SF Advances $195M Bond for Health Facilities, Plazas as $930M in Unspent Funds Draw Scrutiny

The San Francisco Budget & Finance Committee on May 20 unanimously advanced nearly $200 million in general obligation bond spending for health facilities, street safety, and downtown plazas — the second major issuance under the voter-approved 2024 Healthy Safe and Vibrant SF authorization. But the bigger revelation may have been what's sitting untouched: roughly $930 million in unspent medical reimbursement accounts, up to $274 million of which could transfer to the General Fund this August to help close the city's deficit.

• $195M GO bond issuance advances for Chinatown Public Health Center, ZSFG seismic work, Laguna Honda repairs, street safety, and downtown plazas including Powell Street, Harvey Milk Plaza, and Halliday Plaza
• $50M for homeless shelters remains unissued from the voter authorization, with HSH still determining how to spend it
• Chair Chan puts McLaren Park funding shift on the record, questioning whether $5M intended for the Jerry Garcia Amphitheater was redirected to the Embarcadero
• BLA flags untapped state revenue for school mental health: SFUSD only began billing California's CYBHI program in February, years behind 160 other districts
• $930M in unspent medical reimbursement accounts revealed during Healthy SF contract debate; up to $274M in dormant funds headed to the General Fund
• Two SFO restaurant leases terminated — Sushirito (bankruptcy) and Balboa Cafe (22% cost blowout) — freeing premium terminal space

The committee advanced the second issuance under San Francisco's $390 million Healthy Safe and Vibrant SF bond authorization, sending $195 million in new spending to the full Board of Supervisors for final approval.