Resolution: No. 04-04

Approving the Submission of the Department of Public Healthís Base Budget for Fiscal Year 2004-05, and Urging the Mayor and the Board of Supervisors To Develop Strategies for Avoiding Serious Cuts To the Countyís Health Safety Net Services

WHEREAS, the City and County of San Francisco is facing a $258 million dollar shortfall for fiscal year 2004-05 and the Mayorís Budget Office has required that each Department absorb their own increases in costs and further decrease their utilization of General Fund by 5.5% for the base budget and develop a contingency plan that will decrease the utilization of their General Fund by an additional 15%; and,

WHEREAS, the consequence of these instructions is that Department of Public Health must absorb $19 million dollars in unavoidable increases, and decrease its General Fund usage by $13 million in the base budget and $37 million in the contingency budget; and,

WHEREAS, the base budget includes funding to address structural deficiencies such as the Jail Health Services budget, which historically has been underfunded by the City and County; and,

WHEREAS, these are the largest single year General Fund cuts that DPH has ever had to make and there is no way to make cuts this size without eliminating vitally useful services; and,

WHEREAS, the Department has been creative in increasing revenues by $18 million dollars and developing $9 million dollars of administrative and operations reductions; and,

WHEREAS, included in the $9 million dollars of administrative and operations reductions are $5 million dollars in as yet undetermined administrative staff reductions equating to 85 full-time budgeted positions providing administrative support to all areas of the Departmentís operations; and,

WHEREAS, this level of administrative reductions will impact the Departmentís ability to efficiently and effectively manage the Departmentís myriad programs; and,

WHEREAS, despite the size of the fiscal shortfall, the Department has preserved all prevention and promotion activities, all childrenís programs, and all residential mental health and substance abuse programs; and,

WHEREAS, the Department has allocated new General Fund resources to maintain and expand methadone maintenance and Rep Payee services; and,

WHEREAS, although the base budget avoids large-scale program reductions, it eliminates many useful programs and requires that community-based agencies reduce their administrative expenses; and,

WHEREAS, the Department used the principles recommended by the Strategic Plan for planning in times of fiscal constraints to construct the least harmful budget cuts possible; and,

WHEREAS, the base budget does not contain a Cost of Living Adjustment (COLA) to contractors or to the University of California for providing health services, which will result in the reduction of services to the Departmentís clients and patients; and,

WHEREAS, the base budget does not include funding to restore the 7.5% pension contribution made by City employees for the 2003-04 fiscal year; and,

WHEREAS, the base budget does not include funding to offset potential State or Federal budget reductions; and,

WHEREAS, the base budget does not include funding to continue the Citywide Forensic Team, which has served severely mentally ill offenders since January 2000, with demonstrated success in decreasing recidivism rates for this population; and,

WHEREAS, the base budget includes a proposal to develop a uniform policy for assigning indirect costs for non-profit contractors, and the Health Commission is concerned that such a policy would not take into account the different types of contractors the Health Department does business with and may reduce direct services; and,

WHEREAS, the Health Commission has a responsibility to maintain safety net health and public health services for San Franciscoís most vulnerable residents; and,

WHEREAS, the Health Commission remains strongly opposed to service cuts that reduce safety net services, and recognizes that such cuts disproportionately affect the African American population and the mentally ill in San Francisco; now, therefore, be it

RESOLVED, that the Health Commission approves submission of the Department of Healthís base budget for fiscal year 2004-2005 to the Mayorís Office; and, be it

FURTHER RESOLVED, that the Health Commission strongly urges the Mayor and the Board of Supervisors to identify new revenues, fees or taxes that could close the Cityís budget shortfall without reducing vitally needed safety net services; and, be it

FURTHER RESOLVED, that the Health Commission is deeply concerned about the extent of administrative staff reductions proposed and the potential impact on the Departmentís ability to effectively and efficiently manage the wide range of services critical to fulfilling the mission of the Department; and, be it

FURTHER RESOLVED, that the Health Commission supports a continued contribution by employees towards funding pension contributions at the current 7.5% rate, consistent with the principle of employees paying for their share of valuable pension benefits; and, be it

FURTHER RESOLVED, that if the City cannot identify enough new revenue to prevent reductions, the Health Commission strongly urges the Mayor and the Board of Supervisors to preferentially protect human services over other services funded by the City and County; and, be it

FURTHER RESOLVED, that the Health Commission requests that the Health Department work closely with City Administration to develop a standard policy for indirect costs that maximally protects direct services and is appropriate to the various types and sizes of non-profit contractors that the Department does business with; and, be it

FURTHER RESOLVED, that although the Health Commission is aware that the contingency plan will by necessity create even larger gaps in the safety net, the Commission nonetheless believes that it is its responsibility to review such a plan prior to submission to the Mayorís Budget Office, and directs the Department to submit such a plan to the Health Commission at the earliest opportunity; and, be it

FURTHER RESOLVED, that when the FY 2004-2005 budget is finally adopted, the Department report to the Commission on the impact of the budget on health safety net services.

I hereby certify that the San Francisco Health Commission at its meeting of March 23, 2004 adopted the foregoing resolution.
Michele M. Olson, Executive Secretary to the Health Commission