LAGUNA HONDA: Threatened With Medicaid Cut-Off
"State nursing home regulators and the Clinton administration are threatening to cut off all funding for San Francisco's Laguna Honda Hospital unless the city agrees to upgrade the beleaguered facility by September 11," the San Francisco Chronicle reports. Laguna Honda, the nation's largest public hospital for the chronically ill, has previously come under fire from the federal government for its antiquated, open-ward system. The city has operated the hospital under federal waivers since 1980 that allow it to maintain the system, which has largely fallen into disuse in the care of psychiatric and other long-term patients, but is defended by many patients at the facility-of-last resort.
Time For A Change
San Francisco Health Director Dr. Mitchell Katz said yesterday that "both state and federal regulators had rejected city plans to improve the facility." A key sticking point, the Chronicle reports, is the "demand that Laguna Honda provider smaller and more accessible dining rooms and recreation facilities for its 1,200 patients -- a move the city says would force closure of four or five 30-bed wards." Katz said, "It's a real issue of principle for San Francisco. Should we lose 200 residents for the sake of creating dining halls, if they have no other place to go?" He added, "We will not abandon our residents. We will not send people to die in the streets, or live without supervision in hotel rooms."
Fix Up Or Pay Up
The Chronicle reports that the California Department of Health Services "has threatened to fine the city $1,000 a day ... until it meets the demand for improved 'quality of life,'" and the federal Health Care Financing Administration, which oversees the Medicaid program, has threatened to discontinue $90 million in Medicaid funding. While the "city already had plans to implement a $1.9 million" renovation to "lend a more 'homey' feel to the wards," the Chronicle reports that city officials are dubious that they could "win the two-thirds vote needed to build a $500 million earth-quake safe replacement" for the facility, which is ultimately what "city, state and federal officials want" (Russell, 6/12).