Proposition D on the June 6 ballot, which would change admissions policies to bar some types of patients at Laguna Honda Hospital, has sparked an emotional debate over the proper role of The City’s nursing home, which has traditionally served frail and elderly patients.
But a close look at Prop. D reveals a flawed proposal that raises too many nagging questions to gain our support.
Proponents of the measure argue that Department of Public Health decisions to allow younger patients, some with psychiatric problems, into Laguna Honda has resulted in a wave of violence against seniors.
Health officials acknowledge an increase in violent incidents but say the admissions policy has changed. Prop. D supporters, meanwhile, have published advertising pieces depicting an elderly woman with a black eye — apparently not an actual patient — in a bid to inflame passions among the electorate.
Prop. D would change admissions procedures at Laguna Honda to prohibit people who pose a danger to themselves or others, or those whose diagnoses are primarily psychiatric or behavioral. But the measure takes a roundabout way toward that goal, creating a special land-use district at the hospital site that puts the Planning Department in the role of enforcing the admissions policy.
The measure’s supporters, including some neighborhood activists and hospital staff long critical of admissions policy, say The City’s public health officials are not to be trusted with those decisions, hence the Planning Department solution.
But the Planning Department’s zoning administrator — who would become a key figure for hospital admissions under the measure — says the department "does not have the capacity or tools to distinguish patients with a primary diagnosis of psychiatric or behavioral issues."
Further, the city attorney has opined that the fine print of the measure could open the door for private nursing facilities to be built on other city-owned land, a consequence completely unrelated to the intent behind the measure but a potentially significant one.
Prop. D supporters dispute the city attorney’s interpretation. They also challenge the Department of Public Health estimate that as many as 300 patients suffering from dementia — who the department says would fall under Prop. D’s admissions prohibition — out of the roughly 1,000 current patients could be excluded from the hospital, producing letters from Alzheimer’s and neurology experts supporting their view.
Many Prop. D supporters are genuinely worried about safety issues at Laguna Honda, and they want the hospital to stay with its longtime mission of serving mostly elderly patients. But stripping professionals of the power to make admissions decisions and handing it over to zoning authorities who neither want it nor are qualified to handle it is misguided public policy.
Prop. D would lock in hospital policy at the ballot box, allowing no room for modifications without again going to the voters. Add in land-use provisions that seem as though they dropped in from another law, and it becomes clear that good intentions do not outweigh flawed public policy. Vote no on Prop. D.