Mayor Lurie Appoints Mike Levine To Lead Department Of Homelessness And Supportive Housing

SAN FRANCISCO – Mayor Daniel Lurie today appointed Mike Levine to lead San Francisco’s Department of Homelessness and Supportive Housing (HSH), bringing a leader with deep experience addressing the intersection of health and homelessness. Levine joins HSH following decades in public service—including most recently leading Massachusetts’ Medicaid program, a $23 billion agency serving nearly 2 million residents. With expertise in the link between health and homelessness, Levine brings experience integrating primary care, behavioral health, and social supports to keep people healthy and housed. He will work closely with Mayor Lurie and city health and housing leaders to build accountable systems and contracts, draw on experience to leverage state and federal funding, and get people off the streets and connected to care while delivering clean and safe streets across San Francisco. 

Under Mayor Lurie’s leadership, San Francisco has made strides in combatting the city’s homelessness and behavioral health challenges. The most recent tent and encampment count in February 2026 showed tents down to the lowest number on record for the third straight quarter, and down 37% from a year ago. The mayor reformed HSH’s Journey Home program—which is connecting people to loved ones outside of the city at levels not seen since 2022. San Francisco is making progress in getting large vehicles off the streets, with nearly 100 households housed through the city’s large vehicle program and 26 percent fewer vehicles on the street this year than last year. During his first year in office, Mayor Lurie took steps to support the city’s budget deficit by billing more homeless services to Medi-Cal. As part of his Breaking the Cycle work, Mayor Lurie is taking steps to open a Rapid Enforcement, Support, Evaluation, and Triage (RESET) Center to get drugs and drug users off the street, and opened a 24/7 crisis stabilization center and restructured neighborhood street teams—both of which are showing more success at connecting people struggling on the streets to care.  

“Our Breaking the Cycle plan set out to fundamentally transform our homelessness and behavioral health response, and we are moving in the right direction because we’ve brought together our homelessness work with our health care work around addiction and mental illness. Mike is an expert in connecting health care and homelessness services, and he has seen the power of integrating primary care, behavioral health, and social supports to keep people housed,” said Mayor Lurie. “The positive direction is clear, but the work is far from finished. Mike brings the experience and the expertise to build on our momentum, and I look forward to working with him.” 

“My experience in health care has taught me that homelessness is more than a housing issue—we will only succeed in getting people stabilized if we treat addiction and mental health issues. In Massachusetts, we have retooled our Medicaid system so that the health care and homelessness service providers work hand-in-glove, and we recognize providers who successfully engage the hardest-to-serve clients,” said Mike Levine. “I know San Francisco has made tremendous progress in the last year. I am excited to lean in to accelerate our progress to help more people move toward stability and I look forward to being out in the community—meeting with providers, community members, frontline teams, and most importantly, the clients we serve.” 

“As I retire from my role as executive director, I am excited to welcome our new director of the department, Mike Levine,” said Shireen McSpadden, HSH executive director. “Mike has deep expertise and a proven track record of innovative solutions; I have confidence in his ability to lead HSH’s efforts in addressing homelessness with compassion and effectiveness. Under Mike’s leadership, we have the opportunity to create lasting change and to fulfill the promise of Mayor Lurie’s Breaking the Cycle initiative.” 

“San Francisco is making progress on homelessness, and I want to see that continue. What excites me about Mike Levine is that he gets that you can't separate healthcare from housing and expect good outcomes. He's spent his career focused on the people who fall through the cracks—folks dealing with addiction, mental illness, aging, disability,” said Sam Cobbs, Tipping Point Community CEO. “He ran one of the biggest Medicaid programs in the country and built it around actually reaching the highest-need members. He's the kind of leader who can deliver for the people this system is supposed to serve.” 

“I am encouraged to see the city bring in a leader who understands systems and the importance of meeting each person with dignity. Our work calls us to hold both, care that is coordinated and care that is deeply human,” said Dr. Larry Kwan, St. Anthony Foundation CEO. “Michael Levine's experience and prior collaboration with Daniel Tsai positions him well to strengthen that kind of alignment across agencies at a moment when it is needed most. I look forward to continuing to partner together in service of San Franciscans in need.” 

“The quality and breadth of the health care of homeless persons in Boston and Massachusetts is unparalleled in the country, primarily because of the vision, creativity, and dedication of Michael Levine and his remarkable team at MassHealth. Michael is a brilliant leader, trusted by all for his honesty and transparency, and blessed with an uncanny ability to bring together the key partners needed to find solutions to the most difficult health care challenges,” said Dr. Jim O’Connell, President of Boston Health Care for the Homeless. “From respite care to shelter medicine to care on the streets to home visits for those newly housed, MassHealth has made innumerable innovations to improve the quality of life of so many. Whether meeting with legislators, hospitals and health plans, shelters and community clinics, Michael has earned respect and admiration for his quiet and effective leadership. As a physician caring for homeless persons for over four decades, working in a program that cares for over 11,000 individuals and families each year, our success has been a direct reflection of the relentless commitment of Michael Levine and his team to the Commonwealth’s most marginalized citizens. We have been singularly blessed to have such a leader, and we know that San Francisco is gaining a treasure.” 

“Mike Levine has been an exceptional partner to Massachusetts’ community health centers throughout his many years of service at MassHealth. Mike consistently brought thoughtfulness, integrity, and a deep commitment to the patients and communities we serve. He championed innovative policies that strengthened the Commonwealth’s safety net and recognized the social factors that undermined health,” said Michael Curry, President and CEO of the Massachusetts League of Community Health Centers. “Few people are as committed to caring for our most vulnerable as Mike, and I am grateful for his years of partnership. It has been a true pleasure working alongside him, and his leadership will leave a lasting and meaningful impact on our state.” 

Mike Levine is a lifelong public servant with more than a decade of experience steering large, mission-driven health and human services agencies. He most recently served as Medicaid director for the Commonwealth of Massachusetts, overseeing a $23 billion program that provides comprehensive health coverage to nearly 2 million residents—including nearly half of the state’s children, more than 10,000 individuals experiencing homelessness, and the majority of those accessing behavioral health and addiction treatment services statewide.   

As MassHealth director, Levine led a 1,000-person workforce in a transformation of Massachusetts’ Medicaid system to better integrate health care and homelessness services, expanding community behavioral health programs that contributed to a 70% decline in emergency department boarding, and launching a first-in-nation primary care capitation model that has become a blueprint for statewide reform. He has also delivered four billion dollars in additional federal revenue through aggressive federal waiver negotiations.  

Levine brings a deep commitment to financial sustainability, data-driven accountability, and centering the needs of vulnerable populations—ranging from families to seniors to behaviorally complex adult patients. He has managed complex stakeholder relationships across government, health plans, hospital systems, and advocacy communities, and has led his agency through major operational and policy transitions while maintaining a focus on results. Mike is a graduate of Pomona College.