Dr. Katz's 1998 White Paper on
Options for Rebuilding LHH

On December 10, 1998, Mitchell Katz, Director of Public Health, presented then-mayor Willie L. Brown with a White Paper exploring various options for rebuilding Laguna Honda Hospital and Rehabilitation Center.

In the White Paper, Katz notes that “Of Laguna Honda Hospital’s operational beds, the vast majority (1,027) are devoted to long-term skilled nursing beds” (page 8).

Katz concludes that if sufficient funding is not appropriated to build alternative care facilitiess in San Francisco as was done in Oregon, that San Francisco will be short 2,380 skilled nursing beds by the year 2020 (page 10).  In his discussion of various options to rebuild LHH, option number four was to build several smaller facilities throughout the City.  In building several smaller facilities throughout the City, Katz noted that “operating costs would be significantly higher because of the loss of economies of scale running 1,200 beds at LHH”" (page 14), and that “building several smaller facilities would be markedly more expensive” (page 15).

Indeed, Katz notes that should the City consider building 12 ninety-nine-bed facilities rather than a single 1,200-bed facility would cost (in 1994 dollars) $171 million more than his eventual recommendation to re-build 1,200 skilled nursing beds on the current site of Laguna Honda.

So how did we get from rebuilding 1,200 beds on Laguna Honda’s present site, to scaling back the full “scope” by potentially cutting 300–400 beds from the new facility?

Other disturbing questions remain unanswered:  

Most importantly, why are these decisions being discussed behind closed doors, without the public being informed about what its government is doing?

Newsom is reportedly interested in having open dialog with his citizenry, but he is doing everything he can to avoid meeting the very public he was elected to serve.



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Committee to Save LHH.