San Francisco Mayor Newsom Proposes Privatizing Inmate Health Services To Reduce Costs
San Francisco Mayor Gavin Newsom (D) in his budget for fiscal year 2004-2005 is proposing privatizing the San Francisco jail health care system to save as much as $4.5 million in the second half of fiscal year 2005, the San Francisco Chronicle reports. In a county-by-county comparison, Newsom's budget office found that San Francisco spends nearly $15,000 on medical care per year, per inmate in county jail -- more than three times the amount spent by Alameda County and twice the amount spent by Los Angeles County. The city has an average daily inmate population of about 2,000 and spends nearly $34 million per year providing medical care to those inmates, according to the Newsom administration. Newsom says that medical services at the jails could be provided more efficiently to save money by making changes such as allowing lower-paid workers, instead of higher-paid trained nurses, to distribute medications. Representatives of private prison health care contractors said they could save counties money in several ways, such as large-scale purchasing of prescription drugs, negotiating the best price for contract doctors and performing nonemergency medical procedures in jails instead of hospitals. Newsom said he would like to use the projected savings from the proposed changes to expand San Francisco's universal health care for uninsured children and young adults.
Sheriff Michael Hennessey, who runs San Francisco's jails, said that considering proposals to privatize the inmate health care system could be beneficial, according to the Chronicle. However, officials for the city's inmate health care program said that the money spent is needed to care for a population with special needs such as HIV infection and mental health and substance abuse problems, the Chronicle reports. Joe Goldenson, medical director of San Francisco's jail health services, said that beyond inmates' acute medical needs, San Francisco provides comprehensive HIV/AIDS care, screening programs for sexually transmitted diseases, a hepatitis B vaccination program and a discharge program that helps former inmates enroll in public health programs. Goldenson said that health promotion and disease prevention would not be the focus if a private company ran the system because it would be motivated by cost reduction. "Saving money is the carrot, the hook," Supervisor Tom Ammiano, who opposes privatizing the system, said. He added, "You can save money, but in the long term you just don't get the same level of service" (Gordon/Lelchuk, San Francisco Chronicle, 6/1).
Newsom's proposed budget, which is being presented to supervisors Tuesday, includes changes that are "no cause for celebration," as the mayor attempts to address a $307 million budget deficit, a Chronicle editorial states. Although neighborhoods are promised "intact health clinics," other health care-related services will experience funding cuts, with the Department of Public Health, San Francisco's largest agency, losing 17% of its administrators, according to the Chronicle. However, the editorial concludes, the plan remains a "promising start" to lowering costs if Newsom's changes "can be done with minimal pain" (San Francisco Chronicle, 6/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.