Prioritizing Healthcare for All San Franciscans

As District 8 Supervisor, I will work to improve access to affordable healthcare and increase funding for HIV/AIDS and other important health issues.  My record demonstrates strong leadership in securing healthcare access and resources andI know how to build coalitions to support health-related initiatives.  San Franciscans strongly support ensuring that all residents have access to affordable healthcare choices.  I was proud to serve under Mayor Willie Brown, when he introduced the ground-breaking Healthy Kids Program, providing universal health care coverage to 10,000 uninsured children in San Francisco.  This program was only the second in the nation to provide families access to quality medical, dental, and vision coverage.  It provided a critically needed solution for working families who earn too much to qualify for other government-subsidized programs.

Expanding Healthy San Francisco

I have strongly supported San Francisco’s continued leadership in providing healthcare access to all residents through Healthy San Francisco.  This innovative program provides primary, specialty and inpatient medical care through a network of public and private non-profit clinics.  It provides access to a “medical home” that coordinates all necessary care.  Healthy San Francisco is a landmark public health care program.  City residents with incomes at or below 500% of the federal poverty level, and who don’t have any other form of insurance coverage, receive a variety of services, including primary care, prescription drugs, and mental health and substance abuse treatment.  In addition, qualifying employers are required to provide health insurance, and have the option to pay to have employees covered by Healthy San Francisco.

While national healthcare reform legislation will provide coverage to many Healthy San Francisco clients under expanded Medicaid or private insurance exchanges, this legislation will not be fully implemented until 2014.  In addition, economic challenges in San Francisco and potential future cuts to Medicaid and other public health programs could lead to increased demand for Healthy San Francisco services.  I will fight to ensure that Healthy San Francisco always receives full funding, and is expanded when needed, to ensure that all San Franciscans have access to these comprehensive services.

Protecting Resources and Funding for HIV/AIDS

During my career in public service, I have brought diverse communities together in support of programs to assist people living with HIV/AIDS.  As a city, we have much experience building resources to respond to HIV/AIDS.  Together, we have developed a system of care and support that serves as a national model.  Many people with HIV now live longer due to greatly improved treatment options.  Randy Allgaier’s recently published report to the HIV Health Services Planning Council – “HIV and Aging” – estimates that over 50% of all San Franciscan’s living with HIV will be 50 years of age or older by 2012.  Now, we must ensure that  people living with HIV have proper care not only for those health issues common in aging adults, but also for the side effects caused by years of taking toxic drugs to combat the virus.

The HIV/AIDS epidemic continues to have a disproportionate impact on our city, with approximately 16,000 San Franciscans living with HIV/AIDS.  It is the third leading cause of death for men in San Francisco between the ages of 35 and 54.  San Francisco’s model system of HIV care relies on Ryan White Program Funds, along with state and city funding, to deliver a comprehensive package  of care, treatment, housing, and support services.  Funding at all levels of government has been reduced in recent years and many local AIDS service providers have been forced to reduce or eliminate vital services.  We will not be able to depend on Federal healthcare legislation to provide “wraparound services” – such as housing, food, and case management – which are currently funded by the Ryan White Program.

I have worked alongside District 8 Supervisor Bevan Dufty to protect HIV/AIDS services and funding for our community.  As your Supervisor, I will partner closely with the San Francisco Department of Public Health, service providers, people with HIV, and other community advocates to identify ways to continue the services we provide.  In addition, I will work with HIV prevention advocates to assist in efforts to educate queer youth and other at-risk communities.  I strongly support efforts to locate a resource center and shelter for LGBT and HIV positive youth in our District.

I know how to obtain resources and funding to assist those living with HIV/AIDS.  As Mayor Brown’s Liaison to District 8, I led the efforts to approve the development of the 1 Church Street Project.  Working with community members and city officials, we provided 12 affordable housing units for families or individuals living with AIDS.  Facing opposition from some neighborhood stakeholders, I was able to coalesce support by bringing all parties together to develop a sustainable plan for the neighborhood.  I support San Francisco’s affordable housing policies that require developers to include below market-rate housing units in their projects.  These policies are essential to ensure that people who are living with HIV/AIDS will continue to have the option to live in San Francisco.

Focusing Attention and Resources on Hepatitis B and C:

Chronic Hepatitis B and C are diseases that have had a significant impact on San Francisco, and yet they receive little attention.  Both Hepatitis B and C can lead to liver damage, cirrhosis, liver failure, and/or liver cancer.  Hepatitis B disproportionately affects Asian and Pacific Islanders, who make up 34% of San Francisco’s population.  An estimated 12,000 San Franciscans have Hepatitis C, which heavily impacts African-Americans, Latinos, the homeless, gay and bisexual men, people with HIV/AIDS, and veterans, among others.

As Supervisor, I will support efforts by the San Francisco Hep B Free campaign – a coalition of public health officials, Asian-American groups and health organizations – to educate the public and providers about the disease and promote Hepatitis B testing, vaccinations, and treatment.  I will also partner with the recently formed San Francisco Hepatitis C Task Force to assist with implementing its recommendations on addressing the Hepatitis C epidemic.

Providing Effective Mental Health and Substance Abuse Services

San Franciscans understand the importance of supporting mental health and substance abuse services.  Providing access to services not only improves the lives of those affected, it also reduces the burden untreated individuals often place on our communities.  In fact, an essential part of San Francisco’s efforts to eliminate homelessness is providing easy access to mental health services to those in need of assistance.

Providing effective treatment that is readily available to those who need it most is not easy, but it can be accomplished.  The Department of Public Health is currently working to integrate primary care and behavioral health services into a single “medical home” for clients.  I support this initiative and other efforts that will better link individuals to city services and nonprofit contractors.

Behavioral health services are vulnerable to budget cuts because many services are not billable to MediCal.  We must protect those services that are essential to treating addictions and mental health problems and reduce the need for more expensive institutional care.  Some Members of the Board of Supervisors continue to support programs that may have popular support among certain constituents, but have poor or questionable treatment outcomes.  Given budget shortfalls, the City must focus on programs that provide measurable results.  As your Supervisor, I will support programs that provide effective treatment options and have demonstrated successful treatment outcomes.

Medical Marijuana

Those who need medical marijuana should be able to access it as part of their health care. While there has been discussion about taxation of marijuana, I do not believe that patients should be taxed for their medication. I will work to bring vapors to San Francisco’s hospitals and hospices, where feasible, for patients in need.

Securing Healthcare Funding and Access

San Franciscans have long recognized the need for healthcare reform at the national level.  Although we have taken important steps towards ensuring healthcare access for our residents, real change was not possible until the country addressed this important issue.  I am proud of my early support of President Barack Obama – serving in 2007 on his LGBT Leadership Committee and as a pledged Obama Delegate to the Democratic National Convention.  His leadership was critical to accomplish real healthcare reform, something no former President has achieved.  I recognize some of the limitations of the reform package that was ultimately approved but I also understand the importance of passing achievable legislation that will help uninsured Americans.  Although national healthcare reform will assist many San Franciscans, we must continue to support local programs for those who do not qualify for MediCal or the national insurance exchanges.

San Francisco must continue to lobby the Federal Government for healthcare funds for those in need.  As your Supervisor, I will strongly support efforts to lobby the Federal Government for:

• Increased Federal Medical Assistance Percentage (FMAP) funding to provide additional federal Medicaid dollars to California.
• Increased Federal funding for community health clinics
• Increased HIV/AIDS care, treatment, prevention, and housing funds
• Increased funding for viral hepatitis programs at the Centers for Disease Control and Prevention

San Francisco must also ensure restoration of sufficient healthcare funding from the State of California, which is now more necessary than ever due to Federal funding cut-backs.

• Restoration of HIV prevention, care, testing, and housing funds cut by Governor Schwarzenegger in 2009.
• Restoration of Healthy Families (Medi-Cal for low-income children) funds cut by the Governor
• Restoration of Medi-Cal benefits and services eliminated by the Governor

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