By Rachel Brahinsky

Though Mayor Gavin Newsom has consistently named ending homelessness as his top priority, two programs that are essential to the homeless safety net – both of which serve the "chronic" homeless population that Newsom has said is of special concern – are targeted for closure in the next several months.

The cuts to the Central City Hospitality House Self-Help Center and the Tom Waddell Health Center's Urgent Care Clinic are partly fallout from the failure of two tax ballot measures in November. The Hospitality House cut is also linked to policy changes related to Newsom's Care Not Cash program.

Combined, the changes will severely limit homeless people's ability to access emergency health care and will shutter a range of services that have been designed for some of the most troubled street dwellers in the Tenderloin, where nearly a quarter of the city's homeless reside.

Drop-in center cut

The Self-Help Center, a 19-year-old program that has been repeatedly threatened with closure during bad budget cycles, was originally created for people who have a hard time engaging with traditional services because of severe mental health problems and other issues.

Hospitality House director Jackie Jenks told the Bay Guardian the program's closure is "related to a shift in the city's priorities. [They] are focused on people on General Assistance who are higher functioning, which leaves other people to fall through the cracks yet again."

Welfare clients are targeted in Care Not Cash, Newsom's signature homeless plan that got underway last spring. Under Care Not Cash, homeless who have been able to maneuver the city bureaucracy to get themselves on the welfare rolls are asked to trade the majority of their monthly checks for services, including shelter, and for some, permanent housing.

But there are thousands of homeless who don't get welfare checks. The homeless population is estimated at between 8,000 and 12,000, and only about 1,100 remain on welfare (before Care Not Cash kicked in, the homeless welfare rolls numbered closer to 3,000). Many of the rest end up at some point at Hospitality House for respite, groceries, crisis intervention, and other services.

The $567,000 program typically has served 6,000 people annually, Jenks told us. Earlier this year the city moved the program's administration from the Department of Public Health to the Department of Human Services, which also oversees Care Not Cash. Then the DHs put the drop-in center contract out for bid, opening up the program to other agencies, and, Jenks told us, indicating a change of focus.

"They wanted it to be shifted to a more standardized program with tracking," Jenks told us. "It contradicts the idea that the drop-in center is your last stop before the street. Our model has really been low threshold and easy access."

The city chose the Tenderloin AIDS Resource Center to take over the contract, but now, with the city looking to cut some $4 million from the DHS budget, the drop-in center will be closed at the end of the year and won't be reopened at TARC, as originally planned. TARC executive director Tracy Brown told us the move will be a big loss to the Tenderloin. "There has to be a place for the homeless to go in the Tenderloin, whether we run it, or they [Hospitality House] do," Brown said.

DHS director Trent Rhorer said the department chose to focus its limited resources on permanent housing, instead of the drop-in center model. But Brown contends that Rhorer's choice ignores a key need. "Even the housing through Care Not Cash doesn't negate the fact that those people need a place to go to have community," Brown said.

Emergency health care cut

The slashing of funding for the Tom Waddell clinic comes as part of a package of health cuts in the mayor's midyear budget revision, which is a response to the defeat of Propositions J and K, two tax measures the mayor had counted on passing. Without the estimated $97 million that the taxes would have brought the city over the next year and a half, the situation sets up some tough choices for the mayor, who already closed a $352 million budget gap in the spring.

Yet for a man whose policy priority is to help the homeless – and whose soaring popularity is widely seen as linked to his focus on the homeless – cutting the Tom Waddell program seems counterintuitive. With about $1.8 million in proposed funding cuts, the agency's entire urgent care operation will have to close. According to medical director Dr. Barry Zevin (who spoke to us as a concerned citizen and not in his official capacity), about 8,000 people use the clinic annually, and the vast majority are homeless folks who aren't getting health care anywhere else. Staffers there say the clinic serves as an entry point for homeless folks who need other services but who never sought help until they had urgent medical needs.

"We will do everything we can to mitigate the situation," Zevin said. "Where will people go? I don't know the answer to that."

Some services to the homeless provided by the clinic will remain: Tom Waddell staffers who currently visit the homeless at 20 sites around the city will continue their jobs. But about 18 positions will be transferred from the clinic on Jan. 15, and it's not yet known where those employees will be sent. But, Zevin said, "for the most part I can say they won't be working with homeless people."

The mayor is proposing a total of $15.5 million in cuts to the public health department. DPH director Dr. Mitchell Katz was out of town and could not be reached for comment.

Newsom has made a point of noting that he is trying to avoid homeless service cuts, but he hasn't focused on the Hospitality House and the Tom Waddell clinic in his speeches on the budget. His spokesperson Peter Ragone punted us over to Rhorer when we asked for comment, indicating that he's not willing to take public responsibility for these cuts.

Sup. Chris Daly has proposed preserving the Hospitality House funding and wants to move the program back to the DPH.

The Board of Supervisors' Budget Committee holds its first hearing on the mayor's proposed cuts Thurs/2, 10 a.m., Legislative Chambers, City Hall, 1 Dr. Carlton B. Goodlett Pl., S.F. The Finance Committee holds a hearing on the Hospitality House cuts Dec. 8, 1 p.m., Room 263, City Hall. (415) 554-5184.

E-mail Rachel Brahinsky at rachel@sfbg.com.