This year’s city budget is particularly brutal. Again, San Francisco’s budget is balanced on those who can afford the least. Residents with the least money and the most needs will have critical primary health, behavioral health and social services programs cut by $69 million.
The Department of Public Health (DPH) budget wants to cut $32.4 million from public and mental health. The Department of Human Services (DHS) budget wants to cut $7.5 million from welfare benefits and housing services. Both departments claim that these aren’t really cuts, or that they won’t affect people or the direct services they receive. But this is simply not true.
This year’s budget cuts are covert. Instead of closing specific community programs entirely, they are gutting them from the inside. Staff at primary care clinics throughout the City are being fired. Clinic hours will be cut. The entire Dialysis Unit at SF General Hospital will be cut, immediately putting patients in a life-threatening situation if they are unable to transfer to private clinics, which often do not accept them. Co-payments of $5-10 will now be required at the San Francisco General Hospital pharmacy, with an estimated 6,144 people that will go without medication because they will not be able to afford it.
Mental health services and primary care will both suffer under the integration of eight community clinics. This will affect 2482 patients. All the mental health clients will be dumped into unfamiliar and overcrowded primary care clinics. This will be disastrous to everyone’s treatment and service. Over a thousand clients will lose services entirely as they are transferred to community-based services that do not exist, because these services have already been cut in past budgets.
As usual, people of color are disproportionately affected. Translation and interpretation services have been cut by both DHS and DPH. This will mean that 2945 people will leave the hospital without being treated or understanding their diagnosis just because they don’t speak English. The Mission District is targeted to lose Mission Mental Health Clinic and the very successful Mission A.C.T. program. The Bayview Hunter’s Point Adult Day Health Center–one of the few remaining adult day centers that serves mainly African-American seniors–will be cut, resulting in displacement of eight percent of the elderly clients to nursing homes. Sunset Mental Health Clinic will be closed and sold, robbing culturally appropriate services from Asian-Americans.
While the City claims to be tackling “chronic homelessness,” the budget once again makes the most cuts to programs that serve the physical and mental health needs of homeless people. The numerous cuts to primary healthcare centers will essentially gut Healthcare for the Homeless programs. By cutting programs like Tom Waddell and Shanti, whose client base is one-third homeless people with HIV/AIDS, the City is attacking the very same people it claims it is “caring” for.
Continuous Injury Destroys Care
On top of the harsh nature of the cuts, there is the ugliness of the budget process. This year, the cuts were held up for months, and any honesty or transparency to the process was ruined. The late release of the cuts prevented the community from being able to give informed input on the actual consequences of these cuts. The process was rushed through without inclusion of, or respect for, the communities that will ultimately bear the brunt of these cuts.
Every year we are fed the same myth of scarce resources. Non-profit organizations, city programs, unions, and clients are pitted against one other, fighting for the small piece of the budget they need to stay afloat. Meanwhile, our entire system of services is dismantled. This scenario was best illustrated this year by the executive directors of the three largest non-profit mental health organizations (Baker, Progress, Conard) declaring in the face of emotional clients, staff and community members who adamantly opposed the budget, that they support the budget cuts. Because their own programs were saved, they positioned themselves against the union, other providers and all the clients their programs supposedly serve.
More Than Just Bandaids
We do not have to accept these specific cuts or the notion that it is ever necessary to cut services to anyone. We do not have to distract ourselves fighting with each other for crumbs, while the entire system of social services is destroyed and the rich in this City keep getting richer. The City has other options. It can get money from the source, by taxing the rich and the corporations. It can find new revenues sources by:
- Amending the payroll tax to clarify that “payroll expense” includes partnership compensation would raise an estimated additional $13.5 million each year;
- Establishing an occupational license fee on incomes over $150,000 per year would raise an estimated additional $26 million per year;
- Adopting a vehicle license fee for San Francisco would raise an estimated extra $64 million each year;
- Adopting a progressive gross receipts tax would raise an estimated additional $30 million per year.
Mayor Newsom made promises during the first weeks of his administration. He pledged NOT to balance the budget by making cuts in social service programs “that serve the most vulnerable, the most needy.” Our Mayor and the city’s departments all need to be held accountable.
This is city money and it belongs to the People.
The People’s Budget provides more details about the budget and better ways to balance it. Contact The People’s Budget–559 Ellis Street, San Francisco 94109, or just call 415 346-3740.