San Francisco Chronicle - November 26, 2008
Heather Knight, hknight@sfchronicle.com.

Newsom has ordered all city departments to submit midyear cuts to eliminate a deficit that could reach $125 million. The Public Health Department has been told to cut the most because it is the city's biggest agency, but so far officials have come up with only $17.7 million in savings.

Health commissioners said Tuesday that an agency whose mission is as vital as the health department's should bear disproportionately less of the burden.

"We're as concerned as you are," commission President Jim Illig told a standing-room-only crowd of people protesting the cuts at a meeting in the health department building on Grove Street. "We believe the cuts could be found in other parts of city government."

The commission was expected to approve a resolution urging the mayor to "preferentially protect health and human services over other services funded by the city and county."

Nathan Ballard, spokesman for Newsom, said it is unlikely the Health Commission will get its wish.

"There are no easy choices, and we sympathize with the sentiments behind this resolution, but ultimately every department will be feeling some pain," Ballard said.

Public health officials unveiled a list of new proposed cuts Tuesday, bringing the total to $17.7 million. There is no indication of how they will come up with the remaining $9 million.

New proposals highlighted at Tuesday's special commission meeting include nursing cuts in jails and for homebound patients; the end of a program to pair social workers with frequent users of San Francisco General Hospital, such as mentally ill or drug-addicted homeless people; closing a day care center for the elderly at Laguna Honda Hospital; and a 5 percent across-the-board cut to community groups that work with the mentally ill.

Health officials had already proposed slashing funds for substance abuse outreach and HIV prevention programs and outsourcing security now provided by sheriff's deputies at hospitals and clinics. About 400 people in the health department stand to lose their jobs.

Gregg Sass, the department's chief financial officer, said the cuts may end up costing the city more in emergency care at San Francisco General and in jail services and police work.

"We have a safety net that's there for a reason," he said. "There's a ripple effect in everything we do."

So far, the city's unique universal health care program, Healthy San Francisco, has not been affected. But the cuts will set public health in the city back 10 years, Sass said.

And the pain is only expected to increase. City Controller Ben Rosenfield said next year's deficit, once projected at $250 million, will be "significantly worse" when his office releases its outlook in a few weeks.

"There will be more rounds of cuts coming from health and all other departments," Rosenfield said.

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