Public Health Department faces $17M in cuts amid budget crisis

San Francisco’s Department of Public Health must slash $17 million from its budget, forcing cuts to programs that serve the city’s most vulnerable residents as officials scramble to close a widening deficit.

The cuts represent roughly 1.5% of the department’s $1.1 billion annual budget and will affect mental health services, substance abuse programs, and community clinics across neighborhoods from the Mission to the Tenderloin. Department officials said the reductions could eliminate dozens of positions and reduce operating hours at several facilities.

“These are not cuts we want to make,” said Dr. Grant Colfax, director of the Department of Public Health, during Tuesday’s budget hearing at City Hall. “Every program we’re looking at serves people who have nowhere else to turn.”

The department faces particular pressure to maintain services as the city grapples with ongoing challenges around homelessness and drug overdoses. Overdose deaths in San Francisco reached 806 in 2023, with the highest concentrations in SoMa and the Tenderloin.

Supervisor Hillary Ronen, whose district includes much of the Mission, criticized the proposed cuts to community health centers. “We’re talking about primary care for families who can’t afford to go anywhere else,” Ronen said. “This is penny-wise and pound-foolish.”

The budget shortfall stems from reduced federal funding for COVID-19 programs and lower-than-expected revenue from the city’s business tax. Mayor London Breed’s administration has asked all departments to identify potential cuts as the city faces a projected $800 million deficit over the next two years.

Health department officials said they’re prioritizing cuts to administrative functions over direct patient care, but acknowledged that some service reductions are unavoidable. The department plans to reduce hours at three community health centers and eliminate a mobile crisis response team that serves the Castro and Noe Valley areas.

Public health advocates packed Tuesday’s hearing, with several speakers arguing that cutting health services will ultimately cost the city more money as people end up in emergency rooms or jail.

“You can’t balance the budget on the backs of people who are already struggling,” said Maria Santos, a community organizer with the Mission Neighborhood Health Center coalition.

The Board of Supervisors will vote on the budget proposal next month. Several supervisors indicated they would push for alternative revenue sources, including potential tax increases, to restore some of the proposed cuts.