In this corner, we have Mayor Breed’s newly unveiled Urgent Care SF that would add 800 new treatment beds and legions of additional case managers to the city roster. In the other corner, Supervisors Ronen and Haney propose a more universal plan that pays for itself by taxing local companies with the highest-paid CEOs. Which will win out?

Today happens to be the filing deadline for the March 3, 2020 San Francisco elections, which will be more popularly known as the California Democratic Presidential Primary Election. But another measure that may be on that ballot will hit a little closer to home, particularly for the city’s homeless mentally ill population or anyone who cares about them. Supervisors Matt Haney and Hillary Ronen introduced a universal mental health care initiative called Mental Health SF for the November 2020 ballot, which has since been scaled back to a not-quite universal version that would appear on the March primary ballot. Mayor Breed was not pleased with several aspects of the supes’ plan — including the fact that it would provide free mental health services to those with private insurance — and the Examiner reports that she is now introducing a far more scaled-back, dueling measure that would not appear on the ballot, but certainly exposes a rift between the Board and the mayor’s office on how much to spend on mental health for San Francisco’s poorest residents.

Breed’s plan has only been revealed in drips, but Sup. Ronen is already declaring its inadequacy. “On any given day you can see people in hospital gowns wandering the streets of the Mission in complete mental breakdown,” she told the Examiner. “My constituents and I just can’t accept small measures any longer. Mental Health SF is the big systems change we need to get mentally ill people off the streets and into care.”

Ronen and Haney’s plan adds $100 million to the city behavioral health services budget, bringing its total to $500 million. It’s paid for with a separate measure called an Excessive CEO Salary Tax that taxes companies whose CEO makes 100 times more than than their rank-and-file employees. That draws the question of how to calculate such a thing (do Uber contractors count?), and more importantly, what happens if Mental Health SF passes and Excessive CEO Salary Tax doesn’t, or vice versa.  

Mayor Breed’s dueling plan was “shared exclusively with The Chronicle,” which is an odd way to introduce policy, and it is similarly named Urgent Care SF. The Chron also notes that “many details of Breed’s plan are still forthcoming.” The mayor’s plan reportedly involves no ballot measures, but entails “embarking on a hiring spree for case workers and other health care professionals, creating sobering centers for people addicted to drugs and alcohol, adding about 800 new treatment beds and acquiring board-and-care facilities that provide long-term mental health treatment beds at risk of closing down.”

Sup. Haney is unmoved. “This is the same set of incremental policies that the mayor announced three weeks ago, now she’s just changed the name to Urgent Care SF,” he complained to the Chronicle. “They are still refusing to restructure our system to effectively coordinate care so that people don’t fall through the cracks, back out onto the street.”

The obvious question here is what happens if Breed enacts her plan by executive fiat, while voters approve Haney and Ronen’s drastically different plan. The answer is we don’t know. But we also don’t know what specifically Mayor Breed’s plan involves, and frankly, whether it will come with an even higher price tag to produce fewer services.  

Related: Mayor’s Bed Cuts to Residential Mental Health Program Draws Outrage [SFist]

Image: shane star via Flickr