On Nov. 16, the San Francisco Board of Supervisors will make a decision regarding Mayor Gavin Newsom's revised budgetary proposal, which would hit local emergency rooms hardest.

Newsom wrote a letter to the supervisors on Oct. 2 proposing the revised budget that would address the $26.5 million cut to health and human service programs made by the state.

Currently, the supervisors are deciding whether to approve the proposed legislation or change where the cuts come from by proposing an alternative solution. The budget proposal is expected to be finalized by the end of November.

"There's probably a good likelihood that a significant portion of the plan will make it through," said Greg Wagner, the budget director for Newsom.

The cuts will only amount to a loss of about $2 million because the city set aside $18 million in the reserve fund during the summer as preparation for the cuts.

"We knew the state was in a bad financial situation so we planned for that," Wagner said.

The city originally anticipated additional cuts of almost $7 million to Medi-Cal, but the state didn't implement those cuts, leaving the city with almost $25 million to fill the $26.5 million cuts.

"Given the initial estimates of state cuts, the mayor's proposal leaves intact almost all of the funding by replacing the state funds with the local reserve of $18 million and/or using federal funding to replace state funds," said Monique Zmuda, deputy controller for San Francisco. "Therefore, I do not think that there will be a lot of controversy with this proposal."

Although the impact of the budget cuts were smaller than they could have been, $1.1 million will still be cut from local emergency rooms.

"It will result in a lower ability to provide services in emergency rooms," Wagner said.
In the future, the city will have a harder time coping with budget cuts because the money in the reserve will be gone.

"We were able to get through this round of cuts, but it's only a temporary reprieve because the state still has significant budget problems," Wagner said. "It's likely to be a pretty big challenge that we're going to have to face in the coming months."

Over the next several months the state will most likely have to implement more cuts that will affect medical services, substance abuse programs and seniors, according to Wagner.

"We don't have a solution plan for those," he said. "It's a major concern."

The Controller's Office is currently analyzing this year's revenues and expenditures and will issue a report on the status of the city's budget in the coming weeks. The report will help the mayor's office plan next year's budget, which is expected to have a deficit as well, according to Zmuda.