OPINION As San Francisco’s health and human services face unprecedented loss of funding under Mayor Gavin Newsom’s glaringly disproportionate budget cuts, forcing layoffs of city and nonprofit health care workers who work on the frontlines of a strained system, now is the time when the moral implications of budget decisions mean the most.
The midyear cuts alone have eliminated HIV/AIDS services for an estimated 2,660 San Franciscans. Many core health service programs are wrestling with the reality of closing their doors entirely when the next round of cuts arrives in June. As the city scrambles to come up with any and all possible solutions, Supervisor Chris Daly has introduced an amendment to the Rainy Day Fund that would offer up a much-needed safety net for San Francisco’s vital services.
Currently, San Francisco’s Rainy Day Fund contains a provisional trigger focused on protecting the San Francisco Unified School District during tough times. When the Controller’s Office identifies the need and pulls the trigger, Rainy Day Funds can be appropriated at the discretion of the mayor and the Board of Supervisors to offset the costs of maintaining education during the upcoming budget year.
Daly’s clause, which would take effect in years when the city’s deficit exceeds $250 million, would provide a similar safeguard to public health and human services, services that are no less critical than education but tend to bear the brunt of budget cuts during challenging economic times.
Some have argued that we should save this money for the (perpetual) "next year," with the timeless hypothetical that it could get worse. Yet for those who may lose their lives this year because of colossal cuts to vital services, this argument offers little consolation, and in fact begs the question of how we define a rainy day to begin with. While city workers are being asked to cut salaries and business leaders are being asked to support new revenue, now is the time to reach into our reserves to protect the programs that protect lives.
San Francisco’s HIV/AIDS services have become, in many ways, models for the rest of the country, yet the years of battling for and finessing of these services seem to be taken for granted as we brace ourselves for the possibility of losing them overnight. Strained as our safety net may be, it still provides much of the best care available for those at risk of or living with HIV/AIDS, and in these complex budget discussions, we have yet to hear a consideration of what it would cost to reconstruct such a landscape of services.
Finding solutions to this year’s budget crisis will not be easy. It will require a complex solution, and even with givebacks by city workers and even with new revenue, there will be significant cuts to programs. We need to think about all of the possibilities and understand that it will take extraordinary measures to protect a model health care system. Now is the time when San Franciscans need access to their safety net. Today is a rainy day, and baby, it’s cold outside.
Stephany Joy Ashley is on the steering committee for the Coalition to Save Public Health, an executive board member of the Harvey Milk LGBT Democratic Club, and the harm reduction coordinator of the St. James Infirmary.