City won't move mental health clinic, raises privacy concerns

The Public Press
 — Aug 3 2009 - 11:34am

After protests by patient advocates, the city last week reversed its decision to move an Outer Mission geriatric mental health program more than two miles west, meaning elderly clients may continue to receive care in the neighborhood.

But the decision was accompanied by another controversy — whether mentally ill patients belonged in the media spotlight when their clinic was threatened with relocation.

The Department of Public Health expressed concern that patient privacy laws may have been violated at a July 24 press conference staged outside the clinic. A spokeswoman cited media coverage of the event that featured video and interviews with clients who have mental illnesses.

“Because of concerns over possible HIPPA [sic] infractions due to client's [sic] appearing on video and being interviewed at last week's press conference, we are currently reviewing policies and procedures,” department spokeswoman Eileen Shields wrote in an e-mail Friday. HIPAA stands for the Health Insurance Portability and Accountability Act, which outlines legal provisions for patient privacy and confidentiality between clients and health providers.

Shields declined to divulge details about why the department called off the move. “Inasmuch as the clinic is going to remain open, further inquiry on the topic is moot,” she wrote.

On Monday Francisca Oropeza, a psychiatric social worker at Southeast Mission Geriatric, stood by the clinic's decision to hold a press conference attended by outspoken clients, suggesting the privacy argument was disingenuous.

“Even if they have mental illness, they have a right to express themselves,” she said. “Just to assume because people are mentally ill and older that they can’t express themselves is disrespectful and condescending.”

Oropeza said she believed no HIPAA infractions occurred.

She added that she was confident that clients who attended the press conference possessed the mental competence to consent to interviews with the press, although she could appreciate the department’s concern. Those who managed to attend the gathering to protest the clinic’s closure are among the highest-functioning clients it serves, Oropeza said.

Southeast Mission Geriatric Services’ staff and program of care had been slated to move to another facility, in the Ocean View-Merced Heights neighborhood, as part of departmentwide restructuring resulting from deep budget cuts this summer. The city is nearly done finding more than $400 million in savings in a budget season of unprecedented deficits.

A little more than a week ago, the health department had defended the relocation of Southeast Mission Geriatric as a way to preserve services, despite opposition from clinic staff and patients who said the move would disrupt their lives and compromise care. At the time, the department said it would offer patients vouchers to pay for taxis to the new location.

Southeast Mission Geriatric has been in the Mission Street building since the 1980s and has survived several threats of closure.