Analysis of LHH Admissions Policy Changes

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The Laguna Honda Hospital admissions policy has changed at least five times during 2004, within a single year.  No other LHH policy has ever changed quite so frequently, and with quite so many substantive changes.  Following intense disagreement of what the policy should be and which San Franciscans will be served by the policy, and following the filing of a citizen-taxpayer lawsuit challenging the admission policy changes that was eventually withdrawn, Mitchell Katz, MD, Director of Public Health has currently gotten what he had pursued all along throughout the admission policy battles of 2004.

The admission policy changes announced on December 23, 2004 at the Laguna Honda Hospital Joint Conference Committee — a committee comprised of two Health Commissioners and the Executive Committee of LHH — give Dr. Katz exactly what he has sought all along:  Ultimate “arbitrator” authority of who will be admitted to LHH.

Among the most important changes in the attached analysis of the various changes to the LHH admissions policy, are:

Left in the wake following the battle over LHH's admission policy is the likelihood that there will be a de facto policy left in place granting SFGH patients first priority for admission to LHH, and a de facto policy permitting Dr. Katz to be the final arbiter of who will be admitted to LHH, whether or not the new December 16 version of the LHH admissions policy is ever challenged as being inappropriate and contrary to the will of San Francisco voters.

Citizens in extreme danger at home, or are in danger of being hospitalized in acute care settings, and the frail elderly who need long-term care, cannot gain admittance to LHH under the new LHH admissions policy.  It’s a policy battle Dr. Katz has waged (however not-so) skillfully for well over ten months in order to have his way.



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