In a report released Monday, City Controller Ben Rosenfield detailed a raft of reductions, chiefly to health and human services programs — including AIDS treatment, In-Home Support Services, senior services, Medi-Cal coverage, employment services, welfare-to-work programs and child-care funding — that will take a big bite out of programs aiding poor and low-income San Franciscans.
The rollback in services, which may be offset in part by $18 million set aside by the city to ameliorate losses in state monies, includes:
- a loss of $4.2 million in state AIDS funding for HIV education and prevention, and health services;
- $2 million less in funding for substance abuse treatment and crime prevention programs, which are required under Prop. 36;
- nearly $1 million cut from immunization programs, maternal and child health and children’s dental disease prevention services;
- $2.9 million from welfare-to-work employment services and child-care supports;
- cuts to prenatal services and domestic violence shelters, potentially leading to local shelter closures; and
- reduced state supplements for Social Security recipients.
San Francisco is being hit hard because it is a county, as well as a city. Similar reductions are hitting counties throughout the state because of the budget approved by the Legislature and signed by Gov. Arnold Schwarzenegger in July.
The losses add to the deep spending cuts enacted by San Francisco Mayor Gavin Newsom and city supervisors this summer to meet a $438 million deficit; Newsom now has 21 days (following the report) to decide whether and how to fill this new gap in state money, estimated at roughly $5 million after local set-asides and borrowing are used.
Newsom’s press office did not respond to several calls for comment.
Though the cuts are lower than previously projected, “Nothing in the state budget is good news for us,” Rosenfield said. And there’s more fiscal trouble coming soon: along with the prospect of deeper mid-year cuts in the local budget, there could be more slashing of state monies soon.
"Everyone is nervous about the impacts of the state budget and the fact that the state is going to be out of balance again soon — it’s cause for alarm," Rosenfield said.
Adding to the damage, the state also wants to pull $28.7 million from city Redevelopment Agency funds to meet gaps in state education funding — a move that’s being challenged in court by the California Redevelopment Association.
Rosenfield said the city has a “viable” financing program to recoup any redevelopment losses, but he added, “it will mean some projects get delayed.” And advocates said this fiscal “raiding” — as one described it — could hamper efforts to expand affordable housing.
The state’s use of redevelopment money to fill its budget gap has “indirect effects all over the city,” particularly in regard to affordable housing funding, said a mayoral staffer who wishes to remain anonymous.
As low-income seniors, domestic violence victims and others brace for the latest fiscal storm, there is rising frustration about the dearth of alternatives on the legislative table — other than more service cuts and layoffs. These critics point to a lack of revenue proposals on the November ballot, or of any coordinated movement inside or outside of government, to raise revenue anytime soon.
The immediate impacts of these latest cuts will be far-reaching, advocates say, and will include the following:
- diminished public-health staff to handle swine flu vaccinations;
- longer lines at the already over-burdened San Francisco General Hospital emergency room, where the wait can run several hours;
- no optometry or podiatry benefits for Medi-Cal recipients, meaning deteriorating health and discomfort for low-income diabetics and cancer patients; and
- decreased support for grocery shopping and other senior services — which may put some at risk of going without food.
“It’s absolutely devastating,” said Tessie Guillermo, director of Zero Divide, a city nonprofit focused on economic inequality and technology. Guillermo noted the cuts are almost entirely to “services, which disproportionately serve poor, immigrants and working uninsured.”
Coming on the heels of a hiring freeze at the Department of Public Health last year and deep reductions in health spending in this year’s city budget, this latest round of cuts — a $16.4 million incision — will slice public health services closer to the bone.
“I don’t know if there is anybody left to cut,” Guillermo said. “We are going to see the impact of cuts at the crisis level immediately.”
In planning for this fall’s swine flu immunization, she asked: “Do we vaccinate all public health workers or just those keeping their jobs?”
Seniors left behind
Equally dire is the evaporating support for In-Home Support Services, or IHSS, which serves roughly 20,000 clients in San Francisco — 72 percent of whom are over 65 and about 33 percent over the age of 80, according to the city’s IHSS Public Authority. The elderly are among the city’s fastest-growing groups and "everyone’s really scared," said Sarah Jarmon, a program director at Planning for Elders, a nonprofit senior advocacy group.
For many seniors receiving IHSS, new state cuts will mean no support for grocery shopping.
"Without support, they might starve," Jarmon said. "There’s no one to help them shop for groceries and not enough Meals on Wheels to go around."
Compounding the IHSS cuts on Oct. 1, seniors will be hit with reduced grants from state supplemental funds designed to bolster SSI. Social Security recipients are ineligible for food stamps, said Colleen Rivecca, advocacy coordinator for St. Anthony’s Foundation.
“Any reduction in benefit level could affect their ability to purchase food for themselves," she said.
Seniors already are coping with cuts in cost-of-living adjustments that mean smaller monthly benefit checks, said John Melone, who tracks legislation for the Senior Action Network.
“When you don’t have the income, you start figuring out if you buy your medication, pay your rent or you eat,” Melone said. “Some of these folks are actually skipping meals. Can you imagine living in San Francisco, one of the most expensive cities in the world, on $850 a month for everything? That’s rent, food, the occasional roll of toilet paper … you start counting the money — do I do laundry this month? This has got some of our people really upset.”
How are these seniors coping? “Not buying laundry detergent,” Melone said. Others are skipping meals and some are ending up on the streets. “There are more seniors sleeping on the street … they feel like they’re half a citizen.”
Fraying safety net deepens vulnerability
Beyond the cuts’ most severe impacts, such as hunger and homelessness, advocates say that as services evaporate, the safety net aimed at preventing deprivation gets further tattered.
“This is definitely going to move a certain portion of people from being independent to dependent,” said Francis Aviana, communications director at St. Anthony’s Foundation, which provides meals and other services to homeless people. “There are going to be choices between housing, food and medicine. It’s pretty hard to remain independent without those three things in place."
As domestic violence shelters and AIDS treatment supports fall away, more people will move a step closer to homelessness, Aviana said.
"Every program you hear is closing, those people will be coming to us … you’ll see more women in the dining center, more women in the social work center because that’s where they end up after domestic violence if there is no shelter," Aviana said.
AIDS treatment cuts, due to hit next month, are "going to be huge,” she added. "When you’re talking about affecting mental health services, you’re also talking about affecting their ability to remain stable in other areas of their lives," Aviana said, such as paying rent, staying on medications and even remembering to eat. "The folks that come into our dining room come there because they have to — they don’t have anything extra, beyond paying rent for an SRO."
The onslaught of program and service cuts is fraying more than the safety net — it’s also fraying the resources and energy of advocates who would prefer to be waging efforts to expand the protective web while fighting the root causes of the problems their groups combat.
“The freak-out level is massive,” said longtime housing and community activist Rene Cazanave of the San Francisco Information Clearinghouse. "The state of community politics is really low. The problem is groups have burned themselves out fighting cuts … not only are they burnt out, but everybody knows the state cuts are coming down. Nobody knows how bad this will be."
Guillermo, of Zero Divide, said senior service groups, youth, health and homeless advocacy organizations are making efforts to coordinated response. But this work “takes people away from being able to respond to the needs of clients day to day," she said.
The budget battles also clutter the path toward longer-term solutions, St. Anthony’s Rivecca explained: "We don’t like always being reactive to cuts coming down, we like to be proactive." But advocates have to "make sure the safety net isn’t gutted while we’re looking toward the future."
A coalition of service groups is helping direct people to services and "mobilizing people to know what kinds of cuts are happening and how they can interface with policymakers," Rivecca said.
But structural responses to the ongoing budget crisis are few and far between. There is talk of a “split roll” state property tax measure that would reform Proposition 13 and expand commercial property taxes — potentially raising up to $10 billion statewide, Cazanave said. But it’s unlikely this would reach the ballot before 2012.
Cazanave said there’s “nothing from the Democratic Party, nothing from labor,” about reforming Prop. 13. “There’s no discussion with the Democratic Party that would raise a penny.”
Local revenue efforts have been at a standstill. Proposals last winter by Supervisor John Avalos “died for lack of a second,” said Cazanave. Avalos has recently proposed a fee on alcohol to help fund health and emergency services. That plan is being studied and he hopes to introduce legislation on the fee early next year.
“I want to see revenue measures,” said Avalos. “I worked throughout the year to get those on the ballot, but the numbers weren’t there to win. I pushed as far as I could go til the last minute, but things couldn’t go forward … the consultants were telling SEIU you don’t have a chance” on passing revenue measures on this year’s ballot.
While many are advocating new attempts to raise revenues, it’s widely expected that there will be few initiatives before next June. Avalos said he plans to build support for new revenue measures, such as a gross receipts tax, for the November 2010 ballot; anything before then would require a two-thirds vote since this is a non-election year.
Avalos added that the city budget cut wars have left many affected groups weary and divided.
“There needs to be some unity going forward, to help build the movement and power to pass measures,” he said. “What we had after the budget process was a lot of disunity. It’s really unfortunate. If we’re all trying to just get what we can for our own constituency, and not looking out for other groups, we’re looking at a disaster.”
“We can’t make any more cuts, there are going to have to be revenue measures,” Melone said, adding, “as far as I can see it’s dead in the water as far as supervisors are concerned.”
The mayoral staffer, speaking anonymously, agrees there’s a need for long-term responses to the fund-cutting cycle: "The state makes cuts that hurt us and we turn around and make more cuts. Rather than shake our fist at the sun, why not make long-term structural changes?"
Instead of new tax-based revenue measures, the staffer argued for efforts "to make San Francisco more economically competitive, so we grow our tax base in the long run."
Cazanave insists it’s time for a new revenue discussion.
"Local folks have to sit down and look at progressive tax measures,” Cazanave said. “We’ve talked in the past about new hotel taxes and others, but the economy is in the toilet and it wouldn’t even raise that much. Right now what’s lacking is getting the players to sit around a table and see what’s possible."
Christopher Cook is the supervising editor of the City Budget Watchdog project. Reach him at ccook[AT]public-press.org.