San Francisco youth clinics face summer closure after budget cuts

The Michael Baxter Larkin Street Youth Clinic in the Tenderloin and the Cole Street Youth Clinic in Haight-Ashbury were set to close this summer, leaving San Francisco’s young people with fewer places to get sexual health care, counseling and basic medical help without barriers.

At Larkin Street, the loss would hit a clinic built around transitional-age youth, including patients ages 12 to 24. Sophia Padilla, who has worked there for nearly three years, said she sees as many as 20 clients in a typical week and described the clinic as a one-stop stop connected to Larkin Street Youth Services, where young people can get help without judgment. Former patient Alyana Perez, who has used the clinic since she was 18, said the site has been a safe place for her and that losing it would make it harder for young people to know where to go for care.

The closure plan affects more than one neighborhood and more than one kind of service. The Department of Public Health has described the move as a consolidation of three low-volume clinics, including the Southeast Mission Geriatric clinic, as it tries to absorb a two-year city deficit of $643 million. The department has said $306 million of that gap stems from federal and state Medi-Cal and Medicaid cuts, equal to 25% of DPH’s FY25-26 General Fund allocation.

The Health Commission had already approved the FY26-28 DPH budget at its March 2 meeting, and the April 20 hearing was discussion-only, with no vote on the clinic closures. Public comment ran for hours. Health Director Daniel Tsai said Mayor Daniel Lurie would announce a budget proposal on June 1.

Workers and advocates have warned that closing the clinics would leave a real gap even though some youth-focused options remain, including New Generations Health Center, Balboa Teen Health Center and Third Street Youth Center and Clinic. Larkin Street Youth Services says its clinic offers free preventative, primary and sexual medical care, rapid HIV testing, behavioral health, family planning and health education, services that are especially hard for queer and trans youth to replace.

Workers have said staff were told they would be reassigned, and the closures could be finalized by August. Community and labor groups have begun mobilizing, public workers rallied at San Francisco General Hospital, and Supervisor Bilal Mahmood has pushed back on the Tenderloin clinic closure. For a city that often casts itself as a refuge for vulnerable residents, the question now is whether the budget leaves room for the small, specialized clinics that many young people use to stay healthy and stable.