Board of Supervisors Approves Mayor Breed's Streamlining Legislation to Speed Up New Residential Treatment and Care Beds

Approved legislation will reduce red tape and help City meet residents’ behavioral health needs as San Francisco continues to add beds for those struggling with mental health and substance use disorder
February 13, 2024

San Francisco, CA – Today, the San Francisco Board of Supervisors unanimously approved legislation sponsored by Mayor London N. Breed 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. The legislation was put forward in partnership with the San Francisco Department of Public Health (SFDPH) and co-sponsored by Supervisors Rafael Mandelman and Hillary Ronen.  

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. Under Mayor Breed’s expansion plan, the City has added 355 beds, so there is now a total of approximately 2,550 behavioral health treatment and care beds. The City has additional plans to expand this further this year. 

These beds come at a critical time for San Francisco as it becomes the first county in California to implement the new state conservatorship laws under Senate Bill 43, which became effective January 1st. While other counties are delaying implementation, Mayor Breed issued an Executive Directive to begin the process of submitting people for conservatorship under these new laws at the beginning of the year.  Along with CARE Court, which became effective last fall, San Francisco has more tools available to help get people into the care they need.   

“This streamlining law is exactly the kind of tool we need to deliver services faster for those in need, and I appreciate the Board of Supervisors for quickly approving it so we can get more people help,” said Mayor London Breed. “When people in our city see people struggling on our street, they want us to move faster and more aggressively to get people into care. Too often we cling to long, bureaucratic processes that stand in the way of solutions, and I’m grateful for support for this commonsense legislation that will expedite our ability to acquire beds and save lives.” 

At a time when clients in need of residential care are most vulnerable, and San Francisco is vying for out of county beds along with other counties and health systems, the City and County continues to find ways to be more competitive. The approved ordinance waives the lengthy RFP process required for SFDPH to contract beds for public health use in third-party facilities both in and outside of San Francisco, while still adhering to key transparency and accountability measures.  

"With the recent expansion of our conservatorship laws through SB 43, it is critical that we have the treatment placements necessary to meet increased demand,” said Supervisor Rafael Mandelman. “I strongly support the Mayor’s legislation that will help the City acquire behavioral health treatment beds more quickly to get those suffering from mental illness and addiction on our streets into the care they desperately need.” 

"We are experiencing a severe behavioral health crisis on the streets of our city and this legislation will allow our health professionals to better serve individuals with serious mental illness and substance use disorder immediately,” said Supervisor Hillary Ronen. “Getting individuals access to treatment quickly can be life-changing, and making it easier to procure available beds is a huge step in the right direction." 

“Accelerating the process to obtain these critical treatment beds will better serve our most vulnerable clients,” said Director of Health Dr. Grant Colfax. “Thank you to Mayor Breed and our sponsoring Board of Supervisors for championing this legislation to address our residents’ behavioral health needs and streamline contracting.”  

By waiving the lengthy RFP process SFDPH is currently required to undergo when contracting beds for public health use from third-party facilities, the City will be able to:   

  • Reduce wait times for beds to quickly meet the city’s high demand 
  • Provide greater diversity of potential providers who may not otherwise respond to RFPs due to bureaucratic hurdles 
  • Provide flexibility for individual clients with specific placement needs 

The approved ordinance is limited in scope and only waives the RFP process for public health beds, including residential care and treatment and isolation and quarantine beds. 

“We want to ensure treatment options are available and provide appropriate care as quickly as possible, especially for people with serious mental health or substance use disorders,” said Dr. Hillary Kunins, Director of Behavioral Health Services and Mental Health SF at SFDPH. “Our continued goal is to get more people the treatment they may need and make treatment more accessible, putting them on a path to recovery and wellness. 

The approved ordinance waives the RFP process for five years. However, SFDPH will still adhere to City contracting checks and balances, as well as its own internal measures, to ensure that all providers comply with Federal, State and local contract monitoring recruitments. 

For more information about San Francisco’s work to expand treatment beds and services, please visit this page