By Nicholas Olczak

March 21, 2008

The Budget and Finance Committee Wednesday decided that funds for a wheelchair ramp in board chambers should not be re-allocated to counterbalance mid-year cuts to mental health and chronic care services.

Instead they elected to put funds on reserve until alternative designs can be evaluated by the full board later this month. Current designs for the ramp – which would provide wheelchair access to the President’s platform – were not approved by the board in February.

Supervisor Chris Daly, who proposed the re-appropriation of funds, hoped to generate $944,000 to prevent funding cuts to Buster’s Place homeless resource center, citywide mental health services, and the Department of Health’s home chronic nursing service.

Daly said Buster’s Place was the city’s only 24-hour homeless drop-in center serving “a wide array of homeless people including many who have disabilities.” He said the center would be forced to close because of cuts in funding.

He added that home chronic nurses, by delivering “on the road” health services, help to “serve folks who are particularly vulnerable and otherwise may not be able to make it with the dignity they deserve.”

When making budget choices, the committee should “do our best to mitigate harm” to vulnerable groups, Daly said. He stressed, “often there aren’t any other options” for those who use these services.

Martha Hawthorne, public health nurse at Castro Mission Health Center, supported Daly’s claim, stating “nurses can find other jobs but our patients can’t find other nurses.”

Department of Public Health Director Mitch Katz spoke in defense of the proposed mid-year cuts.

“Buster’s place is not a shelter – all we have are chairs,” Katz said, arguing that it is better to focus on homeless support services with beds.

He said moving mental health administrators to run clinics would not affect clinical services.

“We’re not loosing any of that clinical work,” Katz said. “People are now going to be able to devote themselves full time.”

Asked whether mental health administrators would be able to take on additional responsibilities, Katz said, “Generally people in the public sector are willing to do that in order to give more services” in times of financial difficulty.

Doctor Katz questioned the need for home chronic nursing for adults to serve patients who are “ambulatory” and who do not require nursing skills such as the administration of intravenous lines or antibiotics.

“While this is a positive service, it is an incredibly expensive model,” Katz said, adding that it is “not what the field says is the best way to do it.”

Supervisor Chris Daly said Katz was being “creative” in his defense of these cuts.

“There is a loss of service,” Daly insisted. He argued that rather than “cutting [health] services to save other services,” the city should look more broadly at the budget.

Michelle Magar, executive director of international disability rights organization Ratify Now, said that the failure to spend funds constructing a wheelchair ramp would be a “textbook violation” of the Americans Of Disability Act.

“Let me assure you that many of us in the disability rights community are prepared to file a lawsuit that will cost far more to defend than the ramp will cost, and that you will lose,” Magar said.

Supervisor Daly responded saying the proposed cuts to services would “impact a vastly greater number of San Franciscans.” He suggested those concerned about welfare of disabled citizens should look at District 6 which has “the highest concentration of people living with disabilities” in the city.  

“People die every day in the districts I represent,” he said, “These are life or death issues.”