PEOPLE’S BUDGET 2004

LOCAL CUTS WE OPPOSE

These are cuts the City of San Francisco is proposing that we oppose because they target poor, working, and vulnerable city residents who need these services and have no other way of obtaining them.

Program

# no longer served

Cut

Comments

 

DEPARTMENT OF PUBLIC HEALTH

No COLA for City or non-profit contractor workers

   

There are 20,000 City employees who would not receive a COLA

Contractors indirect rates cut

 

$1.5 million

Contractor will be forced to absorb indirect costs, which will amount to cuts in areas of direct service to clients.

30% reduction to Homeless Seniors Housing Project.

50-100 seniors

$240,000

Eliminates the essential support services for seniors and places them in SRO rooms.

Elimination of acupuncture services to homeless clients

76 patients,
250 units of service

$33,333

Eliminates one of the few and most successful treatments for pain management.

Consolidation of SE Mission and Team II Mental  Health Services with OMI Mental Health Clinic.

Restored by Supes.

Southeast Mission Geriatric
225 seniors

$195,818

Disruption of services, risk to discontinuing all clients out of treatment. Significant delays for inpatient and outpatient services, reduction of staff ability to do home visits.

Elimination of UCSF Psych Social workers

1,440 clients

$538,837

7.75 psychiatric social workers will be cut from discharge process-clients length of stay will increase and the quality of service will decrease. Their services, if billed, would generate far more than the savings.

Bayview Hunter’s Point Adult Day Health

125 seniors

$46,925

Eliminates adult day services to all clients in this predominately (85%) African American program. At least 10 people will be displaced to nursing homes.

Anchor Project

 

$33,825

Eliminates unique program for developmentally disabled people with mental illness.

Conard House

Four FTE Staff

$100,000

 

Private Provider Network (PPN) Outpatient Mental Health

177 clients

$352,500

177 clients with no coverage will lose mental health services (therapy and medications) equal to Medi-Cal coverage, through private psychiatrists. 53 additional will be transferred and have their treatment disrupted.

St. Joseph’s Epiphany Center

Restored by Supes.

 

$260,000

Eliminates this residential treatment program for 11 families with children.

Walden House

 

$124,956

Eliminates 12 beds. Shortens length of stay, jeopardizes the treatment of all clients.  Also eliminates support for parents.

San Francisco Study Center

Clients in 180 community orgs

$40,000

Cuts cultural competency training for staff.

SFGH Pharmacy co-pays for patients $5 for each generic and $10 for each brand-name drug each month

Restored by Supes.

3,850 patients

$232,500

These patients have as little as $775/mo income and are 11% of DPH's patient base. DPH estimates that this will result in a 13.3% reduction medice usage among this group because they will not be able to afford all copays.

Ark of Refuge: Ark House

15 youth

$236,208

A decrease in staffing hours, and a reduction in supplies for clients with no income in this residential program for LGBTQ youth 18-23.

Medical Respite Beds

80 clients with severe medical issues

$500,000

Delays establishment of 80 new master-lease respite beds with medical and psychosocial services.

Primary Care Restructure, eliminate Health Center administrative and support positions

$300,000 restored by Supes to restore some clinic-level Nurse Managers, but DPH has not found the money to restore the rest.

 

$1,038,627

Removal of Clinics-wide Medical Director and half of Clinic-level Center Directors, Nurse Managers, and Principal Clerks will shatter organizational structure of Clinic System.

Reduction in interpreter services, reduction of positions

Restored by Supes.

2,945 patients

$372,018

Patients will leave without having been seen or understanding their diagnosis. Loss of 6 of 15 positions. 25 positions are needed.

Reduce Jail Health costs as alternative to contracting it out.

$1.5 million "restored", dangerous cuts in nurse staffing already occuring.

 
$4.5 million
 

Elimination of Castro-Mission Clinic evening hours and reduction of Tom Waddell Satellite Clinic hours

Restored by Supes, also $15,000 for Transgender Life Care Project.

16,000 fewer patient visits.

$950,000

5% cut in system-wide Primary Care Clinic provider hours will cause a corresponding drop in patient visits. Castro-Mission is one of only two after-hours clinics. One evening clinic serves working poor people and the other, Dimensions, serves queer and questioning youth with a large population of transgender youth.

Restructure Primary Care Centers:

Castro-Mission, Chinatown, Maxine Hall, Ocean Park, Silver Avenue, Southeast, Tom Waddell. Transgender Clinic

Provider positions restored by Supes.

28,000 patient visits at risk.

$1.52 million

Loss of 3 Doctors, 2 Nurse Practitioners, 17 Registered Nurses and 5 Health Workers, with no assurance that increased efficiencies will preserve patient volume.

Contract out Laguna Honda Hospital Laundry

Under challenge by SEIU.

52 FTE

$1.76 million

Affected workers currently working at other jobs, but contracting out is still a loss of union-scale jobs to the low-income community.

Shanti Emotional and Practical Support

Restored by Supes.

1,095 people living with HIV and AIDS

$402,000

Eliminates program for HIV/AIDS clients with extensive needs: 50% are mentally ill, 1/3 have substance abuse problems and 1/3 are homeless. 

SF AIDS Foundation, Emotional and Practical Support

Restored by Supes.

900 people living with HIV and AIDS

$383,000

Eliminates program that provides access to the system of services for a client base that have mental health issues, substance abuse problems and HIV/AIDS.

Positive Resources, Reentry to Work Program

Restored by Supes.

400 people living with HIV and AIDS

$140,000

Eliminates program for an emerging population with growing needs. This program provides assistance with reentering the workforce and maintaining employment to a client base that is 96% extremely low income and 40% people of color.

$1.7 million of $4.1 million lost Federal Ryan-White funds replaced by SF Supes.

(See "Federal Cuts" below)

   

Prescription co-pays for City workers in Healthy Workers program. ($5 generic, $10 brand name)

6,000 workers, 3250 Rx/mo

$808,000

Majority of workers in program are IHSS workers with low wages, and at risk of minimum wage because of state cuts. This increase would be significant for them.

Eliminate Disability Evaluation Unit

$192,000 Restored by supes for a small component of the program. $309,000 needed to reinstate 5 FTEs and restore the real program.

739 homeless clients with mental illnesses

$529,000

Eliminates program qualifying people with no previous access to the healthcare system or SSI to become eligible for disability benifits and connected with City health services.

Proposed replacement has less funding and would provide more limited services, no case management, and would serve only clients already connected to services. Over $10.5 million lost in General Fund revenue from this cut.

Eliminate Social Worker Mid-Level Administrators

Restorations by Supes and grant-funding reinstates all 11 social workers.

6.5 FTE City workers plus 4.5 FTE grant funded.

$440,000

Eliminates senior social workers and mid-level administrators that provide oversight and 50-90% of their hours in direct services in Primary Care, Laguna Honda, Community Behavioral Health Service, and Maternal Child Service. This is a cut to direct service.

Close SF General Hospital Outpatient Dialysis Center

Restored by Supes.

82 patients at SFGH, 30 patients at home.

$339,000

Any disruption in the dialysis process can be life threatening. A transition process will jeopardize the health of end-stage renal disease patients, some of whom are homeless and have mental health problems. Those who have only emergency medical and others will not be able to transfer to private clinics outside of SFGH and will have no access to dialysis.  Loss of $2.3 million in revenue from this cut.

DEPARTMENT OF HUMAN SERVICES CONTINGENCY CUTS

Healthcare Accountability Ordinance

 

$177,404

Funds for non-profit organizations to meet requirements of the Health Care Accountability Ordinance.

Minimum Compensation Ordinance

 

$403,170

Funds for non-profit organizations to meet requirements of the Minimum Compensation Ordinance.

CalWORKs Housing Subsidy

 

$279,000

Up to 3 years of rental assistance for 200 CalWORKs families. Not enrolling any new families for housing subsidies.

IT Services

 

$50,000

Delays in bringing on new applications.

Childcare for CalWORKs stage one

 

$500,000

Cuts CalWORKs childcare services for families in job training and career preparation. Funding was budgeted but never received from State.

Childcare for CalWORKs stage two

 

$3 million

Cuts vouchered childcare for CalWORKs families where adult has timed out, from the Governor lowering allowable income and requiring co-payment and paying less to child care providers. Funding was budgeted but never received from State.

Voucher Day Care

 

$13,672

Cuts childcare for non-CalWORKs eligible families with a priority for Child Protective Services.

Youth Task Force/Children's System of Care

 

$75,765

Community outreach for Mental Health and Child Welfare Services targeted for youth. Moved to DPH.

Foster parent mentoring and resource room

 

$85,070

Eliminates foster parent mentoring program and resource room.

South Beach Resource Center

 

$72,777

Cuts neighborhood resource center providing storage, food, resources and showers.

Hamilton Transitional Housing on Fell St.

 

$59,293

Cuts funds to 2-year family transitional program.

Golden Gate Lutheran Church

 

$25,250

Eliminates drop-in center for homeless adults.

Next Door transitional shelter

280 men and women

$107,089

Cuts funds to shelter, meals and supportive services for homeless men and women. Transferred to the Santuary.

DEPARTMENT OF AGING AND ADULT SERVICES

Policy issue: People's Budget opposes the merge with DHS because they are occurring without proper hearings. $750,000 was added back without details on where it should go. In general, the funds address some of the remaining priorities in our budget campaign - including restoring Protective Services programs at DAAS, funding for meals and case management for adults with disabilities under 60, and expansion of the IHSS Share of Cost Program, which serves seniors and younger adults with disabilities. This funding will most likely be put on reserve and released as a result of a hearing, probably in the Board Finance Committee, as soon as possible. We are continuing to push for a public hearing, either in Finance or in the City Services Committee so that we can all take a look at remaining issues as the transition moves forward.

Adult Protective Services

 

$61,500

Actual cuts to this program are compounded by many positions that are vacant and which the Mayor is not allowing DAAS to refill, making it harder to serve senior and adults with disabilities who are subject to abuse or neglect.

Senior Escort

 

$150,000

Another direct service program that is being strangled by funding cuts coupled with hiring freezes

Other Department cuts

 

Up to $1,050,000

A whole range of other cuts, both large and small, continue to compromise this Department’s mandate to adequate serve seniors AND adults with disabilities, including a reduction of Program Analyst positions that help provide oversight and technical assistance to the community-based contractors as well as clerical and administrative support.  At last count, a total of 11 positions have been cut, many resulting in lay-offs.

Cuts to contracts

 

$86,330

1.43% cut to all contracts, except food programs, IHSS/Homecare and those with designated federal funds. Already strapped non-profit agencies will be forced to make their budgets even tighter and provide fewer services.

DEPARTMENT OF CHILDREN, YOUTH AND FAMILIES CONTINGENCY CUTS

Wellness Program

 

$77,000

Staff support cut for high school youth needing counseling services.

Family Child Care

 

$56,000

Reduction in training classes for providers.

Total Local Cuts

9,084 people

$15,952,904

 

STATE CUTS WE OPPOSE

These are cuts in state services which will not only hurt those who can least afford to be hurt, but will also add to the burden of the City’s already-overstressed City services.

 

Program

# No Longer Served (Statewide)

# No Longer Served (San Francisco)

Amount Cut

Comments

 

CALWORKS & FOOD STAMPS

 

CalWORKS  5% grant cut

6,000 families no longer eligible, 475,000 families affected

4,500 families

$44.3 million in FY ’04, $179 million in FY ‘05

Families would receive an average of $35 less a month.

 

CalWORKS COLA cut (July 2004) and October 2003 (retroactive)

475,000 families affected

4,500 families

$198 million, additional $127 million in 2005

October COLA has been successfully challenged in court.   The state is appealing.  With COLA cuts and grant cuts, families would lose an average of $80 a month.

 

Reduce CalWORKS grant by 25% for families who have reached their time limits

57,000 families by June 2005, will increase

179 families

$32.9

million

Family grant reduced on average by $146 a month.

 

Reduce CalWORKS grant by 25% for families who are sanctioned

40,000 families affected

250 families

$30.2

million

Family grant reduced on average by $146 a month.

 

Require CalWORKS parents to participate in “core” work activities within 60 days

125,000 parents affected, 530 families a month will be deterred from applying for welfare

 

$100 million

 
 

HEALTHCARE

 

Cap enrollment in the AIDS drug assistance program

3,500 AIDS patients

 

$550,000

Patients would not receive needed medicines.

 

Cuts to mental health services  for mentally ill offenders

 

150 mentally ill offenders

$542,131

Cuts Intensive case management and unduplicated services for medication and crisis intervention.

 

CHILD CARE

 

New three tiered income eligibility structure

1,500 children lose eligibility

No impact

$9.3 million

 
 

Changes in age eligibility—11 & 12 yr. olds no longer covered if after school programs are available, no care for 13 yr. olds.

18,000 children lose eligibility

200 children potentially impacted

$75.5 million

Lose eligibility only if after school programs are available.

 

New reimbursement rate structure for providers

95,592 children impacted

4,500 children impacted

$57.7 million

Low income parents will have to pay more out of pocket or will lose child care if they cannot afford it.

 

Increase in family fees for families of over 40% median income to up to 10% of income

77,250 children impacted

3,000 children impacted

$22.3 million

Low income parents will have to pay more out of pocket or will lose child care if they cannot afford it.

 

IMMIGRANT PROGRAMS

Cap CalWORKS for legal immigrants

Impact in future years

 

none

Additional administrative costs.

Cap California Food Assistance Program (CFAP)

273 families first year, then increasing

 

$100,000

Additional administrative costs.

Cash Assistance Program for Immigrants (CAPI)

984 families first year, then increasing

750 CAPI recipients in San Francisco

$4,175,000

Additional administrative costs.

IN-HOME SUPPORTIVE SERVICES

Reduction in Services

 

7,000 people

$16.4 million

14,000 San Franciscans receive IHSS, primarily seniors and people with disabilities.  The purpose is to keep people out of institutions by providing care at home. The Governor’s proposal would reduce total hours of service by at least 10 percent.

Reduce Wages of Providers

 

12,000 providers

$11.5 million

The Governor’s proposal would reduce wage from current level of $10.28 per hour plus benefits to minimum wage ($6.75 per hour)

JUVENILE PROBATION DEPARTMENT

Contracts with Community Based Organizations (CBO)

 

2,000 youth

$135 million Statewide

$3.2 million in San Francisco

Through the State TANF allocations to CA, 24 CBOs were providing alternatives to detention for youth in San Francisco. Without these programs, youth will go to jail.

Total State Cuts

32,099 people

$606,667,131

 

FEDERAL CUTS WE OPPOSE

These are some examples (but by no means a comprehensive list) of cuts in federal services which will not only hurt those who can least afford to be hurt, but will also add to the burden of the City’s already-overstressed City services.

Agency

Program

Units of Services Eliminated in San Francisco

Clients Affected in San Francisco

Ryan White Care award, $4 million grant that provides funding for a wide array of services, including outpatient and other clinical care.
$1.7 MILLION REPLACED BY SF SUPES

Project Open Hand

Meals for Continuum clients

8,900 meals

110 people

Shanti Project

Van Transportation

6,392 hours of transportation

226 people

SFDPH/CHN Dental Services

De-Centralized Dental Services

498 Dental Procedures

125 people

UCSF Dental Services

De-Centralized Dental Services

1,281 Dental Procedures

100 people

Family Support Services of the Bay Area

Respite childcare services

1,225 Childcare hours

88 people

Urban Indian Health Board

Client Advocacy/ Treatment Adherence Services to

People of Color

1,171 Treatment Advocacy hours

55 people

Continuum HIV Day Services

Adult Day Health Care & Substance Use Services

554 Substance Abuse Care Coordinator hours, 554 Adult Days, 480 Substance Abuse Group Counseling hours, 538 Individual Substance Abuse Counseling hours

110 people

Glide Foundation

Case Management & Peer Advocacy, Treatment Advocacy

900 Case Management hours

40 people

Larkin Street Youth Center

Case Management, Treatment Advocacy & Peer Advocacy

720 HIV Treatment Case Management hours, 360 HIV Individual Treatment Advocacy hours, 1,296 Peer Advocacy hours

80 people

Asian Pacific Islander Wellness Center

Case Management, Peer Advocacy & Treatment and Advocacy/groups

1232 Case Management hours, 1,126 Peer Advocacy hours, 522 Treatment/Clinical Trials Advocacy hours, 91 group hours of Treatment Advocacy

60 people

Mission Neighborhood Health Center

Case Management, Treatment Advocacy, Peer Advocacy & Nutritional Counseling

1,099 Case Management hours, 521 Peer Advocacy, 495 Treatment Advocacy, 448 Nutritional Counseling, 133 Treatment Outreach

100 people

Shanti Project

Circle of Care Collaboration

1,921 Case Management hours, 2,059 Peer Advocacy hours, 685 Treatment Advocacy hours

226 people

Catholic Charities

Rita da Cascia

1,177 Case Management hours, 1,206 Peer Advocacy hours, 148 Psychotherapy Group hours

31 people

Quan Yin Healing Arts Center

Alternative/Complimentary Therapies Services

1,853 Complimentary Therapy hours

57 people

Immune Enhancement Project

Complimentary Therapies Services

3,443 Complimentary Therapy hours

192 people

American College of Traditional Chinese Medicine

Complimentary Therapies Services

3,525 Complimentary Therapy hours

184 people

AIDS Legal Referral Panel

Client Advocacy

1,623 Legal Assistance hours, 20 group hours

747 people

Legal Services for Children

Legal/Guardianship services for children

526 Legal Assistance hours, 72 Group hours, 878 Case Management hours

255 people

Bar Association of San Francisco

Legal & Immigrant Assistance

840 Legal Assistance hours

102 people

New Leaf

Outpatient substance use counseling (Part of a Multi-Exhibit Contract)

416 Substance Abuse Individual Counseling hours, 384 Substance Abuse Group Counseling hours

35 people

Walden House

Continuing care (Part of a Multi-Exhibit Contract)

793 Individual Counseling hours

27 people

UCSF/SFGH
Department of Psychiatry/AHP

HIV-IDU Case Coordination (Part of a Multi-Exhibit Contract)

1,419 Case Management hours

54 people

UCSF Department of Psychiatry/SAS

Methadone Maintenance (Part of a Multi-Exhibit Contract)

480 Individual Counseling hours, 326 Group Counseling hours, 3,126 Case Management hours, 506 MD/NP Case Management hours

176 people

UCSF/SFGH/Department of Psychiatry/SAS

STOP:  Stimulant Detoxification

1,031 Case Management hours, 272 Individual Counseling hours, 768 Group Counseling hours

30 people

Asian Pacific Islander Wellness Center

Additional Outreach

580 Outreach hours

22 people

Community Awareness and Treatment Services

A Women’s Place – Additional Outreach

650 Outreach hours

50 people

Total Federal Cuts

$3,695,287

3,282 people