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Laguna Honda’s Predictable Crisis

September 13 was the day on which all the patients at Laguna Honda were supposed to have been evacuated and the hospital’s federal funding cut off. So it was decreed back in April by the Centers for Medicare and Medicaid Services (CMS), whose inspectors had been shocked by the hospital’s inability to control their resident drug addicts and deranged people –a significant subset of the patient population. The task of finding other accommodations for 700 mostly frail, disabled people was almost mathematically impossible --there aren’t enough skilled nursing facilities in the region. By the end of July some 60 people had been moved and four were known to have died as a result. 

As recounted by Sylvia Sturm on the Public Press website: “‘This shutdown was predictable,’ former Laguna Honda physician Dr. Teresa Palmer said at a San Francisco Board of Supervisors hearing on June 14. ‘Normally, a nursing home is filled with primarily women over 85. And now you have a nursing home, with predominantly men from 40 to 60. The city needs to provide funding and a place for people with substance use problems and conduct disorders.”

How did it happen that the nature of the Laguna Honda patient population changed so drastically? 

As of 2002 Mayor Willie Brown, the Chronicle, and the Chamber of Commerce had been trying to blame “the homeless problem” on District Attorney Hallinan’s supposed leniency. In 2003 Gavin Newsom ran for mayor pledging to end the crisis by providing “Care Not Cash” (a Clintonesque slogan from a Clintonesque politician). When Newsom took office, to achieve visible results, and with the forceful help of Mitch Katz, director of the Department of Public Health, a scheme called the “Flow Program” was devised to transfer incorrigible addicts and people with “behavior problem” from San Francisco General Hospital to Laguna Honda. Administrators at Laguna Honda protested that the move would undermine their ability to carry out their primary mission –caring for patients who were severely disabled and/or elderly and incapacitated. Katz, like a two-bit Stalin, replaced them with Administrators from SFGH.

By February 2005 it was obvious that the “Flow” program had destroyed the equanimity that once prevailed at Laguna Honda, so Newsom cancelled it – but in name only. The power to decide which patients are in fact manageable at Laguna Honda still resided with the San Francisco Department of Public Health (DPH), which owns and oversees Laguna Honda. Laguna Honda’s population had historically been 54% female. Today it is 63% male. 

San Francisco politicians pleaded with the Democratic Administration in Washington to cancel the evacuation order and give the hospital more time to solve its problems. In July City Attorney David Chiu filed a suit to stay the feds’ hand. Mayor London Breed declared, ”We are working hard to address issues that have been raised at Laguna Honda, and that important work will continue. But closing this facility and forcing residents and families to go through the trauma of transfers should not be part of that process. This facility provides care and support for some of the most vulnerable people in our City, and that support must continue to keep them healthy and safe.”

San Francisco’s DPH, which is run by Dr. Grant Colfax (formerly of Boonville), has spent $5.6 million on consultants who specialize in helping hospitals pass CMS inspections. The consultants completed a mock inspection last month and the hospital did not pass. A second mock inspection is being conducted. If and when the hospital gets the consultants’ thumbs up, re-certification will be requested. 

Why are the Democrat politicians in Washington not cutting their SF cronies some slack in this situation? The only guess I heard ventured was, “Laguna Honda sits on 62 acres west of Twin Peaks that could mean millions for whoever gets to develop it.”

London Breed’s First Plum Job

SF Chronicle sportswriter John Shea covered the groundbreaking Sept. 6 of a “facility” owned by the San Francisco Glens Soccer Club and comprised of a stadium with 1500 seats (plus locker rooms, concession stands and lights) and three practice fields. Shea described the scene as “windswept” and quoted Mayor London Breed saying, “You know what? The wind is just a part of San Francisco. We know it. This is what you practice in, so get used to it.”

The humility this woman exuded when she first took office is long gone. Politically she is a Democratic Party hack, in perfect sync with her predecessors Ed Lee, Gavin Newsom and Willie Brown. I was surprised to see her name when I was looking through some old files to write my disjointed memoir about working for Terence Hallinan. He had made me his “liaison to the medical marijuana community” and I advised that the city should grow its own to provide medical users with an inexpensive, organically grown supply. He was not adverse to the idea. One option we discussed as a site for the grow was Hunters’ Point Naval Shipyard, which had been decommissioned along with Treasure Island and the Presidio.

 Kayo was of the opinion that there had been a divvying up of the spoils, with Nancy Pelosi getting to decide the fate of the Presidio and Willie Brown making the big decisions on Hunters Point. “The Supervisors have some sway on Treasure Island” he said. He wanted T.I. to be the site of housing for those people living on the streets of the city or in vehicles who could fend for themselves, and a mental health hospital for the homeless who could not. I thought his idea was great but the real estate would prove too valuable. Kayo said, “You have no idea how miserable Treasure Island gets when the wind comes whipping off the bay —which is half the time.” He had me draft a press release emphasizing the suitability of T.I. for housing and treatment of San Francisco’s homeless population.

The city’s Treasure Island Development Authority was executive-directed by Annemarie Conroy, a rightwing former Supervisor. London Breed was employed by the TIDA as a “development specialist.” Matier & Ross reported: “Annemarie Conroy Willie Brown’s commodore of Treasure Island has two words for District Attorney Terence Hallinan’s much publicized ideas of setting up drug rehab centers out on the island. ‘No dice.’ And those are the nice words…

“‘Here we are, getting ready to hold a pre-bid conference for people interested in developing the island, and he comes out with idea of dumping drug rehab programs our here,’ Conroy fumed. ‘It’s a public relations nightmare.”

“Hallinan isn’t showing any signs of backing down. ‘Annemarie should keep in mind that Treasure Island belongs to the people of San Francisco not the developers,’ Hallinan said. ‘It’s use will be decided by the Board of Supervisors not by Conroy or her staff…”

“It turns out that Hallinan’s office leases space out on the island for a check-bouncing program. ‘Those leases are up this week,’ Conroy told us ‘and I’m sending him a termination notice right now. As far as I’m concerned he’s been voted off the island.”

Terence is looking better and better in the rear-view mirror.

“It turns out that Hallinan’s office leases space out on the island for a check-bouncing program. ‘Those leases are up this week,’ Conroy told us ‘and I’m sending him a termination notice right now. As far as I’m concerned he’s been voted off the island.”

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