Haight Ashbury Free Clinics/Youth Projects

The Haight Ashbury Free Medical Clinic opened in June 1967, during the fabled Summer of Love, at 558 Clayton Street at the corner of Haight Street, San Francisco, where it continues to see patients. Although the Clinic closed briefly a few times in its early years, it has operated continuously since then. On August 1, 1967, the Clinic incorporated under the name Youth Projects, Inc. (YPI), when it received a contract from the federal government to open an outpatient heroin detoxification program. Other programs followed, and are described below. Over 20 years later, YPI changed its name to Haight Ashbury Free Clinics, Inc. (HAFCI) to better connect its corporate identity to its programs. In June 2011, the Clinics merged with Walden House, a community-based drug treatment program that also had its start in the Haight Ashbury a couple of years after the Clinic opened its doors. Today, the merged entity is known as HealthRIGHT 360, and encompasses a number of other agencies that focus on specific underserved populations.

Haight Ashbury Free Medical Clinic, 1967 – present

The Haight Ashbury Free Medical Clinic opened in June of 1967 during the peak of the Summer of Love. The events leading up to its founding began to escalate in 1967 with the Human Be-In in Golden Gate Park, which attracted a large number of counter culture young people, deeply involved in the pot and acid culture which had just begun in the Haight Ashbury district of San Francisco.

David Smith lived in the Haight during his training in medicine and clinical toxicology at the nearby University of California San Francisco (UCSF) Medical School and was medical director of the Alcohol and Drug Abuse screening unit at San Francisco General Hospital. His colleague Bob Campos and he noted an increasing number of drug-involved youth coming to the emergency room and screening unit at SFGH. They recommended opening a “hippie clinic” in the Haight but were rejected by the city health department (whose director was Dr. Ellis D. Sox), as it was viewed as encouraging hippies to stay in San Francisco.

Fueled by the civil rights movement, which lawyer Terence Hallinan, another resident of the Haight, helped organize in the neighborhood, Smith conceptualized the slogan “Health care is a right not a privilege” and opened the medical clinic at 558 Clayton on June 7, 1967. The clinic operated 24/7 during that Summer of Love and saw 250 patients per day, with conditions that included trauma, bad acid trips, and venereal disease (STDs).
Among the volunteer physicians were Dr. David Breithaupt, who was on the clinical faculty at UCSF and rotated medical students through the clinic, and Dr. Ernie Dernburg, a prominent San Francisco psychiatrist who is chronicled in Love Needs Care, a book about the early days of the Clinic by Smith and John Luce. Luce went on to UCSF Medical School, followed by a distinguished medical career, including chief of staff at San Francisco General Hospital.

Eventually over 400 free clinics organized throughout the United States based on the model of the Haight Ashbury Free Medical Clinic integrating health care and addiction treatment in the community. Today, the National Association of Free and Charitable Clinics (NAFC) provides a voice for the approximately 1200 clinics offering low or very low cost care to the working poor and other underserved individuals. For us in the 1960s, “free” was a philosophical term meaning non-judgmental health care and was embodied in the Free Clinic philosophy:

Health care is a right, not a privilege. It should be free at the point of delivery for all who need it.

Primary health services should be comprehensive, unfragmented, and decentralized.

Medicine should be demystified, nonjudgmental and humane. Health care should be delivered in a courteous and educational manner. When possible, patients should be permitted to choose among alternative methods of treatment.

Health care skills, with an emphasis on preventive medicine, should be transferred to worker and patient alike. The worker and patient should be permitted to practice and share these skills.

Health care should be delivered via a team philosophy, granting respect and authority to each team member’s skills and expertise.

Community and worker input should be established. Free medical clinics should be responsive to the people who use them and work in them.

— Haight Ashbury Free Clinics, Inc.

If any of these statements seems familiar, it is because they became the guiding principles for “Obamacare,” the Patient Protection and Affordable Care Act (ACA). They have also been used as a model for most managed care organizations, and have had nationwide impact on the health care system. In 2011, the Haight Ashbury Free Clinics merged with Walden House, founded by Walter Littrell in 1969, and became part of HealthRIGHT 360 (HR360), a non-profit delivering health care and addiction treatment to a large stigmatized and underserved population throughout California, treating over 27,000 patients per year.

Haight Ashbury Psychological Services

The original Haight Ashbury Free Medical Clinic located at 558 Clayton was a medical and bad trip center treating adverse drug reactions, including LSD, PCP, and marijuana. It soon became clear that some of the young people had more severe psychological problems which were aggravated when the drug scene turned to harder drugs such as methamphetamine, or speed. The neighborhood became violent and the clinic coined the term “speed kills.” Dr. Stuart Loomis, a professor of psychology at San Francisco State College (SFSC), now known as San Francisco State University, started a psychological counseling center at 409 Clayton staffed by student and volunteer psychologists that shared space with the Episcopal Peace Ministry led by Father Lyle Grosjean. The center became Haight Ashbury Psychological Services, which is now an independent organization.

This very violent and turbulent time in the Haight coincided with a high profile student strike at SFSC. Dr. Leonard Wolf conducted alternative SFSC classes at 409 Clayton Street and called it Happening House, prompting a highly publicized police raid. Dr. Roger Smith, whom David Smith met at the UC Berkeley School of Criminology, became head of the Amphetamine Research Project, funded by the first grant the organization received as a non-profit called Youth Projects, Inc.

Drug Detoxification, Rehabilitation & Aftercare Project

The Drug Detox section of the Haight Ashbury Free Clinics opened in 1969 at 529 Clayton as the speed epidemic cycled into downers, including barbs and heroin. It evolved from the Medical section at 558 Clayton and its first director was Dr. George “Skip” Gay, who later spurred development of the Clinics’ Rock Medicine section.

At that time community based outpatient detoxification didn’t exist; all drug and alcohol detox had to take place in a hospital. Using a protocol they developed at UC San Francisco incorporating phenobarbital Smith and Don Wesson demonstrated that detox could occur on an outpatient basis, lowering the cost of treatment and requiring fewer beds, which would allow treating a much larger number of patients than previously. This technique was later supplemented by a variety of non-narcotic medications implemented by Darryl Inaba and his clinical pharmacy staff from UCSF, coupled with counseling. Later, group therapy became the basis for the clinic program, which at its peak during the 1970 heroin epidemic was seeing about 100 patients per day.

The 1915 Harrison Narcotic Act, reaffirmed by the US Supreme Court in 1919, made it illegal for a physician to prescribe controlled drugs for the treatment of addiction in a community-based setting, but such constraints were “overlooked” in the Haight Ashbury at that time because of the severity of the drug problem.

However, when physicians in other parts of California attempted to detox heroin addicts using the same techniques they were arrested. This fueled the development of the organization that became the California Society of Addiction Medicine and the medicalization of addiction medicine. Eventually the American Society of Addiction Medicine was formed, and Addiction Medicine was accepted as a board certified specialty.

Women’s Needs Center, 1970 – 1999

With the publication of the first (print) edition of Our Bodies, Ourselves by the Boston Women’s Health Book Collective in 1971, and the legalization of abortion with the Roe v. Wade decision in 1973, women’s health issues became a rallying point. In late 1970, Kish Stefko and Jeannie Kubicki, who had been working with the Medical and Detox programs, asked for space to provide women-specific services such as STD screening, rape counseling, and abortion counseling and referrals. Ironically, the space allocated had previously been the kitchen at 529 Clayton at the Detox program. They later moved to 558 Clayton in 1972, in the Medical program, again in a former kitchen.

Initial funding was sparse, relying heavily on volunteers. Eventually, in 1974, Title 20 funding was obtained, which allowed a move to 1698 Haight Street – not a kitchen. This funding allowed Anne and the volunteer staff to hire, most notably, Martha “Marty” Fox, RN, FPNP, which allowed the program to provide general medical, gynecological, and family planning services with Anne Salsbury as director. The California Office of Family Planning provided additional funding and in 1982 WNC moved to 1825 Haight in a former boarding house above the Omnibus Café, which sometimes featured a young musician by the name of Chris Isaak.

Anne was followed by Nancy Mayer as director of Women’s Needs, then Kate Lambert, who initiated an Advisory Board for the program. Subsequent directors were Carroll Johnson, Pat Lyons, Meredith Cahn, and Belma Gonzalez, who moved the Center to 2166 Hayes Street.

Although WNC relied heavily on its Office of Family Planning funding, staff and volunteers felt continually under siege as right-wing attacks on family planning surged, receded, and surged again. By developing a strong training program for its many volunteer health educators, the program was able to stretch its dollars and provide useful skills for its supporters.

In February 1999, as the Clinics faced yet another fiscal crisis, Women’s Needs Center closed its doors. Its self-generated donations and funding proved inadequate to overcome the lack of support from the parent body.

At the request of Bill Graham, San Francisco’s legendary rock n’ roll promoter, volunteers from the Medical section provided talkdown and medical services at the Fillmore Auditorium and other Bill Graham concert venues. Rock Medicine evolved from the Medical program, when Bill asked for volunteers to provide services at two large concerts on successive weekends in May/June 1973, featuring the Grateful Dead and Led Zeppelin (on separate weekends…). Half of the volunteer staff, as reported in Dr. George “Skip” Gay’s analysis published in the Journal of Psychedelic Drugs 5 (2) with Robbie Elsenbaumer and John Newmeyer, were surreptiously dosed with LSD and sat out the concert from the sidelines.

A few years later in 1975, Bill Graham asked the Clinic to staff the S.N.A.C.K. concert to benefit sports and after-school activities for funding-challenged San Francisco schools, again at Kezar Stadium, featuring Neil Young and Bob Dylan  with other great musicians and a guest appearance by Marlon Brando.

Bill Graham had been supporting the clinic since 1967 via benefits from the Grateful Dead, Jefferson Airplane, Janis Joplin, the Ace of Cups, Creedence Clearwater Revival and later George Harrison. He always perceived the Haight Ashbury Free Clinics as taking care of his young concertgoers, but after the disaster of Altamont it became clear that uncontrolled outdoor concerts without adequate medical care were not viable. Thus Rock Med was born, with Dr. Skip Gay taking the lead and Robbie Elsenbaumer serving as director.

Rock Med thrived and expanded, later being directed by Glenn “Raz” Raswyck in the 1990s and into the mid-2000s, and currently by Gordon Oldham. Rock Med now covers about 1000 concerts and other events a year with about 3000 volunteers from all over the state, continuing the spirit of the free clinic movement.

Rock Medicine history with photos is chronicled on Facebook, spreading the clinic message that health care is a right, not a privilege, all over the world.

Commune Health Project

As the Summer of Love started to fade in the Haight, as symbolized by the Death of Hippie funeral ceremony and the Grateful Dead bust in October of 1967, much of the counter culture moved out of urban areas such as the Haight into the country and formed communes, groups of people, including non-relatives, who shared living quarters and responsibilities.

Many of these pioneers/refugees were patients at the clinic, and nurse Ruth Fleishman formed the Commune Health Group with a team of nurses who visited the communes for home care and hygiene to prevent communicable disease, particularly as it related to the many newborns and young children. This led to a commune study by David E. Smith and his student, Jim Sternfeld.

One of the communes in the study was that of a group who lived at Cole and Haight Streets and identified as a “family.” Its leader, Charles Manson, reported to Roger Smith, a probation officer and criminology student at UC Berkeley who headed the Clinic Amphetamine research project, at 409 Clayton. Charlie’s young female associates, later known as “Charlie’s girls,” became patients at the Haight Ashbury Free Clinic at 558 Clayton. In 1968, Alan Rose, director of the clinic, moved to the Los Angeles area with the Manson group to form a commune. He left a few months before the Manson family murdered actress Sharon Tate and four others on August 9, 1969, in the home of Tate’s husband, director Roman Polanski.

A description of their commune was contrasted with 3 other types of communes in “The Group Marriage Commune: A Case Study” (DE Smith and AJ Rose), written prior to the events in Los Angeles and published in the Journal of Psychedelic Drugs. When LIFE magazine interviewed David E. Smith and Roger Smith in 1969, the article became national news, an unintended outcome of the commune health research.

Additional Programs

Crackerjack Rehabilitation – Rick Seymour’s articles

Haight Ashbury Training & Education Projects

Jail Psychiatric Services

Acupuncture

Alcohol Treatment Services

AIDS Research

Target Cities

Smith House

Western Addiction Recovery House

Treasure Island

Administrators/CEOS

Robert Conrich

Carter Mehl

Alan J. Rose

others?

Richard A Frank

Richard Seymour

“Troika” – Anne Salsbury, Robert “Skeezix” Corrado, and Stephanie Ross – 1971?

Robert “Skeezix” Corrado

John Newmeyer, Ph.D. (interim)

Herbert Houston

Darryl Inaba, PharmD

John Eckstrom

 

Books

Love Needs Care: San Francisco’s Haight-Ashbury Free Medical Clinic and Its Pioneer Role in Treating Drug-Abuse Problems. David E. Smith, M.D. and John Luce. Boston: Little, Brown & Company, 1971.

The Haight Ashbury Free Medical Clinics: Still Free After All These Years, 1967-1987. Richard B. Seymour and David E. Smith, M.D.. San Francisco: Partisan Press, 1986.