Mayor Breed and Supervisor Mandelman Leading Effort to Implement Prop 1 to Expand Mental Health and Addiction Treatment in San Francisco

Under the Mayor’s direction, City departments have already begun planning so that when the State makes resources available from recently approved ballot measure, San Francisco is ready to help more people get treatment and care
March 21, 2024

San Francisco, CA – Today Mayor London N. Breed and Supervisor Rafael Mandelman announced that San Francisco is planning to be ready to implement Prop 1, Governor Gavin Newsom’s ballot measure to expand treatment and mental health services in California. Under this action plan, San Francisco will coordinate resources to expand access to mental health and addiction treatment to be first in line when new state resources become available.  

Prop 1, which has now been approved by the voters, is a $6.8 billion state-wide bond measure that will help fund the expansion and modernization of the State’s mental health system and provide housing for those on our streets. These investments include:  

  • An estimated 11,150 new behavioral health beds statewide at all levels of care, including for those who are conserved 
  • 26,700 outpatient treatment slots 
  • $1 billion to ensure that veterans experiencing homelessness, mental health, and substance use disorder are given the care that they deserve 
  • $2 billion to further support Governor Newsom’s Project Roomkey program, which provides funding to acquire hotels to house formerly homeless Californians.   

The measure also changes the Mental Health Services Act to better align the State’s investments with the higher level of care required by many who are currently living on our streets.  

Right now, City departments have been convening under the Mayor’s direction to map out an implementation framework for San Francisco that will position the City to receive new resources as they become available.  Now that Prop 1 has officially passed, this working group will expand to include representatives from City departments, health experts, and community stakeholders.  Co-led by the mayor and Supervisor Mandelman, the first meeting of this working group will convene in the coming weeks. 

“The passage of Prop 1 is a major step forward for California cities that need more support to meet the challenges around addiction and mental health we are seeing on our streets,” said Mayor Breed. “I want to thank Governor Newsom for his work to deliver more support for cities in California working to address these problems. Now we begin the hard work to deliver for San Francisco. When major opportunities arise to make real change in our city, whether that’s changes to our mental health laws or more resources becoming available, we have to be aggressive and proactive.”    

“Proposition 1 presents San Francisco with a once-in-a-generation opportunity to secure mental health resources for our most vulnerable residents,” said Supervisor Rafael Mandelman. “I am grateful to the Mayor for convening the working group, and I look forward to continuing to work with her and her departments to make the most of Prop 1 and to pursue all other available resources to get severely mentally ill San Franciscans off the streets and into care.”  

Since 2020, San Francisco has been expanding the supply of residential treatment and care beds to meet the need of people with a variety of behavioral health conditions. The City currently offers approximately 2,550 behavioral health treatment and care beds. Mayor Breed, along with Supervisors Mandelman and Hillary Ronen, recently authored legislation to make it easier to procure public health beds, and provide needed flexibility in obtaining much-needed mental health and/or substance use disorders beds. That legislation was approved by the Board of Supervisors and is now law.  

“Under Mayor Breed and Supervisor Mandelman’s leadership, we continue to expand and evolve vital supportive services to address substance use disorder and mental health in our communities,” said Director of Public Health, Dr. Grant Colfax. “With this necessary investment from the state, San Francisco will have access to much needed, additional treatment and mental health in-patient beds and resources. We will aggressively work with city partners to leverage this opportunity to provide people the treatment, care and housing they need.”  

This kind of proactive planning and action is a key part of Mayor Breed’s approach on major issues confronting San Francisco, including with mental health and addiction needs.    

San Francisco, under Mayor Breed’s direction, took a similar approach to implement the new conservatorship laws approved by the California Legislature last year. Once Governor Newsom signed the bill (SB 43), Mayor Breed immediately issued an Executive Directive to ensure San Francisco was ready to implement these changes to state law on January 1, the day the law took effect.  

With this aggressive action, San Francisco became the first and only county in California to adopt the changes to conservatorship laws. Since taking that action, San Francisco has increased the number of people petitioned for conservatorship by 70% compared to the same time the previous year.