LAGUNA HONDA: Health Commission Gives Boost to Bond Measure

      The San Francisco Health Commission voted unanimously yesterday to support the $437 million Laguna Honda Hospital bond issue. The "expected boost" that comes just days after the San Francisco Board of Supervisors scuttled an effort to lay the groundwork for rebuilding the facility before sending the issue to the voters, the San Francisco Chronicle reports. The final decision to include the measure on the November ballot is now up to the supervisors, "and even the hospital's biggest supporters know that is no sure thing." Commission President Lee Ann Monfredini predicted an uphill battle, saying, "We have to realize that this will require a commitment from each and every (committee member) to rally behind this if it goes to the supervisors." City Health Director Dr. Mitch Katz, who has expressed concern about securing two-thirds voter approval on the issue, spoke yesterday at the commission meeting and identified the "huge size" of the proposal as a "potential stumbling block." Funds for the project are expected to come in part from the city's tobacco settlement, which could total $585 million over the next 25 years. But if tobacco sales drop, said financial expert Monique Moyer, the funds could dry up. Mayor Willie Brown (D) said he will support the bond issue, but has also expressed reservations about how much of the cost the public will be asked to shoulder. The city is already smarting from low Medicaid reimbursements, he said, pointing to estimates that Medicare spending "has been running below budgeted projections by $2.6 billion." However, he said, if "the city could get the per-patient reimbursement level back up, it might help cut the local share of building a new Laguna Honda" (Epstein/Wildermuth, 5/5).