When lessons history should have taught us later resurface as a new problem, biting us on the rear end, how many ways can we say deja vu?
In the Bay Area Reporter's March 6 issue, a front-page story informs us that the Health Commission just approved mid-year health cuts proposed by Mayor Gavin Newsom. But the B.A.R. 's reporting that $19 million in mid-year cuts in the current year, plus budget cuts proposed in the upcoming fiscal year 2008-09 budget, is off target by tens of millions of dollars.
The hearing in which health commissioners voted 4-3 to approve budget cuts only amounts to $1.25 million in current mid-year cuts, according to the Department of Public Health Beilenson notice posted online prior to the Health Commission's March 4 meeting, not $19 million in mid-year cuts.
The Health Commission's fake "Beilenson hearing" was designed to give the Newsom administration smoke-and-mirrors cover, with a patina of being within state law.
The Department of Public Health is anticipating a total of $44.2 million (not $19 million) in cuts for fiscal year 08-09, since the mayor's budget instructions that departments trim 8 percent from departmental budgets has to be submitted with an additional 5 percent reduction in so-called contingency cuts, for a total of 13 percent, not 8 percent. The $44 million figure doesn't include the $1.1 million in current mid-year cuts now being ordered by the mayor, with full complicity by the Board of Supervisors.
The B.A.R. article indicated mid-year cuts are up to Mayor Gavin Newsom and are "out of the Board of Supervisors' hands." Nothing could be further from the truth, though that would be because the Board of Supervisors shirked its legislative oversight of the city's budget.
While board President Aaron Peskin was quoted that Newsom acted unilaterally, refusing to spend money already appropriated by the Board of Supervisors, the pink elephant in the room is that Peskin is ignoring a state law that requires the Board of Supervisors – not the Health Commission – to approve reductions in health care services to county residents relying on Medi-Cal for their health care services before such reductions are implemented. The state law is known as the Beilenson Act, which requires that a Beilenson hearing, under state Health and Safety Code paragraph 1442.5, be held in front of the county Board of Supervisors, prior to any reductions of health care services provided by a county. State law does not permit the county Board of Supervisors to delegate holding a hearing it is required to conduct to a county's Health Commission.
Way back 20 years ago, under Mayor Art Agnos, San Francisco attempted to reduce county-provided health care services supplied by the Department of Public Health, without first properly notifying San Franciscans with due-process public notice. The court eventually ruled San Francisco has to comply with the Beilenson Act, which the city is now violating again.
Fast forward to the Health Commission's fake Beilenson hearing held on March 4. The hearing was an end-run to ram through budget cuts, and does not absolve the Board of Supervisors of its budgetary oversight role. The Board of Supervisors isn't permitted under state law to delegate holding a Beilenson hearing to anyone, and the Health Commission isn't granted jurisdiction under section 1442.5 to hold such a hearing in lieu of the county's Board of Supervisors holding its own Beilenson hearing.
But reportedly, another community health care activist recently questioned under what authority Peskin approved delegating the required Beilenson hearing to the Health Commission on March 4. The reply from Peskin's staff is that Peskin received an opinion from the city attorney's office that since the mid-year budget cuts were proposed by the mayor, no Beilenson hearing is required.
This goes straight back to 1988, 20 years ago, when Mayor Agnos's then-city attorney, Louise Renne, was rebuffed by a three-judge Court of Appeal ruling against her argument that the Beilenson Act does not require the San Francisco Board of Supervisors to hold a Beilenson hearing before the county reduces health care services.
Meanwhile, I've filed a lawsuit against the city, asserting plans to reduce Laguna Honda Hospital's capacity, currently being downsized without a required Beilenson hearing beforehand, is also illegal.
Just how many ways can we say d�j� vu ?
Patrick Monette-Shaw is a health care accountability advocate. He has been advocating for the full, 1,200-bed rebuild of Laguna Honda Hospital for rapidly aging baby-boomers, and the expected "silver tsunami" just 12 short years from now of 10,000 San Franciscans over the age of 85 with Alzheimer's, many of them LGBT elderly, who will eventually need skilled nursing level of care, since San Francisco already has a dire shortage of skilled nursing beds accepting Medi-Cal clients.