Budget Committee advances 'Mental Health SF' ordinance; sponsors and DPH outline scope and funding needs

The Budget Committee voted to advance an ordinance establishing “Mental Health SF,” a city program designed to expand access to mental health services, substance‑use treatment and psychiatric medication for adults who are homeless, uninsured, or enrolled in Medicare/Medi‑Cal or Healthy San Francisco.

Supervisor Hillary Ronan, a sponsor of the ordinance, described Mental Health SF as a comprehensive system including a 24/7 mental health service center, a drug sobering center, an Office of Coordinated Care to provide case management and a street crisis response team. Ronan said the proposal increases seats on the implementation working group, adds an appointee with health‑law expertise, and shifts the staffing analysis to be done jointly with the controller and human resources. She told the committee the mayor has committed to hiring a director for the program by next summer and to accelerate renovations to create a 24/7 service center.

Gráma Colfax, director of the Department of Public Health, said the department welcomes the legislation and called it an opportunity to modernize the behavioral health system. DPH staff highlighted existing initiatives (street medicine, navigations, expanded behavioral health access) and emphasized the need for data, analytics, and workforce expansion.

DPH’s Hallie Hammer described a proposed tiered case‑management model (1:10 for highest‑need intensive teams; 1:17 for intensive case management; 1:50 for lower‑intensity touchpoints) and said the Office of Coordinated Care would oversee transitions from jail and psychiatric emergency services. DPH budget director Jenny Louie described cost ranges: a 24/7 mental health services center estimated at roughly $18–22 million and an Office of Coordinated Care estimated in the $20–35 million range, depending on the model. The sponsors said full implementation will require identifying sustained funding and cited a target of $100 million per year to realize the entire vision.

Supervisors pressed staff and sponsors on workforce recruitment and retention, the design of sobering centers, how the 24/7 crisis response would interact with existing outreach teams (EMS6, HOT teams), data/IT investments to create a real‑time inventory of beds and services, and the need for pilot testing and iterative evaluation. Multiple public commenters representing providers, unions and advocacy groups urged robust funding, inclusion of peer providers, emphasis on treatment (not short stays), and attention to families, employment and housing connections.

After discussion, the committee approved the sponsor amendments, accepted public comment, and moved the ordinance to the full Board as a committee report with a positive recommendation. The sponsors and DPH repeatedly noted the legislation establishes policy direction and that further actions, staffing analyses, and appropriations will be required for implementation.