Absolutely no one was happy at the meeting of the San Francisco Health Commission on Monday evening at City Hall.
Not the NICOS Chinese Health Coalition (facing a $200,000 cut). Not the San Francisco AIDS Foundation (facing an $800,000 cut). Not the University of California, San Francisco (potentially out $5.8 million). Definitely not Livable City (quite possibly dropped from the public health budget entirely). And definitely not the health commissioners.
“There is really no joy in any of the decisions that we’ve been trying to make,”said Department of Public Health Director Daniel Tsai to the nearly 100 people who came to make a case for reinstating their funding. “And sometimes it’s a question of what is the least difficult or least harmful decision to make.”
The two-year city budget, drawn up (mostly) by the mayor’s office and approved by the mayor and Board of Supervisors in July of last year, made it clear that cuts were coming.
Citywide, $400 million in cuts await. Last month, the public health department released a list of $17 million in planned cuts in its contracts with community-based organizations for the fiscal year 2026-27, as required by last year’s budget.
The cuts are preliminary: The Department of Public Health is taking input via email until Feb. 4, and the final list of reductions will be released in late February or early March.
The reductions proposed so far reflect the department’s desire to avoid slashing direct health and clinical services, Tsai said during Monday’s meeting.
Instead, the largest block of the reductions — $6 million — comes from cuts in funding for training programs for public health and contracted employees. That includes some programs providing training on harm reduction, gender-affirming care, sexual health and HIV care, and language access.
Speakers pushed back on the notion that these were not “direct” cuts. “Calling these reductions ‘capacity’ rather than ‘direct care’ ignores reality,” said a speaker from the HIV Advocacy Network during the public comment period. “Care is only as strong as the workforce providing it.”
“What’s really concerning about [the cuts] as well is, they’re sort of being presented as non-essential services, things that are not core to what public health is,” said Anya Worley-Ziegmann with the People’s Budget Coalition, an alliance of over a hundred community organizations and unions.
Cuts like the ones proposed, she said, could affect the safety of patients and shift the city away from expanding access to health programs.
“These cuts are disproportionately going to impact the most vulnerable communities in San Francisco,” Worley-Ziegmann said.
That said, Worley-Ziegmann added, blaming the Department of Public Health was too simplistic: They are only making cuts the mayor has asked them to make.
“We know,” she said, “that the buck stops with the mayor at the end of the day.”
Cuts will keep coming and public services will continue to decline without more taxes. Lurie has ruled out taxing big corporations, CEOs and billionaires. Money has got to come from somewhere. Guess who’s going to pay? They will call your new taxes “fees”
Democrats such as Bill Clinton were paying off the national debt but when Republican Presidents took over they doubled, tripled it and more in order to justify slashing social programs, including public health.
Even 311 couldn’t find an email for DPH to leave a comment. It’s like they don’t care what we think.
funding cuts listed in the article seem to affect programs custom fitted to people’s sexuality, which are completely unnecessary. gender affirming care?
what a cuckold position is that?
programs like that are for insecure narcissists, not people who genuinely need help. kudos to the mayor and the like for nixing this nonsense. if people want “gender affirming care they can get it from the echo chamber of farcebook or some creepy group hug based meeting. this stuff is a total waste of tax dollars just to pacify aby people. this comment will probably get nixed or heavily whined about. bring it on.
Chris —
We’ll publish your comment so everyone can see what a big-hearted genius you are.
Best,
JE
I was there to support Sunday Streets, which for a meager $200k puts on events all over the city that get San Franciscans physically active and meeting their neighbors: a solution to the loneliness and physical inactivity that we know make people sick. Learning about all the other programs on the chopping block was heartbreaking.
I don’t know if it’s quite true that “no one is happy,” though. Our city’s billionaires are probably thrilled Mayor Lurie opposes the billionaire tax and the overpaid CEO tax and is making these cuts instead. That’s what it comes down to. The money is here. It’s being hoarded, and we have a mayor who serves those doing the hoarding over the rest of us.
“What’s really concerning about [the cuts] as well is, they’re sort of being presented as non-essential services, things that are not core to what public health is”. Budget crunches force leaders to focus on what is truely important to prioritize rather than what activists want to prioritize.
Why is Livable City being supported by DPH? They put on street fairs. They should be the first to go. Hoods can quite easily put on a street fair.