February 05, 2003 -- PROPOSED 2003-2004 DPH SERVICE REDUCTIONS

 

PROPOSED 03-04 SAN FRANCISCO DPH SERVICE CUTS IN BASE BUDGET: 

     $17.5 MILLION REDUCTIONS FROM GENERAL FUND,

     $20 MILLION INCREASED COSTS ABSORBED.

 

(These are the cuts that the Health Department is immediately proposing.)

 

 

IMMEDIATE HIRING FREEZE: $2 million estimated

Money saved in current budget to be carried forward into 03-04 budget

 

CLOSE MENTAL HEALTH REAB FACILITY (MHRF) AS WE KNOW IT:   $8.1 million

Care in MHRF to be contracted out to private company. 182 jobs lost. 

 

Change  from locked sub-acute psych skilled nursing facility (IMD) to an unlocked Residential Care Facility (RCFCI),  taking care of significantly lower-accuity patients; mental patients requiring locked facilities will be sent elsewhere.

 

With increased pressure to force patients out of SFGH Psych Inpatient and not pay for sending patients elsewhere, higher acuity mental patients will be sent to Laguna Honda, causing more injuries to staff and other patients at the MHRF and Laguna Honda, which is not getting its planned increased staffing. (See below.)

 

CUT SUBSTANCE ABUSE OUTPATIENT AND DROP-IN SERVICES:   $3.05 million

Clients currently served in outpatient and drop-in programs will be referred to 12-step programs or methadone.

 

Eliminate Westside Youth Awareness Outpatient Program,  $341,761

Individual, group youth counseling, never got going, substitute methadone.

Reduce New Leaf Substance Abuse Program, $122,194

Loose outpatint services to 27 clients.

YMCA Urban Services Huckleberry Youth Program, $36,525

Eliminate early intervention, referral for 700 clients, substitute detox, methadone.

Potrero Hill Neighborhood House, $44,987

Never got going, substiute detox, methadone.

Asian American Recovery Services COPASSA, $162,833

Eliminate outreach, referral, and prevention, substitute direct treatment

Haight Ashbury Free Clinics, Inc. OSHUN, $790,744

Eliminate outpatient services to 260, reduce prevention to 1950 clients.

Haight Ashbury Free Clinics, Inc. Mother’s Ahead Program, $332,836

Outpatient treatment, referral to 72 addicted mothers.

Haight Ashbury Free Clinics, Inc. Mother’s Ahead Program Outreach, $70,758

Walden House Continuing Care, $285,877

Eliminate continuing care, case management for 336 who completed treatment.

Walden House Intensive Treatment Services, $329,877

40 clients.

Sheriff’s Substance Abuse Residential, $256,364

Substitute Prop 36 funds for treatment of incarcerated clients?     

Sheriff’s Post Education Release Program, $60,000

Eliminate educational services to released clients, substitute direct treatment.

Sheriff’s Roads to Recovery Program, $100,000

Eliminate educational services, substitute direct treatment.

Eliminate Ozanam Med Supported Detox, $563,722

Replace medical detox with social detox , service loss for 243 clients.

Increase Baker Places Med Supported Detox, ADD $450,000

Add 143 slots, partial replacement for Ozanam losses.

Create new methadone maintenance slots and replace lost grants,  ADD $272,636

Add 31 slots.

 

 

 

CUT TO HOMELESS REFERRAL/EDUCATION:  $1.5 million

Central City Hospitality House drop-in/outreach, $567,618

Drop in services for 8,000 homeless.

Reduce and consolidate homeless outreach (HOPE & MOST Team), $244,833

Mental health services and outreach, 3 jobs lost.

Progress Foundation Outreach Services, $383,701

Program reductions for outreach services to 300 homeless people.

Instituto Familiar de la Raza Outreach Services, $21,437

Program reductions for outreach services to 180 homeless people.

Decrease Tenderloin Outreach SRO Collaboration, $69,560

Education, advocacy services to SRO residents and owners.

Eliminate Chinatown Comm Develop Corp, SRO Families Collaboration$50,000.

Informational outreach, referral services, peer outreach training, advocacy for families in SROs.

Reduction to SFAF AIDS Hotline, $138,172

Reduce services, 24,000 calls/yr

Eliminate inpatient substance abuse treatment referral team at SFGH, $73,125

Referrals to be made by social workers. Dept does not generate revenue.

Eliminate Community Substance Abuse Services Pretrial Referral Unit, $68,601

Screening, assessment, placement services.

 

CUT MENTAL HEALTH TREATMENT:  $1.3 million

Replace lost mental health services with case management.

 

Eliminate Family Service Agency Day Treatment, $386,846

Reduce adult, older adult services to 121 clients, merge with other program

Eliminate Richmond Area Multi Service Day Treatment, $35,150

Adult, older adult programs for 27 clients.

Eliminate BVHP Thunderseed Program, $447,478

Loose day treatment for 71 clients, substitute outpatient or case management.

Reduce Baker Places Robertson Place, $220,874

Loose day treatment for 40 clients, substitute outpatient or case management

Reduce Conard House Transitional Residential Treatment, $13,183

Reduce from 24 to 16 beds

Reduce Private Provider Network Outpatient budget, $200,000

5% reduction in budget, 197 clients loose services.

Reprogram increased intensive case management, ADD $300,000

Substituted for clients loosing other services.

 

ELIMINATION OF LAGUNA HONDA HOSPITAL LAUNDRY:  $1.28 million

Contract out 48 jobs.

 

CLOSE COUNTY JAIL #7:   $1.3 million in medical costs

2 LVNs, 10 RNs, to other jails, and rest of DPH

 

CUT OUTPATIENT PHARMACY BENEFITS:   $950,000

Outpatient medications to be supplied to patients below  300% of Federal Poverty Level. Requires Bd of Supervisor’s approval.

 

ELIMINATE ALL ADULT DENTAL SERVICES:    $791,357

Assuming State cuts its dental services for adults program. 7 jobs lost.

 

ELIMINATE HIV/AIDS  EMOTIONAL AND PRACTICAL PEER SUPPORT:  $785,000

Services to 900 clients (SF AIDS Fndn) and 600 clients (Shanti)

 

DELETE INCREASED NURSING MODEL AT LHH,          $526,000

Delete 6 more nursing staff promised LHH following continuing staff and patient injuries from understaffing.  

 

ELIMINATE 50% OF INTERPRETER SERVICES:   $475,000

Reduce number of languages interpreted by staff, use more phone translation.  Rely more heavily on bilingual staff.  7 jobs lost.  Dept  is non-revenue generating.

 

REDUCTION OF SUPPORT STAFF AT HEALTH CENTERS:  $433,000

6 jobs  lost, including eligibility workers,  medical evaluation assnt, medical social worker

 

ELIMINATE PATIENT REFERRAL SERVICES AT SF GENERAL HOSPITAL:  $408,000

Eliminate patient services for clinical services, making appointments, directions on solving problems with pharmacy, eligibility, and any other outpatient  problems. 5 jobs lost. Dept  is non-revenue generating.

 

REDUCE ARK HOUSE CONTRACT – ARK OF REFUGE,  $335,000

Reduction of transitional housing for LGBTQQ youth from 15 to 9 beds, less services.

 

REDUCE HOME HEALTH AIDES,  $221,000

Lay off 2 workers, delete 3 open positions.

 

HOLD CURRENTLY OPEN POSITIONS VACANT IN MATERNAL CHILD HEALTH,  $125,000

 

DECREASE USE OF CONTRACTED HOSPITALS BY MENTALLY-ILL:  $100,000

Reduce budget 4% for contracted services by private hospitals, loss for 23 clients.

 

ELIMINATE ENHANCED SERVICES AT BAYVIEW ADULT DAY HEALTH CENTER,   $56,000

150 fewer clients in program.

 

ELIMINATE ACUPUNCTURE SERVICES AT TOM WADELL CLINIC,  $40,000

Eliminate service to 80 clients in program.

 

DECREASE SPENDING OF TAXI VOUCHERS,  $25,000

Prioritize vouchers for sickest patients.