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San Francisco Marin Medical Society Blog

Despite Shortfall, SF Mayor’s Budget Proposal Spares Health Care

Mayor Breed recently released her 2024-25 budget proposal. San Francisco is facing a nearly $800 million shortfall. The Mayor seeks to address this shortfall by leaving non-critical government positions vacant across departments and limiting the addition of new General Fund-funded positions; reducing contract spending; funding new capital and IT projects at reduced levels; and leveraging one-time revenue sources (from state and federal funds) largely in the Department of Public Health (DPH). The proposed DPH budget, which makes up roughly $3 billion of the county’s $15 billion total budget, is $47.0 million (1.5 percent) higher than the 2023-24 budget. This is primarily due to increases in salaries mandated by labor agreements, new programs supported by opioid settlement funding, and state and private funding for capital improvements and mental health services. The Mayor’s proposal avoid large cuts to DPH through saved county money as Medi-Cal expands to cover all individuals regardless of immigration status, and no longer needing to support community COVID testing and vaccines, as that is now handled by individual health systems.

New Proposed Funding Highlights

  • $50.4 million investment in the expansion of emergency family shelter (115 emergency hotel vouchers to provide temporary shelter serving over 600 families), rapid rehousing subsidies (215 rapid rehousing and shallow rental subsidies for families), and time-limited rental assistance.
  • $45 million of opioid settlement funding to expand high impact services and a new sober living housing program. These services include maintaining the Night Navigator program, strengthening existing methadone services in clinics, and expanding service in the community through mobile services Since 2022, the City has doubled the distribution of naloxone doses from 65,877 to 135,610.

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