SF does $600 million to $800 million per year just through DHSH.

My guess is around 300 - 400 million through other depts (SF DPH etc). Behavioral health services alone run $500M and DPH is at $2.4 billion in their budget.

I'm excluding Fire / Police / MOCD / other services (there are a ton).

Rough numbers maybe $1B/year? for 8-12,000 folks?

This is both very large, but SF probably only spends around 8-10% of budget on this - the SF budget is very large.

That's crazy! I know american cities handle services that are handled at a provincial level here in Canada but the budget for the city of Montreal is only around 6B$ in Canadian dollars. And that's with all the costs that come from snow removal and the never ending repairs our roads need due to winter damage.

Montreal is much larger though I think? Sf is 800K or so in population

You also presumably were able to manage your own affairs, had a reputation and connections that meant you could get safe living quarters without being assaulted or having your stuff stolen, weren’t leaving dangerous biohazards around someone else needed to be paid to deal with - all of that adds up.