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Mid-Year Budget Cuts May Kill Off Health Department

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If you’ve been reading the papers, you may have heard that with Propositions J and K falling short of getting voter approval, major cuts are being planned for the City. These propositions would have generated up to $20 million the first year, and much more after that ($40 million sales tax and $57 million for business tax for 2005). As usual, poor folks are being hardest hit by the proposed cuts.

A lot could be said about why the tax measures failed, and whether Mayor Newsom put as much effort into them as he did into his more punitive measures that passed, such as Care Not Cash and the Anti-Panhandling Ordinance (Props N and M). Some are even saying this was part of a grand scheme to make the cuts he wanted all along without looking like the bad guy. On the other hand it is hard to say, because the very same corporate interests who backed him with over a million dollars each on M and N, opposed him on J and K. Apparently, cutting public assistance and putting homeless people in jail is a winner in San Francisco, while paying for services is a loser in our so-called “liberal” city.

However you look at it, there is a $97 million shortfall for the next 18 months and the budget ax is coming down hard and fast, wreaking havoc in its wake.

For one thing, primary health care is being cut by about $2.8 million ,with half of that coming from Tom Waddell Health center. This means the urgent care center at Tom Waddell, serving primarily homeless people, will be closed January 15. This is about 8,000 clients, utilizing 20,000 patient visits. For many, Tom Waddell is their only contact with the health care system. Some patients will end up at the costly already over flowing emergency room, while many will go without any care at all until the ambulance is called.

There are also massive cuts being proposed to AIDS services, including emotional support at Shanti, and work reentry at Positive Resources.

Another particular concern of the Coalition on Homelessness is the City’s plan to cut 1,700 people from mental health services who have no insurance. this would be accomplished by reapplying strict criteria that only allows treatment when an individual has severe mental health issues. This was the policy more than eight years ago when it was almost impossible to even qualify for mental health treatment in San Francisco—harder to qualify for treatment than it was at San Quentin prison. At that time the Coalition fought hard to get the criteria broadened and won. These cuts also include the mental health treatment homeless people receive at shelters through Progress Foundation. Other mental health cuts include $100,000 annual cut to Mission Assertive Community Treatment.

Social workers and public health nurses are also getting axed. The “Public Health Bureaucrat-eze” explanation is that elimination of middle management for social workers will streamline supervision. If the top people at Public Health had sought input from the workers they would find out that these “managers” provide direct services in almost all situations. An additional $1.3 million annual cut to Public Health nurses will be a major loss of nurses who work hard to provide chronic care to their low income patients.

The Health Department is moving forward on jacking up co-pays for pharmaceuticals for people who are impoverished but above the federal poverty levels. Many people cannot afford co-pays and have multiple medicines and will likely go without some or all of them. In fact, Public Health expects a decrease in utilization of pharmacy drugs.

The Health Department is trying to justify these cuts by saying that it has already made massive administrative cuts and no choice remains but to go after direct services. Our perspective is don’t ever cut life-or-death services. Health cuts should never occur. If there is fat, fine. There is plenty of fat still in the Fire and Police Departments—sacred cash cows that are rarely touched. Touch them. Better yet, go after some of the revenue proposals outlined in the People’s Budget. Work hard to tax those who can afford to pay.

The budget is mostly in the hands of the Mayor and at the Board of Supervisors. Make your calls today and help stop that ax from falling.

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Author: Street Sheet Editor

The STREET SHEET is the oldest continuously published street news paper in the United States. Organizationally, it is the public education and outreach tool of the Coalition on Homelessness. Every month, the STREET SHEET reaches 32,000 readers through over 200 homeless or low-income vendors. Our vendors are charged nothing for the papers they receive, and keep all money they earn through STREET SHEET distribution.

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