Fax: (510) 268-8004

Dear Supervisor Miley:

We appreciated the caring and concern shown by the Board during the Beilenson hearing on Tuesday. As activists, it was especially moving to us to hear the stories of a few of those who will be impacted should the Fairmont and Central Clinics actually close. We want to follow up in writing with some of the suggestions we made, in more specific format than three minutes allows.

While the hearing started from a position of the BOS being powerless to alter the proposed closures, it was clear by the end that you do indeed have the means to keep the clinics open for the coming fiscal year. We were pleased and surprised that Dave Kears stated in public that there are more funds in the Tobacco Settlement Reserves than we had previously understood, and that the BOS could choose to allocate those funds towards keeping the Central and Fairmont Clinics open.

Here's the most powerful argument we know of to use the money to keep the clinics open, to whatever degree possible: If that money lasts one year and allows 79,000 more outpatient visits, whether or not an initiative is created and passed at the end of the year, we will have saved the lives of possibly hundreds of people and increased the well-being of thousands, decreasing the numbers of agonizing tales of the indigent souls of our community.

The layoffs at ACMC will occur imminently. Time to reverse the decision about clinic closures is extremely short as the clinics are slated to close by July 1st. The most pressing matter is for your Board to meet immediately with ACMC representatives to determine how the reserve funds could be allocated to prevent the clinic closures. Patients and staff have already suffered extreme stress, and if the clinics are to remain open, this needs to be announced as quickly as possible.

Once the clinics are restored, we should turn our attention immediately to the long range solution. We are urging each supervisor to direct a staff member who is most familiar with health care issues to join together to continue the task force started by your office of crafting a viable "health care tax" initiative for the March 2004 ballot. We are hopeful that SEIU will support this effort, which will be the boost needed. As we said at the hearings, if that tax clearly dedicates the vast majority of the proceeds to ACMC, barring unforeseen problems with other intentions of such an initiative, we will do all that we can to educate the community about the need to vote 'yes.' The amount collected must be adequate to see the ACMC through more years of deficits of $20-30 million dollars, until either the economy improves or the state/country understands the crushing need for a single payer health fund.

People testified on Tuesday that making these clinic cuts have been the most painful process of their many years of involvement in health care policy. We imagine that this is true for each of you: Coping with the worst budget constraints in years must be heart-wrenching. We hope to work productively together toward the best resolutions possible.

Sincerely,

Nancy M. Friedman Kay Eisenhower

Executive Director Chair

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