San Francisco Supervisors Question Plan To Privatize Inmate Health Care

San Francisco supervisors on Friday at a hearing to consider Mayor Gavin Newsom's (D) $5 billion budget proposal voiced concern over a plan to privatize health services at its jails, the San Francisco Chronicle reports. Under the plan, more than 100 public health positions could be eliminated, and the county could save an estimated $4.5 million in fiscal year 2004-2005 (Gordon, San Francisco Chronicle, 6/28). Newsom has said that the county could save money by making changes such as allowing lower-paid workers -- instead of higher-paid trained nurses -- to distribute medications and by making other changes to improve efficiency in the jail health care system. Representatives of private prison health care contractors said they could save counties money by purchasing prescription drugs in mass quantities, 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 (California Healthline, 6/1). Currently, the county spends more per inmate for health care -- $16,762 per year -- than any other county statewide, in part because it provides services such as screening and treatment for HIV, tuberculosis, sexually transmitted diseases, diabetes and hypertension. In addition, the system provides treatment for substance abuse and mental illnesses, which are common among inmates, according to the Chronicle.

Supervisor Gerardo Sandoval, chair of the board of supervisors' budget committee, said, "We have a big decision here, and it seems to be motivated by our tight budget rather than the policy behind it. It's not really the right way to make such a big decision." Supervisor Jake McGoldrick called for specifics on which services would be provided under a private plan. In addition, he asked for a breakdown of services that other counties with lower per-inmate expenditures provide to help determine why San Francisco jail expenses are higher. Ben Rosenfield, Newsom's budget director, said San Francisco provides more extensive services than other counties, but he said, "The question comes down to how [extensive] and at what cost." He added that if San Francisco were to privatize jail health care, minimum standards of care would be set for all bidders. The board delayed a decision on the proposal until later this week (San Francisco Chronicle, 6/28).