Homeless

Buster’s axed: City’s top earners next?

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Anyway you cut it, the city budget deficit is going to be painful

Sup. Chris Daly failed to save Buster’s Place from the budgetary chopping board today—a quest Sup. Tom Ammiano deemed “a Sophie’s Choice,” since it involved disappropriating funds that had been earmarked for making the Board’s Chambers wheelchair accessible.

“But I applaud Daly for trying to do an Immaculate Conception, a Hail Mary to make it work,” said Ammiano, as he joined Sups. Sean Elsbernd, Sophie Maxwell, Jake McGoldrick, Carmen Chu and Bevan Dufty to defeat Daly’s plan.

But by meeting’s end, the homeless weren’t the only ones feeling the city’s budget pain. Hundreds of highly paid city employees were surely chewing their nails, following Board President Aaron Peskin’s announcement that in light of the city’s $338 million deficit, he is drafting an ordinance to eliminate all base salaries over $150,000.

596 city employees make over $150,000 a year, according to the Controller’s Office.

But while the MTA’s Nathaniel Ford tops the list ($297,999), with the Retirement System’s David Kushner ($289,478) and Administrative Services’ Amy Hart ($264,524) in second and third place, followed by the Airport’s John Martin ($256,565), Controller Ed Harrington ($256,553) and DPH’s Dr Mitch Katz ($256,553), don’t expect them to be laid off any time soon.
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You can try dealing with the deficit with lots of little cuts from the bottom up.

As Peskin told the Guardian, the Board is not allowed to tinker with some positions, because of charter mandates.

“Some people are constitutionally protected, such as department heads,” Peskin said, “and Proposition D arguably protects police personnel who make over $150,000. And others are doctors at San Francisco General Hospital.”

But beyond those restrictions, a lot of folks could be standing in Peskin’s potential firing line.

“All of them, regardless of pay, perform an important function in the government,” Peskin observed, “but rather than do what the Mayor is doing and make 8 percent across-the-board cuts, we’re making sure that the most vulnerable people don’t get hurt.”
“And we don’t need public information officers in every department,” Peskin added, noting that their elimination would save the City about $50 million a year.
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Or try attacking the problem from the top down.

Peskin admitted that the police, fire and nurses MOUs, which Mayor Gavin Newsom negotiated last summer in the run up to his 2007 mayoral reelection, explain a large part of the City’s 2007-2008 budgetary woes.

“We are all to blame for that. The Board signed off on them, I’m not going to pretend we didn’t,” Peskin said, observing that this month’s axing of Buster’s Place and the Workers Compensation Clinic are “just the tip of the iceberg.”

“Come the Mayor’s budget, we’ll be crying over much larger things,” Peskin explained. “That’s why we need to take some radical steps now to lessen the impact.”

Monique Zmuda of the Controllers Office told the Guardian that the City will need to determine if the functions performed by folks who make over $150,000 are “mandated”. From the remaining sublist, Peskin will have to decide, “if he is truly intending to delete those jobs,” said Zmuda, noting that many of the remaining positions are lawyers, and that “it’s not Peskin’s intention to stop city departments from being able to do business.”

Pointing to the 8 percent cut that the mayor asked of departmental baseline budgets last November, and the additional 8 percent personnel cut that Newsom just announced, Zmuda said, “Peskin’s request means the Boad has additional options to consider, that it’s not just reacting to the Mayor’s proposal. If we have a $338 million gap, it’s better if the options add up to more than that, so that the Board can pick and choose and decide what is the highest priority to save and to cut.”

Or as Sup. Jake McGoldrick told the Guardian” I think Peskin is trying to invigorate a dynamic dialogue and debate.”

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And then, of course, there’s the Chinese toy axe.

In other Board-related news, the Olympic Torch debate continues to burn.
As protesters chanted ‘Mayor Newsom reject China’s bloody torch” outside City Hall, Sup.Tom Ammiano introduced a resolution urging the Mayor, the Mayor’s Office of Criminal Justice and the San Francisco Police Department to comply with the City’s Sunshine ordinance and immediately release the route of the April 9 torch run, along with other documents that the American Civil Liberties Union of Northern California requested on March 13.

And Board President Aaron Peskin sent Supervisor Chris Daly’s resolution, which proposes to accept the Olympic Torch with “alarm” in light of China’s Tibetan crackdown, to the Rules Committee this Thursday.

FINALLY: T.P. A GUARANTEE

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by Bryan Cohen

We hope. We really hope. After nearly two years of collaboration from a variety of homeless service providers, city officials, and activists, the standards of care legislation for city-funded homeless shelters was finally passed in a quick roll call vote by the Board of Supervisors on Tuesday, March 18.

The legislation is considered a major victory for homeless rights advocates and groundbreaking for homeless programs across the country. The legislation, sponsored by Supervisor Tom Ammiano and co-signed by Supervisors Ross Mirkarimi and Gerardo Sandoval, was initiated after investigations by the city’s Shelter Monitoring Committee found many shelters lacking in basic hygiene products. Over half of shelter residents reported some form of abuse during their stays. Key components of the legislation require shelters to provide toilet paper, clean sheets and towels, sanitary bathrooms, and eight hours of sleep a night.

Over the past few weeks the legislation has caused some tension between Supervisors and supporters of the bill and the Mayors office. One of the biggest points of contention was the pricetag of the legislation, initially ballparked at $6 million by the Budget Analyst’s office. However, members of the Standards of Care work group, which wrote much of the legislation, argued the estimates were far too high. In fact, the final bill passed with an estimated $165,000 per year cost to the city.

The legislation also includes a mandate for a 24-hour drop-in center, another departure from Mayor Gavin Newsom’s fiscal priorities. In his recent mid-year de-funding spree, the Mayor pulled Buster’s Place, the city’s only centrally located 24-hour drop-in center. Read this if you want to know why Buster’s is often the only places to go if you’re looking for a shelter bed. While the legislation requires a 24-hour center, it is not clear who will run the center and where.

Supervisors Carmen Chu (District 4) and Sean Elsbernd (District 7) were the only supervisors present who voted against the legislation. Both were appointed to the Board by the Mayor.

Ammiano gets no respect

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Supervisor Tom Ammiano has been all over the news recently and has a couple of major accomplishments, including a restaurant-nutrition requirement and legislation that sets standards for care in homeless shelters.

And yet he’s still getting a beating from the Chronicle, which seems to think that something as basic as asking chain restaurants like McDonalds to tell you how unhealthy their food is could somehow harm the city’s business climate.

The restaurant disclosure bill got a lot of press, but the homeless shelter standards was more of a political challenge – Ammiano had to get the mayor, who has been reluctant to admit that any part of his homeless program is a failure, to sign on to the program.

The conditions in the shelters are, and for a long time have been, deplorable. So this may actually make the lives of a lot of human beings a lot better.

And of course, Newsom made a bit point the other day of talking about how he was going to use the city’s rainy day fund to bail out the city’s schools – without ever mentioning the Ammiano was the one who wrote that bill (without any help from then-Sup. Gavin Newsom.)

Ammiano’s going to leave the Board of Supes next year with one of the longest and most distinguished legislative records in memory. He deserves a little more respect.

Health care paradoxes

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OPINION What does homicide in the Western Addition have to do with the closure of the worker’s compensation clinic at San Francisco General Hospital? How does a mobile methadone-treatment van affect the broader public health of San Francisco?

These are just two of the questions that University of San Francisco nursing students are asking while San Francisco residents face a public health and safety crisis.

Public health and safety are both affected by economic conditions. Nonetheless, we must all question a need-blind cutback in services to public health.

It’s the task of San Francisco nursing professors to address the following confounding paradoxes:

Homelessness Nursing students, Department of Public Health staff, and a host of individuals and organizations work together at the commendable, but intermittent, Project Homeless Connect, while midyear budget cuts will shutter Buster’s Place, the only 24-hour drop-in center that serves homeless persons every day of the year.

Mental health Last semester USF students learned that increasingly scarce hospital beds for mentally ill and impoverished San Francisco residents were going to be cut back even further. Now budget cuts are planned that will decrease services for individuals on an outpatient basis.

Violence Nursing students learn about the effectiveness of education and physical exercise in ameliorating the deplorable conditions of the city’s housing projects and streets. The Western Addition has recently suffered from a spate of shootings; it seems an odd time to close a healthy and safe alternative to the violent streets such as tennis courts.

Occupational health The Occupational Health Clinic at SF General will soon be closed. USF students want to know why they should choose to work for a public health system that puts them at high risk for hepatitis B, HIV, back injury, and exposure to violent patients.

Substance use Methadone treatment for opiate addiction is an imperfect clinical intervention, but it’s certainly better than users overdosing on the street or spreading HIV and antibiotic-resistant skin infections by sharing needles. However, methadone treatment is expensive, and an innovative program to bring it to addicts will be delayed for budget reasons.

Access to care While the city’s health plan, Healthy San Francisco, is a laudable attempt to provide optional health care coverage to more residents, the budgets of public health clinics and hospitals that provide the care are being cut back.

Public health nursing San Francisco has pioneered effective programs tackling the disproportionate infant-mortality, asthma, diabetes, and hypertension rates among African American and Latino San Francisco residents. Now the cadre of public health nurses who do this work will be reduced, and Laguna Honda Hospital is being rebuilt with fewer patient beds. Who will monitor and support the disabled and seniors in the community if not the public health nurses?

As public health nurses, we implore our elected officials to protect the most vulnerable while making difficult decisions.

Sasha J. Cuttler

Sasha Cuttler is an assistant professor at the University of San Francisco School of Nursing

Beyond beds

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What do army barracks, prisons, hospitals, and dog pounds have in common? They all have minimum and legally enforceable standards of care, something absent in San Francisco’s homeless shelters. Legislation to fix that problem now appears to be shaping up as the latest political skirmish pitting fiscally conservative Mayor Gavin Newsom against progressives on the Board of Supervisors.

The Board of Supervisors’ Budget and Finance Committee met Feb. 20 to hear testimony and discuss proposed legislation that seeks to impose basic requirements on city-funded shelters, improve complaint procedures, and allow fines for noncompliance (see "Setting Standards," 1/30/07).

Prior to the hearing, dozens of activists, city officials, and homeless people rallied on the steps of City Hall in support of the legislation, holding colorfully painted signs with references to some of the proposed requirements, including "nutritious meals," "clean sheets," and "8-hour-a-day sleep."

Marlon Mendieta, program director at the Dolores Street shelter, took to the podium to make his case for supporting the legislation: "It may seem strange that a service provider would be here to support legislation that will cost money and more time and more work — it’s easy though. It’s an issue of human rights."

The scene was just as lively inside as demonstrators and officials packed the board’s chambers. The committee — composed of Sups. Aaron Peskin, Bevan Dufty, and Tom Ammiano (sponsor of the ordinance) — took testimony, almost all of it urging the committee to pass the legislation on to the full Board of Supervisors for approval.

Dariush Kayhan, who has been on the job for six weeks as the mayor’s appointed homeless policy director, gave the only testimony urging the committee not to pass the legislation.

"This is the part where we have some concerns, the fiscal part," Kayhan said. "Give us more time, maybe we can plow some of these items — the ones we can agree on — into the existing contracts," he said, referring to the contracts awarded to nonprofit organizations who manage the city’s shelters.

While the city’s contracts with shelter providers do spell out many standards, a recent Guardian investigation (see "Shelter Shuffle," 2/12/08) and work by the Shelter Monitoring Committee, which developed the recommendations embodied in Ammiano’s legislation, found they are often ignored with no consequences. The Guardian also found that people are being turned away from the shelters every night despite vacancies.

Mayor Gavin Newsom, in a letter to supervisors obtained by the Guardian, voiced his concern with the fiscal impact of the legislation, citing a $2.4 million price tag, the high end of costs developed by the Budget Analyst’s Office, which said the legislation could cost $1.7 million or even less. Advocates of the legislation are confident they can bring its price down.

The $2.4 million estimate assumes a new security guard will be hired at each shelter to meet safety requirements. The legislation does not specifically mandate new personnel and many argue increased staff training and facility improvements could provide cheaper alternatives.

The Shelter Monitoring Committee, composed of mayoral and board appointees, estimates the cost will be closer to $1 million, which amounts to less than half of 1 percent of the city’s total projected deficit of $225 million.

"This is an investment in a population that has not been invested in in a long time," committee chair Quintin Mecke said at the hearing. "I don’t think there is any reason to wait to make sure people have access to toilet paper, have access to clean conditions, have access to ADA [Americans with Disabilities Act] -compatible beds."

At Ammiano’s request, the committee decided to postpone the vote for two more weeks to try to work out differences with the Mayor’s Office, and set the next hearing for March 5. If the supervisors proceed without Newsom’s support and he ends up vetoing the legislation, it would take the vote of eight supervisors to override and implement the standards anyway.

Newsom and the board have been at odds over homelessness and other budget priorities. Buster’s Place, the city’s only 24-hour drop-in shelter, is now caught in the middle of the political tug-of-war between budget cuts and shelter improvements. There is a provision within the standards of care legislation that mandates a 24-hour emergency drop-in center. At the time it was drafted, Buster’s Place filled this requirement.

However, due to the timing of the midyear budget cuts ordered by Newsom, the Department of Public Health cut off funding for Buster’s, effectively closing the center at the end of March (see "No Shelter from the Budget Storm," 2/20/08). It is now unclear how the requirement will be met if the legislation passes.

"We’re tired of having centers like Buster’s Place on the chopping block," Mecke told the Guardian. "It’s ludicrous to keep going in this cycle over and over again." Buster’s was slated to close six months ago but was rescued by a Board of Supervisors’ budget add-back, and a year before that, McMillan’s (another 24-hour center) was forced shut its doors.

The ordinance seems to challenge Newsom’s recent efforts to whittle back shelter services. It would allocate more funds to a department Newsom is trying to cut and assure the existence of an emergency 24-hour center, a clear departure from Newsom’s recent announcement that he wants to ultimately "get San Francisco out of the shelter business."

The most controversial requirement within the standards of care legislation seems to be its enforcement mechanism, calling for fines of $2,500 levied against the nonprofit service providers for noncompliance. While Kayhan voiced reservations about creating new staff positions to carry out enforcement, the SMC has insisted the fines are crucial and will only be used as a last resort.

"In 2004, the supervisors [created the] Shelter Monitoring Committee because contract compliance was not working," Mecke said. "If there are policies in theory, they should be legalized and should become mandates and be enforced."

Barbra Wismer, the medical director of Tom Waddell’s clinic, which frequently serves homeless men and women, urged attendees at the budget meeting to put politics aside and remember the importance of shelter standards, not just for the current homeless population, but for all San Francisco residents.

"If there was a natural disaster like an earthquake, or a fiscal disaster like increased foreclosures, and 1 to 2 percent of people — 14,000 in San Francisco — had to be put in emergency shelters," Wismer said, "we do not have any standards to protect them."

Tooth and consequences

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It’s two days after Christmas and I’m sprawled out on a plastic-lined chaise lounge, sipping fluoride and waiting for the blood to stop gushing from my gums so the doctors can get back to work. Beyond the noise of drills and X-ray machines I hear grunts from several other patients and the sounds of merchants outside hawking sombreros, sweetbread, bootleg Fendi bags, and pottery. Kind of strange, but I’m not worried anymore. This is my second day at Dr. Rafael Lopez’s dental clinic, and I’m no longer freaked out that it’s nestled among trinket stores and cantinas in a bustling bazaar in Mexico.

I also don’t care that the dentists here speak hardly any English, nor I any Spanish. I mean, it’s not like I’m alone. All the other patients at Dr. Lopez’s office are either Canadian or American, and all the people shopping out front are too. In fact, nearly every person I’ve met on the streets here is Caucasian and an English speaker. We’re all dental tourists, and we’ve come to Los Algodones — a sunny border town near Yuma, Arizona, which allegedly has more dental clinics and pharmacies per block than any other city in the world — to save money. In my case, I’m in for three root canals with posts and crowns for the price of a secondhand scooter on eBay: $1,850, about a third of what I’d pay for the same procedures in the States.

I’d heard about Dr. Lopez’s clinic through a friend of my mother’s, but Los Algodones, like other dental tourism destinations, was easy to find on the Web. In fact, the town’s Web site, www.losalgodones.com, is actually a dental clinic referral network, with pictures of smiling clinicians and graphic before and after shots flashing across its home page. Clinics like Dr. Lopez’s, which often handle 10 to 20 patients a day, are set up exclusively for foreigners. Dr. Lopez estimates that 80 percent of his customers are American and 20 percent are Canadian; most Mexicans in the area can’t afford his rates. Many of them come to towns like this for big-ticket procedures like bridges and reconstructive surgery, some of which can cost more than $10,000 at home.

And they’re coming in increasing numbers. According to HealthCare Tourism International, a nonprofit accreditation and information organization set up to monitor the medical tourism boom, an estimated 1 million Americans will travel abroad this year for some of sort of medical service, up from the National Coalition on Health Care’s figure of about 150,000 in 2004. Of the procedures sought, 40 percent will be dental related. A recent article in the New York Times on the dental tourism phenomenon cited a boom in luxury travel packages designed around dental procedures. A root canal followed by a little fly-fishing in Costa Rica? Why not? The money you save can justify a short vacation.

ROOTS OF THE PROBLEM


Dr. Lopez’s clinic is, hopefully, the end of the road for me. I’ve been struggling with dental problems (and the potential resulting bills) for years. With all this talk of health care reform, you’d think I would have been able to find a decent low-cost US dentist, especially in civic-minded San Francisco. But it just wasn’t happening. For whatever reason, dental care and health care are viewed as two separate issues in the United States. When it comes to diseases, colds, and broken bones, you can usually catch a break, but good luck trying to get your teeth fixed on a budget. The truth is, even if you have some form of dental insurance, which is unlikely — according to the American Dental Association (ADA), only about half of all Americans do — dental care is nearly impossible for average wage earners to afford. At least, I’ve never been able to afford it. And I’ve looked everywhere.

My own dental horror story began nearly a decade ago when the Marine Corps kicked me off my retired father’s lifelong dental plan. I was fine for about a year, until the day I awoke with a terrible pain in my mouth. I was 19 at the time, taking classes at a community college and working at a café — barely able to pay rent, let alone find the time and money for a visit to the dentist. So I did the next best thing: simply ignored the pain, staving it off with copious amounts of ibuprofen when it got intense. The over-the-counter denial did the trick for almost two years, but I knew I would be forced to eventually bite the bullet, however softly.

And then it happened. My teeth started breaking. Not hurting, at least no more than usual, just breaking off — in huge, gray chunks.

This went on for years. By the time I was 25, four of my teeth had shattered and the rest seemed well on their way to doing the same. I adopted the diet of a five-month-old, unable to chew anything tougher than bananas or scrambled eggs. It was time to act, but I had no idea where to go. As a full-time student, getting by on financial aid, loans, and whatever I could rake in as a part-time waiter, I was nearly destitute. I’d recently transferred to San Francisco State University, but at that time, in order to purchase the student dental plan the school offered, I also had to purchase its medical plan, a combination that would have increased my monthly bills by nearly $200.

It was tempting, particularly in comparison with most employer-related or individual plans I qualified for, which could run into the thousands. But SFSU’s dental plan screened out existing problems, like the trainwreck I had going on, and carried an annual cap of less than $1,000. (Unlike medical insurance plans, which feature deductibles, most dental plans have annual monetary ceilings.) So even with the plan I would still be unable to afford even a fraction of the work I needed to have done. Since my student days, SFSU has implemented a dental-only plan available to undergrads, but often the limits are too low to cover anything other than cleanings and fillings.

Thus I began my search for a pro bono dentist, figuring that with all the uninsured people living in the city there must be someone around. It quickly became clear, however, that scoring free dental is harder than finding a decent vegetarian restaurant in rural Alabama.

QUEST FOR DENTAL


First, I had a glimmer of hope: a medical and dental clinic in Berkeley that had the word free in its name.

The Berkeley Free Clinic (BFC) has been offering free medical and dental care to the hard-up since 1969. It provides free HIV tests, medicine, preventative education, and more. But I needed dental work — and that was another story. As the only clinic in Northern California offering free fillings, extractions, and referrals to discount dentists, BFC is insanely popular. And since it’s run by volunteers and donors, it’s also chronically understaffed. Jessica Hsieh, a clinic coordinator, explained that the facility does as much as it can with limited resources. "We used to take patients on a first-come, first-served basis," she says. "But there were so many people lined up every night that our waiting room and hallway became fire hazards."

To deal with this problems, the clinic has devised a maddening selection system, which includes spotty business hours and a name-in-the-hat-style lottery. It sounded a little sketchy, but I gave it a go.

After making the 45-minute commute from my home, I arrived at the clinic at exactly 5:30 on a Monday evening. I scribbled my name on a small slip of paper, handed it to the receptionist, and took a seat in a waiting room crowded with students, broke workers, and homeless people. A nurse came out and told everyone to sit tight; the dentists were taking our names into a separate room and she’d return soon with their random choices. Ten minutes later, she came out again, read off three names, and then told everyone else to go home.

The room had been quiet as we all waited to see who’d won, but when a young blond girl with designer jeans and a fancy cell phone rose to claim her prize, the atmosphere became tense.

"That’s fucking bullshit," said a man with dirt on his face and ripped boots. "I’ve been coming here for weeks. This is her first fucking time!"

One of the dentists apologized and reminded us that we were welcome to keep trying as many times as we liked. I took his advice and returned three more times, missing a day of study or work for every fruitless visit until I gave up. One of my teeth in the back had started aching like hell, and I couldn’t stomach the wait any longer.

I broadened my search to include dental schools like that at the University of California San Francisco, where the wait times were rumored to be long, but once on the list, getting work done was guaranteed. After talking to students at the UCSF clinic, though, I realized treatment would require several days off from work and school because each step a student made during surgery would have to be approved by a busy professor and analyzed by other students. And the discount wasn’t exactly phenomenal.

The average cost of a single complete root canal procedure (root canal, post, and crown) at UCSF is more than $1,100, almost twice the amount I wound up paying in Mexico and way more than I could afford at the time.

So I scrapped the dental-school idea and dug deeper, figuring that if I couldn’t find free or cheap dental work, I could at least find a place that offered a payment plan. And I did find such a place.

Western Dental is like the McDonald’s of dental clinics. With multiple locations in almost every city in California, it’s effectively cornered the market on affordable dental work. Only it’s not cheap. A complete root canal procedure on one tooth can cost up to $1,590 — a lot less than a regular dentist, but much more than a dental school and about three times as much as Dr. Lopez charged me in Mexico. People flock to Western Dental because it lets you pay off your dental work like you would a car. You plunk down $99 for a yearlong membership, make a 20 to 30 percent down payment, and then pay the rest off monthly over the course of one year. And Western Dental doesn’t take your credit history into account when working out a plan.

Out of desperation, I eventually did get one of my teeth fixed at the Mission and 24th Street location, and wound up paying a $350 deposit and monthly installments of $110 for the next 12 months.

CAVITY CAVEATS


With my most painful tooth taken care of, I could now focus on finding a better deal, which is how I wound up in Mexico. So far it seems to have been a pretty smart decision. My new teeth look great and they’re holding up fine. I was treated extremely well by Dr. Lopez’s staff. But there are many reasons not go to Mexico for cheap dental work. And Brad Hatfield, a Korean War vet and retired city planner from Arizona City who asked that I not use his real name, knows them all.

Hatfield has been making the three-hour trip to Los Algodones for nearly a decade. He’s seen the town evolve from a haven for cheap trinkets and booze into what it is now: a medical resort for Americans with expensive tooth and eye issues. Hatfield started going to Los Algodones when he realized that even with his insurance he’d never be able to afford necessary dental work. But now, many years and thousands of dollars later, he’s learned his lesson.

"The problem with dentistry in Mexico," says Hatfield, "is that there’s no recourse. If something bad happens, you can’t sue anyone. All you can do is ask for your money back." And that’s just what Hatfield did when he returned from Los Algodones recently and discovered that his new teeth were worthless. Indeed, he claims that almost none of the work he’s gotten in Mexico has held up longer than a year or so.

This last time was the worst. "As soon as I got home," says Hatfield, "my gums started hurting really bad and bleeding off and on." When he called his clinic to complain, they denied his request for a refund and invited him back for some discounted work instead. Hatfield went back, got the work done, and thought his problems were over. But a few days later he realized they weren’t. "I was sitting here eating a piece of chocolate, and all of a sudden I realized I was chewing on two of my teeth and the bridge that was connecting them. All the work they had done had just fallen out."

Hatfield has tried repeatedly to get his dentist to refund his money back, but all he gets in response are invitations to return for more work. "Now they want to just rip all my teeth out and give me a full set of implants. It’s going to cost thousands of dollars on top of the $10,000 I’ve already spent there over the past year."

Hatfield is currently trying to get his problems fixed at a dental college in Mesa, Arizona, but he’s facing steeper prices and will probably have to return to Mexico soon. "My dental and medical problems have ruined me as a person," he says. "I can’t get a job because my teeth are so screwed up, and I can’t think through all this pain. I just don’t understand why dental work is so expensive. It’s much worse than medical."

THE BIG YANK


Hatfield brings up a good point. For some reason dental issues aren’t included in national or local debates about health care. Healthy San Francisco, the universal, citywide health care access program operated by the San Francisco Department of Public Health, doesn’t cover access to dental services, which were never even considered for inclusion. When reached by the Guardian for comment on this exclusion, SFDPH spokesperson Eileen Shields stressed the difference between the city’s program and regular insurance plans, saying "[Healthy San Francisco] is a health access plan, providing access to basic medical care. I mean, my health plan doesn’t even include dental — does yours?"

Denti-Cal, the state dental insurance program offered as part of Medi-Cal, is an option for California residents with a low income, a social security number, and at least one child. But it obviously doesn’t help the throngs who fill the waiting rooms of Western Dental. San Francisco General Hospital keeps an oral surgeon on call for extreme emergencies but if you want your janked-out teeth replaced or aren’t doubled over in chronic pain, SF General can’t help you.

It doesn’t look like any of this is changing soon. None of the candidates running for president this year has announced a platform that specifically deals with the high cost of dental care in America. Why? Why are medical and dental issues treated as two separate entities? And why is it so hard to afford dental treatment even with insurance?

Hsieh of the BFC thinks it may have to do with the fact that dental issues aren’t thought to be as life-threatening as medical issues. But if an infected tooth is left untreated, it can lead to death just as surely as unchecked pneumonia. On its Web site, the ADA acknowledges the high cost of dental insurance but privileges prevention over treatment, claiming that most dental problems are preventable. If Americans would just take care of their teeth, use their paltry insurance plans for routine checkups, and quit eating so much candy, they wouldn’t have to get root canals. But I brush after meals, floss regularly, and stay away from sweets — and I’ve been in and out of dental clinics with major problems since I was five.

Another theory has to do with the high costs of dental school and specialized equipment, which makes sense. But the truth of the matter, commonly pointed out in the ongoing health care debate, is that mixing profit with patients is a recipe for disaster. As long as insurance companies are able to make billions by fleecing their customers, and as long as dental clinics and drug companies are allowed to set their own prices, the general population is going to be cavity ridden and kind of ugly.

For now, it seems dental tourism may be the best option for people with normal-to-low incomes and chronic problems. Two months after my visit to Mexico, my teeth feel much better and I’m back on solid food. But this kind of travel isn’t for the fainthearted. The weather and food in Los Algodones are great. But getting your teeth ripped out and reconstructed in a foreign country with no legal recourse is dangerous and scary, especially during the high-traffic winter season when the tendency to rush through patients escalates.

My triple root canal, for example, took a mere two visits. The doctors hacked away for 10 hours straight, let me heal for one day, and then stuck on the crowns and pocketed my check. I stumbled out of Dr. Lopez’s office a few days before New Year’s, in a Novocain-induced daze, with blood on my shirt and pieces of rubber molding stuck to my cheeks. My jaws and head ached as I shuffled through the mile-long border-crossing corridor, sweating and dry-heaving.

As I approached the checkpoint, I wondered if I had made the right choice.

Then I remembered that I hadn’t actually made one. It was this or nothing.

Emma Lierley contributed to this report.


>>View a video interview with a Canadian dental tourist

No shelter from the budget storm

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Arriving at the steps of Buster’s Place on a cold night is a familiar, comforting act for many of the city’s chronic homeless people. Or rather, it was until recently, when a sign was posted informing clients the facility will be closing its doors for the first time in almost a year.

Buster’s Place, the only centrally located 24-hour drop-in center in San Francisco, is on the chopping block to meet the demands of one of the city’s most drastic midyear budget cuts in recent history. The $1 million cut (roughly the one-year operating cost of Buster’s) is only a piece of the $9.25 million the city’s Department of Human Services must trim from its annual spending.

Buster’s has logged more than 34,000 visits from an estimated 700 clients in the past year. The center serves all walks of life, from lonely elders to those who cannot manage the complex shelter reservation system to newcomers who don’t know where to turn. While staff and resources are limited, Buster’s provides easy access to essential facilities like showers, bathrooms, and laundry rooms. It’s the stop of last resort, as I learned during my recent undercover investigation (see "Shelter Shuffle," 2/13/07, and "Search for Shelter," on the Guardian‘s SF blog).

"There’s a need for this place," Louis Ramon, who is the only case manager working at Buster’s and has been at the center since it opened, told the Guardian. "This is where the too sick, the too paranoid, the too mentally ill come who cannot be housed. Nobody is working with these clients — the really hardcore ones."

Jennifer Friedenbach, the executive director for the Coalition on Homelessness, has been a leading advocate for 24-hour homeless centers and is pressuring city hall to reinstate funds to carry Buster’s through the end of the year.

"It’s frustrating when the mayor makes random and arbitrary decisions without consulting relevant community-based organizations or the homeless themselves," Friedenbach told us. "This is another attempt by the mayor to put a nail in the coffin of overnight shelters."

In a Feb. 14 press conference Mayor Gavin Newsom held with Dariush Kayhan, his newly appointed homeless czar, Newsom discussed plans to redesign the city’s shelter system, as well as the midyear budget cuts. "We’ve got a lot of resources that are being spent, but they could be spent more wisely by coordinating strategies," he said.

"With respect to 24-7 access, we’re going to have that with the [Mobile Assistance Patrol] vans, to ensure that people still have that. People can, in rare instances, come to the shelters directly if they’re in a dire emergency and access a bed if needed," Kayhan said. "And we also want to engage those folks because we don’t think sitting in chairs, around the clock, at night — and especially since a lot of those folks are seniors and disabled — that’s not a proper place to be."

Less than five months after it opened last year, Buster’s was slated to close during the regular fiscal-year budgeting last June. Homeless advocates came to Buster’s rescue and had the Board of Supervisors reinstate most of the funding for the center.

However, many homeless advocates and Department of Public Health officials are less optimistic about this round of budget reductions. For one thing, midyear cuts are generally more reactionary, made with little public deliberation, and made because the deficit is bigger than expected.

"This year is much different because the amount of money we need to cut is much more severe," said David Nakanishi, coordinator for community programs at the DPH and responsible for spearheading the planning of Buster’s Place. "Last year Buster’s was the only cut being made to homeless programs, so the community could rally around that one issue. The fiscal situation is much more dire this year. The supervisors will probably not reinstate the money."

Sup. Chris Daly, whose District 6 includes Buster’s Place, isn’t optimistic. "I will fight, but I won’t be successful," he told us, referring to his reduced power on the board after being removed as chair of the Budget Committee last year. "The cut list resembles very closely the list of board priorities from last year. The board cannot compel the mayor to spend."

Over the past year, Buster’s Place has had an uncertain future. The center was created after the temporary closing of the McMillan Drop-in Center, the city’s previous 24-hour drop-in center, at 39 Fell Street. Homeless-rights advocates campaigned for the creation of a 24-hour facility until Daly lobbied the DPH to keep an all-night drop-in center open. The city then contracted the Haight Ashbury Free Clinics to open Buster’s.

However, since the DPH established the center on a short timetable, it did not follow standard procedures for awarding the contract. The DPH is now going through a request-for-proposals process for a 24-hour drop-in center. Of course, if the midyear cuts are approved, this process will stop.

During a night at Buster’s, visitors can count on a few things: hard plastic chairs, restless sleep (if any), and good conversation with familiar faces. While Buster’s provides 24-hour shelter, it also serves as an important social hub for the homeless community. Elisa Frank, who handles shelter reservations through the city’s CHANGES system at the 150 Otis Street administrative office, sends up to 60 people per night to wait for beds at Buster’s.

"Buster’s is a community for a lot of people. They want supervision so they’re not just on the street doing dirt. Some people even have houses. Some who are in [single-room occupancies] and even some who just live alone come to Buster’s just for company," she told us.

One 31-year-old homeless client at Buster’s told us he has been in and out of shelters and illegal housing for most of his life. He has been staying at Buster’s occasionally over the past year and hopes to get his own apartment.

"When I don’t have a place to stay, I get suicidal," he told the Guardian on a chilly night outside Buster’s. "More people are going to die on the street if this place closes."

Solo budgeting

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› sarah@sfbg.com

Mayor Gavin Newsom is giving his department heads until Feb. 21 to draw up a list of services and positions to be reduced and eliminated, but Board of Supervisors president Aaron Peskin notes this isn’t how city government is supposed to work.

"Technically, things aren’t being cut," Peskin told the Guardian. "Instead, the mayor is signaling that he is refusing to spend the money that has been appropriated by the board in the budget that was voted on and signed last year."

Last summer the Board of Supervisors used the add-back process to appropriate funds the mayor hadn’t sought, thus funding services such as the Workers Compensation Clinic at San Francisco General Hospital and Buster’s Place, the city’s only 24-hour homeless shelter, until the end of fiscal year 2007–08.

But now these same services are being targeted midyear. The mayor announced last November, shortly after he was reelected, that the city faces a projected $229 million budget, so he was demanding an immediate hiring freeze and across-the-board cuts.

As mayoral spokesperson Nathan Ballard reportedly told the San Francisco Chronicle last fall, "Although he wants to trim the fat, the mayor made it abundantly clear he doesn’t want to see a reduction in people sweeping streets or police officers walking beats."

But while city department heads spent the past few months trying to tighten belts, the mayor apparently expanded his, according to budget analyst Harvey Rose’s Feb. 13 report, which details the monetary impact of changes to Newsom’s staff — changes the mayor first announced Jan. 4.

"Don’t think that the irony of the revelations that have been made over the past few weeks has been lost on anyone," Peskin told us, referring to how Newsom added two entirely new positions, increased the pay of senior staff and newly appointed department heads in the Mayor’s Office, and raided the budgets of other agencies to pay for it all.

According to Rose’s report, the budgetary impact of Newsom’s staff changes amounted to an increase of $553,716, with other city departments funding about $1.34 million in annual salaries and benefits for 10 positions assigned to the Mayor’s Office.

These include two newly created jobs — namely, the mayor’s climate change director, Wade Crowfoot, and the mayor’s homelessness policy director, Dariush Kayhan.

Peskin admits that the spending Rose identified is a relative drop in the bucket, compared to the city’s $229 million deficit. "Yes, it’s not enough to significantly close the gap or save a significant number of services, but it’s symbolic," Peskin said, noting that even as homeless shelters are being fingered for elimination, the Human Services Agency is paying $169,624 annually for the mayor’s new homelessness policy director.

"And when voters approved more money for Muni, the mayor used it to hire people to pound out messages about climate change, when the best way to reduce greenhouse gases is to get people out of their cars," Peskin said, referring to Newsom’s new climate change director, hired at an annual cost of $130,112, using the Municipal Transportation Authority’s Safety and Training funds.

"It’s very frustrating and unfortunate," Peskin said, further noting that the $401,392 to terminate Susan Leal without cause as general manager of the San Francisco Public Utilities Commission will come from the city’s water fees.

"This is indicative of the misplaced priorities of the mayor," said Peskin, who doesn’t deny that spending control is required in the face of a looming deficit but resents how the mayor has been trying to do it unilaterally and not in cooperation with the board.

"The budget, by design, is a two-way street," Peskin observed.

Sup. Chris Daly claimed the services being targeted for Newsom’s midyear elimination are "a who’s who of the board’s priorities…. These are human and health services that the mayor has proposed be cut multiple times."

Daly’s legislative aide, John Avalos, who is running for District 11 supervisor, notes that while Daly wanted $33 million for affordable housing, a onetime amount, the mayor took a budget surplus and used it for multiple years, with the police, firefighters’, and nurses’ contracts accounting for his biggest expenditures.

Asked why the city’s deficit has ballooned by $144 million — from the $85.3 million the Controller and Budget Analyst’s offices identified in March 2007 to the $229 million that Newsom’s administration was suddenly projecting last fall — Tom DiSanto, budget and revenue manager for the Controller’s Office, cites an extra $82 million in salaries and benefits.

These include the four-year contracts that nurses and police and fire departments secured last summer, along with five extra police academies, said DiSanto, who also listed $7 million in police crime laboratory debt service, $7.4 million for sheriff inmate housing (required by last year’s Supreme Court order that prisoners can’t sleep on floors), and the $29 million transit set-aside that voters approved last November when they passed Proposition A.

But as DiSanto explains, the city’s budget problem is due not to lack of revenue but to baseline funding and rainy-day reserve requirements, not to mention the political process.

"Right now, with baselines and reserves, 96¢ out of every dollar goes into set-asides, and we’re required to adopt a balanced budget," DiSanto said. "That’s where the cuts come in. If we could access all the city’s revenues, we wouldn’t have a $229 million projected deficit," he added, noting that revenues are up, property taxes are higher than budgeted, and the hotel tax continues to be strong.

Ken Bruce, senior manager at the Budget Analyst’s Office, notes that unlike the federal government, the city of San Francisco has to balance the budget. He also says the current deficit projection comes from the Controller’s and the Mayor’s offices, not the Budget Analyst’s Office.

"In mid-March we get to do a joint forecast," Bruce told the Guardian. "It may paint a better picture, less of a doomsday scenario, but it still leaves us facing difficult policy choices. [The deficit] won’t drop from $230 million to $100 million."

Peskin envisions several long-term solutions, hopefully including positive changes in the White House this fall.

"With every passing year, as the federal government has abandoned the cities, we’ve taken more of a burden, and labor and capital costs have increased," says Peskin, who is mulling changes to the real estate transfer tax and closing a loophole whereby lawyers and accountants in limited liability partnerships have escaped paying payroll taxes.

That said, Peskin sees no easy fixes in the city’s upcoming budget hearings:

"It’s a fluid situation, and it’s all bad."

Mayor announces nothing

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Homeless policy director Dariush Kayhan and Mayor Gavin Newsom

Mayor Gavin Newsom announced a new plan to redesign the city’s homeless shelters this morning.

The press conference was held at Multi-Service Center South, one of the largest homeless shelters in the city, and addressed a small crowd of journalists and shelter staff. There didn’t appear to be any homeless people in the room (unless some of the staffers are also homeless, which is possible. The shelters are required to have homeless or formerly homeless individuals account for 25 percent of their employees.)

After a rambling introduction recounting the various perennial problems with homelessness in San Francisco, Newsom got to the point and said he’d like to import the Project Homeless Connect model into two shelters – MSC South and Next Door – so that clients would be able to one-stop shop for services. “The idea is putting a smaller version of Project Homeless Connect in these two shelters so we’re here seven days a week and to look at the medical side of the equation,” said Newsom. He also said he hopes that one day all the shelters, excepting these two large facilities, are closed for good. “Eventually, I can’t wait until these are the only two shelters remaining in the city and every single other one of them is shut down,” said Newsom.

As for revamping the two remaining shelters, the medical side of the equation would be a respite center, Kayhan clarified, which is curious, since Next Door shelter already has an entire floor of their four-floor building devoted to respite. I recently visited that facility and spoke with Cynthia Lee, a registered nurse, who told me they can only take patients who come out of the hospital. “The idea is to stabilize them, then transition to a bed or room,” she said. If someone on another floor (in this facility which houses 250 people) is having health issues they can’t go there. “I, personally, would like to do that but Next Door has their own clinic – out of Tom Waddell Health Center. It’s not open every day,” Lee said.

In other words, there’s a fully provisioned respite center in a high volume shelter, and the clients there are not allowed to access it. I asked Kayhan if they’d be looking at opening up the facility to the greater shelter population, but he wasn’t able to give me specifics.

Which is true of the entire press conference: no specifics, though a number of questions immediately come to mind.

Homeless people share their stories

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by Amanda Witherell

Note: Though much of the investigation for Shelter Shuffle: Inside San Francisco’s confounding system of housing the homeless was done undercover, the following profiles are of people who shared their stories with me after being informed that I was a journalist.

Ruby-1.jpg
RUBY WINDSPIRIT

Ruby Windspirit has been homeless since Jan. 14, and her first shelter experience, at A Woman’s Place, was not good. “I felt safe only because I know I can take care of myself,” she says, “But the women who were mentally handicapped did not. Their biggest concern was getting thrown out on the street.” She describes instances of shelter staff asking clients to fetch food from the store in exchange for not getting written up when they broke the rules. “I was really upset at that,” she says. “It was only certain members of the staff that did that.”

“The first night I was there I said, ‘Can I have a towel so I can take a shower?’ They gave me three heavy duty paper towels and said I had to give them back because they reuse them.” Windspirit describes the towels as thick paper, like the kind mechanics use to wipe oil dipsticks. She did what she was told and gave them back when she was done.

Windspirit has bone cancer, but when she asked for an extra blanket and a thicker mat to cushion her 59-year-old body from the floor, she says staff turned her down.

“I was getting sicker and sicker there. Finally I ended up in the emergency room,” she recalls. “The doctor who visits a Woman’s Place saw me and said, ‘What are you doing here? You don’t belong here.’ I said, ‘I don’t know the system.’” The doctor sent her to Tom Waddell Health Center, which referred her immediately to the hospital for emergency care.

Team Newsom’s $$$ value. More or less.

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Before we get to the juicy details of how much money Team Newsom is taking home, it’s worth noting that Mayor Gavin Newsom spent last Friday handing out draft copies of the report in which these figures can be found–a report that Budget Analyst Harvey Rose drew up at Sup. Jake McGoldrick’s request to figure out the impacts that staff changes within the Mayor’s Office would have on the City’s budget–changes Newsom announced Jan. 4.

It’s also worth noting that Rose didn’t know that Newsom Chief of Staff Phil Ginsburg was standing around last Friday telling the press that his report was a piece of “bull-.”, until the press called him later that same day and asked him for a comment.

And that all this unauthorized report distribution and undefended “bullshit” calling was happening just five weeks after Newsom announced that the City is facing a $229 million budget deficit and that therefore the city must implement an immediate hiring freeze and across-the-board departmental budget cuts.

Unlike Sups. Chris Daly or Aaron Peskin, who are more typically the targets of the mayor’s famously snippy wrath, Rose isn’t a politician, but a widely respected analyst, and so Team Newsom could hardly accuse him of “political theater”.

Instead, Ginsburg told the Chronicle that, “The budget analyst has no understanding of how salaries work in this city,” while Newsom made the vague claim that, “It’s personal.”

But however much they tried to put a negative spin on Rose report, Team Newsom could not deny that it paints an unflattering picture of the Mayor’s Office as a place that is using over $1 million from other departmental budgets to make new hires and increase the salaries of staff that are assigned to the Mayor.

As Rose reports “The Mayor’s practice of including positions assigned to the Mayor’s Office, but funded in the budgets of the Municipal Transportation Agency, the Human Services Agency and the Planning Department Budgets, understates the Mayor’s Office’s budgeted and actual costs for such positions, while such costs are overstated in those three other Departmental budgets.”

Rose’s report found that

a) The estimated total increased annual salary and fringe benefits costs of the 17 newly-appointed department directors to replace existing directors, and the ten Mayor’s Office staff appointments, two of which are completely new functions, are $553,716.

b) Other City departments fund about $1.34 million in annual salary and fringe benefits for ten positions assigned to the Mayor’s Office, including the mayor’s new climate change director Wade Crowfoot and new Homelessness Policy Director Dariush Kayhan.

c) The costs of appointing Ed Harrington, as General Manager of the SF Public Utilities Commission, Ben Rosenfield as Controller, Mirian Saez, as Interim Director of the San Francisco Housing Authority, and Jordanna Thigpen, as Acting Director of the Taxi Commission have yet to be announced.

d) Terminating Susan Leal, General Manager of the SF PUC, without cause, as is Newsom’s stated intention, will add a further $401,392 to City costs.

e) the mayor’s Office is also recruiting for a replacement to the CityBuild Director, at a cost of $144,596.

In face of these dicey accounting practices, Rose suggests that the Board of Supervisors rescind funding for positions assigned to the Mayor’s Office but included in other departments’ budgets, and the cost of these positions, estimated to be $898, 718, could then come from the Mayor’s General Fund monies.

The Board, says Rose, could also eliminate MTA funding for Mayor’s Office positions which do not directly benefit the MTA’s core functions. Those positions could then be funded, Rose reports, to the tune of $240,943, from the Mayor’s Office’s General Fund monies.

Rose’s report also notes that, “The newly appointed Climate Protective Initiatives Director is a new function unrelated to the MTA’s Safety and Training Unit,” even though the position if currently being funded through monies set aside for that unit.

And now, here are the figures, taken directly from Rose’s report, which show who, on Team Newsom, is making more or less, compared to previous directors and appointees:

Team Newsom t heads making more than Predecessors (the “Gimmee More” gang)

Kevin Ryan, Mayor’s Office of Criminal Justice: $160,862—$42,848 more.

Joyce Hicks, Director Office of Citizen Complaints: $$171,262—$42,276 more.

John Rahaim, Director Planning Department, $210,000—$34,422 more.

Michael Cohen, Director Mayor’s Office of Economic And Workforce Development,
$193,570—$33,930 more.

Mike Farrah, Director Mayor’s Office of Neighborhood Services: $120,900—$28,340 more

Adrienne Pon, Director Mayor’s Office of Community Development: $143,123—$12,993 more.

Luis Cancel, Arts Commission Director: $140,000—$8,648 more.

Chris Iglesias, Director Human Rights Commission: $149,058—$3,146 more.

Team Newsom members making less than Predecessors:

Ed Reiskin, Director, Department of Public Works: $195,000—$25,419 less

Fred Blackwell, Director, SF Redevelopment Agency: $178,724—$18,000 less

Nancy Alfaro, Director, 311, $149,058—$15,942 less

Micki Callahan, Director, Human Resources, $195,000—$9,672 less.

Anita Sanchez, Executive Director, Civil Service Commission, $128,752—$6,986 less.

Cristine Soto-DeBerry, Mayor’s Liasion to the Board of Supervisors: $91,000—$6,084 less.

Appointments to New Functions

Dariush Kayhan, Homeless Policy Director, $169.624
Wade Crowfoot, Climate Protection Initiatives Director, $130,112

Appointments to Existing Functions

Nancy Kirschner Rodriguez, Director of Government Affairs, $143,123—$19,207 more.

Dwayne Jones, Director of Community Engagement and Communities of Opportunity: $143, 123—$14, 371 more.

Catherine Dodd, Deputy Chief of Staff for Health and Human Services: $143, 123—$4,513 more.

Maya Dillard-Smith, Violence prevention Director, $91,520—$4,342 more)

Astrid Haryati, Greening Director, $111, 228—no change.

Jason Chan, Mayor’s Liasion to Commissions, $81,276 ($13,442 less.

Erin Hicks, State and Federal Affairs, tba.

The Salary ‘To Be Announced” Gang.
Ed Harrington, General Manager, SF PUC—tba
Ben Rosenfield, Controller
Mirian Saez, Interim Director, SF housing Authority,
Jordanna Thigpen, Acting Director, Taxi Commission.

Five Days Homeless: The Journals

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MSC South, one of the city’s largest homeless shelters

by Amanda Witherell

DAY ONE – Wednesday, January 16, 2008
Multi-Service Center South, 525 Bryant Street

In San Francisco, you’re not supposed to just walk into a homeless shelter and get a bed, but I decide to give it a shot.

The woman behind the counter wants my “last four.” I have no idea what she’s talking about. She clarifies – of my social security number.

“I don’t think you’re going to find me in the system,” I tell her.

“You’ve never been here?” She says with surprise. She sets up an account for me, with my name, SSN, and date of birth. (Later, I discover I’ve been listed as male — something one of her co-workers kindly fixes.)

I’m told they only have beds at Ella Hill Hutch – do I know where that is? I shake my head no. She passes me off to another staffer, named W. who looks at the clock and decides he’ll “drop beds” and see if they can get me in here tonight instead. He goes through the reservations and identifies the no-shows who haven’t turned up in time for curfew at 6:30. The rule is simple: miss curfew, good-bye bed.

Shelter shuffle

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EDITOR’S NOTE Guardian reporter Amanda Witherell and intern Bryan Cohen spent almost a week staying in various San Francisco homeless shelters. To get an unfiltered look at the conditions, they didn’t identify themselves as journalists, so some names in this story have been changed to protect people’s privacy. Their undercover reporting was supplemented with extensive research and on-the-record interviews with key officials, providers, and recipients of homeless services.

>>Read Amanda Witherell’s nightly shelter journals, with photos

>>Read Bryan Cohen’s nightly shelter journals, with photos

>>Homeless people share their stories

>>The mayor’s Feb. 14 press conference about homeless shelters

It’s about quarter past seven on a Thursday night, and I’m late for curfew. Not even during my wildest high school days did I have to be home by a certain time, but tonight, 29 years old and sleeping in a homeless shelter, I’m supposed to be in by 6:30 p.m.

Heading down Fifth Street toward the shelter, I wonder what I’ll do if I lose my bed for being late. Can they set me up at a different shelter? Will I have to head back to a resource center in the Tenderloin or the Mission District to wait in line for a reservation somewhere else? Either way, I could be walking the streets for the next few hours, so I adjust my heavy backpack for the journey. Waiting to cross Bryant Street, I stare up at the large, hulking building with its utilitarian name, Multi-Service Center South, and notice there are no shades on the windows in the men’s dorm. Since it’s lit from within, I can clearly see someone standing beside his cot, clad in nothing but blue plaid boxers, obviously unaware that he’s so exposed. I wonder if the windows would be shaded if it were the women’s room. Maybe that’s why we sleep in the basement.

Inside the door I shed my pack and step through the metal detector. The security guard dutifully pats it down and pushes it back into my arms. At the desk I give the last four digits of my Social Security number and am checked in. No questions about being tardy. I’m in.

I’m also late for dinner. A staffer hands me two unwrapped sandwiches from a reused bread bag under the counter. Ham, mustard, and American cheese between two pieces of cheap, sliced bread. After two days in the shelter I still haven’t seen a piece of fruit or a vegetable. I wrap the sandwiches in the newspaper under my arm and head down to my bunk. On the stairs I pass a guy and nod hello. He nods back, then calls out, "Hey, can I ask you something?"

I turn. "Sure."

"What’s a nice girl like you doing in here?"

I shrug and step back, unsure of what to say.

"I’m not trying to mess with you," he says. "I’m not fucking with you. I don’t do drugs. I’m straight. I don’t mess with anything," he goes on, trying to reassure me.

I believe him and dish it back. "Then what’s a nice guy like you doing in here?"

He laughs and shrugs. He tells me he doesn’t really stay here. It’s just for a couple of days. He lives in a $200 per week hotel in Oakland, but if he stays there more than 28 consecutive days, it becomes residential and the rates go up, so he clears out for a few days every month and comes here. The hotel’s nicer than this, he claims. It’s clean and safe, and he has his own space. "I can walk around in my underwear," he says.

We sit on the stairs, talking about how you lose all your privacy when you stay in a shelter, how the regimentation is reminiscent of prison. There are no places to go and be on your own, rest, and be quiet. Once you’re in for the night, you can’t leave except to step out for a smoke.

I ask if he has a job. He tells me he’s a chef for Google. I raise an eyebrow, recalling that the company’s stock is hovering somewhere between $600 and $700 per share right now. The pay isn’t the problem — he gets $16 an hour, but he’s been out of town for a while, caring for a sick family member, and has just returned. He got his job back, but only part-time, and he lost his home.

He’s wary of being on welfare — that’s not the way his mother raised him — but he’s in the County Adult Assistance Program, which gets him $29 every two weeks, a guaranteed bed at the shelter, and a spot on a waiting list for a single-room-occupancy hotel room, the bottom rung on the permanent-housing ladder.

What he really wants is a studio, but his searches haven’t turned up anything affordable. He needs a little boost of cash for a security deposit on an apartment, but when he asked the General Assistance Office if it could help him out with that, the answer was no.

His brow furrows with concern, and then the conversation turns to me. "You got a job?" he asks.

What can I say? I’m a reporter for a local newspaper. I’ve heard that some of the city’s homeless shelters are lacking basic standards, accessing a bed can be complicated, and services are scattered. I thought I’d come find out for myself.

Here’s what I learned: San Francisco has a cumbersome crazy quilt of programs, stitched together with waiting lists and lines. Policies that are written on paper and espoused in City Hall are often missing in shelters. Some rules don’t seem to exist until they’ve been broken. Others apply to some people, but not all. Getting a bed is a major hurdle, and I say that as a stable, able, mentally competent, sober adult.

And once you’re in, it’s sort of like sitting in a McDonald’s for too long. Years ago a friend told me the interiors of fast food restaurants are deliberately designed to make you feel a little uncomfortable. They don’t want you to get too cozy; they want you to eat and leave, making way for the next hungry mouth they can feed.

In other words, shelters are designed to make people not want to use them.

The only information I took with me was a one-page handout I got from a San Francisco Police Department Operation Outreach officer. He said it’s what cops and outreach workers give to people they come across who are sleeping on the streets. I figure if it’s good enough for them, it’s all I need to navigate the system.

The map, as it were, is a cramped, double-sided list of places to get free meals, take showers, store your stuff, sober up, and, of course, get a bed.

For the bed, it instructs, you have to go to a resource center and make a reservation. Some of the resource centers are also shelters. Some aren’t. Some are just reservation stations. They all have different operating hours and are located all over the city, but mostly in the Tenderloin and South of Market.

It takes me a while to puzzle out which ones are open, where exactly they are, then which is closest to me. Phone numbers are also listed, so I assume it’s like making a hotel reservation and dial one up on my cell phone.

The first number doesn’t work. There’s a digit missing. Dialing methodically down the list, I discover that none of the numbers connect me to a person. This is obviously not the way to go.

The way I ultimately get into a shelter is not the way you’re supposed to. In San Francisco’s system, you’re not supposed to just walk up to a homeless shelter and get a bed, but that’s what I do.

At first the woman behind the counter at MSC South tells me the only open beds are across town, at Ella Hill Hutch in the Western Addition. Then another staffer looks at the clock and says he’s not sending me out there. He’ll "drop" beds instead.

The city’s 1,182 beds for single adults are managed through an electronic database called CHANGES. It’s a modern-day improvement on people roaming from shelter to shelter everyday, putting their names on lists for possible beds. Launched in 2004, CHANGES now does that electronically and maintains profiles of people who use the system. If you’ve been kicked out of a shelter, missed your tuberculosis test, or not shown up for curfew, CHANGES knows and tells on you.

Every day around 8 p.m. shelter staff trawl through the reservations and drop the no-shows, cancellations, and reservations that have expired or whose makers have moved on to hospitals, rehab, the morgue, or — less frequently — housing.

MSC is allowed to make reservations for any shelter except itself — that’s against policy. I learn this the next morning, and I’m told it’s because there’s too much corruption and favoritism. MSC is apparently one of the better shelters, so to keep clients from cutting deals with staff, the policy doesn’t allow clients to reserve a bed there.

But after half an hour the staffer hooks me up for a two-night stay, bending the rules to do so. While I’m waiting, he turns away a client who had a seven-day bed but didn’t show up the previous night. The guard confiscates his fifth of vodka, and he gets an earful about drinking.

When the city’s shelter system was born in 1982, it was first come, first serve at the doors of churches and community centers. President Ronald Reagan’s cuts to federal domestic spending landed hard on low-income people, so then-mayor Dianne Feinstein called on local organizations to temporarily house and feed the growing number of street sleepers.

Throughout the ’80s wages stagnated while the cost of living soared: between 1978 and 1988 the average rent for a studio apartment in San Francisco jumped 183 percent — from $159 a month to $450. Twenty years later it’s $1,114. In 1978 the Housing and Urban Development budget was $83 billion. Today it’s $35.2 billion, almost nothing by federal budgetary standards, and almost no new public housing units have been built since 1996, while 100,000 have been lost.

Every year the federal government spends almost twice as much on a single attack submarine as the Department of Housing and Urban Development spends on homeless assistance. State and local governments have been left to pick up the hefty price tag.

San Francisco spends more than $200 million on homelessness, through services, financial aid, supportive housing, emergency care, and shelter beds. There are 13 city-funded shelters, four resource centers, and three reservation stations in San Francisco. The Human Services Agency spends $12.5 million per year on shelters through contracts with nonprofit managers. The Department of Public Health also manages two contracts, for a battered women’s shelter and a 24-hour drop-in center.

But it’s not enough: the nonprofits supplement operating expenses with grants and private donations and recently relied on a special allocation of $300,000 to purchase basic supplies like soap, towels, hand sanitizer, sheets, pillows, and blankets.

James Woods, a spry 51-year-old wearing a red Gap parka barely zipped over his thin, scarred chest, rattles off the places he’s lived: Detroit, Atlanta, Seattle, San Francisco, Louisville, Ky., and his hometown, Nashville, Tenn. "Out of all the cities I’ve been in, this is the only city where you have to go and make a reservation for a bed at the rescue mission all the way across the city in order to come back to the place you started," he says, jabbing the floor of MSC with his cane. "I can’t even make a reservation here for a bed here. They’ll send me across the city to another place to do that."

Woods has been pounding the pavement between MSC and the Tenderloin AIDS Resource Center for eight months. Every day around 3:30 p.m. he heads to the Tenderloin, where he gets in line for a bed. Woods has a fractured hip and arthritis, pins in his knees and feet, and hepatitis C. He’s been HIV-positive since 2002. He walks with a limp that can transform into a springy, stiff-legged canter when he chases the 27 bus down Fifth Street.

Rather than tote all of his possessions with him, he hides them in the drawer of an emergency bed at MSC, so it’s imperative that he get back there every night. Sometimes he waits hours for an MSC bed to open up.

Though Woods speaks highly of some city services, swooning a little when he mentions his doctor at the Tom Waddell Health Center, the daily bed hunt has left him exhausted and disgusted with the city. "They’ve got the program designed to run the homeless off," he says. "They have it as hard and difficult as possible for you to take a breath, take a rest, get a routine."

While a person can reserve a bed for one to seven nights and, if on General Assistance, make arrangements through a caseworker for 30- to 90-day stays, Woods has rarely been able to procure a bed for longer than one night. "Maybe twice I’ve gotten a seven-day bed," he says.

The inability to connect people with beds is not lost on city officials. Mayor Gavin Newsom’s recently hired homeless policy director, Dariush Kayhan, told me, "I really want to solve the issue of the juxtaposition of vacant beds and homeless people on the streets. That to me is untenable."

However, he only discussed the issue in terms of people who’ve chosen not to use the shelters and are sleeping in the street. To him, empty beds signify that there’s more than enough shelter for people. "At this time there’s no plan to expand any shelter beds, and I think homeless people, in many ways, many of them vote with their feet and have decided that shelter’s not for them," he said.

But the Guardian found that even if you are willing and waiting for a bed in a place where someone can presumably connect you with one, it often doesn’t happen.

According to the 2007 Homeless Count, there are 6,377 homeless people in San Francisco. The nine year-round single-adult shelters have enough beds to accommodate one-third of that population. Other emergency facilities shelter some of the overflow on a seasonal basis. The remaining homeless sleep in jails and hospitals, respite and sobering centers, parks and sidewalks.

People also pile up at Buster’s Place, the only 24-hour drop-in resource center in the city, where they slump all night in chairs, forbidden by staff to sleep on the floor.

It took Guardian writer Bryan Cohen five nights to find a spot at a shelter. He spent Jan. 20 and 21 at Buster’s waiting to see if a bed would open up. None did. According to the shelter vacancy report for those two nights, there were 108 and 164 beds set aside for men that went unfilled. On an average night this January, a month marked by cold weather and flooding rain, 196 beds were empty.

Buster’s does not have access to CHANGES but can apparently call shelters and ask about empty beds. I was at the Providence Foundation shelter one night and overheard a call come through and shelter staff tell whoever rang that no, they couldn’t bring more people here. There were four empty mats beside me.

Laura Guzman, director of the Mission Neighborhood Resource Center, said CHANGES was a breakthrough in getting people into beds, but when it was first launched in 2004, things were different. "You had a choice. Shelter of choice was much easier to achieve. Then Care Not Cash happened," she said.

Most of the city’s beds are assigned to beneficiaries of certain programs, like Swords to Ploughshares and Newsom’s signature plan Care Not Cash, or to people with mental health or substance abuse issues who have case managers.

Though beds can be turned over to the general public when they are dropped after curfew, one wonders how effectively that happens.

The challenges are worst for Latinos, refugees, and immigrants, who face language barriers and the potential hurdle of illegality.

As a result, they flood one of the few places they can get in. Dolores Street Community Services reported the second-lowest vacancy rate in January, just 5 percent. The 82-bed program hosts a waiting list and is one of the more flexible in the city — deliberately so, as many of its Latino participants have jobs or work as day laborers. Marlon Mendieta, the executive program director, says, "They have a plan and just need to save up some money to move into a place."

However, rising rents have made moving on difficult. "We have people who are basically just cycling from one shelter to another," Mendieta said. "We see some who exit our shelter, find housing, but might end up back at the shelter if rent goes up or they lose work."

Providence is one of the sparest of homeless facilities and is located in a Bayview church. Unlike at other shelters, there’s no hanging out here. When the doors open at 9:30 p.m. about 90 people with reservations are already lined up in the rain on its dark side street.

We receive one blanket apiece, and the men shuffle into the gym while I follow the other females into a smaller side room, where 12 mats are laid out on two ratty tarps. Several women immediately lie down, speechless.

The cook gives a quick blessing when plates of food arrive on two sheet pans: spaghetti, heavily dressed salad, limp green beans mixed with cooked iceberg lettuce, and a very buttery roll. It’s all heavy and slightly greasy, but also warm and a closer approximation of a square meal than any of those offered by the other shelters I’ve stayed in so far.

Moments after I finish eating the lights are turned off, even though a couple of women are still working on their meals. A shelter monitor comes through and confiscates our cups of water, saying she just refinished the floors in here and doesn’t want any spills. I notice that unlike at other shelters where I’ve stayed, none of the women here have bothered to change into pajamas. Some haven’t even removed their shoes. I follow suit, tucking my jacket under my head for a pillow and pulling the blanket around me.

When the lights come back on at 5:45 a.m., I understand why no one changed: there’s no time to get dressed. Shelter monitors enter the room, rousting sleepers with catcalls to get up and get moving. One turns on a radio, loud. They’re brisk and no-nonsense, grabbing blankets and shoving them into garbage bags, pulling mats into a stack at the edge of the room.

A woman becomes perturbed by being hustled and talks back to the shelter monitor. A verbal battle ensues, with the client picking up her mat and throwing it across the room, scattering her possessions. "What a woman, what a woman," the shelter monitor yells. "We’ll see if you get a bed here tonight."

Another staffer comes through with a toxic-smelling aerosol, which she sprays around us as we get ready to leave. The bathroom, the cleanest I’ve come across in the city’s shelter system, is still a clusterfuck as a dozen women wait to use the three toilets and two sinks. One stall has a broken door, and the only morning conversation is apologies to the occupant.

Even though the contract between Providence and the HSA says the former will provide shelter until 7 a.m., it’s a little after 6 a.m. and all 90 of us are back out on the street, rubbing sleep from our eyes, shivering in the dark dawn, and waiting for the Third Street T line. When the train comes, most of us board without paying and ride back toward the city center to get busy finding some breakfast and making preparations for where to stay tonight. I have four hours before I have to be at work.

Shucrita Jones, director of Providence, later tells me the shelter’s materials have to be cleaned up by 7 a.m. because the church is booked for other activities. "We turn the lights on at 6. The clients have at least until 6:10 to get up. We encourage everyone to be out of there by 6:15 so we can be clear of the building by 6:30," she says. To her defense, she adds that the shelter monitors often let people in earlier than the contracted time of 10 p.m. and that when the weather is particularly nasty she’ll open the doors as early as 8:30 p.m. to let people in out of the cold.

As for the discrepancy between empty mats in the shelters and people going without beds, she blames the reservation system. "CHANGES has a lot of glitches," she says. "It’s got a lot of errors the city and county [are] trying to fix."

What I witness isn’t as bad as what I hear. In the shelters everyone has a horror story — some are about how they got there, others about what’s happened to them since they arrived. Nearly all include a questionable experience with staff — from witnessing bribes for special treatment to being threatened with denial of service for complaining. Their observations echo mine: the administration and certain high-level staffers exhibit genuine concern and an ability to help when you ask, but lower-tier workers aren’t as invested in providing good service.

Tracy tells me she sent her daughter to private school and considers herself a victim of the dot-bomb era and an illegal eviction that landed them at the Hamilton Family Center. "We were given one blanket. It was filthy. It had poo on it, and, I’m not kidding, there were even pubic hairs," she says.

She describes the shelter’s intake process as similar to that of jail bookings she’s seen on television. Six days later she and her child were thrown out. No reason was given, though she’s convinced it’s because a staff member overheard her complaining about a recent incident involving another client sneaking in a gun. When she was told to leave immediately, she wasn’t informed that she had the right to appeal. So she and her daughter hastily gathered their things and hit the dark Tenderloin streets.

A grievance system exists for people who’ve been hit with denial of service, or DOS’d, the colloquial term for kicked out. But the process can take months. Shelter managers I spoke with don’t deny that stealing is rampant, favoritism exists, and complaints occur — the greatest number about staff and food.

General complaints are supposed to be handled within the shelter, though they may be copied to the city’s Shelter Monitoring Committee. The SMC submits quarterly reports to the Board of Supervisors, Mayor Newsom, and the public, which show regular instances of inconsistent and unsafe conditions, abusive treatment, and a lack of basic amenities like toilet paper, soap, and hot water.

Those reports prompted Sup. Tom Ammiano to sponsor legislation mandating standards of care for all city-funded shelters (see "Setting Standards," 1/30/08). The new law would create baseline standards and streamline a complaint and enforcement process.

According to the HSA, many of these standards are already policies included in the contracts with the nonprofits that run the shelters, requirements such as "provide access to electricity for charging cell phones."

During my stay at the Episcopal Sanctuary, I asked the shelter monitor on duty where I could plug in my cell phone and was told I couldn’t. When I asked why not, the only reply was that it’s against shelter policy. At Ella Hill Hutch Community Center, Cohen was told he could plug in but at his own risk — his unattended phone would probably be stolen.

I reviewed all of the contracts between the city and the nonprofit shelter providers, as well as the shelter training manual that’s given to staff. I was unable to find the same list of policies the HSA gave to the budget analyst. I asked HSA executive director Trent Rhorer how these policies have been communicated to the shelter staff, but he did not respond by press time.

While the ability to charge a cell phone seems relatively minor, its ramifications can be huge. The first time James Leonard met with his case manager at Next Door shelter, he knew exactly what he needed to get back on his feet: bus fare to get to and from three job interviews he’d already scheduled, a clothing voucher so he’d have something nice to wear when he got there, and a couple of dollars for the laundry facilities at the shelter. He also needed to charge his cell phone to confirm the interviews. He said he was denied all four things.

The standards of care, if passed, could improve access to those basic provisions, but some in the Mayor’s Office have balked at the estimated $1 million to $2 million price tag. The budget analyst’s final report is scheduled for release Feb. 14, in time for a Feb. 20 hearing at the Budget and Finance Committee.

Deborah Borne, medical director of the DPH’s Tom Waddell clinic, is a proponent of the standards from a public health perspective. "For me, I’m looking at decreased funding and how can I best affect the most population with what remains," she said.

Dirty shelters can help spread disease outside their four walls, as clients leave every day to use municipal services like buses, libraries, trains, and restaurants, which we all enjoy. Borne says this is something that’s been tackled by other facilities that house large numbers of people and is long overdue in the shelters.

"You can argue about whether we should or shouldn’t have shelters, but there are no city, state, or federal regulations for them. There are tons of regulations for the army, for public schools and colleges, but we put people in shelters and there’s none," she said. To her, San Francisco is on the cutting edge of care with this legislation. "I can’t wait until we do this on a state level," she said.

Kayhan said he and the mayor support the spirit of the legislation and have no problems with most of the no-cost items, but the price tag for staffing, training, and enforcement is a concern. "I think when you’re looking at how much money you’re going to spend on homelessness overall," he told us, "I would rather allocate additional resources to create another unit of housing for someone as opposed to enhancing the service model of the shelters."

Every day he’s on duty in the Tenderloin, police captain Gary Jimenez comes across homeless people — or people who seem homeless but aren’t.

"One day on Turk Street, I came by a long line of people drinking. I was walking with a Homeless Outreach Team officer, and he said he knew them all. Only about 20 percent of them were actually homeless. They don’t want to sit in their rooms drinking. We give people housing but we don’t acclimatize them, get them used to being inside. They want to do what they’ve been doing, and they go out on the streets to do it. It’s social," he said.

Larry Haynes agrees. "It’s lonely and depressing in your room," he says. He lost his Beulah Street apartment through an Ellis Act eviction and has been living in the Vincent Hotel for three years, after a nine-month stint in the shelter system. He’s a tenant representative now, advocating for improved conditions in the SROs, which still beat the shelters.

"The criticism I hear from people on the streets is that there are some good shelters but you can’t get in them," Jimenez said. "Then there are shelters that are open that you can go to, but you wouldn’t want to because they’re really bad."

He tells me he’s visited shelters but finds it difficult to get a feel for how valid the complaints are. "I can’t tell without waking up there or knowing what it’s like to be thrown out on the street at 6 a.m. in the cold when there’s nothing open," he said.

The Shelter Monitoring Committee has requested that HSA staff stay in shelters at least once to get firsthand experience, but it’s yet to receive confirmation that this has occurred. When we asked Rhorer about the policy, he said, "There are 1,800 employees who work for HSA, so there is no way of knowing if any of them have been homeless and used the shelter system."

In our first conversation, Kayhan told me he had never stayed in a shelter. In a later interview, when I asked what he thought about the public perception of the shelters, he said, "I’m just not sure that the criticism that I hear around the shelters as being dangerous hellholes — or whatever has been said — matches what I see in the shelters or what I read with respect to incident reports or what I hear at the Shelter Monitoring Committee or at the shelter directors’ meetings. So perception is reality."

"Housing first" has been Mayor Newsom’s modus operandi for handling homelessness, and it’s a good one — the idea being to stabilize people, whatever condition they’re in: drunk or sober, clean or using, ill or able, young or old, alone or with family.

The city’s 10-Year Plan to End Chronic Homelessness, released in 2004, recommended 3,000 units of supportive housing to get the chronically homeless off the streets. Kayhan confirms the Mayor’s Office of Housing is on track to meet that goal through master-leasing SROs and building or renovating new affordable units, where occupants will get supportive services.

The chronically homeless, a catchall term for folks who stick to the streets and don’t or aren’t able to use the system, have been the mayor’s target and Kayhan’s priority. This makes sense because they’re the most visible face of homelessness.

Last year’s city budget allowed a tripling of staff for the Homeless Outreach Team, which works diligently to move the most entrenched homeless off SoMa side streets and out of encampments in Golden Gate Park. A special allocation of shelter beds was set aside for them, and those who refused shelter were put directly into stabilization units in SROs, bypassing the shelter system entirely.

For some, this has been great. It’s how Leonard finally started to make some progress. He bailed on the shelters after having his possessions thrown out three times by staff and hit the streets, where HOT found him, deemed him "shelter challenged," and moved him into a stabilization unit.

"I feel almost as good today as the day before I became homeless," he tells me one afternoon in January. The Bay Area native is hoping to transition into a subsidized rental soon.

Twenty-five percent of shelter staff are required to be homeless or formerly homeless. Some shelters hire up to 80 percent. Tyler is one of them — he lives at MSC South but works for Episcopal Community Services, which runs Sanctuary, Next Door, and the Interfaith Emergency Winter Shelter Program. He shows me his pay stub to prove it, and I note that every two weeks he takes home more than I do. "Yeah, I make good money," he agrees.

He’s been looking for an apartment, but rents are high and he hasn’t found anything good. A plan to move in with a family member fell through, so he’s just hanging out on the housing wait list. "What I really want to do is see what they’re going to do for me. I’ve been on [Personal Assistance Employment Services] for six months. Where is my SRO if I can afford to pay for it? So obviously that shit doesn’t work," he says.

He’s bitter about the effect the Golden Gate Park sweeps have had on the SRO stock. "They got SROs right away," he said of the 200-plus people who were removed from the park by HOT, put into stabilization beds, and transitioned to SROs. "They took them right away ’cause Gavin had to clean that shit up," he says.

Tyler, like many people I spoke with, keeps as sharp an eye as possible on City Hall. They read the papers and have opinions informed by firsthand experience about programs like Care Not Cash. They know Kayhan is making $169,000 per year and they’re making $29 every two weeks.

One morning, coming out of the bathroom at Sanctuary, I stop to study a posting for affordable housing on a bulletin board. It’s a studio for $863 per month, more than I pay for my one-room Mission flat. The longer I stay in the shelters and the more people I talk to, the less secure I feel in my economic stability.

Ruby Windspirit has been homeless since Jan. 14, two days before I started my tour of the shelters. The 59-year-old Irish Navajo was attending school in Portland, Ore., studying photography and science, when she became ill with bone cancer. She came to San Francisco to convalesce closer to her daughter, who lives in a one-bedroom apartment in the Castro with three other people.

Windspirit knew she couldn’t stay on the couch for too long and made a reservation for a $27 per night hotel in the Tenderloin. Despite the reservation, she couldn’t get in for two days and the bed she was ultimately given was two box springs with a piece of plywood for support. The sheets were dirty. She left after two weeks and entered the shelter system. She says Next Door is "150 percent better" than the hotel. She has a bed off the floor and the extra blanket her doctor recommended, though she was scolded for trying to plug in her phone.

I try to imagine what people like Windspirit would do if there weren’t shelters. But the Ten Year Council also recommended a phasing out of shelters within four to six years, to be replaced by 24-hour crisis clinics and sobering centers.

There are 364 fewer shelter beds in San Francisco than when Newsom became mayor. This year more may go. The city is currently requesting proposals to develop 150 Otis, which serves as a temporary shelter and storage space for homeless people, into permanent supportive housing for very-low-income seniors. About 60 shelter beds will be lost.

The HSA confirmed there are currently no plans to open any more shelters in San Francisco. The last plan for a new shelter — St. Boniface — fell through, and the money that was set aside for the project still languishes in an HSA bank account. Midyear budget cuts proposed by the mayor put that money on the chopping block.

Buster’s Place is also on the list of cuts. By April 15, the only place where someone can get out of the elements at any time, day or night, could be closed for good.

Kayhan, who previously oversaw Project Homeless Connect, Newsom’s private-sector approach to the problem, agreed that shelters will always be needed. What he worries about are the people who become dependant on them and refuse housing offers, although he’s also thinking about ways that shelters could be more amenable.

"I’d like to look at the next step with Homeless Connect to try and institutionalize that in the way we do business specifically in the shelters," he said, imagining a shelter pilot of one-stop shopping for services.

But just three weeks into his new job Kayhan was reaching out to constituents to try to figure out what isn’t working. He told us, "What I’m trying to do since I came into this position is be on the street and measure the impact the system is having on those that are on the street day in and day out and try to see what part of the system isn’t working properly or needs to be resourced differently so that we don’t see homeless people, long term, on the streets."

One night at MSC, in the bathroom before bed, a young woman tells me her story while I brush my teeth and she washes off her makeup. Not too long ago she drove here from Florida to meet up with her boyfriend. They were hanging out on the street one night when a cop came by, cited him for an open container, and discovered he had a warrant. Now he’s in jail in San Rafael.

She started sleeping in her Suburban while she looked for job and a place to stay. One night while she slept, parked at Castro and Market, she was hit by a drunk driver. She lifts a hank of long blond hair and shows me a bright pink tear of stitches above her temple. An ambulance took her and the drunk to the hospital. Her totaled car was towed. When the hospital found out she had no place to go, it sent her here.

"Now I’m in a fucking homeless shelter," she says, genuinely aghast at the situation and truly lost about what to do. She has her bed for five more days.

She could get a job. She says, "I have hella references," from working in restaurants for years. She could sleep in one of her friends’ cars, but it seems like so much work: waking up in the car, going to a resource center or shelter to wash up, then going to work.

We joke about living in the shelter. "Yeah, you can come over," she imagines telling her friends. "Dinner’s at 4:30."

"You’ve got to leave by 10," I say.

"It’ll be fun. We can hang out and smoke on the patio," she says.

I don’t know what else to say, except "Good luck." I know what it’s like to chase a boyfriend to San Francisco. I remember sleeping in my car when I was 21, during a strange time between graduating from college and getting a place to live for the summer in a town where housing was tight. I think about my little sister, packing up her Subaru one day and taking off to Miami, where she didn’t know a soul. You have a little money, a lot of hope, and that youthful sense of invincibility, but sometimes it all comes down to luck.

I bid her good night, pack up my toiletries, and wipe my face with my shelter-issued towel. It smells vaguely of bleach and shit.

› amanda@sfbg.com

Bryan Cohen contributed to this report.

Cleaning up the shelter mess

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EDITORIAL Shelters aren’t a solution to homelessness. Everybody knows that; everyone agrees. But in San Francisco the shelter system that was set up as a short-term patch to address the growing number of homeless people on the streets in 1982 has, over a quarter century, become a fixture of city life. And as long as the federal government continues to abandon cities and affordable housing and create poverty, this is not likely to change any time in the immediate future. Even the most ambitious local housing program — and there will be a fairly ambitious one on the November ballot — isn’t going to create an immediate and permanent place for all of the 8,000 or so people in this city who can’t afford a place to live.

So shelters are going to be with us for a while — and it’s inexcusable that the city continues to operate them under such horrible conditions.

As Amanda Witherell reports in this week’s cover story, the shelter network is a bureaucratic nightmare. Clients get bounced all over town, it’s almost impossible to reach any of the shelters by phone, and the directions you have to follow to get a bed are complicated and confusing. Although everyone knows that shelters are now more than temporary housing, it’s hard at some shelters to get a bed for more than one night; lots of homeless people spend four or five hours per day waiting in lines for a shot at a bed (and even after that, some wind up not getting a place to sleep). The shelters — mostly run by nonprofits under city contracts — have the feel of prisons; they are strictly regimented and often unsafe and lack even basic amenities like soap. Clients often have to ask for toilet paper.

In 2006 the city’s Shelter Monitoring Committee found that only 6 of the 19 San Francisco homeless facilities met even basic standards for hygiene and sanitation. Fifty-five percent of shelter clients who participated in a May 2007 survey by the Coalition on Homelessness reported some kind of physical, sexual, or verbal abuse. One-third had no access to information in their native language. Thirty-five percent had nothing to eat.

It’s no surprise that many homeless people would rather sleep in Golden Gate Park — and as long as the abysmal conditions persist, that problem will continue.

The city’s not in the position to create luxury hotels, but it can make the shelters a lot less degrading, dehumanizing, and unpleasant. Sup. Tom Ammiano has already vowed to introduce legislation that would mandate minimal standards of care, and the Board of Supervisors needs to pass a tough bill as soon as possible.

Among the things that need to be addressed:

Basic public health The Department of Public Health is concerned that the shelters can be breeding grounds for disease, and that’s a serious problem: there have been some close calls with tuberculosis, and bedbugs are a chronic issue. Many of the shelters lack such basic supplies as hand sanitizer, soap, rubber gloves, and clean towels. For just $15,000, public health nurses from the city’s Tom Waddell Health Center, working on a pilot project, were able to make significant inroads in hygiene and sanitation in two shelters. They’re now moving on to attack bedbugs and scabies. That approach should immediately be expanded to every shelter in the city.

Safety Some of the shelters, particularly the men’s shelters, are lacking in basic security measures. It would be nice to have full-time security staff in every facility, but that might be expensive. At the very least, the staffs need more security and violence-deescalation training, the centers need to have operating and functional locks, and the city needs to mandate that the places are safe enough that clients aren’t afraid to stay there.

A ridiculous bureaucratic labyrinth and lack of coordination Nobody should have to stand in line for three hours per day just to get a reservation for a shelter bed. Nobody should have to trek across town (on foot or on Muni, without the bus vouchers that the shelters ought to be giving out) from one shelter or homeless service center to another just to find out where to stay. There ought to be a one-stop shop (or a series of them) where a person can check in anytime during the day, find a shelter, line up a bed, get a ticket, and be on his or her way. City officials don’t talk much about this, but many of the shelter residents have jobs; they go to work all day but still can’t afford a place to live in San Francisco. The hoops they have to jump through make the system brutally unfair.

A lack of reality Mayor Gavin Newsom says he wants to get beyond the shelters, to use them only as entry points into a system that will find treatment, counseling, job training, and permanent housing for all homeless people. We want that too. So does just about everyone who cares about this issue.

But the mayor also talks about getting rid of aggressive panhandling, and he and his supporters complain about the people on the streets who hassle tourists. And nobody seems to want to admit that many of the folks who are typically lumped under the term homeless actually have homes.

The city has managed to lease, renovate, and otherwise make available hundreds of single-room-occupancy rooms, and quite a few formerly homeless people have found long-term residences there. But the mayor’s Care Not Cash policy ensures that most of the modest welfare payments these people get are seized by the city for their housing, leaving them with nowhere near enough to survive. So they panhandle — is anyone surprised?

It may sound radical, but if the city, state, and federal cash grants to people who for whatever reason can’t find work were increased to a level that would support a tolerable lifestyle in one of the world’s most expensive cities, a lot of the quality-of-life problems Newsom bemoans — and that the city spends millions trying to mitigate with law enforcement resources — might go away.

Meanwhile, the shelter residents who do have jobs or who are looking for jobs spend so much of their lives trying to navigate a Byzantine system that they have little in the way of waking hours to improve their economic prospects.

The disaster that is San Francisco’s shelter system is the legacy of many years of public policy that allowed the interests of developers, landlords, and speculators to trump the needs of the city as a whole. The housing crisis isn’t going away tomorrow — but the victims have a right to a basic level of human decency. The supervisors need to make that happen, with dispatch.

Editor’s Notes by Tim Redmond

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› tredmond@sfbg.com

Mayor Gavin Newsom is all hot and bothered about the report by the Board of Supervisors budget analyst saying Newsom has taken $1 million that is supposed to pay for homeless services and Muni and used it to pay his own staff. The mayor says it’s all just a personal attack on him by the supervisors. He also says other mayors have done the same thing. According to the San Francisco Chronicle, Phil Ginsberg, the mayor’s chief of staff, called the report "bullshit." (Actually, the Chronicle, in its infinite decorum, used the term "bull-," to avoid offending the tender values of its readers.)

OK, look: there are politics going on here. The supervisors and the mayor aren’t getting along, the mayor has unleashed a rather savage attack on board president Aaron Peskin, Peskin is going after some of the mayor’s commissioners, and maybe Sup. Jake McGoldrick, who asked for the report, had some sort of political motivation. Or perhaps McGoldrick, who doesn’t tend to like this sort of bullshit, just got mad that the mayor was doing something funky with the taxpayers’ money.

Whatever. Nobody is denying the factual accuracy of the report. And if Newsom wants to make an issue of it, he ought to get beyond the politics and the accusations and just tell us:

Does he really think this is a good way to spend city funds?

Should the Human Services Agency, which is responsible for the most needy and broke people in town, be spending $95,000 per year to pay for a mayoral press aide? Does that money really help the homeless? Is there a good argument that having a media flack in Newsom’s shop defending the mayor’s homeless policies helps save lives, provide housing, or get substance abusers into recovery?

Fine, Mr. Mayor: perhaps you can elucidate it.

Was Stuart Sunshine, until recently Newsom’s chief transportation aide, really worth $203,000 per year? Did paying him that salary out of Muni’s budget help improve bus service? I dunno, maybe it did. But I haven’t heard Newsom tell me how.

Is it fair — and is it a good idea — at a time when every city department is being asked to cut back, when crucial city programs are being reduced or eliminated, when it’s going to be an ugly year for the public sector in general and San Francisco in particular, for the mayor to be filling his staff jobs on someone else’s dime?

That’s the real issue here: if Newsom thinks his high-paid staffers in his newly renovated office are doing such a bang-up job that two underfunded city agencies ought to be writing their paychecks, then the public is welcome to listen to his pitch. But there is nothing political or personal about asking the questions; that’s exactly what the supervisors ought to be doing.

Newsom is the chief executive of San Francisco. He sets the policies; he hires the senior staff. He can be upset with the legislators who are the checks and balances of his power, and he can disagree with the conclusions of a report that the board’s budget analyst has produced. But to call it bullshit when he knows it’s true (and when he knows from his own experience that Harvey Rose, the budget analyst, is widely respected for his fairness) … well, that just sounds defensive. Bad place to be, Mr. Mayor.

Search for shelter: Bryan Cohen’s nightly journals

2

Editor’s Note: Guardian intern Bryan Cohen contributed to this week’s cover story: “Shelter Shuffle: Inside San Francisco’s confounding system of housing the homeless.” What follows is a fascinating log of his experiences:

DSCN0168.JPG
Mural on the southeastern wall of MSC South, one of the city’s largest shelters

By Bryan Cohen

I have a new saying for the San Francisco Human Services Agency: fool me once, shame on you; fool me twice shame on me; fool me three times . . . Oh wait, shame on you again because public service programs shouldn’t be in the business of fooling people — or making them feel shameful about being fooled.

Here’s the story – I’d just arrived in San Francisco from Boston when my car was impounded. I got a job, but came up short for a down payment on an apartment. With no back up cash, staying at a hotel would put me back even farther and I don’t know anyone on the west coast, let alone the state of California or the Bay Area.

All of this is absolutely true, except for one fortunate detail: I was able to Craigslist my way into a short-term apartment. Otherwise, this would have been much more than just an undercover investigation for a newspaper.

I took off on a chilly Saturday evening, expecting at the very least a gym floor and a blanket. Three days later I had yet to see a bed or a good nights sleep. And to add supreme insult to that injury: official city reports I reviewed later showed lots of vacancies at the very shelters that were denying me and others a place to stay.

Slim’s slimed

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› kimberly@sfbg.com

SONIC REDUCER There are eight jillion stories in the naked, nervous-Naughties city, and one of the increasingly common tales is that of the wannabe slicker who lays out that down payment for a little piece of gritty ‘n’ shitty, gorgeous ‘n’ porous, wild ‘n’ wooly San Francisco. And then supposed slick realizes, "Hey, I’m tired of stepping over panhandlers, looking for parking, and listening to car alarms, building fans, BART musicians, construction blare, and city hubbub in general." Translation: "I actually want to live in Concord, San Carlos, or Corte Madera." So the square spoiler in this happily unholy round hole of a town decides to wreck things for everyone.

That sort of inane, fish-outta-water resolve is, unfortunately, threatening Slim’s, the linchpin of the 11th Street–SoMa club scene since chart topper Boz Scaggs first opened the respected nightspot two decades ago, the site of many a memorable night of music and a venue that, legend has it, bands like Built to Spill have pledged their loyalty to because of its dedication to stellar sound. One of Slim’s neighbors tipped me off last month that the hall — which has consistently passed all sound tests conducted by the city’s Entertainment Commission — was being besieged weekly by a lone complainer living in Juniper Alley. All of this came to a head in December 2007 when the accuser ordered citizen’s arrests of two of Slim’s night managers on three occasions — after, Entertainment Commission industry representative Terrance Alan says, police refused to issue noise-violation citations of their own because they couldn’t hear any vioutf8g sound issuing from Slim’s. The arrests have led the Department of Alcohol Beverage Control to bring an enforcement action against Slim’s liquor license, which may close the club for 15 to 25 days after an April hearing.

"She has been threatening to do this for a while," Slim’s co-owner Dawn Holliday told me. The complaining neighbor and her partner have been registering noise complaints for the past two years, Holliday added, though no other neighbors have complained, and in 2000 all of the area’s condo and live-work residents signed a deed restriction making it clear that the district is a mixed-use neighborhood subject to noise, odors, and other industrial activities 24-7. Nonetheless, Holliday continued, "she calls the police on average four nights a week. The Entertainment Commission has gone into their house and done readings in the house, done readings out in front of house, and we do readings in front of their house every night with a decibel meter on the most sensitive reading you can get, and we are always compliant. It didn’t satisfy them."

One of the charges against a Slim’s manager was dismissed, but both staffers are still due to go to court for the two arrests in February and March. "I’m hoping they let these kids off," Holliday said. "I’ve gone to [San Francisco Police Department’s] Southern Station and asked them to wait for me to come over or Boz to come over and arrest us. It’s not fair that employees get arrested. We’re the two owners that live the closest, and both of us would take tickets before our employees."

Holliday is confident — after going into mediation, consulting with sound guru Charles Salter, and taking actions like installing a new insulated roof and a special four-tiered back door — that a resolution is possible. Still, the idea that one sour grape can pull down another great venue is troubling. "This is a situation where you can see how the system, which was designed to have respect for all the citizenry, can be used by this vexed complainer," Alan said. "They’ve created this history of complaints based only on their complaints. It’s going to cost Slim’s a lot of money and cost their managers a lot of sleepless nights, who want to go on and have a life. And they won’t be able to if they are found criminally liable for this. Imagine, you’re just doing your job …"

And hey, that’s another reason why so many of us come to this cow town in the first place: to work and to cozy up closer to that golden cow pumping pomegranatinis, the raucous crafters of musical ambrosia, et al. Fess up: you didn’t move to SF to feel good about driving a Prius or down Starbucks. What you can’t find regularly in Concord or Corte Madera — and what so many of us continue to crave — is that non-government-regulated minimum requirement of fun: loud, smelly, still safe, inconvenient, sprinkled with homeless parking valets, and still unlike anything you’ll get in the sticks.

For more, see Sonic Reducer Overage at www.sfbg.com/blogs/music.

HOWLIN RAIN MAKE THEIR MOVE

Howlin Rain and Comets on Fire’s Ethan Miller has plenty of news about: HR’s superfine new LP, Magnificent Fiend, will be released March 4 on SF’s Birdman label and HR’s new imprint, Columbia Records cohoncho Rick Rubin’s American Recordings. Why jump? Miller told me he was enticed by larger studio budgets and the opportunity to be produced by Rubin, whom the frontman praised as someone who "seems to chip away at all those extraneous things and just draw out the essential fluids onto the tape.

"Those are the reasons," Miller said. "This is not the type of record deal where you get a million-dollar check and drive away in a Rolls-Royce, and you’re, like, ‘Fuck, cool, man, they bought me a Corvette, and now everyone can just go get wasted on coke and it doesn’t matter now, man!’ And then, whoa, a year later you’re kicked off the label, and you’re, like, ‘Fuck, I blew my $2 million advance now. This sucks! Now I’m a fucking nobody!’ That’s not this."

HOWLIN RAIN

With Black Mountain

Mon/4, 8 p.m., $14

Independent

628 Divisadero, SF

www.theindependentsf.com

Top o’ the world, ma

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› duncan@sfbg.com

My ex-girlfriend hipped me to TopR, short for Top Ramen, around 2003. We were driving in her car, and she cracked open the newly released Burning the Candle at Both Ends (Earthlings/DWA) and slid it into the dash. I’d like to say it changed my life, but to be honest, I can’t remember it. I do remember that she described TopR as this homeless, couch-surfing rapper who’d slept on her previous boyfriend’s couch. It was classic case of his reputation and lifestyle preceding his music.

Later I met TopR — or Topper Holiday, as he’s ceased using his first name — at 111 Minna Gallery, where I still work a side gig as a doorman. Throughout my years there he’s been a semiregular fixture, posted at the end of the bar, skeezing free drinks. He’s well loved but has this Dennis the Menace air surrounding him, like, "Oh, Topper’s here. Here comes trouble." One night in Minna alley, I remember him — a big, bescruffed white dude in a fitted New Era cap, somewhat rotund and more than a little faded — striking up a conversation with some bland, buttoned-down types, telling them he was a rapper and following up with a drunken freestyle. I came away feeling that it was a little sad, like he was busking in a BART station, trying to impress the squares.

"Fuck being glamorous — I’m cantankerous." So goes the first line on "Frankenstein’s Topster," the opener off his latest, fifth album, Marathon of Shame (Gurp City). It was playing when I walked into Dalva on 16th Street to say hello to my friend Toph One and reintroduce myself to TopR. And quite a reintroduction it was: even before Top starts rapping, the track is a fucking winner, anchored by a sample of Black Sabbath’s "A National Acrobat," the driving guitar riff married to an überfunky drumbeat by producer Dick Nasty.

A good hip-hop album is like a good comedy record: the shit’s got to be so sharp that you want to listen to it more than once, want to scan back on the CD and point out lines to your friends who are riding with you. In Top’s case it’s an apt comparison since he’s influenced by stand-up comedians as much as by other rappers and samples Sam Kinison and Bill Hicks on his previous disc, Cheap Laughs for Dead Comedians (Gurp City, 2006). Marathon is packed with lines that’ll make other rappers wish they’d written them, from favorite one-liners like "Puttin’ squares in their place like Tetris" to heartfelt couplets such as "I don’t want to fit into this banality factory / Where together we can all make profit from tragedy."

It stands to reason that TopR can come up with witty rhymes: he’s been rapping since he was 12. Now 30, he gained his rep as a battle rapper at parties and clubs. "From ’93 until 2000 all I did was battle," he says over a pint at the Richmond District’s 540 Club. "I didn’t record music. I didn’t put out anything. I just made a reputation for myself through battling. If I was putting out albums in ’95, ’96, I might’ve been an actual artist like Living Legends, Atmosphere, and Hieroglyphics. You can only be a battle rapper for so long. After a while there’s not very much creative outlet for it. You can only make fun of someone for so long before you actually want to express your real problems and your real feelings about life. And you do that through writing songs."

In a time when your average radio rap track has more advertisements for sneakers and pricey booze than a copy of GQ, TopR represents a more compelling side of the hip-hop spectrum: the storied tradition of rapper as traveling salesman, hawking CDs "out the trunk," or in his case, out the messenger bag, since, as he says on "Siren Song," "the Muni is my chariot." And while he often calls himself out as lazy in his songs, TopR’s tale is a cross between the 1984 runaway-punk movie Suburbia and the classic Horatio Alger story.

A self-described "troubled kid," TopR left his parents’ home in Santa Cruz at 15, living in squats and hitchhiking to San Francisco to hit open mics and do graffiti. He was arrested for vandalism, went back home, and left again, sleeping on couches if he was lucky and outside if he wasn’t. He attributes his notoriety in the bar scene to necessity: "The fact that I was homeless — I had to be in bars every goddamned night, looking for places to stay. I had nothing better to do."

Slumming, bumming, and battling eventually led to some Greyhound cross-country tours and a devoted following of party kids and misfits, unhappy with the status quo and, like him, struggling to get by. There’s no shortage of the usual hip-hop bravado on Marathon: "I’m a piss artist who spits darkness at bitch targets," TopR raps on "Siren Song," "<0x2009>’cause the music that’s honest is the music that hits hardest." True, but the track isn’t merely empty braggadocio: it’s nothing less than an existentialist crisis with a beat, one rapper’s The Sickness unto Death, asking the eternal questions of the artist and, ultimately, everyone who’s been "up against it."

And while it’s the struggle — and the willingness to cop to it — that makes Marathon so compelling, it seems TopR might finally be on the bus toward Figuring It All Out. On a tour in 2005 he met his fiancée, Kelly-Anne, perhaps the muse of "Siren’s Song," bartending at one of his shows in Asheville, NC. He stayed in the South for more than a year before getting an apartment, with a couch and a bed, in San Francisco’s Sunset District. "I came up as ‘the homeless kid who slept on couches,’<0x2009>" he explains. "But I was good at graffiti young, and I was a good rapper. I got away with a lot of stuff that some punk little kid wouldn’t because people respected me for my talents or whatever. But I’ve mellowed out." Here Top takes a contemplative pull on his pint. "I mean, I’m fuckin’ 30. I’ve got a dog now."

I’m going to do my part to go tell it on the mountain, to put this disc on when we’re cruising down the street, to make sure you hear the hilarious lines and crucial cuts. But on the other hand, one reason why it’s so good is because you ran into him in the bar and bought a disc so he could have beer money. TopR may have reached escape velocity from his day job, but he’s still orbiting the homelessness of his recent past. The line that sums up TopR for me is from "I’m on One" on Cheap Laughs: "It doesn’t take a genius to see that we’re livin’ stressful / The secret to my success is that I’m unsuccessful." It might be better for him if he got the juice to leave orbit altogether and rocket into the outer galaxies of hip-hop superstardom, but would it be better for his music if he weren’t "livin’ stressful?" Living hand to mouth myself, I’m heartened to see someone who keeps grindin’, who tries to live a creative life in the face of SF-size rent, the approaching years, and a music industry that may never give a shit. To quote TopR’s MySpace page, "Even when nothing goes right I still prevail."

TOPR CD RELEASE PARTY

With DJ Quest, Conceit, Delinquent Monastery, Thunderhut Project, Ras One, and DJ Delivery

Fri/1, 9 p.m., $10

12 Galaxies

2565 Mission, SF

(415) 970-9777

www.12galaxies.com

Setting standards

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› amanda@sfbg.com

Toilet paper. First aid kits. Drinking water. These are just a few of the essential supplies one might expect to find in high-traffic facilities owned or paid for by the city that serve more than a thousand people per night.

But San Francisco’s homeless shelters, which have been around for about 25 years, have repeatedly fallen short of meeting basic standards or even living up to the policies outlined in their city contracts.

Since 2004, regularly scheduled and surprise spot checks conducted by the 13-member Shelter Monitoring Committee have turned up a range of deplorable and deteriorating conditions in regard to cleanliness, nutrition, and humane treatment of residents — from bloody shower curtains and broken toilet seats to clogged drains and kitchen counters cluttered with dirty dishes. A survey of health and hygiene conditions — from functional sinks to the posting of proper hand-washing techniques — found that only 6 of 19 facilities met basic requirements.

"The Shelter Monitoring Committee makes reports to the Rules Committee, and their reports about conditions in the shelters were very, very disturbing," Sup. Tom Ammiano told the Guardian.

To fix that, Ammiano and a cadre of city staff, homeless-rights advocates, and Shelter Monitoring Committee members are drafting legislation that would require shelters to meet basic standards of care, force compliance through $2,500 fines, and formalize a swifter complaint process.

The Health Services Agency last year had $69 million to spend on housing and the homeless, a portion of which funds nine year-round single adult shelters and four family shelters, as well as four resource centers where homeless people may not find a bed but should be able to access other services, like showers, laundry, phones, and the shelter reservation system.

The management of the facilities is contracted out by the HSA to different nonprofit organizations, including some well-known national groups like the St. Vincent de Paul Society and Episcopal Community Services. The Department of Public Health also handles two of the contracts.

Those contracts stipulate a number of policies, including providing clients with access to electricity for cell phone charging, a guaranteed eight hours of sleep per night, toiletries and feminine hygiene products, first aid supplies, and Spanish translations of printed materials; and a mandate to treat all clients with "dignity and respect."

That doesn’t always happen, and the monitoring committee isn’t the only watchdog saying so.

The Coalition on Homelessness has been fielding complaints from shelter residents for more than 20 years. A recent increase prompted it to investigate deeper. In May 2007 the group published Shelter Shock, a report based on surveys of 215 shelter residents. The findings: 55 percent of people reported some kind of physical, sexual, or verbal abuse. One-third had no access to information in their native language. Thirty-five percent had nothing to eat.

"The Mayor has actually pointed to these problems as reasons to close the shelters," the report states. "Responsible bodies — the Board of Supervisors and the HSA — have failed to take corrective action. There has been a silence around shelters, giving the impression that shelter residents have been forgotten by the administration and the public at large."

Mayor Gavin Newsom, in his Jan. 8 inaugural speech, identified chronic homelessness and panhandling as high priorities of his second term and promised he’d be "redesigning our city shelter system so that they are no longer just refuges of last resort but spaces where homeless San Franciscans can find job training, drug treatment, and encouragement they need to exit homelessness. We’re getting out of the shelter business." At no point did he mention implementing shelter health and safety standards.

James Leonard, a member of the Shelter Monitoring Committee who has spent the past 18 months homeless in San Francisco and San Diego, won’t stay in the shelters anymore. All of his possessions were stolen three times. He missed several job interviews because he couldn’t charge his cell phone. Frustrated, he hit the streets again. The Homeless Outreach Team found him, officially dubbed him "shelter challenged," and gave him a stabilization bed, which he hopes will eventually transition into a lease in a single-room-occupancy hotel.

He told us the lack of standards contributes to the problem of chronic homelessness because more people would stay in the shelters, off the street, if they were safe and treatment were consistent from facility to facility.

"People keep looking at what’s wrong with those homeless people and keep skipping over what’s wrong with those shelters and some of those staff members," he said. "It’s a system set up to fail unless it has standards."

The issues extend beyond each shelter’s four walls. It’s a matter of public health for all San Franciscans. "Even if the shelters exist for a minute, they have to be healthy and humane," said Dr. Deborah Borne, medical director of homeless programs at the HSA’s Tom Waddell Health Center. "Because if they aren’t, they’re a danger to themselves and to others."

She cited the example of sitting on a Muni bus beside someone whose bag may be carrying bedbugs. "Everyone in San Francisco is affected by the fact that we have health issues in the shelters."

Borne moved from New York to San Francisco about a year and a half ago. On her fourth day on the job at Tom Waddell, a resident died at Next Door, which houses about 250 people per night and is one of the city’s largest shelters. She said the death was not the fault of any specific department, agency, or person, but it could have been avoided if some basic health and hygiene practices were standard for shelter staff and residents.

She brought together several key people, secured $300,000 in funding through HSA director Trent Rhorer, and launched the Shelter Health Initiative, a pilot project that included some of the standards that are part of Ammiano’s legislation specifically targeting health and hygiene.

Next Door and Hamilton Family Center participated, were surveyed on needs, and received adequate supplies of things like soap, hand towels, sanitizer, and gloves. "Up to the date of the training, they still didn’t have available the basic equipment required to protect themselves," said Jill Jarvie, a public health nurse from Tom Waddell who ran the pilot program.

It’s not enough to have cases of rubber gloves and hand sanitizer. They have to be used, and used properly. "Something like a cold virus can stay alive for a couple of days," Jarvie said. Close conditions in shelters compound the risk. "When you’re working in a place that sees 300 people a day, how you wash your hands can really make a difference," she added.

Thorough hand-washing techniques and procedures for cleaning up bodily fluids taught to staff trickle down to residents, and so far, it’s working. According to Jarvie, Next Door has reported a decrease in illnesses. "It’s been exciting to see we can actually do this," she said. The price of the pilot was about $15,000, a cost that would fall over time through bulk purchasing of supplies and as training becomes more standardized. Soon public health officials will be launching another phase, focused on bedbugs and scabies.

An initial budget analyst’s report, based on information provided by the HSA, predicted a $6.2 million price tag to fully implement standards throughout the city’s shelter system. Many say it’s an overinflated estimate based on assumptions that need more vetting.

"We were all stunned by the budget analyst’s report," said Quintin Mecke, secretary of the Shelter Monitoring Committee and head of its subsidiary work group on the legislation. "When you look at some of the assumptions, they’re just not true." For example, the HSA interpreted security to mean staffing all the shelters with full-time guards, when other mitigations like locks and staff training could be implemented instead.

Mecke and the work group believe that although there will be hard costs associated with the legislation, many are onetime and others are simply the price of complying with what’s supposed to exist already. Ammiano’s aide Zach Tuller said, "We expect the cost to come in under half a million because HSA claims so many of the services are already being provided. We’re looking to prevent slippage."

Dave Curto, head of contract compliance for the HSA, said the department agreed with some of the legislation and was still talking through specifics. He confirmed that policies do exist and shelters are provided with training manuals to enforce them.

"I think they are happening," he said of the HSA policies. "That’s why we’re a little confused."

A list of those policies is included in the budget analyst’s report, which Mecke said sent a conflicting message. "It creates the impression that things in the shelter system are other than what we found," he told a recent meeting of the standard of care work group, which is redrafting some of the legislation in preparation for a February hearing of the Budget and Finance Committee. "We want to be very clear at the Board of Supervisors that they don’t come away with the impression that these things exist, because they don’t."

Ammiano said this is a necessary first step toward making the shelters more humane, at a time when many assume they already are.

"I think one of the most annoying things that I read was C.W. Nevius [in the San Francisco Chronicle] taking this rather orchestrated Disneyland tour with Trent Rhorer and saying how wonderful the shelters were and then blaming the homeless for not wanting to be in them," Ammiano said. "But obviously C.W. Nevius and Trent Rhorer have something to wipe their ass with."

Bronstein kicked upstairs?

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TN-399068_Bronsteinpic.jpg

That’s what it sounds like. The Chron reports that editor Phil Bronstein, who has been a key part of the operation since Hearst bought the paper in 2000, is “leaving his post to take a larger role in the newspaper division of Hearst.”

His new title will be “editor at large.” His job duties haven’t quite been established yet.

It’s funny — a year ago, I would have said the paper desperately needed new direction. The Chron was flailing, heading nowhere, losing circulation and tons of money. But in the past few months, we’ve actually seen some life — opinion pieces and campaigns on the front page (bad ones, for sure, like Chuck Nevius’s crap on the homeless, but at least they were taking on issues), better design, some decent City Hall pieces etc.

So now we get a new editor with deep local roots. I’m holding my breath.

Bark if you’re psychic

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My furry fourlegged friend is a 17-year-old former dog clothing model and lives in a loft in NYC (the bitch made it as a model in Manhattan and left me behind! America’s Top Meanie!) Back when she was young, we’d huddle together, homeless, in shells of buildings in Detroit and Pontiac, MI. She never got the royal treatment until she was discovered by a talent scout who took one look at me and sniffed — and I’m not sure how she’d respond to this:

dogsongs.jpg

Oh yes, it’s real. And it gets better. This CD was “created by Skip Haynes and Dana Walden of the L.A. based Laurel Canyon Animal Company (the only record label that creates music about, for and with animals), who utilized the talents and expertise of intuitive animal communicator Dr. Kim Ogden to translate for them,” according to the press release.

“Canine focus groups selected from over 250 dogs nationwide were assembled and questioned by Dr. Ogden as to their preferences in music and content. The dogs’ responses were then used as guides for the music and lyrics resulting in a CD of songs that dogs love. ”

The CD, apparently, has already yielded a hit, “Squeaky Deaky” — which is accompanied by possibly one of the best videos EVER.

People on YouTube have already posted vids of their dogs reacting to the music. Straight up viral woofiness?

Where is home?

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› a&eletters@sfbg.com

"I’ve never been inside here before. I don’t like to come in here, because I feel alienated in my own neighborhood by this place, and that is kind of what this play is about," Danny Hoch said recently. His new solo stage production, Taking Over, opens Jan. 16 at the Berkeley Repertory Theatre. Speaking the day before he flew out West from New York to begin rehearsals with rep director Tony Taccone and looking around in half disgust, the New York–born actor-playwright was seated inside the Roebling Tea Room, a recently opened, funkily decorated but high-end restaurant directly across the street from his home in Williamsburg, Brooklyn, where he has lived for the past 20 years.

The yuppie meeting place was Hoch’s choice, as much for convenience, it seemed, as to further emphasize the point of what his new work is all about. "Williamsburg is ground zero for gentrification not just in New York but in the country, because it has provided a blueprint for how fast and how violent displacement and economic development can happen in a short amount of time," Hoch said. "And Taking Over is about how gentrification is really masking the idea of colonialism and how everybody is kind of searching for a sense of home and disconnected from where their home is. And in the kind of neofeudalism that is the new economy of North America, people looking for home wind up displacing people who are home."

As in his previous solo plays, such as the Obie Award–winning Jails, Hospitals, and Hip-Hop — which 10 years ago also premiered at the Berkeley Rep — Hoch channels a myriad of characters of various ages, races, and genders. Embodied with his ever-sharp dry observant wit, these include a major real estate developer, a Dominican taxi dispatcher, a French real estate agent, a revolutionary gangsta rapper, and a New York University student — a "clueless hipster" from Michigan who protests that she feels "like a homeless person" after her parents cut her monthly allowance from $5,000 to $3,000.

Another engaging character is the guy who was just released from incarceration after serving time under New York’s controversial, draconian Rockefeller drug laws. But he’s been gone so long he doesn’t recognize his old hood. "When he arrives they’re shooting a movie on his old block, and he talks to a PA on the movie set and says, ‘When I was growing up here people never came to shoot a movie. People shot things all right — like [other] people or heroin — but not a movie,’<0x2009>" Hoch explained. "And then he points to [a] woman in the window and says, ‘That’s my mother.’ And the PA asks him, ‘Oh, she doesn’t want to come down and check out the movie set?’ And he says, ‘No, she’s still afraid to go outside from the ’80s.’<0x2009>"

According to Hoch, the Bay Area has consistently been the most receptive to his work. "The Berkeley Rep is one of the only theaters, if not the only theater, that would support this kind of show from its inception. A theater in New York that needs to economically sustain itself [is] not going to commission or fund a show at this level about gentrification in New York, because it’s going to alienate their very audience." In fact, for the past 10 years Hoch has been unable to make a living as a writer or an actor in his hometown. "New York stories are no longer viable in New York City because the market is being informed by Americans. This is why you have Subway and Domino’s and Applebee’s and TCBY all over New York City — so that Americans can feel at home," he said.

"Do you know how many vintage clothing stores there are around here and stores that I can’t even identify with what the fuck it is that they are selling?" Hoch asked rhetorically. "How do you economically sustain that? You sustain that with disposable income, not income income. That is how you sustain this many bars and a tearoom like this. I tell you, this neighborhood didn’t need another tearoom. We needed more teachers. We needed a hospital. We needed better schools."

TAKING OVER

Through Feb. 10, $27–$69

See Web site for showtimes

Berkeley Repertory Theatre

2025 Addison, Thrust Stage, Berk.

1-888-4-BRT-TIX

www.berkeleyrep.org

Golden Girls: Ghetto Fabulous!

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Oh, Mary! The girls spend Christmas in a homeless shelter.

REVIEW There’s something about performing old television shows (i.e. “The Twilight Zone”) on a bare-bones stage two feet from the front row that accentuates what was good about them in the first place–the snappy dialogues, the solid story construction, the tinge of the absurd. Needless to say, the additional bonus of having the parts of four scrappy gran’mas living together in Miami, played by a snazzy quartet of the Bay Area’s finest drag queens puts the icing, as it were, on the Hostess cupcake. Heklina as Dorothy-makes the (ahem) perfect straight-woman. The sarcasm practically drips from her three-inch long eyelashes, without her even having to say a word. Cookie Dough plays her ribald Sicilian mother, Sophia, stage veteran Matthew Martin channels racy southern belle Blanche, and Miss Trannyshack 2007, Pollo del Mar embodies spacey airhead Rose Nyland. In “Sisters of the Bride,” Blanche’s baby brother Clayton (Mike Finn) announces his plans to marry his boyfriend Doug (Laurie Bushman). Consternation and eventual acceptance ensue, along with some great one-liners (Blanche: “What will the neighbors think when they see two men in my bedroom?” Sophia: “They’ll think it’s Tuesday.”) The highly-anticipated Christmas episode, set in a homeless shelter, does lay on the schmaltz a bit thick, but after all, ’tis the season, even in Miami, where–the girls remind us–it is 103 degrees. Santa, how ’bout a plane ticket? Or maybe just a ticket to the next sold-out Golden Girls show… (Nicole Gluckstern)

Fri/28-Sat/29
8 and 10 p.m.
The Finn Theatre
814 Grove, SF
$20 cash donation
waiting list starts at 7:30
www.trannyshack.com
www.cookievision.com

Gifts for good causes

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› molly@sfbg.com

Everyone loves the two-birds-with-one-stone approach to gift giving: a piece of furniture that covers both Mom and Dad, a pair of event tickets for your SO that means you get to go too, or the ever-popular this-item-is-so-big-it-covers-Christmas-and-your-birthday gift.

But in most cases, this gift-that-keeps-giving approach only benefits you and the giftee. How about letting one of the worthy organizations below in on some of the action? These gifts for good causes will benefit your loved ones and the planet, giving you the gift of a good conscience.

UNDER ONE ROOF


For everything from sleek kitchenware to funky, rainbow-themed holiday ornaments, this HIV/AIDS service provider has it covered with its "A Home for the Holidays" holiday store and event center, through Dec. 31.

2278 Market, SF. www.underoneroof.org

826 VALENCIA


Pirate gear from this Mission District store helps support mentorship programs in writing skills.

826 Valencia, SF. (415) 642-5905, www.826valencia.org

GOLDEN GATE NATIONAL PARKS CONSERVANCY


Books, art, toys, and games from the Crissy Field Warming Hut Bookstore and Café (Presidio Bldg. 983, SF; 415-561-3040), the Crissy Field Bookstore (603 Mason, SF; 415-561-7761), Alcatraz Island Bookstores (415-561-4922), and the Muir Woods Visitor Center (415-388-7368) all benefit the conservancy.

www.parksconservancy.org

CREATIVITY EXPLORED


When you choose the ceramic masks, tiles, handmade pillows, note cards, or other wares at the Creativity Explored Holiday Art Sale going on through Dec. 28, 50 percent of the proceeds go directly to the artist, while the rest helps maintain this nonprofit visual arts center for artists with developmental disabilities.

3245 16th St., SF. (415) 863-2108

ARC OF SAN FRANCISCO


DRAWBRIDGE


Buying ArcAngel holiday cards will benefit Arc of San Francisco, which serves, supports, and advocates for individuals with developmental disabilities. Or get individual cards or 10-packs from San Rafael’s Drawbridge, a program for homeless children. In both cases, the cards are designed by clients.

www.thearcofsanfrancisco.org

www.drawbridge.org

iGIVE


GREATERGOOD


Shopping online doesn’t disqualify you from do-gooding — even if you want to shop at major retailers. Before buying that radio from Best Buy or that towel set from Target, check online malls that donate a portion of proceeds to organizations like the March of Dimes and the Nature Conservancy (at no extra cost to you).

www.igive.com

www.greatergood.com

WORLD OF GOOD


You can also try the more direct approach at World of Good, a Berkeley organization that works with artisan cooperatives around the world to import high-quality goods, like fuzzy scarves from India and olive trays from Tanzania, while providing living wages, safe working conditions, and career stability to the artisans.

www.worldofgood.com

ORGANIC BOUQUETS


If you’re a sending-flowers kind of gifter, try Organic Bouquets, the Marin florist that not only sells and delivers organic flowers, plants, and chocolates online, by phone, and at Whole Foods Markets nationwide but also dedicates a percentage of its profits to charities like the Red Cross and the National Wildlife Federation.

1-877-899-2468, www.organicbouquet.com

FIFTY CROWS FOUNDATION


The purpose of this organization is to effect positive social change through documentary photography. Support it by gifting one of its prints.

49 Geary, Suite 225, SF. (415) 391-6300, www.fiftycrows.org

CASA BONAMPAK


This Mission fair-trade shop’s paper cutouts, party streamers, clothing, and Day of the Dead items are gorgeous — and proceeds support indigenous artisans from Chiapas and central Mexico.

3331 24th St., SF. 1-888-722-4264, www.casabonampak.com