Cutting experienced Medical Social Workers who connect patients to services and could generate large amounts of revenue.

The proposed budget calls for the elimination of ten Senior Medical Social Workers and one Medical Social Worker Supervisor. They include two at Tom Waddell Health Clinic, two at Laguna Honda Hospital, two at Childrens Health Services, and one each at SF General Hospital Emergency Room/Labor-Delivery, Bayview-Hunters Point's Southeast Health Center, Health at Home, Southeast Child and Family Therapy, and Curry Senior Center.

This is a proposal that would reduce services and severely injure the ability of various DPH facilities to function, and which looses the potential of generating large revenues for the City.

Contrary to DPH's assertion that they are administrators whose loss will not affect services, these workers spend 71% of their time providing direct care to patients, in addition to supervising and providing support for 67 social workers or case managers. Because of their experience and training, they often treat the most difficult clients and situations.

They are trained in Critical Incident Stress Debriefing.

They are called to de-escalate volatile and potentially violent situations.

They do crises management for clients at risk of violence to self or others.

They consult and coach on difficult cases.

They do risk management for their facilities.

They supervise social work interns.

They evaluate for psychiatric hospitalizations.

They assess and report child and elder abuse .

They treat domestic violence survivors.

They coordinate domestic violence reporting requirements.

The SF General ER/Labor-Delivery Social Worker Supervisor also handles

Bereavement and sexual assault counselling services in the ER.

Grief counseling for dying patients hospital-wide.

Rather than consuming General Funds, these social workers have the potential to generate large amounts of revenue, because the enroll patients in Federal and State programs. A conservative estimate is that they could generate $209 for each client encounter if DPH had functional billing.

The rationale used by DPH that these cuts eliminate layers of management and flatten the organization holds no water. What would be flattened would the programs they work in.

In the Fall of 1999, hundreds of patients were forced to stand lines for many hours at the Main Pharmacy of San Francisco General Hospital.    Hospital administrators wanted to drive Medi-Cal patients away, and had closed an auxiliary pharmacy with the express purpose of  creating long lines in the Main Pharmacy.  Hundreds of angry patients and health workers flooded Health Commission meetings to prevent Administration from closing the Main Pharmacy also.