Callers and commissioners press DPH over Laguna Honda recertification, HSAG contracts and transparency

San Franciscos Health Commission heard sustained public concern on Jan. 3 about the future of Laguna Honda Hospital and a series of consultant contracts the public described as costly and opaque.

Callers during the general public-comment period accused the Department of Public Health (DPH) of secrecy around documents they say are central to recertification and possible closure decisions. "The 5 contracts to rescue Laguna Honda across the 3 consultants now totals 26,700,000.0," said Patrick Monette Shaw during public comment, and he later raised concerns about HSAG contracts and steep hourly rates he said had increased to as much as $485 an hour. Michael Lyon, another caller, warned "in exactly 1 month Laguna Honda will close" unless DPH produces substantial improvements and said the public has not seen a root cause analysis for the 26 deficiencies cited by CMS.

Director of Health Grant Colfax responded in the directors report by outlining an organizational structure and workstreams intended to secure recertification. Colfax said acting Laguna Honda CEO Roland Pickens is leading a set of efforts that include survey readiness, facilities and capital projects, and an action plan tied to a root cause analysis. Colfax noted the department is scheduled to provide a report to CMS on accomplishments of the action plan by Feb. 10.

Commissioners and several public commenters pressed for greater transparency. Melanie Grossman, president of the Older Womens League, asked explicitly where residents displaced by any bed reductions would go: "This is my home. Where will I go?" Art Persico, a member of the public, framed Laguna Honda as a unique public nonprofit long-term care facility and urged the commission to preserve it and increase transparency about any plans that could lead to forced discharges.

The meeting also addressed the consultant contracts raising public concern. Commissioner Chungs finance committee reviewed new contract reports and described the work HSAG and other consultants will do, including root cause analysis and helping to develop job descriptions and training for DPH staff. The consent calendar that includes those contracts was approved after the commission extracted and separately voted on a Chinese Hospital contract; the commission voted to approve the consent calendar and the extracted Chinese Hospital item in consecutive roll calls.

Public commenters repeatedly asked for public release of the root cause analysis, the revised closure plan and related action plans. DPH staff said the department is compiling required paperwork for conditional grant awards and for CMS reporting, and that certain deliverables are being led by named managers and the acting CEO.

Next steps: DPH told the commission it expects to submit the action-plan report to CMS on Feb. 10 and said additional updates will follow as the department completes paperwork, surveys and the agencys workstreams. The commission approved the consent calendar that included contracts referenced in public comment, and the matter of Laguna Honda recertification and the associated documents remained an active concern of callers and some commissioners at the meeting's close.