Budget committee advances purchase of Geary/Hyde properties for behavioral-health and supervised-consumption planning

The Budget and Finance Committee on Dec. 8 advanced a proposal to buy two adjacent properties at 822 Geary Street and 629 Hyde Street for a combined purchase price of approximately $6.32 million to support the Department of Public Health's expansion of behavioral-health services.

Andrico Penick, director of real estate, called the pair a unique opportunity that met the programmatic requirements DPH sought, including a vacant parcel on Hyde that would provide separate access and operational flexibility. DPH medical director David Patey said the sites could house a crisis-diversion unit and, potentially, a supervised consumption program, and that the department was seeking to reduce avoidable hospital stays and emergency-room use by offering on-site stabilization and treatment referrals.

"We're requesting you support the purchase of 822 Geary and Hyde for the purpose of our behavioral health services expansion," Patey said, outlining the departments plan to add treatment spaces and recovery-oriented care.

The Budget and Legislative Analyst recommended forwarding the purchase with two conditions: the director of health should report back with (1) a detailed plan for the sitesintended uses, estimated capital and ongoing operating costs and funding sources, and (2) an updated bed-optimization report showing how added capacity will be purchased and deployed. BLA noted that ongoing operating costs for a diversion unit were currently budgeted at roughly $4.5 million per year, and that capital-improvement and safe-consumption costs were not yet known.

"The ongoing costs for the crisis-diversion unit are budgeted at 4 and a half million dollars per year," Nick Menard of the BLA told the committee, adding that the department had not yet identified all capital and operating sources for both uses.

Supervised consumption sites drew the largest public response. Dozens of callers, health-care providers and local service organizations urged the committee to act quickly, citing recent rises in overdose deaths and international evidence that supervised consumption and overdose-prevention sites reduce fatal overdoses and public drug use. Supporters said closer proximity to existing outreach and care providers would improve referrals and linkage to treatment.

Opponents and some neighbors raised concerns about concentration of services in the Tenderloin and the timing of neighborhood engagement. Several supervisors pressed the department to spell out a concrete and prompt outreach plan before programming begins; DPH staff said they would follow an expanded community-engagement process and return to the committee with a timeline.

The committee accepted BLAs suggested report-backs and asked DPH to return in approximately three months with a community-engagement plan and a program-usage and cost review; it requested a fuller bed-optimization report in about 12 months. With those amendments, the committee voted 3-0 to forward the item to the full Board with a positive recommendation.

What happens next: DPH will begin community outreach and site-fit analysis, and will report back to the Board per the committees timeline; any final programming, building improvements or operating agreements will need additional approvals and appropriation of operating funds.

Funding and legal issues: The purchase will be paid with one-time Prop C allocations that had been pre-identified for the kind of acquisition DPH described; however the committee requested confirmation from the Prop C oversight process. BLA also cautioned that a supervised consumption program raises unresolved legal questions at the federal level that could affect implementation and funding if pursued. The department said it would include legal analysis and alternative program scenarios in its report back.