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The "Compact" With San Francisco Voters

The City of San Francisco, as late as January 2005, continues to deny that it has a “compact” with voters who passed Proposition A in 1999. Health Commissioner Jim Illig continued asserting on behalf of The City during the January 27 LHH Joint Conference Committee that the actual language of Proposition A did not promise that LHH would be used would be used for frail elderly and disabled San Franciscans, and that the acutal language of Prop A had said nothing about building 1,200 beds for the replacement facility.  Illig fails to acknowledge that a compact exists between the City and the electorate, just as does former City Attorney Louise Renne, who — during a December meeting between Mayor Newsom and Sister Miriam Walsh — said not one word about the “compact” with voters. 

Nor did Renne refute that a compact existed on December 17 when meeting participant Patrick Monette-Shaw raised the issue of the compact to Mayor Newsom.

However, as noted in Monette-Shaw’s citizen-taxpayer lawsuit seeking to recover $25 million misappropriated from the LHH rebuild project:

“34. Proposition A was passed by a 73% affirmative vote because the respondents and City officials made massive and divers representations to the voters that the tobacco settlement revenues, together with the bond proceeds, would be used to construct a new LHH which would provide long-term care to at least 1,200 elderly and disabled San Franciscans [emphasis added].

 

35. Therein and thereby, by obtaining the passage of Proposition A by these divers representations, a compact and public trust became entered into and impressed upon the City and its officers, (herein, the "Proposition A Compact"), in which the City and the respondents have a duty to expend the tobacco settlement revenues, in addition to the bond proceeds, to construct a new LHH with space to care for 1,200 SNF patients from the community [emphasis added].”

Paid Ballot Aruments Supporting LHH Rebuild

Throughout the paid arguments in favor of the rebuild contained in the 1999 Voter Guide, San Franciscans were told repeatedly that LHH would be rebuilt for frail “elderly” (24 such mentions), would be used for people with “disabilities” or the “disabled” (12 mentions), would continue the “medical” model focus (14 mentions), would be used for “long-term care” (13 mentions), would be used for “seniors” (7 mentions), would be rebuilt with “1,200 beds” (4 mentions), would provide “skilled nursing” (9 mentions), and would continue to be used as a “nursing home” (2 mentions). These various assertions, along with the actual language of Prop A (below) created a “compact” with the voters, who were led to believe that the assertions being made in the voter guide were part and parcel of what was being voted on. It was these assertions, among others, that convinced voters to overwhelming approve the bond measure known as Prop A by 73% of the electorate.

And it wasn’t just anybody paying for those assertions, it was prominent San Francicans the voters were trusting. Former Mayors Willie Brown and Senator Diane Feinstein both asserted LHH would be rebuilt for “long-term care”; so did Congresswoman Nancy Pelosi, the San Francisco Board of Supervisors, and the Health Commission, including current- and then-Health Commissioners Dr. Edward Chow, Roma Guy, and Lee Ann Monfredini. Feinstein, who had two separate ballot arguments, also asserted LHH would be used as a nursing home, and as a medical facility. Joining Feinstein, the then Board of Supervisors, along with former Directors of Public Health Sandra Hernandez and Mervyn Silverman, also asserted LHH would continue to be a “medical facility,” as did SEIU 790 members Richard Rothman and Laura Blue, an RN at LHH who is currently Chapter President of the LHH Chapter of SEIU 790-Nurses.

The arguments LHH would be used for “skilled nursing” included both the Health Commission, and Melissa Welch, the Chief Medical Officer for the Health Community Network who also served at one point as LHH's Acting Medical Director. Those arguing that LHH would be used for the “elderly” included the Health Commission; Dr. Katz, as the then and current Director of Public Health; Louise Renne, Esq., former City Attorney and now President of the new non-profit LHH Foundation; Robert Haaland, an organizer for SEIU 790 and a recent candidate for the Board of Supervisors; Ms. Blue; and the Golden Gate Restaurant Association, a key backer of Mayor Gavin Newsom.

Finally, those arguing LHH would be used for people with “disabilities” — in the classic sense of physical disabilities, not drug addiction, homelessness, or social adaptation problems — included, among others, the full Health Commission, Rothman, Haaland, and Blue. Implicit, or implied, promises to rebuild LHH with 1,200 beds were made by the full Board of Supervisors, Pelosi, and Sal Rosselli, Executive Director of SEIU 250.

Fast forward to December 2004. Now we are told that LHH’s mission, which voters were lured into believing in 1999 included providing long-term care for frail, elderly, seniors and those with “traditional” disabilities using a medical model approach has suddenly had its mission changed by a small tribe led by Health Commissioner Jim Illig, who has been asserting for now a full year that Laguna Honda’s Hospital mission would indeed change.

Despite LHH’s new Executive Administrator, John Kanaley’s spin-driven assertion to homeowners and neighbors of LHH at the December 16, 2004 Town Hall meeting that no such plot was afoot, the change in LHH’s mission has come to pass, barely a week after Kanaley’s bald-faced assertion nothing of the sort was being planned.

After Kanaley announced at the LHH Joint Conference Committe on December 23 LHH’s mission statement change — contradicting his December 16 statements to homeowner neighbors surrounding LHH's property — and that a planned retreat of LHH’s Executive Committee in January will further consider changing LHH’s mission due to matching the hospital’s budget to its mission, Commissioner Illig asked if everyone was “happy” with the mission change. The Executive Committee nodded its unanimous consent: Everyone is happy they’ve now succumbed to Health Commissioner Monfredini’s “get on board this train, we’re leaving the station” metaphor she announced at the October LHH-JCC meeting Fait accompli!

More despicably, and more ominously, during the December 23 LHH-JCC meeting, there was an announcement three LHH bodies - the Medical Staff, the Medical Executive Committee, and the hospitalwide Executive Committee - have now approved yet another change to LHH's admissions policy, against the Compact with voters, who in 1999 had been promised LHH would be used as a long-term care facility.

1999 Proposition “A” Language

The vague language used in Proposition A in 1999 was approved by, and most likely was in part written by, the City Attorney’s office.  The City Attorney, at that time, was Louise Renne, who is now the President of the newly-formed non-profit organization known as the Laguna Honda Hospital Foundation.  She is the same person who threatened to sue to The City to recover the $25 million misappropriated from the tobacco settlement fund earmarked for the rebuild of LHH .

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