San Francisco has a severe shortage of nursing home beds that accept Medi-Cal, yet the City is planning to reduce the number of nursing home beds when Laguna Honda Hospital is rebuilt. Read the SF Gray Panther position on Laguna Honda Hospital.
San Francisco BayView, Wednesday May 2, 2007
African American displacement looms at Laguna Honda Hospital
by Patrick Monette-Shaw
Town hall meeting on Laguna Honda Hospital
Thursday, May 10, 7 PM
Forest Hills Church, Laguna Honda Blvd & Clarendon, SF
Laguna Honda Hospital (LHH) has provided nursing care to San Francisco’s African American community for decades. Drastic changes are underway. On May 10, a community-organized town hall meeting is scheduled to discuss which patient populations will be the new residents of the replacement hospital under construction.
Voters passed Prop A in 1999 to authorize re-building 1,200 skilled nursing, and 140 assisted living, beds for the elderly and people with disabilities, not to build housing for the homeless or people with primarily psychiatric diagnoses.
Although San Francisco’s Black population plummeted from 13.4 percent in 1970 to just 6.5 percent in 2005, African Americans account for 25 percent of the patients at LHH. A report provided to Supervisor Sean Elsbernd shows with a “snapshot” on March 31 in each of the last three years that 25 percent of LHH’s residents are Black. However, the April 19 report shows that between Jan. 1 and March 31 of this year, that figure jumped to 32 percent. Nearly 95 percent of LHH’s residents rely on Medi-Cal for payment.
While the Department of Public Health’s director of placement has told a Health Commission subcommittee she’ll study why LHH has a disproportionate mix of Black patients relative to City demographics, answers are painfully clear.
LHH has been a central part of San Francisco’s African American family, in part because many elderly and disabled Black residents have few options, given access-to-healthcare disparities. LHH is one of few nursing facilities accepting Medi-Cal patients and also the only facility accepting patients with diabetes or morbid obesity, known as bariatric patients. Other facilities won’t accept Medi-Cal or bariatric patients needing long-term care.
This is due, in part, to the City’s failure to build alternative facilities and in part to the loss of healthcare beds throughout the City. Between 1992 and 2005, 300 Medi-Cal beds were lost due to nursing home closures. Currently, another 120 nursing beds are closing.
Between 1987 and 2005, the City also lost 951 board-and-care beds, some operated by African American families forced to relocate outside of San Francisco due to the City’s economic policies. It’s unknown how many additional skilled nursing and board-and-care beds were lost since 2005. These closures increase the need for LHH’s full rebuild.
Although over 1,700 “assisted living” beds were built since 1992, average monthly fees are $4,000 for “rent” alone, with additional fees for healthcare services. It’s unreasonable to believe Medi-Cal clients can afford these fees.
Seniors and people with disabilities needing skilled nursing at LHH are being displaced to out-of-county facilities to create transitional beds for the homeless at LHH. Mayor Newsom’s administration has authorized only 780 of LHH’s planned 1,200-beds for construction. A decision to authorize re-building the additional 420 beds has been stalled for two years.
Neither Supervisor Sophie Maxwell, representing Bayview Hunters Point, nor Supervisor Ross Mirkarimi, representing the Fillmore, have held City Hall hearings to ensure LHH’s full rebuild for their Black constituents. Without LHH’s full rebuild, loss of access may drive more Black San Franciscans out of the City.
If one-third of LHH’s beds are eliminated, many of the hospital’s Black residents will be displaced. Of the 780 approved skilled nursing beds, 210 have been allocated for core populations, leaving 570 beds for LHH’s current dementia, chronic care/ high support (“total care”), and complex medical/ co-morbidity patients, among others. Over 900 residents can’t be squeezed into only 570 beds.
Additional “assisted living” beds for elderly and disabled people needing assistance with activities of daily living planned for LHH may be changed to “supportive housing,” a national model providing permanent housing with social services for homeless people over 18 years old.
Edna James, OMI Community Action Organization’s president, recently presented an update on the African American Community Partnership to the Mayor’s Long-Term Care Coordinating Council regarding disparities in access to healthcare and experiences of elderly and disabled African Americans. I asked her to investigate the impact of the loss of LHH’s beds on San Francisco’s Black community.
Our town hall meeting on Thursday, May 10, is scheduled for 7 p.m. at the Forest Hills Christian Church located at 250 Laguna Honda Boulevard, at Clarendon Avenue; parking is available. Speakers from LHH, local politicians and San Francisco neighbors will discuss concerns regarding who will be the new residents served at LHH.
Patrick Monette-Shaw is a patient and healthcare accountability advocate. He can be reached at firstname.lastname@example.org