The SF Board of Supervisors is holding a hearing on Restoring the Single Standard of (Mental Health) Care.

Monday, June 27, 1 PM

Reinstate the Single Standard of Care Now!

The Single Standard of Care refers to the long-standing policy that uninsured people get access to the same level of care as insured people in San Francisco’s mental health system!  It was arbitrarily reversed in the mid- year budget cuts as an ill-conceived plan to save money.

Taking Away Single Standard of Care Hurts Large Number of People

•  1,170 medically indigent individuals lost their city funding for mental health treatment as of January 1^st, 2005

•     Up to 20% of the total number of people served in SF mental health system are impacted by this policy change.

Taking Away Single Standard of Care Negatively Impacts Vulnerable Populations

•      As this policy targets medically indigent adults to deny services to new immigrants and ethnic minorities are disparately impacted.  The agencies that are hit the hardest are those who serve these populations.  These are individuals that are very difficult to engage in treatment, and once engaged, it makes no sense to discontinue them.

•      Homeless people are also disproportionately hit with these cuts.  This population is already vulnerable and unstable; losing their treatment will be devastating.

•      Untreated mental illness is dangerous – it can cost lives!  With the loss of treatment, individuals are at increased risk for suicide. 

Taking Away Single Standard of Care Is Contrary to Current City Policy

•      City currently is moving towards an integrated model of service.  This policy change fly’s in the face of integration.

•      The City is currently trying to create exits off the street for homeless people, and this policy change will exacerbate homelessness.  Untreated mental illness leads to longer stints of homelessness, and individuals have a more difficult time navigating their way off the streets.

•      City policy currently dictates an emphasis on linking individuals to entitlement programs such as MediCal.  This policy change will make it more difficult for individuals to garner benefits as they are unable to demonstrate their disability without treatment, and their related instability makes it harder to follow the bureaucratic maze public benefits require.

•      City is trying to promote idea in mental health services that “any door is the right door”.  With this policy, a whole lot of wrong doors are being slammed shut.

•      This policy does not prioritize prevention.

•      Moves away from city policy of “Treatment on Demand”.

Taking Away Single Standard of Care was done without proper community process

•      This was a top down decision that was made without input or support from the rest of the Department, community organizations, contractors or the community at large.

•      There was no regular community process to discuss the ramifications of such a major policy change.  In fact, even the Bielensen hearing did not take place. 

•      The criteria did not even get developed until after the policy was put in place.

Taking Away Single Standard of Care is Clinically Problematic

•      Medically indigent Individuals with adjustment, anxiety, minor depression and mood disorders are no longer eligible for treatment under this policy change.

•      This arbitrary policy change does not take into consideration the accuracy of the diagnosis and does not include secondary diagnosis.  Clinicians may not want to label new monolingual patients, for example, with more severe diagnosis to start with.

•      Policy change encourages mis-diagnosis of individual into a reimbursable category.

•      Encourages clinics to serve insured people in order to pull down more MediCal reimbursements.

•      Encourages clinics to turn down treatment for people with other co-occurring issues, such as addictive disorders.

Taking Away Single Standard of Care is Just Plain Bad Policy

•      Do we really want a two-tiered system in San Francisco, where people’s health is determined based on insurance status?

•      In this policy change, health care is not the priority – insurance is!

•      Policy can result in explosion of immigrants, homeless, and ethnic minorities in the hospitals.

•      Public policy should be developed by having a vision first, then instituting policy that implements that vision. 

Brought to you by the San Francisco Coalition on Homelessness 468 Turk Street San Francisco CA 94102 (415) 346-3740