Everyone wants Sunset Night Market back. Just don’t mention the ‘R’ word

<div class="content-grid article-content"><div class="Metadata_container__fxAzw"><div class="Metadata_metadata__W_0LF"><span>By <a class="" href="https://sfstandard.com/author/han-li/">Han Li</a></span><time datetime="2025-08-25T13:00:00.000Z">Published Aug. 25, 2025 • 6:00am</time></div></div><div class="floats"><p class="paragraph-block article-body undefined text-left">When Daniel Ramirez saw that the popular Sunset Night Market was <u><a data-post-id="ad9d6e4a-e6c2-4749-b0f3-d65a3471842f" href="https://sfstandard.com/2025/07/10/sunset-irving-street-night-market-cancelled-recall/">canceled this year amid bitter west-side politics</a></u>, he jumped into action.</p><p class="paragraph-block article-body undefined text-left">The owner of Smokin’ D’s BBQ in the Sunset said he wanted to continue the neighborhood’s tradition of celebrating diversity and food, without letting divisive political issues take over.</p><p class="paragraph-block article-body undefined text-left">“We want to bring back the energy of the night market in a way that’s joyful,” he said.</p><p class="paragraph-block article-body undefined text-left">But throwing a big celebration in the Sunset isn’t easy right now. The neighborhood will vote Sept. 16 <u><a data-post-id="f2e23231-2f10-40a3-835a-157ca212afed" href="https://sfstandard.com/2025/05/29/joel-engardio-supervisor-recall-september/">in the contentious campaign over whether</a></u> to recall Supervisor Joel Engardio, who championed Proposition K, which closed the Great Highway to cars.</p><p class="paragraph-block article-body undefined text-left">The night market is one of <u><a data-post-id="5f93ecbf-0528-46b9-932a-a59aaa55598b" href="https://sfstandard.com/2023/09/16/san-franciscos-sunset-night-market-draws-thousands/">Engardio’s signature accomplishments</a></u>. But organizers rushing to save it are trying to distance the event from him, his opponents, and the recall campaign altogether, worried that politics could once again derail the celebration.</p><p class="paragraph-block article-body undefined text-left">“To keep this politically free, not to bring any negative attention, I’m going to keep repeating the same talking points,” Ramirez said. “You want to keep this community- and merchant-focused.”</p><p class="paragraph-block article-body undefined text-left">After weeks of planning, Ramirez and partner groups are moving ahead with a new event, <u><a href="https://www.instagram.com/p/DMxsMc5RTTJ/">Sunset After Dark,</a></u> an Irving Street fair set for Sept. 26 — 10 days after the recall election. They’ve secured city permits to close three blocks, starting at 3 p.m.</p></div><figure class=""><div class="flex justify-center"></div></figure><div class="floats"><p class="paragraph-block article-body undefined text-left">The fair will feature food vendors, performances from local schoolchildren, and a rib-eating contest — a twist on the <u><a data-post-id="707877d6-3f05-4677-96ba-2d713f91b4ea" href="https://sfstandard.com/2024/09/01/stinky-tofu-contest/">stinky tofu contest</a></u> Engardio once proposed.</p><p class="paragraph-block article-body undefined text-left">Engardio, who has <u><a href="https://x.com/JoelEngardio/status/1943424313258054056">blamed recall politics</a></u> for sabotaging the beloved night market, seems happy to cheer for the new event.</p><p class="paragraph-block article-body undefined text-left">“I’m fully supportive and I’m thrilled the community is coming together to organize a wonderful evening in the Sunset,” he said in a statement.</p><p class="paragraph-block article-body undefined text-left">Ramirez said his group knows the supervisor is available to help but has managed fine on its own, applying for the street closure and Department of Public Health cooking permit.</p><p class="paragraph-block article-body undefined text-left">“We’ll let the politicians deal with the politics,” he said.</p><p class="paragraph-block article-body undefined text-left">The recall campaign declined to comment on the new event.</p><p class="paragraph-block article-body undefined text-left">Sunset After Dark is entirely privately funded, allowing it to move forward more quickly than city-funded events like the Sunset Night Market, which face lengthy bureaucratic holdups.</p><p class="paragraph-block article-body undefined text-left">The nonprofit Dear Community, which focuses on Asian American civic engagement, is helping lead the effort. Its spokesperson, Rob Aiavao — a former TogetherSF political operative — described the event as a chance to heal after months of division.</p><p class="paragraph-block article-body undefined text-left">“You can almost view this as a palate cleanser for the district once the election is done,” he said.</p><p class="paragraph-block article-body undefined text-left">Aiavao said organizers are prioritizing local Sunset businesses and trying to avoid duplication, such as too many boba or dumpling vendors competing with Irving Street shops.</p><p class="paragraph-block article-body undefined text-left">The Civic Joy Fund, led by <u><a href="https://link.sfstandard.com/view/6436ea099b26044931999510ohegd.33h/d4f7a17d">rumored future supervisor candidate</a></u> Manny Yekutiel, has donated $40,000 to support the event — one of 13 night markets the fund has backed citywide.</p><p class="paragraph-block article-body undefined text-left">“We are joy spreaders,” Yekutiel said. “We are happy and excited to fund it.” Michael Moritz, chairman of The Standard, is a donor to the fund, which Mayor Daniel Lurie cofounded.</p><p class="paragraph-block article-body undefined text-left">Would Engardio be invited to speak at the event in his district? </p><p class="paragraph-block article-body undefined text-left">“I don’t believe we plan on having any elected officials speak at this event,” Aiavao said. “The reason for that is to keep the focus on what the community wants.”</p></div></div>

How SF government became a hulking, 34,800-person behemoth


<p>It’s a perennial complaint: San Francisco’s government is just too damn big.&nbsp;</p>



<p>That concern has come to the forefront in recent weeks after Mayor Daniel Lurie <a href="https://sfstandard.com/2025/05/28/san-francisco-mayor-daniel-lurie-budget-layoffs/">proposed layoffs</a> in an effort to resolve a <a href="https://sfstandard.com/2025/05/30/san-francisco-budget-daniel-lurie-deficit-proposal/">historic budget deficit</a>.&nbsp;</p>



<p>Salaries and employee benefits account for the largest chunk of city spending: 43% of the current budget. A <a href="https://www.sfchronicle.com/projects/2025/sf-city-employees/">recent analysis</a> found that San Francisco has the most public employees in core functions of any U.S. metropolis, even after detangling its unusual status as both a city and county.</p>



<p>Our workforce wasn’t always such a behemoth. The Standard analyzed City Hall’s growth over the past 20 years, revealing that it has far outpaced San Francisco’s population.</p>



<p>In 2005, the city employed 26,900 people, according to the Department of Human Resources. Twenty years later, it had 34,800, a 29% increase. During that time, the city’s population grew by 8%, from 780,000 in 2005 to 842,000 in 2025, according to the <a href="https://dof.ca.gov/forecasting/demographics/estimates/">California Department of Finance</a>.&nbsp;</p>



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<p>The mayor’s push to cut around 100 jobs would represent a thin slice of the city’s ballooning bureaucracy — just 0.29% of City Hall’s workforce. Lurie’s office, which also proposed slashing 1,000 unfilled roles, says the mayor is not focused on the number of employees but on prudent spending practices.&nbsp;</p>



<p>“It is really about, ‘How do we not spend money we don&#8217;t have?’&#8221; Sophia Kittler, the mayor’s budget director, said. On Thursday, a Board of Supervisors committee <a href="https://sfstandard.com/2025/06/26/san-francisco-mayor-daniel-lurie-layoffs-negotiation-budget/">approved $15 million to avoid some</a> of Lurie&#8217;s layoffs. </p>



<p>The Standard contacted three dozen city departments to discuss why they have grown over the past two decades. Four major themes emerged: voter-approved ballot measures, new state and federal laws, and expanded city responsibilities and projects; additionally, as these factors swelled the ranks, more support personnel were needed to bolster the larger workforce.</p>



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<h2 class="wp-block-heading" id="h-that-long-long-list-of-ballot-measures">That long, long list of ballot measures</h2>



<p>Successful ballot propositions have forced the city to beef up its staffing.&nbsp;</p>



<p>Take the <a href="https://www.sf.gov/reports--december-2024--about-our-city-our-home-fund">Our City, Our Home initiative</a>, which passed with 61% of the vote in 2018. The measure, also called Proposition C, imposed taxes on businesses to raise money for homelessness services. But raking in all that money requires more staff to administer it. From 2020 to 2025, the Department of Homelessness and Supportive Housing nearly doubled in size, from 124 to 232 workers; a spokesperson attributed this in part to Prop. C. The additional personnel were needed to acquire city-owned housing sites and oversee grants, among other responsibilities.&nbsp;</p>



<p>Or consider the library system. In 2022, San Franciscans overwhelmingly voted to mandate that city libraries be open systemwide at least 1,400 hours per week. Today, San Francisco remains the only big city in California with all its library sites open seven days a week. To keep the lights on, library staffing grew by 23% from 2005 to 2025.</p>



<figure class="wp-block-image alignwide size-full"><img loading="lazy" decoding="async" width="1600" height="1600" src="https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png" alt="The image is a chaotic office scene with scattered papers, a desk, chair, keyboard, telephone, and various office supplies in pastel colors, creating a cluttered atmosphere." class="wp-image-413675" srcset="https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png 1600w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png?resize=150,150 150w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png?resize=300,300 300w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png?resize=768,768 768w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png?resize=1536,1536 1536w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_001b.png?resize=180,180 180w" sizes="auto, (max-width: 1600px) 100vw, 1600px" /></figure>



<h2 class="wp-block-heading" id="h-outside-pressures">Outside pressures</h2>



<p>It isn’t just local lawmaking that has inflated San Francisco’s government. State and federal legislation also play a role in dictating City Hall’s size.&nbsp;</p>



<p>Just look at the Department of Public Health. A driver of its addition of around 1,800 employees in the past 20 years — the most of any city department —&nbsp;was the federal Affordable Care Act. Obamacare vastly expanded the number of people eligible for Medi-Cal, whose healthcare is <a href="https://www.ppic.org/blog/counties-are-key-partners-in-the-medi-cal-program/">provided by the department</a>. Since 2013, the number of San Franciscans enrolled in Medi-Cal has grown by more than 100,000, forcing the health department to add staff.&nbsp;</p>



<figure class="wp-block-pullquote"><blockquote><p>&#8216;It is really about, &#8220;How do we not spend money we don&#8217;t have?&#8221;&#8216;</p><cite>Sophia Kittler, the mayor’s budget director</cite></blockquote></figure>



<p>“As the primary safety-net health care system for the city, SFDPH has become the primary health home and has provided care to many of these new Medi-Cal recipients,” the department wrote in a statement.</p>



<p>That’s just the tip of the iceberg regarding staffing up to comply with outside regulations and programs. The Public Utilities Commission has brought on more staff due to new state water regulations, the city attorney’s office expanded to deal with updates to California’s conservatorship laws, and the Environment Department swelled as it absorbed Obama-era stimulus funding and California Energy Commission grants.</p>



<figure class="wp-block-image alignwide size-full"><img loading="lazy" decoding="async" width="1600" height="1600" src="https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png" alt="The image features an abstract, colorful illustration of multiple interconnected faces and figures, merging together with a playful, surreal style with pastel colors." class="wp-image-413676" srcset="https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png 1600w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png?resize=150,150 150w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png?resize=300,300 300w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png?resize=768,768 768w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png?resize=1536,1536 1536w, https://content.sfstandard.com/wp-content/uploads/2025/06/sfstandard_spot_002b.png?resize=180,180 180w" sizes="auto, (max-width: 1600px) 100vw, 1600px" /></figure>



<h2 class="wp-block-heading" id="h-more-services-more-staffers">More services, more staffers</h2>



<p>Many departments said they’re simply doing more to serve San Franciscans today than they were in years past.</p>



<p>The San Francisco Municipal Transportation Agency grew its staff by 11% in the past decade to improve service on city buses and trains, according to spokesperson Erica Kato. “Prior to 2019, we under-invested in transit maintenance, training, and supervision,” Kato said. “Muni reliability suffered.”&nbsp;</p>



<figure class="wp-block-pullquote"><blockquote><p>&#8216;We are just constantly growing. And not necessarily subtracting.&#8217;</p><cite>Nicole Neditch, a policy director at SF think tank SPUR</cite></blockquote></figure>



<p>Other government agencies have simply taken on more responsibilities.&nbsp;</p>



<p>The Department of Emergency Management, which has grown by 44% to 308 employees since 2005, became a sponsor for a <a href="https://www.bayareauasi.org/about-us">regional security program</a>, created a <a href="https://www.sf.gov/coordinated-street-response-program">coordinated street response division</a>, and is receiving 15.5% more 911 calls than it did in fiscal 2011-12, the earliest available data.</p>



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<p>The Fire Department has also been impacted by that 911 surge; it has staffed up to handle a near doubling of emergency services calls in the past 20 years, according to Chief of Staff Adrienne Sims.</p>



<p>The Recreation and Parks Department has also shouldered more responsibility as it has grown 11% to 952 workers from 856 two decades ago. During that period, the department added more parks to its purview, which required more staff to maintain. The department said the public has also asked for more staff to address vandalism and after-hours calls. That required hiring more park rangers: from 12 in 2005 to 55 today.&nbsp;</p>



<h2 class="wp-block-heading">More employees means … more employees</h2>



<p>As the workforce grows, so do the responsibilities of supporting agencies like the Ethics Department, which oversees financial disclosures and ethics enforcement of city employees. The department has 26 employees, representing a 160% increase since 2005.&nbsp;</p>



<p>The same goes for the Human Resources Department, which has grown by 53% (89 employees) since 2005.&nbsp;</p>



<p>“Once you introduce new legislation, once you add a new department, once you add staff to a particular program, it is very difficult to take those pieces away,” said Nicole Neditch, a governance and economy policy director at the SF-based think tank SPUR. “We are just constantly growing. And not necessarily subtracting.”</p>


Lurie expands controversial Bayview shelter plan, defying supervisor


<p>Supervisor Shamann Walton hasn’t been shy about his opposition to Mayor Daniel Lurie’s plans to build a homeless shelter in the Bayview, the neighborhood he represents.</p>



<p>He’s called Lurie <a href="https://www.instagram.com/p/DIAF-AhBttm/?img_index=1">an oligarch</a> who considers people of color second-class citizens. He said the new mayor broke promises to listen to community feedback by building the shelter without their consent.</p>



<p>Now, Lurie is doubling down to expand homeless services for aging and infirm  Bayview residents.</p>



<p>On Tuesday, the mayor introduced legislation at the Board of Supervisors’ meeting to amend the lease of the contested site, Jerrold Commons, to build out an additional 80 shelter beds. The project at 2177 Jerrold Ave. was <a href="https://www.sf.gov/news-mayor-lurie-expands-interim-housing-capacity-with-opening-of-jerrold-commons-phase-one-in-the-bayview">previously announced</a> with 68 beds across 60 cabins for people without homes, including eight cabins for people living in RVs.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1666" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?w=2500" alt="A person in a suit speaks at a podium with a microphone in front of a clear blue sky. The podium has an insignia for the &quot;City and County of&quot; an unspecified place." class="wp-image-354820" srcset="https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg 7786w, https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?resize=2500,1666 2500w, https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/01/daniel-lurie-mayor-inauguration-008.jpeg?resize=2048,1365 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Lurie has promised to build out 1,500 new shelter beds in San Francisco.</figcaption></figure>



<p>The expanded shelter will prioritize people from the Bayview, particularly older individuals who have severe medical needs.</p>



<p>“San Franciscans expect their elected leaders to tackle the homelessness and behavioral health crisis head-on, and there is consensus on both sides of City Hall that we do that by adding interim housing and giving people on the street a better option,” Lurie said in a statement.</p>



<p>Lurie is using his <a href="https://sfstandard.com/2025/01/29/daniell-lurie-fentanyl-emergency-board-of-supervisors/">fentanyl emergency powers</a> to bypass a normal board approval process, which Lurie previously characterized as lengthy.</p>



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<p>The move puts the ball in the supervisors’ court — for the first time since the emergency fentanyl legislation was passed, a 45-day “shotclock” will start, giving the board one chance to vote against Lurie’s legislation.</p>



<p>It may place Walton in a difficult political position.</p>



<p>He has <a href="https://www.sfchronicle.com/sf/article/lawmaker-blasts-mayor-over-bayview-homeless-plan-20246317.php">previously said</a> that instead of a homeless shelter, the community needs a safe parking site for people living in parked RVs. But opposing Lurie’s action would put Walton on record as opposing shelter beds intended to help aging, sick people in desperate need.</p>



<p>“The community does not support the project or the mayor&#8217;s continued unilateral decision-making,” Walton said in a statement Tuesday. “The mayor is bulldozing community. No one in [the] community supports the site. No one.”</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?w=2500" alt="A person in a suit and blue tie sits at a table, gesturing with one hand. Other people are partially visible in the background of a wood-paneled room." class="wp-image-394496" srcset="https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg 3000w, https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/04/9039634452_sfpdovertime_003.jpg?resize=2048,1365 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Walton says the community needs a safe parking site for people living in RVs.</figcaption></figure>



<p>Constituents in Walton’s district met for more than a year with city staffers to discuss solutions to the RVs, which staff later promised, the supervisor’s office said. When asked about its plans to address people living in parked RVs in the Bayview, the mayor’s office said building out city-sanctioned parking only helps temporarily and that longer-term solutions are needed.</p>



<p>The 80 additional beds slated for Jerrold Commons advance Lurie’s campaign promise to build 1,500 shelter beds. However, <a href="https://sfstandard.com/2025/01/28/san-francisco-daniel-lurie-homelessness-shelter-promise/">the target date</a> for those beds has moved.</p>



<p>The mayor initially said it would be six months from the start of his administration, before adjusting that timeline to six months from March when he introduced his homeless plan, “<a href="https://sfstandard.com/2025/03/17/daniel-lurie-fentanyl-emergency/">Breaking the Cycle</a>.” The definition of shelter beds has also been expanded to include behavioral health beds and other kinds of shelter.</p>



<p>According to the mayor’s office, Jerold Commons will offer a bevy of services to older people in poor health: a nursing station, medical facilities, case management from the Department of Public Health, and more extensive clinical services than most units in San Francisco’s shelter portfolio.</p>



<p>Historically, the city hasn’t targeted many services for people who are aging and health-impaired, Lurie’s office said.</p>



<p>If it passes the Board of Supervisors, Jerrold Commons will be a new model of doing so.</p>


‘The biggest scam’: This hated business fee might help protect SF’s budget from Trump


<p>Businesses hate it. Restaurant customers are bewildered by it. Employees benefit from it.</p>



<p>Now, come budget time, an often-reviled city fee may help protect the city.</p>



<p>The San Francisco City Option program provides medical reimbursement accounts to help thousands of employees pay for health coverage every year. The fees that small businesses — in particular, restaurants — contribute to the program are so high, it’s akin to doubling their rent. Restaurants often pass some of that to customers, in the form of an “SF mandate” or “health fee” tacked onto the bill.</p>



<p>Ben Bleiman, a bar owner and president of the Entertainment Commission, said he pays roughly $350 per employee per month. For a restaurant or shop with a staff of 20, that’s $7,000 monthly — though most businesses enrolled in the program have far more workers than that.</p>



<p>“Don&#8217;t get me started, man. It&#8217;s just the biggest scam perpetrated on small businesses in the city,” Bleiman said. “It&#8217;s a massive expense.”</p>



<p>Roughly $200 million of that fund has gone unused by workers, according to a city report published at the end of March, and the excess will roll over into San Francisco’s general fund in April 2026. That’s just in time to serve as a cushion against the city’s budget deficit, as federal cuts loom.</p>



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<p>But amid complaints from business owners about the fees, city leaders are divided on how to use the money, if at all.</p>



<p>“We cannot paper over a $1 billion budget deficit with one-time funds, especially not funds that rightfully belong to San Franciscans,” Charles Lutvak, Mayor Daniel Lurie’s spokesperson, said in a statement. “Our administration is prepared to make the structural changes needed to close this $1 billion deficit, stabilize our city’s finances, and get back to investing in the workers and businesses of San Francisco again.”</p>



<p>The deficit, estimated at $820 million, could mean cuts in agencies citywide: street cleaning crews, homeless shelter staffers, pro-bono legal aid for low-income residents, and more. If President Donald Trump continues swinging a scythe at funding for healthcare, education, and other services, the deficit could <a href="https://sfstandard.com/2025/04/10/san-francisco-lurie-budget-trump-2-billion/">more than double,</a> officials estimate.</p>



<p>The San Francisco Board of Supervisors negotiates with the mayor’s office to approve the budget, giving them a say in how funding is used. Supervisor Rafael Mandelman, the board president, said the City Option dollars may come in handy at a time of great uncertainty.</p>



<p>“In that kind of environment, you&#8217;re looking for additional sources of reserve dollars,” Mandelman said. “But I think we&#8217;re not there yet, and there&#8217;s all these other elements of the conversation we have to have.”</p>



<p>However, the amount of unspent City Option money has led small business groups to question whether the program is needed. It was created two decades ago, long before the Affordable Care Act helped insure more San Franciscans, according to Laurie Thomas, executive director of the Golden Gate Restaurant Association.</p>



<p>“Many additional healthcare options are now available,” Thomas wrote. “Given the amount of unused funds paid into the city&#8217;s [medical reimbursement] account, we believe it is prudent to look to repeal this ordinance.”</p>



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<p>Small-business owners are pushing the city to repeal the program. Conversations to reform it are underway.</p>



<p>Many entities can make strong claims to the unspent dollars: the employers who paid fees to make it possible, the workers whom the fund was created to help, and unions looking to prevent layoffs.</p>



<p>Insiders said it may be easier politically to spend the spare funds on public health, instead of on general city costs. The federal government’s potential Medicare or Medicaid reductions, for instance, could cost the city roughly $900 million, according to the mayor’s office.</p>



<p>The city doesn’t have its hands on the money just yet. It sits in a $900 million Department of Public Health reimbursement account as part of Healthy San Francisco, the 2006 <a href="https://www.foundsf.org/index.php?title=Healthy_San_Francisco">brainchild of progressive Democrats</a> aimed at helping uninsured San Franciscans with medical care. The city anticipates the bulk of those funds will be used by workers.</p>



<p>Supervisor Connie Chan, the board&#8217;s budget chair and a leading progressive, said the healthcare fund should be reserved for workers.</p>



<p>&#8220;At a moment when Trump is attacking our sanctuary state where many, including immigrant workers, have taken roots and contributed for generations, it is unthinkable for anyone wanting to take away their health care, especially because this is not funded by any business but all San Franciscans who dine out and&nbsp;support our restaurants,&#8221; Chan said.</p>



<p>Chan said the current system should become more accessible to workers. She said she will demand that the city use a separate pot of money called the Health Security Fund as a bulwark against Medicaid cuts. That fund has about $240 million accessible.</p>



<p>Roughly 5,225 employers have opted into the San Francisco City Option program, which houses the healthcare reimbursement account. More than $500 million has been paid out in claims to workers since 2021, according to the Department of Public Health.</p>



<p>The city’s ability to reclaim unspent dollars is fairly recent. In 2022, the Health Commission approved a tweak to the healthcare reimbursement fund to bring it in line with state law. From then on, funds unclaimed in a three-year period would roll over to the city’s general fund.</p>



<p>“Closing accounts is the last resort,” a Public Health spokesperson said.</p>



<p>Mandelman said shrinking or eliminating the healthcare fee could “provide relief for some small-business owners,” and he’s taken part in meetings to figure out its future.</p>



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<p>City records show various meetings aimed at reforming the healthcare fund: a Feb. 26 meeting between Supervisors Danny Sauter, Joel Engardio, and Mandelman, as well as mayor’s office and city department staff. On March 27, a team from the mayor’s office met with the San Francisco Labor Council, and on Friday they are due to meet with the Golden Gate Restaurant Association.</p>



<p>Small businesses pay the smallest portion of the fund; groups that represent them argue that this is a reason to exempt them. Roughly 4% of contributions come from companies with 20-49 employees, but a whopping 79% comes from companies employing more than 500.</p>



<p>Even Democrats are pushing for change. Eric Kingsbury, a member of the San Francisco Democratic Party board, said he’s writing a resolution to put Democrats on record seeking to repeal the healthcare fund.</p>



<p>“It was a great initiative that did its work and no longer serves its purpose,” Kingsbury said.</p>



<p>The Department of Public Health has recognized the need to reach more workers so funds don’t go unspent. In September, the agency kicked off a splashy ad campaign on BART, Muni, and billboards to direct San Franciscans to an online tool where they could look up their healthcare reimbursement accounts.</p>



<p>This summer, the Public Health Department aims to issue debit cards so San Franciscans can more easily pay for medical expenses upfront, instead of seeking reimbursements later.</p>



<p>Bleiman, the bar owner, thinks most small-business owners want the fund scrapped. He said he hears from restaurateurs and bar owners who hate the fee “every goddamn day, dude. Every single day.”</p>



<p>“It&#8217;s so offensively unfair that it&#8217;s infuriating,” Bleiman added. “It&#8217;s exactly why San Francisco has a reputation of being the most unfair to small businesses in America.”</p>


New estimate puts federal threat to SF at more than $2 billion, Lurie says


<p>Nonprofit funding <a href="https://sfstandard.com/2025/02/10/trump-executive-orders-impact-san-francisc-bay-area-nonprofits/">is evaporating</a>. Local government is <a href="https://sfstandard.com/2025/02/06/san-francisco-layoffs-daniel-lurie-budget-deficit/">contemplating layoffs</a>. Parking meter prices might go up. Hell, even the streets <a href="https://sfstandard.com/2025/02/18/san-francisco-city-hall-street-cleaning-services-department-of-public-works/">might not be as clean</a>, after the city’s latest budget is decided in June.</p>



<p>It could get much, much worse.</p>



<p>San Francisco’s budget deficit could more than double, from an estimated $820 million to nearly $2 billion, Mayor Daniel Lurie told The Standard in an interview.</p>



<p>That’s the latest internal estimate of the fiscal threats posed by President Donald Trump’s administration, which has sought to eliminate or withhold funding for <a href="https://sfstandard.com/2025/04/01/trump-comes-for-pelosi-again-risking-318-sf-jobs/">healthcare</a>, <a href="https://sfstandard.com/2025/03/11/sfusd-americorps-lawsuit/">education</a>, and more. It’s higher than numbers <a href="https://sfstandard.com/2024/12/03/san-francisco-budget-deficit-trump-funding-deportations/">previously discussed</a>, which have largely focused on the roughly $147 million in Federal Emergency Management Agency reimbursements that were expected in the next fiscal year but the city may not receive. Even that is looking more dire, as the controller’s most recent budget estimate lowered the expected FEMA reimbursement to $80 million.</p>



<p>“We are facing an existential threat in terms of our budget,” Lurie said. “It could be $500 million. It could be a billion dollars more that comes at us in terms of cuts,” on top of the <a href="https://sfstandard.com/2025/03/31/san-francisco-budget-deficit-lawsuits-business-taxes/">possible $1 billion deficit</a> already announced. “And guess who that will affect the most? It will affect our immigrant community, our LGBTQ+ community, those living in poverty.”</p>



<p>“The attacks coming at San Francisco are my sole focus,” the mayor added.</p>



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<p>Lurie’s assessment includes the cost of federal litigation and possible federal cuts to new airport capital projects, plus hundreds of millions of dollars for programs at the Human Services Agency. Medicare and Medi-Cal programs from the Department of Public Health stand to lose $900 million. The estimate doesn’t include multi-year projects underway at the airport and SF Municipal Transportation Agency that are being funded by the federal government.</p>



<p>San Francisco’s budgeting process is well underway. In late February, city departments submitted <a href="https://sfstandard.com/2025/03/05/san-francisco-budget-deficit-departments-daniel-lurie/">proposals for 15% in budget cuts</a>, which are now being reviewed by Lurie’s team. Former Mayor London Breed relied on one-time funding sources to shore up the budget, rather than making large cuts. In his public statements on the budget, Lurie has signaled a desire to make deeper structural changes instead.</p>



<p>That will undoubtedly raise the ire of various political camps — from organized labor and nonprofits to constituent groups that want increased spending on transit or affordable housing production.</p>



<p>The latest estimate shared by Lurie may help make his case: Let’s make deep cuts now, while we have the time to make them deliberately, instead of in a rush after the latest White House tantrum.</p>



<p>Trump&#8217;s issuance of virtually worldwide tariffs — which he paused Wednesday — is a perfect example of uncertainty in federal leadership leading to economic uncertainty, Ted Egan, the city’s chief economist, said during a public talk Tuesday night at Manny’s.</p>



<p>San Francisco’s economy would be uniquely vulnerable to the tariffs if they continue, Egan said, which would threaten the city’s tax revenue.</p>



<p>“The long-term impact is sort of Econ 101. How much smaller is your economy? How much less are U.S assets worth? How much less are people going to earn because you&#8217;ve cut off trade? And for us in the Bay Area, that&#8217;s likely to be significant,” Egan said.</p>



<p>“It&#8217;s far too early to see” just how bad it could get, he added, “because so much can change.”</p>


Suspended city official paid $85K to ‘dear friend’ for ‘weird’ trainings


<p>Back in October 2023, employees in San Francisco’s Department on the Status of Women made a nearly four-hour trek to Gravity Haus, a resort in Truckee that bills itself as a “storied California playland” due to its amenities and proximity to Tahoe’s ski slopes. It was an unusual sojourn for the small department, which now has just eight employees after experiencing significant staff turnover in the last several years.</p>



<p>The group — led by its executive director, Kimberly Ellis, a once-rising star in California progressive politics <a href="https://sfstandard.com/2025/03/20/kimberly-ellis-san-francisco-status-of-women-leave/">who was suspended from her job last week</a> — kicked off the two-day work retreat by discussing budgets, trainings, and its upcoming “Shift Happens” policy summit, according to an agenda obtained by The Standard. Later that night, the group gathered for a working dinner at Stella, a restaurant that receives high marks for its “soulful eats.”</p>



<p>A menu from the retreat shows that offerings included swordfish, Spanish octopus, and Duroc pork cutlets. Employees who attended the retreat recalled Ellis and her top executives reveling in the moment as they extinguished multiple bottles of wine, despite the meal being listed as a work event.&nbsp;</p>



<p>This was just the beginning of the bizarre outing.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?w=2500" alt="A woman in a pink sweater stands solemnly between two flags, while another woman in a dark outfit appears beside her, looking slightly downward." class="wp-image-380163" srcset="https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg 8091w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-1246540999.jpg?resize=2048,1365 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Kimberly Ellis was suspended last week as the head of the city&#8217;s Department on the Status of Women.</figcaption></figure>



<p>Christina Harbridge, a longtime political ally of Ellis’ who <a href="https://christinaharbridge.com/about-christina">runs a behavioral coaching company called Allegory, Inc.</a>, also attended the mountain resort retreat. Multiple employees said they had “weird” interactions with Harbridge, who quietly took notes while sitting in the corner during meetings and conducted one-on-one sessions with staff. Even stranger, some staffers recalled being told to personally pay for hotel room incidentals because Harbridge was picking up the cost of the rooms. Sources familiar with the city’s contracting process described this as highly unusual.</p>



<p>An inspection of contracts shows that between 2022 and 2024, the Department on the Status of Women paid almost $85,000 to Harbridge, whom Ellis described on social media as a “<a href="https://www.instagram.com/realkimberlye/p/Bzs7dSmgGEU/">dear friend</a>.” The two had known each other for years, collaborating during Ellis’ time at Emerge California, a women’s political incubator Ellis led. Harbridge also backed Ellis’ contentious bid for California Democratic chair in 2017 when she lost, initially refused to concede, and <a href="https://theliberaloc.com/2017/06/26/ellis-fundraises-to-keep-cdp-chair-challenge-alive-albert-finds-issues-with-ellis-ballots/">alleged vote tampering</a>.</p>



<p>The grants for Allegory were billed as trainings, but employees said Ellis and Harbridge — <a href="https://christinaharbridge.com/about-christina">the latter of whom specializes in &#8220;natural physiology</a>” and conducted another city staff training where staff molded figures out of a clay-like substance — never followed up with any reports or insights to be shared with employees.</p>



<p>The Truckee retreat appears to be part of a pattern of Ellis steering city funds to friends and allies and boosting her own career as a political consultant.&nbsp;</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1668" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?w=2500" alt="Two people walk down a wet pathway flanked by trees and light posts, with a large domed building in the background under a gray sky." class="wp-image-334817" srcset="https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg 5000w, https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?resize=2500,1668 2500w, https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?resize=1536,1025 1536w, https://content.sfstandard.com/wp-content/uploads/2024/11/20242011-sfweather_1201.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Kimberly Ellis&#8217; tenure at the Department on the Status of Women was marked by high turnover. The agency currently has eight employees. </figcaption></figure>



<p>Interviews with almost a dozen former employees of the Department on the Status of Women — which was established in 1994 with the mission of protecting and advancing the equitable treatment of women and girls in the city — suggested that under Ellis’ leadership, staffers who raised questions about department operations were punished and marked for dismissal. The effect, according to those ex-employees, was to instill a culture of fear and blind loyalty, allowing Ellis to potentially abuse the agency’s contracting processes by giving taxpayer money to close associates.</p>



<p>The department’s budget totaled $11.7 million last year, roughly $10 million of which was allocated for outside grants. According to former staffers, Ellis’ tenure was marked by a startling amount of turnover at the small department combined with lax oversight of spending. City officials did not provide records to The Standard about the cost of the Truckee event and other contracts by deadline.&nbsp;</p>



<p>“That was such a colossal waste of time,” one former employee said of the retreat. Another former staffer said they were confused as to why they even left the city: “We were just in a conference room doing the same meeting we could do in San Francisco. There was no reason for us going all the way there.”</p>



<p>Ellis and Harbridge did not respond to requests for comment.</p>



<p>The city’s conflict of interest rules <a href="https://codelibrary.amlegal.com/codes/san_francisco/latest/sf_campaign/0-0-0-1610">require that officials report personal, professional, and business relationships</a> with those who enter into city contracts. The city has no record of Ellis disclosing her personal relationship with Harbridge.&nbsp;</p>



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<p>Contracts and the treatment of staff under Ellis’ watch have come under greater scrutiny since last week, when she was placed on leave pending an investigation.&nbsp;</p>



<p>In December, just a few months before her suspension, Ellis <a href="https://www.documentcloud.org/documents/25870574-ellis-kimberly-fppc700-2024-2024-12-13-annual-1/">amended economic disclosure forms</a> for 2023 to note that her consulting company, Southern Belle Strategies, received income from Power PAC, a progressive political action committee. Records show her company received $19,350 in payments. Meanwhile, her department has funded Power PAC’s nonprofit affiliate with roughly $120,000 since 2022. City officials told The Standard it could find no evidence that Ellis sought the required permission to have a second gig.</p>



<p>Since former Mayor London Breed appointed Ellis in late 2020, at least three employees have filed grievances with their union against the Department on the Status of Women, and 24 people have left the department, records show.</p>



<p>“It’s insane,” a former employee said. “People were leaving without having jobs lined up.” Another former staffer echoed a sentiment shared by other employees: “It was a culture of surveillance, fear, and bullying.”</p>



<p>Over time, sources said, Ellis and her top lieutenants became more savvy in avoiding labor grievances while continuing to push out staff.</p>



<p>“Rather than learn from their mistakes,” a former staffer said, “they just became more efficient in their cruelty.”&nbsp;</p>



<h3 class="wp-block-heading" id="h-loyalty-was-everything">‘Loyalty was everything’</h3>



<p>In one instance, a former employee in the Department on the Status of Women recalled being told to bill unrelated work to a federal grant they were managing. The employee said they raised concerns about the arrangement with Ellis, but the issue was never resolved. The worker was fired, filed a grievance with their union and received a settlement from the city.</p>



<p>“That put a target on my back,” the ex-staffer said. “Being outspoken on some of the things.”</p>



<p>At least two settlements have been paid to department employees since 2021, The Standard confirmed.</p>



<p>Another worker said they faced retaliation after trying to maintain proper accounting practices in the office. The former employee recalled hosting a presentation regarding rules for contracts under $10,000 and seeing Ellis walk out.</p>



<p>“She was going to do things that were not clean,” the employee said. “She knew I wasn’t going to follow.”</p>



<p>Former workers said Ellis unfairly fired a colleague shortly after the person raised concerns about department operations. Ellis later implied the person was a safety risk by changing the locks on the department’s doors.</p>



<p>“For Kimberly, loyalty was everything,” said the fired employee. “Either you did everything without questioning, or you weren’t loyal to her.”</p>



<p>Those in Ellis’ inner circle were rewarded with perks, former staff said.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?w=2500" alt="A woman in a white dress stands in a dimly lit room holding a microphone, surrounded by a crowd. Some people are applauding, and one person is taking a photo." class="wp-image-381985" srcset="https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg 5399w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/03/gettyimages-686523346.jpg?resize=2048,1365 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Kimberly Ellis ran for the state&#8217;s Democratic Party chair position in 2017 and initially refused to concede defeat.</figcaption></figure>



<p>Staffers said Ellis routinely held court with her executive team at lavish lunches at the five-star Claremont Hotel in Berkeley. One outing in August 2023 totaled just under $500 for seven people, according to an itemized receipt obtained by The Standard. The check included teas, coffees, espressos, mushroom omelets, steak frites, branzino, strawberry and spring salads, two scoops of ice cream, sweet pea agnolotti entrees, a smash burger, prawns, a virgin cocktail, two hot chocolates, and a yuzu mango tart.</p>



<p>“It was just gluttony at best,” said a staffer who attended the meal. “It was really strange and made me uncomfortable.”&nbsp;</p>



<p>Naz Rydhan-Foster, a senior program manager for the department who previously worked with Ellis at Emerge California, was listed as the name on the check for the $500 meal. Rydhan-Foster did not respond to requests for comment, but a former employee told The Standard that they were asked to submit reimbursements for a Claremont lunch. </p>



<p>Expense reports for Ellis show three charges for team meetings in Berkeley in 2023, although it&#8217;s not clear if those were at the Claremont. The report also lists expenses for the Truckee retreat for mileage, a bridge toll, and a per diem of $25, but it does not list anything related to hotel rooms at Gravity Haus. No charges related to the Claremont meals or Truckee retreat were listed on records related to a procurement card Ellis had for the department.</p>



<h3 class="wp-block-heading" id="h-this-department-was-supposed-to-support-the-women">&#8216;This department was supposed to support the women&#8217;</h3>



<p>Other questions about spending on events are part of a broader inquiry that led to Ellis&#8217; recent suspension from the department, sources told The Standard. </p>



<p>The department budgeted $700,000 to host the April 2024 conference “Shift Happens,” which was billed as a policy summit focused on women. The one-day summit at Moscone Center featured a fashion show and sessions on abortion rights and political organizing, as well as a fireside chat between Ellis and Jennifer Siebel Newsom, the documentary filmmaker and wife of Gov. Gavin Newsom.</p>



<p>Records provided by the department show the conference included a $90,000 catering tab, $120,000 for video production, $70,000 for administrative expenses, and $25,000 for exhibitions and educational materials. The organization that received the contract for the summit, Ignite, has previous financial links to Ellis. Her Form 700, filed in December 2020 shortly after her appointment by Breed, shows Ignite paid Ellis’ consulting firm over $10,000.</p>



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<p>Last summer, The Standard requested detailed payment records for the 2024 Shift Happens conference, but the department claimed it hadn’t retained receipts, invoices, or information on other vendors associated with the event.&nbsp;</p>



<p>Ellis released a statement hours after her suspension and called allegations against her “baseless.” She quoted Kendrick Lamar’s Grammy-winning song “Not Like Us” and claimed she was retaliated against after raising concerns about misconduct in a foster care pilot program. She did not provide further details on those concerns and indicated she would not comment further on the situation.&nbsp;</p>



<p>“If the intent behind these misleading, sensational narratives was to deter me — even at personal cost — then they clearly don’t know me,” Ellis wrote.&nbsp;</p>



<p>In response to her suspension, the 450-member Black Employees Alliance called out the city for a double standard in its treatment of Ellis, a Black woman, <a href="https://sfstandard.com/2022/10/21/sf-public-health-official-resigns-from-unauthorized-nonprofit-gig/">compared to Lisa Pratt, a white Department of Public Health director</a> who was found to be improperly moonlighting for a nonprofit funded by her department. Pratt was allowed to keep her city job after the side gig came to light in 2022.</p>



<p>“I think this is disgraceful,” Dante King, a founder of the alliance, said in an interview. “And it is incredibly racist.”&nbsp;</p>



<p>It’s unclear how the Department on the Status of Women intends to move forward now that it has come under the purview of City Administrator Carmen Chu. Former employees said the only surprising thing about Ellis’ suspension is that it took this long for her actions to come to light.</p>



<p>“This department was supposed to support the women in the city,” said one former employee. “But it is all a lie.”</p>


Supervisor opposes drug center across from his home. Now city may lose $10 million grant


<p>Drug treatment facilities, needle exchange centers, homeless shelters — all usually face opposition from irate neighbors.</p>



<p>But those neighbors don’t often include members of the Board of Supervisors.</p>



<p>The city has ended its efforts to spend a $10 million grant to move drug treatment services from Howard Street to a Mission Street location kitty-corner from Supervisor Matt Dorsey’s home.</p>



<p>The promised money now sits unused, and the state may revoke it.</p>



<p>Dorsey and a cadre of his constituents, including roughly 50 businesses and more than 300 individuals in the South of Market area, pushed the mayor’s office to stop the Department of Public Health from creating the service center on 1125 Mission St. The neighborhood is already home to many drug service centers, including the <a href="https://www.sf.gov/location--maria-x-martinez-health-resource-center">Maria X Martinez Health Resource Center</a> a block away.</p>



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<p>Dorsey said such facilities, while they do help those in need, can lead to open-air drug use that harms businesses and affects neighbors.</p>



<p>“When I come home and leave for work, the entrance to my apartment building looks down Julius Street, which has drug use all the time,” he said. “I think some [city] departments aren&#8217;t taking responsibility for the challenges of public safety they&#8217;re creating.”</p>



<p>The grant was awarded from California’s $430 million <a href="https://www.infrastructure.buildingcalhhs.com/">behavioral infrastructure bond</a> to enact “projects that will address significant crisis service gaps,” according to the bond’s website. The money has not been disbursed.</p>



<p>Oz Erickson, chairman of the developer Emerald Fund, on Monday wrote an email to Mayor Daniel Lurie and Dorsey with the signatures of 50 business owners, arguing that SoMa has more drug treatment centers than other city neighborhoods.</p>



<p>“Not a single resident or merchant wants the return of those dreadful days when the sidewalks were so jammed with dealers and users that pedestrians such as Governor Newsom in July of 2023 had to walk on the street instead of using the sidewalks,” Erickson wrote. “We do not want any more drug treatment service locations in our neighborhood.”</p>



<p>Lurie’s office declined to comment.</p>



<p>In a statement, the Department of Public Health said, &#8220;With every decision we make at SFDPH, our goal is to most effectively connect San Franciscans to the resources they need to have stable and healthy lives, while working with communities to support their neighborhoods. After extensive community feedback the best way to achieve those goals is to keep the Behavioral Health Access Center at 1380 Howard Street for the time being. As always, we will continue exploring opportunities to expand our services and ensure continuity and stability for everyone we serve.&#8221;</p>



<p>The drop-in center at 1380 Howard St. offers drug screening, medical referrals, and access to mental health services, as well as Medi-Cal enrollment. Dorsey said if that center had moved, the Department of Public Health would have used the state funding to also build new offices on the site.</p>



<p>“At the end of the day though, the thing that made this indefensible is, I don&#8217;t think it&#8217;s a good or wise use of [state] dollars,” Dorsey said.</p>



<p>Dorsey, who is open about his struggles with addiction, said the Department of Public Health proposed client-facing drug treatment services at the Mission Street site. He thinks the city already has too many of those types of services.</p>



<p>Instead, Dorsey wanted to see state funds spent on facilities San Francisco lacks, like a locked treatment center for the mentally ill or abstinence-based services with medically assisted treatment.</p>



<p>Since joining the Board of Supervisors in 2022, Dorsey has emerged as a leading voice for abstinence-based drug treatment.</p>



<p>City officials are increasingly lambasting harm reduction drug treatment strategies. Those methods include the distribution of safe paraphernalia to prevent the spread of disease and consumption sites where users can be monitored for overdoses.</p>



<p><em>Correction: An earlier version of this story misstated the proposed new location of the treatment facility. </em></p>


City departments are blowing off Lurie’s budget-cut mandate


<p>During his mostly cheery inauguration speech in January, <a href="https://sfstandard.com/2025/01/08/daniel-lurie-inauguration-speech-san-francisco/">Mayor Daniel Lurie shared some grim but unsurprising news</a>.&nbsp;</p>



<p>City Hall’s finances are in the red. “Painful decisions” — as he put it — must be made.</p>



<p>Less than two months into his tenure, those words appear to have fallen flat with a significant swath of the city’s departments, which have been tasked with 15% reductions to fill an $840 million budget deficit — the largest in San Francisco’s history.&nbsp;</p>



<p>A whopping 22 city agencies submitted budget proposals to the mayor’s office that did not hit that benchmark. Some came close, while others proposed no cuts whatsoever. A handful — the sheriff’s, elections, and fire departments, along with the Asian Art Museum and public defender — are even asking for more money.</p>



<p>The proposals could portend a tug-of-war between the mayor’s office, led by an inexperienced politician urging fiscal responsibility, and the departments he oversees, which assert that they’re already working on threadbare budgets and can’t take any sizable cuts to staff or operations.</p>



<h3 class="wp-block-heading" id="h-there-s-not-a-lot-of-fat-left-on-the-bone">‘There’s not a lot of fat left on the bone’</h3>



<p>It isn’t uncommon for departments to shirk a mayor’s request for belt-tightening. But this time around, the sheer size of the deficit means that common bookkeeping strategies, like padding up the budget with reserves or unused funds from the previous year, won’t be enough to magically fill the hole.&nbsp;</p>



<p>“There’s not a lot of fat left on the bone,” a person familiar with the budget process said. “There isn’t some $800 million budget-balancing trick that will make it so the departments don’t need to make reductions.”</p>



<p>Ed Harrington, who led the city controller’s office from 1991 to 2008, said the city’s financial situation “appears to be dire,” and there is “less flexibility” than in previous years when it comes to pulling levers to balance the budget.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1668" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?w=2500" alt="The image shows several police officers in uniform gathering around parked patrol cars in an urban setting, possibly engaged in a discussion or briefing." class="wp-image-349900" srcset="https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg 3000w, https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?resize=2500,1668 2500w, https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?resize=1536,1025 1536w, https://content.sfstandard.com/wp-content/uploads/2025/01/how-is-sf-keeping-street-partiers-safe-after-new-orleans-attack-_001.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Lurie has indicated that public safety and health employees will not take the brunt of the city&#8217;s budget deficit.</figcaption></figure>



<p>After receiving submissions from the city departments, Lurie will propose his budget in June. The Board of Supervisors will review the budget and vote on whether to approve it in July.&nbsp;</p>



<p>Documents from a January all-hands meeting with department heads show that Lurie laid out his intention <a href="https://sfstandard.com/2025/01/23/daniel-lurie-san-francisco-mayor-budget-cuts/">to “eliminate $1 billion in overspending</a>” in the next three years. However, he instructed departments to maintain core services and to refrain from proposing “politically untenable” cuts.&nbsp;</p>



<p>Immediately after taking office, Lurie announced a <a href="https://sfstandard.com/2025/01/09/san-francisco-mayor-daniel-lurie-hiring-budget-deficit/">hiring slowdown.</a> But, in keeping with his campaign promise to improve public safety and street conditions, that order exempted law enforcement and public health employees.&nbsp;</p>



<p>The mayor’s office declined to comment.</p>



<h3 class="wp-block-heading" id="h-truly-discretionary-expenses-are-nonexistent">‘Truly discretionary expenses are nonexistent’</h3>



<p>A handful of city departments referenced the 15% reduction request before explaining their need to retain their funding — or asking for more.&nbsp;</p>



<p>The Sheriff’s Department wants nearly $30 million more, which would bring its yearly support from the city’s general fund to $283 million. A spokesperson told The Standard the department needs more funding for staffing and to address a rising jail population. Its proposal mentions those requests, the mayor’s <a href="https://sfstandard.com/2025/02/06/union-square-hospitality-zone-increased-police-presence/">Hospitality Zone Task Force</a>, and “much-needed” safety equipment and supplies.&nbsp;</p>



<p>Like the sheriff, the San Francisco Fire Department wants more funding: $3.8 million for employee pay. It argues that instituting the 15% cuts would mean removing seven fire engines or six truck companies in a year — or cutting 23 daily, 12-hour ambulances from the 911 emergency system.&nbsp;</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1668" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?w=2500" alt="A grand building with a domed roof is framed through a window. Flags line the path leading to it, and a couple of people walk across the plaza." class="wp-image-338102" srcset="https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg 5000w, https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?resize=2500,1668 2500w, https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?resize=1536,1025 1536w, https://content.sfstandard.com/wp-content/uploads/2024/12/20241203-sfbudgetcrisis_001.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">The $840 million budget deficit is the largest in the city&#8217;s history.</figcaption></figure>



<p>“As always, we’re working with the mayor’s office collaboratively to meet the budget needs,” said an SFFD spokesperson.</p>



<p>The public defender is asking for an additional $13.6 million, which would bring its support from the city to $70.3 million. “Public defenders are already grossly underfunded compared to police, prosecutors, sheriffs and probation departments, whose ever-expanding budgets continue to significantly increase our already heavy caseloads,” Public Defender Mano Raju wrote in a statement. </p>



<p>Other departments aren’t asking for more funding but say they cannot make significant trims.&nbsp;</p>



<p>The city attorney’s office proposed cutting $60,000 (a 0.16% reduction) from its budget. “While we appreciate the City faces a substantial deficit, cutting our budget and freezing our hiring will only exacerbate it.” The office explained that its work generates “hundreds of millions of dollars in revenue” and protects the city from “billions” in liability.&nbsp;</p>



<p>Jen Kwart, a spokesperson for the city attorney’s office, also mentioned the White House as a reason for retaining funding, which, under its proposal, would amount to $37.1 million. </p>



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<p>“We have not received new positions for our work defending our communities and billions of dollars of federal funding threatened by the Trump administration,” she wrote in a statement.&nbsp;</p>



<p>The San Francisco Police Department is in a similar boat. It said it would trim&nbsp; $53,811 (0.008%) from its budget, stating in its submission that “after parsing by Fund Source and by types of expenses, truly discretionary expenses are nonexistent. Further, ongoing structural budget constraints prevent the elimination of vacant positions to generate reductions.” Its financial support from the city would reach $673.7 million under its proposal. A spokesperson did not respond to a request for comment.</p>



<p>A portion of city departments did follow Lurie’s order to make cuts valued at 15%, including the Department of Emergency Management, human resources, the Department of Public Health, and Public Works.</p>



<p>Board President Rafael Mandelman said preserving public safety funding means the “larger potential sources of savings are not on the table.”&nbsp;</p>



<p>“That means you’re making harder choices in other departments,&#8221; he said. &#8220;And we need to have the budget be sustainable over a particularly difficult period of time.&#8221;</p>



<p><em>Editor&#8217;s note: This story has been updated to clarify details of the public defender&#8217;s budget proposal. </em></p>


‘A lack of respect’: Ousted police commissioner blasts Lurie


<p>A nearly monthlong dust-up over a police commissioner’s seat ended with the San Francisco Board of Supervisors voting to remove Max Carter-Oberstone, an ardent advocate of law enforcement reform, from his role on the oversight body.</p>



<p>In a 9-2 vote Tuesday — with supervisors Myrna Melgar and Jackie Fielder opposing — the board removed Carter-Oberstone just weeks after <a href="https://sfstandard.com/2025/02/04/san-francisco-mayor-bold-play-remove-sfpd-commissioner/">Mayor Daniel Lurie&#8217;s Feb. 4 request for the commissioner&#8217;s ouster</a>. In a subsequent vote, supervisors unanimously appointed Lurie&#8217;s nominee, <a href="https://www.sf.gov/mayor-lurie-makes-first-round-of-new-appointments-wilson-leung-to-police-commission-jean-fraser-to-prop-e-commission-alicia-john-baptiste-to-mtc-tessie-guillermo-and-dr-laurie-green-reappointed-to-health-commission" target="_blank" rel="noreferrer noopener">former federal prosecutor Wilson Leung</a>, for a separate vacant seat.</p>



<p>Carter-Oberstone, whom former Mayor London Breed nominated in late 2021, <a href="https://sfstandard.com/2022/09/23/whats-really-behind-the-mayors-spat-with-her-appointee-influence-over-sfpds-future-leadership/">fell out of her favor</a> by refusing to push for her policy recommendations and <a href="https://sfstandard.com/2023/02/07/supervisors-fix-breeds-resignation-gate-get-earful-on-delayed-reparations-hearing/">revealing her practice of forcing appointees to sign undated resignation letters</a>. While on the commission, Carter-Oberstone called for tackling police misconduct and <a href="https://sfstandard.com/2024/02/21/san-francisco-police-commission-final-vote-to-limit-pretext-stops/">racial profiling</a>.&nbsp;</p>



<p>The commissioner’s critical perspective of the San Francisco Police Department contrasts with Lurie’s call for more law enforcement. Additionally, Lurie created a committee during last year’s March primary to support Proposition E, a voter-approved measure <a href="https://sfstandard.com/2024/01/22/london-breed-prop-e-san-francisco-police-fundraising/">that loosened rules surrounding vehicle pursuits and surveillance technology</a> and drew the ire of police reform advocates.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?w=2500" alt="A man in a suit and a police officer in uniform are walking and talking. They are surrounded by other uniformed officers on a city street." class="wp-image-360281" srcset="https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg 5958w, https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/01/ap2500878949232711.jpg?resize=2048,1365 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Mayor Daniel Lurie has the power to remove SFPD Chief Bill Scott, though candidates for a replacement are chosen by the police commission.</figcaption></figure>



<p>In an interview Tuesday, Carter-Oberstone blasted Lurie for trying to make commissioners “do as they&#8217;re told.” During his time on the police oversight body, Carter-Oberstone often disagreed with his moderate colleagues and the mayor’s office.</p>



<p>&#8220;It indicates a lack of respect for our city&#8217;s founding [charter] and for our city&#8217;s system of government,” he said. Carter-Oberstone also said the lack of explanation for his removal flies in the face of the promises of transparency Lurie made while on the campaign trail.</p>



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<p>&#8220;There&#8217;s a big difference between campaigning and governing, and Daniel Lurie doesn&#8217;t have a track record in public life, in public office, and so the public&#8217;s getting to see what kind of leader he is,” Carter-Oberstone said.</p>



<p>The former commissioner delivered a 10-minute speech at Tuesday’s hearing, saying his job is &#8220;not to become popular with the agency I&#8217;m supposed to be overseeing [but to] protect and defend the rule of law.&#8221;</p>



<p>Dozens of public commenters at the hearing defended Carter-Oberstone, including representatives of the American Civil Liberties Union and organizations advocating for criminal justice reform.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1668" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?w=2500" alt="A person sits at a desk with laptops and microphones, surrounded by others in a formal room. American, California, and San Francisco flags are on display." class="wp-image-371884" srcset="https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg 3000w, https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?resize=2500,1668 2500w, https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?resize=1536,1025 1536w, https://content.sfstandard.com/wp-content/uploads/2025/02/8565060456_maxoberstone_007.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Board of Supervisors President Rafael Mandelman, center, supported Carter-Oberstone&#8217;s ouster.</figcaption></figure>



<p>&#8220;Why would a police commissioner be a road block to Mayor Daniel Lurie&#8217;s plans?&#8221; one commenter asked. &#8220;Public safety is Max Carter-Oberstone. He has stopped the violence coming from within our own halls of justice.&#8221;</p>



<p>Some defended Lurie&#8217;s move to unseat Carter-Oberstone.</p>



<p>&#8220;The mayor has the right to have his picks,&#8221; said Marie Hurabiell, executive director of ConnectedSF. &#8220;No mayor has to honor the previous administration. It is completely procedural and completely within the bounds of the law.&#8221;</p>



<p>Carter-Oberstone said he met with Lurie’s chief of staff, Staci Slaughter, in late January and asked about rumors of his removal. He said Slaughter told him a decision had not yet been made.</p>



<p>Lurie has not provided a reason for the ouster other than emailing the city clerk: “I look forward to nominating a new commissioner in the near future who will work collaboratively to make our city safer.”&nbsp;</p>



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<p>The move has raised questions about whether Lurie is trying to get a firmer grip on naming an eventual replacement for SFPD Chief Bill Scott. Lurie has already replaced multiple department heads, including the fire chief and director of the Department of Public Health. The mayor has the power to remove the chief; commissioners would pick three nominees from whom Lurie would choose a replacement.&nbsp;</p>



<p>“Many have speculated that he needs more commissioners who will put whatever name he wants on that list of three,” Carter-Oberstone said.</p>



<p>The mayor’s office did not respond to a request for comment about the board’s decision Tuesday.&nbsp;In an emailed statement, Lurie touted Leung as an important asset for advancing his agenda at City Hall. </p>



<p>“Throughout the government, we are appointing leaders who will work with fellow commissioners and departments to deliver better services for our city,&#8221; Lurie wrote, &#8220;and Wilson’s decades of work in compliance and oversight will make him an asset as we work together to protect San Franciscans.&#8221;</p>



<p><em>Joe Fitzgerald Rodriguez</em> <em>contributed reporting.</em></p>


New SF public health chief was part of notorious McKinsey opioid-marketing operation


<p>Daniel Tsai, Mayor Daniel Lurie’s choice to lead the Department of Public Health, has a blue-chip résumé: After studying at Harvard University, he landed a prestigious consulting gig before jumping into government, leading Medicaid programs in Massachusetts, then federally under former President Joe Biden.&nbsp;</p>



<p>Along the way, Tsai, in his capacity as an employee with McKinsey &amp; Company, helped to market a powerful painkiller called tramadol during the company&#8217;s years-long streak of pushing opioid sales. The company’s actions ultimately led to a criminal probe, more than $1 billion in settlements, and a public mea culpa over its role in fueling an overdose epidemic that has killed more than 500,000 Americans over 25 years.</p>



<p>Tsai’s actions at McKinsey are detailed in a tranche of documents that were released as part of a settlement with the consulting firm in which it was accused of accelerating opioid sales despite growing awareness of the risks.&nbsp;</p>



<p>The records show that Tsai — who worked for McKinsey from 2007 to 2015, according to his LinkedIn page — helped develop a marketing strategy for tramadol sold under the brand name Ultram ER, an effort that involved cultivating relationships with doctors who became prolific prescribers. The records are housed at the <a href="https://www.industrydocuments.ucsf.edu/opioids">UCSF-JHU Opioid Industry Documents Archive</a>.</p>



<p>In a March 2008 PowerPoint presentation, Tsai outlined a marketing strategy for the drug that included guidance on targeting “specific physician segments to grow high-prescriber group (i.e., physicians more sensitive to patient needs)” and an idea to introduce “coupons” for the drug as part of a pilot program.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1629" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?w=2500" alt="A booth with &quot;McKinsey &amp; Company&quot; in bright letters on a wooden panel. Two men stand nearby, one looking at a touchscreen display." class="wp-image-367908" srcset="https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg 4396w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=300,196 300w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=768,501 768w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=2500,1629 2500w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=1536,1001 1536w, https://content.sfstandard.com/wp-content/uploads/2025/02/gettyimages-1247557771.jpg?resize=2048,1335 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">McKinsey &amp; Company has paid more than $1 billion in settlements related to its role in the opioid crisis.</figcaption></figure>



<p>“We hope to be interviewing some high-prescriber physicians next week,” Tsai wrote in an email the same month, attaching a list of questions that could be used to screen doctors. </p>



<p>Lurie’s office defended Tsai’s appointment as Public Health chief. In a statement, the mayor’s office wrote, “Nearly 20 years ago, Dan Tsai was a 23-year-old entry-level staffer assigned to conduct research for a project at work. He has spent nearly his entire two-decade career supporting those struggling with homelessness and addiction and helping tens of millions of our most vulnerable neighbors access critical medical care, and he will continue that work in San Francisco.”</p>



<p>Several drug and homelessness service providers in the city said they were disappointed by a lack of transparency surrounding Tsai’s appointment process. The revelation of his past role at McKinsey intensified those concerns, they said.&nbsp;</p>



<p>“You’d want a public health official of that caliber to articulate what his participation was in that role,” said Laura Guzman, director of the National Harm Reduction Coalition. “This is an important moment to bring in people with federal bureaucracy expertise. But if [Lurie] wants to address the lack of treatment, we need leadership with expertise in evidence-based interventions.”</p>



<p>Others were less diplomatic in their reaction to the news.</p>



<p>“Holy fucking shit,” said Liza Murawski, co-chair of the city’s Behavioral Health Commission, when told of Tsai’s role at McKinsey. “Why would he be the director? Why don&#8217;t you have someone in there who’s a mental health expert?”</p>



<p>It wasn’t immediately clear who Tsai’s client was when he was marketing Ultram ER. The brand, which has been discontinued, was developed by a Canadian company and licensed to a subsidiary of Johnson &amp; Johnson in 2005, <a href="https://pharmatimes.com/news/orthos_ultram_er_reaches_us_market_996469/">according to PharmaTimes</a>.&nbsp;</p>



<p>Experts say tramadol was initially thought to be less harmful than OxyContin, another product McKinsey marketed for Purdue Pharma. But that view has changed.&nbsp;</p>



<p>Tramadol is a Schedule IV drug — in the same category as Xanax, Valium, and Ambien — and has <a href="https://www.voanews.com/a/report-highly-potent-opioids-now-showing-up-in-drug-users-in-africa/7653980.html">more</a> <a href="https://www.bbc.com/news/world-africa-44306086">recently</a> <a href="https://www.occrp.org/en/news/un-report-tramadol-use-in-africa-is-increasing">been</a> linked to addiction in Africa. “It was seen as this alternative,” said Dr. Rachel Sussman, a South Bay-based addiction medicine specialist. “It is just as risky and just as dependency-creating as any other opioid medication.” In fact, the drug carries more complications than some other opioids, including a risk of seizure and negative interactions with antidepressants, said Sussman.</p>



<figure class="wp-block-image size-large"><img loading="lazy" decoding="async" height="1667" width="2500" src="https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?w=2500" alt="Two men in suits stand near a podium. One is holding papers, and the other rests a hand on his shoulder. A calendar and TV are visible in the background." class="wp-image-366616" srcset="https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg 7510w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=300,200 300w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=768,512 768w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=2500,1667 2500w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=1536,1024 1536w, https://content.sfstandard.com/wp-content/uploads/2025/02/w2a5893.jpg?resize=2048,1366 2048w" sizes="auto, (max-width: 2500px) 100vw, 2500px" /><figcaption class="wp-element-caption">Mayor Daniel Lurie tapped Tsai to lead the city&#8217;s Public Health Department. The sprawling agency has a roughly $3 billion budget.</figcaption></figure>



<p>Dr. David Juurlink, an expert on tramadol, called the drug a “minor player in the opioid crisis, but a player nevertheless.”</p>



<p>He added, “To the extent that McKinsey helped advertise it as a notionally safer opioid, I think they did a disservice in doing so. The main reason I say tramadol is a minor player is because it wasn’t prescribed like candy, like OxyContin was.&#8221;</p>



<p>McKinsey’s method of targeting high-volume prescribers was part of its playbook to juice opioid sales, despite mounting evidence that the drugs could be highly addictive. In other emails uncovered in the McKinsey documents, employees wrote excitedly about finding doctors who were willing to write opioid prescriptions. <a href="https://www.industrydocuments.ucsf.edu/opioids/docs/#id=hlmn0255">In one instance</a> in 2015, a McKinsey partner wrote, “The challenge which we need to start working on is to identify the sweet spot of docs so we can do targeting. … Fun be[g]ins on Monday!”</p>



<p>San Francisco’s fentanyl crisis is part of a broader trend of opioid overdoses <a href="https://www.cdc.gov/overdose-prevention/about/understanding-the-opioid-overdose-epidemic.html">that traces back to the 1990s,</a> when prescription opioids became popular among doctors for chronic pain management. Companies such as Purdue Pharma, which manufactured OxyContin, brought in consulting firms like McKinsey to help with sales strategies. After a Department of Justice probe and settlement, McKinsey <a href="https://www.justice.gov/usao-ma/media/1380236/dl">acknowledged that it knew</a> the dangers of OxyContin but continued working with Purdue Pharma — even after several of the drugmaker’s executives pled guilty in 2007 to misrepresenting addiction risks.&nbsp;</p>



<p>McKinsey, along with a slew of drug companies and pharmacies, agreed to pay billions in settlement funds over their roles in fueling opioid addiction. California received <a href="https://oag.ca.gov/news/press-releases/attorney-general-becerra-announces-573-million-nationwide-settlement-mckinsey">roughly $60 million</a> from the 2021 McKinsey settlement. San Francisco, <a href="https://www.sfcityattorney.org/2023/05/17/san-francisco-city-attorney-announces-230-million-settlement-with-walgreens-after-victory-in-opioid-litigation/">under the 2023 settlement</a> of an opioid-related lawsuit, was expected to receive about $230 million from Walgreens.</p>



<p>In both instances, the funds were slated to be used for opioid recovery efforts.</p>



<p>In 2019, McKinsey said it would no longer work on opioid-related businesses.&nbsp;Last year, McKinsey formally apologized for its Purdue Pharma work, <a href="https://www.mckinsey.com/about-us/opioidfacts">saying it was “deeply sorry”</a> for its role in selling OxyContin. “This terrible public health crisis and our past work for opioid manufacturers will always be a source of profound regret for our firm,” the company said in a statement.</p>



<p>At the San Francisco Department of Public Health, Tsai replaced Dr. Grant Colfax, who took the reins in 2019 and led the city through the pandemic <a href="https://sfstandard.com/2025/01/16/grant-colfax-resign-san-francisco-public-health/">before stepping down in January</a>. The role paid $546,133 in 2024, one of the highest city salaries.&nbsp;&nbsp;</p>



<p>On Monday, the San Francisco Health Commission unanimously nominated Tsai as director of Public Heath. Dr. Laurie Green, president of the commission, said the governing body conducted a “multi-hour” interview.</p>



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<p>“In the interview with Mr. Tsai, the Health Commissioners focused on his preparedness to address the current public health challenges facing San Franciscans and his ability to sustain the Department through a potential tumultuous time ahead,” Green wrote in a statement. “This includes his unique expertise in Medicaid funding and programs, in addition to healthcare innovations and transformation.”</p>



<p>Tsai is expected to work with <a href="https://sfstandard.com/opinion/2025/01/07/the-fresh-faces-in-luries-cabinet-will-have-vast-power-but-will-they-know-how-to-wield-it/">Kunal Modi</a>, another McKinsey alum, whom Lurie has tapped to lead the city’s response to health and homelessness. In a statement this week, Tsai highlighted&nbsp;the city’s opioid and homelessness crises and said he was looking forward “to partnering with stakeholders and individuals with lived experience to find new, data-driven approaches to tackling this important challenge.”</p>



<p>Representatives of McKinsey did not respond to a request for comment.</p>



<p>Richard Beal, director of recovery services at the Tenderloin Housing Clinic, said he appreciates Lurie’s early focus on the fentanyl crisis and remains optimistic about Tsai’s appointment.<br><br>“Just like [Tsai] distributed the drugs, maybe he can distribute the solution to the drugs,” Beal said. “Hopefully, he can use the knowledge he has from helping to create the monster to figure out how to solve it.”</p>


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The Abatement Appeals Board provides a final review process for City permitting decisions. It ensures fair and efficient adjudication of permit-related disputes before an impartial panel. The board holds authority to make binding decisions on appeals concerning notices of abatement.

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Adult Probation Department supervises individuals on probation and facilitates their reintegration into the community. It provides reentry and rehabilitative services, including victim restitution and financial assistance for crime victims. The department values public safety, offender rehabilitation, and community partnerships.

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Advisory Committee of Street Artists and Crafts Examiners

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San Francisco Arts Commission invests in a vibrant arts community and shapes cultural policy. It enlivens the urban environment through public art programs and supports diverse artistic expressions. The commission facilitates meetings and discussions to engage the community in cultural development.

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The Asian Art Commission determines policy and administers the Asian Art Museum of San Francisco. It oversees museum operations and collaborates with the Asian Art Museum Foundation on fundraising efforts. Commissioners ensure the museum's strategic direction and financial sustainability.

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Asian Art Museum showcases Asian art and culture through exhibitions and educational programs. It offers diverse collections and hosts special events to engage the community. The museum fosters cultural appreciation and understanding by providing access to its extensive art collections.

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The Assessment Appeals Board #3 provides a platform for San Francisco taxpayers to contest property tax assessments. It conducts hearings where evidence from both taxpayers and the Assessor is evaluated. The Board makes binding decisions on property assessments based on presented evidence.

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The Bayview Hunters Point Citizens Advisory Committee provides policy advice on planning and land use matters in Zone 2 of Bayview Hunter's Point. It offers expertise in land use policies, zoning issues, and urban development. The committee advises the Board of Supervisors, City Boards, and commissions on relevant projects and initiatives.

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