San Francisco Chronicle Examines Service Reductions Under Proposed San Francisco Budget

The San Francisco Chronicle on Thursday examined how some services could be affected by proposed funding reductions included in San Francisco Mayor Gavin Newsom's (D) proposal for budget cuts (Gordon/Fagan, San Francisco Chronicle, 12/9).

The San Francisco Health Commission last month approved a budget plan that would reduce funding for the San Francisco Department of Public Health by $15.5 million over the next 18 months. The budget cuts would reduce funding for services to people with mental illnesses and support for residents with HIV/AIDS and result in layoffs for some nurses who visit patients with chronic illnesses.

Newsom proposed the budget plan in response to voters' rejection of two tax measures on the Nov. 2 ballot -- supported by Newsom -- that would have raised funds to maintain some services. The tax increases proposed by Measures J and K would have raised $25 million through the end of fiscal year 2005 and $80 million in subsequent fiscal years.

Newsom's budget plan would save the city an estimated $97 million over the next 18 months. City law requires the budget to be balanced, and the mayor has the authority to enact midyear funding reductions unilaterally. Even if Newsom's plan is implemented in its entirety, San Francisco officials expect to begin the next fiscal year with a $135 million budget deficit (California Healthline, 11/10).

Newsom has called for the service reductions, program cuts and the layoff of 100 city employees to take effect Jan. 15. The Board of Supervisors budget committee on Thursday will hold its second hearing on the proposal.

According to the Chronicle, one of the programs targeted for elimination under Newsom's plan is the public health nursing program, which provides care to chronically ill patients in the city. About 23 nursing positions would be eliminated, resulting in annual savings of about $1.3 million, the Chronicle reports.

The nurses, who can care for as many as 24 patients at a time, make regular home visits to patients, conduct telephone consultations and help connect patients with government and other charitable programs.

If the program is eliminated, some of the affected patients would be eligible for the city's alternative in-home care program, under which workers who are not trained as nurses help clients with basic health and safety services. Other patients who meet eligibility requirements could be enrolled in the state's skilled-nursing program. However, the Chronicle reports that some patients "likely would go without the care they've come to rely on."

Mitch Katz, director of the San Francisco public health department, said patients also could be forced to seek treatment in emergency departments or decide to move into assisted-living programs or nursing homes. "We'll do the best we can," he said, adding, "If this wasn't a good service, I would have cut it long ago" (San Francisco Chronicle, 12/9).