Uninsured San Franciscans jonesing for medical treatment have an alternative to still-clunky, sometimes slow and often unpredictable Healthy SF: going to jail.

Under state law–and the principles upon which this democracy was founded–jailbirds are guaranteed medical care, and inmates in county lockup at 850 Bryant or San Bruno receive medications for diagnosed issues like HIV, diabetes and anxiety within 12 hours of checking in, according to Dr. Joe Goldenson, director of jailhouse health services.

Sup. Dufty fears hidden costs like lawsuits associated with less-than-stellar health care more than he does the extra $12 million. That would change under a plan to contract out city-provided inmate medical care, part of Mayor Gavin Newsom’s proposed budget (which also includes charging parents of juvenile hall inmates for their food and contracting out security at SF General Hospital). Many other municipalities do the same; health care in Alameda County, for example, is provided by a company called Prison Health Services. Mental health services in city lockup are already contracted out (but to a nonprofit, Haight Ashbury Free Clinics).

Privatization could cut city spending on con care by almost 50 percent–from $27.4 million to $15.3 million, according to a Controller report. That savings would also mean trimming 147 full-time jobs from the Department of Public Health (but not 147 layoffs, as those jobs could be transferred elsewhere).

It would, if it had any support on the Board of Supervisors. Which it does not, not even from Friend of Newsom (and future Mayoral candidate) Supervisor Bevan Dufty, who said Thursday he fears hidden costs like lawsuits associated with less-than-stellar health care –some inmates in need of protease inhibitors at jails with private medical staffs can wait up to a week for their meds, doctors testified Thursday–more than he does the extra $12 million.

“The services we provide in (SF jails) are a model for other jurisdictions,” Supervisor David Campos said. “We’re saving lives in jail.”

Indeed, as numerous public commenters attested Thursday, the medical treatment one receives free-of-charge in jail often rivals the attention from doctors on the outside.

This will only continue, of course, if money can be found elsewhere to offset the cut. The money comes from the General Fund, meaning a saving found almost anywhere can be applied, “but we’re not off the hook yet,” Supervisor Ross Mirkarimi warned.

Also receiving heat was the Department of Juvenile Probation, who floated a plan–also approved by Newsom–to charge some parents of inmates at its Log Cabin Ranch near La Honda about $25 a day for food.

“We won’t let that happen,” said Supervisor John Avalos, who bristled at the idea of charging low-income parents for prison food (and then placing a lien on their property tax bills if they didn’t pay).

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