Michael Levine, a Massachusetts Medicaid executive, is the sole nominee to lead San Francisco’s homeless department, Mission Local has learned.
Following his approval today by the Homeless Oversight Commission, Mayor Daniel Lurie will tap him to be the next director of the city’s Department of Homelessness and Supportive Housing, according to multiple sources close to the process.
After the publication of the article, the mayor’s office confirms that Levine “is expected to be appointed” on Wednesday.
Lurie himself put Levine before the Homelessness Oversight Commission, sources said. On Tuesday morning, the commission, a body formed in 2023 that has the power to hire and fire the homeless department head, discussed the candidate in a closed session.
After the vote, commissioner Sharky Laguana confirmed to Mission Local that the Homeless Oversight Commission advanced Levine, leaving only the formality of Lurie approving his own preferred leader for the department.
“We nominated him and it’s very clear the mayor will accept this nomination — with good reason,” Laguana said.
“Mike oversees a budget of $23 billion, he has 1,000 employees, tens of thousands of providers contract with MassHealth, he’s done over 600 audits and MassHealth has two million clients, more than 10,000 of which are homeless,” Laguana said.
Laguana described Levine as “ridiculously qualified.”
The Homelessness Oversight Commission last week declined motions to conduct a larger search or establish an advisory group regarding recruitment. Mission Local has confirmed that Levine was the only candidate put forward for the position.
Shireen McSpadden, the current head of the homeless department, who announced her June departure, said she “cannot confirm or deny” the pick, stating that it is “not my role.”
After the publication of the article, the mayor’s office shared statements from Lurie and Levine. “Mike is an expert in connecting health care and homelessness services, and he has seen the power of integrating primary care, behavioral health, and social supports to keep people housed,” Lurie said. “Mike brings the experience and the expertise to build on our momentum, and I look forward to working with him.”
“I am excited to lean in to accelerate our progress to help more people move toward stability and I look forward to being out in the community—meeting with providers, community members, frontline teams, and most importantly the clients we serve,” Levine said.
“They want some fresh take, fresh eyes on homelessness in San Francisco,” a source familiar with the hiring process said, pointing to Levine’s experience with Medicaid, a federal program that is a public health insurance plan for low-income residents and is called Medi-Cal in California.
Levine’s experience in the Medicaid system was likely seen as a major plus. If he could fund homeless services through Medicaid and Medi-Cal — the federal waivers — the city could save on its general fund.
This would be the second time Lurie sought out talent from MassHealth, Massachusetts’ Medicaid program. Levine’s time there overlapped with the Health Department’s Tsai for about four years from 2016 to 2018 and then 2019 to 2021, according to LinkedIn.
Daniel Tsai, the director of the Department of Public Health, speaking during a press conference at the Maria X Martinez Health Center on Feb. 11, 2025. Photo by Kelly Waldron.
Levine’s public sector career has been largely devoted to MassHealth, where he has worked in two stretches totaling nearly nine years starting in 2016.
Commissioners were impressed by his track record, which includes a redesign of Massachusetts’ behavioral health system that heavily reduced emergency room visits, a tenancy preservation system to keep people in their housing and a streamlining of onerous processes to enroll homeless people to Medicaid.
Multiple sources have pointed out that Tsai “works well” with Kunal Modi, Lurie’s deputy chief overseeing homelessness and public health, as well as Lurie.
Levine also worked at the Bridgespan Group, a nonprofit strategy consultancy in Boston, where he put in two separate stints from 2013 to 2019, rising from associate consultant to manager.
McSpadden in March told staff she would step down as the city’s homelessness department director on June 30, marking the end of a five-year tenure that began in 2021 in former Mayor London Breed’s administration.
McSpadden’s successor will also work with Lurie on his “Breaking the Cycle” initiative, a pillar strategy of his administration to battle homelessness and behavioral health crises — whether it’s the team of teams response system on the streets or the mayor’s latest move away from longer-term shelter stays to shorter-term shelters.
“Whoever it is — not just Michael — coming into this position, is going to have the mayor’s demand of cutting services,” said Sunny Angulo, who served as chief of staff to former Board President Aaron Peskin. “I hope there is a plan before he comes in and we can all support him and follow that plan and make sure people don’t fall through the cracks. ”
Santiago Lerma, former District 9 legislative aide and the current lead of the Mission street team for the Department of Emergency Management, agreed.
“It’s a tough job and a very important one,” said Lerma, who said he had not heard of Levine as a possible candidate. “There is the benefit of starting off fresh — you are not being jaded. But you need to get the understanding of how the department and city government function. And it is going to be a steep learning curve.”