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West of Twin Peaks Observer
February 2008

Downsizing Laguna Honda: Who Gets the Boot?
by Patrick Monette-Shaw

"Where Will They Go?  What Will They Do?"
"No on Proposition D" Campaign Flyer Mailed to Voters in Spring 2006

Click photo to enlarge

The mailer falsely claimed
300 patients would be
"evicted" from Laguna
Honda if Prop D passed.
Nothing was farther
from the truth.

Where is the No on D Committee and its outrage now that
112 residents
in LHH’s Clarendon Hall are
suddenly being
transferred during a
budget-cutting measure?

The No on D Committee,
backed by Mayor Gavin Newsom,
are, ironically, nowhere
to be found, and aren't asking where Laguna Honda
residents will go, and
what they will do.

In last November's Observer, John Farrell, San Franciscans for Laguna Honda chair, noted that radically reducing the number of skilled nursing beds at Laguna Honda Hospital (LHH) would place our elderly and physically disabled in danger of not receiving proper care. His prediction is dangerously close to rapid implementation.

In the November 1999 election, 139,210 San Franciscans — 73.3 percent of 190,019 casting ballots — approved bond financing to rebuild 1,200 beds at LHH for the elderly and disabled. LHH supplies one-third of San Francisco's skilled nursing beds.

Voters know LHH's residents are among the most vulnerable San Franciscans, in part because they're dependent on nursing home caregivers for their day-to-day safety and well-being, and because 95 percent rely on Medi-Cal for their care; fewer San Francisco nursing homes are accepting Medi-Cal patients. Since 2002, LHH has admitted 3,199 patients, including at least 611 who have had strokes, traumatic brain injuries, spinal cord injuries, or orthopedic disorders, like hip fractures, and scores of others with Alzheimer's, Parkinson's, and Multiple Scerlosis.

In 2006, the "No on D" Committee backed by Newsom administration allies raised nearly $300,000 to defeat Proposition D, hiring the same political consultants — Barnes Mosher Whitehurst Lauter and Partners — that Mayor Newsom and SEIU use. BMWH, reportedly paid $173,000, developed the campaign mailer riddled with disinformation shown above, falsely asserting 300 Alzheimer's patients would be evicted if Prop. D passed.

Now, just six Plaintiffs in the Chambers vs. City and County of San Francisco lawsuit are about to overturn the will of 139,000 voters if San Francisco accepts the settlement agreement. There's been a virtual media blackout regarding this lawsuit, and there's been no public forums sponsored by the City or LHH since the case was filed on October 12, 2006 by six LHH residents and their lead organizational plaintiff, Independent Living Resource Center of San Francisco in collaboration with Protection and Advocacy, Inc. (PAI).

Among other provisions, the Chambers settlement proposes that upon completion of the reconstruction project, the City agrees to restrict LHH to 780 beds — eliminating 420 planned beds — and LHH will focus on 90-day short-stay and rehabilitation patients. The Chambers settlement doesn't specify LHH can continue its long-term care mission. Where will vulnerable elderly San Franciscans needing long-term care go? Out of county?

The Health Commission voted in closed session January 22 to accept the Chambers settlement, knowing San Francisco faces a potential shortage of 4,000 skilled nursing beds in the next 12 years and 10,000 Alzheimer's patients over the age of 85 by the year 2020. Apparently alarmed by public testimony linking future bond measures to failure to rebuild LHH as promised, Health Commissioner's took an unusual step, disclosing a Deputy City Attorney advised them during closed session that some language in the Chambers settlement doesn't really mean what it says it plain English. But the rationale offered to reassure community members is Orwellian, using unbelievable, twisted logic even PAI disputes.

The Chambers settlement proposes San Francisco will create 500 rental subsidies — 100 annually over five years — to discharge residents slowly. Health Commissioner's reportedly proposed during closed session to rapidly fast-track LHH's downsizing to 780 beds, displacing 240 residents two years prematurely, in the absence of a Board of Supervisors policy decision to do so. This will occur partly through attrition (deaths and transfers), through aggressive discharge planning, and by curtailing general skilled nursing admissions for long-term care. LHH is expected to submit a fiscal year 08–09 budget revision based on a 780-resident census, and concomitant reduction in staffing, involving layoffs.

Why aren't Newsom's allies now asking "Where will our vulnerable elderly go, and what will they do, without Laguna Honda?" Will the City of St. Francis strip thousands of San Franciscans of their right to choose long-term care at LHH?

Since 240 residents face rapid discharge, out-of-county placement, and unknown levels of care, get involved and take action: Call or write to the Health Commission, Board of Supervisors, and Mayor Newsom urging them to reject the Chambers settlement.

Patrick Monette-Shaw
is a Skilled Nursing and Healthcare Accountability Advocate

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