The San Francisco office of Sophia Padilla is downright cozy. There’s a framed poster celebrating the famed parrots of Telegraph Hill in the corner, and dim lighting creates a warm glow. The goal is to help her patients feel more comfortable as they get mental health care for potentially the first time.

Padilla is a licensed family therapy counselor working with the “small but mighty” team at the Michael Baxter Clinic, located in the basement of the Larkin Youth Center in the Tenderloin. The clinic provides medical testing, basic medical treatment and counseling for some of the most vulnerable children and young adults in San Francisco, who are often living on the streets. 

The clinic is supposed to act as a one-stop shop for the at-risk people coming in. They can get both medical and mental health care all in one spot, and potentially all in a single day. 

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Back in Padilla’s office, a small bin of plastic fidget bracelets sits next to the upholstered chair facing her desk. 

It’s “hard to know what to do with your hands when you’re being vulnerable,” she explains. 

Pictures hang on the wall in counselor Sophia Padilla’s office at the Michael Baxter Youth Clinic within the Tenderloin’s Larkin Street Youth Services in San Francisco on April 29, 2026.

But soon the bin, along with the rest of the resources provided by the staff, will be gone. The Michael Baxter Youth Clinic is slated to close later this year as the San Francisco Department of Public Health is grappling with a massive loss in funds due to President Donald Trump’s “Big Beautiful” budget bill, passed last summer, which slashed Medicaid spending as well as other federal financial support.

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The federal cuts to Medicaid — administered as Medi-Cal in California — mean there will be a loss of $306 million over two years for the city, according to a budget outlook published by the agency in April. The budget presentation points out the Medi-Cal cuts equal one quarter of the funding that SFDPH gets from the San Francisco General Fund. Mayor Daniel Lurie has ordered an increase in general funds to help cover the shortfall, but also asked SFDPH to cut $40 million from its budget. In addition to the three clinic closures, SFDPH is taking other cost-cutting measures, including eliminating the managed alcohol program, moving clinical staff out of administrative roles and reducing middle management.

So, in early April, the team at the Michael Baxter Youth Clinic was told that they, along with the staff at the Cole Street Youth Clinic in the Haight and the South East Mission Geriatrics clinic near Holly Park, would be reassigned and the clinics would be closed. 

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Padilla said the team at Michael Baxter was in “complete shock.” 

The examination room at the Michael Baxter Youth Clinic within the Tenderloin's Larkin Street Youth Services in San Francisco on April 29, 2026.

While the Department of Public Health said all patients would be directed to other clinics, Padilla and her team are skeptical their at-risk patients will make the trek to another part of the city for specialized care. For her younger patients, she worries they won’t get........

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