The San Francisco County government meeting held on July 24, 2025, focused on updates from the Department of Emergency Management (DEM) regarding its policies and initiatives aimed at addressing complex street conditions, particularly those related to homelessness and substance use disorders.

Adrienne Bechelli, the Deputy Director of DEM, began by explaining the department's role in coordinating interdepartmental efforts through the Healthy Streets Operations Center (HSOC). This initiative, which started before the COVID-19 pandemic, aims to improve street safety and health by addressing issues such as encampments and behavioral health crises. Bechelli emphasized that DEM's involvement in recent legislation is due to its ongoing coordination of various programs, including neighborhood street teams and community safety ambassadors.

Bechelli outlined the key components of the DEM's policy, which includes referrals to treatment, access to naloxone, and connections to syringe access programs. She noted that training is mandatory for all city and contracted staff involved in HSOC operations, focusing on overdose prevention and response protocols. The policy also mandates that naloxone be readily available during operations to reverse suspected overdoses.

The meeting highlighted the importance of collaboration among city departments to enhance services for individuals experiencing substance use disorders. Bechelli reported an increase in monthly admissions to substance use care since 2022, although overdose deaths continue to fluctuate, underscoring the need for ongoing efforts to reduce these numbers.

Several recommendations were made for improving the current policy framework. These included removing the requirement for annual policy submissions and adjusting language regarding the posting of specific services to ensure timely access to information about the full continuum of care. The department also expressed a desire to incorporate recovery-first principles into policies to better reflect comprehensive treatment approaches.

Discussion among attendees included inquiries about outpatient treatment programs and the potential impact of federal funding on contingency management initiatives. Bechelli confirmed that while some programs utilize Medi-Cal funding, there are concerns about future funding continuity.

The meeting concluded with a report on the implementation of Proposition F, which mandates substance use disorder assessments for individuals accessing the county adult assistance program. Preliminary data indicated that 179 clients had been identified for intensive services, with a notable retention rate in treatment.

Overall, the meeting underscored the city's commitment to addressing substance use and homelessness through coordinated efforts and policy updates, with a focus on improving outcomes for vulnerable populations.