Fentanyl & Meth Push Overdose Deaths to Record Highs

by Dr. Derek Kerr

There’s another deadly epidemic in the City. Until now, San Francisco’s robust drug treatment and harm reduction programs had forestalled the opioid overdose epidemic sweeping the nation. A 2/18/20 DPH Press Release and Health Commission presentation detailed how fatal drug overdoses surged to a projected 400 cases in 2019. Deadlier than homicides, suicides and traffic accidents combined, drug overdoses are now primarily driven by fentanyl. Most casualties are men, 40 to 59 years old, and disproportionately African-American.

Fentanyl

A potent and fast-acting opioid, fentanyl is about 100 times more potent than morphine and 50 times stronger than heroin. Formulated in 1959 to control pain from cancer or surgery, fentanyl was later adopted by drug traffickers because it’s cheaper to produce and easier to smuggle than heroin. As detailed in journalist Ben Westhoff’s book, Fentanyl, Inc., it mostly comes from China where chemical companies synthesize recreational drugs with government subsidies. These labs produce fentanyl variants or precursors that haven’t yet been declared illegal in China and ship them to US clients and Mexican cartels. Ironically, criminalizing heroin has spawned a more toxic substitute.

Fentanyl is supplanting Mexican black-tar heroin, long a mainstay of San Francisco’s drug scene. It emerged as an additive mixed into various street drugs to give them more “kick”. Despite its potential lethality, fentanyl is becoming the street opioid of choice because it’s cheaper and delivers a better rush, per Dr. Phillip Coffin, DPH’s Director of Substance Use Research. Because the purity of street fentanyl varies, users don’t know the dosage taken, hence the overdoses. Data Dr. Coffin shared with the Westside Observer shows that fentanyl-related deaths have doubled annually since 2015, reaching 162 in 2019. But that’s a partial count due to the 6-month delay in processing autopsy and toxicology results. DPH projections for 2019 foresee around 200 fentanyl-linked overdose deaths. Fentanyl fatalities far exceed heroin plus prescription opioid deaths.

To counter the overdose epidemic, the DPH employs a Harm-Reduction model. This includes sending alerts to shelters and clinics, freely distributing naloxone (Narcan) a drug that reverses opioid overdoses, providing fentanyl testing-strips so users can check their stash, and planning drug sobering centers. Needle access programs are advising users to smoke rather than inject fentanyl and offer aluminum foil to facilitate this safer option. The DPH also reaches out to single-room occupancy hotels where 30% of overdose deaths occur, advising drug users not to shoot up alone. Treatment strategies include easing access to methadone and buprenorphine (Suboxone) substitution programs. Once implemented, Mental Health SF will expand these services.

Methamphetamine

Methamphetamine is largely produced by Mexican cartels that import the chemical precursors from China. Like cocaine, it’s a stimulant but longer-lasting and cheaper. Meth-related overdose deaths have steadily risen over the past decade. However, the numbers exploded in 2019. As the Medical Examiner told the WSO, the tally for 2019 was 227 deaths as of March, with a projected total of 252. That’s double the 126 meth deaths logged in 2018. Apart from overdoses, the DPH found that 47% of Psychiatric Emergency visits in 2017-18 were meth-driven.

Although no medications can reverse methamphetamine overdoses or block cravings, a promising approach is Contingency Management, whereby users receive cash rewards for staying clean. Senate Bill-888, introduced by Senator Scott Wiener, would provide Medi-Cal coverage for this intervention. Based on DPH Methamphetamine Task Force recommendations, a 12-bed Meth Sobering Center with access to counseling and treatment will open in the Tenderloin this year.

Overdose Deaths and Prevention

Overdose deaths refer solely to acute drug poisonings. They exclude drug-related deaths due to suicide, traumatic injuries, and infections. Also excluded are alcohol related deaths that are categorized differently. Because most overdoses involve multiple drugs, it’s difficult to determine which one was lethal. For example, 80% of methamphetamine overdoses involve other drugs - mostly fentanyl. So fentanyl contributes to the rising fatalities attributed to meth, cocaine and heroin. When one death is caused by 2 drugs, it generates 2 drug-associated death reports. That’s why the sum of individual drug-related fatalities exceeds the number of deaths.

Overall, opioids, meth and cocaine have already claimed 330 lives but are projected to reach 400 once all reports for 2019 are compiled. That’s a big jump from the 259 deaths recorded in 2018.

Overall Drug Overdose Deaths by Year

There’s more to this carnage because many deaths are narrowly averted. EMS technicians administered 1,647 doses of Narcan in 2018. Many more were administered by police officers and civilians. In 2018, the DPH Drug Overdose Prevention Education Project (DOPE) handed out over 7,500 Narcan kits.

Why are overdoses exploding? It’s not simply due to the increased homeless population. DPH data show that from 2006 to 2016, injection drug users increased from fewer than 10,000 to almost 25,000 – yet the overdose mortality stayed flat. And it isn’t due to the national prescription opioid epidemic. Local prescription overdose deaths have steadily dropped since their peak 2010. The breakdown in the City’s containment efforts came with the greater availability and desire for fentanyl - and meth.

To curb the availability of dangerous drugs, the US Attorney for San Francisco launched a one-year crack-down on dealers and suppliers last August. This “Federal Initiative for the Tenderloin” started by busting a Honduran crew of 32 drug traffickers who commuted from the East Bay. This intervention gave residents a welcome respite from an intimidating open-air drug market. Yet, prior drug raids by the SFPD faced criticism for targeting minorities. Though needed, such enforcement measures bring transitory relief.

Our overdose epidemic gives reason to establish Supervised or Safe Injection Sites like those in Canada and Europe. As reported in the September 2017 WSO, Safe Injection Sites (SIS) can prevent overdoses, reduce infections, and facilitate addiction treatment, but may relieve a fraction of the problem without improving it overall. Participation by drug users is low due to registration requirements and the stronger allure of the street scene. A DPH survey showed that more City users wanted “food and showers” than drug treatment from an SIS. Injection sites hardly address the traumas and despair that drive addiction.

San Francisco’s 3-year quest for SISs has been thwarted by federal prohibitions and opposition from State law enforcement groups. Hopes that the State would protect SIS operators were dashed when Governor Brown vetoed Assembly Bill-186 in 2018. Brown called the bill “all carrot and no stick” for “enabling illegal and destructive drug use” without requiring treatment for addiction. With Governor Newsom in office, an identical AB-362, co-authored by Senator Scott Wiener and re-branded as an “Overdose Prevention Program” was introduced in 2019 to allow a City SIS. This February, Supervisor Matt Haney called on the Governor to issue an Executive Order for an “Overdose Prevention Site” in San Francisco.

Hopes soared this February when Philadelphia got Federal Court approval for an SIS by showing that it aims to decrease rather than enable drug use, thereby not violating federal law. However, a public backlash and threats from the local US Attorney torpedoed the plan. Although Mayor London Breed introduced legislation on 3/3/20 for a City-run SIS, US Attorney David Anderson who orchestrated the Tenderloin drug raids vows to shut it down. Uncertain is the impact of the COVID-19 pandemic on efforts to contain the opioid epidemic.

All told, the DPH funds 65 programs to provide drug and alcohol treatment services – a good chunk of its $400 million mental health budget. Contractors served 5,975 substance abuse clients last year. Yet on 2/18/20, the DPH failed to show the Health Commission that its many - and costly - interventions are still effective. The swarm of overdose deaths, drug-related Emergency Room visits and hospitalizations indicate that City programs are falling short. DPH officials and non-profit contractors call for more services. There’s a “carrot” versus “stick” divide between the City’s approach and Federal interventions. More integration would be better than more of each.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

April-May 2020

Court Upholds $5 Million Whistleblower Judgment against City Attorney Herrera

The Court of Appeal vindicated whistleblower Joanne Hoeper, the former Chief Trial Deputy under City Attorney Dennis Herrera. Three judges sustained a January 2015 jury decision that Herrera retaliated against Hoeper after she investigated the City Attorney’s Claims Bureau and found multiple costly irregularities in the way sewer repair claims were handled.

Some sewer claims were fraudulent but routinely approved by the Claims bureau, at taxpayer expense, as detailed in the Westside Observer in September and November 2014, and February 2015. When Hoeper’s probing threatened managers close to Herrera, her investigation was shut down and she was yanked from her position in July 2012. She was transferred to the DA’s Office and later terminated. The WSO dubbed the saga “Sewergate.” In 2018, the NorCal Society of Professional Journalists recognized Hoeper with its Freedom of Information Award in the Whistleblower category.

The Court of Appeals sustained Hoeper’s awards of $1,338,578 for lost wages, $1,291,409 for emotional distress and $2.4 million for attorney’s fees. The City argued that these awards were unwarranted and excessive. The Court characterizedthe City’s appeals as “without merit”. Taxpayer costs will exceed $5 million since the City has been paying the Keker & Van Nest law firm $850/hour to defend Herrera. Keker & Van Nest already billed the City $2,267,752 back in September 2016, records show. Karl Olson, one of Hoeper’s attorneys, told the WSO that the City could ask the California Supreme Court to review the case, but only 5% of such Petitions for Review are granted. (See Ms. Hoeper's  Op-Ed — A special to the Westside Observer)

February 2020

Auto Burglars Assail Westside, East Bay and Migrate to LA

by Dr. Derek Kerr

Although citywide auto burglaries seemingly dropped 2% in 2019, they soared by 24% on the Westside. The table below is derived from the Taraval Police Station’s excellent website. Note the surge in auto burglaries since August.

As explained in the July 2018 Westside Observer, these numbers are static. They are not updated to include late crime reports. Such updates are logged into SFPD’s separate CompStat database. Therefore, the crime figures reported on Taraval Station’s website are lower than those shown on CompStat for the Taraval Police District. For example, CompStat’s updates boosted Taraval Station’s 2017 count of car break-ins by 9% and raised its 2018 count by 5%. Ergo, the true numbers for 2019 will end up higher as well.

The bleak news about Taraval District car break-ins is offset by a big drop in residential and commercial burglaries. CompStat shows that in 2019, home and shop burglaries numbered 334 versus 507 reported in 2018 – a 34% decline. That may reassure Sunset residents. As the July 2019 WSO reported, home invasions and burglaries prompted an uprising in that predominantly Asian neighborhood.

According to citywide CompStat figures, there were 25,677 car break-ins in 2019 versus 26,111 in 2018. That 2% drop is dubious. By the time all the delayed reports for 2019 are tabulated, the updated total could easily wipe out the tiny reduction. On top of this, published numbers are understatements. Folks without comprehensive auto insurance don’t bother to report break-ins when arrest rates linger around 2%. However, compared to the stunning 31,398 thefts from vehicles in 2017, the crime wave has subsided.

The stabilization in citywide car break-ins masks a shift in crime targets. Auto-boosters are moving from tourist sites to residential areas – like the Westside, and even Safeway parking lots per the 1/31/20 SF Chronicle. As police monitor tourist sites, criminals seek opportunities for easier pickings elsewhere

San Francisco isn’t suffering alone with this epidemic. East Bay auto break-ins soared in 2019. Compared to 2018, there were increases of 25% in Oakland, 32% in Berkeley and 48% in San Leandro. As reportedin the 1/10/20 SF Chronicle, East Bay police agencies have formed a “roving task force” to crack down on auto burglars, one city at a time. It gets worse.

This January, the Los Angeles Times described a new crime trend plaguing LA since 2019. Audacious Bay Area gang members have been traveling to LA in rental cars to steal belongings from autos parked at tourist destinations. Criminal tourists now prey upon regular tourists. After scouring parking lots for out-of-state license plates and rental cars, they brazenly break windows in broad daylight - even in view of surveillance cameras.

Because Bay Area smash-and-grab crews are known to local cops, they hit the road to ply their trade where they enjoy anonymity. So, LA detectives are sharing data with their Bay Area counterparts to track these touring gangsters. That data includes social media where thugs like to brag about their exploits. Last April, an Oakland gang committed 40 auto burglaries in Hollywood, using electric scooters to hustle the goods away. The stolen merchandise was sold in Oakland and 5 people were arrested.

What’s happening closer to home? The WSO asked Taraval Station’s Captain Nicholas Rainsford to comment on Westside car break-ins. He indicated that he was reviewing the crime data with his staff, but provided no further comment.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

February 2020

Cannabis Quagmire Foils City’s Goals

by Dr. Derek Kerr

Cannabis in San Francisco, the 12/5/19 Controller’s Report on the legalized adult-use/recreational marijuana industry, shows how efforts to curb the illegal market while helping those injured by the War on Drugs can backfire.

In 2016, 74% of San Francisco voters passed California Proposition 64, allowing the production and sale of cannabis for adults over 21 without a prescription. Since January 2018, these recreational marijuana products have been tracked from “seed to sale” to ensure consumer safety and prevent illegal diversion.

Doors are open at 2161 Irving St.

With this mandate, the Board of Supervisors passed Ordinance 229-17 that keeps cannabis businesses 600 feet away from schools and largely in Eastside locations and along commercial corridors. Then Ordinance 230-17 set up a permitting process. It included an Equity Program that prioritized persons disadvantaged by the War on Drugs, and an amnesty program so some illicit operators could enter the legal market by complying with regulations. The Office of Cannabis was set up to manage these processes. The Controller’s Office monitors the impacts of permitted cannabis operations.

Cannabis Storefront Retailers in San FranciscoStorefronts are heavily clustered in the Mission District and along the Market Street corridor. Note: Delivery-only retail operators not shown.

The land-use Ordinance worked, as shown by the Office of Cannabis location map. At this time, the only Westside storefront dispensary that offers both recreational and medicinal cannabis is Barbary Coast Sunset at 2161 Irving Street, because the two on Ocean Avenue are closed for renovations. But the permitting Ordinance created a self-defeating solution.

REGULATORY LOGJAM: Although 212 cannabis businesses are authorized, only 118 are currently operating. That’s way less than the 387 operating in Oakland. Of these 118 operating businesses, 39 are store-front retailers and all were pre-existing or pre-approved Medical Cannabis Dispensaries. Likewise, the authorized delivery-only retailers, growers, manufacturers, and distributors were already in place. New businesses have been stymied. That’s because Equity Program applicants hold top priority. By City law, no other applicants can be considered until the equity entrants get 50% of all permits issued. Only three equity entrants have been approved to date, hence the backlog.

EQUITY REVERSAL: Equity Program applicants must meet strict criteria involving income, City residency and school attendance, loss of housing, or arrests for cannabis-related crimes. Then, they need departmental approvals from SFPD, Cannabis, Planning, Public Health, Building Inspections and Fire, where equity applicants get no priority. Because of this grueling complexity, and because the Office of Cannabis has just 3 full-time equivalent employees, it takes 18 to 24 months to get a permit. Languishing in the pipeline are 133 equity applications - just for store-front dispensaries. Another 144 await approvals for delivery-only outfits or cultivation, manufacturing or distribution operations. The backlog is so bad that new equity applicants face an additional 6 month delay before being considered. As for non-equity applicants, they’re shut out entirely.

Meanwhile, equity applicants are crushed by expenses since they must maintain a site for their proposed businesses. Rent alone can amount to hundreds of thousands of dollars while waiting for a permit. So, already-disadvantaged equity applicants are forced into debt. Or, they sell ownership shares to well-heeled investors or multi-state cannabis companies. Either way, the aims of the Equity Program are thwarted.

Although a Community Reinvestment Fund was set up to offset costs for equity applicants, it hasn’t been funded. The City fears liability for aiding sales of a federally-outlawed drug. Further, there are so many applicants for store-fronts that the market will be saturated before they’re all approved, per the Controller’s analysis.

As for the black-market entrepreneurs who opted to go legit, they’re stuck in the permit queue. Many will revert to the thriving illicit market that dwarfs the legal upstart by a factor of 3 to 1. As the Report concluded; “The City has undermined its own equity goals and intent to eliminate the illicit market.”

ECONOMIC BURDENS: This quagmire burdens taxpayers. The Office of Cannabis makes money from permit application and renewal fees. In 2018-19 it collected $360,000, about half of its operating budget. Those fees came from existing businesses. But in 2019-20 it will collect zero application fees due to the logjam. Yet, its operating budget will top $1 million. Deficits will persist until the Office of Cannabis clears the backlog. By counting expenses for all 12 City departments supervising the cannabis industry, the cost to taxpayers exceeded $2 million in 2018. So far, cannabis sales taxes covered these losses. That may not last. After 3 years of steady increases, taxable sales declined by 16% then leveled out in 2019. Statewide cannabis sales saw a similar decline. Regulatory tangles and black-market competition are cramping tax revenues. Meanwhile, legal cannabis prices are rising and driving buyers to the illegal market.

Retail Storefront Locations of Proposed Equity Business (currently in queue). Out of 183 applications from equity applicants,133 are applying for storefront retail. The proposed locations are heavily concentrated in Civic Center, Union Square, the Mission and SOMA

PUBLIC SAFETY PRESERVED: In 2006, the City assigned marijuana offenses the lowest policing priority. Since then, cannabis arrests have steadily declined, although African-American men are still disproportionately affected. SFPD incident reports show a 17% drop in cannabis offenses – down to 186 cases, after adult-use was legalized. However, this number does not include low-level infractions. In 2018, cannabis offenses comprised 0.1% of recorded City crimes. As for marijuana-related complaints reported via 311, there were 15 or 0.003% of 2018 calls. The Westside enjoys the lowest incidence of cannabis-related crimes; Taraval Police Station logged just 4% of the City’s 2018 total.

In accord with other studies, the Controller’s Report found that property and violent crimes within 600 feet of cannabis retailers dropped by 2%, whereas they increased citywide. Larceny theft and burglary prevailed around cannabis dispensaries – but also throughout the City and at similar rates. Since dispensaries cluster in commercial zones, the Controller’s Report concluded; “…crime that occurs near cannabis locations is likely driven by the crime occurring in commercial districts, rather than the notion that cannabis operators attract more crime”.

California Highway Patrol records showed that cannabis-only stops for San Francisco amounted to 4% of all DUIs in 2018. Those 31 cases were 10 more than in 2017, a post-legalization increase. However, alcohol-only DUI’s also increased and comprised 82% of DUIs. The remaining DUIs involved other drugs or mixtures, including 3% where cannabis was used with other intoxicants.

PUBLIC HEALTH CONCERNS: When adult-use cannabis was legalized, the City aimed to ensure safe consumption and limit access for young people. Current data for San Francisco is lacking, but in Colorado, where recreational marijuana was legalized in 2012, there was no change in youth use rates. National surveys show that cannabis use among youth decreased - even as many states legalized marijuana.

According to SF Unified School District surveys, suspensions for drug possession (largely marijuana) went up. But the numbers are small. There were 57 suspensions in 2018 compared to 44 in 2017 – among 50,000 students. Of concern is the popularity of vaping, given the outbreak of life-threatening pneumonias likely caused by a Vitamin E additive. California has logged 208 cases and 4 deaths to date. The SFDPH hasn’t responded to our requests for data on San Francisco cases. Cannabis edibles pose another risk. Their onset of action is slow, so overdosing is easy. In February 2018, multiple students were sickened after eating edibles on campus, but that was an isolated event. These risks are being addressed in a DPH student education campaign.

Cannabis-related emergency department visits steadily increased over the past decade, well before adult-use cannabis legalization. Since marijuana is no longer criminalized, this trend may reflect increased reporting. Patients are now more likely to admit they are users. At SF General Hospital (SFGH), cannabis-related visits and admissions have increased slightly since 2018. Again, the numbers are small, averaging less than 1% of Emergency Room encounters. On the other hand, cannabis admissions to DPH Substance Abuse Treatment Programs have declined. In 2018, just 355 or 4% of admissions were for marijuana. Per the Controller, these numbers do not signal a need to reduce cannabis, just further monitoring.

The Office of Cannabis has rallied City departments to streamline the permitting process. To further support applicants, a $1.3 million grant was secured along with pro bono legal assistance from the SF Bar Association. An 8-member Cannabis Oversight Committee, inaugurated in December 2019, will advise the Board of Supervisors and “facilitate socially responsible growth of the cannabis industry.” Hopefully, it will help to tackle the snafus and recommendations detailed in the Controller’s Report.

Dr. Derek Kerr is a SF investigative reporter. Contact: watchdogs@westsideobserver.com

February 2020

A Precarious Partnership:

SFPD and the FBI

Supervisor Gordon Mar opens the hearing investigating the Joint Terrorism Task Force

by Dr. Derek Kerr

In its July report, Joint Terrorism Task Force: Balancing Public Safety with Civil Rights, the Civil Grand Jury recommended that the SFPD reconsider its expired counter-terrorism partnership with the FBI. Although the Jury did not recommend for or against re-affiliating with the FBI, the Mayor, Police Chief and Police Commission responded cautiously. Not mentioned was the turd in the punch bowl – a secret FBI White Paper acknowledging grave conflicts between SFPD policies and those of the FBI’s Joint Terrorism Task Force (JTTF). The SFPD received the White Paper in 2017, but couldn’t disclose it. Superior Court ruled it was “property of the FBI.” (Case CFP-19-516706) The FBI released it to Supervisor Gordon Mar this October.

Joint Terrorism Task Forces (JTTF) are FBI-led partnerships with local police and other law enforcement agencies that address national security threats. After the events of September 11, 2001 the SFPD joined the regional JTTF in 2002. That arrangement was secretly renewed in 2007, adding tighter FBI controls and secrecy, without notifying the Police Commission. When its contract with the FBI expired in February 2017, the SFPD bailed out amidst mounting civil rights concerns and the turmoil of switching its Police Chiefs.

San Francisco Taxpayers Tapped Previously, the SFPD had usually assigned 2 full-time investigators to the JTTF under the direction of the local FBI Office, and ultimately the US Attorney General. However, City taxpayers paid their salaries. These officers received Top-Secret security clearances and access to classified data. Their identities were secret. They signed non-disclosure agreements that barred information sharing without FBI approval, and underwent polygraph exams. As federal deputies, they could operate anywhere in the US. As such, they could maneuver beyond local civilian oversight and local privacy and civil rights laws. Nominally, they were expected to abide by such laws, notably SFPD’s Department General Order 8.10: Guideline for First Amendment Activities.

Supervisors Weigh In DGO 8.10 was designed in 1990 to prevent police intrusions into religious gatherings, protests, and political assemblies. In the post-9/11 era, unwarranted JTTF practices began impinging on civil rights. Alarming reports and warnings were issued by the Human Rights Commission, San Francisco Bar Association, ACLU, and 79 civic groups represented by the Asian Law Caucus, Council on American Islamic Relations and the ACLU. Accordingly, in 2012 the Board of Supervisors unanimously passed the Safe San Francisco Civil Rights Ordinance to govern SFPD participation in federal counter-terrorism activities. The Ordinance enshrined within City law the gist of DGO 8.10’s transparency and accountability provisions. It also mandated Police Commission approval of agreements between the SFPD and FBI. In effect, the law authorized SFPD brass and City officials to oversee its FBI-driven JTTF investigations

That expectation proved unworkable because the FBI included “threat assessments” in its “classified” investigative activities. FBI “assessments” seek information about persons who may threaten national security or violate federal laws. Unlike formal investigations, no “reasonable suspicion” of criminality is required. In 2008, revised standards allowed more intrusive practices like pretext interviews, physical surveillance, telephone record searches and deploying informants, all without evidence of wrongdoing. Anyone could be targeted based on a tip or politics, religion or race, thereby landing on a federal “terror watch list”. Despite the slippery taxonomy, “assessments” are investigations that can circumvent criminal justice principles and First Amendment rights. And they are classified.

SFPD and FBI Conflicts As the FBI White Paper admits, such assessments were “generally assigned” to SFPD officers working as JTTF agents. Further, these assessments “usually involve, on some level, the exercise of First Amendment activities.”

This conflicts with SFPD policy because DGO 8.10 requires officers to submit memos showing “reasonable suspicion” of a crime to justify investigations involving First Amendment activities. And these memos must be approved in writing by two superiors plus the Chief of Police. But, per the FBI White Paper, “The FBI will not allow such disclosure.”

There’s more. DGO 8.10 states that the memos and approvals for investigations must be reviewed monthly by the Police Commission and audited annually by the Department of Police Accountability. Per the White Paper, “The FBI will not allow this type of information to be disseminated.”

ACLU Lawyer John Crew

Accordingly, none of the 119 assessments/investigations conducted by SFPD’s JTTF agents from 2014 through 2016 received departmental approvals. None were forwarded to the Police Commission or the Department of Police Accountability, records show. That’s because none targeted “solely constitutionally protected activities” as the SFPD repeatedly told the Police Commission. But, “That’s the FBI standard – not the SFPD standard”, declared former ACLU attorney and police practices expert John Crew and several Commissioners at the explosive 2/1/17 meeting. Plainly, DGO 8.10 requires approvals and oversight for investigations that “involve” First Amendment activities, not just those that “solely” target such activities. The SFPD had been bending, if not violating, its own rules by adopting FBI investigative and secrecy tenets.

Worse, SFPD’s JTTF activities defied the oversight imposed by the Safe SF Civil Rights Ordinance. Because JTTF activities are classified, they were withheld from SFPD brass, the Police Commission and the Department of Police Accountability. Those folks lack security clearances. Indeed, the Police Chief’s annual JTTF reports to the Police Commission merely assert proper conduct, without evidence. The FBI White Paper addresses this disclosure impasse by proposing workarounds including, “sanitizing” JTTF reports, or amending DGO 8.10 to withhold “classified information” from the Police Commission.

Secrecy in Violation All this secrecy surrounding JTTF investigations nullifies the Civil Grand Jury’s assurance that it “did not detect any instance of non-compliance with a DGO” by SFPD’s JTTF officers. This point was highlighted by former FBI counter-terrorism expert Mike German at the must-see Government Audit & Oversight Committee hearing on 10/3/19. Further, an egregious violation did occur in 2014 when an SFPD JTTF agent badgered a Google engineer for filing a public records request. Inspector Gavin McEachern reportedly interrogated Sarmad Gilani about his “delusions of being persecuted” and tried to recruit him as an informant. The Department of Police Accountability determined that the officer had accepted an FBI assignment against SFPD policy due to “inadequate training”. Like all other JTTF assessments, it hadn’t been authorized by SFPD’s chain of command or audited by the Police Commission or the Department of Police Accountability.

JTTF partnerships are precarious because FBI policies protecting privacy and civil rights are weaker than those adopted in San Francisco and California. And those protections can be slashed, depending on the US Attorney General and President. As local politicians including Mark Leno, Scott Weiner, Jeff Sheehy, Tom Ammiano, David Campos, Rafael Mandelman and Angela Alioto warned in 2017: “if this (Safe SF Civil Rights) Ordinance is not effectively enforced…local offices will become entangled in the implementation of Trump’s policies, which our city’s leadership and residents have unequivocally rejected.” On the other hand, the Police Officer’s Association asked the Police Commission to restore its JTTF partnership, decrying that it was abandoned “in a political stunt.”

Currently, JTTF policies are antithetical to transparency and accountability. Upholding DGO 8.10 and the Safe San Francisco Civil Rights Ordinance keeps the SFPD accountable to the community it serves rather than the FBI. Involvement in JTTF political surveillance entrains our police to view First Amendment activities as potential threats. Worse, more law-abiding San Franciscans view police as potential threats because unreasonable JTTF activities contravene civil rights. There are other ways the SFPD and FBI can collaborate to address terrorism. Uncoupling from the JTTF, as Portland, Oregon has done, strengthens public trust in the SFPD.

Note: Source references for this article are provided as links in the electronic version at www.westsideobserver.com.

Acknowledgement: Mission Local and The Intercept first reported on the FBI White Paper.

Dr. Derek Kerr is a SF investigative reporter. Contact: watchdogs@westsideobserver.com

December 2019

CNO Madonna Valencia with Supervisor Norman Yee

Hedging the Shake-Up at Laguna Honda Hospital

by Dr. Derek Kerr

Three months after Laguna Honda Hospital (LHH) CEO Mivic Hirose and Quality Director Regina Gomez were ousted, another top executive has fallen. On Sunday, October 7, Acting CEO Maggie Rykowski announced, “Madonna Valencia, our Chief Nursing Officer, has left Laguna Honda Hospital.” By adding “We should think of this as an opportunity for us to welcome meaningful changes to our standards, reputation and purpose,” she tied Valencia’s exit to the patient abuse scandal covered in the September Westside Observer.

Restoring LHH’s standards, reputation and purpose won’t be easy given the long tenure of disgraced former CEO, Mivic Hirose. Hirose served as Associate Director of Nursing since 1999, then as Chief Nursing Officer from 2005, and finally as CEO from 2009 until the scandal emerged this June. Over those 20 years, Hirose helped shape the hospital’s culture. Lackeys were recruited, mentored and boosted into positions of power. As reported in the February 2016 Westside Observer, some nurses openly denounced “favoritism, nepotism and cronyism” at LHH. Rykowski’s challenge will be to manage and transform her predecessor’s entourage.

The long-delayed departure of Valencia is intriguing. After all, she was directly responsible for overseeing the deviant nurses who abused 23 patients as well as their negligent supervisors. Retaining Valencia while suspending the Quality Director looked like scape-goating. The palatable rationale for keeping Valencia was to avoid the disruption of deposing 3 key executives concurrently. Incidentally, delays can stifle personal injury claims against the City, as these must be filed within 6 months.

LHH Medical Director, Dr. Michael McShane

Using the passive term “has left” for Valencia’s exit is interesting. In fact, records show that Valencia was demoted to a Nurse Manager job paying $202,852/year elsewhere within the DPH. Similarly, the ex-CEO’s “resignation” masked a soft-landing into a well-paying job at SFGH. Such reassignments avoid recriminations from folks who know where skeletons are buried. Given the swirl of investigations by State and City agencies, more carefully calculated transfers are expected.

A cone of silence hovers above LHH’s Medical Division. California Department of Public Health (CDPH) inspectors found that 5 patients had been drugged with non-prescribed opioids and sedatives. All suffered life-threatening overdoses requiring emergency transfer to outside hospitals. The overdoses were caused by medications – not illegal drugs smuggled into the hospital. LHH physicians knew something was seriously wrong. Physicians at the receiving hospitals conveyed their alarms.

In February 2018, one outside doctor notified LHH Medical Director, Dr. Michael McShane, and was told that; “an internal investigation was underway,” per CDPH records. Another kept a patient hospitalized for an extra week, afraid to send the patient “to her death” at LHH. Apparently, LHH’s internal medical investigation was fruitless. Twelve months later, by chance, an unrelated investigation of an employee dispute exposed the patient druggings with pilfered meds. What happened with LHH’s physician-run Medical Quality Improvement Committee and its Performance Improvement & Patient Safety Committee? Both are charged with probing adverse medical outcomes? So far, silence.

Meanwhile, LHH has stepped up its reporting of adverse incidents to the State. In May 2019, the month before the scandal erupted, LHH sent 20 reports of alleged abuses and other lapses to CDPH. In July, the month after the scandal, LHH forwarded 37 reports to CDPH. In August, it was 42. Health Director Dr. Grant Colfax commented that, “as Laguna Honda changes its culture, there may be an increase in the volume of incidents reported.”

A burst of reporting is expected because staffers have been rattled by the scandal and the resulting scrutiny. Changing the culture is another matter. One can be open about symptoms but silent about the underlying illness. For example, on 9/10/19 LHH finally admitted that there had been a 50% increase in AWOL cases compared to the prior year. But the trend has been ignored for 4 years. Recently, almost 1 in 3 patients discharged to the community actually fled LHH by going AWOL or signing out against medical advice. Further, theft/loss reports and battery incidents have quadrupled over the prior year. Notably, there was a 54% increase in “Serious Incidents” compared to the 3 prior years, although a change in reporting methods may explain some of the rise. But the cause of the rising numbers is shrouded.

LHH officials won’t admit that DPH’s Flow Project brings disorder that undermines patient quality of life and strains caregivers. Increased altercations, threats, thefts, and AWOLs are predictable with the forced influx of younger, able-bodied and volatile patients from SFGH. So, the data showing mounting problems piles up, without explanation or remedy. Ignoring root causes is a structural component of LHH’s Culture of Silence.

Whether the plan to address the patient abuse scandal transforms LHH’s Culture of Silence, or is engulfed by it, depends on DPH brass and City Hall. At Supervisor Norman Yee’s 10/23/19 hearing before the Board’s Government Audits & Oversight Committee, a breakthrough: LHH is surveying staff about their inclination to report wrongdoing and their fears of retaliation. Also, further forensic analyses of staff cell-phone videos showed that a total of 130 patients – not just 23 - had sustained privacy violations. So far, LHH has paid $780,000 in fines, and way more are expected, said SFGH Chief Quality Officer, Troy Williams.

Back in December 2016, the CDPH issued an “AA” citation (the most severe), plus a $100,000 fine, against LHH. As detailed in the February 2017 Westside Observer, a nurse had parked an elder’s wheelchair on an incline, but forgot to set the brakes, resulting in a fall and a fatal head injury. Surprisingly, LHH contested that State penalty. The City Attorney sued the CDPH to drop the citation and fine. In Superior Court case #CGC-17-558162, the City argued that LHH’s lapse did not warrant an “AA” citation and that the fine was invalid as it was issued 5 months after the State investigation rather than within 30 days as required. After 2 years of legal wrangling, the CDPH reduced the citation to an “A” but wouldn’t budge on the $100,000 fine. However, the cost to taxpayers will far exceed $100,000 due to City Attorney fees.

In comparison, the recent abuses of 23 patients were deemed so grave that CDPH inspectors declared a temporary state of “Immediate Jeopardy” – the top category of patient endangerment. State penalties will surpass the $780,000 already levied. If the City again litigates against them, it could signal that Laguna Honda’s Culture of Silence is protected.

Dr. Derek Kerr was a senior physicians at Laguna Honda who exposed wrongdoing by the Dept of Public Health. Contact: watchdogs@westsideobserver.com

November 2019

Attempted Assassination of Westside Journalist Brandon Lee

by Dr. Derek Kerr

On August 6th, gunmen shot Brandon Lee in the face and back outside his home in Ifugao province in the northern Philippines. On the way to the Baguio City Hospital, he repeatedly shouted that the Philippine Army was responsible for the attack. Internal bleeding required transfusions. Numbness below the waist indicated a spinal cord injury. During surgery to remove a bullet lodged in his jaw, he suffered several cardiac arrests. Weeks later he is responsive but remains in critical condition with 3 bullets in place.

Brandon, age 37, is Chinese-American, born and raised in the Westside, a graduate of Lincoln High School. His mother, Louise Lee, was an always-helpful manager in Laguna Honda Hospital’s Medical Records Department. Inclined toward community service, he served as a YMCA camp leader. At SF State University, he pursued Asian-American Studies under Professor Eric Mar and volunteered with the Chinese Progressive Association where he met now-Supervisor Gordon Mar. However, it was his joining the Filipino Students League that set him on his life’s path.

In 2010, he moved to the Philippines to pursue his passion; helping farmers and indigenous people assert their rights. He became a permanent resident, married Bernice and raised their daughter Jessie, now 8 years old. Soon, he became a correspondent for the Northern Dispatch, an English-language weekly news outlet. His articles addressed police and government corruption, military depredations under Martial Law, the framing of political prisoners, land rights and environmental justice. Also, he volunteered as a paralegal for the Ifugao Peasants Movement (IPM). A Northern Dispatch open letter declared, “The attempt on the life of Brandon is to sow fear and to silence indigenous communities of Ifugao fighting against a corporate-led hydro-electric project and his colleagues in the Cordillera people’s mass movement.”

His writing was fearless. In a May, 2014 article titled; “Phil. Army Desecrates Ifugao Dead,” Brandon described how soldiers raided homes of local farmers at gunpoint and forced them to open the coffins of dead relatives. Those searches were part of the Aquino government’s anti-insurgency program that he labeled “fascist”. That year, Brandon bravely took over some duties of the IPM paralegal officer who had been murdered after being tagged by the Army as a “communist sympathizer”. Per the Inquirer Northern Luzon, “In 2015, Lee was among the Ifugao Peasant Movement members accused by the military of supporting the New People’s Army” - the armed wing of the Philippines Communist Party. A slew of Facebook threats and vilifications such as “terrorist” and “communist” ensued. Also, Brandon and 9 colleagues were mailed pictures of Ifugao burial blankets – an implicit death threat. Included were references to “GTFO” (Get the F—k Out) and “NorCal” – pointing to his “outsider” American roots. He described all this publicly in 2018, after another colleague who campaigned against the hydro-electric plant was assassinated. When Army investigators asked Brandon to name his coworkers, he disclosed just two - those who had been murdered.

In the days and weeks before being shot, soldiers had repeatedly appeared at IPM offices, asking about Brandon’s whereabouts, office hours, and family members. In an e-mail to his brother Aaron, Brandon conveyed worries for the safety of his family and colleagues due to the government surveillance and harassment. After the shooting, local Army commander Maj. Gen. Pablo Lorenzo stated; “As regard the propaganda issue wherein the AFP (Armed Forces of the Philippines) is behind the alleged shooting incident, this is devoid of logic and factual basis as this is not in the best interests of the government and AFP”. Instead, Lorenzo proposed that the Communist Party sponsored Brandon’s shooting, then blamed the military “to incite the people of Ifugao”. An investigation was promised. Contra, the Committee to Protect Journalists, announced, “Until President Rodrigo Duterte shows he is serious about protecting journalists, all the talk about investigations will come to nothing and violent attacks on the press will continue.”

Brandon Lee led a doubly precarious life as a journalist and an environmental protector. In April 2019, President Duterte’s office endangered journalists by telling the Manila Times that reporters were “blackening the image of the President” and orchestrating a “plot to oust” him. As for environmentalists, a Global Witness report titled “Enemies of the State?” identified the Philippines as the most dangerous country for environmental defenders, with at least 30 murdered in 2018. This April, our own Board of Supervisors passed Resolution 209-19 condemning the Duterte-sanctioned extra-judicial killings that had “taken the lives of 29,000 Filipinos”, including many dissidents.

Brandon’s family and friends have stayed with him, given the ominous intrusions of military personnel at the hospital. Supervisor Gordon Mar publicly condemned the “unconscionable human rights abuses” that have “left a son of the Sunset District fighting for his life.” Mar also lobbied the US Embassy to afford Brandon the protections owed to American citizens. Supervisor Matt Haney flew to the Philippines on a fact-finding mission and visited Brandon in the hospital. On 9/10/19 the Board of Supervisors unanimously passed a Resolution calling for Brandon’s “immediate evacuation” for medical care, a Congressional investigation, and suspension of US military aid until his case is resolved. A Go Fund Me campaign has been set up to raise money for Brandon’s medical treatment and repatriation via airlift to San Francisco.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

October 2019

Raided Westside Journalist Bryan Carmody Speaks Out

by Dr. Derek Kerr

Bryon Carmody

Bryan Carmody, the freelance journalist whose Sunset newsroom was raided by the SFPD this May, spoke out August 13th at a Society of Professional Journalists (SPJ) forum at Northwestern University’s Medill School of Journalism in San Francisco. The panel included National SPJ President, J. Alex Tarquinio, and Thomas Burke, the media lawyer who represents Carmody.

Carmody was catapulted into international controversy after the SFPD broke into his home and office on May 10th. Using illicit search warrants, cops sought to identify the source who leaked the confidential police report on Public Defender Jeff Adachi’s 2/22/19 death. One month before, Carmody had refused to reveal his source when SFPD inspectors dropped by with a cryptic threat of a federal grand jury subpoena.

National SPJ President, J. Alex Tarquinio

“Woken up from a deep sleep” by the sledge-hammering of his gate, a shirtless Carmody was handcuffed for 6 hours as gun-toting officers plundered his belongings. Upon asking to make a call, a cop offered, “Here’s your phone, go ahead and unlock it for us.” No way. Similarly, Carmody said nothing to 2 FBI agents who prodded him about “criminal conspiracy” and “obstruction of justice”. The cops then raided Carmody’s office at 794 45th Avenue near Cabrillo where they confiscated computers, cameras plus 30 years of notes and digital photos. He was left with no phones, no equipment, no way to work. A friend set up a GoFundMe campaign to replace $6,000-worth of equipment. Eventually, the SFPD returned the devices but security experts advised him not to use them.

Thomas Burke

Ethical questions about privacy and purloined documents came up. Although the Adachi family was traumatized by the police report that Carmody distributed, SPJ’s Tarquinio noted that elected officials forego the privacy rights of ordinary citizens. Carmody added that the police report would eventually be made public, albeit with privacy redactions. And none of the TV stations that purchased it revealed the whole file. He emphasized that he had no animus toward Adachi, and defended selling the report as “sunlight” that “cleared up what happened and dispelled rumors.” He contrasted the City’s murky statement about Adachi’s death with the forthright announcement when Mayor Ed Lee died. As for being a “non-mainstream journalist”, Carmody explained that staffing cuts at media outlets raised their reliance on stringers – freelance photojournalists who cover breaking news. Once the media pounced on the story, Carmody decided his best defense was to “talk to everybody and anybody.”

Attorney Tom Burke asserted that “receiving and requesting information” is part of “the sausage-making process of journalism.” City Hall’s “condemnation and lack of appreciation for what journalists do every day” surprised him. While search warrants for journalist sources are generally illegal, journalists can be subpoenaed to testify, with 5 days advance notice to seek legal counsel. Even though the Shield Law protects sources from being outed, he felt that the raids would inhibit sources from contacting journalists. Burke was confident that the SFPD wouldn’t use the seized information in a legal case. However, the SFPD now knows the phone numbers of police officers who have spoken with Carmody. As for the FBI involvement, Burke was mystified. Carmody previously indicated that the FBI investigates public corruption, a charge that would apply if a police officer sold the stolen report. Carmody insisted that didn’t happen; “I did not compensate, in any way…the officers who were involved in this – not even a cup of coffee.”

In 30 years of practice, Burke said “I’ve never known an American journalist, who hadn’t gone to jail, who was more targeted.” That targeting was fueled by outrage from the Board of Supervisors, the Mayor, the Public Defender’s Office and Adachi’s family. Once the City Attorney informed Police Chief William Scott that his raids were legally untenable, and barraged by media criticism, Scott apologized.

The Carmody search warrants were pursued by the Internal Affairs Division – part of SFPD Administration under Chief Scott. As ex-cop Lou Barberini reported in the July Westside Observer, there are “cowboys” within SFPD’s Internal Affairs Division. Their botched raids resembled the retaliatory “get-the-cop” investigations that Barberini described. Accordingly, Carmody received sympathy; “Most of the rank and file came up to me and said; ‘What they did to you was wrong.” Further, the Police Officers Association blasted Chief Scott as “deceitful” for blaming “a lack of due diligence by department investigators” when the fault arose within his administrative circle.

Given law-enforcement capabilities for unlocking computers, Carmody advised, “Don’t write stuff down that you don’t want someone to see.” He admitted that he “would have been sunk” without Burke’s legal assistance. Journalists who are threatened by police can find legal help through SPJ’s NorCal chapter or the First Amendment Coalition.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

September 2019

Laguna Honda’s Silent Abuse Scandal

By Dr. Derek Kerr

Acting CEO Margaret Rykowski

In July, the California Department of Public Health (CDPH) declared a state of “Immediate Jeopardy.” An abbreviated survey found that 2 Licensed Vocational Nurses (LVN) and 2 Certified Nursing Assistants (CNA) shared cell-phone images of 19 patients without their consent. Three were naked, showing buttocks, genitals – even an enema treatment. Another sprawled on the floor in a soiled diaper. Some were filmed as staff taunted them with sexual affronts or asked to borrow money. One was being kicked by a staffer; another muffled with a towel. These photos and videos had emerged incidentally during a staff-to-staff sexual harassment investigation. LHH sent families a “Notice of Data Breach” disclosing privacy violations – without mentioning the abuses.

Worse, 5 patients were drugged with non-prescribed morphine, methadone, and tranquilizers, resulting in life-threatening complications and emergency hospitalizations. An LVN had pilfered the medications from other patients. He and a CNA exchanged text messages joking about making patients “sleep” and displaying a bag of stolen medications. They were on duty when the druggings occurred. One patient was treated for 2 overdoses. Another had 8 urine tests showing non-prescribed narcotics between January and August 2018. He died that September. Like all LHH caregivers, the perpetrators received annual Abuse Prevention and Reporting training.

In a 2015 lecture, Dr. Ron Wyatt, from the Joint Commission on Accreditation of Hospitals, identified a Culture of Silence as detrimental to patient safety. The remedy, a Culture of Safety, requires trust that reporting problems will result in action and improvement. Silence arises from a mistrust of leaders and fear of retaliation. Silence also exhibits a lack of empathy. Health care without empathy leads to abuse and neglect. Nationwide, the top 3 causes of patient harms are lapses in supervision, leadership and communication. All are aggravated by fears of speaking up.

Leadership: Organizational climate is set at the top. Unethical or incompetent leaders engender undesirable behaviors below. When leaders are selected for obedience rather than competence, they are easily threatened by criticism or setbacks. Worse, they are threatened by competent subordinates and often push them out. Since the imposition of CEO John Kanaley in 2004, then Mivic Hirose in 2009, loyalists were rewarded and critics ostracized. To make the trick work, LHH managers pursued recognition and trumpeted awards. A PR Director was hired to embellish and publicize achievements. A puffy website was created. Happy faces crowded LHH’s Facebook page. All this boosterism made it onerous to differ by reporting flaws or abuses.

The announced “resignation” of former CEO Mivic Hirose, whose 2018 salary was $308,762, was Kabuki. Records show that she remains employed as a Clinical Nurse Specialist. What hasn’t been addressed is her entourage. The folks she promoted are unlikely to empower staff to expose misconduct. Now, Margaret Rykowski is LHH’s Acting-CEO – and also DPH Director of Compliance and Privacy. Her dual role harbors conflicting interests. Suppose someone reports misconduct by LHH brass. Would Rykowski adjudicate that violation as DPH Compliance Director – and also defend against it as LHH’s CEO?

The mystery is why Quality Director Regina Gomez, who earned $273,436 in 2018, was removed. The July WSO mistakenly reported that she had resigned. In fact, she was placed on paid administrative leave. Importantly, Gomez did not govern clinical nursing and those nurses didn’t report to her. Yet, LHH Chief Nursing Officer, Madonna Valencia, who does oversee nurses, wasn’t held accountable. Neither were the supervising nurses for the affected wards.

Gomez’s job involved reporting alleged patient abuses – once brought to her attention – to regulators. Obeying stricter reporting requirements, LHH reported more cases: 28 over the past 2 years. LHH was deemed deficient in handling 15 cases, 9 for tardy reporting. All were patient-to-patient altercations. That helped sink LHH’s 2019 Medicare rating from a proud 4 stars to a mediocre 2 stars. Ironically, Gomez’s amplified reporting set the stage for blame. Because the separate spate of patient abuses by staff went undiscovered, Gomez was apparently fingered as the ultimate reporting authority.

Paradoxically, Gomez was replaced by Troy Williams, SF General Hospital’s (SFGH) Quality Director. Under his watch, State inspectors threatened SFGH with fines and payment cuts for an improper policy allowing the under-reporting of patient abuses allegations since 2016. Plus, SFGH was cited for 2 negligent deaths and deficient Skilled Nursing services. The rationale for Williams replacing Gomez is elusive.

LHH leaders have been preoccupied with flow, rushing patients in and out to accommodate SFGH referrals. Quality of care turned to process, churning out data and dashboards. “True North metrics”, core measures, survey outcomes and “Kaizen” workshops became proxies for patient well-being. For example, LHH’s May 5th Executive Committee meeting celebrated metrics showing; “100% patient satisfaction with their care experience. We are currently on target.” Meanwhile, managers were apologizing to the families of 23 abused patients. Splendid metrics don’t ensure good care.

Supervision: Gone are the days when former Nursing Director Virginia Leishman roamed the wards, chatting with patients and checking on staff. In the old building, each 30-bed ward had a Head Nurse who interacted with patients and staff. Nowadays, Nurse Managers cover 60 beds, spending much of their time at desks, computers and meetings. When important people disengage from patients, patients become unimportant. To mask this loss of engagement, wards were re-named “neighborhoods”, then “community meetings” were introduced. Nonetheless, Nurse Managers were out of touch with patients and their caregivers. If no one noticed that 6 staffers abused 23 patients over 3 years, supervision failed.

The mistreated patients resided on North 1 and North 2, the “Integrated Wellness” neighborhoods where 40% are cognitively impaired. Per LHH’s Facebook page, North 1 has; “a dedicated staff of qualified professionals with years of experience helping residents with challenging behaviors. The program provides a variety of therapeutic services… and compassionate counseling with the goal of improved social functioning.” North 2 aims “to achieve a satisfying quality of life while meeting their psychosocial and emotional needs.” What happened? Why were deviant employees assigned to such specialized wards? How did they pass the hiring process? Why were they playing with cell phones while working?

The Health Commission is supposed to oversee LHH. Three commissioners meet monthly with LHH managers as a Joint Conference Committee. There, they are spoon-fed a diet of good news. Rarely do patients, families or members of the public attend. Lacking situational awareness, commissioners seldom ask relevant questions. They miss signs of trouble, often acting as cheerleaders rather than overseers. When former Health Director Barbara Garcia was fired for a conflict of interests, the commissioners commended her.

Communication: Cultural factors and peer pressure can inhibit the open expression of discontent. As reported in the February 2016 Westside Observer, a brave handful of nurses protested before the Civil Service Commission about favoritism, nepotism and cronyism at LHH. A 2007 LHH report warned about the lack of diversity within Nursing and the problems associated with cultural dominance. A majority of LHH nurses are from the Philippines. Asian cultures tend to be collectivist rather than individualistic. Though dedicated and caring, LHH nurses may be reluctant to speak out - or cannot afford the risk.

Establishing a Culture of Safety requires a root-cause analysis of why these abuses festered untold. Why did LHH’s own Compliance Office and Hotline fail to spot the scandal? Does LHH still treat whistleblowers as pathogens? Were abuses reported and buried? What derailed supervision on the affected wards? Were line-staff afraid to speak up, indifferent, or blinded by group allegiance? How did hiring and assignment practices inflict such troubled workers upon helpless patients? Hopefully, these questions will be addressed in LHH’s “Turn-Around Plan” in September.

For now, LHH has promised State inspectors that all staff will be re-trained in reporting abuse. Nurse Managers will check their patients weekly instead of monthly, and re-engage with their staff. Hiring will require 2 references and questions about abuse and neglect. Tighter controls will be applied to narcotics and sedatives, and cell phones. Abuse allegations will be audited for timely reporting. As to why this scandal occurred, perhaps Supervisor Norman Yee’s proposed hearing will provide insights – if employees can safely testify.

Acknowledgement: Thanks to the current and former LHH employees who provided tips and insights.

Dr. Derek Kerr was a senior physicians at Laguna Honda Hospital where he was fired for repeatedly exposed wrongdoing by the Department of Public Health. Contact: DerekOnVanNess@aol.com

SEPTEMBER 2019

Breaking the Silence:

Laguna Honda’s Patient Abuse Scandal

Former CEO Mivic Hirose

Stunned and bewildered. That was the reaction when 1,650 Laguna Honda employees received an explosive email from DPH Director Dr. Grant Colfax on June 28th. “I regret to inform you that a months-long investigation showed incidents of staff misconduct towards patient-residents at Laguna Honda Hospital” it began. Colfax went on to describe how 6 employees shared cell-phone images of 23 patients in the North 1 and 2 wards and engaged in sexualized conversations, privacy violations, verbal and physical abuse, neglect, and administration of non-prescribed substances to pacify patients. These abuses persisted for 3 years, from 2016 until January 2019.

The staff memo, a follow-up Press Release and a City Hall Press Conference were carefully crafted, placing abuses in the past and delivering remedies. These include the resignations of CEO Mivic Hirose and Quality Management Director Regina Gomez - both nurses, along with the firings of 6 unidentified staff members. Wellness checks for impacted patients, family notifications, and retraining of staff in preventing and reporting abuses were implemented. An Acting CEO has been appointed; Margaret Rykowski, RN, Director of the DPH Office of Compliance and Privacy Affairs. She is a retired US Navy Reserve Rear Admiral with the Nurse Corps who previously served as Patient Safety Officer at SFGH and oversaw Laguna Honda’s Health at Home program. Within 60 days, Rykowski will present a Laguna Honda “Turn-Around Plan” to the Health Commission and the Mayor’s Office.

Former Quality Management Director Regina Gomez

So far, all that is known about the scandal is what the DPH has reported. It’s telling that Mayor London Breed referred to “horrific actions”. A more granular analysis will emerge from an investigation pursued by the California Department of Public Health. Supervisor Norman Yee is seeking additional public and professional testimony via a hearing before the Board’s Public Safety and Neighborhood Services Committee. The Westside Observer will examine the root causes of the scandal and welcomes confidential input from Laguna Honda employees.

Perhaps the most disturbing aspect of these violations is that they were discovered by accident – during an unrelated Human Resources investigation this January. Nobody reported the shocking misconduct. Why no whistleblowers? Director Colfax made an accurate diagnosis when he identified a “culture of silence” at Laguna Honda. By allowing abuses to fester, this institutional silence has not only harmed patients but unfairly shamed the many dedicated workers who care for patients with skill and compassion.

Dr. Derek Kerr was a senior physicians at Laguna Honda Hospital where he was fired for repeatedly exposed wrongdoing by the Department of Public Health. Contact: DerekOnVanNess@aol.com

JULY 2019

Sunset Uprising: Residents Tackle Property Crimes

By Dr. Derek Kerr

Photo courtesy: stopcrimesf.com

District 4 Supervisor Gordon Mar heard an earful about property crimes from his constituents. In addition to car break-ins, residents are alarmed about residential burglaries and package thefts. Core concerns are the worsening safety in previously low-crime neighborhoods and the targeting of Chinese-American elders by criminals.

On April 25th, Supervisor Mar held a hearing before the Board’s Public Safety & Neighborhood Services Committee. A dozen residents expressed frustration and outrage. A construction contractor testified that his company had lost $80,000 in equipment due to job-site and office break-ins, and a stolen truck. Yet, police investigations and follow-up were disappointing. Most of the commenters were older Chinese residents who recounted home invasions, burglaries, and even the theft of food delivered to a 90 year old woman. Some feared going out at night with more homeless people wandering about and sleeping on private property. Seeing strangers now “caused a tremor in our heart,” one said. Amid demands for more police patrols, arrests and prosecutions, one gentleman wondered, “Where is police, maybe policeman sleeping?”

Supervisor Gordon Mar-Photo: Sunset Beacon

SFPD Captain Tim Falvey provided statistics showing a steady decrease in residential burglaries and robberies since 2015. The term robbery means that perpetrators confront victims and take property by force or fear, whereas burglaries occur without victims being present. A “hot prowl” occurs when burglars enter premises while residents are present but without confronting them. Taraval Station logged 57 hot-prowls in 2018 – the highest number in the City. However, the 379 burglaries, robberies and hot prowls recorded in 2018 were less than in the prior 3 years. An additional 41% decline was noted in 2019.

These declines were attributed to the 2018 re-activation of Citywide Burglary and Robbery Units that tackle crimes across all police stations. Previously, police stations handled residential crimes within their own districts with Neighborhood Crime Units. That system missed criminals who worked across station boundaries. Under the new system, arrests for burglaries and robberies increased from 322 in 2015 to 465 in 2018. Also, arrests increased to 16% of reported burglaries in 2018, versus 10% in prior years. Yet many Sunset residents contend that arrests are lagging while property crimes spread. The Westside Observer has documented the unreliability of some SFPD crime statistics.

The SFPD and Sunset residents agree that package thefts are mounting and can escalate to home burglaries. However, the SFPD doesn’t track package thefts as a distinct crime. Instead, they are lumped together with other thefts and classified as “larceny/theft”. Without data on the incidence and demographic patterns of package thefts, the SFPD couldn’t say whether Chinese residents were targeted. Despite the citywide impact of package thefts, they’re still handled as low-level crimes at the station level. SFPD’s focus has been public education and prevention as shown on Taraval Station’s website; taraval.org.

Cristine DeBerry from the District Attorney’s Office reported 16,000+ thefts in 2018. She had no data on package thefts since these were mixed into the larceny/theft category. Prosecutions are based on the value of the stolen items, so anything under $950 is considered petty theft – a misdemeanor. Although residential burglary cases had risen from 137 in 2014 to 237 in 2018, she reported an 18% drop so far this year. In 2018, the DA filed charges in 86% of burglaries and 88% of these yielded convictions.

Kyra Worthy, director of SF SAFE (Safety Awareness for Everyone), explained how her crime prevention nonprofit partners with the SFPD to conduct free residential security surveys. SF SAFE also sets up volunteer Neighborhood Watch groups and Community Police Advisory Boards.

Frank Noto, co-founder of Stop Crime SF, described how his network of anti-crime volunteers evolved from protecting rental cars to “our homes.” He said crimes targeting Asians had increased and favored making package theft a felony. This organization holds law-makers, the police, the DA, and judges accountable for crime.

Wendy Wong, SF Coalition for Good Neighborhoods, said just 4 of 140 SFPD dispatchers speak Cantonese, an obstacle to timely reporting. Chinese people are already hesitant to report crime, and weak enforcement makes this worse.

Supervisor Mar emphasized the need for data on package thefts and victim demographics to develop better strategies. He called for increased responsiveness from the SFPD and the DA along with more outreach by SF SAFE, as well as a Sunset Town Hall meeting to gather more input.

On May 26th, 140 energized residents packed Grace Lutheran Church for a lively Town Hall meeting organized by Supervisor Mar’s aide, Alan Wong. SFPD’s Taraval Station distributed tips on preventing burglaries and package thefts. The handouts also showed that burglaries and robberies had fallen in May, compared to April. Mar introduced a panel of anti-crime neighborhood leaders; Amos Lim, a gay and immigration rights activist, Susan Pfeifer from the FDR Club, Wendy Wong from Coalition for Good Neighborhoods, John Zwolinski, a Neighborhood Watch block captain, and Nancy Tung from Stop Crime SF and a DA candidate. Also present was mayoral candidate Ellen Lee Zhou, running on a “make SF safe and clean” agenda.

The multitude was separated into 4 groups. Afterwards, group leaders reported results from their huddles;

• Ask SFPD to provide more patrols and track package thefts.

• SFPD should facilitate crime reporting, address language barriers and improve responsiveness.

• Increase police-community contacts to make cops more approachable and help residents understand SFPD services.

• Seek City subsidies for security cameras and alarms.

• Know your neighbors through events like Neighborfest, a City program that strengthens community networks.

• Work with SF SAFE to organize more Neighborhood Watch groups.

• Community Ambassador Program, a City job-training program providing safety escorts for elders and a visible presence.

• Use Nextdoor, a free social network for neighbors to report suspicious behaviors.

All this led Supervisor Mar to form the D-4 Public Safety Working Group. Good thing because without effective community action, crime fears intensify. Meanwhile, he has to navigate between progressive and conservative approaches to crime, as well as conflicting claims of crime abatement and a crime wave. We asked Taraval Station’s Captain Nicholas Rainsford for a comment but received no response.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

JULY 2019

The Struggle for Sunlight on Dark Money

By Dr. Derek Kerr

TheSunlight On Dark Money initiative launched this March is a rear-guard action to salvage constraints on pay-to-play politics. The back-story features a split within the Ethics Commission, the resignations of Commissioners Peter Keane and Quentin Kopp, and 2 years of excruciating deliberations that pitted the Ethics Commission against nonprofits. Sponsored by Keane and Supervisors Mar, Haney, Fewer, Ronen and Mandelman, the Sunlight measure will land on the November ballot.

The Sunlight initiative aims to restore some anti-corruption and transparency provisions that were scrapped during sausage-making at the Ethics Commission (Ethics) and the Board of Supervisors (Board). Briefly, it expands bans on corporate contributions to candidate campaigns, prohibits developers pursuing land use decisions from funding campaigns for Mayor, Supervisor, or City Attorney, and requires Independent Expenditure Committees (aka Super PACs) to name their 5 top donors.

One impetus for this Initiative was the 2013-14 Civil Grand Jury report titled Ethics in the City – Promise, Practice or Pretense. It revealed that Ethics and the Board had covertly neutered Prop J of 2000, a grassroots initiative that banned “legal kickbacks” whereby City officials took contributions, gifts or jobs from those to whom they granted contracts, land deals or similar benefits. This “Taxpayer Protection Amendment” received 83% of the votes.

But in 2003, Prop J was repealed by Prop E, an “Ethics Reform” Charter Amendment sponsored by the Board with input from Ethics. Prop E empowered the Board to amend - or undermine – voter initiatives incorporated into the Campaign and Government Conduct Code. Sold as a more efficient way to update ethics laws, it allowed revisions by a super-majority of votes; 8 of 11 Supervisors plus 4 of 5 Ethics Commissioners. Prop E drew plenty of opposition for its “fox guarding the hen-house” features, but passed with 62% of the votes. Thereafter, conflict of interest and campaign finance laws could be altered without a public vote. For example, in 2009 the Board and Ethics decided“expenditure lobbyists” - those who influence City Hall indirectly by subsidizing the lobbying of astro-turf, political, and nonprofit groups – did not have to disclose expenditures.

On 4/27/15 Ethics Chair Paul Renne asked Commissioner Keane to assess Prop J and expenditure lobbying as possible ballot measures. Ethics can independently introduce ballot measures without Board approval. Accordingly, Ethics placed Prop C “Expenditure Lobbyists” on the November 2015 ballot. Approved by 75% of voters, it was opposed by the nonprofit sector. Then in November 2016, Ethics introduced Prop T to bar lobbyists from contributing to City officials whom they lobbied. It got 87% of the votes.

In March 2017, Keane started a “Prop J Revision Project” that evolved into a complex Anti-Corruption and Accountability Ordinance (ACAO). The ACAO sought a ban on behest payments whereby City officials press those seeking City entitlements to fund their favored nonprofits or political committees – what Keane called “extortion by behest”. Keane wanted Ethics – not the Board - to place the ACAO on the ballot since it “cramps the style of elected officials in terms of raising money.” But it also cramped the fundraising and influence of nonprofits.

The Nonprofit Perspective: According to the June, 2018 Budget Book, City expenses for nonprofits will increase from $970 to $990 million annually. As recipients of almost $1 billion in taxpayer funds yearly, nonprofits are a major interest group. These private-public partnerships generate mutual benefits – and conflicts of interest. The dilemma is whether the exchange of favors inherent to such partnerships should be restricted even if their outcomes are beneficial.

Immediately, the nonprofit sector opposed any language that could affect their incomes or reporting burdens. Business interests warned against abridging their constitutional rights to participate in politics without intrusive disclosures.

Since the ACAO applied to nonprofits big and small, the nonprofit representatives emphasized the plight of small nonprofits that struggle to make ends meet and serve needy clients. For these Mom-and-Pop outfits, the ACAO was too complicated, they argued, drowning them under layers of accountability. They could get blindsided by technical violations, then sued out of existence by corporate adversaries.

Nonprofits resented being stigmatized as self-serving. If they don’t lobby in the land use arena, they face obstacles to opening or renovating their facilities – even displacement. By necessity, nonprofit developers of low-income housing try to influence land use decisions. Further, nonprofit board members often serve on City Commissions. But the ACAO would prohibit them from fundraising for their nonprofits, or supporting candidates who could help them get City contracts and benefits. Such limits would deter nonprofit leaders from sharing their expertise with City Commissions. Or, they might quit their nonprofit boards to avoid conflicts of interest.

Nonprofits wanted City officials to steer donations to them. They viewed behest payments as altruism rather than extortion or quid pro quos. So, Ethics agreed to switch from banning to simply disclosing such donations. Still, nonprofits objected; having to report donations could discourage potential donors. Ethics tried repeatedly to accommodate their concerns. Yet after every amendment, they sounded the same refrain – thanks, but we’re still threatened.

The Split within Ethics: On one side were Commissioners Renne, Keane and Kopp who wanted to prevent pay-to-play corruption via a ballot measure. They were generally allied with Friends of Ethics (FOE), a good government group of former Ethics Commissioner and Civil Grand Jurors. FOE collaborated with MapLight a nonprofit that tracks money in politics, to provide data supporting bans on certain campaign contributions and behested payments. For example, in 2015-16, City Commissioners appointed by the Mayor had reportedly funneled $1.1 million to campaigns supporting mayoral agendas. Further, of $23 million in behested payments logged from 2012-2017, none went to nonprofits serving low-income San Franciscans. FOE also pushed to limit the huge monetary impact of developers on campaigns, and the resulting displacement of local residents by luxury housing.

On the other side were nonprofits and big businesses. The nonprofit cause was bolstered in August 2017 when Mayor Ed Lee appointed Commissioner Yvonne Lee who has long-standing ties with nonprofits. She said City officials had “a duty to support the most vulnerable and community service organizations.” She rebuffed the “perception of corruption” as arising from “anecdotes” rather than facts and because negative perceptions of “Asian-American brothers and sisters” had incited their persecution. Commissioner Daina Chiu, a corporate attorney appointed by Assessor Carmen Chu, initially wanted to move “expeditiously” given the “harm done.” Then she drifted, citing nonprofit and business concerns, to join Lee against placing the ACAO on the ballot. After a 9/27/17 Chronicle editorial blasted Ethics for failing to tackle money in politics, Chiu deplored “the high-jacking of our electoral process” – by Russia.

The Sausage-Making Finale: At the 2/16/18 2018 Ethics meeting, the staff recommended placing an amended ACAO on the June ballot. However, Supervisor Peskin’s aide, Lee Hepner, implored Ethics to let the Board pass the ACAO legislatively instead. Peskin also wanted to insert a Major Donor Disclosure requirement into the ACAO and pass it before the June 2018 elections when a flood of dark money was expected.

Then-Chair Keane warned against “putting our faith in a legislative body…that is hyper-political, jockeying for Mayor, jockeying for power, one group trying to screw the other.” Keane emphasized that he saw no need for an Ethics Commission that didn’t act independently. Placing the ACAO on the ballot required 4 votes. Lee was sure to vote No, so Chiu’s vote was pivotal. She decided to “honor the democratic process” by working through the Board as that could “strengthen” the ACAO and get it implemented sooner. Their “No” votes spurned the call for independence. Keane announced “I resign” and walked out.

Thus stymied, Ethics acquiesced to a joint meeting with the Board. But at that April 2018 meeting, Peskin withdrew his Major Donor Disclosure proposal. The Board voted 6 to 5 against banning campaign contributions exceeding $5 million from developers pursuing land use permits, citing the “highly diffuse and technical nature of land use decision-making.” Commissioner Kopp’s motion to ban behest payments failed. Worse, most of the ACAO, now absorbed into Ordinance 129-18, took effect after the 2018 elections – thus failing to stem the torrent of dark money. For example; London Breed’s mayoral bid gained$1,248,098 in funds from Independent Expenditure Committees, topping the dark money to all other mayoral candidates.

Commissioner Renne’s term ended in February 2019. Isolated, Kopp resigned in March. His resignation letter mentioned Ethics’ failure “to illuminate so called ‘dark’ money” given the “refusal by some Commission members in the face of political pressure from nonprofit corporations and businesses.” Keane, Kopp and Renne now back the Sunlight on Dark Money initiative to restore some provisions that succumbed to divisions within Ethics and the Board.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

JUNE 2019

Tough Contract Negotiations: Unions Wield Civil Disobedience to Disrupt Inequality

By Dr. Derek Kerr

On April 11th afternoon, some 400 Service Employees International Union (SEIU)-1021 and International Federation of Professional and Technical Engineers (IFPTE) Local 21 members staged a novel civil disobedience protest at City Hall. Some 2 dozen workers were arrested for blocking traffic by sitting on the Polk Street crosswalk. Demonstrations during arduous contract negotiations are nothing new. But this one tied contract demands to the theme: “Disrupt Inequality.” Unions want City leaders to steer corporate wealth to the workers who keep the City functioning.

According to Union statements, “City workers are being told in negotiations that the City can’t afford to invest in the vital programs we provide or in allowing us to keep up with the skyrocketing cost of living. Meanwhile, multi-billion dollar corporations like Uber and Lyft get to play by their own rules and not have to pay their fair share towards the public services that City workers provide.” Union contract negotiations now include appeals to City officials to “take a stand to ensure that San Francisco is a city that works for everyone – not just the 1%.” Instead of extracting more money from beleaguered taxpayers, the idea is to hold big corporations and their CEOs accountable for using the City services and infrastructure that allow them to thrive. Recent data from the Institute on Taxation and Economic Policy shows that some of the largest and most profitable corporations pay no taxes. In 2018, US corporate tax revenues fell by 31% according to US Treasury records. Most corporations use tax shelters and subsidiaries to shield their enormous revenues from taxation. So workers and small businesses have to make up the difference or bear public service cuts.

Targeted by this demonstration were “unicorns” – privately-held start-up companies valued at $1 billion or more. A handful of San Francisco-based unicorns are scheduled to go public through IPOs or Initial Public Offerings that could mint hundreds of new millionaires. This influx of wealth could further widen income inequality, boost housing prices, increase homelessness and drive further displacement of long-time San Franciscans. Currently, many City workers can’t afford to live in the City and endure protracted, congested commutes.

Demonstrators displayed colorful placards of unicorn figures with messages like; “Fair Contracts for City Workers,” “Safe and Healthy Communities,” “Affordable Housing for All,” “Dignity and Respect for All Workers.” Chants of “We don’t get no contract, you don’t get no peace” resounded throughout Civic Center as workers marched down Polk Street waving signs and banners. That fervor was balanced by a demure minister from Grace Cathedral whose homily concluded with an appeal; “Let justice roll down like a river and let inequity wash away.” No City officials participated.

Hundreds then charged to Uber headquarters on Market Street to shame the ride-sharing colossus for exploiting gig-workers and shielding its revenues from taxation. Union members see similarities between corporate gig-work and the 15% of City employees who are retained as temporary rather than permanent employees. Temps lack the benefits and protections of regular workers.

Upon returning to City Hall 24 City workers staged a sit-in across Polk Street facing City Hall, forcing the SFPD to divert traffic. Monitoring the demonstrators were some 50 police officers plus 12 Sheriff’s deputies who guarded the entrance to City Hall. The police respectfully warned that arrests were forthcoming. None of the 24 demonstrators budged. So the cops gently guided the demonstrators one at a time to stand up to be zip-tied and escorted into waiting paddy wagons.

Apparently, rising corporate wealth and predations, coupled with shortfalls in public services and household budgets, portend more discontent, protests - and strikes.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

1. https://itep.org/notadime/

MAY 2019

Taraval’s Transit-Only Lanes Trouble Merchants

By Dr. Derek Kerr

Westside merchants are still wrangling with the SFMTA over the installation of transit-only lanes. Such lanes, separated from regular traffic, aim to improve MUNI reliability and reduce pedestrian injuries. But they eliminate the parking that sustains businesses along commercial thoroughfares. A colorful protest against purged parking was covered in the June 2018 Westside Observer’s “Taraval Merchants See Red Over Parking Ban.”

In a March 10 letter to the SFMTA, Albert Chow, President of People of Parkside Sunset (POPS) demanded that an evaluation of planned transit-only lanes on Taraval Street be conducted as promised. POPS is a coalition of merchants and residents who promote local businesses as well as neighborhood activities and quality of life. Back in July 2018, SFMTA Rapid Team Leader Michael Rhodes had assured Chow that he would compile “qualitative feedback from residents and merchants” and “reconvene the small working group to share the results and gather feedback before finalizing any staff recommendations.” But the L-Taraval Project will resume this year and Chow says the feedback part is missing. POPS members worry that SFMTA is “walking back understandings and agreements” that were supported by then-Supervisor Katy Tang.

We asked Rhodes to comment, but he is out on leave. Instead, SFMTA’s Philip Pierce responded that the renovations will continue until 2021, with ongoing community surveys and engagement with POPS. He noted that a 2015 community survey of about 1000 people showed that 49% supported transit only lanes while 38% opposed.

Simultaneously, the Controller’s Office released a study of SFMTA’s community outreach³. It was conducted because, “Members of the public report that notification can be inadequate and that SFMTA can appear to make decisions regardless of the public input received.” In early 2018, SFMTA staff upgraded its public notification and hearing processes. Improvements included public notices with maps and project manager contact information, sending emails to interested persons, and conducting satisfaction surveys. Satisfaction ratings leaped from 66% to 83% for SFMTA’s public hearing notices and from 66% to 89% on the clarity of its approval process.

Statistics aside, POPS expects SFMTA to survey merchants and residents and hold community forums “to ensure that the impact of the transit-only lanes on merchants and residents is fully explored.” In addition to better outreach, POPS also wants SFMTA to consider limiting transit-only lanes to the eastern part of Taraval, or to rush-hours only.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

APRIL 2019

Jeff Adachi’s Last Case

by Dr. Derek Kerr

Nine days before the untimely death of Public Defender Jeff Adachi on 2/22/19, the Westside Observer (WSO) received an email from his office. It detailed allegations of prisoner abuse by Sheriff’s deputies in City jails and offered an interview with Adachi. WSO reporters were busy preparing articles for the March issue. There would be time, we thought, to confer with Adachi, a former WSO contributor and St. Francis Wood resident.

Adachi’s message included a 1/16/19 formal complaint to Sheriff Vicki Hennessy about the “deplorable conditions at the San Francisco jails and ongoing and repeated misconduct by SFSD deputies.” Adachi warned that the inmates were “fearful of retaliation for coming forward with their complaints” but were willing to do so.

Sunset attorney and “soccer-mom” Kathleen McCowin arrested for peacefully protesting the rushed bulldozing of Golden Gate Park to install artificial turf and stadium lights witnessed abuse of women prisoners while in jail

Attached were reports by 16 female inmates alleging that some were strip searched in view of male deputies. Instead of individual private strip searches; these were conducted en masse. Once naked, the women were ordered to lift their breasts then squat, spread their genitalia and cough for vaginal and anal exams. They felt humiliated and degraded. Another 15 male inmates at the San Bruno Jail reported “abuse or physical assault” by deputies whom they identified. There were injuries from fists and kicks as well as being dragged by handcuffs. In all, some 20 deputies were implicated.

Sheriff Vicki Hennessy rejected Adachi’s designation of “deplorable conditions” but launched an internal investigation. Adachi wanted an outside investigation – with good reason. Back in 2015, he had exposed “outrageously sadistic scenarios” at the Hall of Justice jail on Bryant Street. Sheriff’s deputies had manipulated inmates to engage in “gladiator-style” fights while betting on the outcomes. A year-long probe by the FBI and the DA led to criminal charges. But the case fell apart because Sheriff’s investigators had obtained “compelled statements” from deputies during an internal affairs investigation then improperly used them in a criminal investigation. Because compelled statements are self-incriminating, they’re inadmissible in criminal prosecutions. Astoundingly, an investigator had also hammered to smithereens a computer hard-drive containing evidence of the tainted investigation. Therefore, this February, the DA had to drop criminal charges, although 3 deputies involved in the fight club had been disciplined, and 3 inmates received a $90,000 settlement.

Alarmed that his current complaint would be similarly torpedoed, Adachi and Supervisor Shamann Walton publicly called for an independent investigation and oversight of the Sheriff’s Department. After Adachi’s death, Sheriff Hennessy referred the investigation to the Department of Police Accountability – without mentioning the prior investigative fiasco.

Mistreating prisoners is an occupational hazard for guards. That was made clear in the 1971 Stanford Prison Experiment. Psychologist Philip Zimbardo recruited students to act as guards and prisoners. The study was aborted after 6 days because the subjects who played guards became sadistic toward the inmate subjects. The study showed that situational forces overtook the subjects’ sense of morality and agency. A similar transformation was described by Mother Jones reporter Shane Bauer who spent four months undercover as a prison guard. Bauer noted; “Striving to treat everyone as human takes too much energy…I focus on proving I won’t back down.” And, “I feel ashamed of my lack of self-control, my growing thirst for punishment and vengeance.”

One reason that jail conditions matter is that almost anyone can be arrested. Take Sunset attorney and “soccer-mom” Kathleen McCowin, a proponent of natural grass and limited lighting in playing fields. In November 2014, five cops arrested her for peacefully protesting the rushed bulldozing of Golden Gate Park to install artificial turf and stadium lights. Her December 2014 WSO article, The Shame of Rec and Park, provides the back-story and a video of her arrest.

During her one-day stay at County Jail #2, McCowin says her pregnant cellmate “Amanda” was mistreated. At first, Amanda’s cramps and leaking were dismissed. Once bleeding occurred, she was taken to SFGH and reportedly chained to a bed as she miscarried. Upon returning to jail, McCowin offered to switch bunks to give the still-bleeding Amanda the lower bed. Reportedly, the guard wouldn’t allow it and no menstrual pads were provided.

The Sheriff’s Department was anxious for McCowin to sign herself out as she was considered a liability. Instead, she settled in after a reassuring but expensive phone conversation with her teen daughter. Soon, a deputy claimed to have also called her daughter who was supposedly crying for her release. The deputy needled McCowin for ignoring her daughter’s needs, hoping to get her to leave. That call was “fabricated” McCowin insists, and the manipulation riles her to this day. Upon recounting her jail experiences to her Public Defender, she recalls that he commented “welcome to my world.”

The jail environment depersonalizes all involved, so the latest allegations of illegal beatings and strip-searches aren’t surprising. The prisoner-guard dynamic creates power struggles that compound the trauma of incarceration. This March, the Health Commission passed Resolution 19-5 declaring; “Incarceration is a Public Health Issue.” It states that “each experience of being incarcerated is physically and psychologically traumatic with lasting harm to individuals, their families, communities.” But it’s also traumatic and corrosive for guards who are easily drawn into abuses they would normally disavow. Too often, “rogue” actors are blamed instead of the pathologies arising from carceral cultures, role expectations, and unchecked power.

At a March 7 hearing before the Government Audits and Oversight Committee, Supervisor Walton sought ways to oversee the Sheriff’s handling of jail complaints. He insisted that the Sheriff’s Office cannot impartially investigate itself. Unlike the SFPD, the Sheriff’s Department isn’t overseen by a commission. Its use-of-force incidents aren’t monitored by the DA’s Office, and citizen complaints aren’t independently reviewed by a body like the Department of Police Accountability. One reason for the difference is that the Police Chief is appointed by the Mayor whereas the Sheriff is elected and accountable to voters.

Deputy Public Defender Chesa Boudin stood in for Adachi. After describing past lapses by Sheriff’s investigators and potential pitfalls with Hennessy’s ad hoc investigative switch, he called for a more consistent and transparent process. He lamented that outcomes of misconduct investigations are generally treated as confidential personnel matters where discipline is determined solely by the Sheriff. Sheriff Hennessy defended her service and department, referring to a chronic lack of staff and funds. However, Hennessy acknowledged that in 2018 there were 119 administrative and citizen complaint investigations, double the number of previous years. She affirmed her decision to delegate the probe of 21 misconduct claims to the Department of Police Accountability (DPA). While the DPA cannot compel deputies to testify, Hennessy agreed to require their cooperation. Since the DPA cannot pursue criminal cases, DPA Director Paul Henderson vowed to promptly refer such cases to the DA. And the DA’s Chief of Staff, Cristine DeBerry, was more than willing to assist and pushed for immediate referrals. It seemed that Jeff Adachi’s death had provided the impetus to collaborate - and resolve his last complaint.

Dr. Derek Kerr is an SF award winning investigational Journalist. Contact: DerekOnVanNess@aol.com

APRIL 2019

City’s Lapses in Rape Reporting and Handling Propel Reforms

By Dr. Derek Kerr

Across the country, police departments convey that they solve rape cases. Usually, they simply close them according to an investigation of 60 police agencies and 70,000 rape cases conducted by Newsy, Reveal and ProPublica.

The public views arrests as the way to clear rape cases. But police agencies often “clear” such cases - even when suspects go free and victims don’t get justice. Nearly half of law enforcement agencies studied cleared more rape cases by “exceptional clearance” than by arresting a suspect in 2016. For example, the Oakland PD reported that 60% of rape cases were cleared in 2016. When journalists obtained those rape records, turns out that only 13% of rapes were solved by arrests while 47% were solved by “exceptional clearance”.

Exceptional clearance is the term used when police have enough evidence to make an arrest, and know who and where the suspect is, but can’t make the arrest due to circumstances outside their control. These include when the suspect is dead or incarcerated, when the District Attorney declines to prosecute, or when the victim drops the case. However, some police agencies stretch this definition.

As shown by above-cited investigation, there is pressure within police agencies to clear cases, rather than keeping them “open” for further investigation or labeling them “suspended” when victims are reluctant to cooperate. High clearance rates are deployed to signify successful policing. But by bundling arrests and exceptionally cleared cases together, the overall clearance rate inflates crime control and makes the City seem safer than it is.

Currently, the SFPD logs crime data into the FBI’s Uniform Crime Reporting Program. That database gives the overall clearance rates for rapes – but not “exceptional clearance” or arrest rates. For example, in 2016 SFPD reported 342 rapes with an improbable 334 (98%) cleared. Adding to the confusion, SFPD’s own CompStat data for 2016 shows 429 rape cases – 87 more than what was reported to the FBI. Perhaps those 87 cases were deemed “unfounded”, or were sexual assaults short of rape, but we can’t tell. The table below shows these discrepancies;

SFPD Rape Case Reports

When journalists request SFPD’s rape data for exceptional clearances, arrest rates or unfounded determinations, they get stone-walled. As Mark Fahey, one of the Reveal collaborators told us; “I talked to the SFPD – both the records department and the Media Relations office – more than a dozen times between January and November 2018. They indicated that they did intend to respond to our request, but missed their own deadlines and eventually became unresponsive…” The Westside Observer’s own records request on 12/27/18 was ignored. A reminder sent on 1/7/19 was acknowledged…but no response to date.

By 2021, the actual outcome of rape cases now dubiously reported as “cleared” will become more transparent. That’s when the FBI will implement its National Incident-Based Reporting System nationwide. This system separates exceptionally cleared cases from arrests - unlike the Uniform Crime Reporting Program used by the SFPD. However, this new system is also flawed as it doesn’t count the many cases deemed “unfounded” by police departments. Omitting unfounded cases can mask the prevalence of sexual violence and impede social interventions. Yet it’s incentivized. Labeling rape cases as unfounded can make police agencies appear more effective since it reduces reported crime rates while boosting clearance rates. Because of the Newsy/Reveal/ProPublica investigation, the FBI plans to add the “unfounded” category to its new reporting system. The SFPD should be doing so already.

The need for reforms emerged when the Board of Supervisors’ Public Safety & Neighborhood Services Committee heard from sexual assault survivors and experts on 4/25/18. In emotional testimony, they emphasized the lack of empathy, respect and investigative zeal from the SFPD’s Special Victims Unit. The City’s Sexual Assault Response Team also faced criticism. That entity includes the SFPD Special Victims Unit, the DA’s prosecutors and its Victim Services Division, SFGH’s Rape Treatment Center, the Medical Examiner’s Toxicology Lab, UCSF’s Trauma Recovery Center along with community groups like SF Women Against Rape. The City agencies involved were faulted for lacking coordination and survivor-centered practices.

Part of the problem is that law enforcement agencies tend to be perpetrator-focused rather than victim-centered. The skepticism of investigators seems like disbelief to traumatized victims. However, some interrogations were described as dismissive and without privacy, leaving survivors feeling shamed and blamed for being assaulted. That sense of re-victimization is accentuated when sex workers and immigrants report rape. Some claimed that named witnesses and perpetrators were not interviewed and that investigations dragged on for years. Despite ongoing service improvements, navigating the City’s sexual assault services remains a lonely, grueling experience. It conveys that rape isn’t treated as a public safety threat. Similar deficiencies were identified in a 2017 report by the Task Force on Sexual Violence commissioned by the Department on the Status of Women and a 2018 report from the Department of Police Accountability.

The lack of transparency in the handling of rape was exemplified when SFPD Commander Greg McEachern couldn’t give the clearance rate for rapes at the Hearing. And the DA’s Chief of Victim Services, Dr. Gena Rodriguez, couldn’t say how many of the 436 sexual assault cases served by her Division in 2017 were charged. Further, the DA’s Annual Reports only show the percent of cases charged that result in convictions – without disclosing that the actual number remains in the low single digits. Prosecuting sexual crimes is difficult. Nationwide, 20% of reported rapes lead to arrests and just 2% to convictions.

So we asked the DA’s Office for the number of rape/sexual assault cases it charged and convicted. From 2013-2017, law enforcement presented an average of 141 arrests/year to DA prosecutors. (The DA’s Victim Services Division sees 3 times more because it also helps victims of unreported and uncharged crimes.) On average, the DA “took action” such as filing new criminal charges, proceeding on another case, revoking probation, or reacting to a parole violation in 52% of cases. But we couldn’t get the actual numbers charged with or convicted of sex crimes because; “…our office does not presently have responsive and reliable information”.

After the Hearing, Supervisor Ronen crafted Ordinance 215-18 creating the Office of Sexual Harassment and Assault Response and Prevention (SHARP). It was enacted in September 2018. Working under the Human Rights Commission, SHARP will have a Director and 2 full-time employees at a cost of around $400,000. Key goals are to reduce victim blaming, promote survivor-centered services and oversee all City agencies dealing with sexual assaults. Its mandate is to receive complaints about City services for sexual assault, help victims navigate the system, compel City employees to meet with complainants, report service failures to involved departments and City Hall, and recommend policies to combat and prevent sexual crimes.

Importantly, SHARP will gain access to and publish sexual assault data that is now unobtainable.

Dr. Derek Kerr was a senior physician at Laguna Honda Hospital where he repeatedly exposed wrongdoing by the Department of Public Health. Contact: DerekOnVanNess@aol.com

March 2019

Rape, Stolen Valor Charges Jolt Human Services Agency

by Dr. Derek Kerr

Simmering anger over hiring practices at the Human Services Agency (HSA) turned to dismay after 2 employees were arrested for rape and another accused of stolen valor.

Gabriel Jones, a promising 45-year old Training Manager for HSA’s Welfare-to-Work Services is embattled after 2 years on the job. In August 2018, he received an Employee of the Month award from the Human Services Commission for his “excellent project management, supervision and analytical skills”. The notice of his award, widely distributed throughout HSA, also lauded how; “Gabe started his career serving our country…as a Navy SEAL. After an admirable career in the Navy, Gabe transitioned to serving the local community”. Jones earned a salary of $92,927 ($125,631 with benefits) in 2017.

Five months later, he was accused of stolen valor by the veteran-operated “Military Phonies” website. Reportedly, Jones had been representing himself as a former Navy SEAL with combat duties and injuries in various war theaters. However, military records disclosed by Military Phonies show that he actively served the Navy from 1998-2000 – with no overseas deployments, SEAL training or service. His 2002 discharge from the Naval Reserve Personnel Center was “for the convenience of the government” these records show. On 1/22/19, Jones apparently sought a retraction of the “false allegations”. Military Phonies responded by asking for his BUD/S class number. All SEALS take a numbered 6-month Basic Underwater Demolition/SEAL class but Jones’ records showed none. And the SEAL’s roster is not classified.

The 2013 Stolen Valor Act imposes penalties for fraudulently claiming to have received certain military awards if doing so secures money, property or other tangible benefits. HSA’s Human Resources Department (HR) will be sorting out whether Jones embellished his military service and whether tangible employment benefits ensued.

However, HR Director Luenna Kim had to surmount a bigger challenge – in her own office. Jared A. Harris, a 34-year old attorney and Labor Relations Analyst was arrested for rape in Dublin in November 2018. A San Leandro resident, he is being held without bail at Santa Rita Jail according to the Alameda County Inmate Locator. His pre-trial hearing will be in March.

Prior to working at HSA, Harris was an Investigative Analyst with the DA’s Office. Although his 2017 HSA test scores were excellent, sources say his arrival at HSA entailed some controversy. A University of San Francisco law school graduate, he was admitted to the California Bar in 2014 and remains in good standing. Records show he earned a salary of $82,108 ($112,687 with benefits) in 2017. HSA disclosed that he’s no longer employed.

There’s more. In June 2018, long-time HSA engineer Albert K. Broohm, age 59, was arrested in San Francisco on a warrant for aggravated sexual assault of a child under 10. A stunned HSA colleague describes him as “the nicest person”. A resident of Hayward, Broohm remains incarcerated at Santa Rita Jail with a $2.5 million bail. His pre-trial hearing is due in February. He too is no longer employed.

Given HSA’s 2,000 employees, occasional scandals are expected but not 3 in 7 months. HSA has been a hotbed of protests about “cronyism, nepotism and favoritism” — the unfair hiring and promotion of unqualified personnel — as the Westside Observer reported in May and June 2016. These events have convinced some current and former employees that staff selection is flawed. After all, HSA’s “Strategic Plan for 2016-2021” was supposed to “improve staff morale” and the “…quality of hiring process”.

Dr. Derek Kerr was a senior physician at Laguna Honda Hospital where he repeatedly exposed wrongdoing by the Dept. of Public Health.: DerekOnVanNess@aol.com

March 2019

The Way We Were

by Dr. Derek Kerr

Each Branch will hold 3 special events. The West Portal Library held an opening event on Jan. 26 and two more will be held on Feb. 23 and 24 when New Deal scholar Harvey Smith will speak about the project and the era, at 190 Lenox Way and Ulloa. Details or call librarian Melissa Riley at 355-5790. Ms. Riley tells us the West Portal Library itself is a product of the WPA and will celebrate its 80th birthday with an open house party on May 4th, 2019.

Between 1938 and 1940, the New Deal’s Works Progress Administration (WPA) hired some 300 artisans to create a detailed wooden model of San Francisco for the Planning Commission. The idea came from notable SF architect Timothy Pflueger. The 3-D scale model served as a planning tool for the many WPA projects, such as the approaches to Golden Gate Bridge and the Bay Bridge itself, as well as the development of Treasure Island. These projects kept the City working during the Great Depression. Built at a scale of 1 inch to 100 feet, the 6,000 wood blocks of this mini-mundi covered 1000 square feet. The cost; $100,000. The model was displayed at the Golden Gate International Expo in 1939, then at City Hall in 1940. It was packed away in 1942 to make room for administrative projects during WW II. In the late '60s, it was shipped to UC Berkeley for urban design studies.

Last year, the SF Museum of Modern Art, in partnership with the SF Public Library and the Dutch artist duo Liesbeth Bik and Jos van der Pol, restored the model of San Francisco circa 1938. The goal was to reunite the model with the public in a memorable way and promote civic engagement. The result is an exhibition called “Take Part” whereby each branch of the Public Library will display sections of the scale model corresponding to its neighborhood. The unveiling will reveal something about the way we were and the City’s evolution. Events and programs based on local interests will accompany the display from January 25 through March 25. For more information contact your local library and see Take Part

Opening ceremony for the W.P.A. Scale Model of San Francisco, April 1940; image courtesy of the San Francisco Department of City Planning Records, San Francisco History Center, San Francisco Public Library.

Dr. Derek Kerr was a senior physician at Laguna Honda Hospital where he repeatedly exposed wrongdoing by the Department of Public Health. Contact: DerekOnVanNess@aol.com

LIBRARY BRANCH EVENTS

2. publicknowledge.sfmoma.org/events

3. publicknowledge.sfmoma.org/events/categories/west-portal

February 2019

Moving Toward a San Francisco Public Bank

By Dr. Derek Kerr

Animated by indigenous tribes protesting the Dakota Access Pipeline and its threat to the Standing Rock Sioux water rights, local supporters lobbied to divest from banks funding oil pipelines. In March 2017, the Board of Supervisors directed City Treasurer Jose Cisneros to do so. But those banks also financed private prisons, hedge funds, weapons manufacturers, fossil fuels, tobacco interests, and luxury real estate. Plus their predatory practices cheated customers and tanked the financial system. When it came to loans for City housing, infrastructure, transit and higher education, their interest charges were steep. Since the Westside Observer’s May 2017 article “A Public Bank for San Francisco” appeared, much has happened.

During the early 1900s, North Dakota’s economy was based on agriculture, specifically wheat. Frequent drought and harsh winters didn’t make it easy to earn a living. The arduous growing season was further complicated by grain dealers outside the state who suppressed grain prices, farm suppliers who increased their prices, and banks in Minneapolis and Chicago which raised the interest rates on farm loans, sometimes up to 12%.North Dakotans were frustrated and attempts to legislate fairer business practices failed.

A.C. Townley, a politician who was fired from the Socialist Party, organized the Non-Partisan League with the intent of creating a farm organization that protected the social and economic position of the farmer.

The Non-Partisan League gained control of the Governor’s office, majority control of the House of Representatives and one third of the seats in the Senate in 1918. Their platform included state ownership and control of marketing and credit agencies. In 1919, the state legislature established Bank of North Dakota (BND) and the North Dakota Mill and Elevator Association. BND opened July 28, 1919 with $2 million of capital.

Per the Controller’s SF OpenBook website, the City paid private banks a whopping $581,707,462 in debt interest on bonds and loans in 2017-18. Of that amount, taxpayers owed up to $121 million, according to the Comprehensive Annual Financial Report. The rest was owed by ratepayers using water, transit, airport and other revenue-generating services. Either way, bank executives, shareholders and bond holders reaped the proceeds. Also, the Treasurer’s Office reported $864,000 in bank fees last year. In response to public pressure to save money and place our money where our values are, City officials, like those in Oakland and Los Angeles, began exploring Public Banks utilities that serve the public good.

Pursuant to the Board of Supervisors’ Resolution 152-17, sponsored by Malia Cohen, Sandra Lee Fewer, Jeff Sheehy, and Hillary Ronen, Treasurer Cisneros organized a 16-member Municipal Bank Feasibility Task Force. At Supervisor Fewer’s request, the Budget & Legislative Analyst’s Office issued a November 2017 report upholding Public Banking and other community supportive banking options.

After 9 months of deliberations and consultations with experts and other municipalities, the Municipal Bank Feasibility Task Force released an Executive Summary in September 2018. It presented 4 models.

The Wholesale Municipal Bank, providing real estate, small business, and student loans, was based on the nation’s oldest public bank, the Bank of North Dakota. It would cost $134 million upfront, plus $425 million over 10 years, and would lose $60 million before showing a profit by year 10. However, a full-service municipal bank offering direct loans to consumers, small businesses, and students would lose $84 million over 10 years and “will never be profitable.”

The most viable model, a Commercial Municipal Bank, would use the City’s General Fund for lending. By not taking deposits, it would eliminate the complexity and costs of a getting a charter. It would make money by year 2, and a $17 million profit by year 10. But it wouldn’t break from Wall Street or provide consumer loans.

On 12/13/18, the Board’s Budget & Finance Committee heard updates from the Treasurer’s Office regarding the Municipal Banking Task Force. Its service priorities are affordable housing, small businesses, infrastructure, unbanked residents, then cannabis. Turns out the 4 models proposed in September took flak for being “too small – not thinking big” according to Amanda Kahn Fried. Public input also favored divesting from Bank of America and Wells Fargo. However, the Treasurer’s Office finds it daunting to “create a Public Bank from scratch,” declines to recommend a Public Bank, and hasn’t provided a roadmap to establish one. By focusing on the costs of a Public Bank, the social costs of depositing public dollars in private banks are obscured. Supervisors Cohen and Fewer urged the Treasurer’s Office to “think big,” move beyond its comfort zone, and create a path forward with State legislators. The goal would be “local control, financial empowerment, and transparency” for the City’s $11 billion bank balance. Accordingly, the Task Force will present 3 new models: Divestment, Re-Investment, and a Combination at its last meeting at 3 PM on January 31, Room 305, City Hall.

The counting room at the Bank of North Dakota

Meanwhile, on 1/10/19 over 200 people packed the Women’s Building to launch the San Francisco Public Bank Coalition (SFPublicBank.org). Among the speakers were former Supervisor John Avalos and Supervisor Fewer. Avalos, who pioneered hearings on Public Banking in 2011, recalled how private banks were bailed out by taxpayers, while thousands of residents lost their homes or were displaced from the City. He too defaulted and lost his home. Supervisor Fewer emphasized “there is no social justice without economic justice.” Since money is power, she wondered why the City renders its $11 billion fund unto predatory banks.

Julie Carter from the California Nurses Association explained how big banks fund corporations that exploit people and harm public health. She viewed a Public Bank as supporting public health and well-being, while serving as an antidote to corporate greed and profiteering. Claire Lau from the SF Berniecrats, and Fernando Marti from the Council of Community Housing Organizations, also voiced enthusiastic support. Dozens of other community groups support the concept. SF Public Bank Coalition organizers Kurtis Wu and Jackie Fielder announced their intention to place a Public Bank Charter Amendment before voters in November. Supporters can check SFPublicBank.org for educational sessions and work groups.

Regulatory and political hurdles abound. Last November, Los Angeles placed a Charter Amendment on the ballot to allow the creation of a Public Bank. A robust 44% of voters approved - but it failed. Oakland, Berkeley and Alameda commissioned a study concluding that a multi-Jurisdictional Public Bank was feasible. But the Oakland Treasurer’s Office rejected it citing “no clear roadmap, structure or supporting data.” As for cannabis, an exhaustive study by the California Treasurer’s Office found that “No State-backed financial institution designed to support the cannabis industry is feasible. All alternatives fail on both risk and financial grounds.”Banks handling marijuana proceeds risk asset seizures and employee prosecutions for enabling a federal crime.

Yet the quest to transform banking is gaining momentum. In 2016, the second US Public Bank, the Territorial Bank of American Samoa, opened with Federal Reserve approval. Hundreds of Public Banks thrive in Germany and Europe. The nascent Green New Deal movement dovetails with Public Banking. Recall the Great Depression when President Roosevelt tapped the publicly-owned Reconstruction Finance Corporation to finance New Deal infrastructure – without Congressional appropriations. While campaigning, now-Governor Newsom declared, “We must break Wall Street’s chokehold on state finances and develop our own state bank.”

Meanwhile, City Treasurer Cisneros actively pursues socially responsible investments. In 2018, the “Safe, Sound and Local” program allocated $80 million from the County’s Pooled Investment Fund to banks and credit unions to boost community lending. Other City agencies facilitate loans. For example, the Mayor’s Office of Community & Economic Development backs $86 million in home loans for lower-income residents. Such services will expand as support for a Public Bank grows.

Dr. Derek Kerr was a senior physician at Laguna Honda Hospital where he repeatedly exposed wrongdoing by the Department of Public Health. Contact: DerekOnVanNess@aol.com

February 2019

Laguna Honda Grapples with Fleeing Patients

Dr. Derek Kerr & Dr. Maria Rivero

Three years ago, in Exodus from Laguna Honda Hospital, The Westside Observer reported a whopping increase in the number of LHH patients who fled the premises. Now, LHH managers are publicly acknowledging the exodus and testing ways to reduce “unplanned discharges.” Unplanned discharges refer to patients who sign out of the hospital Against Medical Advice (AMA), or who simply walk out, Absent Without Official Leave (AWOL). Less than half of AWOL patients eventually return to LHH.

Janet Gillen Social Services Director

At LHH’s 11/13/18 Joint Conference Committee, a public meeting of LHH managers and Health Commissioners, Social Services Director Janet Gillen presented an analysis of unplanned discharges. She confirmed that FY 2014-15 saw a significant spike, with 23.6% of all community discharges leaving AMA or AWOL. In subsequent years, the rate of unplanned discharges hovered between 18% and 24%. And in the year ending in September 2018, the AMA/AWOL rate hit 26%, a new high. That’s double the historical rate around 13%,even in the old LHH with its open wards and fewer amenities.

Concurrently, LHH is coping with a rise in unruly patients with “behaviors affecting others” like wandering, screaming, aggression, and rejecting care. The new LHH’s private and semi-private rooms were supposed to contain such jarring behaviors. Instead, the proportion of patients showing bothersome behaviors steadily increased from 23% in 2013 to 31% in 2017, almost twice the State nursing home average of 17%. Recently, largely by changing reporting standards, LHH claims that patients with disruptive behaviors fell to 23%. Hardly a healing environment. Nothing was said about bothersome patients provoking others to bail from LHH.

LHH is working hard to reduce the turmoil while keeping its roots hidden. Without addressing what had been changed in its admissions process, or the population it serves, LHH set a goal of reducing the number of unplanned discharges in 2018. But instead of reducing these departures below the 52 cases recorded in FY 2016-17, LHH reached way back to an easier target, FY 2014-15, when there were 74 unplanned discharges.

Compared to the 74 unplanned discharges (33 AMA and 41 AWOL) in 2014-15, there were 45 (16 AMA and 29 AWOL) in 2017-18. That reduction in absolute numbers was deemed a success. However, the percentage of unplanned discharges is identical at 24% for both years. That’s partly because there were many fewer discharges last year, 188 compared to 313 in 2014-15. So last year’s drop mirrored the decline in total discharges and admissions. Nonetheless, for the past 4 years, about a quarter of LHH discharges actually ran away.

Why do LHH patients flee? Here, we are baffled by contradictions. Between 2010 and 2015, prior the big exodus, the reasons for AMA and AWOL discharges included 33% who “Did not want to be here” and 26% related to substance abuse. Now, according to Gillen’s November presentation, 70% of unplanned discharges are related to substance abuse. Only 18% didn’t want to be at LHH. However, in a September presentation, Chief Psychiatrist Dr. Yifang Qian insisted that merely 18% of unplanned discharges were tied to substance abuse between January 2017 and April 2018. If that 18% is correct, treating substance abusers won’t do much to curb runaways. Yet, virtually all efforts to reduce abrupt decampments seem directed at drug users. The conflicting numbers presented by Ms. Gillen and Dr. Qian are unlikely to guide effective interventions. We asked Ms. Gillen and Dr. Qian to clarify their discrepancies. No response yet.

Currently, records show that 25% of LHH admissions are designated as homeless. Surprisingly little was said about caring for these sometimes challenging patients. Although LHH documents are almost devoid of demographics, Gillen did say that most AMA discharges were homeless. But their presence within the larger AWOL contingent wasn’t disclosed. Gillen mentioned in passing that 44% of unplanned discharges fled from the Rehabilitation Unit, and 38% from the HIV/AIDS ward. Such information should help to target specialized services.

LHH deploys a host of interventions to cut unplanned discharges. These include early identification of patients troubled by drug cravings, as well as more support groups, motivational counseling, and psychiatric consultations. Surprisingly, a 16-month trial of Medication Assisted Treatment, offering buprenorphine or methadone to opioid users, was a flop. Turns out only 1% of unplanned discharges were opioid users. So, treating heroin addicts didn’t impact AMA and AWOL discharges. Another 17% of runaways craved non-opioids like cocaine, alcohol, and methamphetamine. These drug habits cannot be treated with methadone or buprenorphine, though psychotherapy, support groups, and anti-depressants can help. Even so, LHH Psychiatry surveys show that addiction treatments won’t have a major impact on patient flight. Wisely, LHH recently abandoned its draconian policy of tobacco prohibition. After 3 years of harassing smokers who defied no smoking rules, and causing some to rebel by going AWOL, LHH has restored a patient smoking area.

Intriguingly, LHH hasn’t explained why it admits patients who “do not want to be here,” comprising 18% to 35% of AMA and AWOL departures. Were these patients appropriately evaluated and screened prior to admission? That query is taboo because screening impedes flow, namely the Health Department’s Flow Project. Flow refers to flushing non-paying patients out of San Francisco General Hospital (SFGH) in order to open up beds for acute cases and generate revenue from new admissions. Most LHH admissions come from SFGH. When SFGH patients exceed the allotted length of stay for their ailment, state and federal reimbursement stops. Typically, patients who complete treatment are sent home to recuperate. But the homeless or mentally impaired cannot be readily discharged. Rushing them into LHH saves money.

There are costs. This year LHH faces a $2.5 million budget shortfall “mainly due to the increased need for coaches in an effort to facilitate patient flow within the network.” Coaches are staffers assigned to watch unruly or unsafe patients. And there are escalating costs for security services, including staffing, patrols, security technology and environmental controls. For example, every AWOL event triggers a burdensome campus-wide search by the Sheriff’s Department and busy LHH staff. Meanwhile, LHH becomes more guarded and restrictive.

Finally, San Francisco lacks nursing home beds, shelters and housing. The Health Department only provides 45 Medical Respite beds on Mission Street for homeless persons discharged from SFGH. So, some patients are sent to LHH even if they don’t want to be there. Because LHH always has a waiting list, folks who want to stay at LHH get displaced by those who don’t.

Dr. Maria Rivero and Dr. Derek Kerr were senior physicians at Laguna Honda Hospital where they repeatedly exposed wrongdoing by the Department of Public Health. Contact: watchdogs@westsideobserver.com

December 2018

Proposition B

Mayor London Breed's Aversion to Sunshine Clouds Prop B

by Dr. Derek Kerr

London Breed's ascent into Room 200 portends a loss in City Hall transparency. If Proposition B – the City's "Privacy First Policy" - passes in November, it would allow Supervisors to amend the Sunshine Ordinance without voter approval. And thus, our sunshine-averse Mayor could veto any amendment to reinforce it.

As District 5 Supervisor, Breed repeatedly defied the Sunshine Ordinance by evading public records requests. When thwarted requesters filed complaints with the Sunshine Ordinance Task Force (SOTF), the panel that adjudicates alleged violations of the Ordinance, Breed ignored SOTF summons to attend its hearings. Her intransigence came to a head in August 2017 when public advocate/gadfly Michael Petrelis asked then-Board President Breed for a list of addresses she had blocked from her Twitter account. No response. Petrelis sent 2 reminder emails. Still nothing. Unlike Breed, other Supervisors responded to the same request.

"Blocked" means that those individuals cannot view what Breed is tweeting, or converse with her via Twitter. Trouble is, some of those tweets entail City business. The case was timely because a March 2017 State Supreme Court ruling (San Jose v Superior Court) established that public business conducted on personal electronic devices or accounts is subject to disclosure. (In May 2018, a US District Court ruled that President Trump violated the First Amendment by blocking his critics from his Twitter account.)

Breed's stonewalling was odd. To an identical request from Petrelis in January 2016, Breed had responded with a list of 20 names. So in August 2017, Petrelis filed sunshine complaint #17094. Over the next 7 months, the SOTF and its committees scheduled 5 hearings to assess the case. Breed never attended, despite several SOTF reminders "to explain the basis of your decision to withhold requested records." The SOTF determined that Breed had violated the Sunshine Ordinance by withholding public records and failing to attend its hearings. This April, frustrated SOTF members voted 7-0 to refer Breed's delinquencies to the District Attorney to "ensure compliance."

In a May 1st letter to DA George Gascon, SOTF Chair Bruce Wolfe explained that Breed has "a history of non-compliance with the Sunshine Ordinance and has failed to respond to public records requests and failed to attend SOTF hearings." Wolfe noted Breed's non-compliance in 5 prior cases: #15029-2, #15038, #15060, #17018 and #17047. The rebuke stirred the Mission Local to describe Breed as one who "continually flouts public records law" and "has no patience for public records requests or the task force that oversees them." On May 9th, Gascon punted the case to the Ethics Commission where it awaits resolution.

Breed's aversion to public scrutiny of her public service isn't new. As The Westside Observer reported in October 2015, Breed had refused to disclose her work calendars. When the Board of Supervisors voted to disclose its calendars and the names of participants in its official meetings, Breed voiced the sole no vote. On second reading, Breed folded. Yet, that September she deployed her unique aversion to calendar disclosures as a litmus-test for SOTF applicants.

Thanks to a tip from Patrick Monette-Shaw, here are Breed's sunshine violations per the SOTF;

In complaint #15029-2 Michael Petrelis showed that his request for Breed's outgoing emails in January 2014 was ignored. When the SOTF met in June 2015, it found his request was unduly broad and asked him to whittle it down. Nobody from Breed's office appeared. Although her aides Connor Johnson and Iris Wong did attend a follow-up sub-committee hearing, Breed was cited for dodging the full SOTF hearing and failing to respond in any way to a records request.

In complaint #15038 from March 2015, Ray Hartz requested Breed's records about approving gifts from Friends of the Public Library. No response. The SOTF unanimously cited Breed for failure to provide the records – and for failing to appear or send a representative to its hearing. The matter was referred to the SOTF's Compliance & Amendments Committee. There, Breed's aides Connor Johnson and Iris Wong did show up. Offended, Johnson claimed he hadn't seen Hartz's request, had no responsive records, and had replied - to the Clerk of the Board! By then, Hartz had received the requested records from other Supervisors. Nevertheless, Breed's aides were instructed to send a written response directly to Hartz - after 7 months.

In complaint #15060 from December 2015, Michael Petrelis requested Breed's work calendars for February to April 2015. Astoundingly, he was told that Breed didn't keep calendars. In October 2016, he presented his complaint before the SOTF's Compliance & Amendments Committee. Connor Johnson and Iris Wong did attend - and agreed to furnish Breed's calendars. They had to. By then, the Board of Supervisors had voted to disclose its work calendars - despite Breed's opposition. The SOTF cited Breed for failing to timely respond to a public records request.

In complaint #17018 from March 2017, journalist Josh Wolf requested a list of persons "blocked" from Breed's Twitter account. No response. Wolf's follow-up request 10 days later was also ignored. The SOTF concluded that Breed could block spammers and trolls, but had to disclose who she blocked. Further, Breed had violated the Sunshine Ordinance by withholding public records and not sending any representative to 2 hearings.

In complaint #17047 from May 2017, political blogger Angela Gerben requested a list of names that Breed blocked from her Twitter and Facebook accounts. No response. In contrast, other Supervisors responded. The SOTF reviewed the case in June 2017, but couldn't proceed because neither Breed nor Gerben attended its hearing. Due to commuting difficulties, Gerben withdrew her complaint. Breed withheld her records.

An instructive exception to Breed's intransigence occurred with SOTF complaint #15067 wherein Petrelis stated that Breed had withheld emails from March and April 2015. This time, Connor Johnson and Iris Wong appeared right away - and spoke out. They claimed Petrelis' request initially landed in the "junk folder." Then they said a City Attorney told them the request, involving 1,000 emails, was overly broad and burdensome. Johnson condemned Petrelis for "Pushing the boundaries of the Sunshine Ordinance at every turn" and using the law "for harassment and punitive purposes." But by showing up at the first SOTF hearing, they saved everyone's time, reaching a compromise to disclose only one week's emails.

Yet, Breed's sunshine aversion persists. This August, Petrelis requested Breed's calendars for May and June 2018, right before she was sworn in as Mayor. He received a same-day response - 41 grossly-redacted pages. He posted them on Google drive for all to see, then filed a sunshine complaint alleging egregious redactions. Auspiciously perhaps, a subsequent request for Breed's mayoral calendars received a prompt response. But judging from past behavior, and the ominous implications of Prop B, a sunshine eclipse may characterize Mayor Breed's tenure.

Dr. Derek Kerr is a member of the Society of Professional Journalists and an investigative reporter. Contact: watchdogs@westsideobserver.com

October 2018

“Privacy First Policy” Threatens Sunshine Laws

by Dr. Derek Kerr

The “Privacy First Policy” (PFP), a Charter amendment proposed by Supervisor Peskin to safeguard private data from abuse by tech-based companies, undercuts the City’s Sunshine Ordinance. Set to appear on the November ballot as Proposition B, it heightens tensions between privacy and transparency. By conferring “First” place to privacy, transparency may be sacrificed.

Origins of the Privacy First Policy: Drafted by Peskin’s legislative aide Lee Hepner, a respected veteran of the Sunshine Ordinance Task force, and Deputy City Attorney Paul Zarefsky, the PFP was initially co-sponsored by Supervisors Yee, Ronen, Kim, Fewer and Sheehy. It propounds 11 privacy principles. These affirm the public’s right to know how its personal information is being used, how to access that information to ensure its accuracy, and how to provide informed consent for the use of that information by the City or parties benefitting from city entitlements. The bill is offered as guiding rather than binding City policy. In a round-about opaque way, it directs the City Administrator to devise an Ordinance implementing the policy guidelines by May 2019. Then the Supervisors will reconsider it.

One impetus for the upcoming Prop B is a scandal: the political data mining firm Cambridge Analytica exploited the personal information of millions of Facebook users to target ads for Donald Trump’s presidential campaign. Locally, tech companies deliver services that also capture users’ private data and compile expansive personal profiles. Nothing prevents Twitter, Airbnb, Uber, Amazon and a host of City contractors from selling personal information they acquire while doing business in the City. And, Supervisor Peskin wants to set a standard for the nation. All’s well – except for one deal-busting clause, and stealthy procedures.

Sources of Consternation and Mistrust: Here’s the shock clause, in the PFT’s subsection (i);

“Notwithstanding any other provision of the Charter, the Board of Supervisors is authorized by ordinance to amend voter-approved ordinances regarding privacy, open meeting or public records, provided that any such amendment is not inconsistent with the purpose or intent of the voter-approved ordinances.”

Who decides if an amendment of the Sunshine Ordinance is “not inconsistent” with its purpose? The City Attorney, according to Peskin. City Hall would rule on voter intent – and its own intent. Trouble is, the City Attorney has dual loyalties, representing the public and City government. When the two clash, the City Attorney defends City officials. It’s not a hypothetical concern. Recall how City Attorney spokesman Matt Dorsey told the New York Times in 2011 that the Sunshine Ordinance Task Force (SOTF) was; “…a rogue, lawless jury that beats up on City departments…” As the Westside Observer has repeatedly reported, the City Attorney advises the Ethics Commission to dismiss virtually all sunshine violation referrals. Plus, the City Attorney is plenty empowered already - as the “Supervisor of Records” to adjudicate public appeals for withheld City records, and as legal counsel to the SOTF.

Granting the City Attorney and Supervisors Charter powers to amend the Sunshine Ordinance portends a power grab. It happened before. In 2014, a cabal of Supervisors (Wiener, Chiu, Farrell, Tang and Yee) purged the SOTF and blocked qualified applicants who were deemed too independent. Instead, City Hall shills were installed. Prop B exposes the Sunshine Ordinance to tampering by the very City officials who contend with sunshine requests, and battle sunshine complaints. Unlike California’s Consumer Privacy Act, Prop B becomes a Trojan Horse that slips the alteration of open government laws into a bill that appears to protect consumer information. If it passes, City officials will be tempted to lessen transparency – despite assurances to the contrary.

The current Sunshine Ordinance was voter-initiated and approved As such, it can only be amended by voters, not Supervisors. That’s apt because sunshine complaints are all directed against City Hall and its agencies. Supervisors and City Attorneys are regular targets. Allowing them to modify the Sunshine Ordinance invites conflicts of interest. Since 1999 the Board hasn’t touched the Ordinance, except to add something. In 2008 — at the request of the SOTF - Supervisors amended the requirement that audio and video recordings of City Hall meetings be taped, to allow them to be digitally recorded, and available to the public in digital form. Under public pressure, in 2015 Supervisors required themselves and other top officials to maintain work calendars as public records, and to identify participants in official meetings. These add-ons neither altered existing mandates, nor bypassed the SOTF — something that Prop B would permit.

Stakeholders Beware: Almost privately, PFP was composed within the confines of City Hall. Although some tech companies were consulted, the bill received a perfunctory, unnoticed introduction at the May 22nd Board of Supervisors meeting. Then came two fleeting reviews before the Rules Committee in July. The proposal escaped public input, save for a single sunshine concern voiced by Peter Warfield from the Library Users Association. It was quickly adopted by the full Board on July 24th, with Supervisor Cohen joining as a co-sponsor. Only then did Supervisor Peskin mention his intent to work with “a broader set of stakeholders on trailing legislation.” However, the legislation itself says nothing about stakeholders, apart from Supervisors and the City Administrator.

Notably absent was any outreach to the open government advocates who drafted or lobbied for the Sunshine Ordinance that 58% of voters passed as an amendment in 1999. Many of those folks are affiliated with San Franciscans for Sunshine, a grassroots advocacy group. The Sunshine Ordinance Task Force (SOTF), the panel that adjudicates sunshine complaints, was left out of the loop. Also excluded were entities with vital interests in transparency and information access, like the Society of Professional Journalists and the League of Women Voters. Both groups nominate candidates for SOTF seats. Though Peskin and Hepner have privately expressed regret for this astonishing lapse, the PFP hurtled onward without a “broader set of stakeholders.”

Granted, the PFP/Prop B is well-intended. We need protection from digital platforms and tech firms that harvest, share, and monetize our private data. Granted, its sponsors generally support open government. Despite outreach lapses, they likely wanted to facilitate updates to the Sunshine Ordinance, some of which are sought by sunshine advocates. Alarmingly however, Prop B asks voters to give up power for politicians’ good intentions. Between intent and execution lurks the fox. Giving future politicians the leeway to amend the Sunshine Ordinance is too risky. A sunshine-averse City Hall could simply deem self-serving revisions as “not inconsistent” with the Sunshine Ordinance. Trust us, anyone?

Dr. Derek Kerr is a member of the Society of Professional Journalists and an investigative reporter. Contact: watchdogs@westsideobserver.com

Sept 2018

No Takers Yet: Laguna Honda’s Aid-In-Dying Program

by Dr. Derek Kerr & Dr. Maria Rivero

As reported in the June 2017 Westside Observer (WSO), Laguna Honda Hospital (LHH) approved a medical aid-in-dying policy last May. Based on California’s 2016 End of Life Options Act, it allows terminally ill patients with decision-making capacity to self-administer prescribed lethal sedatives in the hospital. While awaiting LHH’s promised annual report on its aid-in-dying program, the WSO requested records showing the number of lethal prescriptions issued and the number of associated deaths. LHH’s response: “zero” and “zero”.

Zero takers may seem surprising in a hospital that reported 181 deaths in 2017. However, few dying patients choose this option. For example, Oregon’s 20 year old “Death with Dignity” program accounted for just 144 deaths in 2017. Despite a steady rise in participants, that’s merely 0.4% of Oregon deaths. In California, data for the first 6 months of the End of Life Options program, June through December 2016, show that 191 patients received lethal prescriptions. But only 111 (58%) took them. That accounts for 0.06% of California deaths during that period. Data for 2017 show that 577 prescriptions were issued and 374 (65%) of those patients died as a result, amounting to just 0.14% of California deaths

There are other reasons for LHH’s zero participation rate. In both Oregon and California, the overwhelming majority who opted for aid-in-dying were over 65, white, college-educated, insured cancer patients living at home with Hospice services. LHH serves a different population, and many are cognitively impaired and thus ineligible for aid-in-dying. Since 1989, LHH’s Hospice and Palliative Care Service has provided support for terminally ill patients, thereby reducing demand for life-ending prescriptions. Also, patients may not be aware of LHH’s program – and it’s awkward to inform patients of a life-ending option while in the hospital. Lastly, the majority of LHH physicians and nurses declined to participate.

This May, a legal challenge by the Life Legal Defense Foundation temporarily suspended assisted dying statewide. Despite pleas from Compassion & Choices, a group that supports assisted dying, a Riverside County Superior Court judge invalidated California’s End of Life Options Act - on procedural rather than substantive grounds. In this Ahn v. Hestrin case, the judge ruled that the Act was wrongly passed in a special legislative session geared to restore funding for Medi-Cal recipients. That maneuver was deemed unconstitutional as it skirted the agenda of the special session. Special sessions also bypass committee reviews and potential opposition. After 3 weeks of legal wrangling, Attorney General Xavier Becerra’s motion to stay that ruling was granted by the 4th Circuit Court of Appeal in June. However, arguments to overturn that decision will be heard this July. Given the strong public support for the Act, and the absence of reported abuses, the Legislature could simply reenact the bill in general session if the Court again blocks the Act.

Since the LHH’s medical aid-in-dying program was enthusiastically introduced to the Health Commission last year, and since controversy abounds, the reasons for zero patient participation, the program’s prognosis, and cost, should be disclosed this year.

Dr. Derek Kerr & Dr. Maria Rivero were a senior physician at Laguna Honda Hospital, they are currently investigative reporters. Contact: watchdogs@westsideobserver.com

July 2018

Westside Car Break-Ins Subsiding - Perhaps

by Dr. Derek Kerr

Uncorrected data from the Taraval Police Station's website (www.Taraval.org) show a downward trend in reported auto burglaries. The average number of auto break-ins for 2018 now stands at 115/month. That's a big improvement from the 140/month average logged in 2017, and slightly better than the 118/month rate for 2016. Still, it means 4 local car break-ins each day. While the best protection is to remove belongings from parked cars, many tourists are not aware that this is a major problem in "the City of Love" they have traveled so far to visit. These are the major prey for the unscrupulus .

Here are Taraval Station's under-counts for thefts from autos;

Unfortunately, these numbers are misleading as they're never updated. The updates appear on the SFPD's CompStat (computer statistics) database. Last month, WSO columnist Lou Barberini – a CPA and former SFPD officer, called out the SFPD's CompStat numbers as "phony statistics" because they quietly increase – sometimes substantially - with age. That's partly due to the addition of cases filed after the monthly crime reports are tabulated. But why are large corrections inserted so many months later? Initially, the current crime rate is understated. Waiting for months to update the data creates an illusion of improving crime trends by pairing current undercounts with boosted older numbers.

For example, car break-ins recorded in Taraval Station's monthly reports totaled 1,418 in 2016, but the numbers later logged into CompStat show 1,614. That discrepancy amounts to a 14% surge - from 118 to 135 break-ins/month. Notably suspicious, the 81 auto break-ins Taraval Station recorded for December 2016 later zoomed to 139 in CompStat. Similarly, Taraval reported 1,680 auto break-ins in 2017, while CompStat shows 1,783 – a 6% increase. So instead of 140 break-ins/month, the retroactive average for 2017 was 149/month. Given anecdotal reports that some thefts from autos go unreported, the true numbers are likely about 10% higher than Taraval's official ones.

Last month, SFPD Lt. Tim Paine told the West of twin Peaks Central Council that the recent drop in thefts from autos - and home burglaries - was tied to the arrests of 12 of 30 members of a gang targeting the Westside. Indeed, residential burglaries plunged to 26 this May. That looks better than the 2017 average of 42/month. However, because home burglaries had risen in early 2018, the drop in May merely kept this year's average at 43/month. Because statistics are malleable, and because burglary gangs are resilient, vigilance remains necessary.

Dr. Derek Kerr is an investigative reporter living in San Franciscco
Contact: watchdogs@westsideobserver.com

July 2018

When business owners along Taraval Street arrived at work on Monday morning, they were surprised to find MTA had painted the curbs red along the entire block. Alioto denounced MTA’s process at a press conference three days later

Taraval Merchants See Red Over Parking Ban

by Dr. Derek Kerr

Coursing through the Parkside and Sunset neighborhoods, Taraval Street is dotted with small businesses. Since 2015, their owners have strenuously opposed Metropolitan Transportation Agency (MTA) plans to cut parking along the commercial corridor. The latest flare-up came on Monday, May 5th. Taraval merchants were vexed to see fresh red paint along the entire curb of the 2200 block. Gone were the parking spaces in front of Gene's Liquor & Deli, Universal Fire Equipment, Avenues Pet Hospital, Allstate Insurance and the Zhong Shan Restaurant. Reportedly, there was no forewarning. Although the MTA had promised fliers, business owners say they weren't notified. Worse, the parking ban deters customers and eliminates loading zones for daily deliveries of essential supplies.

Taraval is an MTA Rapid Transit Project. The rationale, per www.muniforward.com/1/, is to speed up transit times, and enhance public safety. The City's Vision Zero program, designed to end pedestrian deaths, labels Taraval between 26th and 36th Avenues a "High Injury Network." However, there are many hazardous roadways and Taraval doesn't rank among Vision Zero's 57 priorities. According to MTA's website, 22 people have been hit getting on and off L-Taraval trains in the last 5 years. The agency blames motorists who failed to stop as passengers were boarding. Just 72% of drivers complied with required stops. In April 2017, a 6-month pilot project sought to improve motorist compliance by deploying street markings, signs and flashing lights on trains. If the compliance rate reached 90%, MTA would have continued these measures. But compliance stalled at 74%. So, 36 parking spaces were expunged in order to install concrete boarding islands at train stops. Apparently, the 2200 block was the last to get red-zoned – and the last straw.

”I was at wits end,” Dianna Anderson (left) of Avenues Pet Hospital said, “I heard mayoral candidate Alioto criticizing MTA’s tactics recently at a mayor’s forum, and it gave me some hope that someone would listen to our small businesses.” Shown above is Ms. Anderson as she talks with Marcello the owner of Marcello’s Restaurant and Sue Hoffman, neighbor

For affected merchants and residents, cutting parking doesn't make sense. Importantly, they feel disrespected by the MTA and abandoned by their Supervisor, Katy Tang. That's why Diana Anderson, co-owner of the Avenues Pet Hospital, appealed to mayoral candidate Angela Alioto. On May 8th, Alioto and her team joined a gathering of irate locals for a 30-person Press Conference outside the Pet Hospital.

No longer able to drop off her dog at the curb, a customer carries a large, sick and wiggling dog, from her car, blocks away to Avenues Pet Hospital which has been at 2221 Taraval for 68 years

Much discontent was directed at MTA officials, its unelected Board and Director Ed Reiskin. Diana Anderson said that over the past 3 years, the agency "just steamrolled over any objections and refused to implement any alternative solutions we offered to address safety concerns." She's also skeptical of MTA's "disingenuous" research assumptions and methodology. She doubts that cutting parking will improve safety, citing the small number of accidents given Taraval's 30,000 daily transit passengers - about one collision per 2.5 million riders. As for speeding up transit, she questioned why a 24 hour/day parking ban was imposed given the paucity of riders outside of morning and evening rush hours. Indeed, several nearly-vacant double buses rumbled by during the noon rally.

Greatwall Hardware Business owner, Albert Chow, President of People of Parkside Sunset( POPS), outlines the inflexible pattern of SFMTA’s responsiveness to neighborhood concerns. “This is not the kind of public interaction I would expect from a Director who makes almost a half-million dollars a year,” Alioto responded

Mike O'Rourke, representing the Transportation Alliance of San Francisco, a grass-roots transit improvement group, characterized the MTA as an "autocratic fiefdom, insulated from the public." Albert Chow, president of People of Parkside Sunset and owner of the Great Wall Hardware store joined past-president Alan Sam who owns the Allstate Insurance office, in decrying the many hours they wasted conveying community concerns, petitions and suggestions to the MTA. They say their pleas for parking recuperation and mitigation of "highly impactful" changes fell on deaf ears. Barry Hermanson, a 40-year Sunset resident and Green Party candidate for US Congress recalled; "SFMTA's original presentation to the community was a fully-formed plan. They didn't come to us to help craft a solution."

Desperate merchants reached out to candidate Alioto, fearing as one merchant remarked “we only have to look at what happened to the businesses along the N Judah Line to see what will soon happen to our Taraval businesses

Economic and service disruptions emerged. Gene, the 20-year owner of Gene's Deli, keeps his shop open until 10 PM. Now, he's losing customers because nearby parking is scarce after 6 PM. Veterinarian Brandy Vickers emphasized that she's legally obligated to see emergency patients, while MTA prohibits emergency access to the hospital. It's risky when guardians of large dogs have to scrounge for parking and haul their ailing pets several blocks for medical attention. Customers are complaining and some have canceled visits for lack of parking.

These complaints are reminiscent of a prior revolt against the MTA, championed in these pages by former District 7 Supervisor Tony Hall. Backed by the Coalition for San Francisco Neighborhoods, a motorist and parking-friendly Proposition L reached the November 2014 ballot. The "Restore Transportation Balance" initiative failed with 37% voter support. Advocates for public transit, pedestrians and bicycles won then and remain formidable. For the Taraval resistance, there may be hope. On May 15th, the Board of Supervisors, citing "frustration" with MTA, agreed to veto certain transit decisions based on neighborhood appeals.

So where was Supervisor Tang? In the October 2016 Westside Observer, Tang promised to update her constituents. Mostly, she's worked to quell acrimony between the pro-parking and pro-safety factions, steering them into small focus groups after MTA hearings devolved into shouting matches. While siding with the MTA, Tang did support merchants who wanted additional study before sacrificing parking for boarding islands. That pilot study delayed alterations for a year. Still, several rally participants viewed Tang as unresponsive to their parking concerns. Hence, the oddity of District 4 merchants appealing to Angela Alioto rather than their own Supervisor.

While Alioto has pledged to "Fast track infrastructure projects to our most heavily traveled corridors," she famously vowed to fire Ed Reiskin and audit MTA's billion dollar budget. That's why she was recruited. And Alioto's message resonated; "Neighborhood serving businesses are suffering devastating losses. With behemoth competition like Amazon on one side and ever more-demanding City agencies like MTA on the other, our small businesses are being squeezed out of San Francisco."

To a Westside Observer query, Supervisor Tang replied that she wasn't invited to the rally but found it "appalling that a Mayoral candidate would insert herself and prey on angry merchants given that she did not partake nor fully understand the history of the project." Tang added; "Our office has been working with SFMTA to recuperate as much parking as possible along Taraval…creating more parking turnover by installing time-limited parking…(and)…looking into creating more passenger loading and business yellow zone parking…" She cautioned; "Just because certain merchants are unhappy…does not mean I have been unresponsive. The SFMTA Board ultimately makes final decisions…and the Board does not always listen to my recommendations."

None of the folks at the rally believed that MTA's goals of transit efficiency and safety justify expelling business-sustaining parking. Is there some other agenda? Alioto suggested that Taraval's reconfiguration is "getting ready for 5 to 7-story construction" - taller, denser buildings on the Westside. Heads nodded. We asked Supervisor Tang if this was the case. Her emailed statement didn't say.

Dr. Derek Kerr is a San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

June 2018

A small group of counter-protesters attempt to disrupt the crowd gathered to protest. SB 827. Photos: Derek Kerr

SB 827 Protesters Vie With Counterprotesters

by Dr. Derek Kerr

SB 827 is dead. It garnered just 4 yes votes from the 13-member Senate Transportation and Housing Committee on 4/17/18. Senator Scott Wiener's audacious and polarizing bill had aimed to boost housing development. But it resorted to preemption of local democracy – over-riding local zoning regulations to promote taller, denser buildings around transit lines. Its presumed beneficiaries; cities and counties, low-income tenants, environmentalists, and trade unions largely rejected it. Hurried amendments to reduce building heights, prevent demolitions and tenant displacements, and add affordable units didn't help. None of the gubernatorial candidates and just one of the City's mayoral candidates, London Breed, supported SB 827. However, Senator Wiener vows to revive the bill next year with backing from big technology firms, realtors and developers.

The bill's defeat was foreshadowed, and its divisiveness was exemplified, at an April 3rd City Hall rally against SB 827. Gathered in opposition was a diverse coalition of tenant, neighborhood, business and civic organizations represented by some 100 multi-ethnic and multi-generational protesters. Many were unmoneyed seniors and half appeared to be Asian. Their message was that SB 827 would wrest control of land use from the City and displace low-income residents. Their slogan; "Say goodbye to your neighborhood." They cheered speakers from communities of color, Supervisors Jane Kim, Aaron Peskin and Sandra Fewer as well as former Mayor Art Agnos. George Wooding, who penned a comprehensive critique of SB 827 in the April Westside Observer, spoke for the Coalition for San Francisco Neighborhoods. But their messages were suppressed.

Shouting them down were barely 20 young, white counter-protesters. These self-described YIMBYs tend to stereotype their opponents as old, wealthy, self-serving, white NIMBYs. So they were taken aback by the turnout. Outnumbered and out-represented by an unexpectedly diverse crowd, the YIMBYs stooped to drowning out the speakers. Riling them up were YIMBY Action head Laura Clark, Bay Area Renters' Federation leader and wannabe District 6 Supervisor Sonja Trauss, and SF Housing Action Coalition director and Wiener acolyte, Todd David. Trauss even barged into the larger group twice yelling and shaking her placard. An offended demonstrator slipped her own poster over Trauss's placard. A Sheriff's deputy asked Trauss to leave that section of the rally. The YIMBY's disruption provoked angry verbal exchanges and soon a team of deputies came out to separate the clashing factions.

Some of the elderly demonstrators were startled and intimidated by the YIMBY's bullying, but stood their ground. Eventually, the larger group began chanting "Shame! Shame!" and "racism" while pointing at the homogeneous YIMBY contingent. True to form, Laura Clark resorted to victimology, later claiming that her boorish comrades had walked into "a trap" and were "gaslighted." The Examiner's Joe Fitzgerald-Rodriguez's provided a nuanced analysis of the clash and its fallout. Tim Redmond of 48 Hills provided additional background including the position statement from the coalition opposing SB 827.

There was something jarring about this exchange. Preoccupied with their cause, the counter demonstrators weren't just disrespectful. They were gleefully disruptive. Instead of seeming aggrieved, they came across as spiteful. They couldn't conceive of any hardships – or tolerate any views - besides their own. It was a tribal display of young, white privilege and entitlement. Hours later, the Board of Supervisors voted 8 to 3 to oppose Wiener's bill.

Getting San Francisco to cede local control of land use may require a catastrophic earthquake. Until then, better outreach and collaboration is needed. With passions aroused and battle lines drawn come opportunities to find common ground and co-create solutions.

Dr. Derek Kerr is San Francisco investigative reporter Contact: watchdogs@westsideobserver.com

May 2018

Who Owns Voting?

by Dr. Derek Kerr & Dr. Maria Rivero

San Franciscans are seeking more autonomy in some of their public-private partnerships. Alongside the movement for a Public Bank is a similar quest for a Public Voting system. There's unease when public votes are counted secretly by private corporations.

The 2000 Bush v. Gore "hanging-chad" debacle drove computerized voting. But the new technology begat glitches. In 2007, California Secretary of State Debra Bowen decertified all of the proprietary voting systems tested because of security and auditing flaws. That year, the SF Elections Commission prioritized voting systems that "provide the maximum level of security and transparency." The Department of Elections (DoE) then contracted with Sequoia Voting Systems. The upfront cost was $9.6 million. In 2010, Dominion Voting Systems acquired Sequoia and became the DoE's vendor. Over 11 years, these contracts have totaled $22 million. The current contract will expire in December 2018 so the Elections Commission has been reviewing its security and transparency goals, nicely summarized at www.SFopenvoting.org.

Current Problems: Dating from the 1990s, the technology running our leased voting systems is antiquated. There's a high risk of malfunction - and vulnerability to hacking, as shown by the breach of voting machines at the 2017 DEFCON conference. Importantly, transparency is lacking since the computer codes operating the machines are proprietary, guarded by copyright. Election officials cannot verify their accuracy or security, or even improve them. Worse, existing machines lack auditing functions and thus, accountability for their transactions. Although vote tabulations are verified by random 1% manual tallies, today's voting machines are "black boxes" when electoral integrity calls for "glass boxes". Compounding these flaws is "vendor lock-in." Only one company can service or adjust the systems. Any adjustment requires vendor permission. And, options are limited with just 3 major vendors in the US. Ultimately, vote tabulations are largely controlled by contractors – not government officials.

Open Source Voting: Accordingly, the Elections Commission wants a publicly-owned voting system with a public infrastructure - like libraries and parks. Hence the move toward open source voting. Open source refers to publicly accessible computer codes licensed by the Open Source Initiative. Unlike proprietary code, open source software is free for anyone to inspect, copy and improve. Because many eyes scrutinize the software, it's harder for hackers to corrupt it unnoticed. Though publicly visible on platforms like GitHub, the code is still controlled by its owner.

Most super-computers use open source codes, as does the US Department of Defense and NASA. That's why former CIA Director R. James Woolsey opined in the New York Times; "To Protect Voting, Use Open Source Software." In fact, federal policy requires that 20% of all new software be open source to facilitate inter-agency sharing, cost-savings and peer review. Personal computers also use open source software via the Firefox and Chrome browsers, or Linux and Android operating systems. Open source systems are transparent, secure, flexible and affordable – unencumbered by proprietary barriers and fees.

Plodding Progress: In 2011, the Board of Supervisors' Voting Systems Task Force recommended an open source voting system. In 2014, the Board unanimously supported such a system, along with a feasibility study by the Local Agency Formation Commission. Based on this study, the Elections Commission passed an Open Source Voting Systems Resolution in 2015, requesting funding to "develop and certify an open source paper-ballot voting system." That means voters would still get paper ballots, and touch-screen votes generate a voter-verified paper trail that can be recounted by hand.

The plan is to advance incrementally, developing and certifying individual components of the voting system. Much of the development would rely upon consultants overseen by the DoE. Meanwhile, groundwork is being laid by the Election Commission's Open Source Voting System Technical Advisory Committee.

Chaired by Commissioner Chris Jerdonek, PhD, its meetings are open. OSVTAC members are excluded from contracting for the new voting system. Cost savings are anticipated from using commercial off-the-shelf computer terminals and optical scanners instead of proprietary hardware. Buying replacement parts would be cheaper. No longer obligated to a single vendor, the DoE could hire any contractor to maintain and upgrade the system. The Elections Commission has requested $4 million for 2018-19 to start building it.

That money awaits the approval of the Mayor's Office and the Committee on Information Technology. Although San Francisco's 5-Year Information & Communication Technology Plan touts an Open Source Voting System among its goals, Universal Broadband is a competing objective. Until a publicly-owned voting system is created, the DoE will spend $2 million/year on an interim proprietary system that accommodates open source software components.

However, the 2016-18 City Budget did provide $300,000 to develop "a new voting system based on open source software. The DoE allocated $100,000 for a salaried Project Director. But no satisfactory candidate applied. So DoE Director John Arntz assumed the role. In September 2017, the DoE engaged Slalom Consulting for $175,000 to "prepare a business case" for an open source voting system.

Risks and Challenges: Slalom's February 2018 draft report emphasizes the complexity involved and the commitment required to build, certify, run and maintain an open source system. One challenge is that the Secretary of State certifies entire voting systems – not individual components. Building it bit by bit or adjusting the code won't be easy because every single change needs to be reported and certified. Plus, the certification process is laborious and complicated. Similarly, a volunteer "open source community" that searches for bugs and delivers fixes will need steady coordination and governance. Research shows that without careful management, open source systems are susceptible to security and compliance risks.

Slalom's initial cost estimates resemble current private contract expenses. Even cost savings from buying off-the-shelf hardware bring security risks as most of these devices are manufactured in other countries. Importantly, no other local government has implemented open source voting. Los Angeles and Travis County, Texas tried but didn't follow through. Ominously, contractors shunned the Texas project because open source systems aren't profitable. Not mentioned in the Slalom draft is the expected resistance from corporate vendors. Slalom's final report, due soon, will recommend more planning.

State Support: State funding is likely because California's voting system is overdue for an upgrade, and an open source model designed here could be freely copied by other counties. Secretary of State Alex Padilla described open source voting as "the ultimate in transparency and accountability." Last year, the Assembly approved a $450 million upgrade to California's voting machines via a 2018 Voting Modernization Bond Act. But that measure stalled in the Senate. However, Governor Brown has proposed spending $134 million from the budget surplus to fix voting systems.

Elections Commissioner Chris Jerdonek seeks public input and support by speaking to community groups. He can be reached at chris.jerdonek@gmail.com.

Dr. Maria Rivero and Dr. Derek Kerr were senior physicians at Laguna Honda Hospital where they repeatedly exposed wrongdoing by the Department of Public Health. Contact: watchdogs@westsideobserver.com

April 2018

Parkmerced: Class Action Lawsuit, Secret Settlement, Small Changes

by Dr Derek Kerr

On December 13, 2017, the City's Superior Court approved a settlement in the contentious case of Stewart v. Parkmerced Investors Properties. Notably, "The Settling Parties, and their counsel, are barred from initiating any publicity of the Settlement…and will not respond to requests by any media…"Accordingly, this report was derived from court records

In May 2014, Danilo Stewart and his girlfriend moved to Parkmerced. They settled into a 1 bedroom unit in a 13-story building at 405 Serrano Drive. The rent was $2,391/month. Soon, Stewart developed nausea, dizziness, fatigue and headaches. He attributed these symptoms to moisture and mold caused by building and ventilation defects that allowed water intrusion and excess humidity. Parkmerced abuts Lake Merced and sits 1.3 miles from the ocean. There's fog. Its leases include a "Disclosure of the Presence of Moisture/Mold/Mildew" with prevention tips. Stewart commissioned air quality testing that reportedly showed "excess dampness" and "harmful levels of airborne illness-causing contaminants." Parkmerced responded by performing its own air quality testing. Whatever was done, or not done, Stewart claimed his symptoms persisted, leading to "severe mental and emotional …distress." After 3 months, he deemed his apartment "not habitable" and moved out.

There's more. Rent is due on the first of each month. If payment isn't received within 5 days, Parkmerced charges a $75 late fee. On July 3rd 2014, Stewart paid $2,550 for rent, garbage and utilities, but inadvertently fell $243 short of total dues owed. For this minor shortfall, he was charged $75. The next month, his rent payment was late and another $75 penalty was imposed. Stewart felt that Parkmerced's flat-rate late fee was unfair. It was imposed regardless of the amount owed or the length of the delay. He charged that the late fee was excessive, generating "unlawful profits" by over-compensating Parkmerced for so-called "cost and damage". He alleged that tenants weren't given proper notice of outstanding dues for services and utilities, thereby increasing their risk of fines.

Further, his lease defined the late fee "as additional rent". The SF Residential Rate Stabilization and Arbitration Ordinance doesn't allow late fees to be collected as rent. Although Parkmerced did not raise the basic monthly rent when it imposed a late fee, the Law Offices of Eric Lifschitz considered it an "illegal rent increase". On 4/27/16 a Class Action lawsuit was launched on behalf of 5,186 Parkmerced residents – expressly for those saddled with late fees. It asked for "restitution of all excessive late fees."

Parkmerced moved to dismiss the suit as meritless. It denied that its late fees were rent increases since it "never increased the monthly rent due, merely assessed a late fee when rent wasn't timely paid." In effect, it was an administrative fee, not added rent. Parkmerced also rejected Stewart's claim for punitive damages, citing no evidence of malice or reckless disregard. However, in October 2016 Judge Ronald Quidachay allowed the claim to proceed, since the lease verbiage related the late fee to a rent increase and Stewart's ill-health could be related to malice.

An arduous discovery process ensued during which Parkmerced showed that its late fee was low compared to those of 8 similar City landlords overseeing 75,000 units. Most charged $100 with a range of $75 to $200. An expert witness testified that tailoring late fees wasn't feasible and a flat rate was both reasonable and standard. Moreover, Parkmerced's $75 late fee undervalued its administrative costs for handling delinquencies. For example, in 2016 Parkmerced assessed 2,271 late fees (some were waived) totaling $132,825 of which $111,750 was collected. But its calculated management costs were double the sum recovered.

After a year of wrangling, mediations and conferences, a Final Settlement was approved on 12/13/17. Parkmerced will retain its $75 late fee, but agreed to delete the descriptive phrase "as additional rent" from 3,221 leases. They'll be replaced. Only the late fee language can be revised on the new tenancy agreements. As a good will gesture, Parkmerced reduced its separate fee for bounced checks from $50 to $25. While denying any fault, Parkmerced agreed to pay $120,000 in legal fees, and $30,000 to Danilo Stewart for work loss, environmental testing, health and moving costs, plus acting as the Class representative. Parkmerced residents with concerns about the settlement or their newly-revised leases can contact the Housing Rights Committee of San Francisco at HRCSF.org or 415-947-9085.

(Case #: CGC-16-551696)

Dr. Derek Kerr is an Investigative Reporter living in San Francisco

March 2018

Cannabis Green Rush: Public Health Impacts

by Dr. Derek Kerr and Dr. Maria Rivero

California Proposition 64, the "Adult Use of Marijuana Act", ended cannabis prohibition in November 2016. Garnering 57% of votes statewide - and 74% in San Francisco - it legalized the sale of recreational marijuana. Medical marijuana has been legal in California since 1996. Prop 64 allows adults aged 21 and older to possess 1 ounce of marijuana, or 8 grams of marijuana concentrates, and to cultivate 6 plants at home. To sell marijuana to adults – not just patients – retailers need both State licenses and City permits. Detailed State regulations were issued. On 12/6/17 the City's Cannabis Consumption Ordinance installed the Office of Cannabis with regulations and equity policies for recreational cannabis providers.

In December 2017 the City's Department of Public Health (DPH) reported the potential negative public health impacts of legal cannabis, focusing on youth exposure and neighborhood quality of life. The 20-page "Health Impact Assessment on Legalization of Adult Use Cannabis" aims to minimize health risks, youth exposure, and community disruptions. Based on these guidelines, the DPH reviewed the scientific literature, consulted experts and conducted surveys to come up with key findings and recommendations.

Youth Impacts

Owners of 2505 Noriega have filed in court after the Supervisors upheld an appeal by neighbors to deny the permit granted by the Planning Department.

Although the new law applies to adults, youth may be affected by the legalization of recreational use. Marijuana use among youth has been associated with learning difficulties, lower school performance and occasionally addiction. Recent City surveys cited by the DPH show that 17% of our high-schoolers use marijuana. That number is lower than the national average, partly because of low use rates among Asian students. For example, in 2013-2015, just 2.8% of Chinese students used marijuana versus 43% of African-Americans, 33.6% of Whites and 28% of Latinos/Hispanics. LGBT students use marijuana at twice the overall rate. The DPH advises adding cannabis prevention programming to middle and high school curricula.

Since marijuana has long been tolerated in San Francisco, its formal legalization is unlikely to raise usage or risks for young people. Back in 1991, nearly 80% of San Francisco voters approved Proposition P supporting medical marijuana - 5 years before California legalized it. And in 2006, the Board of Supervisors passed Ordinance 297-06 giving adult possession of marijuana the "lowest law enforcement priority". In 2011, the SFPD reported just 11 arrests for misdemeanor marijuana possession – and all were secondary to other charges. Per the DPH, cannabis legalization in Colorado, Washington, Oregon and Alaska has not resulted in increased use among young people, or adults. That could change with uncontrolled advertising and marketing.

Young people are especially susceptible to advertising, a vulnerability long-exploited by the alcohol and tobacco industries. Conversely, restricting advertising is a proven strategy for preventing drug use. Although Prop 64 restricts advertising by licensed marijuana businesses, there's a loophole. Advertising agencies and Internet platforms that do not directly sell marijuana can freely promote marijuana. That's why local vigilance plays a role. The SF Municipal Transportation Agency stripped marijuana ads from buses in November. The Golden Gate Bridge, Highway and Transportation District, followed suit. The DPH recommends regulating the content and placement of ads as the City does with tobacco and alcohol.

Medical Impacts

Even before the legalization of recreational cannabis, "cannabis-related" hospitalizations and ER visits were increasing. However, from 2011-2015 City hospitalizations and ER visits directly caused by cannabis each numbered about 100 annually. In comparison, alcohol-driven hospital visits were around 80 times higher. The majority of the marijuana cases involved young people under 24 years of age. Interestingly, hospital visits attributed to marijuana were 5 times higher for African-Americans than for the overall population.

A particular concern is poisoning by edible forms of marijuana like cookies, chocolates and candies. When comparing cannabis poisonings between 2006-2010 and 2011-2015, ER visits increased from 133 to 251 while hospitalizations, indicating more serious impairments, rose from 21 to 52. These are small numbers as they cover 5-year periods. And, unlike other drugs, marijuana has never been fatal.

Not mentioned in the DPH report is the August 2016 incident at a Quinceaniera celebration in the Mission District. Nineteen people were taken to the hospital complaining of confusion, dizziness and lethargy. They had eaten gummy-bears containing tetrahydrocannabinol or THC, the psychoactive agent in cannabis. Of the 19 patients, most between 6 and 18 years old, 12 were hospitalized. All recovered within days. According to the UCSF Poison Control Center, 51% of all poisonings afflict children under 5 years of age. Accordingly, the DPH recommends "strong regulations for cannabis edibles". State regulations already prohibit products that appeal to children, require child-resistant packaging and limit the THC content of edibles to 10 mg per serving. Adding the Poison Control Center's number 1-800-222-1222 to packaging could help.

Not addressed in the DPH report is the rate of marijuana dependence: 9% overall and up to 17% among teenagers according to the National Institute on Drug Abuse. Nation-wide, some 138,000 people required costly detox and counseling services in 2015. There's no mention of the 5-fold boost in the potency of today's marijuana strains compared to those of past decades. That raises the risk of intoxication for those who partake after a long absence. Drugged driving isn't mentioned. That may be because research has not yet proven that marijuana significantly increases crash risk. Nevertheless, marijuana can impair critical driving skills. While traffic fatalities fell where medical marijuana became legal, recreational marijuana-linked crashes and fatalities have risen steeply in Colorado and Washington.

Also missing is a Kaiser Permanente study of 35,000 pregnant women. In 2016, 6.6% tested positive for cannabis – rising to 19% among those between 18 and 24 years old. Fetal development may be affected. A 2016 international study of 5,588 women showed a 5-fold rise of pre-term births among those who continued using marijuana during pregnancy. Most medical marijuana dispensary physicians discourage marijuana during pregnancy or when there's a history of addiction or mental illness. And because marijuana harbors bacteria and fungi, patients with compromised immune systems are advised against smoking it. Recreational purveyors won't be so careful. The DPH will launch a public education campaign targeting pregnant women, youth, parents and seniors. For now, it has issued a fact sheet.

Community Impacts

Like retail outlets for alcohol and tobacco, marijuana dispensaries gravitate toward lower income neighborhoods and communities of color. As of August 2017, there were 38 medical marijuana dispensaries in the City, 10 of which were delivery-only services. Of these, 64% were located in 4 neighborhoods: South of Market, Mission, outer Mission and the Financial District. Commercial zoning laws and community participation in the approval process determine this distribution. The Westside's sole approved retailer is Barbary Coast Collective due to open at Irving and 22nd Avenue. Check WeedMaps.com for dispensary locations.

Because alcohol and tobacco outlets are associated with increased youth exposure as well as loitering, altercations, traffic, vehicle accidents, and crime, the DPH is concerned about the impact of marijuana outlets. Although data is sparse, most community complaints mention malodorous marijuana smoke. The risk of robberies is heightened as cannabis retailers are cash-only enterprises with lots of it at hand. Cannabis tourism may impact communities. Nearby retailers may be adversely affected. Importantly, the DPH reports that; "…none of the stakeholders representing organizations serving communities of color, or living in these communities, believed cannabis legalization would benefit communities of color, and instead would have a negative impact…". While the DPH advises limiting cannabis outlets in neighborhoods burdened by drug abuse, it doesn't address the opposition from segments of the Chinese community where cannabis use is very low.

The DPH promotes a "measured approach" that mitigates disparities - and fears - by urging outreach and engagement, especially in lower-income, higher-crime neighborhoods. Health and safety inspections will be conducted jointly with the Office of Cannabis, Fire Department and Department of Building Inspections. Complaints can be lodged by calling 311.

Dr. Maria Rivero and Dr. Derek Kerr were senior physicians at Laguna Honda Hospital where they repeatedly exposed wrongdoing by the Department of Public Health. Contact: watchdogs@westsideobserver.com

February 2018