Supervisors approve $246,000 supplemental to keep SFGH workers' compensation clinic open amid sharp testimony from clinicians and unions

The Budget & Finance Committee approved a $246,000 supplemental appropriation from the general fund reserve to the Department of Human Resources to keep the San Francisco General Hospital workers' compensation clinic operating for the remainder of the fiscal year.

Committee members heard detailed testimony from the clinic’s medical director, nurses and SEIU representatives who argued the clinic returns employees to work faster, provides case management not easily replicated by private providers, and produces citywide savings by reducing lost‑time costs. Dr. John Hall, the medical director, told the committee that similar closures elsewhere led to poor service and, in at least one Peninsula case, the service was later brought back in house. Nurse case managers explained that changes in workers’ compensation law and billing practices have reduced reported clinic volumes and that parking and travel costs will rise for employees sent to off‑site clinics.

Department and budget staff said the clinic experienced declining new patient volumes (from approximately 3,400 in an earlier year to 2,759 most recently) and an annual structural deficit estimated around $700,000 when annualized; the budget analyst estimated a remaining shortfall for the fiscal year of roughly $191,000 but cautioned it was unclear whether a $246,000 supplemental would be fully sufficient given declining revenue and staffing changes. Controller’s office staff said no city layoffs would result from the cut but that three HSA positions would be displaced to other positions within the health department; physicians are contract staff. The mayor’s budget office cautioned the city is facing historically low reserves and that midyear trade‑offs remain difficult.

After extended debate about the absence of comprehensive metrics—particularly return‑to‑work rates and a full accounting of workers’ compensation lost‑time costs—the committee conducted a roll call. Supervisor Ellsberg recorded a dissenting vote; the committee chair announced the item passed with four ayes and one no. Members requested that the controller and departments provide further analysis—return‑to‑work rates, billing/utilization reviews and cross‑departmental workers' compensation costs—before the full Board acts or as part of the upcoming budget cycle.