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Were S.F. Tax-Payers 'Sold A Bill Of Goods?';
Laguna Honda Accepts Younger, Violent Patients

By Dave Reynolds, Inclusion Daily Express
June 8, 2004

SAN FRANCISCO, CALIFORNIA--Health officials, medical professionals and staff members at Laguna Honda Hospital are growing increasingly concerned over the City of San Francisco's decision to send younger and potentially dangerous patients to the city's only publicly-owned nursing facility.

There has been a trend in recent years of sending patients with long-term medical needs from San Francisco General Hospital to Laguna Honda. The trend sped up recently when Mitch Katz, the city's Department of Public Health Director, asked Laguna Honda to give those patients priority for admissions over seniors from the community.

"Everyone is entitled to skilled nursing care,'' Katz explained. "And Laguna Honda was set up as a skilled care center."

But many of the patients are under age 60 and have mental illnesses or chemical addictions. A few are violent. Some are repeat offenders.

Benson Nadell, director of the San Francisco's Long Term Health Care Ombudsman Program, wrote in a May 17 report that the new admissions plan "puts the regular resident at risk."

The San Francisco Chronicle on Monday recounted an incident in which an older resident was assaulted by two young gang members affiliated with a 25-year-old Laguna Honda resident. The younger resident was later found to be in possession of two bags of marijuana.

"We can handle pretty disturbed people, but not if they hurt or upset or take advantage of people around them," one staff member, Dr. Teresa Palmer, told the Chronicle. "Or if they take up so much staff time that the staff doesn't have time for other patients.''

Staffers who complain or question the admissions plan are warned that refusing these patients could mean cuts in funding and jobs.

The decision to give younger patients priority at Laguna Honda could also affect the citizens of San Francisco in a broader sense.

Five years ago, voters approved a $299 million bond issue to rebuild Laguna Honda, primarily to house seniors.

"When supporters -- including Katz -- encouraged voters to enact the measure, they continually emphasized the need for senior care and said a renovated Laguna Honda would help provide it," read an editorial in the San Francisco Examiner. "To change the emphasis -- or even to dilute it -- at this point would mean that voters were sold a bill of goods five years ago."

In July 2000, a group of Laguna Honda residents sued San Francisco and several state agencies, claiming the agencies violated the federal Americans with Disabilities Act, the Nursing Home Reform Act, and Section 504 of the Rehabilitation Act of 1973, by not providing community-based services for those who want to live in their own homes. The lawsuit cited the 1999 U.S. Supreme Court's Olmstead decision, which ruled that unnecessarily institutionalizing people with disabilities is a form of discrimination.

In October 2001, approximately 600 disability rights activists from ADAPT and other groups from around the nation gathered in San Francisco to protest the plans to rebuild the aging facility.

Last May, the U.S. Department of Justice said that the city and county of San Francisco are violating the rights of people housed at Laguna Honda by not providing them with the choice to live in the community.

The 135-year-old Laguna Honda Hospital is the oldest nursing facility in California. With 1,200 beds, it is the largest publicly-owned nursing home in the United States.

"More violent patients are going to Laguna Honda" (San Francisco Chronicle)
"Laguna Honda is for seniors" (San Francisco Examiner)
"Laguna Honda Hospital -- Largest Nursing Home In US" (Inclusion Daily Express)


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