Admissions Issues and Downsizing
of Laguna Honda Hospital
Raised in National Magazine

The many inter-related issues facing Laguna Honda Hospital has drawn the interest of prominent author, essaysist, and columnist, Patricia Nell Warren.

In the January issue of Art and Understanding (A&U) magazine, a national publication addressing HIV/AIDS issues, Ms. Warren observes in Closing the Door that doorways — whether at Laguna Honda Hospital, or to AIDS service providers in San Francisco and elsewhere, domestically — are swinging shut, curtailing the provision of healthcare to Americans most in need.  

Warren’s current essay notes that the downsizing of LHH and its changing patient population, and the curtailment of eligibility at so-called “integrated service programs” (ISP’s) serving people with HIV/AIDS in San Francisco — using federal funding appropriated through the Ryan White CARE Act that are further allocated by San Francisco’s HIV Health Services Planning Council (a.k.a., the SF CARE Council) — are limiting healthcare options for our frailest citizens.

Interestingly — and most likely not accidentally — both the CARE Council’s ISP construct and Lagunda Honda’s new CEO are now calling for referring to these disparate facilities as “Centers of Excellence.” [John Kanaley, LHH’s new Executive Administrator, refers to LHH as becoming a “Center of Excellence” in his January 27, 2004 report to the LHH-Joint Conference Committee.]  What is really meant by Centers of Excellence is not yet widely understood, but it may portend budget-saving measures designed to reduce services to people in dire need of healthcare safety nets.

Closing the Door is re-posted on this web site with the permission of Patricia Nell Warren.  A&U Magazine kindly provided a PDF file containing the press-proof, including the accompanying artwork that appeared in its January edition.  Closing the Door can also be read on-line at  Readers may want to view other content on A&U’s web site at

Readers may also want to explore a collection of Ms. Warren’s essays posted on the Partners link on her web site, Wildcat Press International at



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