Flawed Report Recommends Replacing Laguna Honda
and a Critical Analysis "Rebuttal"
The Ja Report ...
The Davis Ja and Associates report recommends replacing Laguna Honda Hosptials physicians with registered nurses, social workers, and psychologists. This may lead to adverse health outcomes for LHHs vulnerable patients, who are all admittted for medical reasons.
The Ja report was contracted for by the Department of Public
Healths Community Behavioral Health Services (CBHS) section,
as part of the Chambers settlement agreement that required
assessment of behavioral health services at Laguna Honda Hospital,
patient flow within DPH, and linkages to behavioral health services
following discharge to the community. The Ja report contains
a number of flawed assumptions and startling admissions, but it
failed to assess the availability of community linkages to behavioral
health services (or to primary medical care services) following
discharge, which had been part of the scope of work to be performed
under the contract.
That Ja was awarded this contract may involve an actual, or perceived, conflict of interest from not adequately acknowledging his personal relationships with staff employed by the Citys CBHS department that commissioned the Ja study.
The personal and financial relationship between Ja and the Director of Research, Evaluation and Quality Management for CBHS (who is a direct subordinate of CBHS Director now appointed to a committee to determine the role of LHH in providing behavioral health services) were not disclosed in the Ja report. This relationship may have potentially influenced: 1) The development of the content and context of the contract eventually developed; 2) The award of the contract to Davis Y. Ja & Associates; and 3) The findings of the Ja final report, which appears to have been edited by CBHS prior to being finalized, given the gushing acknolwedgement that the CBHS director helped develop the final report. Despite Jas Disclaimer section indicating the opinions expressed in his final report reflect the opinions of the authors and are not intended to represent the views, positions, or polices of CBHS, Appendix 1, Acknowledgements indicates Bob Cabaj, Director of CBHS, was particularly helpful in developing and facilitating completion of the Ja final report.
When the former Mental Health Rehabilitation Center (MHRF) was set to open and suddenly changed its mission from serving psychiatric patients to other mixed uses, a Blue Ribbon Committee was formed with various community partners to determine how the MHRF would be used. When California Pacific Medical Center proposed shutting down St. Lukes hospital, another Blue Ribbon Committee was formed with community partners to determine how to service St. Lukes patient population. So why is the future of Laguna Hondas services being turned over to an in-house committee of Department of Public Health staff, rather than to a Blue Ribbon Committee? Why shouldnt there be a Blue Ribbon Committee on Laguna Honda Hospital evaluating the Ja Reports recommendations before LHH is turned into a mixed-use facility?
... and A Critical Analysis of the Ja Report
A Critical Analysis of the Ja Report has been written by two medical doctors, who each have 20 years of direct patient care experience at Laguna Honda, and who have cared for many hundreds of patients with behavioral health needs. The opinions expressed in the Critical Analysis are theirs alone and are not intended to reflect those of LHH, or of its Medical Staff. Their analysis was written in response to widespread concerns among LHHs Medical Staff about the Ja reports recommendation to subtract primary medical services at LHH in order to increase behavioral health services. They note that the Ja reports recommendation to reduce medical services for LHH residents is unacceptable, is potentially harmful, may likely increase barriers to safe community discharges, and may increase adverse outcomes after discharge.
Twenty LHH physicians signed a resolution rejecting the Ja reports recommendation to reduce physician staffing, due to Jas bias, inadequate data, flawed methodology, and lack of professional qualifications to assess physician services at LHH.
Copyright (c) 2009 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.