2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 Summary of Testimony
Mayor's Office on Disability
Hearing:
Implications and Impact of Proposed
Local and State Budget Cuts
On Persons with Disabilities
Mayor's Disability Council
21 February 2003
Introduction -- Walter Park, Director, Mayor's Office on Disabilities:
The purpose of the hearing is to increase transparency, meaning that everyone will be working with the same information. Six invited include: Phil Arnold, Director of Finance and Planning, Department of Human Services; Derrick Lam, Executive Director of Aging and Adult Services; Julian Low, Analyst, Mayor's Budget Office, Kate Toran, Program Director, MUNI Accessible Services; Anthony Wagner, Executive Administrator For Hospital Systems, Department of Public Health and Marie Jobling, Director, Planning for Elders in the Central City. In addition, members of the public and representatives of community organizations are invited to give public comment.
Testimony from City Departments
Mayor's Budget Office
Julian Low, Analyst:
· In December, the City found out that there would be $170 million in lost revenues due to the business, hotel and sales tax losses.
· In January 2003, the number increased to a $350 million deficit due to the State's budget plans.
· The City's budget is $5 billion. Departments such as the Port and the Airport generate about 50% of the revenue. Certain amounts are set aside for programs such as MUNI, Children and the Library. Only 25% of the budget can be modified to meet the deficit.
· The initial request to from the Mayor to city departments was to reduce their budgets by 10% and later to prepare a contingency budget cutting another 10%, which would address the first $100 million of the $350 million deficit. The remaining $250 million will be addressed through labor negotiations.
· In terms of the disability community, last year, $25 -30 million was allocated in the capital budget to work on the Transition Plan. This year it will be $10 -12 million with $8 - 10 million going towards maintenance of departmental buildings. That leaves only a few million for Transition Plan work.
MDC Chair Edward Evans asked whether there would be an increase in fees for services and whether there would be aggressive enforcement and collection of fines from the departments that issue the fines. Julian Low replied that fee increases and reducing expenditures as part of the budget plan to increase revenue will still be presented to the Board of Supervisors between now and the end of the fiscal year. Improvement on fees collection will also aid in the economic recovery.
Dept. of Human Services
Phil Arnold, Director of Finance and Planning
· DHS budget for the next year has been approved by the Human Services
Commission and will be forwarded to the Controller and the Mayor for approval.
· There were no programmatic reductions in any major programs within DHS.
· In-Home Support Services Program, which provides services to seniors and people with disabilities to keep them in their homes and out of institutions, had no reductions. However, the workload on cases continues to grow, requiring constant review by staff, without an increase in staff.
· The state has proposed the maximum allowable income for people receiving IHSS services will be dropped from 133% of the Federal poverty level to 100%, which means that many people receiving services will need to pay a share of cost or be dropped from the program. The $750,000 that would be needed to cover that share of cost is not included in the DHS budget proposed for next year.
· Wages for IHSS workers will remain at $10.10 per hour. The state increased its contribution to the hourly wage rate by $1.00, but the general funds saved are being used to preserve other DHS programs that may need to be cut back.
Dept. of Aging and Adult Services (DAAS)
Darrick Lam, Executive Director:
Mr. Lam explained that DAAS came into being in July of 2000 by combining the former Commission on Aging, Office on Aging, Public Administrator's Office, Public Guardian, County Veteran's Service Office, and the Public Conservatorship Program. In 2002, Adult Protective Services was added. Combined, the goal is for DAAS to provide coordinated services to seniors and people with disabilities. He reported the following:
· The Department has restructured the former ten neighborhood senior resource centers to be resource centers for aging and disabled adults. Unfortunately, funding for these centers has been reduced from $1.5 million to $1.2 million.
· State cuts will reduce funding for seniors by $253,000, for Nutrition and Support Services. These cuts will totally eliminate Brown Bag Programs, Foster Grandparents, and the Senior Companion programs.
· There is no major impact in the Adult Protective Services, the Public Conservator (provides services to people with disabilities) or the Representative Payee Program.
· Local cuts required a reduction of $783,000 in funding for DAAS. The major impact occurs in the Office on Aging in which 40+ contracts will be up for bid (home delivered meals, home support services, case management, adult day health services, etc.)
· The Commission approved the reduction in budget to be shared 55% by the contract agencies and 45% by the Department of Aging and Adult Services. Some savings should be achieved through reducing the lead number of agencies from 8 to 3, thus reducing administrative and overhead costs.
· DAAS expects to increase revenue through Targeted Case Management (a program in which the Public Guardian Service bills Medi-Cal for Services). Revenue for the Department of Aging and Adult Services from parking fees is down. The Department has been asked to cut an additional $550,000.
MUNI Accessible Services
Kate Toran, Program Director
MUNI has succeeded in improving rider satisfaction and employee morale. MUNI, like the other City departments is also working on closing the $15 million shortfall by holding vacant positions, by not creating new programs, and by improving and increasing management and operating efficiencies. In the fiscal year 2004, the projected budget deficit will be $52.3 million - $21.6 million from a revenue shortfall and $30.7 million from increased expenses.
She reported the following on revenue and expenditures:
· MUNI receives revenue from four main sources:
· MUNI's Expenditures include:
· Salaries and fringe benefits = 73%
· Paratransit worker's comp and claims = 15%
· Materials and supplies = 7%
· Services of other depts. = 5%
· To meet the $52.3 million deficit, MUNI proposed to raise $37.6 million in revenue through:
- Flexible Federal funds - $10 million
- Increased parking fees and fines - $10.4 million
- Increased garage rates - $1.7 million
- Increased fares - $15.6 million
· MUNI plans to save $15 million through:
· Service management and efficiencies - $3 million
· Internal efficiencies - $4.7 million
· Labor participation - $7 million.
The revenues from fares will be as follows [updated as of March 13, 2003]:
Fixed route fare proposal as it relates to seniors and people with disabilities:
- Senior and disabled cash fare, current $ .35
- Senior and disabled cash fare, proposed $ .35
- Senior and disabled discount fast pass, current $ 8.00
- Senior and disabled discount fast pass, proposed $10.00
Paratransit fare proposal:
- Lift van, current: $8 for a monthly pass or $.40 per trip
- Lift van, proposed: $10 for a monthly pass or $.40 per trip
- Group van, current: $8 per average daily attendance
- Group van, proposed: $10 per average daily attendance
- Taxi, current: $3 per $30 book of scrip
- Taxi, proposed: $4 per $30 book of scrip
- ADA Access, current: $1.65 per one-way trip
- ADA Access, proposed: $1.65 per one-way trip
Edward Evans inquired about the revenue impacts of fraud reduction, and how the new fuel-efficient vehicles would affect the deficit. Kate Toran responded that since switching to a fare sticker last August, fraud has been reduced. Alicia Fletcher, MUNI Finance responded that there is definitely operating efficiency from new, reliable vehicles which eliminated spending on services and repairs, but those efficiencies have already been factored into projected budgets.
Dept. of Public Health
Anthony Wagner, Executive Administrator for Hospital Systems:
The Department of Public Health's budget is approximately $1 billion. Of that $273 million comes from the general fund. DPH has been asked to reduce its budget by $8.7 million in the current fiscal year; and for the next fiscal year, to reduce the budget by $16 million in inflationary increases, $18 million in general fund reduction, plus an additional $27.2 million for the 10% general fund reduction.
DPH used the following four principles from their Strategic plan as guidelines to carry out the reductions:
1. Expand community-based alternatives and decrease the need for institutional care, by providing the most appropriate, least restrictive level of care.
2. Allocate resources to targeted populations with the most need and who lack other options.
3. Strengthen and promote prevention
4. Use data to reorganize, reprioritize, reduce or eliminate services based on priorities, performance measures and the strategic plan.
Based on these principles, the following reductions have been presented to the Health Commission and sent to the Mayor:
· Change the Mental Health Rehabilitation Facility (MHRF) from a locked facility to a residential facility for mentally disabled clients - $8.1 million reduction.
· Eliminate or reduce seven community-based mental health programs - $1.3 million
· Reduce or eliminate 16 community based substance abuse programs - $3.1 million
· Eliminate contracts for emotional and practical peer support for persons with HIV and AIDS - $800,000
· Reduce support staff at health centers - $433,300
· Eliminate acupuncture services - $40,000
· Reduce home health aids - $221,000
· Decrease the number of taxi vouchers - $25,000
The one area in which there will be an increase is in funding for the prevention of sexually transmitted diseases. An additional $150,000 is budgeted for next year.
There is no proposed additional decrease to the census at Laguna Honda.
The department-wide budget shortfalls will impact many of San Francisco's low-income disabled residents by targeting services that assist the disabled and elderly.
Council Member Norma Block asked if there would be reductions in the psychiatric units at the jailhouse where a large portion of the mentally ill are currently housed. Anthony Wagner responded that there would not be any proposals at this time.
Testimony from The Public
And Community Organizations
Planning for Elders in the Central City
Marie Jobling, Director
Ms Jobling asked everyone to think about what ordinary people in this city face in terms of balancing their future. The stories of "Joe" and "Mary," who both depend on government-subsidized programs for their basic survival needs, were presented on a power point presentation. Each are faced with all the various cuts in services provided by the Senior Centers, emergency home care programs, home delivered meals, adult day health, Paratransit taxi scrip, Medi-Cal coverage, including prescription drugs that are necessary for their survival. Without these services, they and others like them will suffer. Departments need to look at the cumulative impacts on individuals rather than impacts on the department itself.
· Marie Jobling asked the MDC to help the Mayor see the entire picture of how cuts in SSI and Medicaid, coupled with local budget cuts to safety net services would affect seniors and people with disabilities. Let the Mayor know that it is not right that departments are trying to balance the budget on those who can least afford to fight back and that is unfair to people like Joe and Mary, who could not survive in San Francisco if these multiple cuts were to occur.
· Marie Jobling stated that San Francisco is a city where people care about one another and telling the story of people and pain would make a difference. A few key events will take place regarding this issue. For more information, contact: Planning for Elders in the Central City's Hot Line: 415-703-0188 x 313 or email: [email protected].
Mental Health Association of SF
Madigan Shive
· Opposes cuts vociferously, would like to send the budget back for revisions to look closely at where one can find other ways of capturing these funds so that cuts are not done on the backs of people with disabilities.
· Wants the MDC to alert the Mayor to the concerns about the approved budget cuts.
· People will be impacted on a monumental level in terms of losing access to housing, social services that keep people with psychiatric disabilities from being on the streets and mental health needs that already are not being met.
· Thanks the council for prioritizing this issue, to save these services and not allow these cuts to take place in the way that they are being proposed.
Delphine Brody (Formerly homeless)
· Has first hand experience with homelessness and the Mental Health System.
· Cuts will devastate low-income people with mental illness and homeless people in particular, and people with substance abuse problems.
· People will begin to leave the city with all their contributions.
· Would like the MDC to encourage the Mayor not to allow these cuts to go forward
Joanna Hagerty (Formerly homeless and now a tenant advocate with the Mental Health Association)
· First concern: How will the cuts affect behavioral health integration?
· Second concern: People with mental health disabilities are so under-served, any cuts would leave them out of touch completely.
· Would like to urge the Mayor to set a new precedent by doing something new: Cutting Salaries! The airlines had to do it, why can't we?
L.S. Wilson - Substance Abuse and Mental Health Workgroup
· Opposes cuts, cannot see the logic behind closing the doors of these programs that have made a positive difference in so many people's lives.
· Doesn't understand how priorities are set when health service cuts are at the top of the list.
· Mental Health and Substance Abuse has been cut year after year to the point of closing doors on services such as: Central City Hospitality House Drop-In Center
· Mental Health System has been in crisis for years - it cannot provide basic services and support for people with psychiatric disabilities.
· Rather than cut away parts of the Health System, we should be trying to add on.
· Tell our Mayor that we want to help people, and that the proposed budget cuts offer nothing but hurt to those who have little or nothing.
· The Substance Abuse and Mental Health Workgroup opposes the closing of the MHRF.
Machiko Saito
· Speaking as a concerned citizen / SF resident / US citizen who has had to advocate for herself and deal with the mental health system over the last 14 years.
· Suffers from mental disorders and a history of substance abuse problems.
· Was not provided with adequate resources or support on how to deal with these issues and was institutionalized, hospitalized, arrested and completely misdirected in health care.
· Today has been clean and sober for 14 years. She is able to find housing, employment but it is definitely a struggle.
· Recently, friends have died from drug overdoses; they have been institutionalized, and arrested.
· Through personal experience, she has found that it is almost impossible to advocate for oneself to get the resources needed due to programs that are in jeopardy of being cut, such as "Suicide Crisis Hot Line" which has helped to keep her alive.
· As inadequate, insufficient and unavailable as these systems are, these programs made a difference in staying alive as opposed to other friends who are either in jail or dead.
· Would like to thank the MDC from the hundreds of people who have benefited from the limited resources available.
Joseph McCowan
· Supports all the issues of previous presentations and feels it's a very serious time for cutbacks.
· Government has put money and politics before God and humanity in every aspect of society.
· Mental Health clients, supported by Senior Peer Programs, Disabled Veterans Program and Laguna Honda's Drug and Rehabilitation Program often get institutionalized in the system as felony convictions and are placed in prisons where the systems forces them into a criminal state.
· Their problems escalate into violence because that's the only resort left.
Darwin Diaz, Mental Health Activist since 1966
· A "graduate" of Napa State College (Napa Hospital) with SSI credential. Involved with Spiritmenders.
· One of the original advocates to have MHRF built, which took a long time but now the situation will be changing to where people who need to be hospitalized will be sent out of town.
San Francisco Network of Mental Health Clients - Mark Adamek
· Requests that current cuts in the Health budget not be carried out.
· One of the community casualties will be the SF Network of Mental Health Clients, which is run for and by mental health clients. Due to lack of sufficient community support and funding, the center will be shut down.
· Would like the Mayor to realize the importance of keeping the city's agencies open, especially the city's non-profit organizations which are struggling very hard to make a difference by providing free assistance to all of San Francisco's low income and mental health consumers.
San Francisco Network of Mental Health Clients, Co-Executive Director of Network's Project Julia Diaz - Vice President and Treasurer
· Formerly homeless, had been attacked and left with low self esteem when being housed in inappropriate programs.
· Would like the Mayor to know the importance of continuing to have the freedom of choice, to determine one's own form of treatment and to add strong elements of consumer-driven and consumer- provided services including peer case management, self help and drop-in services.
· Since there will be more untreated, depressed people on the streets, helping oneself as well as others is a very major aid in recovery.
Independent Living Resource Center - Victoria Tedder,
· The proposed program and service cuts are going to translate into more homelessness.
· Without government help, people will be paying for services out of their own pocket, with less money, many will not be able to pay their rent which will then result in eviction and homelessness.
· Jessie Lorenz, ILRC, is advocating around the state of California addressing the budget cuts. Interested people may contact Jessie at 415. 543-6222.