Health workers and community leaders urge board to stop ‘deskilling’ of CNAs and clerks amid budget cuts

Dozens of health-care workers, union representatives and neighborhood leaders urged the Board of Supervisors to intervene after the Department of Public Health issued notices to reclassify and demote hundreds of certified nursing assistants (CNAs) and clerical staff — changes supervisors and speakers described as “deskilling” that would cut wages and disrupt services.

Speakers described workers who perform specialized, on-site duties — reception work in high-volume clinics, patient handling teams and units serving vulnerable patients — and said the proposed demotions would both reduce pay and undermine patient care. Several CNAs and clerical workers testified they were already experiencing lower morale and that service problems, billing errors and longer clinic waits followed an earlier round of reductions in May.

Supervisor John Avalos, Supervisor David Campos and others said they would pursue legislative and budget remedies. Supervisor Daly said he asked the Controller to prepare a supplemental appropriation after a Department of Public Health reporting indicated an unexpected surplus of roughly $8 million; Daly urged that the surplus be used to avert further deskilling. Campos introduced a hearing request and a proposed supplemental to address the deskilling and to seek alternatives to cuts that fall disproportionately on lower-paid workers.

Union representatives and community organizations described the workforce impacts as concentrated among women and people of color. A union information request cited in testimony reported that 96% of those affected are people of color and 79% are women. Speakers urged the board to prioritize protecting frontline workers whose work the speakers said is essential to public health operations and patient safety.

There was no vote to restore positions during the meeting. Supervisors asked the Controller and Department of Public Health for additional data and alternatives and requested follow-up reports. Several supervisors said they would support supplemental appropriations if funds could be identified or reallocated.

Why it matters: The Department of Public Health’s workforce changes affect direct-care and clerical staff who serve large numbers of San Francisco residents; the board’s response could include supplemental appropriations, oversight hearings and policy changes affecting both the department’s budget and personnel practices.

What’s next: Supervisors instructed the Controller and DPH to provide documentation and consider supplemental appropriations; multiple supervisors promised to pursue legislative and budgetary remedies and to continue oversight.