City Option account setup delayed; initial in‑shipment projected in 2026 with outreach ramping up

Stella Chow, director of managed care at the Department of Public Health, and Sumi Souza of the San Francisco Health Plan updated the commission on implementation of the City Option Program established earlier this year. Staff said a three‑year statutory requirement and pending controller’s‑office steps mean the first in‑shipment of accumulated funds will not occur until calendar year 2026, delaying the earlier target of October 1.

Chow said city staff are working with the controller and the treasurer and tax collector to set up the treasury account needed to receive funds and start the in‑shipment process. Souza explained that because the program and revenues have grown substantially, staff project the initial in‑shipment (the accumulated amount from prior years) will exceed $100 million, and the ongoing annual initiation was estimated around $38 million (staff characterized these as estimates and said the figures depend on outreach success and program utilization).

Staff described completed and ongoing work: a memorandum of understanding on roles between departments, a draft memo assigning responsibilities to the third‑party administrator (San Francisco Health Plan), redesigned web materials in multiple languages, user‑research–driven branding changes and continued community outreach to maximize utilisation of benefits. Commissioners pressed staff on the basis for the projected annual amount; Souza said the projection reflects program growth and that outreach aims to reduce the recurring impact by increasing use of the benefit.

Staff said they will return with additional updates and confirmed the in‑shipment timing remains contingent on action by the controller’s office.