Board holds hearing as health officials defend proposed Department of Public Health cuts; providers urge restorations

A public hearing of the San Francisco Board of Supervisors on June 14 examined proposed Department of Public Health (DPH) reductions that the department says are needed to close a budget gap for fiscal year 2011–12.

The hearing drew scores of providers, clients and advocates who urged the board to restore funding to programs serving homeless people, people with serious mental illness, veterans and other vulnerable groups. Barbara Garcia, director of the Department of Public Health, told the board that DPH focused its review this year on “non‑matched” general‑fund dollars and identified about $70,000,000 in such funds; she said the mayor’s office restored roughly half of the originally proposed reductions and that roughly $3,200,000 in cuts affecting about 23 organizations remained under discussion.

Why it matters: City‑funded community providers deliver services that advocates say prevent higher‑cost use of hospitals, jails and emergency services. In several cases speakers said cuts would shorten drop‑in hours, eliminate case managers and reduce outpatient mental‑health and substance‑abuse treatment — changes they said would push patients into crises that cost the city more.

What officials said Barbara Garcia, director of the Department of Public Health, told the board the department purposely targeted funds that do not leverage federal matching dollars and focused on smaller contracts where cuts would produce less systemwide disruption. “We looked at the smaller organizations with those cuts under $1,000,000 of contracts so that those cuts wouldn't have great detrimental effects on the smaller organizations,” Garcia said, and added DPH continues to work with community‑based organizations and the mayor’s office to reduce harm.

What speakers told the board - Alfreda Nesbitt, director of substance‑abuse services at Bayview Hunters Point Foundation for Community Improvement, said the foundation’s methadone and outpatient programs serve about 300 clients a year and urged restoration. “Substance‑abuse services in the Bayview and in the city at large should be increased instead of reduction in funding,” Nesbitt said. “Treatment works.”

- Rand Park, director of the San Francisco Homeless Outreach Team (SFHOT), described the outreach team’s street work and said the mayor’s budget would eliminate 9 outreach specialists and “decimate the homeless outreach team.” Park told supervisors a typical two‑hour intervention by SFHOT costs the city about $64 compared with roughly $1,000 for an ambulance response.

- Representatives from Central City Hospitality House, Walden House, the Mental Health Association, Stonewall Project, Shanti, Institute on Aging’s Linkages program and dozens of other community providers described cuts that would shorten hours, eliminate positions and shrink services for seniors, veterans, people with serious mental illness and people recovering from substance use disorders. Many speakers said the cuts would increase emergency room visits, hospitalizations and interactions with police.

- Several clients and peer workers described personal recoveries tied to specific community programs and asked the board to protect continuity of care and local expertise. “These are services that form a safety net,” said a commenter who identified herself as a Hospitality House participant.

Board and process notes The board opened the hearing under item 30 and allowed an extended public comment period; supervisors signaled they would continue deliberations during the budget process. Garcia said DPH would continue meeting with community‑based organizations and that the department had scheduled further talks with supervisors and CBO representatives.

Ending After closing the public comment, the board did not take an immediate vote on program restorations; supervisors will consider restorations and compensating budget adjustments as they finalize the city budget in the coming weeks.