.