Health and Human Services

Platform – as ratified at the SF Community Congress, August 15, 2010.

These recommendations were first developed in July 2010 at the New Realities conference sponsored by the San Francisco Human Services Network. On August 14, 2010 attendees at the Community Congress 2010 Health and Human Services breakout group made revisions and additions for submission to the development of a Community Congress Platform.

Vision and Values

San Francisco is a place where its citizens have access to healthcare, social support services and livable neighborhoods so that they may become full participants in the educational, social, political, arts and recreational systems in the city for an enhanced quality of life.

Health and human services in neighborhoods.


Near Term

1.  As the city implements the 2009 ballot measure that calls for a two-year budget cycle informed by five-year financial plans, require department heads and commissions to include the perspective of professional service providers and services users, including a standards analysis plan and a narrative about the impact on services.

2.  Require city departments to implement fully the recommendations to streamline the city’s contracting and monitoring process approved by the 2003 City Nonprofit Contracting Task Force and ensure that current procedures and processes are consistent with those recommendations.

3.  Preserve services for the most vulnerable San Franciscans by focusing on revenue solutions to the city’s ongoing structural budget deficit, including November 2010 campaigns to increase the hotel tax and the real property transfer tax and other opportunities.

Early Recommended Actions

4.  Conduct a coordinated citywide health and human services needs assessment with specific attention paid to health and human services disparities across populations and neighborhoods.

5.  Create a 10 year plan, reviewed at 2 year intervals linked to the two year budget process, for health and human services.

  • As part of an overall revenue strategy,  open a dialogue with the philanthropic foundation sector on addressing the changing needs of the non-profit health and human services sector, including community needs, accountability, and funding cycles.


6.  Streamline and standardize the Request-for-Proposals (RFP) process by moving it out of the city departments and into the Controller’s Office or another appropriate entity (e.g. “contracting out contracting”).

Long Term

7.  Amend the charter to create a “SF Health and Human Services Authority” to plan, monitor, control and hold accountable all relevant parties in the arena of health and human services delivered in the City and County of San Francisco. The “Authority” would be responsible for the development and implementation of all health and human service policy, and would:

  • Have direct control of the budget for the SF Department of Public Health
  • Have direct control of the budget for the SF Human Services Agency
  • Appoint the heads of departments under its jurisdiction
  • Receive requests for service changes and issue Certificates of Need based on a comprehensive evaluation of relevant factors
  • Hold accountable health and human services educational institutions for their role in ensuring the health of all San Franciscans
  • Apply the City’s precautionary principle to guide decision-making: If an action or policy has a suspected risk of causing harm to the public, the burden of proof that it is not harmful falls on those taking the action.
  • Determine how the City would engage in housing issues, purchasing hotels, creating co-ops, etc.
  • Prioritize mental health services (beyond just substance abuse treatment)

Additional comments

Educating the Public: How do we engage the public in a larger conversation about the health of all San Francisco?

Mayor’s Role in Budget: How do we address the power of the Mayor’s total control of expenditures?


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