Laguna Honda still not out of the woods: report

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San Francisco leaders spent most of Tuesday’s meeting trying to understand the more complex aspects of bringing Laguna Honda Hospital back to normal ahead of the impending deadline. They also called for more action to find shelter beds, gun safety and set a date for a hearing on a proposed controversial reparations plan.

Critical moment for Laguna Honda

Supervisory authorities listened to representatives for more than two hours Department of Public Health and concerned members of the public during often emotional status hearings Hospital Laguna Honda and his path to re-certification Centers for Medicare and Medicaid Services (KMS).

One big concern for watchers was the approaching February 2 deadline for CMS to decide whether it would extend the moratorium on involuntary patient transfers, with the agency not saying how it would make a decision.

District 5 Member Dean Preston compared the lack of communication on the part of CMS to “a sadistic and abusive landlord”, describing it as a sign of bad faith on the part of the agency.

Warden 8 Rafael Mandelman agreed: “It’s shocking to me that with twelve people dead, we don’t know in four days that we’re not going back to that place,” referring to the Laguna Honda patients who were forced to transfer to the hospital. other sites, mostly outside of San Francisco, after the site’s certification ceased last April.

Adding to the injury, the hearing revealed that the State Department of Public Health cited Laguna Honda in connection with the transfer-related death and imposed a $36,000 fine. city ​​attorney David Chiu appeal the fines.

Warden 7 Myrna Melgarwhich convened the hearing, noted that CMS’s lack of communication and inflexibility in allowing more vulnerable patients to delay transfer meant that it was possible that patients could be involuntarily transferred again, with many of them potentially harmed significantly because of what she called “transfer injury”.

Meanwhile, the director of health Grant Colfax and interim director of Laguna Honda Roland Pickens expressed confidence that CMS would not only extend the moratorium on transfers, but that there was a clearer – albeit longer – path to re-certification for Laguna Honda.

Under an agreement approved by the City last November, CMS will continue to fund care for current patients at the facility until next November while the hospital implements an action plan to address gaps in care.

Pickens told executives he expects the action plan to be fully implemented by the May 13 deadline.

In the meantime, the hospital’s quality improvement expert will produce monthly reports, and CMS is expected to conduct another monitoring study before that time. Pickens told executives the schedule should give a “good indication” that the Laguna Honda will be ready for recertification.

This process will require some significant changes to how the hospital currently operates.

Laguna Honda is unique in that it has functioned as a skilled nursing facility as originally intended, and increasingly as an emergency facility, with the result that many of its policies and practices have “become inconsistent with highly efficient skilled nursing homes.”

Part of the dual mission of the hospital was the result of a gradual increase over time in the number of patients with behavioral disorders admitted to the facility. Answers the questions of the head of the 4th district. Joel EngardioPickens noted that 1 in 8 patients falls into this category but is integrated into the general patient population.

“It looks like we have a mixture of patients who have poor mixing,” Engardio said.

member of District 11 Ahsha Safai also explored the issue in their survey of Pickens, who described it as “an annoying and complex issue” and noted that they would have to explore alternatives such as “bunching” mental health patients together or, in the long term, creating a separate facility for them.

The Board voted to continue hearing until May 9, when they will hear another progress report.

More mental health issues and homelessness

In addition to the Laguna Honda hearing, Mandelman raised additional questions about the direction and capabilities of the city’s mental health service, particularly for the homeless. During the vote to renew the mental health services agreement with Progress Foundationhe expressed disappointment that the increase was not large.

“We have been talking for four and a half years about the great need for additional beds for people with severe mental illness … if we were effective in our sincerity in this matter, this contract would be larger, or there would be other contracts. for this work, and it didn’t happen,” Mandelman said ahead of the unanimous vote.

Mandelman went further on the matter during the roll call when he demanded that a Committee of the Whole hold a hearing on the Department of Homeless Affairs and Supportive Housing (HSH) “A Place for All” report on the implementation of the on-demand shelter order issued by superiors. June.

“This is far from a realistic or workable plan to end unprotected homelessness in San Francisco,” the executive said, noting that HSH recommendations favor more permanent supportive housing over shelter beds.

“They seem to be hoping to show us that ending homeless homelessness is impossible, so we shouldn’t try, and we certainly can’t hold them accountable for the fact that our sidewalks continue to serve as a waiting room for permanent, comfortable housing.”

More gun safety steps

The oversight bodies adopted the decisions introduced by the District 2 Supervisor. Katherine Stephanie urging Congress to pass a new assault weapons ban and recognizing National Week of Survivors of Gun Violence, in response to the recent surge in mass shootings. Then, during roll call, Stephanie submitted a letter to city law enforcement inquiring about their firearms procurement practices.

The latest step was taken in response to a recent report Brady Center this showed that at least 67 police agencies purchased firearms and equipment from LC Action Police supplya San Jose arms dealer with a long history of violations of federal firearms laws, including selling guns to possible front buyers and failing to verify that buyers are prohibited from owning guns.

Damage Plan Hearing Next Week

Before adjourning for the evening, the board also voted unanimously to consider a controversial draft black reparation plan drafted by a city council committee. Human Rights Commission. More about this story here.

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