The Coalition on Homelessness, along with the help of numerous community based organizations, chalked up yet another stunning victory for poor people. The Single Standard of Care legislation, which creates a requirement for mental health treatment parity, was passed unanimously by the Board of Supervisors. This restores treatment for 1,700 poor people, and forbids the City from withholding their mental health treatment simply because they have no insurance.
In these times of increased repression—and greed-based policymaking from Bush to Schwarzenegger—poor people prevailing is indeed a sight to behold. While this may not seem a major issue, to those impacted it is huge. Mental health is often a life threatening issue, and it has a huge impact on the individual’s quality of life. Undeniably, this is an important victory.
The Single Standard of Care has a multiple year history in San Francisco. For years, the Coalition had been pushing the Department of Public Health to broaden its mental health criteria, at that time dubbed “Cluster Criteria.” The criteria were so strict that often people would end up in Psychiatric Emergency after being repeatedly denied preventative care. In fact, the City’s criteria were stricter than those used at San Quentin prison.
Finally, the state came in and forced a change through MediCal regulations, which dictated new, broader criteria for San Francisco. At that time, a coalition of community groups rose up and demanded that those same criteria be used for medically indigent or uninsured individuals. This was supported by the current Director of the Department of Public Health, Dr. Mitch Katz, as well as by the Health Commission and most of the department staff.
Suddenly, this all changed. This past winter as part of the mid-year budget cuts, the Mayor arbitrarily changed the policy. With the stroke of a pen, 1,700 people lost their treatment because they had certain diagnosis no longer eligible combined with being uninsured. Apparently, this change was at the advice of Dr. Katz.
DPH arbitrarily picked certain diagnosis—like post traumatic stress, and personality disorders—and deemed them “less severe” mental illnesses, and therefore ineligible. The problem was that the new policy did not actually take severity into account. It only looked at diagnosis. Diagnosis can be somewhat arbitrary as well (ie. there is no blood test to dictate if someone is bi-polar positive). Of course the policy only affected uninsured people, which is also arbitrary. It depends on a person’s ability to navigate bureaucracies, immigration status and so forth. This created the huge mess we outlined for you in last month’s STREET SHEET. It created a contradictory policy within mental health and made it even harder for uninsured people to qualify for public health insurance.
This decision was made without public input or process, so the guidelines had to be developed after the fact. In addition, the policy didn’t even enjoy support in the ranks of the city’s mental health bureaucracy. The Coalition on Homelessness swiftly took action, but Mayor Newsom was quicker—implementing his bad policy immediately.
We were told by policy makers it was a done deal and it was too bad but there was nothing we could do. We ignored all that and fought for what was right. We brought together community organizations, conducted outreach to homeless people and ultimately wrote legislation that would reverse this decision. We brought this to Supervisor Daly, who championed the issue at two separate hearings before the Board of Supervisors. The first hearing was a Daly sponsored collection of challenges to Mayor Newsom’s homeless policy—that while constantly glorified by the Chronicle has some serious weaknesses. The Single Standard of Care played a central role in this hearing as community members, homeless people, immigrants and service providers turned out en mass to call for a reversal of the policy. A second hearing was focused on just this issue and the testimony was so powerful that Supervisor Peskin ended up co-sponsoring the legislation.
Meanwhile, getting the legislation passed was one step—funding totaling $1.1 million had to be restored to the budget to make it all a reality. We included this in the list of cuts in the People’s Budget, researched data, created a fact sheet, raised the level of awareness among politicians, including the Mayor and so forth. And THE PEOPLE PREVAILED! At this time it looks like the Single Standard of Care will not only be law, but it will be fully funded as well!
This effort was successful because it was truly collaborative, with community organizations doing their part to get all the votes. And all those votes we sure got… every last one of them!
Special thanks to Supervisor Chris Daly and his aide John Avalos for making this all possible!