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San Francisco will see the closure of three public health clinics in coming months, including two youth clinics in the Tenderloin and Haight-Ashbury amid an ongoing budget crunch, Mission Local has learned.
The Department of Public Health did not confirm the names of the clinics that are closing. But workers this week were told they were being reassigned from both the Cole Street Youth Clinic within Huckleberry Youth Programs, and the Michael Baxter Larkin Street Youth Clinic within the Tenderloin’s Larkin Street Youth Services.
The city has only a handful of clinics for people ages 12 to 25. The clinics offer mostly drop-in care for a vulnerable demographic.
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It is unclear whether the third clinic expected to close is also catered to youth.
In a statement, a Department of Public Health spokesperson confirmed that the department plans to “consolidate” three “low-volume” clinics amid a citywide deficit and federal and state cuts to Medi-Cal and Medicaid, but did not provide a timeline for doing so.
Lisa Cadillo, a medical evaluation assistant at Larkin Street’s clinic, said that the clinic had seen a lower volume in recent years. Still, she said, the announcement on Monday that her workplace of 10 years was closing came as a “total shock.”
Over the past couple years, Cadillo said the clinic was chronically understaffed and saw a revolving door of providers who were overwhelmed and at times, reluctant to work at that location.
“It definitely takes a different type of person to work in the Tenderloin, at the Larkin Street clinic,” Cadillo said.
On a good day, she said about 10 kids would come in, but the care they received was more involved than at a typical health clinic. She worried about where her clients — some of whom are unhoused, transient, or undocumented — would go instead. By August or sooner, Cadillo was told she will be transferred to San Francisco General Hospital.
According to its 2024 impact report, Larkin Street Youth Services served over 2,000 people in its various programs that year. Huckleberry Youth Programs reported in its last annual report that it served 518 youths at its two health clinics, and provided 608 with counseling services.
Huckleberry is one of San Francisco’s longest-standing youth service providers — it opened the country’s first shelter specifically for runaway and homeless youth in 1967. The organization’s groundbreaking HIV prevention program eventually became its health clinic in 1992. It soon became the city’s largest community-based adolescent health clinic.
Today, things are different.
Another worker who works at one of the city’s youth clinics, who is familiar with the matter but wanted to remain anonymous for fear of retaliation, said that hours had been reduced at the Cole Street Clinic to two days a week — which meant fewer people were coming in, leading to further cuts.
“If the clinic is closed, they’re not going to come back,” the worker said, emphasizing the need for drop-in service. “Then they tell their friends that it’s closed.”
The low volume, in turn, became the reason for the closures announced this week.
Mayor Daniel Lurie’s office has called for budget cuts across city departments, with the current two-year deficit around $643 million.
Last month, Lurie called on the Department of Public Health to cut an additional $40 million from its budget, with half coming from community-based organizations and the other half from staff reductions.
“This may result in service reductions,” read a memo at the time. This week, the city issued layoff notices for 127 positions across multiple departments, including the public health department, and more are expected.
The department told Mission Local that it has also “identified” $226 million in savings that won’t impact staff or programming, and that the city’s general fund will help offset the federal cuts.
The department spokesperson said that services provided by the clinics will continue despite the closures.
“This is a resource realignment — not a reduction in services,” the statement said. “Every patient currently seen at these locations will be offered a seamless transition to another outpatient clinic, with no gap in care.”
Cadillo estimated that about half of her youth clients are from the Tenderloin, the neighborhood known for the highest density of children in the city. In the Tenderloin, youth services are practically synonymous with Larkin Street.
“Even though at our clinic we didn’t see that many people, it’s not just an easy, ‘Okay, let me check your ears and your stomach and have a great day,’” Cadillo said. When she sees her clients, she tries to lift them up, because “life has torn them down.”
The other worker said the small clinics “build relationships” to make the youths feel safe there, as compared to a “very big and intimidating adult clinic.” All that work, they said, is “so that when they’re in crisis, they come to us.”
Keana Giles, the director of health services for Huckleberry who is not employed by the public health department, said she also learned abruptly this week about the imminent closure of the clinic, and had received little information.
Giles said the health department never consulted Huckleberry about any strategies to keep the clinics open. She said “the impact to the community, staff and young folks who access our services, will be instant.”
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