Nurses won't be making home visits to their homebound patients anymore, and operating rooms at San Francisco General Hospital will be closed eight hours a day. Those are just two effects of the city Health Commission's Tuesday night budget slashing, described by the Department of Public Health as the deepest cuts officials have ever seen.
Hundreds of people packed the commission's chambers on Grove Street and spilled into the hallway, many of them imploring the panel to vote against the cuts over the course of five hours.
Public health officials and commissioners said they had no choice, considering the city's bleak financial outlook. Mayor Gavin Newsom has asked the department - which accounts for one-fifth of the city's $6 billion annual budget - to cut $28.1 million to help the city bridge a $251 million budget gap for the 2008-09 fiscal year.
With medical costs rocketing every year, the department has to cut about $50 million to hit the mayor's benchmark. On Tuesday, the commission approved about half of the $33 million in cuts the director of the department proposed, meaning more will be coming unless officials find a way to increase revenue.
Cuts that will take place April 15 include eliminating Health at Home, a program in which public health nurses visit chronically ill, homebound people; closing Buster's Place, a 24-hour drop-in center for homeless people who are looking for shelter or a hot shower; closing a workers' compensation clinic at San Francisco General Hospital; reducing mental health services; and reducing hours for the hospital's oral surgery clinic and operating rooms.
Cuts approved by the commission for the next fiscal year include closing a wing at Laguna Honda Hospital, limiting services for sex workers and reducing funding for residential treatment for gunshot victims. Unlike the cuts happening in April, those cuts will need approval from the Board of Supervisors.
Critics say the budget decisions contradict the city's bold new initiative to provide universal health care to its residents because many uninsured people use the programs suffering because of the budget deficit.
They also say the city will save money in the short-term, but eventually cost more because fewer preventative care options will lead to more emergency room visits.
But Newsom has said that if certain public health programs are spared, other cuts will have to be made elsewhere. In addition to the $251 million budget gap for the next fiscal year, a $40 million shortfall in state money is expected as California struggles with its own budget crisis.
The mayor's office says the budget shortfall stems from the addition of hundreds of new positions to the city payroll, big raises negotiated by labor groups, and several new spending requirements approved by voters.