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San Francisco Urged To Scrap Giant Nursing Home
By Dave Reynolds, Inclusion Daily Express
July 21, 2005

SAN FRANCISCO, CALIFORNIA--The San Francisco Controller's Office recommended Thursday that the city reconsider its plan to rebuild a 1,200 bed skilled nursing facility to replace the aging Laguna Honda Hospital, and to choose other, smaller options, including in-home and community-based services.

In his 106-page report to Mayor Gavin Newsom, the Board of Supervisors, and San Francisco Health Commission, Controller Ed Harrington said that the city can better meet the needs of its citizens -- while saving millions of dollars -- by scrapping plans to rebuild the huge facility and instead provide "a mix of long term, skilled nursing, in-home and community-based services."

Harrington wrote that, with a population of about 775,000, San Francisco institutionalizes approximately one out of every 700 residents in Laguna Honda.

"The City has effectively institutionalized more of its population, across a wider spectrum of needs, than anywhere in the country. By DPH's (Department of Public Health's) own assessments, a significant fraction of the Laguna Honda population does not need hospital-based long term care and could be effectively treated in another setting -- at home or in the community."

The report noted that the U.S. Department of Justice has ordered San Francisco to change how it provides long-term care or risk losing federal Medicaid money. The Department found last year that the state is violating the ADA by failing to comply with the U.S. Supreme Court's 1999 Olmstead ruling. That decision found that it is illegal to unnecessarily place and keep people with disabilities in nursing homes and other institutions.

Among other things, Harrington recommended that the city build three smaller nursing homes, with less than 200 beds in each, on the current Laguna Honda site.

"With the changes outlined in this report, we estimate that the City could, at minimum, avoid a $3 to $5 million expense to build skilled nursing beds at General Hospital, and, at an absolute minimum, reallocate $14 million annually by getting patients out of hospitals and into the right level of either skilled nursing or community based care."

Mayor Newsome refused to take a position on the report when asked by the San Francisco Examiner.

The oldest nursing facility in California, Laguna Honda was built in 1867 as San Francisco's Alms House. At 1,200 beds, it is the largest publicly-owned nursing home in the country.

In 1999, San Francisco voters approved a bond to help pay for a new $401 million facility to replace Laguna Honda.

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

Report by Health Management Associates (Office of the Controller)
"Report calls for dividing new hospital into three" (San Francisco Examiner)
"Laguna Honda Hospital -- Largest Nursing Home In US" (Inclusion Daily Express Archives)


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