Bay Area Reporter - December 4, 2008
Seth Hemmelgarn, s.hemmelgarn@ebar.com

Mayor Gavin Newsom's budget office has asked the health department to cut almost $26.7 million from its budget, and the commission makes recommendations on those cuts. So far, $17.6 million in potential cuts have been identified.

Another meeting on the cuts will be held Tuesday, January 6 at 4 p.m., at the department's office at 101 Grove Street.

The reductions are part of an effort to close a citywide budget gap that's expected to be $90 million to $125 million. The city charter requires a balanced budget.

At the special hearing, held Tuesday, November 25, the commission approved a resolution stating that if enough new revenue can't be identified to prevent reductions, it strongly urged Newsom "to preferentially protect health and human services over other services" that San Francisco funds.

There are seven commissioners. According to minutes of the meeting, Commissioner Steven Tierney was not present for the vote and Commissioner Margine A. Sako was absent from the meeting.

The city's HIV prevention budget is facing a mid-year cut of $1.13 million. Dr. Grant Colfax, the health department's HIV prevention director, was at the meeting.

Colfax told the Bay Area Reporter that the numbers could change, and said, "Nobody wants to make these cuts," but "this is a difficult time."

Colfax said most programs will take an across-the-board cut of 14 percent to 16 percent. Needle exchange programs, which have been shown to be highly effective in preventing HIV transmission, will be held harmless, and programs providing prevention to men who have sex with women and women who have sex with men will be reduced to come into line with allocation recommendations from the HIV Prevention Planning Council, which is made up of community members and representatives from AIDS services agencies.

"Our goal is to continue to provide HIV prevention services to those most affected by the [San Francisco] epidemic: men who have sex with men, transgenders, and injectors," Colfax wrote in an e-mail to the B.A.R.

The meeting resembled many others, including in the spring and summer when the commission, city officials, and the public expressed dread over proposed reductions. The Board of Supervisors restored most of those cuts.

However, since these are mid-year cuts, they don't go to the board; the mayor has spending authority.

Jeffrey Hall, legislative affairs director for the San Francisco AIDS Foundation, addressed the commission, and told the B.A.R. that he's "very concerned" about the proposed cuts.

"I think it's clear that opportunities and sources of alternative funding are greatly diminished, so I think these proposed cuts are real," said Hall.

In an e-mail to the B.A.R., Hall wrote that the foundation's Stonewall Project "is the only state certified and Drug-MediCal certified program in San Francisco that specializes in serving gay men and other [men who have sex with men] who do crystal meth," men who may be more at risk of contracting HIV than other groups.

Hall wrote that for Stonewall, the proposed cuts to the health department would mean a 25 percent, or $61,839 reduction in Community Behavioral Health Services funding of their Outpatient Methamphetamine Treatment program, and an additional 16.24 percent, or $54,471, cut in funding for their HIV prevention services.

The cuts follow a loss of federal funding that came when a Center for Substance Abuse Treatment grant ended. The termination of that grant represented a $286,000 loss in funding for the Stonewall Project, wrote Hall.

The combined loss of federal, city and county funding, "will reduce the number of annual participants who can be seen annually at Stonewall from 220 to 115," he wrote. "These cuts will mean a return to the days when gay and bisexual men in San Francisco had to wait weeks and often months to get help with crystal meth problems."

Dr. Edward Machtinger, director of the Sexual Health and Empowerment Program ("Positive She"), who also directs the women's HIV program at the University of California, San Francisco, also addressed the commission.

Machtinger told the B.A.R. that Positive She's prevention with positives program has 170 clients, including biological women and transgender women.

"Our network of programs sees transgender women as women," Machtinger said. "We feel they belong in an environment in which they feel comfortable and safe."

The total budget is $166,500 for the entire program, he said. That includes costs such as salaries and rent. There's a proposal to reduce that by 37.5 percent, "which makes a program unviable," said Machtinger.

Machtinger said if the program ends, the women and transgender women they serve "would simply not have access to the crucial services they need to become empowered and not transmit the virus to sexual and drug-using partners."

Many at the hearing thanked the commission for its work, and said they wanted Newsom, who was not present, not to make the cuts.

Nathan Ballard, a spokesman for Newsom, wrote in an e-mail to the B.A.R. that "We are in a very serious situation that will require cuts to the health department. Wherever possible, the mayor will act to protect vital services. But significant cuts must be made."

According to minutes of the meeting, Catherine Dodd, Newsom's deputy chief of staff, said at the hearing that the cuts were not the mayor's idea.

In an e-mail to the B.A.R., Dodd wrote that all general fund departments are making cuts.

"The economic crisis is affecting everyone," wrote Dodd. "We expanded many programs when the city had more money and the situation today is very different. ... We still do not know what additional cuts the state will make."

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