San Francisco Mayor London Breed is proposing an expansion of addiction and behavioral health treatment as part of a budget proposal that includes three "wellness hubs" for overdose prevention and other services for those addicted to drugs.
The sites, which were initially outlined in a Department of Public Health proposal last year, are described as low-barrier sites intended to prevent overdoses and provide connections to resources such as basic medical aid, food assistance and connections to treatment.
Any "possible inclusion of safe consumption would be funded by private entities," said the Mayor's Office in a press release.
“We’ve expanded our resources significantly in recent years, but the challenges around fentanyl require even more support," Breed said in a statement. "While it’s critical that we focus on accountability, we also need to continue to find ways to get people into care and treatment."
Because safe-consumption sites are illegal, City Attorney David Chiu's office has advised against using public funds, including funds from recent opioid litigation settlements, for safe-consumption sites. Elected officials have explicitly voiced support for nonprofit-run safe consumption sites similar to those currently operating in New York.
Apart from the wellness hubs, Breed's budget includes funding for 30 new residential treatment beds for patients with dual diagnoses along with continued funding for street outreach teams who respond to people experiencing behavioral health crises. As of April, over 18,000 calls have been diverted from police to those response teams, according to the Mayor's Office.
Other behavioral health priorities include funding for the implementation of the Community Assistance, Recovery and Empowerment (CARE) Court, a newly enacted state law that allows family members, health providers and others to petition for an individual to enter treatment, along with expanded medication-assisted treatment and abstinence-based programs that include a women's therapeutic community.
The budget also seeks to prioritize investments in "culturally congruent" programs for communities at high risk for overdose. Over the past two years, the Black community accounted for 28% of fatal overdoses despite representing less than 6% of the city's population.
Breed is expected to unveil her full citywide budget, which will include further details about the health investments, by June 1. The budget is expected to close a projected deficit of $780 million over the next two years.