This coming fiscal year, the Mayor’s Office is demanding of the Human Services Agency (HSA) and the Department of Public Health (DPH) cuts that will definitely eliminate mental health services for 1,600 San Franciscans, and may eliminate mental healthcare access for over 45% of San Francisco mental health consumers; that will shut down such vital community services as Caduceus Outreach Services (a treatment program, despite its name) and Tenderloin Health’s drop-in center; that will increase rents by a third for HIV+ individuals who hold a rental subsidy. These are devastating changes that will result in destabilization for a great number of San Franciscans, in homelessness for many, and that may cause some deaths. These are changes our communities cannot sustain.
The Obama administration’s American Recovery and Reinvestment Act of 2009 (that stimulus package we’ve been hearing so much about), however, offers us one of our very few reasons for hope. Since the middle of the 20th century, the Social Security Act has caused the Federal government to refund states and municipalities a certain portion of all their expenditures on Medicaid, Temporary Assistance for Needy Families, In-Home Support Services, foster care, and other basic service expenses through the Federal Medical Assistance Percentage, or FMAP. Through the stimulus package, the quantity refunded to state and local governments through FMAP has increased substantially. We’re only working with estimates, right now, but DPH has been using a number of $27 million for its fiscal year 2009-2010 budgeting purposes, and the Mayor’s Budget Director Nani Coloretti used an estimate that would amount to $18 million for HSA in the same year when speaking to the Board of Supervisors’ Budget and Finance Committee. In terms of these departments’ budgets, the FMAP for DPH would eliminate the need for over a quarter of the department’s cuts. For HSA, the FMAP is over 80% of the department’s mandated cuts.
There shouldn’t be any debate, here: The funds are required to stay within the departments, and it’s the Obama administration’s intent that these funds should be used to save essential services. But through its Budget Director, the Mayor’s Office has indicated that it is very seriously considering another use of the money: The Mayor will move more money away from HSA and DPH, and then fill the new gap he has created with FMAP funds, thus effectively leveraging the FMAP money to fund other City programs than those in the departments which directly serve low- and no-income people. This protects the Mayor from having to deal with solutions he might find politically more distasteful, such as cutting the City’s $10 million PR budget, laying off his City-funded gubernatorial campaign staff, or looking seriously at revenue options.
This is the kind of political shenanigans that can occur when the electorate is not informed of what’s going on in the corridors of power. One of the greatest sources of hope, right now, is that neither the Mayor nor his Budget Director has not yet committed to this course of action. Contacting their offices to let them know what you think of this budgetary shell game may well make a difference. The Mayor’s Office may be reached at 415∙554∙6141. The Mayor’s Office of Policy and Finance, headed by Budget Director Nani Coloretti, may be reached at 415∙554∙6114.