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Health and human services budget cuts will show on the streets

When the Guardian contacted one of those staff members, she declined to comment but did acknowledge that her position had been written out of the budget.

Steve Bingham, an attorney with Bay Area Legal Aid, notes that state law actually requires the city to have a civil-rights mechanism in place. "The law doesn't require that there be specific full-time people to do it. The law requires that somebody be designated and that certain work be done," he explained, adding that he'd been told the civil-rights responsibilities would now be shared among several staffers.

"I'm very disturbed that they're basically going to divvy up responsibilities," he said. "We are constantly bringing to the attention of management in the department deficiencies that are essentially civil rights deficiencies. For example, somebody who just can't process written information misses a meeting with a worker that he was informed about with a notice. Accommodation means that you figure out that that person needs a telephone call. If you miss a meeting with a worker, you get a notice that you've been terminated from benefits."

Human Services Agency executive director Trent Rohrer did not return repeated calls requesting comment about budget cuts.

Meanwhile, in the Department of Public Health, the consequences of deep budget cuts are already taking a heavy toll. Over Valentine's Day weekend, 93 certified nursing assistants employed at Laguna Honda and SF General hospitals received pink slips, a blow that represents just one of several rounds of layoffs being administered in the wake of midyear budget cuts. (An earlier round, which included 19 CNAs, took effect Feb. 20.) The fallout from budget reductions for the 2009-10 fiscal year won't take effect until May 1, according to Deputy Controller Monique Zmuda. Everyone the Guardian spoke with expects that round to be worse because there's a much larger projected deficit.

Ed Kinchley, healthcare industry chair and executive board member of SEIU Local 1021, is employed as a social worker in SF General's emergency room. He says the cuts have diminished the quality of service the hospital can provide. "Part of my job is trying to hook up the patients who are coming into the emergency room with services, and almost every week when I come into work, there's some service we have had in the past that isn't there anymore," he says.

"The biggest thing they're doing is what we call 'de-skilling,'" Kinchley continues. "For example, in the first round, they took 45 unit clerks — the clerical people who sit at the centralized desk and make sure the right labs get done and sent to the right place — and replaced them with clerks who don't have any medical knowledge. That's at the clinic where all the people go who are supposed to be getting quality care under Healthy San Francisco."

Reassignments are another issue, he says. When an African American nurse was reassigned, she was made to leave her post at a program that offered therapy for youth and adolescents that had suffered sexual abuse. Since many of those clients are African American, Kinchley points out, her removal diminishes the culturally competent service that was previously in place for these youth. Sometimes the new assignments shake up people's lives: staffers in the process of completing nursing programs who were recently reassigned to completely different work hours, for instance, have had to abandon their studies because of the scheduling conflict.

The end result, in his opinion, is a decline in both the quantity and quality of service at SF General, even in the wake of voters approving a bond measure in the November election to borrow some $887 million to rebuild the facility.

"I have worked there since 1984," Kinchley says.