San Francisco holds marathon public hearing as Health Department proposes deep cuts to mental‑health, outpatient services

The San Francisco Board of Supervisors held a state‑law hearing on June 15 after the Department of Public Health (DPH) proposed sweeping reductions affecting outpatient mental‑health, substance‑use and community case‑management programs.

DPH Director Dr. Mitch Katz told the board the department had worked to minimize damage while closing an unprecedented shortfall, saying, “we recognize the city’s budget crisis,” and that staff “had to make difficult choices” to fit programs into available general‑fund dollars. Katz said DPH reduced its general‑fund request by roughly $135 million when assembling the mayor’s balanced package.

The hearing — a so‑called Buillenson process required when a health department proposes eliminating or sharply reducing services for indigent care — ran for hours and featured more than a hundred public speakers: clients and relatives, senior‑care providers, psychiatrists and clinic…