Proposed San Francisco Budget Includes Cuts to Health Services, Plan To Privatize Inmate Health Services

San Francisco Mayor Gavin Newsom (D) on Tuesday released his $5 billion budget proposal for fiscal year 2004-2005, which calls for the elimination of some jobs, consolidation of departments and funding cuts to public health programs but would preserve "critical services for the poor," the San Francisco Chronicle reports. Newsom's budget includes additional funding for several such programs, including substance-abuse treatment, but calls for a number of changes to public health programs that could "run into resistance," according to the Chronicle. For example, Newsom is proposing to privatize the inmate health program -- a move that could lead to layoffs of more than 100 city workers -- and outsourcing laundry services at Laguna Honda Hospital (Gordon, San Francisco Chronicle, 6/2). By putting the jail health program out to competitive bid, Newsom hopes to save as much as $4.5 million in the second half of fiscal year 2005. The city spends nearly $34 million per year providing medical care to inmates (California Healthline, 6/1).

Newsom proposed reducing public health staff at primary care clinics, closing the dialysis unit at San Francisco General Hospital and reducing supportive services for people with HIV. Most of the eliminated staff positions at the city Department of Public Health would be administrative and middle-management positions. In total, the plan is expected to result in 550 layoffs citywide. Newsom's budget proposal also calls for several revenue-generating initiatives, including raising the monthly surcharge on phones to pay for San Francisco's emergency communications system; raising the sales tax; and imposing new taxes on some businesses. Newsom is hoping to place his revenue-generating proposals on the November ballot. If they fail, he has proposed a $30 million budget reserve to help "cushion the blow to his budget," according to the Chronicle. The proposed budget will now undergo two months of public debate and likely revision by the Board of Supervisors.

"This budget represents a series of tough choices and shared sacrifices required to overcome the incredible financial challenges we face in the coming years," Newsom said. He added, "We need to make government smaller, more agile, more effective, more efficient, more results-oriented. We do that by recognizing that we clearly need to do more with less, and that's what this budget offers." Supervisor Aaron Peskin, a member of the board's budget committee, said, "The dialogue will begin now. There are painful decisions that have to be made." Martha Hawthorne, a public health nurse at the Castro-Mission public health clinic, said the staffing cuts at the city's primary care clinics will "mak[e] a terrible situation worse" because patients will face longer waits for appointments. The Chronicle reports that city employee unions are planning to oppose the proposed job cuts and are likely to "find some success at the Board of Supervisors" (San Francisco Chronicle, 6/2).