Public Health

Hairy dilemma

3

news@sfbg.com

It used to be rare to see dogs in restaurants — which many people see as gross and the health codes don’t allow — but not anymore. It’s an increasingly common sight to see dogs in Bay Area restaurants, grocery stores, bars, and others businesses that traditionally haven’t allowed them.

Call it part of our love affair with canines, a loophole in medical privacy laws that stymies inquiries into whether Fido is a service dog needed for some ailment, or a manifestation of some people’s entitlement issues, but more and more pet owners see no problem with bringing their dogs to the dinner or lunch table.

Some have even angrily defended their supposed right to do so when confronted.

The city estimates there are about 120,000 dogs living in San Francisco, which equates to almost one dog per seven people. Sometimes it seems like even more than that given how omnipresent dogs seem to be, popping in places that used to be off-limits to them, such as restaurants.

Some people now see restaurants as dog-friendly zones, but they’re not, and for good reason. Due to public health concerns, dogs are banned by federal law from any establishment that serves or handles food.

The lone caveat to that rule is provided by the Americans with Disabilities Act (ADA), and it allows those who need service dogs to have them at all times, overriding the aforementioned policy established by the US Food and Drug Administration. The existence of the caveat isn’t really a problem — service dogs are necessary, helpful, and are highly trained animals — but the loophole it provides is.

That loophole allows regular, untrained folks to take regular, untrained dogs into restaurants under the guise of service.

“Under those provisions, restaurants are somewhat limited in that they can’t be too forceful in their line of questioning,” said Angelica Pappas, communications manager at the California Restaurants Association (CRA). “So I think that some people who want to bring their dogs know that and might think that they can get around the law that way.”

And in San Francisco, the trend is particularly pronounced, creating a problem for those who work in restaurants.

“The most obvious issue you see [when a dog is in a restaurant] is cross contamination,” said Terrence Hong, senior environmental inspector with the San Francisco Department of Public Health. “A food handler might pet a cute dog, for instance, where service dog handlers go through training themselves and are more prepared for that situation.”

Food can be contaminated with fecal bacteria — something many dogs just love to roll around in — in addition to just the unsightly hairs ending up in people’s meals. The US Centers for Disease Control estimates that one in six people (about 48 million) are sickened by food-borne illness each year. Of those, 128,000 are hospitalized and 3,000 die, according to the CDC’s last comprehensive study of the issue in 2011.

“Safety, too, is an issue,” Pappas said. “There’s no guarantee that all these dogs are well-trained and even having them on a patio is really no different than having them inside when it comes to that.”

Florida became the first state to allow non-service dogs in outdoors seating areas in restaurants in 2006, and California had followed the lead of the Sunshine State by 2012.

“But the application of those laws is far more difficult than the black and white on a piece of paper,” Hong says.

The ADA — the same law that allows service dogs to enter restaurants— is proving to be one of the biggest obstacles when it comes to identifying the fakes. The language in the ADA states that anyone entering a business with a dog claiming to be a service animal can be asked only two questions: Is the dog a service dog? What task is it trained to do for you?

Business owners can’t ask a person in question for identification, because no federally or municipally approved uniform identifier exists, according to Hong. They can’t ask what a customer’s ailment is, because that question violates a privacy clause in the ADA.

 

DOGS EVERYWHERE

While the restaurants are being unlawfully infiltrated, other areas around the city are experiencing atypical levels of canine traffic as well.

Buses? Sure, why not. As long as your dog has a muzzle, it can legally take part in the herkiest, jerkiest, most claustrophobic ride available in the Muni playground, at least according to the unbothered gentleman with his dog on the 47-Van Ness bus on a recent Saturday.

Cabs? Hop on in, Rover. The mall? Every dog could use an afternoon at Michael Kors. Grocery stores? Screw the food handling laws, dogs gotta eat too.

And if someone gets in the way of you and your pet canine’s umbilical relationship? Just claim it’s a service dog. Sure, it’s considered a federal offense to misrepresent your pet as a service animal, but you can order a super-official looking vest off the Internet easier than you can order a book off of Amazon. The malfeasance is also nearly impossible to report.

Thus, the misrepresentation of service dogs is a rapidly growing problem, and one that seems to be trivialized by a large number of people.

Unfortunately for those who need legitimate service dogs, Hong said the general public has offered little opposition to the fakes. He said that there is no exact figure for dog-related complaints, because they don’t consolidate them, but he also noted that many people are reluctant to speak out against the malfeasant service dog owners.

Whether it’s because they think the business owners will handle the complaint (they won’t, according to the CRA) or if they are just privately, rather than publicly, opposed to the trend (which Hong had said he thinks people are), it still leaves the owners of real service dogs in a tough place.

“We’ve been affected many times by fake service dogs,” said Wallis Brozman, service dog owner from Corporate Advancement Assistant for Canine Companions for Independence, a service dog training academy located in Santa Rosa. “It’s happened to us everywhere, we’ve been attacked right outside of restaurants. We’ve been denied service at restaurants, denied service at hotels.”

Brozman says that she has been denied service at those institutions expressly because of the bad name that poorly trained service dogs have given to the whole industry.

But Brozman needs her dog. She uses a manual wheelchair full-time due to a condition called dystonia, a neurological movement disorder that causes extremely painful and involuntary muscle contractions. Even with her condition, she says that she has been made to pay pet deposits in hotels, even though her dog isn’t even classified as a “pet” by the ADA.

And Caspin, Brozman’s dog, is definitely not a pet. He understands both Sign Language and English, making him a bilingual dog (and more linguistically savvy than this writer). He’s been trained to stay calm in loud, obnoxious public settings. He can pick up anything Brozman might drop. He’s a talented dog, but he’s no pet.

 

NOT JUST PETS

According to the California Penal Code Section 365.5, a “service dog means any dog individually trained to do work or perform tasks for the benefit of an individual with a disability, including, but not limited to, minimal protection work, rescue work, pulling a wheelchair, or fetching dropped items.”

Service dogs not only provide assistance when necessary, but they provide their handlers with a sense of autonomy that they can’t achieve through other means. That’s why service dogs were included in ADA of 1990.

It was a huge victory for the people that really need service dogs, like Brozman, for instance, or war veterans suffering from post-traumatic stress syndrome. One of the prescribed treatments for PTSD victims happens to be the presence of a service dog.

“It can cost us $5,000 to train these dogs for veterans,” said Robert Misseri, president of a service dog training organization called Guardians of Rescue. “Poorly behaved dogs make things more difficult for the vets who need our dogs.”

But the benefits of owning a service dog can be voided in a hurry if the dog encounters another dog without the same composure, training, and restraint.

“Our graduates have been bitten by dogs in public, provoked, and mistreated by other dogs,” said Angie Schact, an instructor at Canine Companions for Independence, a program that requires a minimum six-month program for their graduates. “They have gone through so much more training than the average dog. We’ve raised the issue with the Department of Justice. We’re serious.”

But when the ADA was originally drafted, according to Paul Bowskill, general manager of ServiceDogsAmerica.com, it “provided for very few mental disabilities. Most of the qualifying disabilities at the time were physical and [visible].”

After the ADA was passed, guidelines were expanded to include mental illness and seizure risk, in addition to physical ailment, so visual cues became far less notable.

“You can’t tell if someone needs a service dog now,” said Bowskill. “The law was written so you can train your own service dog, and by law, you don’t need an ID.” And as we, as a culture, become even more accustomed to steady streams of “Sure you can!” responses and discomfort demolishing inventions, our reluctance to leave pets behind is only trending upwards.

But for service dog owners just trying to lead an autonomous existence and those patrons simply tired of seeing dogs in places previously forbidden, it’s a scary thought. “Sometimes, [people] just assume that my service dog is a fake,” said Brozman. “I explain to people again and again, and I show them that my dog is perfectly trained and there to help me, yet people still stigmatize us.”

Homeless for the holidays

0

news@sfbg.com

As temperatures dropped in recent weeks, those who care for San Francisco’s homeless snapped into action.

Shelters stopped requiring reservations, making any beds still open after 8pm available to anyone who needed them. General Hospital’s Emergency Room treated the annual uptick of hypothermia cases, working closely with the city’s Homeless Outreach Team. Seven people in the Bay Area died as a result of cold weather in the last month — mercifully, none in San Francisco.

“Just one homeless person passing from being cold is way too many,” Carol Domino, program director at Mother Brown’s Drop-In Center, told the Guardian.

When the cold hit, Mother Brown’s staff could be found scouting encampments near its location in Bayview. Besides a respite from the weather, it offers bathrooms, showers, access to case management services, and other resources, as well as two hot meals a day in its dining room. But there’s one thing it can’t offer: a warm bed.

But that may change. A proposal for a 100-bed homeless shelter next door to Mother Brown’s gained political footing this year, despite controversy and a divided neighborhood.

 

SHELTER IN BAYVIEW

Behind the shelter effort is Gwendolyn Westbrook, director of the United Council of Human Services. Westbrook says the idea didn’t come from her, but from Barbara J. “Mother” Brown, the local legend who served hot meals out of the back of a Cadillac Seville before founding Bayview Hope Homeless Resource Center and Mother Brown’s Dining Room in 2001.

“People have come in here needing a place to sleep for as long as it’s been open,” Westbrook said. Brown’s solution was to set out folding chairs where people could sleep. Nowadays, 80 people rest in the chairs on a typical night.

Before Brown died in 2005, Westbrook remembers, she made it clear to her successor how much she wanted shelter beds where clients could lie down.

Of her clients, Westbrook says, “it’s a lot of people who are from this area, grew up in this area. Some people never leave this district. Their homes might have gone into foreclosure, or somebody died that set them back and triggered something mentally, and now they’re on the street. So this is a safe haven for them. This is a place where they can come and just relax.”

Even as the cost of living soars and the neighborhood changes, Westbrook says, her clients hold on.

“Most of our clients won’t leave the Bayview,” she said. “Some of them have told me, ‘well if I die, just cremate me and put my ashes up on Third Street. Spread them on Third Street.’ That’s how much they love this neighborhood.”

Human Services Agency (HSA) director Trent Rhorer witnessed the chair arrangement during an August 2011 visit to Mother Brown’s. He called the sight “simply not acceptable from a view of humanity.”

When Rhorer learned that a warehouse next door had recently been put up for rent, the shelter idea was born. The HSA applied for a forgivable loan from the state’s Emergency Housing and Assistance Program (EHAP). In January 2012, the project was approved for $978,000.

On Nov. 19, the Board of Supervisors voted to accept the grant, and on Dec. 10, it assigned the next two steps: city adoption of the lease for the property and creation of a special use district. The rezoning process could take six months to a year at the Planning Commission, and if the shelter ultimately goes through, construction is not likely to begin before 2015.

Until then, shelter options in Bayview-Hunters Point will stay slim. There is no single adult shelter with beds in the neighborhood. The closest thing is Providence Baptist Church at 1601 McKinnon. There, staff lay out mats on the gym floor each night.

“In Bayview-Hunters Point, that’s it. Providence is the shelter,” said Nick Kimura, shelter client advocate with the San Francisco Coalition on Homelessness.

In Mayor Ed Lee’s 2013 State of the City address, he said he was “proud to support” efforts to expand services for the homeless in Bayview—specifically “Sup. Cohen’s effort, aided by a federal grant — to build a new 100-bed shelter”

The only problem: that was the first Cohen said she had heard of it.

“My first concern was how the proposal came about,” Cohen told us. “I wasn’t made aware of it until it was announced.”

 

SHIFTING POLITICS

After Lee’s announcement, there were two community meetings, one in March at the police station and one in April at the YMCA. The idea gained support from the Southeast Community Facility Commission and the San Francisco branch of the NAACP.

A wave of opposition also grew, including the neighborhood organization Bayview Residents Improving Their Environment (BRITE), and a handful of businesses led by David Eisenberg, president of Micro-Tracers, a food testing company next door to Mother Brown’s.

On July 16, Cohen herself came out against the shelter. Cohen said her decision came after “meeting with residents about their concerns and fears.”

Neighborhood residents are a shifting demographic. The African American population has declined by 10 percent since Mother Brown’s was founded in 2001. The Asian population increased slightly in the same time period, and the white population has more than doubled.

Homelessness in the neighborhood has also increased. According to the city’s biannual homeless count, the number hovered around 400 until January 2011, when the number jumped to 1,151. It had 1,278 homeless people in 2013.

After Cohen declared her opposition, the meetings went back behind closed doors. In September, David Curto, director of contracts at the HSA, said that “[city homeless czar] Bevan Dufty and other folks in the Mayor’s Office are trying to revive it.” On Oct. 9, Lee met with a group of neighbors. And on Oct 30, the shelter proposal made its public reappearance.

Sups. John Avalos, Eric Mar, and Mark Farrell of the city’s Budget and Finance Committee heard the issue. They were tasked with voting on whether to accept the EHAP loan, a question that would be put to the Board of Supervisors if it passed.

Out in the gallery, the two sides sat divided down the aisle like squabbling families at a wedding. House left were the shelter’s supporters, a mix of residents and community leaders and staff of Mother Brown’s and their clients, some with their shoes pulled on only half way over feet swollen from sleeping in their chairs. On the right, BRITE members, an ad hoc group called Protect MLK Pool and Playground, Eisenberg, and other community members in opposition.

The shelter became a vehicle for a debate about larger changes in Bayview. BRITE member David Armagnac saw no need for shelter beds in the neighborhood that he has “seen transform and emerge into an ever-increasing vibrant area.” Bayview business owner Carla Eagleton wanted economic and quality of life impact reports on the proposed shelters “as it relates to the city’s only remaining blue collar industrial area, MLK Park, surrounding neighborhoods and the Third Street corridor, which the city of San Francisco has spent billions of dollars to revitalize.”

Meanwhile, resident Sandy Thompson testified that “for you guys to move in and make yourself comfortable,” many of her neighbors have been displaced. “Make the homeless comfortable, just like you guys are making yourself comfortable, because they need a place too,” Thompson said.

A client of Mother Brown’s talked about being homeless in the neighborhood her family had been in for generations. “My grandparents are the ones that migrated from the south, that came up here to work on those shipyards,” she said. “Think about that parent who is working at McDonalds, or working a low, minimum-wage job. They can’t afford the new housing that’s coming in, that’s being developed. Yes, we love it. We love to look at the property that we cannot live in.”

Both sides made passionate pleas, but shelter supporters won over the Budget and Finance Committee.

“It’s very rare that I get moved from hearing public comment. I hear a lot of public comment, and sometimes I feel like my heart is hardened to everything. But not today,” Avalos said.

Farrell agreed: “It’s rare that you get touched here, because we do hear so much public comment all the time. And the personal stories are pretty incredible.”

 

INSIDE MOTHER BROWN’S

Inside Mother Brown’s cool blue walls, there’s no shortage of incredible personal stories. Lonnel McCall took a break from helping to cook dinner at Mother Brown’s kitchen to describe what the place has meant for him.

“I didn’t have nothing, not even ambitions. I felt I was a loser. I had no self-esteem,” he remembers. “I was smoking crack under the bridge and all that stuff.”

He now has a job as a hotel chef and lives in a HOPE House home. He rolled up his sleeves to reveal cuts and burns, the battle scars of a chef.

“These are my cook wounds,” he said, “instead of dope wounds.”

But for a period, McCall slept in the chairs. “It’s hard. Your ankles swell up,” he said.

Wade Verdun also slept in the chairs and went through HOPE House.

“I’ve got my own place now, got my own car. I’m no longer on drugs. And I’ve got a two-year-old son,” Verdun said. “This place saved my life, to tell you the truth.” Smiling, he patted his belly. “I’ve never been this fat. Trust me.”

If the shelter does get built, Westbrook hopes, it can lead to more happy endings like McCall’s and Verdun’s.There are already too many sad stories.

On Dec. 19, candles lit the dusk on the steps of City Hall in a vigil for the homeless people who have died in San Francisco. The vigil was organized by Night Ministry, a crisis intervention and counseling service that operates in the Tenderloin from 10pm to 4am. Reverend Lyle Beckman, director of Night Ministry, said that he got the names of 22 deceased homeless people from the Department of Public Health, but knew it was low. During the vigil, attendants came forward with the names of more dead, until the number reached 100.

Beckman said the crisis line gets busy this time of year. “We always see more conversations around holiday time,” he said. “When people have memories of it being a family time and then they’re not connected with their family in some way, it can bring isolation and loneliness.”

In a city of chosen families, Mother Brown’s “children” have found a way to heal that kind of loneliness. Perhaps McCall put it best when he described the first time he came back to his native Bayview and found Mother Brown’s after decades of isolation.

“When I came in through the door — this is God’s truth — I felt like I was at home,” he said. Soon, people like McCall may find a bed, too, when they walk through that door. Maybe for Christmas 2015.

Laboring for better health care

2

Gardening, plumbing, construction, janitorial work and washing dishes: the jobs day laborers perform for San Franciscans are done with their bodies. Their physical fitness is their gateway to work.

It’s that physicality they risk on the job every day. Undocumented Latino laborers have a hard time reaching options for medical care though, even in a sanctuary city like San Francisco.

To be clear, San Francisco has gone far and beyond many cities to provide medical care. The city’s Healthy San Francisco program, UCSF, and a smattering of nonprofits all provide medical care to undocumented immigrants, which often includes day laborers.

The problem is not a matter of options, but a matter of trust.

James Quesada, an anthropology professor at San Francisco State University who studied health care options for day laborers, said even when options are available, many day laborers actively avoid them.

The specter of deportation is always lurking, he said, stopping many from seeking clinics in the first place.

“Despite the fact that we’re a sanctuary city, there’s always that fear and threat that someone could come at any time,” Quesada said. “There are do-gooding public health services for them, public health contracted satellite clinics and the like. But one of the hardest things is to really convince them that they’re not in peril by going.”

At the U-Haul rental facility near Bryant street, laborers stand in pairs waiting for potential customers to drive by. When a customer comes into sight, they’ll start toward the passing car in huffing sprints. Their work is unpredictable and never guaranteed.

One man the Guardian spoke to, Gonzalo Moran, 62, cited one health care center as a timely godsend: the Mission Neighborhood Health Clinic. The wait there is only half an hour, he said, and in an emergency they make referrals to SF General Hospital.

But heading to SF General for care can carry a high price tag in both time and money, and results are not guaranteed.

“One day I had a toothache, I went to the emergency [room], was there from about four o’clock in the morning to four o’clock in the afternoon,” Moran said. “I told them I was homeless, that I didn’t have no income, I have no immigration papers or nothing. A nurse came to check on me, my tooth. They just gave me a prescription for Tylenol, but then a month later they sent me a bill for $300. For Tylenol.”

Moran isn’t necessarily out on the streets, but crashes regularly at different places. Whenever he tried to get a credit score the bill would come up in searches.

The hit wasn’t only monetary. The day he spent at the hospital was a day he could have worked.

Moran’s story reflects findings made by Quesada in his research. Though many providers claim to help the undocumented, the level of service can depend on just which doctor or nurse you happen to get that day. Service and safety are uneven, and there’s no way to keep track of it all.

“It’s a patch quilt, a moving target,” he said.

Moran told his story with strong English skills gained through City College classes, but he’s had the time to learn — the El Salvador native landed in the United States in 1976 to earn money for his family. Others Quesada talked to were not as lucky.

In his research on undocumented day laborers and health care, he found many who avoided clinics and hospitals for fear of being deported. Quesada found the laborers in the streets, and spent time in clinics and hospitals to find what kept them away from medical care. What he found was fear.

Some men would jump even at the sight of a rent-a-cop security guard, he said.

In an academic paper he published on the subject, Quesada related the story of Juan, a day laborer in his 50s who suffered terrible tooth pain. He refused to seek help.

“Look Jim, if I show up at the clinic [nearby public clinic] I cannot be sure I won’t be arrested and taken away. You know, it is more dangerous now. I can never be sure when it is safe to go [get medical attention]. But, you know what it is, I do not want to be like those others [Latinos] who have “no shame” [sin verguenzas] and want what they want for nothing. If I can I will pay my way, and if I can’t, I can’t. I’ll withstand the pain and take care of it myself, even if I have to pull them [his teeth] out myself. “

Juan would medicate the gaps in his teeth with Tequila soaked cotton balls, and aspirin.

Quesada tried to get him help, but Juan had to cancel dental appointments repeatedly when jobs became available. Day laborers never know when the next opportunity may drive up to them.

This is what pushes Quesada and others to push for a merging of social work and health care. Some facilities in San Francisco have already moved that way, as hospitals like UCSF visit churches and community centers on weekends to reach out to undocumented people in need of medical attention. Still, there’s room for change.

“Doctors shouldn’t have be social workers, but social workers should be there in the room,” Quesada said, saying that would go a long way towards helping undocumented workers find the help they need. But despite a lack of options, they carry on.

“They’re valiantly making a go of it, and don’t want to dwell on the negative,” he said. “They don’t want to be seen as fighting for basic human rights, as not fully human.”

The man we met outside the U-Haul on Bryant, Gonzalo Moran, has three trade school certificates, one of them in floor tiling. But he longed for one thing: time to attend school so he could get ahead.

“I go to school all the time, you know, if I have it,” he said. “But it’s hard, we’re always getting a lower wage.” And it’s a barrier. A barrier to health, a barrier to education, and a barrier to a better life.

 

Fieldwork

4

marke@sfbg.com

After two more hours of hiking, we stop in a dry creek. One of the younger men enlists help pulling large cactus spines from one of his legs. We sit in a circle sharing food. The tastes link us to loved ones and Oaxaca…

After we have hiked again through blisters for many miles and I have shared all my ibuprofren with the others, we stop to rest. We fall asleep, using torn-open plastic trash bags as blankets. Our coyote leaves to talk to his contact on a nearby Native American reservation about giving us a ride past the second boarder checkpoint to Phoenix….

Suddenly, our guide runs back, speaking quickly in Triqui. Two Border Patrol agents — one black and one white — appear running through the trees, jump down in our creek bed, and point guns at us.

— Seth M. Holmes, Fresh Fruit, Broken Bodies

According to the US Public Health Service, there are, on average, an estimated 3.5 million migrant farmworkers in the United States, the majority of whom are undocumented immigrants. At harvest season, most of them perform the backbreaking work of picking our fruits and vegetables for an average $12,500 annually; at other times, they share slum-like apartments or live out of cars looking for odd jobs — 68 percent of them wondering if they should return home to Mexico and risk another border crossing to the US when picking time rolls around again. Only 5 percent of migrant workers have health insurance, and what happens to the rest if they get injured or fall ill doing the work the rest of us won’t is an eye-opening American tragedy.

To many Americans, this cheap, legally and socially vulnerable population is a faceless brown mass in the fields somewhere, maybe receiving a noble thought at Cesar Chavez Day or inducing the occasional twinge of guilt in the produce aisle, if thought of at all. But a provocative, important new book by UC Berkeley Assistant Professor of Public Health and Medical Anthropology Seth M. Holmes, Fresh Fruit, Broken Bodies: Migrant Farmworkers in the United States (University of California Press), which is picking up awards and has been featured on mainstream news outlets, is helping to re-personalize migrant farmworkers and move their health care situation into the media spotlight.

As the US finally addresses the facts that it spends the most money on health care for the worst outcomes, that a huge chunk of its population has no health care at all (and is severely underpaid for its work), and that we’re dependent on undocumented immigrants to harvest our produce and keep food costs down, we’re only just starting to realize the irony in giving the people who devastate their bodies to provide our healthiest foods perhaps the lousiest health care deal of all.

 

COMPLEX VOICES

Part heart-pounding adventure tale, part deep ethnograhic study, part urgent plea for reform, Fresh Fruit starts off with Holmes embedded in an ill-fated group of border-crossers from the mountains of Oaxaca: he gets arrested, they get deported after a harrowing stay in a detention center. Holmes then writes about his 18 months spent picking fruit alongside hundreds of others at a large family-owned farm in Skagit Valley, Wash., living in a closet with a dozen farmworkers in a rundown apartment while they look for work on the off-season, returning to Mexico to spend time with workers and their families, and shadowing the medical professionals in the publicly and privately funded clinics that serve migrant populations. Throughout, Holmes saw people “give premature birth, develop injured knees and backs, suffer from extreme stress, experience symptoms of pesticide poisoning, and even have farm trucks run over and crush their legs,” as he told Farmworker Justice magazine.

Holmes, a medical doctor as well as a doctor of anthropology — the book resulted from his thesis work — brings an enlightening complexity to the issue of migrant workers. (Including the label “migrant worker” itself, which, he notes piercingly at the end of the book, has been ossified with classist and racial overtones. If this group of people were flying over every summer from Europe or Hong Kong to secure investments on Wall Street, they would be called “international businesspeople.”)

He’s especially concerned not just with the grueling minutae of trying to receive treatment for the aches and pains that come with stooping to pick strawberries 12 hours a day, struggling to meet ambitious quotas in order to get paid very little, but also the larger, physically devastating effects of the structural violence visited upon a whole population by neoliberal economic policies that continue to widen the global income gap and entrench the wealthy in power. His “participant observation” method of studying migrant farmworkers means he writes about his own experiences in the field, and he brings his sophisticated anthropological knowledge to bear on the way contemporary society ensures that migrant farmworkers stay on the bottom rung of the economic ladder, building on the work of Pierre Bordieu, Philippe Bourgois, and others who’ve studied power relationships and structural violence in terms of workers’ health.

But, although there are scholarly footnotes and personal interjections, Holmes avoids an icky “anthropological tourism” vibe by providing the workers themselves with room to tell their histories, talk about their bodies, and react to the way they’re treated. People like Abelino, who falls victim to a series of misunderstandings over his severely injured knee, or Crescencio, who suffers acute headaches whenever he’s called racist names or ordered around degradingly, but is labeled a potential domestic abuser by one caregiver and resorts to drinking up to 24 beers per night to soothe his pain. We also hear from Marcelina, who talks to a Skagit Valley community gathering about low wages and high quotas.

And Holmes lets the owners and operators on all levels of Skagit’s Tanaka Brothers Farm — a pseudonym to protect his sources — speak as well, about the need for cheap labor in an increasingly competitive global agribusiness environment, among other concerns. (One especially interesting tidbit: organic distributors pressured Tanaka Brothers Farms to sign a machine-pick contract, which relegates farmworkers to the pesticide-ridden fields, despite the growing market for organic produce.) The Japanese-descended Tanaka family is deeply embedded in the Skagit Valley community, with roots stretching back before the Japanese internment period. The farm has seen different waves of migrant workers from poor white to Asian to Mexican. The Valley community itself has a fascinating relationship with the migrant community, emerging from it while reacting to it, developing its own social hierarchy as each generation “graduates” from farmworker to resident.

 

ANOTHER GENERATION

A lot has changed from Chavez’s day. For one thing, the previous generation of field workers, mostly from Guadalajara and northern Mexico or from Central America, has gained a toehold on American society — like the Asian workers that preceded them, many Hispanic workers’ children, placed in American schools, have grown up, providing their parents with a path to citizenship or work visas that allow them access to better jobs.

Today, a lot of workers are not mestizo Mexican, but of indigenous Mixtec descent, from increasingly violent mountain villages of Oaxaca in southern Mexico like San Miguel and San Pedro. Bloody land disputes, ethnic tension, the collapse of the local agriculture market that was exacerbated by the North American Free Trade Agreement in the 1990s and continued through the recent global recession, and the rowdy and malevolent presence of US-funded anti-drug military forces (strange since no major drug cartels operate there) have isolated this area, forcing its men, women, and children to look for work in America.

Triqui, not Spanish, is their native language — just one of the major hurdles when it comes to delivering healthcare to this population. Another hurdle comes with the specific cultural record of Triqui and general Mexican healthcare. Many Triqui workers rely on native healers, even in American farmworker camps, whose methods of consulting cards and drawing evil spirits from bodies using oils surely provide some psychosomatic respite. But reliance on native healers — out of a combination of tradition, availability, and fear of discovery or of health institutions in general — often prevents workers with deeper problems from receiving a wider range of appropriate treatments. Self-medication through alcohol is common (Holmes observed no drug use), and in one case a man named Bernardo took to the habit mashing his abdomen with soda bottles to ease a chronic stomache ache.

The migratory nature of these workers — and their shifting relationship to the law — all but insures disruptions in preventative and prescriptive care, lack of access to medications, frustratingly spotty medical records, and the inability to form a valuable personal bond with a trusted physician. But the major hurdle is that the system put in place by the government to serve migrant populations hasn’t been revisited since 1962, when a wave of media concern spotlighted the plight of migrant workers — most of whom, at that time, were white Oakies descended from the great Dustbowl diaspora of the ’30s and ’40s. The system has been only slightly adapted and enlarged since then, with dozens of clinics and organizations competing for limited grants, and nonprofits charging as little as they can (often still a steep fee on a farmworkers’ wage).

The picture Holmes paints of the clinics he visits and the doctors, nurses, and caseworkers he encounters is a mostly warm one — most health workers are hard-working and well-intentioned, stymied by cultural and linguistic differences, lack of funds and proper medical records, and racist attitudes from the surrounding communities. Some are prone to misinterpretation, and there are a couple outbursts of frustration that borders on stereotyping.

Still, most migrant worker health care providers are dedicated to their patients’ welfare. As one doctor, a mountaineer who serves the Tanaka Brothers Farm workers, put it: “It’s a very difficult problem. We have a bad situation where citizens cannot really afford health care. And the migrant workers, I truly believe they should have at least the same access as the others. I mean, this work that they are doing is something that nobody else is willing to do. That’s the truth. That’s probably the only reason why we are able to go to the supermarket and buy fruit for a fair price. So this is a group of people that really deserves our attention.”

That group will most likely be left out of the Affordable Care Act’s initial implementation, with possible implications for other, growing fields of migrant work, like software coding or childcare. Holmes’ book will hopefully inspire other investigations into this critical area of the nation’s health care gap — and concerted action to bridge it.

BART standoff continues as board modifies contract

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The BART Board of Directors voted 8-1 on Nov. 21, with conservative young Director Zakhary Mallett in dissent, to approve a hard-won contract with its unions, after removing Section 4.8, the paid family leave section that the district says was inserted by mistake.

The motion also directed management to negotiate a settlement over that issue with its unions, which have already approved the contract and now must decide whether they are willing to do so again without that provision or whether the possibility of another BART strike is once again looming.

The next day, BART’s largest unions, SEIU Local 1021 and ATU Local 1555, issued a joint statement: “We consider the Board’s actions to be unprecedented and illegitimate, and we’re considering our next steps, including possible legal action. The BART Board of Directors has disregarded the vote of more than 2,000 BART workers and has chosen to subvert the collective bargaining process, and we take their actions seriously.”

After meeting in closed session for about two hours, Vice President Joel Keller began the open session with a motion to remove Section 4.8 from the contract, approve the rest, and direct management to negotiate with the unions.

Mallett, the 25-year-old newbie who lives in unincorporated West Contra Costa County but whose District 7 includes part of San Francisco, spoke first: “Even before this hiccup, I was not in the position to support this contract. I find it too costly.”

But he was the only one to take that stance, with the rest of the directors calling the underlying contract a fair compromise, even if all said they couldn’t support the paid family leave provision that would add anywhere between $4 million and $44 million to a contract that was already going to cost the district an additional $67 million.

Director Gail Murray noted that the unions had given up raises for years when BART had budget deficits, and now that the district is running surpluses, it’s reasonable to give workers raises that amount to about 2 percent per year for four years.

“Our employees kept the system going…They’re the reason why we keep 40-year-old cars still running,” Murray said, later adding, “To say this contract is not a good contract is wrong.”

The rest of the board agreed, even while acknowledging it is more than they hoped to pay given the district’s capital needs and aggressive expansion plans.

“We’re probably paying more for this than we anticipated we would pay, and labor is probably giving up more than they want to, but that’s the nature of collective bargaining,” Keller said, who also began what turned into a chorus of criticism for how district negotiators signed off on a provision the board never agreed to.

“We ended on a sloppy note and that’s regrettable,” Keller said, pledging that if he’s elected president next month — an ascension that is customary for the vice president — he plans to launch a full investigation into what happened.

“I’m pained that we put ourselves in such adversarial positions with each other and that we lost the lives of two employees,” Director John McPartland said of the protracted labor negotiations and the fatalities that occurred while the unions were on strike Oct. 19. He called the contract “more than fair and equitable.”

Director James Fang, who represents western San Francisco, sounded the strongest criticisms of BART management and negotiators. “Yes, it was a mistake, but nobody has come forward and said ‘there was a mistake and I’m responsible,” Fang said, later adding, “The ones who signed this must be held to account.”

Fang then went further, albeit without specifics, when he said, “Every bit of management advice we’ve received has not worked out to the district’s best interests.”

Director Robert Raburn echoed Fang’s calls for accountability: “I’m still not clear on how that [contract provision] arrived and it hasn’t been accounted for by anyone at the district who said ‘I am responsible.'”

But he also said that the provision was clearly an error and not something arrived at through the negotiations: “Both parties agreed on a $67 million package and we should keep that intact because it’s fair.”

Reached by the Guardian while union leadership was conferring to plan next steps, SEIU Local 1021 Political Director Chris Daly told us, “We are about as up in the air as we’ve ever been.”

He called it “unlikely” that union leadership would simply submit the board-revised contract to an up-or-down vote by union membership, saying that he doesn’t think it would be approved.

And Daly echoed the concerns expressed by several BART directors about how this mistake happened and why nobody has taken responsibility or been held accountable: “If I were on that board, I’d have the general manager’s head, there’s no two ways about it.” (Steven T. Jones)

SF General reduces psych care

A 22-bed psychiatric unit at San Francisco General Hospital will be taken out of service, and reopened only if the facility experiences a high caseload of patients exhibiting the worst signs of psychiatric crisis.

As of Nov. 19, five patients were receiving care in that unit, 7B, according to spokesperson Rachael Kagan. None had symptoms that rose to the level of requiring acute care. Instead, they were classified as sub-acute patients, a distinction that essentially means they didn’t present an immediate threat to themselves or others.

But under a new policy that will take effect after they have been released, all 22 beds in 7B will be closed — unless they are needed for acute patients who do reach that critical threshold. The unit will be staffed only if patients can’t be accommodated in the hospital’s other acute psych unit, which has 21 beds.

The decision was made in response to a changing financial picture under federal health care reform, Kagan explained.

“There is a big push … to ensure hospitals are only providing acute care,” Kagan said, and this trend is driving efforts to reduce sub-acute patients. “It fiscally makes more sense,” she added, because insurers pay higher rates for acute care than for lower levels of treatment.

Yet some hospital staff members are nervous about the implications of this shift, because it means fewer patients will be able to access psychiatric care at SF General unless they represent a danger to themselves and/or the general public — at a time when demand for these services is on the rise.

“To us, it’s a matter of priority for the city,” said Brenda Barros, an employee at SF General who is active with hospital union SEIU 1021. “Do you want to take care of these people, or don’t you?”

Some staff members are doubtful that 7B will reopen. An internal SF General memo issued Nov. 18 informed the 7B staff: “Our census will be gradually reduced until we won’t have any more patients. Then 7B will be closed.” The memo added, “this came from [SF General CEO] Sue Currin due to budgetary constraints.”

However, a second internal memo went out the following day, to “clarify” the first one. In that message, Nursing Director Kathy Ballou wrote: “We are not closing psych beds or any beds.” Instead, beds in 7B would be closed unless “we get acute patients needing that level of care,” she wrote. “As in other hospitals, we are accountable to our operating budget.”

Further complicating matters, said Barros, is that patients can fluctuate rapidly between needing acute care and a lower level of attention. “They absolutely can swing back and forth.” She added that patients initially requiring a lower level of care could experience worsening conditions if they’re unable to secure an appointment in time to get help, and delays are very common.

Kagan emphasized that the unit wasn’t being closed down, but did confirm that sub-acute patients would no longer be able to receive treatment in 7B. Instead, those patients will be placed with various service providers throughout the city, she said. “The goal is to move the patients to their appropriate placement.”

Meanwhile, this shift coincides with an overall rise in citywide demand for psychiatric services. According to a report delivered to the Police Commission earlier this year, SF General had 6,293 patient admissions for psychiatric holds in 2012, a sharp increase from 5,837 in 2009.

While there were deep cuts to the city’s Department of Public Health during the economic downturn, Mayor Ed Lee has recently trumpeted a boost to city coffers thanks to growing economic activity. But if the city’s financial health has improved, it seems odd that its safety-net hospital would be put into the position of reducing psych care due to budgetary pressures when that kind of care is sorely needed.

For Barros, it’s a matter of whether or not city officials will decide to allocate more funding for mental health services. “If they don’t have enough money in Public Health,” she said, “then they need to put more into Public Health.” (Rebecca Bowe)

SF General reduces psychiatric care

A 22-bed psychiatric unit at San Francisco General Hospital will be taken out of service, and re-opened only if the facility experiences a high caseload of patients exhibiting the worst signs of psychiatric crisis, the Bay Guardian has learned.

As of Nov. 19, five patients were receiving care in that unit, 7B, according to spokesperson Rachael Kagan. None had symptoms that rose to the level of requiring acute care. Instead, they were classified as sub-acute patients, a distinction that essentially means they didn’t present an immediate threat to themselves or others.

But under a new policy that will take effect after they have been released, all 22 beds in 7B will be closed – unless they are needed for acute patients who do reach that critical threshold. The unit will be staffed only if patients can’t be accommodated in the hospital’s other acute psych unit, which has 21 beds.

The decision was made in response to a changing financial picture under federal health care reform, Kagan explained.

“There is a big push … to ensure hospitals are only providing acute care,” Kagan said, and this trend is driving efforts to reduce sub-acute patients. “It fiscally makes more sense,” she added, because insurers pay higher rates for acute care than for lower levels of treatment.

Yet some hospital staff members are nervous about the implications of this shift, because it means fewer patients will be able to access psychiatric care at SF General until they represent a danger to themselves and/or the general public – at a time when demand for these services is on the rise.

“To us, it’s a matter of priority for the city,” said Brenda Barros, an employee at SF General who is active with hospital union SEIU 1021. “Do you want to take care of these people, or don’t you?” 

Some staff members are doubtful that 7B will reopen. An internal SF General memo issued Nov. 18 informed 7B staff: “Our census will be gradually reduced until we won’t have any more patients. Then 7B will be closed.” The memo added, “this came from [SF General CEO] Sue Currin due to budgetary constraints.”

However, a second internal memo went out the following day, to “clarify” the first one. In that message, Nursing Director Kathy Ballou wrote: “We are not closing psych beds or any beds.” Instead, beds in 7B would be closed unless “we get acute patients needing that level of care,” she wrote. “As in other hospitals, we are accountable to our operating budget.”

Further complicating matters, said Barros, is that patients can fluctuate rapidly between needing acute care and a lower level of attention. “They absolutely can swing back and forth.” She added that patients initially requiring a lower level of care could experience worsening conditions if they’re unable to secure an appointment in time to get help, and delays are very common.

Kagan emphasized that the unit wasn’t being closed down, but did confirm that sub-acute patients would no longer be able to receive treatment in 7B. Instead, those patients will be placed with various service providers throughout the city, she said. “The goal is to move the patients to their appropriate placement.”

Meanwhile, this shift coincides with an overall rise in citywide demand for psychiatric services. According to a report delivered to the Police Commission earlier this year, SF General had 6,293 patient admissions for psychiatric holds in 2012, a sharp increase from 5,837 in 2009.

While there were deep cuts to the city’s Department of Public Health during the economic downturn, Mayor Ed Lee has recently trumpeted a boost to city coffers thanks to growing economic activity. But if the city’s financial health has improved, it seems odd that its flagship safety-net hospital would be put into the position of reducing psych care due to budgetary pressures when that kind of care is sorely needed.

For Barros, it’s a matter of whether or not city officials will decide to allocate more funding for mental health services. “If they don’t have enough money in Public Health,” she said, “then they need to put more into Public Health.”

Overstimulated

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Environmentalists who oppose fracking in California are concerned about more than possible groundwater contamination or other hazards that could directly result from the fossil fuel drilling practice. They also want to save the planet.

The Monterey Shale, a massive underground geological formation spanning a large swath of California, contains approximately 15 billion barrels of hard-to-get oil that could technically be extracted in massive fracking operations, Kassie Siegel of the Center for Biological Diversity said during a Nov. 15 call with reporters.

All told, burning that quantity would eventually release six billion metric tons of carbon dioxide into the air. “That is a carbon bomb,” Siegel stated bluntly. Combined with methane that is released from the wells during the drilling operations, “a fracking boom in California could undo all the progress our state has made on greenhouse reductions,” she warned.

But for now, the debate on fracking in California is focused on newly drafted state regulations that would place controls on the practice for the first time. The proposed rules pertain to permitting and disclosure in the areas surrounding individual wells — yet they don’t contemplate the cumulative impact of fossil fuel combustion over time.

Fracking, formally known as hydraulic fracturing, is a technique used for extracting oil or natural gas. It involves injecting high-pressure fluids underground, often containing toxic chemicals, to break up bedrock in order to access the fossil fuel sources trapped within. The California Division of Oil, Gas, and Geothermal Resources (DOGGR) released a set of draft regulations Nov. 15 proposing new rules around what’s known as “well stimulation,” industry-speak for a type of drilling that includes fracking.

The new rules are slated to go into effect on Jan. 1, 2015. They’ll continue to be hashed out throughout next year, and DOGGR will accept public comment on the initial proposal until Jan. 14, 2014.

The regulations came about in response to Senate Bill 4, legislation enacted Sept. 30 after a statewide coalition of environmentalists launched a campaign to put a stop to fracking, which is already happening in some parts of California. Many groups within that coalition viewed the legislation as flawed, because it didn’t prohibit the practice outright.

“The only safe way forward for California is a halt to fracking in our state,” Siegel said.

Still, the draft regulations do seek to place new requirements on the oil and gas industry in an effort to protect public health where fracking occurs. According to DOGGR records, fracking is most common in Kern County.

“There are some good provisions in the regulations,” Bill Allayaud of the Environmental Working Group said in the briefing. “For the first time, all forms of well stimulation will require a permit from DOGGR. That’s a good thing.”

The rules will also require companies to conduct an analysis of groundwater and other wells nearby before proceeding with fracking operations, unlike before. The new regulations also establish a notification process to make nearby residents aware of new drilling operations.

Meanwhile, SB 4 calls for an environmental impact report and a study on the overall health and safety effects of fracking — but it’s unlikely that this study would result in a prohibition on the drilling practice, as environmentalists had initially called for.

“The Natural Resources Agency is currently developing the scope of the study and will begin the analysis in December 2013,” according to a fact sheet published by DOGGR.

“We don’t think we’ll be getting deep answers as to whether fracking and acidization and all forms of well stimulation are safe or not, for both protecting public health and the environment,” Allayaud said.

Meanwhile, he expressed concern that the public comment period for the initial set of proposed rules did not provide enough time for concerned Californians to respond, because people are being asked to weigh in over the course of the holiday season. The Environmental Working Group has requested an extension of that deadline, but it seems unlikely that DOGGR will grant one.

“The comment period was extended from the mandatory 45 days to 60 days for that reason,” California Department of Conservation Chief Deputy Director Jason Marshall said when asked whether the deadline extension would be granted in light of the holidays. “Additionally, we are anticipating an additional 45-day public comment period after the initial draft regulations are adjusted based on that initial public comment.”

Environmentalists also voiced the concern that while DOGGR plans to hold a series of public hearings on the proposed fracking regulations, none will be held in the Bay Area, despite its concentration of advocates who helped get the statewide opposition campaign off the ground.

“The law requires one public meeting, if requested. We are doing five, primarily in areas of the state where oil production is most common,” Marshall responded when asked why there weren’t any Bay Area meetings scheduled.

Asked whether any of the pending studies would take into account the six billion metric tons of CO2 that could potentially be released if the Monterey Shale were to be developed, Marshall seemed to suggest that the state was willing to go along with a regulated form of fracking even as it continues pursuing initiatives to curb greenhouse gas emissions.

“We still derive over 90 percent of our transportation fuels from hydrocarbons,” he wrote in an email. “With SB 4 and these regulations, California is acting now to ensure that extraction of those hydrocarbons happens in the safest way possible, even as we work to reduce our energy dependence on those hydrocarbons.”

SF General will lose much of its federal subsidy under Obamacare

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As President Obama’s Affordable Care Act is phased in over the next couple years, San Francisco General Hospital will lose at least 25 percent of the $123 million it receives from the federal government to offset costs of caring for the uninsured, but hopefully that will be offset by its expansion of those who will have health insurance.

General Hospital receives those funds for being a so-called “safety-net hospital,” a place where those without insurance can still get quality healthcare. Even though the need for such safety nets is supposed to diminish under Obamacare, SF General will remain a critically important safety-net hospital.

Many San Franciscans – including non-U.S. citizens who won’t qualify for coverage under the Affordable Care Act, as well as homeless individuals – will continue to rely on the hospital when in need of medical care.

Yet here and nationwide, concern is brewing about whether funding for safety-net hospitals could be impacted if enrollment in the new state health exchanges doesn’t reach anticipated levels.

“The financial question every state is asking is: What are the newly eligible patients going to do? What plan will they enroll in? Will they enroll?” Greg Wagner, CFO of the San Francisco Department of Public Health, told the Guardian, referring to the health insurance marketplaces created under the Affordable Care Act.

Most safety-net hospitals in the country are bolstered with federal subsidies, and are especially reliant on funds known as disproportionate share hospital payments, or DSH. However, those subsidies are about to be slashed with machete-like strokes.

All told, as much as $18 billion nationwide could be siphoned away from safety-net hospitals by 2020. Compounding that is another $22 billion that could be cut from Medicare subsidies, depending on the number of insured.

There’s an expectation that the looming safety-net budget cut will be offset by the burgeoning population of insured residents who would flock to state health exchanges. It makes sense: Instead of absorbing the entire cost of an uninsured patient, hospitals would be getting money from newly active insurance policies, and no money would be lost.

The New York Times recently ran a story detailing how low-income patients in Georgia may be put in a precarious position under federal healthcare reform because safety-net hospitals in Georgia might not be able to make up for lost funding once DSH payments evaporate.

California isn’t likely to experience this problem to the same degree, Wagner said, because the state chose to expand Medi-Cal, the state version of Medicaid, to include all low-income residents and not just those who previously qualified under a narrow set of criteria. Georgia had the same option to expand, but chose to keep its Medicaid qualifications in place, like many states led by Republicans looking to tweak President Obama.

As things stand, enrollment in Covered California – the state’s health insurance marketplace under the Affordable Care Act – remains low. Until enrollment closes at the end of March, it’s an open question whether it will reach the necessary levels to make up for pending cutbacks.

So far, 59,000 Californians had completed applications and enrolled in health insurance plans within the new marketplace as of Nov. 13. That’s a drop in the bucket, considering that 2.3 million are eventually expected to enroll. According to state data, 203,904 applications had been started online (reflecting an estimated 370,000 individuals). In addition to those applying for Covered California plans, another 72,000 people were determined eligible for Medi-Cal. 

“SF General operates on a huge amount of federal money,” Wagner explained. “Some comes directly from the federal government, and some comes from DSH.” He said the hospital received $123 million in DSH funds last year, “and not all of that will go away” once cuts go into effect.

“Healthy SF will still be around after March 31,” said Wagner. “We’re still retaining the program for anybody not eligible for Medi-Cal, and through Healthy SF those people can still access primary healthcare.”
He even said that under extreme circumstances, like the delivery of a child, for instance, some undocumented immigrants will have the opportunity to enroll in Medi-Cal. 
And it’s not all gloom-and-doom on the subsidy front, either. There is a safety-valve for the safety-net hospitals: If everyone who is expected to enroll in Covered California actually does so, the funding will be available without the need to rely on federal aid. 
But in order to achieve that idyllic plateau, a serious push is needed on the enrollment level. Granted, those enrollment figures should rise. But what if they don’t? 
“If people don’t enroll in the new programs, it will be a big problem,” said Wagner. “If we have a significantly lower enrollment number than we initially predicted, we will have some major financial issues. There’s still some uncertainty.”

He added, “We’ll still provide care for the uninsured at SF General. The money will decrease, but it won’t disappear. By no means will all of the money go away. The hope is that the newly enrolled will offset the decreasing number of uninsured, then the federal government could take the DSH payment and redirect it to the providers.” 

That being said, “we still have lots of optimism moving forward,” Wagner said. “We think people will enroll.”

[Correction: We corrected the amount of the reduction from 50 percent down to 25 percent].

 

Promo: O+ Festival is this weekend

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The O+ Festival – an art, music, and wellness festival that began in Kingston, NY – is making its way to the left coast and will be hosted for the first time in San Francisco from November 15-17. Participating bands and artists perform in exchange for free and discounted healthcare and medical services, while wristband holders receive free yoga all weekend and access to some of the best music, art, and public health and wellness activities around. This is promised to be the year’s best and biggest push for community-based urban renewal with creativity and fun at it’s core, and there is bound to be something for everyone. Check out sf.opositivefestival.org for a complete schedule.

Making it fit

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joe@sfbg.com

San Francisco’s overheating housing market has polarized the city. While progressive activists push to protect rent-controlled apartments and encourage construction of new below-market-rate housing, moderates, Realtors, and developers say any new housing helps keep prices in check, calling on the city to build 5,000 units per year.

But there is a hidden side to the housing issue in San Francisco, one that offers both complex challenges and enormous potential as a source of housing for low-income city residents, and it’s getting a fresh look with desperate eyes.

Secondary units — also known as granny flats or in-law housing — dot the city by the thousands, and are for the most part illegal. They’re tucked behind garages, in basements, or in backyards, most of them single serving sized and largely ignored.

Such units are legal under California law, and the reasons they’re quasi-legal in San Francisco are complex. It mostly boils down to the fact that often these units aren’t up to Building or Planning codes, but there have also been decisions to deliberately limit density in some neighborhoods, sometimes driven by concerns about more competition for street parking spaces.

Tenants in such units can be reluctant to report housing code violations for fear of losing cheap apartments in this rapidly gentrifying city, even if that means living in substandard housing. And the owners of those units often can’t afford to bring them up to code or pay the fines. It remains an underground industry with few watchdogs.

Caught between conflicting realities of housing shortages, poverty, and safety, the city has largely turned a blind eye to in-law units, adopting what housing advocates call a “don’t ask, don’t tell” policy around inspecting in-law units. Now that may change.

Board of Supervisors President David Chiu and Sup. Scott Wiener have plans in the works that could spur development of secondary units in the city. San Francisco has been there and done that though, and the bodies of failed past granny flat campaigns litter the political wasteland.

“In-law legalization has been for a lot of housing advocates the holy grail, but for a lot of politicians, it’s been a third rail,” said Tom Radulovich, executive director of Livable City, a nonprofit group that advocates for a more walkable, livable San Francisco.

Despite the many failed jump starts over the years, Radulovich sees hope in the prospects of legalizing more secondary units because “it’s a good, cheap, and green way to add housing.”

 

BUILD SMALL

So what’s different now? First off, unlike past efforts, the politicians involved are taking some small but significant steps.

Wiener’s plan could directly spur the creation of new secondary units, but it’s limited to only the Castro District. It basically lifts caps on the number of units that can be built in a single residence, waiving some density and other Planning Code requirements.

Wiener views his plan as a pilot program. “I decided to try a more limited geographic area to show that it can work,” he told us, saying that the past failed campaigns tried to force the issue citywide.

The Castro is a prime candidate for more affordable housing. The neighborhood has many tenants who are single, Wiener said. And as gentrification slammed the Castro, the vulnerable were hurt as well. Jeremy Mykaels, a 17-year Castro tenant living with AIDS, recently fought back an Ellis Act eviction that would have cost him his home.

“I am not looking for pity,” Mykaels wrote on his website, addressing his eviction. “I just want to shed a light on a growing problem in this city for many senior and disabled tenants like myself.”

Wiener’s office declined to say how many secondary units could be built. But as he introduced the legislation to the Board of Supervisors on Oct. 22, he said that many longtime residents in the Castro, in terms of housing, “are living on the edge.”

Castro residents like Mykaels have lived under rent control for years, and once folks like him are pushed out, they often can’t afford to stay in the city.

Fair market rent in the Castro for a two-bedroom apartment is $3,295 a month, according to the Department of Public Health. According to its rental affordability map, a tenant would need 6.2 full-time minimum wage jobs to afford to live there.

“It’s a neighborhood in desperate need of additional housing options,” Wiener said.

Enter in-law units, which are often more affordable. Though there have been no citywide studies of their affordability, a study this year by the Asian Law Caucus, “Our Hidden Communities,” said the average cost of those units in the Excelsior neighborhood is between $1,000–$1,249 a month, way below average rents.

Wiener’s legislation was turned over to the Land Use and Economic Development Committee, where it will be evaluated for impacts to the neighborhood. The supervisors will hear it again in 30 days.

 

GO BIG

One housing advocate thinks Wiener is thinking too small and needs to expand his vision.

“I think Wiener’s proposal is creating a patchwork of regulation, but this will create a mess, which the board is accomplished at doing,” Saul Bloom, head of Arc Ecology, told the Guardian. He thinks a citywide proposal to legalize in-law units is the only way go to — because the city is in a housing crisis right now, he said, and we don’t have time for just a pilot.

One big advantage is the units are far cheaper to construct than traditional houses or condominiums. Bloom notes the Lennar Urban will be spending about $400,000 for each of the thousands of homes it will build at Hunters Point Shipyard and surrounding areas, but that small secondary units can be built in existing neighborhoods for $75,000 to $200,000 each.

“We’re not expanding units in affordable housing through existing strategies,” Bloom said, and he’s right.

San Francisco has mostly built about 1,500 new housing units a year, which is much less than needed to keep up with demand, according to San Francisco Planning and Urban Research Association (SPUR) and the Housing Action Coalition.

To keep up with the frantic demand, San Francisco would need to build 5,000 new units a year, the groups argue. If the city could keep up with demand for housing, the price of housing itself could go down — meaning lower rents for everyone.

“If we want to actually make the city affordable for most people — a place where a young person or an immigrant can move to pursue their dreams, a place a parent can raise kids and not have to spend every minute at work — we have to fix the supply problem,” SPUR Executive Director Gabriel Metcalf wrote in a recent article for The Atlantic (“The San Francisco Exodus,” Oct. 14).

Yet progressive housing activists have long said that the city can’t build its way to affordability, arguing that demand for market rate units is essentially insatiable, and that what the city needs to do is build housing specifically for low-income residents.

Bloom put out a study from Arc Ecology, suggesting that if just 5 percent of the city’s 100,000 single family homes converted their excess space into in-law units, an additional 5,000 affordable rentals would spread across town.

Wiener’s proposal looks at making new units in just a slice of the city, but another proposal will look at the issue citywide. Chiu’s legislation seeks to take that sea of hidden and unlawful granny flats and bring them up to code, but it wouldn’t look to build new ones.

“The big picture is that we’re exploring legalizing existing [in-law] units that are illegal, to make sure they become safe and protect residents there,” said Amy Chan, an aide in Chiu’s office.

 

UP TO CODE

Safety isn’t the only consideration, as this could also help the housing supply in the city, those involved told the Guardian. Often these in-law units are rented out to friends and family, and once up to code they’d open up to the market.

But safety is important because these units also often lack city permits because they’re dangerously constructed. Sometimes that can lead to death.

“A lot of time (the units) may not have proper egress for an emergency,” said Dan Lowrey, deputy director of inspection services at the Department of Building Inspection. “We just had a fire last month where three people died because of that.”

Lowrey is part of Chiu’s workgroup that’s navigating the complexities of his new legislation. Just how do you make these units legal? There’s a number of challenges, he said.

When looking at a unit, housing inspectors have a checklist to look through, and some of it is real garden variety stuff. Smoke detectors? Check. Proper floor covering? Check. Those are easy. The real challenge is when there are ceilings that are too low, hallways not wide enough to navigate in an emergency, or the unit has no windows from which to escape in a fire.

That’s when you have an in-law apartment that requires total reconstruction to be brought up to code, a straight up illegal unit. As the law stands now, the only recourse for the city in that case is to evict the people living there.

“That’s the challenge, what do we do with the [in-law apartments] that can’t be legalized?” said Bill Strawn, a spokesperson for DBI. Those are some of the questions that Chiu’s workgroup is tackling now.

The good news, he said, is that there are a good number of units that are up to the Building Code, but not the Planning Code — that’s a much easier hurdle to clear.

The Planning Code basically separates neighborhoods of the city into zones for one, two, or three families in a housing unit. This looks at the amount of available free space, sunlight, air, and parking. With those lifted, many units could be more easily converted to living use.

But finding the units that aren’t up to code is important, said Omar Calimbas, a senior staff attorney at the Asian Law Caucus.

He led the “Our Hidden Communities” study that revealed 33 percent of homes in the Excelsior district contained in-law units, far above the city’s estimates.

His team went door to door and found out for itself. What Calimbas saw was that those living in unregulated units often lived in substandard conditions with nowhere to go for help.

There are some units with no heating, he said. Other times the in-law unit is in a basement barely renovated for use as a living space. Sometimes the bathrooms and shower are really tiny cubes. There are mold and dampness problems.

“You’re living in a space that doesn’t make you feel protected from the elements,” he said. And when the units are made without permits, tenants feel they can’t go to the city for help.

To put it in a nutshell, they are in dire need of regulation. Calimbas is also working with Chiu on his legislation to do just that. But ultimately, each of the two ordinances around secondary units takes small bites out of the housing pie.

Bloom is calling for the city to move aggressively on this issue. “We’re rapidly becoming a more expensive city to live in, more and more so every year.” As more and more San Franciscans are priced out of their homes, time may soon run out.

No room left in San Francisco for an artist who helped make the Mission what is

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After four decades living and creating art in the Mission, iconic San Francisco artist and curator Rene Yañez is being threatened with eviction.

Yañez made local history in 1972 when he brought Dia de los Muertos, the Mexican holiday honoring the dead, to San Francisco. The parade through the Mission District every Nov. 2 quickly became a Bay Area tradition, drawing thousands of people each year.

He founded the Galeria de la Raza and brought Latin America’s premier artists and photographers to showcase their work there. When the Museum of Modern Art rejected the work of a little-known Mexican woman, it was Yañez who gave a young Frida Kahlo a space to exhibit her paintings. He taught art classes for youths in the community and offered crucial support to many of the Mission’s mural projects.

In 1998, the San Francisco Foundation awarded Rene the “Special Trustees Award in Cultural Leadership.” Now, the man who has contributed so much to the culture of this city finds himself on the verge of being expelled from it.

Rene’s impending eviction from the house on San Jose Avenue where he has lived for the for 35 years is producing a fierce reaction. Fellow artist and personal friend Guillermo Gómez-Peña recently released an open letter expressing his outrage and rallying for public support of Rene’s cause.

“You are being physically and culturally evicted,” Gómez-Peña writes. “Shame on this city! Shame on the greedy landlords and politicians! Your sadness is ours…A city without Rene Yañez…can’t be called San Francisco.”

Gómez-Peña’s cry to action will be answered tomorrow (Sat/12) at 2pm at the Brava Theater on 24th Street with Our Mission: No Eviction, a march in protest of the Ellis Act, the law used to evict all of the tenants living in the five-unit house on San Jose, including Rene, his partner Cynthia, his former wife Yolanda, and his son Rio. (For more on tomorrow’s event and the city’s eviction trend, see our Politics blog).

On Saturday, Oct. 26, Brava Theater in the Mission will host “Our Mission: No Eviction!” a fundraiser in honor of Rene and Yolanda featuring art and performances.  All proceeds from ticket sales to the event will go to the legal expenses of fighting the eviction, as well as Rene and Cynthia’s medical bills; both the artist and his partner are currently battling cancer.

“They were kind of at peace that this would be their home when they passed away, in the community they’ve put so much into,” Rio told us. “Cynthia could be dying or dead while they are in the process of moving.”

Under the Ellis Act, Rene and Cynthia qualify for a year-long postponement of their eviction because of their illness, a fact which their landlord, Sergio Iantorno of Golden Properties, LLC, neglected to tell Rene when he offered him $21,000 and a years’ free rent if he accepted his eviction immediately.

Consulting his lawyer, Raquel Fox, Yañez was informed about the legal extension and proceeded to successfully apply for it. Even without her advice, though, Yañez would not have accepted Iantorno’s offer. As Rio explained, that amount is nowhere near enough for Rene and Cynthia Yañez to get another place in San Francisco, especially in the neighborhood that they call home.

“They are in their 70s. They aren’t looking for a huge buyout so that they can start a new life,” Rio told us.

When their original landlord died 13 years ago, Yañez and his fellow tenants pooled their money to make a bid for the house. Golden Properties saw their offer, and doubled it. Now, they are banding together again to refuse Iantorno’s money and fight  the eviction.

“I would rather take my chances and fight it,” Yañez told the Guardian. “And also I see it as resistance to what is going on and affecting a lot of people.”

On Oct. 1, the San Francisco Rent Board released its Annual Statistical Report for fiscal year 2012-2013. The report revealed a 36 percent increase in eviction notices since the year before. Evictions from rent-controlled apartments in particular are at an 11-year high.

The Ellis Act was used 81 percent more than last year, providing the basis for almost 10 percent of all evictions. The law was used with greatest frequency by landlords in the Mission District. Meanwhile, city public health officials estimate that someone earning minimum wage would need to work more than eight full-time jobs to be able to afford a two-bedroom apartment downtown.

“It is a disaster,” states Christopher Cook, an organizer with the nonprofit group Eviction Free Summer. “Individuals, families, and increasingly small businesses are being hammered by these twin tsunamis of evictions and dramatic rent increases. Those two factors have been driving people out of the city in ever greater numbers for the past 10 to 15 years.”

Gómez-Peña blames these changes on the mass of high-paid young people produced by the second dot-com boom. They may work in Silicon Valley, but they play in San Francisco, and this new class of wealthy young techies can and will pay any price to live in the city—especially the Mission District.

“I see them everyday, the hordes of iPad and iPhone texting zombies, oblivious to us and our lives, our inspirations and tribulations,” he writes. “I see them in my building and on the street, invading the city with an attitude of unchecked entitlement, taking over every square inch and squeezing out the last drops of otherness.”

It is no easy task to make room for all that wealth when the majority of the city’s residents are renters protected by law against unfair rent increases, landlord mistreatment, and unwarranted evictions. The actual strength of these safeguards may be waning, though, leading Gómez-Peña to warn the public in his letter that, “As renters our hours here are numbered.”

The only way to evict a tenant in San Francisco is by claiming one of 15 “just cause” reasons for removing them. Among those 15, the Ellis Act is something of a landlord’s dream date, skipping all the talking to get straight to the action—eviction. Established in 1985, the California law gives landlords the unconditional right to evict tenants if they are “going out of business.”

In order to implement the Ellis Act, a landlord must evict all of the tenants in his or her building, giving them 120 days notice, and wait five years before they can put the units back on the rental market at an increased price. However, the law does not prevent landlords from renting the units out as short-term lodgings, or converting them to be sold as one massive unit, tenancies in common or condominiums.

“Ellis Act evictions are impossible to fight,” admitted Ted Gullickson, the head of the San Francisco Tenants Union. This makes them an ideal weapon against rent control, which has allowed residents from lower income brackets to hold onto their homes in San Francisco for decades while the values of the real estate grew and grew. Even then, many tenants do not feel secure. Guerra has heard stories about people with rent control living for decades without hot water, working windows, heat, or even a stove. “To have this amazing rent control,” she concludes, “they put up with substandard living.”

When something broke in their building, Yañez and his family often did not even tell the landlord about it. If they did ask him to fix something, and he ignored their request, no complaints were ever made. “Because of rent control, we tried to keep a low profile,” Yañez acknowledges. “We tried not to bother the landlord or make too much of a fuss, because we did not want to find ourselves in this position.”

Rene has been aware of how precarious his situation is for years. Iantorno attempted to evict him multiple times. He watched as neighbors, nonprofit organizations, and local artists accepted their own eviction notices without a fight. When he first opened the Galeria in 1970, Yañez had a list of artists living in the Mission that neared 200 names. Today, it does not even reach 20.

“Since 2000, they’ve started this thing in the Mission,” he states. “They were very quiet about it at first, but now it’s accelerating. Willie Brown started it, this trend of redevelopment, eviction, displacing people without consideration. He opened up this gaping wound in the Mission, and now these developers are throwing salt on it, trying to kill the patient,” he chuckles. “People get really upset when somebody paints over a mural, like, ‘It has history, it has value, it’s been here for years,’ but they don’t have anything to say if the muralist gets evicted.”

Legally, there is not much that Yañez and his family can do in the coming year to stop their eviction. Even an advocate like Cook admits, “You can’t reverse an Ellis Act. All you can do is fight it, try to make it clear that it’s not worth the landlord’s while, that they’re gonna be in for a world of headaches, costs, and public shaming if they do this.”

Yañez has not accepted the eviction, but he is preparing for the worst, searching for a new home for Cynthia and himself. He continues to scour the Mission, in vain. “I love the Mission,” he explains. “I’ve been there 40 years. I adopted it, it adopted me. And it needs cultural preservation,” he says, curling his hands into fists that bang the air. “We saved the community from really greedy people who had absolutely no interest in who we were as a people. They just saw us as savages standing in the way of them making money. That attitude is still here. It’s actually worse than ever—unregulated and devastating. When I see the trucks moving people out, older people who have no idea where they’re going, sometimes they go downtown to the hotels—I just think it’s really heartless,” he finishes, his eyes wide in earnesty.

Guardian of San Francisco culture that he may be, Rene and Cynthia Yañez will be forced to leave the city in search of somewhere more affordable if their eviction occurs. In that event, there is little chance that the elderly man will be able to return to the city to curate SOMArts annual Dia de los Muertos exhibition as he has every year since he began it.

“I’m hoping that I can hang in. It’s a throw of the dice, but I still have some miles left in me,” he says, his eyes drooping wearily.

There is a chance that the exhibition, which opened today (Friday/11), might be Yañez’s last. Every year, he changes the theme. This November, the Dia de los Muertos exhibition is dedicated to all the living battling cancer, and  all the dead for whom that battle is over. Each piece is haunting, and all together it is a stunning collection encompassing a range of ages and races to touch any and every person that sees it. Like a loved one lost to cancer, the exhibit leaves you wanting more, yet so grateful fpr what you have experienced.

His last or not, it is something that Yañez can be very proud of.

Friends in the shadows

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rebecca@sfbg.com, joe@sfbg.com

It’s a simple fact of life: Money buys influence. But in San Francisco, despite strict sunshine laws to illuminate donations to city agencies and gifts to the regulators from the regulated, money still circulates in the shadows when it flows through the coffers of “Friends” in high places.

Major real estate developers, city contractors, and large corporations often lend financial support to San Francisco city departments, to the tune of millions of dollars every year. But the money doesn’t just flow directly to city agencies, where it’s easily tracked by disclosure laws. Instead, it goes through private nonprofits that sometimes label themselves as “Friends Of…” these departments.

They include Friends of City Planning, Friends of the Library, a foundation formerly known as Friends of the San Francisco Department of Public Health, Friends of SF Environment, and Friends of San Francisco Animal Care and Control.

The Friends pay for programs the departments supposedly cannot cover on their own. Bond money can build a skyscraper, but sometimes not fill it with furniture. Agencies are barred by law from funding an employee mixer or a conference trip, so departments turn to their Friends to fill in the gaps. Adding bells and whistles to city websites, holding lunchtime lectures, hiring a grant writer — or, in the case of the Department of Public Health, bolstering health services for vulnerable populations — these are all examples of what gets funded.

The extra help can clearly be a good thing, but the lack of transparency around who’s giving money raises questions — especially if it’s a business gunning for a major contract or a permit to build a high-rise.

City agencies receive outside funding from a wide variety of sources. Sometimes grants are made by the federal government, or a well-established philanthropic foundation — and according to city law, gifts of $10,000 or higher must be approved by the Board of Supervisors. But in the case of organizations like Friends, which are created specifically to assist city government agencies, the original funders aren’t always identifiable. And the collaboration is frequently much closer, with city staff members serving on Friends boards in a few cases.

the circle of donations to "friends of" foundations

Friends board members told the Guardian that their partnership with government helps bolster city agencies in a time of increasing austerity, in service of the public good. But do the special relationships these influential insiders hold with high-ranking city officials come into play when awarding a contract, issuing a permit, making a hiring decision, or determining whether a developer’s request for a rule exemption should be honored? Without more transparency, it’s tough to tell.

City disclosure rules state that any gift to a department must be prominently displayed on that department’s website, along with any financial interest the donor has involving the city. But Friends and other outside funders are under no obligation to share their supporters’ names, much less financial ties, when they distribute grants. Meanwhile, the disclosure rules that are on the books seem to be frequently ignored, misunderstood, or unenforced, our investigation discovered.

How are donors repaid for their support? Consider the controversy earlier this year around Pet Food Express, which won approval in June for another store in the Marina District despite opposition from four locally owned pet stores in the area that fear competing with a large national chain. Pet Food Express won the unlikely support of the city’s Small Business Commissioners, some of whom reversed their 2009 positions opposing the chain’s previous application.

SF Animal Care and Control Director Rebecca Katz personally lobbied the commission to support Pet Food Express, at least partially because the company has donated pet supplies valued at $50,000 to $70,000 per year to the department. That’s a lot of money for a cash-strapped city department, but a pittance compared to the profits of an expanding national chain.

It’s moments of clarity like those, when the public can easily trace the line from donations to political influence, that show why disclosure is so crucial. But those moments are few and far between when trying to trace the funders of private foundations and Friends organizations, where deals often happen in the dark.

 

WHEN DEVELOPERS ARE FRIENDS

At the Merchant Exchange Building in May, a crowd of high-profile real-estate developers mixed and mingled with city planners, commissioners, and even Mayor Ed Lee, wine glasses in hand. Sources told the Guardian that most of the planning staff was present, and not all were happy about having ribbons and name tags affixed to their shirts, as if they were being auctioned off.

With around 500 in attendance, the event was an annual fundraiser hosted by the Friends of San Francisco City Planning, a nonprofit organization that accepts contributions of up to $2,500 per individual to lend a helping hand to the Planning Department. This year’s event was titled “Incubator Startups, New Jobs for the Future,” hinting that the development community shares the mayor’s affinity for new tech startups and the droves of high-salaried IT professionals they’ve attracted to the city.

Some Friends of City Planning board members are major real-estate developers who routinely seek approval for major construction projects. Others are former planning commissioners, or have a background in community advocacy.

Amid widespread concern about displacement, gentrification, and the overall character of San Francisco’s built environment, no city department has greater influence than Planning. An individual’s interpretation of the Planning Code can carry tremendous weight; it’s a series of small decisions that shape a project’s profits and the look and feel of San Francisco’s future. And with cranes dotting the city’s skyline and market-rate construction catering to the wealthy while middle income residents get priced out, the amount of capital flowing through the development sector these days is astonishing.

In this dizzy climate, there might seem to be something askew about affluent developers and land-use attorneys rubbing elbows with city regulators, all eager to pass the hat for the Planning Department. Whiff of impropriety or no, the fundraiser appears to be totally legal.

“We aren’t violating the law — that I know,” Friends of City Planning Chair Dennis Antenore told the Guardian. “We’ve had legal advice on that for years.”

There is close collaboration between Friends of San Francisco City Planning and the Planning Department — a partnership so entrenched that it’s almost as if the nonprofit is an unofficial, private-sector branch of the agency.

“We are certainly thankful and appreciative,” Planning spokesperson Joanna Linsangan told the Guardian. “They’ve helped us for many, many years.” The additional funding is needed, she said, because “there isn’t a lot of wiggle room” in the departmental budget.

Each year, Planning Director John Rahaim submits a wish list to the Friends, outlining projects he wants funding for. This year, he requested $122,000 for a variety of initiatives, including training support to help planners assess proposals for formula retail (read: chain stores). That’s a hot-button issue lately, and one that shows how seemingly small decisions by planners can have big impacts.

When the department’s zoning administrator ruled that Jack Spade, a high-end clothing chain that opened up in the old Adobe Books location on 16th Street, wasn’t considered formula retail and therefore didn’t need a conditional use permit, neither widespread community outrage nor a majority vote by the Board of Appeals could reverse that flawed decision. It was a similar story with the Planning Commission’s Oct. 3 approval of the 555 Fulton mixed use project, where Planning Department support for exempting the grocery store for the area’s formula retail ban made it happen, to the delight of that developer.

Even though the planning director makes specific funding requests each year to the Friends and pitches the projects in person at their meetings — and the Friends publishes a list of the grants it awards to the department online — the Planning Department is not reporting those gifts to the Board of Supervisors.

“I confirm that the Planning Department did not receive any gifts,” Finance and IT Manager Keith DeMartini wrote in official gift reports submitted to the Board of Supervisors for the years 2011-12 and 2012-13. Those reports were sent to the board on Oct. 7 and Oct. 4, respectively, well after the July filing deadline and after the Guardian requested the missing reports.

The Friends typically funds two-thirds of the requests, said board member Alec Bash, totaling around $80,000 a year. In 2012, the Friends awarded a $25,000 grant to make the department’s new online permit-tracking system more user-friendly, making life a lot easier for developers.

When asked what safeguards are in place to prevent undue influence when the director is soliciting funding from a nonprofit partially controlled by developers, Linsangan responded, “those are two very separate things. One does not influence the other.”

She stated repeatedly that planners are not privy to information about individual contributors — but the fundraisers are organized by a board that includes identifiable developers, and anyone who attends can plainly see the donors in attendance. Nevertheless, Linsangan insisted that planners would not be swayed by this special relationship, saying, “That’s simply not the way we do things around here. We do things according to the Planning Code.”

But as the ruling on Jack Spade shows, as well as countless rulings by planners on whether a project is categorically exempt from the California Environmental Quality Act, interpreting the codes can involve considerable discretion.

The public can’t review a list of who wrote checks to the Friends of San Francisco City Planning for the May fundraiser. Since the organization waits a year between collecting the money and disbursing grants, donors stay shielded from required annual disclosures in tax filings.

But Antenore says the system was established with the public interest in mind. “We don’t reveal the contributors, because we don’t want anybody to have increased influence by a donation,” he insisted. Bash echoed this idea, saying the delay was to “allow for some breathing room.”

Unlike some of his fellow board members from the high-end development sector, Antenore has a history of being aligned with neighborhood interests on planning issues, helping author a 1986 ballot measure limiting downtown high-rise development. He emphasized that the developers on the Friends board are balanced out by more civic-minded individuals.

Still, developers who regularly submit permit applications for major construction projects sit on the Friends board. Among them are Larry Nibbi, a partial owner of Nibbi Bros.; Clark Manus, CEO of Heller Manus Architects; and Oz Erikson, CEO of the Emerald Fund development firm.

“We’re not making use of [the funding] in a way that benefits these people,” Antenore said. “I wouldn’t do this if I thought otherwise. I have been careful to maintain the integrity of this organization.” The money is meant to facilitate better planning, he added. “I don’t think there’s any conspiracy,” he said. “We’re not financing anything evil.”

Both the Planning Department and its Friends dismissed the idea that the donations could open the door to favoritism or undue influence. So why isn’t the department reporting gifts it receives from the Friends to the Board of Supervisors, or disclosing them on its website, as required by city law?

According to a 2008 City Attorney memo on reporting gifts to city departments, when an agency receives a gift of $100 or more, it “must report the gift in a public record and on the department’s website. The public disclosure must include the name of the donor(s) and the amount of the gift [and] a statement as to any financial interest the contributor has involving the city.”

John St. Croix, director of the San Francisco Ethics Commission, confirmed that’s the current standard, telling us, “The actual disclosure should be on the website of the department that received the gift.”

Linsangan said records of the gifts are indeed available — listed as “grants” in the department’s Annual Report. But while the 2011-12 report lists grants from sources such as the Metropolitan Transportation Commission and the Environmental Protection Agency, there was no mention of Friends of City Planning.

The memo also says any gift of $10,000 and above must first be approved by a resolution of the Board of Supervisors. But last year, when the Friends provided $25,000 to upgrade the permit-tracking system, it wasn’t sanctioned by a board resolution. Asked why, Linsangan made it clear that she was not aware of any such requirement.

As is common, when it comes to adhering to disclosure laws, confusion abounds. And sometimes, only sometimes, politicos get caught.

 

READING UP ON DISCLOSURE LAWS

When the head of a city agency fails to report gifts totaling $130,000, how much do you think he is fined?

City Librarian Luis Herrera failed to report receiving that amount in gifts and he was fined exactly $600 by the California Fair Political Practices Commission on Sept. 19. Specifically, Herrera had to file a form 700 with the FPPC to state the gifts he received. From 2008-2010, the forms he turned in had the “no reportable interests” box checked.

The money was used in what he calls the City Librarian’s Fund, which is the money he keeps on hand to pay for office parties and giving honorariums to poets and speakers who perform at the library’s branches, money that wasn’t disclosed on the very forms designed for reporting it.

There are two stories of how the fine came about. Longtime library advocate James Chaffee said that it was the result of a complaint he filed with the FPPC in April, and indeed, he sought and obtained many public documents revealing the money trail. San Francisco Public Library spokesperson Michelle Jeffers disagreed, saying that the fine was the result of an ongoing conversation with the FPPC to figure how exactly to file the gifts appropriately.

“The law wasn’t clear around these forms and it wasn’t clear if he had to report them,” she told the Guardian. “For amending the reports you have to pay a $200 fine for every year it was proposed. We keep scrupulous records on every pizza party we have.”

When government officials receive “gift of cash or goods,” they must report them annually in statements of economic interest, known as a Form 700, to the city Controller’s Office. The form is kind of a running tally of who is receiving gifts from whom, a way for the public to track money’s influence in government.

The gifts came from the Friends of the San Francisco Public Library, another nonprofit that bolsters city agency funding. Now Herrera has to list the $130,000 gifts from fiscal years 2008-09 and 2009-10 on his website.

What exactly does that accomplish? As it turns out, not a whole lot.

City Administrative Code 67.29-6 defines the reporting of gifts to city departments, and one of those requirements is to make a statement of “any financial interest the contributor has involving the city.” Now that Herrera lists the Friends of the San Francisco Public Library as donors on the department website, the statement of financial interest by the friends group is this: “none.”

There are myriad donors to the Friends of the SFPL, and the group doesn’t have to state the economic interests of its donors, or even mention who its donors are. The code requires gifts be reported to the controller, and the deputy city controller told us this doesn’t apply to the “friends of” organizations, or any nonprofit foundation arms of city departments.

“If gifts are made to a department, yes, they have to disclose, so people don’t get preferential interest in getting city contracts,” Deputy Controller Monique Zmuda told us. “I know it’s a fine line. The foundations don’t provide us with anything.”

Friends of the SFPL doesn’t provide money just for pizza parties. A breakdown of a funding request from the library to its Friends shows requests up to $750,000 to advertise the library on Muni and in newspapers, funding for permanent exhibits, and the City Librarian’s personal fund. That’s just the money it gives to the library. Other monies are spent directly on activities supporting the library.

As Jeffers pointed out to the Guardian, the money isn’t spent on “trips to Tahiti.” Friends of the SPL do good city works, from a neighborhood photo project in the Bayview branch library to providing books for children. But the question is: Who’s buying that goodwill and why?

The millions of dollars in donations made to the Friends of the SFPL don’t need to be approved by the Board of Supervisors, like gifts to departments do. They’re not checked for conflicts of interest or financial interest by any governmental body. Donors give and the Friends of SFPL spend freely, financial interest or not.

When our research for this story began, no financial statements were available of the Friends of the SFPL website. After a few days of inquiries, the most recent year’s financial statements from 2011-12 were posted to the website.

Ultimately, the San Francisco Public Library is one of the smaller city departments, with an annual budget that hovers around $86 million. The Department of Public Health is a much bigger beast, with a 2011-12 budget of around $1.5 billion.

One of its main foundations, the San Francisco General Hospital Foundation, is also one of the largest nonprofits that supplements city spending. In many ways, it could be described as the model of disclosure for city foundations, although its disclosures are not by law, but by choice.

 

FOUNDATION OF FRIENDS

The Department of Public Health relies on a few entities that fundraise on its behalf: the San Francisco Public Health Foundation, the Friends of Laguna Honda Hospital, and the San Francisco General Hospital Foundation.

“They’re private nonprofit entities that are separate from the department,” CFO Greg Wagner told us. “But their roles are to support the department in its efforts.” He cited examples such as sending its staff to conferences or hosting meetings, “things that we don’t have the budget for or don’t have the staff or resources.”

The lion’s share of the DPH’s gifts are funneled through the SFGHF. Unlike many of the assorted Friends groups or foundations that support city services, the SFGHF extensively reports the sources of its $5 million in donations. The donors include a veritable who’s who of San Francisco: the Giants, Sutter Health, Xerox, Pacific Union, and Kohl’s all donated between $1,000 and $10,000 in the past two years.

But the largest gifts to the SFGHF came from Kaiser Permanente, and its financial interests in the city run deep. Kaiser came into the city’s crosshairs in July, when the Board of Supervisors passed a resolution calling on Kaiser to disclose its pricing model after a sudden, unexplained increase in health care costs for city employees. Kaiser holds a $323 million city contract to provide health coverage, and supervisors took the healthcare giant to task for failing to produce data to back up its rate hikes.

In the meantime, Kaiser has also been a generous donor. It contributed $364,950 toward SFGHF and another $25,000 to SFPHF in fiscal year 2011-12.

The funding from Kaiser and a host of other contributors — which include Chevron, Intel, Genentech, Macy’s, Wells Fargo (another city contractor), and a pharmaceutical company called Vertex — does support needed programs. They include research into the health of marginalized communities, services through Project Homeless Connect, screening for HIV, and immunization shots for travelers.

But because DPH doesn’t count much of this support as “gifts” formally received by the city, it isn’t subject to prior approval by the Board of Supervisors, or posted on the department’s website along with the contributors’ financial interests. Major contributions are disclosed in a report to the Health Commission, something Wagner described as a voluntary gesture in response to commissioners’ requests.

“Most gifts to foundations are donations to a nonprofit and do not come through the city or DPH at all,” he noted.

This distance is maintained on paper despite close collaboration with the department. In the case of Project Homeless Connect, a program that holds a bimonthly event to aid the homeless, it supports programs headquartered in city facilities. Penny Eardley, executive director of SFPHF— which used to be called Friends of San Francisco Public Health — noted that her organization occasionally makes grants or seeks funding in response to department requests. And Deputy Director of Health Colleen Chawla is a foundation board member. It’s almost like these foundations are extensions of the department, except they’re not.

SFPHF also earns revenue as a city contractor. When DPH received a grant from the Centers for Disease Control, it contracted with SFPHF to manage subcontracts with about a dozen community-based organizations.

The web gets even more tangled. The president of SFPHF is Randy Wittorp — who’s also Director of Public Affairs for Kaiser Permanente’s San Francisco Service Area. It’s a similar story with SFGHF, whose board includes several General Hospital administrators, including CEO Susan Currin.

Former Health Commissioner James Illig said people shouldn’t worry, that hospital the staff would never direct foundation funds to pet projects or mishandle funds. They maintain a separation and a firewall,” he said, for example noting, “Sue Currin is not directing funds to her own hospital.”

But he did admit that since SFGHF’s minutes are not public documents, that “raises a few concerns,” arguing the public should be able to inspect financial documents to decide if the foundations are directing funds lawfully to city departments.

Even when the public by law has a right to access financial records of a city department, rooting out corruption can be like pushing a boulder up a San Francisco hill.

 

FROM PATIENTS TO PARTIES

In 2010 and 2011, Laguna Honda Hospital administrators and staff used money from the hospital’s patient gift fund to throw a party. And then they spent it on airfare. And then they gave laser-engraved pedometers to the staff. All told, they spent nearly $350,000 meant for the dying and the infirm, nearly half of the total funds.

The incident was big, messy, and out in the public eye. It was an all-too-rare glimpse into the shady use of public funds by public officials. But when hospital staff members Dr. Derek Kerr and Dr. Maria Rivero blew the whistle on Laguna Honda’s misuse of patient funds in 2010, they were drummed out of their jobs.

Eventually litigation on behalf of the whistleblowers and their complaints of corruption were found to have merit.

Kerr’s vindication came at a meeting of the Health Commission in April 2013. In the packed City Hall meeting room, the public watched as Laguna Honda Executive Director Mivic Hirose read her apology to Kerr and Rivero aloud, even announcing a plaque in Kerr’s honor.

“The hospital will install the plaque in the South 3 Hospice,” she read, stiltedly, from a written statement, surrounded by microphones at the podium. “The plaque will say: In recognition of Derek Kerr MD of his contributions to the Laguna Honda’s hospice and palliative care program 1989-2010.”

Kerr received a settlement of $750,000 and something more important: His good name cleared.

But that conflict of interest was rooted out only after years of litigation that revealed the financial abuse through legal discovery of the department’s documents — documents that should’ve been public in the first place. ABC 7’s I-Team broke the story and did much of the reporting at the time, otherwise the entire affair may have been swept under the rug.

The misuse of funds was only brought to light with the revelation of public documents — revelations not possible with most Friends groups. The Laguna Honda Hospital Foundation has also had financial dealings with potential conflicts and a lack of transparency.

The now-defunct LHHF’s board chair, former City Attorney Louise Renne, made an interesting choice for her vice chair after she formed the nonprofit in 2003. Derek Parker was vice chair of the LHHF while simultaneously heading architecture firm Anshen-Allen, with a $585 million city contract to rebuild the hospital.

So he was not only rebuilding Laguna Honda under city contract, but soliciting and spending donations meant to supplement his project. Renne wrote to the Health Commission in December 2011 that LHHF’s purpose was to manage over $15 million in donations meant to furnish the hospital with beds, chairs, and other necessities. Eventually, then-Mayor Willie Brown found funding for the hospital, reducing the foundation’s role.

In a phone interview with the Guardian, Renne said the goals of the LHHF were only ever to furnish the newly christened hospital. “Our purpose was to fill the void, if you will, for what the city and its services could not do,” she said.

But in her letter, Renne advocated for LHHF to take an active role in fundraising for the hospital for years to come. “Today, the members of the Board of Directors of the Foundation continue to assist the hospital in various phases of its new projects and operations with projects approved by the City and/or the hospital administration,” she wrote to the Health Commission.

And Parker would have potentially managed millions of dollars flowing through donations for countless other hospital projects, while heading an architectural firm with contracts to build in San Francisco. We were unable to reach Parker for comment.

“I never saw Derek use his position as an architect or position for any political gain, I never saw it,” Renne told us. But no one else would see it either, because organizations like the now closed Laguna Honda Hospital Foundation operate without public oversight.

The Health Commission itself even noted this in its March 2012 meeting, the minutes describing then-commissioner James Illig as critiquing the foundation for not being open about its source of funding.

“Commissioner Illig thanks Ms. Renne and Mr. Parker for coming to the Commission,” the minutes read. “Because (LHHF) is a project of Community Initiatives, a fiscal sponsor for nonprofits, it is not possible to find basic financial information about the Foundation or its activities.”

Divided interests on hospital board

Due to a quirk of her foundation being under the “umbrella” of a separate entity, Community Initiatives, Illig was never able to even get the LHHF’s IRS forms, he told us. “We tried to get information and reports, and the Community Initiatives [Form] 990 was giant,” Illig said. “It didn’t separate anything out.”

Illig told us that it made sense to have Parker on the board because he is monied and well connected, making it easier to solicit donations. But insiders close to the board told us that Parker’s position may have made it easier to swing getting other contracts for his firm.

Parker got another city contract building the UCSF Benioff Children’s Hospital at Mission Bay, slated to open in 2015. No doubt his firm got the job partly due to his reputation as pioneering architecture that leads to healthy patient outcomes — but then again, the board he served on also approved donations to research at UCSF.

Laguna Honda Hospital Foundation may now be defunct, but it serves to illustrate the lack of controls and oversight of the foundations beyond even gift disclosure.

 

OFF THE BOOKS

It might be characterized as a web of influence, cronyism, or just the way business is done. But is there something improper about all of this?

Private funding often represents a needed boost that allows for important work to take place beyond what could happen under ordinary budgeting. At the same time, it smacks of privatization. While departments and funders point to lean times in the public sector to justify the need for this help, the funding continues to flow whether it’s a good year or a bad year for city government. And at the end of the day, the most glaring issue of all seems to be the lack of transparency.

Are city departments ever tempted to bend the rules to lend a little help to their Friends? As long as the funding is in the dark, the public has no way of knowing.

Ethics chief St. Croix told us his office lacks the resources to visit every city website and check up on whether departments are following the disclosure rules. “If someone brought it to my attention that a department received a gift and didn’t post it [on the website],” he said, “we would look into it.”

But if the watchdogs need watchdogs, citizens who can’t even review documents that should be publicly available, then these quasi-governmental functions and the people who fund them will remain in the shadows.  

Danielle Parenteau contributed to this report.  

ADDENDUM  

When city funders operate in the dark, one of the best ways to learn about corrupt influence, misuse of funds, and other transgressions is from whistleblowers. If you have a tip for us, send us snail mail at SAN FRANCISCO BAY GUARDIAN, 225 Bush, 17th Floor, San Francisco, CA 94104. Or email us at news@sfbg.com. Just make sure not to use an email address provided by your workplace, which is less secure.

Legal foes invited to weigh in on healthcare policy

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A few years ago, the Golden Gate Restaurant Association lost a legal battle it waged over the employer mandates in the city’s landmark Health Care Security Ordinance, a universal healthcare program that has provided safety-net services for the city’s uninsured since its passage in 2006, partially through the Healthy San Francisco program.

Composed of San Francisco restaurant owners, GGRA took issue with a mandatory employer spending contribution designed to help employees cover healthcare costs. While the city’s flagship healthcare program ultimately emerged unscathed, the lawsuit went all the way to the U.S. Supreme Court and consumed city staff time and legal expenses.

Now that the federal Affordable Care Act is poised to begin, with enrollment in low-income programs starting in October, a new debate has surfaced over whether current employer requirements should stay the same under Obamacare. While ardent supporters of HCSO have urged the city not to make any drastic policy changes because the existing system can help low-wage workers take advantage of federally subsidized healthcare options, local business interests have signaled that they think it’s time to scale back employer contributions.

In late August, representatives from the city’s Department of Public Health sent out invitations to various stakeholders to join an advisory body called the Universal Healthcare Council, which will be charged with “reviewing local policies against the backdrop of the federal law.” Despite the failed, messy legal battle that nearly undermined Healthy SF just a few years ago, and the more recent scandals involving restaurants fraudulently using customer surcharges and still stiffing employees (see “Check please,” April 23), an invitation was sent to Rob Black, executive director of GGRA. For the sake of uninsured employees throughout San Francisco, let’s hope the restaurant association doesn’t have another lawsuit up its sleeve.

Solomon: Memo from Oslo: If peace is prized, a Nobel for Bradley Manning

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Norman Solomon is co-founder of RootsAction.org and founding director of the Institute for Public Accuracy. His books include “War Made Easy: How Presidents and Pundits Keep Spinning Us to Death.”

Oslo, Norway: The headquarters of the Nobel Committee is in downtown Oslo on a street named after Henrik Ibsen, whose play “An Enemy of the People” has remained as current as dawn light falling on the Nobel building and then, hours later, on a Fort Meade courtroom where Bradley Manning’s trial enters a new stage — defense testimony in the sentencing phase.

Ibsen’s play tells of mendacity and greed in high places: dangerous threats to public health. You might call the protagonist a whistleblower. He’s a physician who can’t pretend that he hasn’t seen evidence; he rejects all the pleas and threats to stay quiet, to keep secret what the public has a right to know. He could be content to take an easy way, to let others suffer and die. But he refuses to just follow orders. He will save lives. There will be some dire consequences for him.

The respectable authorities know when they’ve had enough. Thought crimes can be trivial but are apt to become intolerable if they lead to active transgressions. In the last act, our hero recounts: “They insulted me and called me an enemy of the people.” Ostracized and condemned, he offers final defiant words before the curtain comes down: “I have made a great discovery. … It is this, let me tell you — that the strongest man in the world is he who stands most alone.”

Alone, Bradley Manning will stand as a military judge proclaims a prison sentence

As I write these words early Monday, sky is starting to lighten over Oslo. This afternoon I’ll carry several thousand pages of a petition — filled with the names of more than 100,000 signers, along with individual comments from tens of thousands of them — to an appointment with the Research Director of the Norwegian Nobel Committee. The petition urges that Bradley Manning be awarded the Nobel Peace Prize. Like so many other people, the signers share the belief of Nobel Peace laureate Mairead Corrigan-Maguire who wrote this summer: “I can think of no one more deserving.”

Opening heart and mind to moral responsibility — seeing an opportunity to provide the crucial fuel of information for democracy and compassion — Bradley Manning lifted a shroud and illuminated terrible actions of the USA’s warfare state. He chose courage on behalf of humanity. He refused to just follow orders.

“If there’s one thing to learn from the last ten years, it’s that government secrecy and lies come at a very high price in blood and money,” Bradley Manning biographer Chase Madar wrote. “And though information is powerless on its own, it is still a necessary precondition for any democratic state to function.”

Bradley Manning recognized that necessary precondition. He took profound action to nurture its possibilities on behalf of democracy and peace.

No doubt a Nobel Peace Prize for Bradley Manning is a very long longshot. After all, four years ago, the Nobel Committee gave that award to President Obama, while he was escalating the war in Afghanistan, and since then Obama’s dedication to perpetual war has become ever more clear.

Now, the Nobel Committee and its Peace Prize are in dire need of rehabilitation. In truth, the Nobel Peace Prize needs Bradley Manning much more than the other way around.

No one can doubt the sincere dedication of Bradley Manning to human rights and peace. But on Henrik Ibsen Street in Oslo, the office of the Nobel Committee is under a war cloud of its own making.

Norman Solomon is co-founder of RootsAction.org and founding director of the Institute for Public Accuracy. His books include “War Made Easy: How Presidents and Pundits Keep Spinning Us to Death.”

(Bruce B. Brugmann edits and writes the Bruce blog. He  is the editor at large of the Bay Guardian and the former editor of the Guardian  co-founder and co-publisher with his wife Jean Dibble 1966-2012.)

Mayor on local health care policy: “Everything is on the table”

A recent controversy has been brewing around San Francisco’s Health Care Security Ordinance, the 2006 legislation authored by then-Sup. Tom Ammiano that created Healthy San Francisco, the city’s medical services safety net program for the uninsured.

As we explain in greater depth in an article for tomorrow’s issue of the Guardian, influential forces in the business community such as the San Francisco Chamber of Commerce and the Golden Gate Restaurant Association have been publicly raising questions about the Health Care Security Ordinance in light of the federal implementation of the Affordable Care Act, aka Obamacare.

In a recent article in the San Francisco Business Times, Small Business California President Scott Hauge was quoted as saying, “We question whether Healthy San Francisco should continue in its current form with the ACA coming in.” And an article published today suggests that some are continuing to question whether the HCSO can legally coexist alongside the federal requirements under the ACA despite clarification given by Jon Givner of the San Francisco City Attorney’s Office last Thursday stating that the ACA expressly allows jurisdictions like San Francisco to adopt health-care policies such as the HCSO.

Meanwhile, the message from defenders of the city’s health care policy at a hearing called by Sup. David Campos last week was clear: Funding for employee health care generated by employer contribution provisions under the HCSO will be needed more than ever once the ACA is implemented, because many people who now rely on the low-cost Healthy San Francisco for medical care will suddenly find themselves ineligible for that program and automatically funneled into a new system where they are eligible to sign up for subsidized health care, but won’t necessarily be able to afford it.

The ACA will begin enrollment in October, and will take effect in January of 2014. At that point, roughly two-thirds of current enrollees in Healthy San Francisco will either transition to Medi-Cal (if they earn up to 138 percent of the federal poverty level) or qualify for subsidized health care coverage under Covered California, the health benefit exchange created under the ACA. Things are apt to be the most complicated for Healthy San Francisco enrollees who discover they cannot actually afford to take advantage of the options offered under Covered California. 

For this reason, Campos stressed that the HCSO should remain in place without being scaled back or tampered with, because medical reimbursement accounts provided by employer contributions under the ordinance could serve to fill those gaps and help low-wage earners obtain coverage regardless of income. As things stand, Campos and Healthy San Francisco advocates said, gaps created under the ACA will be filled by stronger HCSO provisions, so the programs stand to complement one another.

But the business community, seeking what GGRA executive director Rob Black described to the Guardian as “guidance” from the city on how to move forward given the pending implantation of federal health care reform, wishes instead to open up a new policy dialogue about the HCSO. The mayor has been receptive to their concerns, and recently reconstituted the Universal Healthcare Council, a body that was previously formed to hash out local health care policy.

A key question is who will be appointed serve on that board: Department of Public Health Director Barbara Garcia will chair it, but so far the only indication of who else will be named is that it will consist of “community, healthcare, labor and business stakeholders,” according to a quote attributed to Garcia in the Business Times. Will the makeup include members of the GGRA, the business organization that sued the city to overturn the employer contribution mandate under the HCSO? 

In response to questions about whether the mayor believed the employer spending requirement ought to be revisited in light of ACA implementation, and who would be appointed to the newly convened healthcare council, mayoral spokesperson Christine Falvey responded ot the Guardian with the following statement: “Everything is on the table as the City develops a plan to best implement [the Affordable Care Act]. This is a great opportunity to see how the city can continue to be a leader in making sure San Franciscans have access to quality healthcare. We are currently updating a membership list for the Universal Healthcare Council. More information on that as it becomes available.”

Under fire again

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rebecca@sfbg.com

At a recent hearing on San Francisco’s Health Care Security Ordinance — once-controversial legislation that is now in the business community’s crosshairs once again — a nursing student stood at the podium to address members of the Board of Supervisors Neighborhood Services & Safety Committee.

She told them about her mother, who battled illness but did not have access to healthcare for 14 years due to her immigration status, recalling a day when her mother explained why she wasn’t seeking medical attention: “If I go to the hospital, I’ll bury you in debt.”

For the uninsured and undocumented, going without medical care or going into insurmountable debt could be the only options if it weren’t for Healthy San Francisco, a medical services safety net that was created by the HSCO in 2006. The program is expected to continue to provide care for undocumented enrollees who won’t be eligible for federal assistance once the Affordable Care Act, also called Obamacare, takes effect early next year.

The HCSO’s mandate that businesses provide some healthcare coverage for their employees was fiercely opposed by the business community, which challenged it all the way to the US Supreme Court. Now, those same powerful forces are gearing up for a fresh challenge that could jeopardize HCSO’s potential to fill coverage gaps that will be created under Obamacare.

Under federal health care reform, two-thirds of the enrollees in Healthy San Francisco will become ineligible to continue receiving coverage because they will automatically gain eligibility for some form of federal assistance. Those earning up to 138 percent of the federal poverty level will be guaranteed coverage under Medi-Cal. But for low-income earners whose wages hover around $14 an hour, things are far less certain because they will be eligible to enroll in the federally created health benefit exchange, Covered California, although they won’t necessarily be able to afford it. For someone earning around $30,000 per year before taxes, the estimated monthly cost for a health insurance plan under Covered California hovers at more than $200 per month, in many cases making it too much of a stretch.

As things stand, uninsured San Francisco employees who earn too much to qualify for Medi-Cal, but not enough to afford enrollment in Covered California — despite being eligible — can still access funds set aside for them in medical reimbursement accounts under the HCSO. This option may provide enough of a financial boost for low-wage earners to take advantage of federally subsidized health insurance after all.

“For working people, the implementation of the Affordable Care Act actually makes the Health Care Security Ordinance more important,” explains Ian Lewis, research director at UNITE-HERE Local 2. “There are many consequences of the ACA … and the Health Care Security Ordinance is a buffer against them.”

As it stands, the local law “makes Covered California actually work in a high-cost city like ours,” Lewis added.

Under HCSO, San Francisco employers are required to contribute toward employees’ health care on a per-hour basis for each employee working more than eight hours per week, regardless of immigration status or city of residence, amounting to an estimated $255 per participant per month.

This mandate, known as the Employer Spending Requirement, has been the target of multiple lawsuits brought against the city by the Golden Gate Restaurant Association since the landmark health care ordinance, authored by then-Sup. Tom Ammiano, was first enacted in 2006.

That same requirement also makes the local ordinance stronger than the federal law when it comes to worker protections, because the federal mandate only requires employers to offer coverage for workers who put in 30 hours a week or more. That has prompted businesses nationwide to reschedule their workers down to 29 hours per week in a gesture of opposition to health care reform, but no such incentive exists in San Francisco because of the hourly contribution requirement.

Now that federal health care reform is poised for implementation, with enrollment set to begin in October and a transition to the new system slated for early next year, GGRA and the San Francisco Chamber of Commerce are urging the city to open up a new policy dialogue about employer requirements under the local health care law — and Mayor Ed Lee has been receptive.

“We question whether Healthy San Francisco should continue in its current form with the ACA coming in,” Small Business California President Scott Hauge told the San Francisco Business Times (“Healthy San Francisco, related program to shrink dramatically, but not price tag,” July 16). Hauge has met with Jim Lazarus, the Chamber’s senior vice president for public policy, and GGRA Director Rob Black on the issue, the article noted.

Reached by phone, Black emphasized to the Guardian that GGRA employers are merely seeking guidance on how businesses should comply with the local and federal mandates. “It’s important that we really focus on getting together, and getting together quickly,” Black said, to ensure “San Franciscans have access to the full benefits and subsidies of the Affordable Care Act.”

Longtime advocates of Healthy San Francisco and progressive policymakers are watching closely. “They’ve been trying to get out of their responsibility to provide worker’s health care since the law was passed,” Hillary Ronen, a legislative aide for Sup. David Campos, said of business interests who are airing complaints about employer requirements.

Once the federal law takes effect, San Francisco employers will have the option of either providing coverage, or contributing to a city program that establishes medical reimbursement accounts for employees administered by city government, Ronen explained. A third option, “standalone health reimbursement accounts,” under which employers manage reimbursement funds for employees, will be rendered illegal under Obamacare. That system generated controversy in recent years because employers were placing undue restrictions on the use of those funds, and in some cases even pocketing the money after neglecting to inform their workers that it was available (see “Check, please,” 4/23/13).

On July 25, Lee announced that the city’s Universal Health Care Council, a body previously tasked with guiding local health care policy, would be reconvened to “examine San Francisco’s implementation of the Federal Affordable Care Act (ACA) and engage stakeholders in identifying necessary local policies” to support the transition.

In response to signals that the business community is gearing up for a fresh challenge to the city’s health care law using the ACA as ammunition, Campos convened a hearing July 25 to discuss the importance of the HCSO in relation to the federal law.

For several hours, advocates of Healthy San Francisco — many of them members of the immigrant community who would have no other options if it weren’t for the program — delivered passionate defenses of the current program. Campos emphasized that federal health care reform stood to be a great success in combination with the local health care ordinance, which would serve to fill in any gaps in coverage.

Deputy Director of the Department of Public Health Colleen Chawla explained during the hearing that of the 60,000 San Franciscans currently enrolled either in Healthy San Francisco or SF Path, a second medical assistance program, roughly 40,500 will automatically become eligible to enroll either in Medi-Cal or Covered California under federal health care reform come January. The remaining 19,500 won’t be eligible, however, mostly due to immigration status. Healthy San Francisco is expected to continue providing a safety net for those who would otherwise fall through the cracks. But when it comes to the two-thirds who are eligible for federal assistance, but may not be able to actually afford it, things would be thrown into uncertainty if the Employer Spending Requirement were altered or eliminated. “Folks in the business community would be happy to say, the Affordable Care Act is enough, and businesses shouldn’t be complicated with an additional burden,” notes Le Ly, program director at the Chinese Progressive Association. But the HCSO “is an important pillar of the total continuum of care,” he said. “We see it as continuing to complement and strengthen health care coverage.”

New director triggers a brain drain at SFDPH

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The San Francisco Department of Public Health has seen an exodus of top officials over the 18 months since Barbara Garcia took the reins from longtime chief Mitch Katz, the most recent being Environmental Health Director Dr. Rajiv Bhatia, who was placed on administrative leave last month pending an investigation into unspecified concerns.

Bhatia has been a hero to many progressive San Franciscans and public health professionals for his innovative work supporting expanded worker protections, regulation of cannabis dispensaries and restaurants, environmental justice initiatives, and other work that has landed him in the pages of the Guardian many, many times.

“The poorest Americans are about two times as likely to die. People in low-wage jobs have less access to health care … food, shelter, clothing, and transit,” Bhatia testified during the 2002 Board of Supervisors hearing that led to the creation of a city minimum wage.

Neither Bhatia nor the department would comment on his leave, although sources tell us that he has not been informed of the charges against him (which an item in the Chronicle last month suggested was a possible conflict of interest issue relating to his regulation of restaurants) and that Garcia has clashed with many top officials in the department since taking over.

Among those who have left the department are Dr. Susan Fernyak, Director of Communicable Disease Prevention and Control; Dr. Masae Kawamura, Director of TB Control; Dr. Grant Colfax, Director of HIV Prevention; Elizabeth Jacobi, Director of Human Resources; Tangerine Brigham, Director of Healthy San Francisco; Mark Trotz, Director of Housing and Urban Health; and Dr. Erica Pan, Director of Emergency Preparedness.

“SFDPH has a national and worldwide reputation for innovative solutions to traditional public health problems. As a citizen of this city, I’m concerned that the current leadership is fostering an environment that is driving out and stifling that innovation to the detriment of all of us. A number of staff people have told me they have been instructed not to stretch themselves to innovate, to do only what their job description says and no more,” said the source, who works for a nonprofit that partners with the department.

Asked to comment on the exodus and her role in it, Garcia issued the following statement in response to questions from the Guardian: “Three staff that reported to me directly were recruited and provided promotions in the Los Angeles Department of Health Services. I’m very proud of these staff who are now involved with Health Care Reform efforts for the Los Angeles area. Several other staff that reported to our Public Health Division left for positions that were closer to home and the majority of these departures were promotions. All staff left in good standing with the San Francisco Department of Public Health.”

Meanwhile, 93 “members of the public health, social and environmental justice, foundation and education communities” wrote a signed letter to Mayor Ed Lee on July 10 on behalf of Dr. Bhatia, highlighting his work and appealing for a just resolution to the situation.

“Many across the nation have been grappling with how to improve the social and environmental conditions that are the cause of poor health and health inequities. Under Dr. Bhatia’s leadership, the San Francisco Department of Public Health Environmental Health Section has found practical ways — using research, policy, regulation, and cross-sector collaboration — to produce measurable improvements to environmental and social conditions throughout San Francisco’s diverse communities,” they wrote.

While writing that they “have no knowledge or commentary on the details of the leave or investigations, they went on to note the initiative that Bhatia has shown in going beyond his prescribed duties to work with various San Francisco constituencies to support equitable solutions to this city’s problems: “He takes his responsibilities as a public servant seriously, working well beyond required hours, and he is committed to improving the life-chances of socially, economically, and politically marginalized communities.”

Change in leadership at DPH triggers brain (and heart) drain

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The San Francisco Department of Public Health has seen an exodus of top officials over the 18 months since Barbara Garcia took the reins from longtime chief Mitch Katz, the most recent being Environmental Health Director Dr. Rajiv Bhatia, who was placed on administrative leave last month pending an investigation into unspecified concerns.

Bhatia has been a hero to many progressive San Franciscans and public health professionals for his innovative work supporting expanded worker protections, regulation of cannabis dispensaries and restaurants, environmental justice initiatives, and other work that has landed him in the pages of the Guardian many, many times.

“The poorest Americans are about two times as likely to die. People in low-wage jobs have less access to health care … food, shelter, clothing, and transit,” Bhatia testified during the 2002 Board of Supervisors hearing that led to the creation of a city minimum wage.

Neither Bhatia nor the department would comment on his leave, although sources tell us that he has not been informed of the charges against him (which an item in the Chronicle last month suggested was a possible conflict of interest issue relating to his regulation of restaurants) and that Garcia has clashed with many of top officials in the department since taking over.

Among those who have left the department, said one knowledgeable source, are Dr. Susan Fernyak, Director of Communicable Disease Prevention and Control; Dr. Masae Kawamura, Director of TB Control; Dr. Grant Colfax, Director of HIV Prevention; Elizabeth Jacobi, Director of Human Resources; Tangerine Brigham, Director of Healthy San Francisco; Mark Trotz, Director of Housing and Urban Health; and Dr. Erica Pan, Director of Emergency Preparedness.

“SFDPH has a national and worldwide reputation for innovative solutions to traditional public health problems. As a citizen of this city, I’m concerned that the current leadership is fostering an environment that is driving out and stifling that innovation to the detriment of all of us. A number of staff people have told me they have been instructed not to stretch themselves to innovate, to do only what their job description says and no more,” said the source, who works for nonprofit that deals with the department.

Asked to comment on the exodus and her role in it, Garcia issued the following statement in response to questions from the Guardian: “Three staff that reported to me directly were recruited and provided promotions in the Los Angeles Department of Health Services.   I’m very proud of these staff  who are now involved with Health Care Reform efforts for the Los Angeles area.  Several other staff that reported to our Public Health Division left for positions that were closer to home and the majority of these departures were promotions. All staff left  in good standing with the San Francisco Department of Public Health.”

Meanwhile, 93 “members of the public health, social and environmental justice, foundation and education communities” wrote a signed letter to Mayor Ed Lee on July 10 on behalf of Dr. Bhatia, highlighting his work and appealing for a just resolution to the situation.

“Many across the nation have been grappling with how to improve the social and environmental conditions that are the cause of poor health and health inequities. Under Dr. Bhatia’s leadership, the San Francisco Department of Public Health Environmental Health Section has found practical ways — using research, policy, regulation, and cross-sector collaboration — to produce measurable improvements to environmental and social conditions throughout San Francisco’s diverse communities,” they wrote.

While writing that they “have no knowledge or commentary on the details of the leave or investigations, they went on to note the initiative that Bhatia has shown in going beyond his prescribed duties to work with various San Francisco constituencies to support equitable solutions to this city’s problems: “He takes his responsibilities as a public servant seriously, working well beyond required hours, and he is committed to improving the life-chances of socially, economically, and politically marginalized communities.”

Parents, behind bars

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By Ross Mirkarimi

OPINION Nearly 50 percent of the 2.7 million people incarcerated in US prisons and jails are mothers and fathers. In San Francisco, about 40 percent of the prisoners are parents. For their children, the punishment does not fit the crime.

Federal and state recidivism registers at 78 percent; locally the rate is 65 percent and dropping. If we’re serious about breaking the cycle of incarceration, we must get serious about restoring the family ties of the incarcerated.

Studies support what common sense suggests — strengthening the parent-child bond reduces recidivism. It also reduces the prospect that children of the incarcerated are more likely to violate the law. While maintaining appropriate safety and legal protocols, the San Francisco Sheriff’s Department is reexamining policies that invariably damage or strain relationships between an inmate parent and child, starting with birth. In honor of Mother’s Day, on May 9, the Community Works Jail Arts Program, with our department, converted the lobby of the SF women’s jail into a temporary gallery of art created by incarcerated and formerly incarcerated mothers.

That provided a warm environment to announce a policy first in California: The Birth Justice Project, designed to affirm the reproductive rights of all incarcerated women and provide prenatal and postpartum care during the transformative experience of pregnancy, birth and parenthood. With the stewardship of Dr. Carolyn Sufrin, an OB/GYN from UCSF, along with the Department of Public Health, Zellerbach Foundation, and our volunteer doulas (professional birth assistants), we’re radically distancing ourselves from the barbaric attitude of 33 states that still shackle women during labor. Rather, we seek to nurture the inimitable bond between mother and child.

While most jails and prisons shun a lactation policy, we’ve unveiled our pro-lactation program. Breast pumps, refrigeration, and delivery are provided around the clock, facilitated by our jail health professionals. While the arcane national practice is to separate baby and mother after the third day of birth, we’re working to maintain the connection. If we can’t do it through diversion (alternatives to incarceration), then we’ll continue to assess our facility in allowing mother and baby to stay together. I look forward to promoting breast feeding in San Francisco’s jails.

For children of incarcerated parents, the absence of a mother is the loss of a primary caregiver. Ninety percent of incarcerated fathers in the US report that while away, their children live with the child’s mother. In contrast, only 28 percent of incarcerated mothers report that their children live with their father. Routinely, her children are cared for by a grandparent or relative — and about 11 percent are placed in foster care. Many children are bounced from caregiver to caregiver during their parent’s incarceration.

These disruptions to a child’s life negatively affect their social and mental development. Acknowledging the sense of disconnection experienced by children whose parents are incarcerated also means we must grapple with the emotional poverty that increases the likelihood of criminal behavior. In San Francisco, we’re taking steps to bridge this disconnection by reforming visitation policies to facilitating regular contact between children and incarcerated parents.

The people in our jails will eventually be released and will return to communities that historically have been underserved. We’re trying to intensify resources toward exit planning for newly incarcerated parents and guardians. Depending on individuals cases, that could include a regiment of parenting classes, substance abuse and mental health treatment, domestic violence counseling, reunification counseling for parent and child, reading and writing comprehension, high school completion, life skills such as financial literacy, and vocational training.

Many people don’t know what the Sheriff’s Department does or the difference between us and the SFPD; we’ve launched a monthly e-newsletter to keep the public informed. To sign up or contact us at: Ross.Mirkarimi@SFgov.org

Ross Mirkarimi is sheriff of San Francisco

City budget boosts homelessness spending, but not enough to meet demand

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The city budget that is now awaiting approval by the Board of Supervisors includes new funding for individuals and families facing homelessness, but community advocates say it doesn’t devote enough of the city’s rebounding revenues to addressing this growing problem.

Last Thursday, the Board of Supervisor’s Budget and Finance Committee approved $2.4 million in “add-backs” to homeless services, on top of the $2.3 million that Mayor Ed Lee pledged to supplement the city’s initiatives to curb the burgeoning number of San Francisco’s individuals and families becoming homeless.

The committee’s proposed budget will go before the full Board of Supervisors’ for a vote this month, devoting at least $2 million for this fiscal year and $1 million the next in to continue the successful Homelessness Prevention and Rapid Re-housing (HPRP) program that provides eviction defense and rent and utility vouchers to residents at-risk of homelessness.

Other homelessness initiatives in the proposed budget include extending the Lower Haight First Friendship shelter for homeless families to a year-round schedule, permanent housing units at 5th and Harrison streets for transitional age youth, 33 Local Operating Subsidy Program (or LOSP) subsidies for low-income homeless individuals and families, and funding to construct 24 shelter beds for the City’s first LGBTQ-focused homeless shelter at Dolores Street Community Center.

But for many residents and families, these initiatives may not be enough to stay in their homes, or re-house themselves after becoming homeless. And as the rent prices continue to drastically rise in San Francisco as the city’s economy heats up, the search for affordable housing or shelter beds has become more and more desperate.

January’s point-in-time homeless count identified 6,436 homeless persons on the streets and in the shelters in the city, a majority of which became homeless as San Franciscans. The current number on the city’s wait list is 220 families with an expected wait of seven to eight months, according to the Human Services Agency, which runs the city’s homeless shelter system. This is slightly down from 268 families earlier this year, then the largest in city history.

As the Guardian reported recently, the number of eviction notices in San Francisco hit a 12-year high this year, indicating an increase in displacement that may compound the number of families on the emergency shelter waiting list.

Bevan Dufty, the mayor’s point person on homelessness, told the Guardian that “the city definitely is not seeking to expand the shelter system,” despite the near-record waiting list.

 “Yes, we have lost shelter beds in recent years, and the 24 we are adding at Dolores Street Community Services is a minimal number,” Dufty added. “But you have to have a toolbox to respond in different ways.” And Dufty claims that re-housing families through programs like HPRP services in the budget has been shown to be the best way to prevent homelessness.

In response, Jennifer Friedenbach of the Coalition on Homelessness told the Guardian that, although the $1 million of HPRP services did prevent 1,300 San Francisco households from becoming homeless last year, it only covered 15 percent of the city’s overall need based on the number of people seeking services through San Francisco’s Eviction Defense Collaborative.

When asked to respond to the Coalition’s estimate, Dufty replied that he could not comment on its accuracy, but he conceded that the HPRP funding is “certainly not going to satisfy all the need.”

Dufty stressed that the city has been able to reduce the number of homeless veterans and has responded to a noticeable outcry in the need for more transitional housing, especially from LGBTQ community activists. Although the version of the budget making it to the Board of Supervisor’s vote this month would not expand the homeless shelter system beyond the Dolores Street Community Services project, it would improve the city’s oft-criticized shelter reservation system for single adults.

Along with Dufty and the Mayor Lee’s support, Friedenbach advocated in the homeless community to change the current line-based system to a lotterized system run through the city’s 311 system.

“The current shelter waitlist system is really archaic,” Friedenbach told the Guardian. “People spend 17 hours a day trying to get a bed at night.” Mayor Lee proposed this change in his budget, especially so the indigent and elderly no longer have to stand for hours waiting in line for a bed.

Though Friedenbach acknowledges the positive in the budget initiatives, she pointed out that there is still only one shelter spot for every six homeless persons in San Francisco, and that she “doesn’t know what standard you can go by to say that is too much.”

The new revenue from November’s business tax reform measure, won through a ballot initiative pushed by on-the-ground community groups like the Coalition on Homelessness, should “go back to low-end communities who are hurt from years of reduced services in mental and public health,” Friedenbach said.

Last month, the Coalition on Homelessness and other advocates pushed the Budget and Finance Committee to double Mayor Lee’s proposed $1 million for HPRP for 2013-2014 and an additional 75 LOSP rental subsidies on top of the 25 the Mayor had already pledged. At its last meeting before the new fiscal year, the Budget and Finance Committee pledged an addition $1 million for HPRP, but only added eight new LOSP subsidies.

Friedenbach attributed the lower number to the city’s logistical problems of trying to find additional service providers for subsidies. The “add-backs” marked “a lot of progress for poor folks,” Friedenbach said, although the city will still have “a situation where a lot of money is coming in, but not trickling down.”

“San Francisco is at a critical juncture,” Friedenbach prefaced her public comment at a Budget and Finance hearing last month. “The influx of wealth is pushing the heart of the city—the working class and poor—out.”

The budget approved by the Budget and Finance Committee last Thursday will likely go to the full Board of Supervisors starting next week, July 9.

Scorning smokers

news@sfbg.com

San Francisco officials are attempting to ban the public use of e-cigarettes under the same laws that restrict smoking cigarettes, which are banned in most public places purportedly because secondhand smoke endangers others. However, the alleged lack of toxic emissions from e-cigarette vapor raises questions about the basis for the crackdown.

Has the crusade against smoking in public really been about protecting the innocent, or is the moralistic motivation to try to save people from their own bad choices also driving the trend? And if so, does that undermine the legal basis for restricting an otherwise lawful product?

Since 2011, the San Francisco Department of Public Health has backed legislation to hold e-cigarettes under the same public smoking laws as traditional tobacco products. Currently, San Francisco’s continually expanding smoke-free ordinance bans cigarette consumption in nearly any public place. This consists of Muni stops, festivals, parks, farmers’ markets, non-smoking apartments and, unfortunately for all you nicotine-addicted bingo lovers, the obscure addition of “charity bingo games.”

San Francisco has yet to pass any regulatory laws regarding e-cigarette consumption, or “vaping.” But Nick Pagoulatos, a legislative aide to Sup. Eric Mar, a staunch sponsor of San Francisco’s many anti-smoking policies, says a plan is in the works.

“Currently there is nothing on the books,” Pagoulatos told the Bay Guardian. “But there has been discussion with the health department [which is] working something up and the Mayor’s Office has been talking with them as well. The timing is unclear, but at some point it will happen.”

California Senate Bill 648, approved in May and currently on its way to the California Assembly, would elevate similar e-cigarette regulations to a state level. So why are California and San Francisco pushing so hard to regulate these products?

“The suspicion is that allowing people to vape these things reinforces the culture of smoking,” Pagoulatos said. “It continues in the tradition of making smoking look cool, even if it’s not actual smoke.”

Traditionally, San Francisco’s smoking ordinances have derived from the hazards of secondhand smoke on innocent bystanders, but the regulation of e-cigarettes evokes an entirely new basis for public smoking laws.

California has an active history of anti-smoking legislation beginning in the 1990s when San Luis Obispo became the first city in the world to ban smoking in all public buildings. In 1998, the public smoking ban elevated to the state level, specifically because of the health risks posed to bar and restaurant employees by secondhand smoke. This year, the San Francisco Board of Supervisors voted to extend the already strict non-smoking laws to cover festivals and street fairs and require landlords to designate their building units as smoking or non-smoking. Now, vapers in California face a similar threat.

 

VAPING ISN’T SMOKING

E-cigarettes contain a battery operated heating device that vaporizes a combination of nicotine and a binding liquid such as propylene glycol, a substance “generally recognized as safe” by the FDA. Since nicotine is not what kills smokers, e-cigarettes have the potential to exist as a safe alternative for smokers who can feed both the physical and mental habit of smoking without the detrimental effects of tar and the plethora of other chemicals found in traditional cigarettes.

However, conflicting studies exist regarding the safety of e-cigarettes for both users and the public. While the FDA has yet to regulate e-cigarettes, a 2009 evaluation reported the finding of numerous chemicals in e-cigarette liquid, such as those found in antifreeze.

Gregory Conley, legislative director for The Consumer Advocates for Smoke-Free Alternatives Association, told us these reports are misleading.

“Essentially, there is absolutely no evidence that e-cigarette vapor poses any significant threat to public health,” said Conley. “The antifreeze chemical was found in one of the 18 cartridges and tested in an amount that was less than 1 percent. Additionally, the amount of the chemical diethylene glycol found by the FDA would take thousands of cartridges to reach a toxic level.”

Conley cites the publication Tobacco Control, a premier tobacco science journal in the US with no tobacco industry ties, as the leading evidence in the case for e-cigarettes. The study, funded by the National Institute of Health, tested 17 different brands of e-cigarettes for chemicals known to cause harm in secondhand smoke.

“These amounts were nearly identical to the amounts in the control product, or the FDA approved nicotine inhaler,” said Conley. “They are trace levels, and anyone who has been in a room with an e-cigarette knows that there is a vast difference in comparison to a normal cigarette.”

A study by the Fraunhofer Wilhelm-Klauditz-Institut in Braunschweig, Germany found similar results, reporting that the release of toxins from e-cigarettes were marginal to non-existent. In fact, researchers attributed many of the low level chemicals detected in the tests, such as formaldehyde and acetone, to the test subjects, since our lungs naturally exhale these chemicals in small amounts.

Conley says e-cigarettes not only provide a safe alternative, but also offer a public promotion of smoking cessation by illustrating the addicting effects of nicotine.

“It’s a walking advertisement to show how addictive cigarettes are,” Conley said. “The fact that you have to buy one of these things to quit smoking, with a battery and everything, it’s ridiculous.

 

TARGETTING TOBACCO

Equating e-cigarettes and traditional cigarettes does tend to disregard the potential benefits safer nicotine alternatives can have on addicts. The language of the FDA and the DPH appears to dismiss the advantages of e-cigarettes over smoking. While issues certainly arise with the lack of regulation and quality control of e-cigarettes, much of the discussion from these groups pertains to reversing social views on smoking.

“The major concern for us is about social norms,” Derek Smith, a health program coordinator at the Tobacco Free Project, told us. “People get confused about the use of these products in public where they might think tobacco use is allowed. That’s one of the major concerns because there are limits to where people can safely smoke indoors. It’s the idea of a copycat item.”

According to Smith, AT&T Park, San Francisco General Hospital, and the San Francisco Airport Commission have all already banned the use of e-cigarettes on their premises. Some Bay Area cities, such as Petaluma, have already classified vaping under their smoking ordinances. In Canada, the sale of e-cigarettes is entirely prohibited due to a lack of regulation and quality control, while cigarettes remain legal.

FDA regulation could certainly alleviate much of the pressure e-cigarette companies face from the public. However, if a safe e-cigarette is proven to exist via an official FDA evaluation, organizations like the DPH may still not allow public vaping for the sake of remaining strictly against the use of tobacco related products in public places.

Many of the arguments against the use of e-cigarettes are seemingly arbitrary to the discussion of public use since San Francisco’s public policy holds so much blunt hostility toward anything tobacco related (but, of course, anything marijuana related is okay with the city). Oddly, e-cigarettes continue to get flack from the FDA, while other nicotine delivery systems such as patches and gum are FDA approved.

Under what legal grounds could San Francisco’s government have the right to ban e-cigarette usage in public places if they are proved harmless? If the legislation passes, residents of non-smoking apartments would be unable to legally vape a scentless, allegedly toxin free e-cigarette in the privacy of their own home.

 

FEDS AND E-CIGS

In March the FDA appointed Mitch Zeller as the new director of the Center for Tobacco Products. According to his FDA profile, Zeller, a lifelong proponent of FDA tobacco regulation, has deep-rooted ties to the anti-smoking movement and is currently an executive of a pharmaceutical consulting firm working closely with sellers of FDA approved, nicotine-replacement pharmaceuticals.

But Zeller has openly advocated the idea of harm reduction through nicotine-replacement systems, much more than his predecessor, Dr. Lawrence Deyton. So hope may yet exist for the plight of vapers who don’t want to be lumped in with smokers. So much of the anti-smoking conversation is drenched in black-and-white thinking, promoting a system of total abolition over harm reduction. Unfortunately for smokers, this could impede their transition to a safe nicotine delivery system that they can use virtually anywhere, and one that may consequently help save lives. As of now, public discourse and education may act as the most important catalyst toward a widespread understanding of e-cigarettes.

For anyone who has seen an e-cigarette, the soft glow of the LED light at the end has little resemblance to a traditional cigarette, which is on fire and emitting a cloud of noxious smoke. If an FDA approved, emission-free e-cigarette eventually hits the market, users in San Francisco could still face a loss of freedom solely backed by the ideological social standards of the anti-smoking movement, which would bar them from vaping in public. But for now, San Francisco’s vapers should enjoy their freedom while it lasts.

CORRECTION: This article was corrected to change the chemical name in Conley’s quote from propylene glycol and to clarify that the FDA studied the liquid in e-cigarettes, not their emissions. 

Prostitution and Mitt Romney

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Four and a half years ago, San Francisco had the chance to make history as well as eliminate a major social problem. Measure K would have eliminated the prosecution of sex workers in the city. Sensible, sane and prudent, this ballot initiative would have finally given some legal recourse to one of the city’s biggest underground businesses. Because it is sex-based, however, hysteria ruled the day and the measure was defeated.

The arguments against it are the same arguments one hears when one discusses recreational drug legalization. That if legal, street walkers would spring up like so many weeds on heels in every neighborhood and that pimps and hookers would flock to San Francisco en masse. Never mind that the exact opposite would have been the result–no longer in the shadows and with their business legitimate, sex workers could part ways with the parasitical pimps without recourse and also if legal, a “red light district” could exist anywhere (I opt for City Hall myself, as it has been home to courtesans for centuries now). Lost tax revenues reclaimed, better public health for the workers and clients and a win for all.

One would think in the supposed progressive and free-thinking capital of America, this would have been a slam dunk. It lost resoundingly. Which proves that for all of San Francisco’s bluster, at heart it is a provincial city filled with a lot of sexually uneasy residents. That our next door neighbor, the generally “red” Nevada has had legalized prostitution for years speaks volumes about what “liberals” really believe. “Not in my backyard” times ten. Prostitution is called “the world’s oldest profession” and yet it is rarely legal anywhere–why?

As human beings are one of only a few species to have sex for pleasure, you’d think we’d clearly admit same. And that sex between consenting adults is already legal anyway, why does it become illegal when money is involved (unless filmed and sold)? These are incontrovertible facts. I suspect that the real reason prostitution is illegal and has been for eons is that it empowers women at the expense of men (the male escort being about 1/10th as popular as the female, sexual ratios being what they are). A woman that can negotiate the price for her “favors” directly now has some say in her destiny. Yes, it would probably be better for her physical and mental health if she chose another line of work, but in a capitalist system where money talks, a 300 dollar an hour escort is higher up on the ladder than a nine dollar an hour barrista. A couple of grand a day and a person whose educational and class background placed them at the lowest rung on the ladder now has say–it’s the same reason that gambling and drug dealing are decried by moralists. Folks with no options are now equal to the privileged at birth and that upsets the so called “natural order of things”. So, they have to be denigrated.

I got to thinking about that paradigm and realized that in reality, a hooker is part of a much more honest profession than someone that runs or ran an equity capital group. Namely Willard “Mitt” Romney. When a john makes contact with an escort or sexworker, they negotiate a fixed price for a certain act or acts. Upon consumation (or at some time during or before), payment. Both sides happy. Compare that to Mr. Romney’s manner of acquiring businesses. Putting 10% down, leveraging the other 90% as tax free debt larded onto the acquired entity and then tacking on enormous fees paid to backers. Usually what happens with these companies is massive layoffs and often bankruptcies. One side very unhappy. Yet this perfectly legal version of a Mafia bustout is applauded by Wall Street–the same Wall Street that poo-poos sex workers as a moral scourge (while utilizing their services).

Taking advantage of the human tic of discomfort when it comes to acknowledging the sex drive has kept the church alive for centuries and jackasses like William Donahue and L Brent Bozell in cash. Simply recognizing biological normalcy would end a lot of misery. Next time this comes up, be sane San Francisco, be sane.