Mayor Lurie To Add 73 New Treatment Beds for People with Most Complex Needs, Including Locked Beds for People Under Conservatorship

SAN FRANCISCO – Mayor Daniel Lurie today announced a plan to significantly expand behavioral health care resources for people with some of the greatest or most complex mental health challenges. The plan includes 73 new treatment beds, with 57 locked subacute treatment beds for those with mental health disorders who are under a conservatorship and 16 dual diagnosis beds for those with substance use and behavioral health needs. These new resources will be funded by $27.6 million in state Behavioral Health Continuum Infrastructure Program (BHCIP) funding, secured today by the Lurie administration, which will go towards two projects.

Mayor Lurie continues to deliver on his “Breaking the Cycle” plan to fundamentally transform the city’s response to the behavioral health and homelessness crisis, announcing plans last month for 279 new recovery and treatment beds. Those beds are coming online thanks to Mayor Lurie’s Fentanyl State of Emergency Ordinance, passed 10-1 by the Board of Supervisors in February.

“Under our Breaking the Cycle Plan, my administration is taking full advantage of every available resource to get people who are suffering off the streets, while reclaiming our public spaces,” said Mayor Lurie. “This state funding is a strong first step that will allow us to add some of the beds and services our city needs most—including an expansion of locked subacute treatment for those with complex behavioral health needs. This is how we build a stronger behavioral health system, keep neighborhoods safe and clean, and help people find lasting stability.”

“To truly address our behavioral health crisis and provide every individual a real chance at a healthier, more stable future, we must have the beds and the services at the right levels of care,” said Department of Public Health Director Daniel Tsai. “Here in San Francisco, we are taking necessary and bold steps to build a more responsive behavioral health system, and we thank the State for recognizing that the scale of this crisis requires more than local action. The capital funding from the State is essential to our ability to expand local treatment capacity for our most behaviorally complex clients.”

The San Francisco Department of Public Health (SFDPH) applied for capital funding under Proposition 1, passed by Californians in March 2024. As part of Proposition 1, the state authorized additional BHCIP funding and is awarding one-time behavioral health capital funding in two rounds, with $3.3 billion awarded statewide and another $1.1 billion to be awarded statewide by March 2026.

“If we are to make effective use of conservatorship as a tool, we must have appropriate beds for the people who need conservatorship. Proposition 1 represented the State’s most significant move in decades to address the glaring statewide shortage in mental health beds,” said Board of Supervisors President Rafael Mandelman. “With this funding announcement, San Francisco can now take a significant step toward meeting the needs of a population we have largely abandoned for far too long. Building out our portfolio of locked subacute beds was a key recommendation of the Residential Care and Treatment Workgroup, which I co-chaired and which released its findings and recommendations earlier this year. It’s exciting to now see us able to actually act on the recommendations of that report.”

“San Francisco needs significantly more drug treatment options, and leveraging Prop 1 dollars is exactly the kind of investment to help meet that need,” said District 6 Supervisor Matt Dorsey. “I’m grateful that a portion of that voter-backed funding will help to reopen a residential treatment program in my neighborhood, while also supporting expanded capacity for similar services citywide. Expanding access to care for those struggling with addictions and other mental health challenges is essential to deliver better health outcomes and help restore order to our streets.”

More information about the projects awarded:

Locked Subacute Treatment (LSAT) Beds

$21.3 million to expand capacity at the Behavioral Health Center on the Zuckerberg San Francisco General Hospital (ZSFG) campus by adding 57 additional locked subacute treatment beds

Locked subacute treatment facilities, also known as Mental Health Rehabilitation Centers, offer 24/7 intensive psychiatric care, nursing care, and psychosocial rehabilitation services to adults with severe mental illness and/or placed under conservatorship. These facilities serve some of the most behaviorally complex clients, including individuals under conservatorship.

Locked treatment facilities are difficult to acquire or construct due to the high building standards required. The Behavioral Health Center at ZSFG was built as a locked treatment facility, and with BHCIP funding, SFDPH will complete critical renovations to expand the locked subacute treatment capacity at the Behavioral Health Center by 57 beds.

Dual Diagnosis Treatment Beds

$6.3 million for 16 residential treatment beds to serve individuals with both mental health and substance use disorders

SFDPH will reopen the 7th Street Dual Diagnosis residential treatment program using the BHCIP capital funds to address maintenance needs and make the 16-bed facility ADA accessible. This facility location was previously operated as a behavioral health dual diagnosis program (formerly Jo Ruffin Place). It was acquired by the city in 2024 as part of the debt settlement with the prior provider. The BHCIP funds provide the city with a solution to reopen these much-needed services.