No. 1-03

Approving the Department of Public Health’s Base Budget for Fiscal Year 2003-2004, and Urging the Mayor and the Board of Supervisors To Develop Strategies for Avoiding Serious Cuts To the County’s Health Safety Net Services

WHEREAS, the mission of the Department of Public Health is to protect and promote the health of all San Franciscans; and,

WHEREAS, the City and County of San Francisco is facing a $350 million dollar shortfall for fiscal year 2002-03 and the Mayor’s Budget Office has required that each Department absorb their own increases in costs, and further decrease their utilization of General Fund by 6% for the base budget and develop a contingency plan that will decrease the utilization of their General Fund by an additional 10%; and,

WHEREAS, the consequence of these instructions is that the Department of Public Health must absorb $20 million dollars in unavoidable increases, and decrease its General Fund usage by $18 million in the base budget and $27 million in the contingency budget; and,

WHEREAS, these are the largest single year General Fund cuts that the Department has ever had to make and that 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 12 million dollars and developing 5 million dollars of administrative and operations reductions, including the elimination of the Office of Managed Care and the Laguna Honda Hospital laundry in order to limit the impact of service cuts; and,

WHEREAS, the Department projects it can generate an additional 2 million dollars of surplus revenue in the current fiscal year 2002-03 budget by freezing all non-critical positions and requests that the surplus be applied to balance next year’s budget; and,

WHEREAS, despite the size of the fiscal shortfall, the Department has attempted to preserve all prevention and promotion activities, all children’s programs, and all residential mental health and substance abuse programs; and,

WHEREAS, the Department has allocated new resources to support the sobering center, increased syphilis prevention and control activities, supportive housing, and the expansion of the Healthy Kids Program; 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 Department has recommended reprogramming of the Mental Health Rehabilitation Facility to become a residential care facility so as to decrease expenses and increase revenue without decreasing the number of clients served; and,

WHEREAS, the Department was forced to cut important referral/education services, outpatient and drop-in substance abuse services, change eligibility requirements for outpatient medications, reduce hospital based translation services, reduce adult dental services, eliminate contracts for emotional and practical peer support, and make other service cuts in order to meet the budgetary targets; 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 Department’s clients and patients; and,

WHEREAS, the Health Commission has traditionally supported a safety net system for San Francisco’s low-income, uninsured and vulnerable populations that is equal or superior to the standard of the State Medicaid program; and,

WHEREAS, the health care safety net is the default system of care for low-income, uninsured and vulnerable populations, and there are an estimated 130,000 people who represent the core of the safety net in San Francisco; and,

WHEREAS, the Health Commission remains opposed to service cuts which will be detrimental to safety net services; now, therefore, be it

RESOLVED, that the Health Commission strongly urges the Mayor and the Board of Supervisors to identify new revenues, fees or taxes, including State, Federal and extramural opportunities, that could close the City’s budget shortfall without reducing vitally needed safety net services; 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 approves submission of the Department of Health’s base budget for fiscal year 2003-2004 to the Mayor’s Office; 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 Mayor’s Budget Office, and directs the Department to submit such a plan to the Health Commission at the appropriate time; and, be it

FURTHER RESOLVED, that the impact of the cuts to the base budget, if implemented, be studied and reported by the Department to the Health Commission, with subsequent dissemination of this information to the Mayor and Board of Supervisors.

I hereby certify that the foregoing resolution was adopted by the San Francisco Health Commission at its meeting of February 18, 2003.

Michele Olson, Executive Secretary to the Health Commission