The Department of Public Health and Department of Human Services were asked to submit “baseline” budgets to the Mayor in February, as airport and sales tax revenues were down. They were asked to submit also a contingency list of cuts in case revenues were down.
Baseline means they submit the same budget amount as last year. That means any cost of living increases, or increased pay for civil services employees has to be paid for by cutting programs or additional revenue. DPH had huge increase in civil service, but they also had an increase in MediCal revenue. So they cut out all the new programs (mostly) that were added into the budget last year by Supervisor and Mayor. DHS baseline went a little deeper (see below)
The contingency was a 10% cut to general fund. Since the Departments won’t touch civil service jobs, they look to non-profit contractors who receive general funds. Since non-profits get a small portion of city money, and the 10% is for the entire general fund, that translates into 20%, 50%, even 100% cut to contractors. At the beginning of the year, Department Financial Officers and Commissioners were saying, “Don’t worry, it will just be the baseline, this is just a precaution.” But the scenario is changing.
The Mayor submitted a preliminary budget to the Supervisors that has just the baseline, and goes $130 million over. It does have a 23 million increase to police. Mayor’s office is now reporting that they will have to cut even further then the contingency cuts, as the state budget is cutting huge amounts of funding from the City as well.
The “minus 10%” budget assumes a $25 million cut in General Fund income and contains drastic cuts and outright eliminations of large parts of mental health, substance abuse, jail health, pharmacy services, and City clinic services. DPH submitted the “minus 10%” budget to the City with a recommendation against adapting it, but now the City can use the budget as DPH policy if it decides its reserves are too low.
The “minus 10%” budget is not a single entity that must be accepted or rejected as a whole. The recommendations for cuts are independent of each other.
Any one of them, or any combination of them, can be imposed this year, or in following years, depending on how much the City wants to, or dares to, reduce services.
None of these cuts are acceptable!
MENTAL HEALTH SERVICES
First-level cuts: 490 clients lose outpatient treatment.
Second-level cuts: Transitional Residential Care eliminated.
Day Treatment eliminated.
Outpatient Services = 350 less clients;
Outreach Services = 375 less clients.
Residential Treatment = 367 fewer clients.
Inpatient Care = 721 less beds.
SUBSTANCE ABUSE SERVICES
First-level cuts: Prevention Services = 276 less clients.
Outpatient Services for Addicts = 2,027 less clients.
Residential Treatment = 335 less beds.
Second level cuts: Prevention Services = 680 fewer
clients. Transportation/Outreach = 175 fewer clients.
Cut 19 positions (Jail Health is dreadfully understaffed already). Eliminate ALL of the following: OB/GYN care; Chronic Care for 1200 cardiovascular, asthma, diabetes, and seizure patients; STD Screening and Treatment for 3000 inmates; Weekend Sick Call used by 500 patients; Observation Area for 400 inmates (“may increase suicide risk”); Evening Coverage for 5000.
NEIGHBORHOOD PRIMARY CARE CLINICS
Eliminate Adult Dental at SouthEast, Potrero Hill, Chinatown, Silver Ave (3903 patients) Eliminate 9 currently vacant clinical positions, reduce clinical contracts with Lyon-Martin, Haight Ashbury, California Acupunture, and Mission Neighborhood Health Centers.
SAN FRANCISCO GENERAL HOSPITAL
Eliminate 50% of interpreters. Eliminate Pediatric Inpatient Care. In Pharmacy: mandatory $5 co-pay per medicine. Stop dispensing the following: Cholesterol- lowering drugs (which prevent heart attacks, stroke, and kidney failure), non-sedating anti-allergy drugs, and newest stomach acid drugs unless actively bleeding.
LAGUNA HONDA HOSPITAL
Eliminate 76 added clinical staff in baseline budget. Eliminate 28 added nurse positions in Behavior, Psychosocial, and Dementia Areas (300 patients), where patients and workers are injured by understaffing. Eliminate new safety equipment for patients and staff. Contract out laundry costing 48 jobs, an MOU violation.
HOMELESS AND HOUSING SERVICES
<p. Hospitality House loss of drop-in self-help services for 8000 homeless people.
Housing and Urban Health: reductions in transitional housing, rent subsidies, and residential care.
Reduce Homeless contracts by 3%.
Eliminate programs for emotional support (900 clients), emotional and practical support (600 clients), and AIDS/HIV hotline (24,000 calls yearly)
Eliminate 3.7 FTEs, eliminate startup home visits program for 22 pediatric patients
Eliminate OMI FRC and Booker T. Washington Family Resource Centers, $363,052 and $467,651 respectively; Both provide support services to very poor families receiving Calworks and/or at risk of losing custody of children. Reduce FCS contracts by 3%. Cut Calworks Housing subsidy by $240,00 resulting in 15-20 fewer families getting subsidies.