San Francisco's Proposition A, a bond measure to partially fund the rebuilding of a 1200-bed Nursing Home called "Laguna Honda Hospital," is in our view perpetuating the myth that very sick or very disabled people can ONLY be cared for in institutions. Our goal is to spend these dollars on a mix of in-home services and smaller, community-based facilities that will offer people a real choice in how and where they live. Unfortunately we were unable to pursuade San Franciscans of the virtues of looking at another model.
September 6, 1999
Willie L. Brown, Jr.,
Mayor of San Francisco
City Hall, Room 200
1 Dr. Carlton B. Goodlett Place
San Francisco, CA 94102
Subj: Opposition to the rebuilding of Laguna Honda Hospital
Dear Mayor Brown:
The California Disability Alliance (CDA) joins the San Francisco Independent Living Resource Center (ILRC) and many other local and state disability organizations in opposing the rebuilding of Laguna Honda Hospital at its current level of 1200 beds.
CDA is a statewide organization of persons with disabilities and their friends, family members and supporters of human and disability rights. Our members include San Francisco residents as well as Associates from across the country.
Like the ILRC, we are "opposed to rebuilding at any level without the commitment of equal resources to community living options for current and future Laguna Honda Hospital residents and elderly and disabled San Franciscans."
(The entire text of the ILRC statement is attached.)
We share the ILRC's conviction that rebuilding Laguna Honda would entrench forever the wrong approach to long-term care. Instead, we believe that long-term care must recognize the fact that given the proper support, more and more people with severe disabilities have the capacity to live independently at home or within the community in a variety of settings.
The Independent Living movement spawned many of the changes that make it possible for people who once were warehoused in giant facilities like Laguna Honda to instead live reasonably independently, with the assistance of a variety of community services. Assistive technology and the growing cadres of in-home support services also play a significant part in making this change possible--and desirable--as our lives with acquired disabilities (including the infirmities of old age) extend for longer and longer periods owing to advances in medical science.
Nevertheless, although the California Disability Alliance strongly believes that in-home support or supported living and community inclusion make the most sense for many, if not most, of the present residents of Laguna Honda Hospital, we want to alleviate the fears of those for whom community living arrangements may be inadequate. The CDA advocates for every last one of our brothers and sisters, no matter what their disability--including those who may require 24-hour care (often skilled-nursing care), and for whom there are no alternatives.
We encourage the City of San Francisco and all interested parties to work together to plan a range of options for living and personal care, including the provision of long term and skilled nursing care in a variety of alternative settings as needed. We strongly believe that this approach will be cost effective and allow maximum personal choice for any who are able to make such choices. While we oppose construction of a new, huge Laguna Honda facility, we also want to assure that this will not result in the abandonment of or loss of services for any individual. Our goal is to better the lives of all those who need long-term care services.
We look forward to hearing from you on this matter, and to working with you to see that quality care and choice are available to all who are confronted with long-term illness and/or disability.
Jean Nandi, Member, Executive Committee
California Disability Alliance
1529 Josephine St., Berkeley, CA 94703-1168
phone: (510) 845-8236
CC Tom Ammiano, President, San Francisco Board of Supervisors
Kathy Uhl, Executive Director, SF Independent Living Resource Center
Mary Lou Breslin, Disability Rights, Education and Defense Fund
[RETYPED FOR ELECTRONIC DISTRIBUTION BY JEAN NANDI]
Office of the Mayor 401 Van Ness Avenue, Room 336
San Francisco San Francisco, California 91402
Willie Lewis Brown, Jr. (415) 554-6141
September 16, 1999
California Disability Alliance
1529 Josephine Street
Berkeley, CA 94703-1168
Dear Ms. Nandi and members of the California Disability Alliance,
Thank you for your letter dated September 6, 1999, concerning the rebuilding of Laguna Honda Hospital. I'm sure we share the same concerns both for those who need skilled nursing care and those who are capable of more independent living in community settings.
I agree that San Francisco needs to provide "a range of options for living and personal care, including the provision of long term and skilled nursing..." I do not completely disagree with your statement that "more people with severe disabilities have the capability of living independently..." [if] "given the proper support."
You must realize, however, that the total number of persons who need care will grow tremendously in the next twenty years as 'baby boomers' swell the numbers of seniors. The Health Department has informed me that while our current San Francisco population has a need for 3,831 skilled nursing beds, by 2020 we will need 6,005. Only 1,200 of these will be publicly funded at Laguna Honda. Thus, even if we were able to reduce the number of persons who need skilled nursing at Laguna Honda today to 765, by 2020 the need would rise again to 1,200. We must plan today for this eventuality. Compounding this need is such severe financial pressure on private nursing homes that many may be driven out of business during this period.
In addition, we must act immediately to make the patients of Laguna Honda Hospital safe in the next major earthquake, and to get them out of the large, antiquated open wards into a more modern setting.
San Francisco has done a great deal to implement supportive housing. Since 1990, according to my Office on Housing, we have subsidized, built or planned forty-four separate supportive living projects with more than 2,280 housing units plus 630 beds. The local cost of these has exceeded $73 million; total cost exceeds one quarter billion dollars. These facilities are dispersed in neighborhoods around the city. I believe they provide the most appropriate level of care possible for each group served. Groups served include people with HIV/AIDS, people with other severe physical disabilities, people with mental health conditions, people with dual diagnoses, and others who have been chronically homeless. I am proud of San Francisco's record of providing a continuum of care. And we will continue to do better.
September 16, 1999
I encourage your involvement and input into these issues which are critical to the citizens of San Francisco. As you know, Walter Park of my Office on Disability, has attempted to arrange a discussion of these vital matters among representatives of the disability community, including Kathy Uhl of ILRC, Donna Calame of IHSS Public Authority, and City Attorney Louise Renne, who chaired the Laguna Honda Task Force. I urge you to conduct such a meeting or meetings. Subsequent to these discussions, I would be happy to sit down with members of CDA and representatives of the disability community and the Health Department staff to discuss your concerns more fully.
As you know, by voting Yes on Proposition A, citizens of San Francisco are not excluding other options. In fact the Health Department report to the Board of Supervisors clearly states that the reconstruction will create space for at least 140 units of 'assisted living' on the Laguna Honda site, which will become an integral part of San Francisco's continuum of services.
WILLIE L. BROWN, Jr.
c. Dr. Mitchell Katz, DPH
Louise Renne, City Attorney
Walter Park, Office of Disability
Independent Living Resource Center San Francisco is opposed to the rebuilding of Laguna Honda Hospital at its current level of 1200 beds and is opposed to rebuilding at any level without the commitment of equal resources to community living options for current and future Laguna Honda Hospital residents and elderly and disabled San Franciscans. ILRC supports rebuilding only in a manner that supports independent living choice.
ILRC is for short term solutions for current Laguna Honda Hospital residents and can assist potential future residents. In the longer term, ILRC's position is about community supports such as housing and health care for all people in a Long Term Care system.
If the only choice is institutional care then it is not a choice! We are opposed to lack of choice and building institutions that must be financially supported at the expense of community based options.
This is a time of vision and planning. The Independent Living model of the last thirty years must be expanded in the new millennium.
The Independent Living Resource Center San Francisco envisions a society in which people with disabilities are valued as contributing, fully participating members. Our mission is to empower persons with disabilities to achieve full economic and social participation in the community and promote opportunities for independence, self-direction and freedom of choice.
The California Disability Alliance wishes to add the following paragraph in addition to supporting the ILRC's statements.
The CDA agrees that in-home support or supported living and community inclusion make the most sense for many, if not most, of the present residents of Laguna Honda Hospital. However, we need to alleviate the fears of those for whom community living arrangements may be inadequate. The CDA advocates for every last one of our brothers and sisters, no matter what their disability, including those who simply must have 24 hour--often skilled nursing--care, and for whom there are no alternatives. We encourage the City of San Francisco and all interested parties to work together to plan a range of settings for living and personal care, including smaller skilled nursing facilities as needed. We strongly believe that this approach will be cost effective and allow maximum personal choice for any who are able to make such choices. Opposition to the construction of a new, huge Laguna Honda facility must not result in the abandonment of any single individual needing services now available to them. It is intended to better the lives of all.