For well over six months, San Francisco Health Commissioner Jim Illig has been dropping clues that the mission of Laguna Honda Hospital will change when the DPH Strategic Plan now under revision is finalized.  At its October 26 meeting, the Health Commission was presented with the proposed changes; DPH’s Strategic Planning Department first claimed there were no substantial changes to the Strategic Plan,, but then an underling employee of the Strategic Planning Department indicated that there have been 83 changes made to it, either by way of modifications or by the addition of totally new “goals and objectives.”  All told, 83 changes cannot hardly be viewed as “no subtaintial change, even by the wildest implementation of spin control.

The Health Commission was thwarted in its attempt to race to implement a sudden, unannounced “resolution” approving of the changes to the Strategic Plan, because an astute community member observed that the Health Commission had failed to note in its October 26 agenda that it was going to consider an “action item” voting to approve a resolution that had not been presented to the public beforehand, as required by our local open meetings law known as the San Francisco Sunshine Ordinance.

On November 9, the Health Commission has now adequately forewarned the public about its plans to simply rubber-stamp the changes to DPH’s Strategic Plan, and on its November 9 agenda is the proposed vote to accept the Strategic Plan, as written by DPH.

On this web site is a two-page extract of the “goals, objectives and strategies” in DPH’s 28-page 2004 update to its strategic plan that relate to the changing mission of Laguna Honda Hospital.  Among the changes are:

• Goal 1 of the Strategic Plan is to make sure San Franciscans have “access to the health services they need.”  A major change to DPH’s Goal 1 involves sending behaviorally-disturbed patients from SFGH to LHH.  The new Objective 11 under Goal 1 seeks to “Improve patient flow and standardize record keeping, in order to improve continuity of care and reduce decertified days [emphasis added].  The continuum of care should include acute care (SFGH), skilled nursing (LHH), residential care, intermediate care, and community-based care.”  Strategy “a” DPH plans to employ to achieve Objective 11 states that DPH will “Ensure patients are transferred to the appropriate level of care within the continuum of services provided by or contracted by the Department.”  Strategy “b” DPH plans to employ will “Define the role of discharge planning and develop alternative placement options for LHH, SFGH, our community partners and inmates being released from the criminal justice system. ”
  
  
  This new objective, and these two new strategies, have all along been about reducing “administrative days” or “decertified days” at SFGH — which are synonymous terms seeking to address the un-reimbursed psychiatric costs currently borne by the City’s General Fund when a patient’s Medi-Cal or Medicare reimbursement for psychiatric hospitalization runs out — by transferring behaviorally disturbed patients from SFGH to Laguna Honda Hospital at a lower cost to the City, whether or not the patient will receive better care at LHH, and whether or not LHH is staffed to provide both patient and staff safety.
  
  
• Goal 3 of the Strategic Plan involves ensuring that “Services, programs, and facilities are cost effective, and resources are maximized.” Objective 3 of Goal 3 is also a new or changed objective, and notably, Objective 3 has a new strategy “d,” which states that DPH (and therefore, the City) will “Complete the Laguna Honda Hospital rebuild on schedule and on budget.”  
  
  What this means is that DPH has no intention of completing the rebuild of LHH at the full “scope” of 1,200 beds!
  

The complete 28-page new DPH strategic Plan is available on DPH’s web site at www.dph.sf.ca.us/stratplan/default.htm.

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Copyright (c) 2004 by Committee to Save LHH.  All rights reserved.  This work may not be reposted anywhere on the Web, or reprinted in any print media, without express written permission.  E-mail the Committee to Save LHH.