SAN FRANCISCO: Public Health Director Defends Mental Health Cutbacks
Dr. Mitchell Katz, San Francisco's public health director, yesterday "told skeptical members of the Board of Supervisors" that his proposed reductions in mental health care services "was an opportunity both to save money and help patients." The San Francisco Chronicle reports that Katz wants to close a 21-bed ward for people who need acute psychiatric care at San Francisco General "because the San Francisco Department of Public Health is beset by budget problems." Testifying before the Board of Supervisors Finance and Labor Committee, Katz "emphasized yesterday that he does not propose to dump patients on the street," but wants to move patients into less costly outpatient centers. "Here is an opportunity to decrease costs and provide a more appropriate level of care," Katz said. But Supervisor Tom Ammiano pointed out that Katz's plan "ignored the fact that private care beds are either disappearing or are not open to the poor patients." He said, "We all recognize the extreme financial pressures ... [b]ut we cannot pursue cuts that hurt our most at-risk populations." Ammiano added, "We have already seen a serious erosion in the availability of beds for these people."
A Chorus of Skeptics
Dr. Kate Beyrer, director of San Francisco General's emergency psychiatric services, criticized the proposed plan. She argued that "doctors have already scrounged around for enough money to send more patients to less acute care facilities as their condition improves." Beyrer contends that eliminating 21 beds "will feed the hospital's downward financial spiral," by cutting off state Medi-Cal funds. "If [Katz] cuts those beds, he cuts our only way of getting Medi-Cal revenue," she said. Eva del Campo, a psychiatric nurse at the hospital, said, "The people of this city should be ashamed of making more health cuts." She continued, "These are often the most stigmatized, needy people of our society we're talking about." Supervisor Gavin Newsom predicted that the "best course would be a middle one," incorporating concerns brought forward by both Katz and Beyrer (Epstein, 3/30).