Clinic workers push back against San Francisco budget cuts

SAN FRANCISCO, Calif. - Staff at three community clinics serving youth and seniors in San Francisco are at risk of closing due to budget cuts. The workers there are advocating for their clinics to stay open.

The San Francisco Department of Public Health is proposing consolidating the staff at the three clinics with low patient volume, so they can redirect them to higher-need locations.

Reshuffling resources

What they're saying:

Keana Giles is the Director of Health Services at Huckleberry Youth Programs in Haight-Ashbury, where the Cole Street clinic is housed. 

"There will be young people that are unable to receive services," she said.

The clinic provides people aged 12 to 24 with access to reproductive and sexual health, therapy, and case management, as well as basic needs services.

She said after the city made cuts a couple of years ago, medical providers were split between other clinics and the clinic was forced to operate only two days a week, resulting in a significant dip in the number of visits. 

"There isn’t low turnout, but if there’s no provider here, how does a young person get seen?" Giles said. 

‘Seamless transition,' SFDPH says

This comes after Mayor Daniel Lurie asked SFDPH to cut $40 million from its budget.

The other side:

The city, facing a $643 million deficit, including $300 million in federal and state medi-cal/Medicaid, blamed federal funding cuts. 

SFDPH wrote in a memo last month that it plans to get rid of 120 positions, 60% of which are vacant, and strategically move people to other organizations within the city.

Three community clinics were chosen to consolidate, with the staff there re-assigned, due to what the city says is "low utilization."

In a statement, SFDPH wrote, "Every decision in DPH's proposed budget was made with one goal: preserving the public health system San Franciscans depend on and ensuring patients  continue to receive the care they need, where they need it."

SFDPH said every patient seen at these locations will be offered a seamless transition to another clinic, with no gap in care.

Workers fear seniors are being ignored

Local perspective:

Over in the Mission, Southeast Mission Geriatric Services is on the list. 

Francisca Oropeza, a behavioral health clinician at the clinic, said it’s the only clinic serving seniors.

"There will be no other clinic that will be able to do home visits for older adults something that is vital for the mental health of our seniors," said Oropeza.

Leslie Meneweather, another therapist, said they have been reassigned to positions they have less of an interest in. 

"This is folks’ home, this is their community, this is the reason that when they’re so depressed that they get out of bed, to come to this clinic," she said. "We're invisible to them."

One client for almost 10 years wanted to remain anonymous, but shared that she does not want to go elsewhere for care because she's established trust, and feels safe with the therapists there.

"This is where they feel safe, coming to this location that they’re used to for so many years," added another clinician Helen Liang. 

The third clinic on Larkin Street, which is also serving at-risk and homeless youth, is also on the chopping block.

Domino effect

Giles, who isn’t a city employee, said the problem spans beyond SFDPH to its community-based organizations who receive city funding. 

"We can expect that there will be residual impacts as we go," she said. "This is one domino that’s going to fall and could lead to greater impacts."

Timeline:

These changes are set to go into effect by the end of August.

The staff at Southeast Mission Geriatric Services is planning protests to continue their fight to save the clinic.

There is also a hearing in mid-May to discuss the budget cuts.

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