Mission Neighbors Vow to Save Beloved UCSF Clinic

Facing a budget in the red and a loss of patients, UC San Francisco officials plan to close a beloved family planning clinic for low-income teens and young adults in the city's Mission District.

The New Generation Health Center, which has provided free reproductive health care for two decades to patients as young as 13, is scheduled to close its doors on July 31.

Health providers say the decision could imperil at-risk Latino and African-American youth who already like and trust New Generation's confidential and prompt services. Concerned residents and others say they want to find funds, or pressure UCSF, to keep the clinic open.

Over the last five years, the clinic's finances have been decimated by decreases in grant revenue and a potentially irreversible loss in patients, says Dr. Rebecca Jackson, a UCSF professor of obstetrics and gynecology and supervisor at New Generation.

"This was an awful, awful, heart-wrenching decision to have to make," says Jackson. "New Gen is a very special place. They really take their mission seriously, which is empowering young people to make decisions in a world and in an age where it’s hard to have a choice."

Jackson and her staff have been working for weeks to transition New Generation's 2,200 patients to nearby clinics with similar services, such as Mission Neighborhood Health Center and 3rd Street Youth Center & Clinic.

Residents Vow to Fight for Clinic

The news of the closure did not sit well with several Mission residents, students, health providers and youth advocates at a forum with UCSF officials last week.

A funeral-like mood pervaded a packed auditorium to discuss the clinic's closure. Jackson and Dr. Sue Carlisle, a UCSF Medical School vice dean, spoke about the financial reasons for the closure and efforts to ensure all patients are matched with "best fit" clinics in the area.

Still, speaker after speaker called on a new effort to save New Generation, not shutter it.

"What we have to do as a community is not take this and stand together and fight back. We need to hold UCSF accountable," said Ronnishia Johnson, who grew up in the nearby Bayview neighborhood. "From my perspective this is nothing but them turning their backs on the community."

Nataly Ortiz, who become a mom as a teen, says it's hard for local Latina and undocumented teens to get same or next-day appointments for reproductive health in clinics other than New Generation.

"Sometimes it’s a very emotional case of being scared of being pregnant at a very young age," said Ortiz, who refers patients to New Generation through her work at a neighborhood nonprofit.

"They need a clinic like this. So for you to take it away, it’s just saying our community doesn’t matter, the people that benefit from this clinic don't matter.  But I'm here to tell you, we do matter!" Ortiz said to UCSF officials. 

Affordable Care Act 'Hurting' Family Planning Clinics

Ironically, the Affordable Care Act (ACA) is partly to blame for New Generation's troubles, says Jackson.

Under the ACA, more people have become eligible for Medi-Cal, the state's health insurance program for people who are low income. Many New Generation clients are choosing to get their reproductive services addressed with their new doctor or medical clinic that handles all their health needs. Other family planning and specialty clinics are also feeling this squeeze.

"For a lot of people, it's more convenient to get that [reproductive] care at the same time they are getting the rest of their health care," Jackson says.

Still, she added, "a small subset" of patients want to keep reproductive health care separate.

One of those patients is Rocio Navarro, a student at Abraham Lincoln High School.

"Where else would I go where I won’t run into my parents, where I won’t run into my aunt, where I won’t run into my neighbors?" asked Rocio, 15. "This makes me really mad. The Mission is our neighborhood and that's where this place should stay!"

San Francisco Teen Pregnancy Among Lowest in California

Jackson believes that funders who previously supported New Generation's operations have "different priorities" because the city's teen pregnancy rate is very low.

Community advocates and school nurses credit resources like New Generation with helping drive that rate down. They worry that dismantling what they see as a well-oiled, efficient system that provides excellent services will chip away at that public health achievement because at-risk teens will fall through the cracks.

"They are still sexually active," says Mary-Michael Watts, a nurse at the Mission High School Wellness Center who often refers students to New Generation, and is critical of the closure. "I applaud these young people that are taking responsibility for not getting pregnant … and they are really safe and competent hands at New Generation."

UCSF and San Francisco's public health department are planning to hold a second community forum to include more people directly affected by the closure, possibly by the end of this month. No date has been confirmed yet.

Last year, UCSF raised more than $600 million in private contributions, the highest total of any public U.S. university, according to the Council for Aid to Education.

Nearly all of those funds go toward specific programs and projects, says Jackson, and like most community clinics, New Generation must survive on its own clinical and grant revenue.

"I’m hoping maybe now with the community being involved that some new idea will come up or people will be outraged enough they’ll want to fund it to stay open," said Jackson.