UPDATE 5/22/25: Since this story was published, San Francisco Mayor Daniel Lurie has called on the state to provide more resources for municipalities to combat homelessness.
Gov. Newsom is blaming ongoing homelessness and behavioral health crises on local governments. Amid a slew of press conferences and announcements last week on the release of new mental health funding and a push to make homeless encampments illegal statewide, Newsom repeatedly called on local governments to take charge. He said the state has done everything it can to address the public effects of mental illness and substance abuse, and touted a new accountability website tracking counties’ progress by housing, homelessness and behavioral health metrics.
“The state is giving you more resources than ever,” he said on May 12. “It’s time, I think, to just end the excuses.”
San Francisco is assessed favorably on the accountability website and is engaging in many of the initiatives Newsom cited, but still faces considerable challenges in addressing homelessness, behavioral health issues and substance abuse.
Newsom cited money from a 2024, $6.4 billion state bond measure, which San Francisco applied for but didn’t receive nearly as much as it requested. He cited conservatorship reform, which San Francisco quickly adopted, but the city doesn’t have enough resources to support those receiving involuntary treatment. He cited the creation of CARE Court, a program for people diagnosed with untreated schizophrenia or a related psychotic disorder, which San Francisco implemented, but which few have participated in. He cited the need to remove encampments, which San Francisco has repeatedly done despite having insufficient shelter for everyone eligible.
While some city and county leaders across the state rejected the governor’s accusations, San Francisco Mayor Daniel Lurie stopped short of criticizing Newsom.
“My administration is taking full advantage of every available resource to get people who are suffering off the streets, while reclaiming our public spaces,” Lurie said in a written statement. “This state funding is a strong first step that will allow us to add some of the beds and services our city needs most.”
However, after Newsom’s decision not to include another round of funding for the Homeless Housing, Assistance and Prevention program in his budget proposal, Lurie and several other mayors called on the state to restore $1 billion for the program in next year’s budget.
“I share the governor’s frustration. I have his former job, and I was frustrated this morning driving out of the city,” Lurie said during a May 21 press conference. However, he noted the funding for the program was working. “To take a step back is the wrong way to go. ”
A spokesperson for Newsom doubled down on his rhetoric that local governments needed to do more and that the state was done with excuses, the Sacramento Bee reported.
Conservatorship reform
A report from early this year by a city working group found that the city needs to add at least 135 residential treatment beds in the next two years to meet anticipated needs. San Francisco has not added beds for those struggling with mental health or substance use issues in a year, despite new state laws that have led to increased need through expanded eligibility.
In 2024, Newsom lauded the county for being one of the first to implement a law that expanded eligibility for involuntary treatment — like 72-hour mental health holds and conservatorships — to include people considered unable to care for themselves because of substance use. But healthcare providers noted that the city didn’t have capacity for increased patient loads.
The county was also part of the initial rollout of CARE Court, a controversial program proponents said would help people struggling with illnesses like schizophrenia get off the streets and into treatment. However, nearly a year into the program the city had received only 42 petitions to enroll people in the program, despite initial estimates that 1,000 to 2,000 people would be eligible.
New funding
California spends billions annually on homelessness, supportive housing and behavioral health services through a variety of departments, including Health Care Services, and Housing and Community Development. The governor recently shared his updated budget proposal and must work with the Legislature to reach a final agreement for the fiscal year that begins on July 1.
Meanwhile, municipalities have been applying for funding for behavioral health services from the afore-cited bond measure, Proposition 1, which voters narrowly passed in 2024, to expand California’s behavioral health system and help create housing for veterans and homeless people with mental health or substance use issues. Most of that money will be disbursed through grants that cities and counties may apply for.
In 2024, San Francisco applied for $144 million from the first round of grants funded with Proposition 1 money. However, the state allocated only $27.7 million to San Francisco, which will be routed through its Department of Public Health.
The health department plans to use the funding to create 73 residential treatment beds for people with mental health or substance use disorders. Fifty-seven of those beds, at the Zuckerberg San Francisco General Hospital and Trauma Center, will be “locked,” meaning they will house people with severe mental illness or those living under a conservatorship. The other 16 beds, at the 7th Street Dual Diagnosis residential treatment program, will serve people with both mental health and substance use disorder diagnoses.
But Mission Local reported that the locked beds will partially replace 97 existing treatment beds at the site, 82 of which are occupied by long-term patients who will need to be moved to other facilities.
A San Francisco-based organization unaffiliated with city government is also receiving Proposition 1 funds for behavioral health treatment.
The Friendship House Association of American Indians, a Native-led nonprofit licensed and certified by the state that focuses its programming on Indigenous values and cultural practices, is to receive $31.4 million for a community wellness center that includes residential treatment programs for adults with substance use disorder and an outpatient mental health clinic. The center is intended to serve Native American and low-income people from throughout California. Friendship House intends to break ground on the project in November.
Cracking down on encampments
The announcement of the behavioral health grant awardees came the same day that Newsom released a model ordinance to outlaw encampments that he encouraged cities to adopt and tailor to their needs.
Though his office suggested prioritizing shelter and said no one should face criminal punishment for sleeping on the streets when they have nowhere else to go, many cities, including San Francisco, issue citations to people camping on the street and do not have the capacity to house everyone living on the street.
There are hundreds of families on the city’s family shelter waitlist, and nearly 500 people on the adult shelter waitlist. On May 12, unhoused mothers gathered outside San Francisco City Hall to demand the city allocate $66 million, mostly from the general fund, to end child homelessness.
San Francisco has already increased enforcement against encampments, arresting hundreds for sleeping in public in recent months. A memo that the Breed administration issued in July stated that officers are not required to offer shelter before arresting people for illegal lodging. Service providers and advocates have repeatedly noted that encampment clearings make it harder for people to exit homelessness, as city workers routinely confiscate or discard items like mobility aids, tents, medicine and identification, a practice that service providers say can keep people on the streets longer.
