SAN FRANCISCO: Board Cancels Home Health Contract
The San Francisco Board of Supervisors voted 7-3 yesterday to "sign off after the fact" on Mayor Willie Brown's (D) "decision to cancel three contracts with California Pacific Medical Center to provide home health care services to the poor and AIDS patients." The San Francisco Examiner reports that the "unionized Health Department has taken over services at what critics say is a much higher cost." California Pacific Medical Center, which runs the Visiting Nurses Hospice Group, was targeted by the mayor and the unions "after the private, nonprofit health care provider tried to block efforts by home health care workers to unionize." Under orders from Brown, the Health Department canceled its contracts with the organization and shifted the "workers to the city's payroll." Proponents of the switch contend that patients are "[receiving] better care under direct city jurisdiction -- a contention that critics, including representatives from California Pacific Medical Center, say hasn't been proven."
In addition, critics contend the city's program is run at a much higher cost. According to Board of Supervisors Budget Analyst Harvey Rose, the "switch cost taxpayers an estimated 38% more. The program now costs $1.5 million, covering pay for 28 nurses and other operating expenses" (Gordon, 2/3). "Despite the provision of this new information by the Department of Health, the conclusion ... that the city's assumption of services previously provided under contract with the Visiting Nurses Hospice Group would result in significant cost increases, remains unchanged," Rose said. However, City Health Director Dr. Michael Katz said the cost to the city for the program would be about $1.45 million annually -- "just a bit more than the $1.43 million price tag on services provided by the visiting nurses group." The San Francisco Chronicle reports that his figure did not include overhead costs.
History of the Controversy
The controversy began last April, when, according to Katz, the Health Department canceled the contracts after the visiting nurses group "refused to take new patients or referrals." However, Board President Barbara Kaufman said the "decision had less to do with quality and more to do with political pressure from powerful unions." She said, "It was over a labor dispute. ... I think it is simply amazing that this body would actually say it's OK to cancel a nonprofit contract and hire people to work for the city instead of the nonprofit ... and then come to the board later and say 'we've done this.'" Service Employees International Union official John Borsos "objected to Kaufman's characterization of the nonprofit doing nothing wrong." "There were 140 workers fired in May for essentially trying to form a union. I think it's an outrage," he said (Wilson, 2/3). The board was scheduled to vote two weeks ago, but delayed the vote until two supervisors, Leland Yee and Michael Yaki, "who had indicated earlier that they would oppose the plan, made an about-face." Yee said he changed his mind because "'the train has already left the station,' and he didn't want to risk interrupting services to patients" (Examiner, 2/3).