Saturday, October 29, 2005



Read President Peskin's letter to Martin Brotman, M.D. below.


Democratic National Party Chairman, Howard Dean spoke at the San Francisco California Pacific Medical Center Campus Campus (Buchanan and Webster) in support of SEIU-United Health Care Worker strikers at 5:00 p.m. Friday, October 28. Dean added his voice to other national and local political leaders, Barbara Boxer, Nancy Pelosi, Jesse Jackson, San Francisco Mayor Gavin Newsom, Board President Aaron Peskin, Supervisors Chris Daly, Tom Ammiano, and Bevan Dufty.

Howard Dean's presence underscores the real issue embedded in this strike: The corporatization of national health care.



There they were, the usual suspects, stereotypes from Upton Sinclair's novel, "The Jungle." Replacing Big Meatpacking in the blood-red waters were the new circling sharks --- Big predatory Healthcare. Instead of cattle entrails, human fluids, blood, and tissue were splattered on inadequately cleaned hospital walls and floors. Sunset Scavengers refused to pick up contaminated needles discarded in the trash outside, among which the pigeons pecked.

At two Monday San Francisco Board of Supervisors Government Audit and Oversight Committee meetings October 17 and 24, 2005, union and management spokespersons addressed the ongoing strike at California Pacific Medical Center before President Aaron Peskin, and Supervisors Chris Daly and Sean Elsbernd.

A queue of nurses told how displacement of low-wage employees by squadrons of even lower-wage "replacement workers" savaged patient care at CPMC's three sites, pitting underpaid against poorer.

Communications Director, Cynthia Chiarappa insisted the strike had "no impact on our ability to provide high quality health care." Strikers hissed and booed.

Vickie Bermudez, Regulatory Policy Specialist for the California Nurses' Association, testified that "the absence of assistive personnel, housekeeping, dietary, laundry, and central processing service," and an "inadequate screening, orientation, and competency validation of the replacement staff" has compromised patient care.

One R.N. refused to work with replacement nursing assistants who couldn't report abnormal vital signs. Sloppy "cleaning" is done by untrained people who don't understand the serious blood and body fluid hazards in their scab jobs.

Nurses can't get linen or scrubs. Trashcans overflow. Garbage blocks hallways. Bathrooms have empty soap dispensers and no paper towels, essential for infection control. Patients wait hours for pain meds.

Tissue and blood products from surgeries and labor and delivery areas are left in basins for the next pregnant mother to discover.

Diane Wayna, confessed through tears, " These people out there on the line are worth their weight in gold. I didn't realize how good a job they did."


According to SEIU pickets and organizers, this is a Corporate corruption story - Race and Class-War style.

Earnest shirt-sleeved John Borsos, SEIU Administrative Vice President, stood at the public podium in chambers battling The Evil Corporation on behalf of exploited workers, while sympathetic nurses poured out compassion toward the sick and underpaid, and inconvenienced NIMBY Pac Heights neighbors barked complaints about picketers' cacophony during evening meals.

High-level hospital managers who hired African American "replacement workers" fresh from Gilmore, Oakland, Bayview Hunters Point, and Hurricane Katrina appeared alongside striking employees, largely of color.

The muted bong of the two-minute bell punctuated each impassioned speech.

The grievants in the 46-day, "open-ended" strike by the Service Employees International Union - United Healthcare Workers West (SEIU-UHW) Local 250 are 800 underpaid overworked hospital caregivers, LVNs, CNAs, food service workers, aids, technicians, housekeepers, custodians and clerks.

The grievance is not primarily about pay, but about workers having a voice.

According to Andi Bruce, Davies UHW organizer, "(Sutter) gave (the workers) generous wage offers. They've been rejected."


On December 1, 2004, workers conducted a one-day strike protesting Sutter's bad-faith bargaining. The Court mandated Sutter recompense striking workers for unlawfully locking them out four additional days.

In a Board hearing, caregivers urged Sutter to settle the contract according to a set of uniform standards to which other hospitals agreed --- "a real voice" in increased staffing to lighten heavy workloads, a fast and fair election process, a Master Agreement, and funds for training and education through which, for example, certified nursing assistants could upgrade training to become registered nurses.

Negotiations deadlocked through Summer, 2005. On August 28, David Weinberg, Federal Mediator, attempting to avert a walkout, proposed a settlement. Both agreed, then CPMC reneged, precipitating the September 13 strike.

Peskin reviewed August 29 e-mails between the mediator, the union, and CPMC Director Martin Brotman.. Sutter Health apparently pressured CPMC to alter the contract title and language. Borsos testified, "We rejected that. It changed the mediator's recommendation for settlement to something less."

Cynthia Chiarappa, Communications Director, said "CPMC has requested that the union restart negotiations." Borsos stated CPMC's lawyer denied this.

"This dispute is not about wages and benefits," Chiarappa continued, "but union leaders' demands that would place a gag order on physicians, nurses, and hospital management from talking with employees about union representation... Placing a gag order on one side and not the other is not fair."

Later on the CPMC line, David Colburn, Rehab aide, explained Chiarappa's concern. Management wants to conduct one-on-one meetings about unionism with non-union workers in a room with a boss who could potentially fire them. "No words have to be said," said Colburn. "It's intimidating simply to be in the room under those circumstances. That's the kind of thing we want to eliminate."

Peskin asked if Chiarappa had a copy of the mediator's "unfair" recommendation.

"I do not have that with me today."

Supervisor Daly reminded Chiarappa that management's legions of lawyers would have such documentation if it, in fact, existed.

Peskin said he read the mediator's proposal, and "Mr. Brotman's piece in 'The Business Times' where he (too) said --- this has nothing to do with wages and benefits or patient care (but) with the union's desire to organize and expand.

"Section 247... says that the employer...may contact employees who wish to organize. I don't see this gag order."

Cheers drowned out Peskin's rebuttal.

Peskin continued the hearing to Monday, October 24, urging a higher level CPMC official like Dr. Martin Brotman, to "come down here and talk to us."

When Paula Likens, Community Relations Manager, raised her voice calling strikers noisy and unclean, Peskin gaveled her out of order, "It is precisely this kind of arrogance...that has this going on."

Managers then made a great show of filing out of the chambers.

On the Sunday, October 23 CPMC strike line, most doubted Brotman would show. Said Colburn, "I'm skeptical. I think they are that arrogant."

Martin Brotman, in fact, did not present himself at the Monday, October 24, San Francisco Board of Supervisors hearing. President Peskin announced he had been in touch with Brotman by phone. Brotman had told him there could be positive developments before the end of the week.


Nonprofit Sutter Health, the largest chain in Northern California, last year made nearly half a billion dollars, far more than for-profit hospitals.

Said Andi Bruce, "CPMC is the most profitable Sutter. If this chain was paying its taxes to the San Francisco Treasury, we wouldn't have fire stations closing or the police department in a three-year hiring freeze."

Bruce explained Sutter pads its balance sheets four ways


To qualify for nonprofit status, Sutter should provide 10% charity care, but provides 2% to 5%.



Sutter charges some patients 50% to 60% above area hospitals.


Sutter's for-profit collection agencies go to court with a fistful of cases suing uninsured students and poor people for miniscule amounts. Combing through Stanislaus county public records, Bruce emerged with a foot-high stack showing Sutter sued for $50 or $100, taking homes and cars.


Bruce said Sutter's refusal to give workers a voice is classist. He described Sutter as philosophically opposed to unionism. "Kaiser or Catholic Healthcare West would have said, 'Forget it. Let's give it to them.' Sutter's response to our demand for staffing arbitration is ' I don't want (workers, who coincidentally do the jobs every day) having a voice and telling me how I should staff this hospital.'"

Said Brenda Jensen, CNA, "I go to staff meetings, and my voice isn't heard. "You're (just) one of the health care workers.' "

I asked Bruce, Is Sutter/CPMC unrepentantly hard-core corporate, racist, and classist toward people who make far less than they do?

"Yes. Van Johnson, Sutter CEO, just retired (to) be a missionary for the Church of Latter Day Saints. Before he left, (he) gave himself a 60% raise. He ended up at almost $2 million a year."

California site organizer, Michael Bender stated that "Their spokesman saying patient care hasn't deteriorated probably hasn't been on a nursing unit for weeks or months . That (is not) coming from the people doing the care."

Of CPMC corporate racism and classism, Keith Herbert, California site Housekeeper said, "It's obvious that a corporation like Sutter and CPMC --- their feet don't touch the ground. They don't usually walk amongst the people."


Organizer Bruce verified, "Staffing is definitely classist. They put the biggest burden on nursing assistants, LVNs, or housekeepers who clean 15, 20 rooms. You are not going to do a good job with that many."

An "At Will" employer unrestricted by a union has arbitrary power to replace CNAs and LVNS with "travelers," floater nurses that management shifts around with versatility. Permanent nurses are sent home early. "Travellng is the healthcare industry's answer to outsourcing."

Brenda Jensen, 7-year CNA at CPMC, told Supervisors she cares for 18 people without breaks, getting vital signs, feeding patients, changing diapers, moving post-surgical cases to and from commodes and procedures. She has no time to remove patients' dentures at night.

Romero and Rudy, California campus Housekeeping workers want "safe staffing." They are required to work two people's jobs plus overtime. They feel pressure to do more. "If the room is dirty, if the restrooms are not clean, the patient and the family suffer."


SEIU/UHW is asking for a real training and education program up to the local $1,000 standard.

Bruce emphasized that, though housekeeping is a necessary ,job, "We are saying somebody shouldn't be stuck there. If they want to upgrade their skills, even housekeeping skills, Sutter should invest in its workers like they invest in a building."



"Sutter's hiring practices are as racist as any profit-making business," said Bruce. "They don't hire these people for normal jobs. When the strike is over, they are fired."

Sutter used ex-con, forger and union-buster, Gary W.Fanger to hire "some Katrina victims in an opportunist manner, offering them desperately needed low-paying jobs."

Said Bruce, "They have gone into poor communities, to projects," and simply asked, "Who wants a job?"

CPMC hired poor black rival gang members from Hunter's Point who fought turf wars inside the hospital. During the October 17th hearing, President Peskin confronted Cynthia Chiarappa with reports of "replacement workers stealing drugs at one particular hospital."

Scabs make $10 to $15 an hour, though not as much as regular CPMC workers. CNAs make $19 to $28. Scabs know they will neither be turned away nor suffer background checks.


At CPMC, a burly, black-suited Rent-An-Enforcer told me he was from the Steele Foundation, analogous to Blackwater, a private soldier of fortune company.

"I just got back from Katrina. I'm like a secret service agent who guards the President" Such hired soldiers protect political figures, athletes, celebrities, CEO's, business leaders, and senior management.

While a few strikers huddled for warmth around a propane heater on the dark sidewalk, the Steele mercenary said he was protecting hospital executives from violence.

According to Bruce, several guards returned to Iraq, for the $200,000 a year.. They expressed frustration at having no guns, unable to control the strikers walking past them outside and the scabs inside stealing Viagra and M.D.s laptops.

The reason for "men standing around with the secret service thing in their ear like the FBI" --- was intimidation. "They are telling us, 'This is a war.'"

Sutter Health/ CPMC's over-reaction seems based on fear of SEIU membership expansion.

"They are afraid of our union growing," Colburn explained.

In January 2005, the Northern California health care workers union, SEIU Local 250, voted to merge with Los Angeles Local 399, expanding to 130,000, the largest California union.

If the union wins at Sutter/CPMC, especially with the AFL-CIO split, other hospitals countrywide may lose power over a huge swath of the national workforce.

The power balance between organized labor and corporations could be deeply effected by the CPMC strike.

As of Thursday evening, October 27, strikers on the line outside the California and Davies campuses related rumors of a Friday settlement. Brotman's Monday promise to Peskin, however, had not yet materialized.

(This original version appeared in BeyondChron.org on Friday, October 28, 2005)


October 27, 2005

Martin Brotman
2100 Webster St. #423
San Francisco, CA 94115

Dear Mr. Brotman:

I am writing to follow up with you regarding our conversations earlier this week prior to the scheduled hearing of the Government Audits and Oversight Committee. As you are well aware, this Committee remains interested in learning more about the issues that have precipitated the strike by some 800 workers at California Pacific Medical Center 9CPMC) for nearly 8 weeks.

During our conversation on October 24th, you told me that there was reason to be optimistic and you were hopeful that there would be some good news by the end of the week. As I understand, CPMC has been and was willing to continue a series of "off line" conversations in order to end the strike and get the 800 workers back to work.

During our first hearing on October 17th, your representatives created more questions than answers, and left my colleagues and me with no understanding as to CPMC's reluctance to accept the federal mediator's recommendations. At our last hearing on the 24th of October, we were given ample opportunity to question the Union's chief negotiator in order to fully understand the workers' proposals. I left the hearing with a more complete understanding of their perspective and the intricacies of their demands. Our committee is very interested in hearing CPMC's management's perspective at our next hearing, unless an agreement is reached prior thereto.

One alarming factor raised at our last hearing was the testimony of the Registered Nurses who complained about the quality of care now taking place inside the hospital as well as the lack of training afforded to the 600 replacement workers CPMC has hired. Our Committee saw pictures of hazardous materials, including needles and other biohazardous waste that may have been dumped into a non hazardous waste receptacle. Needless to say, this testimony and the pictures have caused serious concern.

This letter should serve as notice that the Government Audits and Oversight Committee intends to recalendar this hearing in the coming days. If your office communicates to me that an agreement has been reached, or is imminent, I would, of course, be willing to dispense with this item. I respectfully request that you or Mr. Jack Bailey, as well as any other appropriate staff or CPMC board members, attend the hearing. I will promptly notify you as soon as this item is placed on the calendar. As always, please feel free to contact me at any time.


Aaron Peskin


San Francisco Board of Supervisors
Mayor Gavin Newsom
CPMC Board of Directors
St. Luke's Hospital Board of Directors
Dr. Mitch Katz, Director - SF Department of Public Health
John Borsos, Chief Negotiation, SEIU UHW
John Williams, CEO, St. Luke's Hospital
Pat Fry, Sutter Health


During a call for my bank balance, the worried teller confided that her husband had enlisted in the National Guard for an education but ended up in Iraq. He has never seen his infant son. The couple is terrified the hijacked guardsman will be killed before his release. The anguish this woman poured out to me has convulsed America.

The increasingly unpopular Iraq war has put President George W. Bush in a precarious political position. On August 1, 2005, Zogby International polls showed "two-in-five voters (42%) say they would favor impeachment proceedings if it is found the President misled the nation about his reasons for going to war with Iraq."

Bush's numbers sometimes dip lower than Lyndon Johnson's before public opinion forced him out of office, and, eventually, the U.S. out of Vietnam. Even some Republicans are upset about the series of apparent lies that suggest that Bush fabricated a war, caused 100,000 innocent Iraqi deaths and killed 1,800 American troops to line the pockets of his elite base.

Cindy Sheehan, California mother of a slain soldier, and member of Gold Star Mothers for Peace, set up camp two miles from Bush's Crawford, Texas, "ranch" during his five-week August vacation. She named the spot "Camp Casey" for her 24-year-old son, Spc. Casey Sheehan of Vacaville who was killed in Baghdad's Sadr City on April 4, 2004.

Sheehan vowed to stay until Bush leaves or meets with her to answer one unanswerable question: "For what noble cause was Casey sent to die in Iraq?"

California Rep. Maxine Waters, Minnesota State Sen. Becky Lourey, who also lost her pilot son, and Medea Benjamin of Global Exchange, joined Sheehan at the peace camp. Joan Baez performed a concert there on Sunday, August 21.

In his movie, "Fahrenheit 9/11," Michael Moore interviewed grieving mother Lila Lipscomb of Flint, Michigan, who said she hated the protesters at first for dishonoring the troops. After her son Michael's death, she came to believe he died for nothing. She realized people were not criticizing the soldiers, but the war.

During a heart-wrenching visit to Washington, Lila stood before the White House where she finally released her suffering and rage. I wondered if Lila wished to be at Camp Casey with Cindy Sheehan.

To justify his attack on Iraq, Bush first falsely claimed that Saddam Hussein threatened the U.S. with weapons of mass destruction. Further allegations of Hussein's ties to al-Qaeda were discredited.

The third justification -- that Bush wanted to give Iraqis democracy -- is laughable. A worldwide influx of "insurgents" currently finds a terrorist training ground complete with hourly practice in suicide car bomb detonations. A puppet government missed the deadline for concocting a "Constitution."

The normally unaware press are covering Sheehan's protest. However, the media avoided reporting the June 2005 release of the top secret June 2002 Downing Street memos sent by the head of Britain's Secret Intelligence Service to Prime Minister Tony Blair, detailing talks with the Bush Administration to determine its upcoming plans for invading Iraq. These "smoking gun memos" revealed that "the intelligence and facts were being fixed around the policy" of Bush's prearranged NeoCon war.

In retaliation against, and to undermine the credibility of, Ambassador Joe Wilson for contradicting claims that Niger sold yellow-cake uranium to Hussein, Karl Rove use Lewis "Scooter" Libby, Dick Cheney's top advisor, to leak to reporters the name of Wilson's wife, Valerie Plame, as a CIA agent investigating WMDs. Rove destroyed a 20-year spy operation, endangering national security and Plame's life. Many fear that countless other deep cover operatives working with Plame have been killed.

Such revelations unmasked Bush's pretext for invasion, and answered Sheehan's question. Bush needed Iraq for oil, power, and money for his very rich friends.

When asked why he would not speak to a grieving mother of a dead soldier camped a few minutes down the road, Bush agreed it is nice to be "thoughtful and sensitive," but said, "I think it's also important for me to go on with my life." Casey Sheehan can never go on with his.

Sheehan's dangerous question, considered a moment of crucial activism and speaking Truth to Power, seems as close to revolt as the dumbed-down, numbed- down American public can get. Anger about The Downing Street Memos and the Plame affair drew groups of fed-up people to Crawford demanding a response.

A New England Journal of Medicine study showed 17 percent of 955,000 U.S. troops who served in Afghanistan and Iraq "met the screening criteria for major depression, generalized anxiety, or post-traumatic stress disorder." Soldiers describe blood and mutilated body parts strewn in the streets.

Bush and the Neocons designed Iraq as a perpetual war machine, killing or grinding up soldiers, pouring them maimed and homeless onto American streets. Reporter Amy Goodman interviewed one traumatized veteran who lost his home because of delinquent combat pay.
American youth leave for war in the prime of their life. They drag back broken minds and discarded flesh, financing their own rehab. They will sit on sidewalks beside veterans of past conflicts, panhandling, disabled, and self-medicating their post-traumatic stress with alcohol or drugs.

Moore ended "Fahrenheit 9/11" with Neil Young's song "Keep on Rocking in the Free World." The song said it all:
"We got a thousand points of light for the homeless man.
We got a kinder gentler machine gun hand."

Said Moore, the only thing asked by the brave soldiers who enlisted after 9/11 to protect America is not to be sent into harm's way for no good reason. Cindy Sheehan is simply asking for that reason.



This seems like the year in which Bush will use any rationalization to cut social programs and entitlements. Causing people to starve is no way to balance a budget concocted to fight a war that causes even more people to starve, become homeless, and die.


Dieters know hunger’s hollow ache can stop you cold.

During a 15-day spiritually motivated water and coffee fast, I discovered a hunger-busting phenomenon described in a Franz Kafka story. Middle Age “Hunger Artists” would lie in cages in their town squares starving for money. Passersby tossed them coins.

Initial pangs vanished completely. This enabled Kafka’s “artist” to fast 40 days.

Sure enough. Fasting was easy. I got tired, but I was never hungry.

On day 15, my auburn-red hair turned gray. I was scared back to normal eating. B Vitamins restored my hair color.

My brush with starvation was a privileged luxury. I was not a member of an impoverished family without means to feed its children an adequate nutritious diet.

The stunting affects of hunger on bodies, brains, and futures of children are well understood. If malnutrition persists, hunger will disappear, but so will one’s health, and finally one’s life.

CAUTION: DO NOT FAST PAST DAY 15! Feedback to this piece from several folks who carried the fast past the 15th day report that when the body gets the message it is being truly starved, dehydration and malnutrition causes terrible physical pain.

(In any case, losing weight by fasting is a really bad idea.)


On February 7, 2005, Bread For the World Institute, a Christian citizens’ nutrition justice lobby, released an analysis of the Bush Fiscal Year 2006 Domestic Nutrition Initiatives.


It noted that, even as Bush’s Federal Budget proposes food stamp cuts, hunger and poverty is on the rise. It stated that recently released Bush administration data illustrates “for the fourth straight year there are more people in the U.S. struggling to feed their families.

“However, a careful analysis of the president’s fiscal year 2006 budget request shows that he proposes cuts to the Food Stamp Program by $500 million over the next five years.”

It points out that, “These proposed cuts come at a time when 36. 3 million people, including 13.3 million children, live in homes that struggle to put food on the table.”

U.S. Department of Agriculture data reveals that hunger and “food insecurity” jumped from 31.0 million people in 1999 to 34.9 people in 2002, an increase of 1.4 million. In 2003 it leapt to 36.3 million.

Kim McCoy Wade, the co-director of the 40-member California Association of Food Banks expressed urgency about Bush Administration and Congressional cuts to the Federal Food Stamp program.

The California Association represents small to large food banks statewide, including LA County, one of the Country’s biggest food banks.


According to Wade, Bush is calling for a nationwide one billion dollar cut in the food stamp program.

Additionally, Congress has directed the Agriculture Committee to slice 3 billion dollars from the Department of Agriculture’s budget. The President and Congress hash it out and come up with a total. “Where that (money) comes from,” said Wade, “is the fight that is currently being fought, and food stamps are vulnerable.”

Agricultural subsidies and food banks in the same committee, which previously represented a united front, now must compete. Though they share the goal of feeding poor and hungry people, agriculture interests are pitted against nutrition interests.

Wade observed, “We don’t want to do (that) because we partner with farmers all the time.

“And, people in farm country are hungry, too. So, we try to do an urban-rural coalition that says the food stamp program benefits all of us.

“Our job this summer is to talk to the Ag Committee saying, ‘Don’t cut this funding.’” She noted they could do anything, going after working families like the President did. “They could say, `We are going to lower everybody’s benefits by a buck. They could cut off all immigrants. I mean, they could do anything.’”

Allison Pratt, education and advocacy coordinator of a member bank, the Alameda County Community Food Bank, seconded Wade’s alarm.


Pratt and Wade anticipate June 7, 2005, when, according to the National Hunger Awareness Day website, several thousand people from the “grass roots” will visit Washington D.C. to “to raise awareness about the solvable problem of hunger in America.”


A prayer service will be held Monday night at the National Cathedral.

On Tuesday, Wade will be one of a three-member delegation from the California Association of Food Banks that will lobby the Congressional Agriculture Committee about the cuts.

Bread For The World and Second Harvest, a certifying organization that reviews Food Banks for quality, safety, and accountability, are co-organizers of this important event.


The delegation will visit the offices of each California member of the AG Committee to communicate their concerns. Busy Senators like Feinstein and Boxer represent several million people. Lobbyists will likely talk with staff, which does research, informs, and advises the member.

Wade said, “Our message to the Ag Committee is how important this food stamp program is in bringing healthy food to hard working families.”


“Our two goals are to protect the food stamp program funding and its structure. Those are under attack this year.”

The structure dictates which families can be allowed into the food stamp program and which will be denied.

The key funding question is, “Which money will be available?”

The Temporary Aid to Needy Families Reauthorization Bill is a second threat “traveling separate from the budget debate,” stated Wade. TANF reauthorization would change food stamps from an entitlement program in which the federal government supplies the money despite the cost, to a block grant program in which states are provided a flat rate amount.

Unanswered questions arise:

What if there is more need than block granted funding?

Will the block grant amount be based on last year’s need?

What if the need changes?


Providing less money is a simple maneuver. Bush’s trickiest gambit is restructuring and shrinkage of the definition of the Poverty Group. Defining it more narrowly makes less money necessary.

Bread For The World’s site states, “The administration plans to enforce these budget cuts by reducing the number of people eligible to receive benefits, especially for low-income working families.” If the President gets his way with the Federal cuts, his proposal would eliminate the Categorical Eligibility option.

“Currently, people who are eligible for some welfare services are automatically eligible to receive food stamps. The president’s proposal will dramatically reduce the number of people who automatically qualify for food stamps.”

Said Pratt, “When the President proposed his budget cuts in February, the one cut he proposed to the food stamp program was this: Right now States have the option of automatically enrolling people who are receiving Medicaid into the food stamp program.”

“The connection to health care is just another doorway into the food stamp program for working families,” Wade confirmed. The President’s proposal eliminates that option.

Says Bread For The World, “This proposal strips individual states of flexibility provided in the bipartisan 1996 welfare law that allows states to streamline eligibility for the Food Stamp Program. The most heavily impacted families would be low-income workers because they may have modest savings or own a reliable car.”

Right now California lacks “Categorical Eligibility” for working families with slightly higher earnings, but whose child-care and medical expenses render their net incomes “super low.” Los Angeles Assemblywoman Judy Chu authored Bill 696, proposing California creates “Categorical Eligibility,” automatically enrolling them in the food stamp program.

If the President eliminates Categorical Eligibility, California cannot do that.

Said Bread for the World President, David Beckman, “To propose removing hundreds of thousands of hard-working, low-income people from the Food Stamp Program is anything but compassionate.

“Overall the president’s budget misses the mark. It does not balance our nation’s need for security with our moral commitment to help hardworking people who are struggling to feed their families to build a better life.”

Friday, April 22, 2005


By Carol Harvey

The rich and powerful often have a close personal relationship with addictive substances. Every month or so, it seems, a famous Hollywood actor is caught with drugs. Neither media figures nor politicians are exempt. Conservative commentator Rush Limbaugh recently entered rehab to dry out from addictive, illegally obtained pain pills.

America's foremost born-again Christian, President George W. Bush, was known to have abused alcohol. His former sister-in-law, Sharon, tattled to tabloid biographer Kitty Kelly that, at Camp David during his father's presidency, the younger Bush used the drug of choice in high social circles - cocaine.

Confessing to the abuse of drugs and alcohol may take real courage for politicians, which explains why so few step forward. Dr. Abraham Twerski, director of the Gateway Treatment Center in Pittsburgh, noted that power-brokers fear loss of status after admitting to addiction. Twerski cited many recovery meetings on Capitol Hill and "state capitols, city halls and municipal buildings across the country. You just don't know about them."

Drug use has infiltrated all strata of society. California Association of Food Banks Board President Suzan Bateson said, "In 1969, you could have walked down almost any street in California and picked up somebody (now in their mid-50s) who could have been popped for a drug offense. (They) might have gone on to be very successful, maybe were contributors to society for many years as well, (then) come on hard times, and need a little help (to feed) their families."

In recognition of the hardships faced by poor mothers in providing for their families after recovery from drug addiction, San Francisco Assemblyman Mark Leno authored a compassionate reform bill in the state legislature, AB 1796, that lifted the lifetime ban on food stamps for recovering addicts convicted of felony drug possession. The bill, signed into law by the governor on October 1, 2004, went into effect on January 1, 2005.

Laura Bibelheimer, Leno's legislative assistant, said he worked long and hard, successfully lobbying Gov. Schwarzenegger to sign the opt-out bill into law out of his concern for the group most impacted by the lifetime food stamp ban, poor mothers like Oakland resident Ramona Choyce and their children. "It was a great accomplishment," she said.

Leno told Street Spirit, "Those who served time for possession are, in many cases, young women with children. We know for a fact that a young mother, often from ethnic communities with limited resources, who must... provide herself food, will have that much less to spend on her children. Children who go to school hungry are more likely to fail. Those who fail are more likely to drop out. Those who drop out are more likely to find themselves in the criminal justice system. Here we see that our failed policymaking produces failed results."

I asked Leno why he pursued this legislation so vigorously.

"It seemed like a great injustice had been done by Congress in placing this lifetime ban on eligibility for food stamps for those who have been convicted of drug felonies," Leno said. "It only becomes more clear when you realize that someone could have served time for murder, rape, child molestation, bank robbery and be eligible."

The prohibition on food stamps for drug offenders was imposed in 1996 as part of the Federal Welfare Reform Act. Bateson observed, "This is a state-by-state decision. States were given the option to change or modify the restriction."

As of January 1, 2005, California has joined 32 other states, including Maine, New York, Iowa, Ohio, and the District of Columbia, in opting out of the ban, exercising a federal option to provide food stamp benefits "in support of individuals' efforts to successfully recover from drug lifestyles," wrote Schwarzenegger.

The Governor stated "universally denying food stamp benefits to people with felony drug convictions has created additional obstacles to independent drug-free living and increases the likelihood of re-offending behavior."

Suzan Bateson, who is also the executive director of the Alameda County Community Food Bank, said, "To ban (recovered drug abusers) for a lifetime seemed like such a ridiculously punitive move. It's time to be a lot more enlightened. It is a waste of energy and resources to deny families the right to have food stamps because in 1969 they may have been caught with a small amount of marijuana. I mean, c'mon, we've got better things to do with our time."

The Assembly bill continues to prohibit drug pushers and manufacturers from receiving food stamps.

Said Leno, "Unfortunately, we had to limit our opt-out bill to just those who had been convicted of drug possession (as opposed to) possession with intent to sell, which is a slightly larger quantity, or the felony of selling drugs, manufacturing, distributing. There is still an inequity there," he said, sounding a bit disappointed.

Leno's bill, AB 1796, affects at least 1,640 former California drug felons denied food stamps last year. The bill mandates that they must first serve out their sentences and complete a recognized drug program.

The Alameda County Community Food Bank is celebrating its 20th anniversary this year. The Food Bank provides access to nutritious food to about 120,000 Alameda County residents each month, and also works to remove barriers like the drug felony ban for all families seeking food stamps.

Bateson agreed with Bibelheimer that Leno "was really instrumental in making this piece of legislation go through."

"There had been a long history of failed attempts by anti-hunger activists to try to get this kind of legislation passed," Bateson added. "It was always defeated either by the legislature or vetoed by the California governor."

The Alameda County Community Food Bank has been working for years on this issue, along with other anti-hunger advocates. The California Hunger Action Coalition and L.A. Coalition to End Hunger and Homelessness led the work by coordinating letter campaigns and meetings with legislators and the governor.

Bateson explained that they informed state legislators that, even though "this was a difficult piece of legislation because it was talking about people who, quote-unquote, have committed crimes, it was really time for it to be brought forward."

Bateson observed that AB 1796 "had come before the governor and legislature several times, hadn't moved forward at all, and people were kind of dispirited with regard to it. However, we just thought it was one that we should keep putting on the radar screen, but we weren't going to see that needle move."

Bateson said the Food Bank's hard fight to pass AB 1796 geared up in the autumn of 2003. She said the impetus was a funders' conference where Food Bank staff discussed with other anti-hunger advocates the possibility of introducing a bill to end the ban during the 2004 legislative session.

In January 2004, this group, which included the California Association of Food Banks and groups belonging to the California Hunger Action Coalition, approached Leno, who had already introduced the bill. Leno was able to connect anti-hunger advocates with the Drug Policy Alliance, an organization that played an essential role in getting the bill passed. What made a real difference in the success of the legislative effort this year was that anti-hunger advocates were able to work hand in hand with recovery advocates.

I asked Bateson why the Governor stepped up to the plate and signed the bill.

"I think there is a lot to be said for Mark Leno really taking this on," she said. "I'm talking from one person's perspective, but I think Leno was really good with him. Leno was really committed to getting this ban lifted. He was very polite and politic in the way he interfaced with the governor. It could have been the right time, but Leno was definitely the right guy for it, because he held his ground and stood firm."

Bateson agreed with the speculation by activists that, even though 31 other states had already lifted the ban, California's former governor, Gray Davis, wishing to appear tough on crime, kept it in place.

Leno said in an interview, "In their wisdom, (Congress) allowed states to opt out, and though 32 states already had, California had not taken advantage of that opt-out provision. Not for lack of trying. Previous legislators had successfully authored similar bills in slightly different fashion only to have them vetoed by Gray Davis who, unfortunately, on issues of criminal justice was rarely open-minded. So, with the new governor, I thought that it was worth giving a try."

Activists pointed to the Electronic Benefit Transfer or EBT card as a mechanism preventing food stamp fraud. Bateson said, "There was a lot of concern about fraud and about food stamps getting into the wrong hands, and would people trade them for drugs, or cash, or whatever." The EBT card, an electronic debit swipe card, now solves this problem.

Gov. Schwarzenegger wrote, "Technological developments in the benefit delivery system and... the successful implementation of the Electronic Benefit Transfer system assures that food stamp benefits cannot be easily exchanged or converted into drugs."

Activists argued that another good reason to pass the bill was that money from the federal government would help invigorate California's flagging economy. Denial of food stamps to felons, together with those who just don't apply, has cost California approximately $2 million in federal food stamp assistance annually.

On the bill's passage, the Governor acknowledged, "Food stamp benefits are entirely federally funded, and AB 1796 will bring millions of dollars into the state's economy at little cost to the state."

As Bateson pointed out, food stamps are a federal entitlement program. When the State of California gets money for food stamps, it does not come out of state funds, but from the federal government. She said, "It provides commerce in our cities and communities, which brings dollars into the economy of the state and into the grocery companies up and down the state."

"When the bill was passed, we were absolutely thrilled!" she said. "We are very excited about getting anybody who meets eligibility requirements into the federal food stamp program."

Bateson acknowledged that the food stamp program "doesn't solve the problem of hunger, but it really does help families. It provides 10 days to two weeks worth of groceries for them, which eases the burden on food banks.

"It helps organizations like ours who are trying very hard to put food on the tables of hungry people in our community. We don't have the resources to provide enough food for a month for a family's needs. That is a constant battle for us."

Sunday, April 17, 2005



Many wealthy Americans with substance abuse problems possess the means to pay for drug rehabilitation programs and nutritious food to speed their recovery. But what of young mothers like Ramona Choyce, an Oakland resident and recovering addict who lives in extreme poverty?

Ramona's two-year crack habit began in 1998 after the birth of her first baby, "because my baby's daddy was abusing, and I was curious." Child Protective Services removed two of Ramona's four children to foster care. Because she could have lost her youngest son, Jahiem, as well, her motivation to beat her addiction was strong.

"CPS would have taken my baby if I was still using," she said. After three years of imprisonment for drug possession and her successful completion of a recovery program, Ramona has been clean for five years.

"I learned a very big lesson," she confessed. Her goal is to stabilize herself financially and secure adequate housing to get her older children back.

In recognition of the difficulties facing poor mothers like Ramona in providing for their families following recovery from drug addiction, S.F. Assemblyman Mark Leno championed Assembly Bill 1796, and succeeded in lifting the lifetime ban on food stamps for recovering addicts convicted of felony drug possession.

The bill went into effect on January 1, 2005; but the passage of AB 1796 was only half the battle. Word of its passage has been slow to reach those whose quality of life it would benefit.

Leno's bill requires former drug felons to first serve out their sentences and complete a recognized drug program. Ramona Choyce met both requirements by 2003, making her eligible for food stamps now.

Yet, many former users have completed their sentences and drug programs, but are unaware that they may now receive food stamps because they have fulfilled the requirements.

Bill Hart, executive director of San Francisco's General Assistance Advocacy Project (GAAP), expressed concern that former drug felons across California, believing they were prohibited for life from receiving the benefit, have been forced to use their children's food stamps to feed their families.

Social service agencies seem not to actively disseminate such information, nor do they assertively administer benefits to their clients. No mailings seem to have been sent or announcements made. In Ramona Choyce's case, the agencies seem to have taken steps that actively barred her receipt of her food stamp entitlement.

In managing her complicated life, Ramona resembles a circus performer balancing spinning plates on sticks. A roommate will soon move out, leaving Ramona with $950 in monthly rent payments she cannot meet. A male relative who was helping out lost benefits when he turned 18. Visits to friends and her church's food pantry help supplement what little food she has. Food stamps would considerably ease her financial strain.

At age 26, Ramona has found a job working 15-plus hours a week as a nurse's aide to a 108-year-old woman.

Ramona's goal is to stabilize her family financially to get her older children back. However, despite having successfully met the bill's requirements, and procuring a new job, Ramona is still forced to use her son's food stamps to feed her family of four: two children, her sister and herself.

Just before the passage of AB 1796, Ramona called the Alameda County Food Bank hotline. The hotline put Sacramento Bee reporters in touch with Ramona, and they reported about her case in an article about the bill published on December 29, 2004. In January, Ramona twice spoke about the provisions of AB 1796 with her social worker at Alameda County Social Services Benefit Center, and asked to apply for food stamps. Apparently, both times the worker told Ramona that she had "heard nothing about" the AB 1796 food stamp benefit.

"The ban was lifted January 1, but not everyone who processes the applications in counties across California knows about it," said Suzan Bateson, executive director of the Alameda County Food Bank. "County officials, unaware of the new law, may not have changed their protocols yet. They may not have been able to make all the changes necessary to go ahead and accept these applications."

As regulations are written, Leno's staff keeps in touch with the California Human Services Department to ensure the wording honors the bill's intention. "The devil is in the regulations," Leno said, "so we have been keeping an eye on how the department will craft its regulations for the implementation, and we need to make sure that no changes are made from the way we had agreed to things."

Jessica Bartholow, Alameda County Food Bank director of education, advocacy, and outreach, stated, "It is my understanding that the January 1st implementation gives counties up to six months to comply." By July 1, 2005, the ban should be fully lifted statewide.

Bartholow also wondered whether that meant clients would receive retroactive pay back to January 1, 2005.

In answer to a query on this point, Andrea Ford, interim policy director at Alameda County Social Services, wrote in a March 28th e-mail: "We are issuing benefits effective January 1, 2005, for individuals who have applied effective this date or applicants who applied for benefits in December... if the disqualified drug felon met all the eligibility conditions (including verification that the use of controlled substance has ceased).

"All other applications are processed according to the date the individual applies for benefits. We cannot go back and issue benefits retroactively to January if the person did not apply for food stamp benefits. (A food stamp application is required for all individuals in order to determine eligibility.)"

In January 2005, because the Alameda County worker told Ramona she knew nothing about AB 1796, Ramona could not submit the food stamp application provided her by the Alameda County Food Bank. The worker's ignorance of the law effectively blocked Ramona from finalizing the requisite paperwork.

This raises the question as to whether Ramona should receive retroactive food stamps from the time she approached the worker and was turned away, rather than from the later date on which she will be forced to apply. Leno told me he would have his staff look into this question.

Andrea Ford's e-mail response clearly indicates a complete knowledge of Bill 1796 and the implications flowing from it. This raises the serious issue of why one of her staff was uninformed about this bill. Additionally, if the Alameda County Food Bank and the Sacramento Bee knew about the bill's passage, why was an employee at Alameda County Social Services Benefit Center, the food stamp dispensing agency, unaware?

Some argue that Social Services workers labor under a barrage of rules and regulations, and can't keep up with the changes. This explanation seems insufficient, especially since Social Services itself is responsible for creating this convoluted tissue of rules. It is clearly the responsibility of Alameda County Social Services directors to stay alert to new laws that make major changes to such a vitally important lifeline program as food stamps, and to train their workers accordingly.

Why does it devolve to the food stamp applicant, already mired in poverty and recovery, to be fully cognizant of rules and regulations too complex for the social service worker? The end result of the County staff's "lack of knowledge" is that food does not reach the tables of deserving and hungry families.

Laura Bibelheimer, Leno's legislative assistant, phoned Ramona Choyce and urged her to take the documentation of her drug program completion to the social worker when she applied. Prepared to do so, Ramona approached her social worker a second time on March 25, 2005. This time the worker stated she first knew of AB 1796 in February. Again, if the Food Bank knew about the bill in January 2005, why wasn't the agency first in line to administer it?

Ramona said that the Social Services worker insisted that even if she submitted her application and proof of successful drug program completion, the worker still had final, arbitrary power to accept or deny Ramona's food stamp petition.

AB 1796 sets forth two requirements. First, the person must have served their prison sentence. And second, as Leno stated, "The individual would have had to enroll in or complete a drug treatment program or would self-certify that he or she was sober." The individual's written and signed assertion of sobriety is enough.

Considering that the Department of Corrections can verify Ramona did her jail time, and she possesses certification proving she completed her drug rehab program in 2003, I asked Leno whether the worker had unilateral power to override AB 1796 with her own judicial decision.

"I would challenge that," Leno said. "From my understanding of the final form of the bill, the woman would be breaking State law." Leno added that, unfortunately, problems like these are "often the case, especially with a new law."

Bibelheimer cited an appeals process to which applicants like Ramona have access, in which questions about the fair dispensation of food stamps are raised.

Leno encouraged writing letters to editors, using the Internet, and contacting Assembly members to make sure the intent of this law is followed.

The message is clear. For many people, successfully procuring food stamps will require broad awareness of the passage of AB 1796. In order to feed their children and themselves, recovering recipients will be forced to be extremely vigilant and persistent in the pursuit of the federal food stamp entitlement that is their legal right.

Friday, March 18, 2005


by Carol Harvey

“Care Not Cash is a bunch of hash,
I see Care Not Cash as my cigarette ash.
After Care Not Cash you don’t have any cash,
And don’t nobody care about you.”

- Wildman

Dominic Simeo, soft-spoken and articulate, has the face of a young Sylvester Stallone. His dark Italian hair contrasted with a white shirt and a simple ivory cross on a beaded lanyard around his neck that he had made himself.

On Sunday, January 30, in Civic Center Plaza, Dominic waited his turn with Rev. Jana Drakka, Rabbi Alan Lew, and others, to speak at the "Covenant of Compassion with Homeless People," a ceremony organized by Sister Bernie Galvin's Religious Witness with Homeless People to honor 72 homeless dead and tell "the other side of Care Not Cash." Religious leaders representing every faith and every area of San Francisco were present.

Dominic gazed over the crowd, smiling at Sister Bernie's slim, blue-suited figure, recalling her kidding him that he should stay in the nursing home with his grandparents. "It's not a place for this young guy," he joked.

He flashed back to the rainy night when he hauled three suitcases through a downpour, asking around the Tenderloin for the best place to stay. Soaking wet, he ran into Michael Moore, director of Hospitality House, on the street, who let him stay one night. It was like running "into a stream of light when you've got a dark tunnel ahead of you," Dominic said.

This New Jersey native has a business and management degree from Rutgers University. For six years, he was a service manager at a Reno, Nevada, Wal-Mart.

His grandfather, a blinded war vet, had surgery for skin cancer and needed 24-hour-care. His grandmother was hospitalized with breast cancer. Because his younger brother was in college in Connecticut, and he was closer to California, in mid-January, Dominic came by bus to San Francisco to sell his grandparents' home and move them from the hospital into a skilled nursing facility.

After his $3,000 ran out, he was too proud to allow his elders to help financially or pay his rent. "I took care of myself by finding Sister Bernie, and Michael Moore," who got him into the shelter.

Dominic liked Hospitality House. He applied at the 39 Fell McMillan Resource Center for a seven-day stay. Moore put him ahead on the waiting list for a 90-day bed, and "that got me in the G.A. program." Moore perceived Dominic as responsible and serious about getting a job. "He saw some inspiration and motivation in me to get out quick and handle my life. I proved him right. That's why he went out of his way to stretch above and beyond and help somebody out."

Too little Care, too little Cash

Speaking at the Covenant of Compassion ceremony, Dominic said, "People on Care Not Cash do not get enough care. Many could use the extra help or care, (someone) to sit down with them and really find out what's going on with their lives. Some with medical problems and illnesses don't have direction and can't function well or do it alone. They need support. That's where that Care comes in.

"As for the Cash program, any one person cannot survive on $59 dollars per month for their food (and) basic necessities. You only can buy simple things that you need - the little stuff. That money runs dry quick. You won't get anymore when it's gone. What do you do? (The GA workers) just look at you and say, 'Wait until next month, until the next paycheck.'"

Experienced homeless advocates point out that Care Not Cash targets only 2,600 to 3,000 people receiving General Assistance out of San Francisco's total homeless population of 12,000 to 16,000. Newsom's plan forces 2,600 to 3,000 homeless people to pay for 600 to 800 SRO units and 550 to 600 shelter placements.

Sister Bernie Galvin, the director of Religious Witness with Homeless People, stated, "We believe that it is basically morally wrong to impose the burden of solving the lack of affordable housing crisis of our city on the backs of the poorest members of our community, the homeless people themselves. And that is exactly what Care Not Cash has done. A new phrase has emerged in the last several months, 'Housed but Hungry.'"

She pointed out the City's responsibility to build affordable housing during financially stable times when San Francisco had the money.

The New Untouchables

After seeing the World War II movie, "The Piano," and then being panhandled by a ragged homeless man on Fillmore, I thought, "These streets are our Polish ghettos. These people are our new Untouchables, forced to live in miserable filth, hunger, and deprivation, blamed and victimized for it."

As was the case before Care Not Cash, homeless people report that pressure washers constantly roam the night streets, the loud humming significantly disrupting their sleep. Barriers have been erected in front of certain establishments to keep homeless people away.

Of these discomforts and indignities, Sister Bernie declared, "If the City of San Francisco wants to address homelessness in a compassionate way, then it must not only correct the many unfair aspects of the implementation of Care Not Cash, but must discontinue cruel practices such as placing huge metal barriers on the sidewalks and removing benches so that homeless people have no place to rest, spraying sleeping homeless people with water early in the morning to move them for street cleaning, and chasing homeless people from one end of this city to the other and from one neighborhood to the next."

To gain a closer understanding of survival issues in San Francisco, I interviewed 20 unhoused people, about an equal number of women and men. Four were receiving treatment for medical problems. Three had mental or emotional issues, of which two were in treatment. Six admitted problems with alcohol or drugs, none receiving treatment.

Three were presently housed in the Care Not Cash program. One was leaving the program, having foregone the required 20-job search, and finding employment on his own. One of the 20 had experienced the changeover from the full grant of $350 to the reductio ad absurdum of a $59 monthly cash grant. He said the full grant had allowed him to pay storage for his belongings, but now he used a friend's Berkeley garage, and eschewing the program, slept on the beach.

A third was housed by Care Not Cash but she said, "They should shut it down. We were housing ourselves fine on the old system."

Each unhoused person I interviewed was, in some way, modeling for the world the incredible toughness, resourcefulness, and creativity that marks supreme survivors.

The selling of Care Not Cash

For four years, Bill Hart, a former homeless client, has been the executive director of GAAP, the General Assistance Advocacy Project. He is a Public Benefits advocate, helping homeless people keep and sustain their benefits.

Hart told me, "In selling Care Not Cash to the voters, the voters didn't understand that the people affected by Care Not Cash were a small portion of the City's overall homeless problem. They voted for it because they thought it applied to homelessness in general."

Homeless people without children receiving cash aid from San Francisco's County Adult Assistance Program (CAAP) were phased into Care Not Cash from May through November 2004.

When their General Assistance benefits were cut from $350 to $59 a month, homeless CAAP clients were promised housing in shelters until they could be placed in Single Room Occupancy (SRO) hotels. According to the SFGOV website: The larger portion of their welfare benefits are "being used to expand permanent housing and services for this population, including access to mental health, substance abuse, and other support services."

Bill Hart would like to believe, despite Newsom's contacts with the Chamber of Commerce and the business community, that the mayor recognized the true nature of San Francisco homelessness. Philip Mangano, the federal government's homelessness czar, said San Francisco had the worst homeless problem of any major U.S. city.

Homelessness and tourism

In running for mayor, Newsom saw that the people of San Francisco were fed up with homelessness. Tourism is San Francisco's biggest source of income, Newsom reasoned, yet homelessness and panhandling have spread to every neighborhood, including Fisherman's Wharf, and other tourist areas. That's the image both tourists and residents have of the City by the Bay.

Hart said he thought Newsom went into this knowing, "I've got to tackle this problem. It's going to take time. I'll model this after Chicago, Alameda County, and New York."

Newsom did not reveal to the voters that the Chicago plan was like Frank Jordan's Matrix program of repression, with police cleaning up the streets by tossing homeless people in jail. In New York, former Mayor Rudy Giuliani made the streets sparkle by picking up the homeless and delivering them to armories that were former military bases. The streets looked good, but the situation wasn't all that Newsom painted to the public.

Then, the Philadelphia idea arrived. With a population twice as large as San Francisco, Philadelphia had a low per-capita homeless count. The City's objective was to get people off the street into their own space where they had a bathroom and privacy. They would then receive psychological support, and alcohol and drug programs. Hart felt Philadelphia was successful because "the key was to get you into your own place no matter what your issues, then give you the support on the spot. That worked. And that's what Care Not Cash is doing."

Hart explained, "We are seeing clients taken off the street into their own SRO with their own space, put into permanent housing with services. We are seeing many known addicts or alcohol abusers get medical services and counseling on the spot. When we see many rehabilitate, Care Not Cash is working. We've seen the transformation of a number of our homeless clients."

A client with mental issues, on the street since 1999, was placed into the McAllister Hotel with case management and psychiatric consultation. He is comfortable and happy in his own room.

"We are seeing many wanting to return to the workplace, looking for part-time work, wanting us to help them with their resume," Hart said. "We've done over 450 resumes for clients in the past year. We provide them with dedicated computers, Internet, and a printer. We teach them how to look on open jobs on Craig's list, and the EDD line - Bay Area jobs."

Hart still faulted the Care Not Cash program for the meager monthly benefits. "However, a $59 grant, or $63, depending on the program, is just not adequate. You can't live on it even with the food stamp benefit."

I pointed out the numbers of advocates who think Newsom simply wants to further his political career, that he has found an angle, and that is homelessness.

Hart has talked to Newsom and disagreed with his ideas. He believes, however, Newsom's true intent is to stop homelessness. "He knows he's not going to stop homelessness, but I think he believes that we can rehabilitate, and we can get a lot of homeless people off the streets - perhaps with services, making them more productive for themselves in life, and for other human beings."

Despite the positive reports of Newsom's approach, Hart was adamant that "Newsom has taken most of this off the backs of those receiving CAAP benefits. He has reduced their grant inhumanely, promising them housing if they go into a shelter transitionally. Those that may have been there a year will say, 'Screw this. I'm out of here.' A year in a shelter, when they agreed to go in there with promises of housing! How long should they wait?"

Even though Care Not Cash is working to some extent, perhaps the average San Franciscan barely perceives that the volume of 12,000 to 16,000 homeless people makes the process very slow.

The real nature of SROs

Asked where Newsom would find housing for all these thousands of people, Hart replied, "Newsom had to start some place. He focused on increasing the availability of the single room occupancy hotels (SROs)."

Newsom envisioned the solution was to negotiate with owners of rundown hotels, entice them to fix them up and enter into a Master Lease program with the County. "He's done that successfully," Hart said. "They've cleaned up many rundown hellholes and enticed these owners. You're guaranteed your rent. The County will pay for it! If we agree, we will occupy 100 of your rooms after you fixed it up, we will pay for that. You've got guaranteed occupancy."

Dominic reports that he saw a SRO hotel room while helping a friend move. It was a cubicle without a window. You shared a bathroom down a hall, and were not allowed visitors, inviting depression. If this was the pot of gold at the end of the Care Not Cash rainbow, he felt the program wasn't worth the 20-interview-a-month job-hunting process for $59.

Are there enough places?

Significantly, the public may not fully grasp it will take many years before San Francisco can provide housing for 12,000 to 16,000 people on the streets.

Will there be enough places? "No! No!" said Hart. "Definitely not enough to house 12,000 to 16,000."

As of April 30, 2004, 2,600-plus were homeless on Care Not Cash. Those were the ones Newsom told, "You may have to stay in a shelter transitionally until we can get you into housing."

According to Hart, the public also does not understand that Newsom made this promise to only the smaller group of people receiving Care Not Cash. The larger group of 12,000 to 16,000 homeless people were not promised that.

"We went on exit interviews and explained this to them," Hart said. "The general consensus (was), 'I voted for it because I'm sick of homelessness, and he's going to do something about it.' But, Care Not Cash only applied to less than 3,000 of the 12,000 to 16,000 that were homeless at the time. What about all the others?"

Hart highlighted the lack of fairness and incorrect priorities in shelter placement that allowed Dominic Simeo and Manhattan Dave to be placed ahead of people waiting for shelter for eight months or more.

"There is no plan to prioritize those people that have been waiting in transitional shelters without permanent housing," Hart said. "They run the same lottery and the same gamble as anybody else. They see their worker once a month. If housing is available, they'll be offered it. If it's not, they're still in the shelter under Care Not Cash, transitionally."
Of the people put into transitional shelters - about 550 occupied beds - Trent Rhorer, head of the Department of Human Services, cannot provide the statistics telling advocates how long those individuals have been there. Said Hart, "We believe some of them have been there almost since the time Care Not Cash started when it was implemented in May of 2004."

"I don't think they feel it is a priority as we do," said Hart. "We advocates believe it is a political hot potato. We could go to the press and the public and say, "These people were promised transitional housing. They are not getting it. They are staying in the shelter bed. How long are they expected to do that with a $59 grant? Listen to us. This is one reason Care Not Cash isn't working."

There is no visible record keeping for the length of these transitional shelter stays. Homeless advocates are demanding to know how many of those people have transitioned out of a shelter into housing.

Hart said, "The people that accepted the transitional shelter have the right to know how long they are going to end up having to wait for it while other people (the chronically homeless) are getting it on demand and applying for C.A.A.P. or being picked up off the streets by workers when they are not on C.A.A.P. and taking up those SROs."

City officials, he said, should "define that your shelter stay is going to be only so long, and, if we can't get you housing before that time lapses, then we will restore your grant - the $198.00 that the State says is for housing, and also restore the utilities of $41.00."

Hart thinks the Board of Supervisors should step in and take action to rectify this unfairness. "If your shelter stay exceeds so many months, and you are not offered permanent housing like Care Not Cash promises you, you, in fact, get your full grant restored, or you stay on a waiting list, or you can stay in the shelter with your full grant until housing is available to you. That would have been (what to do)."

Is homelessness shrinking?

Doing simple math, there are a total of 12,000 to 16,000 people homeless in San Francisco. The Care Not Cash program applies to only 2,600 to 3,000 people, with 600 to 800 reportedly housed in SROs, and 550 in shelters, with a total of 1,150 to 1,350 unaccounted for.

There is another way the non-release of statistics confuses an accurate Care Not Cash count, said Hart. "Trent Rhorer who runs the Human Services Department, and Gavin Newsom, are convincing the press that, `Oh, these people were probably illegally here getting San Francisco's cash-rich benefits, getting it illegally. They've gone.'

"That could be. We agree a lot of people were getting the benefits illegally because it was so simple to get. But, we believe that there are still hundreds and hundreds who've dropped off Care Not Cash that are still living on the streets of San Francisco, and they are panhandling; they are stealing; they are prostituting to survive. Animalistically, they will do anything to survive."

Hart questioned the economics of Newsom's program. "They reduced the grants of people they've thrown into shelters. They take away almost $290.00 every month. You annualize that! With 500 in the shelter, they are saving millions and millions of dollars, which is supposed to be put into housing. While they are trying to increase housing, they still have a promise, a commitment made to these people in the shelters that have sat there for so long."

Current scene on the streets

Aggressive panhandling continues with force on the streets. Care Not Cash pays rent for Mama and Papa Bear in the Seneca Hotel. However, she cannot buy food, shampoo and soap on the meager grant she receives per month. She sits out "panning" every day, so she and her husband can eat.

Bill Hart reported that more homeless people are screaming in frustration at service providers, complaining they cannot live on $59 a month.

Many people, like Shorty and Wildman, are San Francisco natives, destroying the myth that the bulk of the homeless are people from elsewhere here to get drugs and feed off the system.

People like Manhattan Dave, Minnesota Traveler, and Dominic Simeo still travel cross-country. Dark Glasses Anonymous, Wayne's World, and J.C. Jack hail from Berkeley. Neither Dominic nor Manhattan Dave came in search of drugs. As a 14-year recovering addict, David attends three meetings a day, and tries to "stay around positive people." If Care Not Cash was intended to discourage anybody from coming to San Francisco, it has certainly failed here.

I asked Bill Hart whether, as some advocates speculate, Care Not Cash's actual agenda is to force the homeless to leave town by making it so difficult to live here, with General Assistance benefits so complicated, and the wait to get out of bug-infested shelters into housing so long that they find the whole thing unwieldy, and just give up and go away.

Hart's immediate response was that the availability of drugs makes San Francisco an attractive magnet. If people walk three blocks, they can get any kind of drug they want within an hour. "Let's face it," he said. "San Francisco has a heavy population of addicts living homeless on the streets, many of which are not, in fact, receiving C.A.A.P. benefits, (or) SSI benefits. Many are receiving nothing because they are fleeing felons and can't be eligible for benefits."

Wayne stated, "The drug problem in San Francisco is huge beyond your imagination, much worse than people realize." He believed the homeless were now forced to jump through so many hoops "because people became too complacent and dependent" upon San Francisco homeless services. He added, "They have gone out of their way to make it difficult to be a freeloader here anymore. There is no way you can go through all the hoops if you're on drugs. You'll wash out of the system and be back on the sidewalk."

Long waits for a bed

Because 60 to 80 beds a night are reserved for the core group of Care Not Cash participants, all the rest must wait two to four hours outside a Service Center for a one-night stay. If they cannot get to the assigned shelter in time, or no bed is available, they must do what Wildman did, "ride the bus all night until the driver throws you off, then sleep in a doorway to keep out of the rain."

Care Not Cash cots are usually tied up, except in cases where you are known and liked by the shelter staff. According to the "Care Not Cash Fact Sheet," the majority of cots at service-enriched shelters go to Care Not Cash.

Sympathetic directors allowed Manhattan Dave and Dominic Simeo directly into shelter. Mama and Papa Bear, desperate to get off the street, were housed faster, ahead of others on the list because they played the system, made friends, and followed the rules.

Insomnia forced Dark Glasses Anonymous from the shelter at MSC South. He had difficulty sleeping with a lot of people around. There was a wall where everybody watched each other's backs. Still, he had to drag his gear with him to the bathroom at night to prevent thefts. Even though he tied them to his suitcase, a pair or steel-toe boots disappeared in two days. "You're dealing with a lot of people who are highly institutionalized in shelters or prison," he said.

Care Not Cash job search

Dominic Simeo reported that the required job search of 20 contacts a month was too difficult for him to finish even ten. He complained that prospective employers cannot call you back; and if they do so at the call center, you cannot hear the interview because of the din behind you. Many job seekers miss callbacks because they are without a phone.

The system seems set up to make you fail. Said Wayne, "Every time I've even gotten anything to get to the next (step), it gets pulled out from underneath me. Yeah. It's pretty horrible."

Discrimination was reported against one disabled person, a friend of Simeo's with a mental problem who was fighting being thrown off Care Not Cash for not filling out a form properly, a mistake caused by his disability.

J.C. Jack told me he would not participate in Care Not Cash because Newsom, though not the devil himself, was one of his denizens.

As he readied himself to leave town, Dominic Simeo told me that Gavin Newsom should look down from his palatial height where he probably has no idea what it is like to be homeless. He suggested he try it out for one night.

THANKS - My deepest thanks to each unhoused person for your incredible toughness, resourcefulness, and creativity. You are the Supreme Survivors, and you will prevail.


Dominic Simeo for an objective observer’s insights into San Francisco,
Backpack Slim for the homeless car wash idea,
Mama and Papa Bear for warmth and openness,
Manhattan Dave for being a good Dad,
Wayne’s World for being a loving person,
Wildman for his poetic intelligence and wit,
Anonymous In Dark Glasses’ for a brilliant future in the biotechnology industry,
J.C. Jack for his hard grasp on Reality and Care Not Cash.
Wanda for lovely word salad metaphor,
Peter on Clement, good wishes to get on the transplant list,
Minnesota Wanderer for clarifying, “The Word `Politics’ comes from `Polite,’ but Polite It Ain’t.”
Working Woman for unmasking the Resource Center.

Wednesday, January 05, 2005

For National and International News at
AskWHYBlog: Carol Harvey in San Francisco, click here.

Wednesday, December 29, 2004


A Tsunami Sized Death-Dance Change To Laguna Honda Hospital’s Mission Overturns 1999 Prop A Promises to Voters

By Patrick Monette-Shaw / pmonette-shaw@earthlink.net

[Mr. Shaw is a healthcare accountability activist who has filed a lawsuit seeking to make the City return $25 million misappropriated from the LHH replacement facility budget.]


On November 11, the www.SanFranciscoSentinel.com web site ran a story titled “Change in Mission at Laguna Honda: Whose idea is it?” I thought then that I suspected who's idea this was; I hoped, simultaneously, that I was wrong. With less than week-old news now in my hip pocket, my first thoughts, based on the Sentinel's coverage, proved true.

Six weeks later, on December 23, a tsunami sized death-dance change to LHH’s mission was announced at the Joint Conference Committee for LHH, a committee comprised of two Health Commissioners and the Executive Committee of LHH. The mission statement change will remove “long term care” as a key component of LHH’s mission, replacing it with a “skilled nursing” mission instead. This represents a major sea change to LHH’s mission, as the two terms are not interchangeable.

Additionally, the LHH-JCC announced that a "compromise" admissions policy for LHH has been completed and approved by LHH’s Executive Committee, but those present December 23 neglected to mention that a bait-and-switch maneuver had taken place over the admissions policy, which bait-and-switch appears to have perhaps been designed to undercut a public interest lawsuit to overturn the policy change.

The mission change was announced just one week after LHH’s new Executive Administrator, John Kanaley, assured neighbors and homeowners at a Town Hall meeting on December 16 sponsored by the Committee to Save Laguna Honda Hospital and Rehabilitation Center that the mission of LHH was not going to change. Surely Kanaley knew of LHH’s changing mission statement even as he attempted to put spin control on the issue at the Town Hall meeting held at St. Brendan’s Parish Hall.


In fact, San Francisco voters were promised in the November 2, 1999 voter guide seeking to pass Proposition A to rebuild LHH that the new facility would be used to care for San Francisco’s frail elderly. The voter guide contained 42 paid arguments in favor of the LHH bond measure, 34 of which were paid for by the Committee to Save Laguna Honda (a separate committee from that mentioned above), using funds from the three highest contributors to the 1999 Committee: SEIU 790, the Residential Builder’s Association PAC, and Dr. Mitchell Katz, Director of Public Health.

Throughout those paid arguments in favor of the rebuild, San Franciscans were told repeatedly that LHH would be rebuilt for frail “elderly” (24 such mentions), would be used for people with “disabilities” or the “disabled” (12 mentions), would continue the “medical” model focus (14 mentions), would be used for long-term care (13 mentions), would be used for “seniors” (7 mentions), would be rebuilt with 1,200 beds (4 mentions), would provide “skilled nursing” (9 mentions), and would continue to be used as a nursing home (2 mentions). These various assertions created a “compact” with the voters, who were led to believe that the assertions being made in the voter guide were part and parcel of what was being voted on. It was these assertions, among others, that convinced voters to overwhelming approve the bond measure known as Prop A by 73% of the electorate.


And it wasn’t just anybody paying for those assertions, it was prominent San Franciscans the voters were trusting. Former Mayors Willie Brown and Senator Diane Feinstein both asserted LHH would be rebuilt for “long-term care”; so did Congresswoman Nancy Pelosi, the San Francisco Board of Supervisors, and the Health Commission, including current- and then-Health Commissioners Dr. Edward Chow, Roma Guy, and Lee Ann Monfredini. Feinstein, who had two separate ballot arguments, also asserted LHH would be used as a nursing home, and as a medical facility. Joining Feinstein, the then Board of Supervisors, along with former Directors of Public Health Sandra Hernandez and Mervyn Silverman, also asserted LHH would continue to be a “medical facility,” as did SEIU 790 members Richard Rothman and Laura Blue, an RN at LHH who is currently Chapter President of the LHH Chapter of SEIU 790-Nurses.


The arguments LHH would be used for “skilled nursing” included both the Health Commission, and Melissa Welch, the Chief Medical Officer for the Health Community Network who also served at one point as LHH’s Acting Medical Director. Those arguing that LHH would be used for the “elderly” included the Health Commission; Dr. Katz, as then and current Director of Public Health; Louise Renne, Esq., former City Attorney and now President of the new non-profit LHH Foundation; Robert Haaland, an organizer for SEIU 790 and a recent candidate for the Board of Supervisors; Ms. Blue; and the Golden Gate Restaurant Association, a key backer of Mayor Gavin Newsom.

Finally, those arguing LHH would be used for people with “disabilities” — in the classic sense of physical disabilities, not drug addiction, homelessness, or social adaptation problems — included, among others, the full Health Commission, Rothman, Haaland, and Blue. Implicit, or implied, promises to rebuild LHH with 1,200 beds were made by the full Board of Supervisors, Pelosi, and Sal Rosselli, Executive Director of SEIU 250.


Fast forward to December 2004. Now we are told that LHH’s mission, which voters were lured into believing in 1999 included providing long-term care for frail, elderly, seniors and those with “traditional” disabilities using a medical model approach has suddenly had its mission changed by a small tribe led by Health Commissioner Jim Illig, who has been asserting for now a full year that Laguna Honda’s Hospital mission would indeed change.

Despite John Kanaley’s spin-driven assertion to homeowners and neighbors of LHH at the December 16, 2004 Town Hall meeting that no such plot was afoot, the change in LHH’s mission has come to pass, barely a week after Kanaley’s bald-faced assertion nothing of the sort was being planned.

After Kanaley announced on December 23 LHH’s mission statement change — contradicting his December 16 statements to homeowner neighbors surrounding LHH’s property — and that a planned retreat of LHH’s Executive Committee in January will further consider changing LHH’s mission due to matching the hospital’s budget to its mission, Commissioner Illig asked if everyone was “happy” with the mission change. The Executive Committee nodded its unanimous consent: Everyone is happy they’ve now succumbed to Health Commissioner Monfredini’s “get on board this train, we’re leaving the station” metaphor she announced at the October LHH-JCC meeting Fait accompli!

More despicably, and more ominously, during the December 23 LHH-JCC meeting, there was an announcement three LHH bodies — the Medical Staff, the Medical Executive Committee, and the hospitalwide Executive Committee — have now approved yet another change to LHH’s admissions policy.


For almost a year, an intense battle over LHH’s improper admission policy change has been waged. Dr. Katz unilaterally changed the admissions policy on March 2, 2004, without seeking required permission from LHH’s medical staff to do so beforehand. Due to improprieties in the March 2 version, DPH issued a modified version on June 10, 2004. On June 24, 2004, then Supervisor Tony Hall called into question Dr. Katz’s decision-making abilities in light of Katz’s unilateral decisions. As a result, a citizen-taxpayer lawsuit filed was by Michael Lyon in July 2004 seeking to overturn and vacate the admission policy changes.


Just before Lyon’s lawsuit was to be heard in Superior Court on December 13, LHH mysteriously changed the proposed policy back to its original pre-March 2004 wording.

Lyon had alleged that only the hospital’s Executive Director could be the final arbiter of any disputes over potentially dangerous and unsafe admissions of behaviorally disturbed patients, and

That the policy of placing both people at home awaiting admissions on an equal footing with patients at SFGH as a two-bullet point category of the first priority for admission to LHH was improper.


Somewhere between late November and December 3, LHH posted to its intranet an admissions policy change, which, in hindsight, appears to have been nothing more than a bait-and-switch tactic.

When the change back to the original version of the admissions policy was discovered on or about November 30, Lyon and his attorney withdrew Lyon’s lawsuit on December 3, thinking the Superior Court would rule that DPH had complied with the specifics of Lyon’s complaint, by returning LHH’s admissions policy to its pre-March 2004 status.

But a mere 13 days after Lyon’s lawsuit was withdrawn – and dated exactly with the same date as the December 16 Town Hall meeting organized to oppose LHH’s changing mission and planned downsizing — LHH reached a new “compromise” with Teflon Dr. Katz, who has all along improperly insisted that as Director of Public Health he has the final authority of which patients will be admitted to LHH.


And in the new (final?) version of the “compromise” policy that Health Commissioner Illig has had a strong hand in influencing, we suddenly see a brand new paragraph, granting Dr. Katz “final authority” to resolve any problems in admission decisions that are not resolved between LHH’s admitting physicians and LHH’s Executive Administrator, Mr. Kanaley — the latter of whom is desperate to please his boss, Dr. Katz, at all costs in order to keep his new job. The new paragraph of December 16 granting Dr. Katz his long-sought authority, which appears to continue to contradict State law, regarding medical staff autonomy from undue pressure, also eliminates both the June 10 and the nebulously dated late-November versions of the admission policy, in which both versions asserted that it would be the LHH Executive Committee — not Dr. Katz — who would resolve any “perceived discriminatory admission policies.”


Indeed, the paragraph entitled “Resolution of perceived discriminatory admission practices” noted in the June 10 and mid-November versions of the admission policy has been wordsmithed to read “Resolution of problem screening and admissions,” possibly in order to exculpate Dr. Katz from future claims his admission decisions to LHH may be, in fact, discriminatory.


So who has changed LHH’s mission and the patients who can be safely admitted? Well, there’s a few key dancers named in this story who cannot be separated from the dance. It’s known as the “Dancers in Death of San Francisco’s Long-Term Care of Our Frail Elderly.”

The next dance, perhaps a waltz, will be the change in LHH’s mission from long-term care to “social rehabilitation of the urban poor,” instead. Stay tuned for more about this rapidly-changing dance designed to facilitate Mayor Newsom’s quest for re-election as “the mayor who ended homelessness,” and who ended our focus on long-term care for frail elderly San Franciscans. Since Newsom — supervisor for seven years and mayor for one — remains speechless on his “vision” for LHH’s mission and future, while he continues to search for clues that are readily available to everyone else, we’re going to have to rely on the news that broke on Thursday, December 23: That the LHH-JCC and LHH’s Executive Committee has decided LHH’s future and mission without Mayor Newsom having uttered a single word, with District 7 Supervisor Sean Elsbernd’s potentially complicitly abetted silence.

So goes the dance of death to long-term skilled nursing care in San Francisco. In its wake, we will likely get short-term care instead ... while Katz remains water-boy to the Mayor, while Monfredini waltzes with Illig, and while Guy boogies down with Chow — all henchmen to one another beheading long-term care to San Francisco’s aging baby boomers, just as Bush is about to behead Social Security for the elderly. Same theme, different dance, same music (albeit, a different stanza).

We can’t separate dancers from their dance, any more than we can separate a sea change facing California’s coastline. Or any more than we could stop a tsunami’s death dance from hitting LHH’s long-term care shores.

Knowing some of the dancers, and suspecting that an impending tsunami-size train wreck may soon hit our shores, might we succeed in stopping them?

I remain hopeful,

Patrick Monette-Shaw

Saturday, December 25, 2004



Against the will of San Francisco voters, elderly female San Franciscans are being forced out of County for skilled nursing facility care.

According to an unnamed source, a recent bed count by admitting physicians at Laguna Honda Hospital reveals a “significant drop in admissions of people over 70, especially women” in the past year. There is a corresponding shift representing “a significant rise in admissions of people under 60, especially men. Women’s beds are being changed over to male beds.” These admissions especially represent patients who require hospital care to heal from traumatic wounds or physical complications resulting from alcoholism.

Such an admissions pattern shift benefits San Francisco General Hospital by freeing up more beds in that facility. It does not benefit elderly San Francisco females who, as a consequence, are forced out of the City and County of San Francisco to find nursing home placement elsewhere.

In addition, compared to previous years, fewer Chinese elderly are being admitted to Laguna Honda Hospital. They tend to end up at Chinese Hospital and St. Francis Hospital instead of San Francisco General Hospital whose patients get admission preference at Laguna Honda.

In place of the “medical/protective care” model traditional for the frail elderly, a new "social rehabilitation" model is being introduced at Laguna Honda Hospital targeting an under-60 population.

The unnamed source sees social rehabilitation programs as a way to facilitate people reaching their full potential.

However, they worry that the reasonable expectation of Laguna Honda Hospital as a place for all San Franciscans is being undermined.

They fear that Laguna Honda Hospital has suffered by becoming “an extension of the defunding of public health” to make San Francisco General Hospital run “efficiently.”

They express concern that, without asking anyone, Mayor Gavin Newsom and Public Health Director, Mitch Katz, et al, have decided that, even though in 1999 voters approved a $300 million bond measure, San Francisco cannot afford to provide protective skilled nursing facility care for its frail elderly.

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