San Francisco’s Universal Mental Health Care Ballot Measure Pushed to March 2020

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A photo of the San Francisco Department of Public Health building. If voters approve Mental Health SF, the department will be charged in implementing the program. (Kathryn Hunts/KQED)

A controversial ballot measure that would give San Franciscans universal mental health care is being pushed from the November 2019 ballot to the March 2020 ballot to give lawmakers more time to come to an agreement as to how it should be implemented.

The measure, dubbed “Mental Health SF”, was announced in May. After the announcement, Mayor London Breed and the San Francisco Department of Public Health, which would be in charge of implementing the program, expressed concern about the high costs of implementation and a lack of input from the city’s health experts.

Now it seems that all parties are working together to come up with a compromise for the March 2020 ballot.

“It is important that we take a comprehensive, inclusive process to build on the progress we have made to strengthen our mental health system,” Breed said in a press release. She also emphasized the advancements already made this year including the passing of a contentious conservatorship law and the opening of 200 new behavioral health beds.

If passed by residents, the program would provide free and immediate access to mental health care to San Franciscans with or without insurance. It would also require the creation of a new 24 hours a day, 7 days a week drop-in center for people seeking psychological help or help with substance abuse.


The city controller and city’s economist gave preliminary numbers that annual costs would be as high as $100 million per year, not including start-up costs for building the drop-in center.

San Francisco Supervisor Hillary Ronen says she’s hopeful but not positive that the supervisors will come to a consensus with the mayor and DPH about how to address the problem, although they plan to meet weekly to negotiate.

More on Mental Health SF.

Ronen said she didn’t initially consult with the DPH because in early hearings about the problem, representatives were initially “obfuscating and denying that the problem was as grave as it is.”

She said if the supervisors can’t come to a consensus, she and Supervisor Matt Haney, the co-author of the bill, will still put the measure on the ballot.

Ultimately Ronen said the legislation is crucially important to address San Francisco’s mental health and homelessness crisis, and the delay is necessary to get the bill right.

“What we're proposing is a complete overhaul and creation of a new universal system, and that doesn't happen overnight,” she said.

The measure would be financed through the city’s proposed Excessive CEO Salary Tax — another ballot measure that would be imposed on CEOs making more than 100 times the median wage worker. That proposal will also be on the March 2020 ballot, having been moved from the November 2019 ballot.

The San Francisco Chamber of Commerce didn’t immediately respond to a request for comment on the Excessive CEO Salary Tax.