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League of Women Voters of California Education Fund
Zoning Changes to Limit Services at Laguna Honda Hospital and Other Residential Health Care Facilities
City and County of San Francisco
Ordinance - Majority Approval Required -- 50% + 1
Fail: 35,418 / 26.34% Yes votes ...... 99,060 / 73.66% No votes
Index of all Measures
|Information shown below: Summary | Fiscal Impact | Yes/No Meaning | Arguments | Full Text|
Shall the City amend the Planning Code to create the "Laguna Honda Hospital Special Use District" that includes the site of Laguna Honda Hospital, limit the patients who can receive services at Laguna Honda Hospital and certain other residential health care facilities, and allow both publicly and privately-owned residential health care facilities in "public" districts throughout San Francisco?
Laguna Honda is located in a "public" district rather than a residential, special use, commercial, or industrial zoned district. According to the City Planning Code, "public" districts generally allow for publicly-owned residential health care facilities, but not for privately-owned residential health care facilities.
THE PROPOSAL: Proposition D is an ordinance that would amend the City's Planning Code to create the "Laguna Honda Hospital Special Use District" and would change zoning laws that govern "public" districts throughout the City.
The only new facilities permitted in this special use district, which includes the current site of Laguna Honda Hospital, would be:
The ordinance amends the Planning Code to create a new "special use district" at Laguna Honda Hospital and limits who may be a patient there. While the ordinance excludes patients for several reasons, the cost increase is primarily due to excluding patients who pose a danger to themselves or others or to the safety of the environment. The Department of Public Health estimates that approximately 300 of the 1,021 current patients at Laguna Honda would be excluded. The largest group of such patients have dementia due to a variety of causes such as Alzheimer's disease, Parkinson's disease, and other conditions.
In effect, the ordinance would mean that these and other public health patients could not be treated at Laguna Honda. Instead, those patients needing skilled nursing care would typically be treated either at a facility outside of San Francisco or at San Francisco General Hospital. The general fund cost of these alternatives ranges from $213 to $643 per day per person.
The $27 million estimate above assumes that Laguna Honda Hospital continues to house approximately 1,021 patients who do meet the limitations of the ordinance. To the extent that fewer patients meet the limitations and portions of the Hospital could be closed, the City's costs to operate Laguna Honda could decrease.
|Arguments For Proposition D||Arguments Against Proposition D|
|This Special Use District initiative will correct a major flaw in the 1999 bond measure and guarantee that frail, elderly, and longterm physically disabled San Franciscans will be able to live out their lives in safety and dignity, free from dangerous, greedy, and self-serving political interests.
The Laguna Honda Hospital bond measure was sold to the voters in a campaign that promised to rebuild the hospital for our seniors, so that aging San Franciscans who lacked money for private health care would always have a caring place to go.
Two years ago, patients, families, healthcare professionals, neighborhood advocates and taxpayers learned that those bond monies were being used to rebuild the hospital for a different patient population. Seniors and those with long-term medical conditions were being turned away, sent to nursing homes out of county, away from families and friends. The Health Department began admitting younger, dangerous patients with psychiatric and behavioral diagnoses, for which the hospital was not licensed and lacked essential security. State inspectors found that the rights of vulnerable patients were frequently violated; physical abuse was cited in numerous, well-documented, appalling reports.
This initiative will guarantee that the $299 million in bonds will be used for the purposes intended.
Opponents have a well-financed campaign, and have begun circulating false information that resident Alzheimer and dementia patients are dangerous to others, and will be discharged if this proposition passes, despite overwhelming expert medical evidence to the contrary.
Proposition D will cost you nothing but your vote.
KEEP THE PROMISE OF LAGUNA HONDA FOR OUR SENIORS.
Join us in voting YES on D.
The City Zoning Administrator says Prop D will allow private developers to build for-profit facilities on public land. The Zoning Administrator also says Prop D takes patient admission decisions away from health care professionals and forces the Planning Department to determine which patients should be admitted to Laguna Honda.
The Director of Public Health says Prop D will cause 300 mostly elderly patients to be discharged from the hospital. Because of a drafting error, the measure prohibits patients with Alzheimer's Disease, Parkinson's Disease, AIDS-related dementia and other diseases from remaining in Laguna Honda.
The City Controller says Prop D will require the City to spend $27 million it doesn't have to care for these patients at other facilities.
Please reject this poorly drafted measure. Please vote No on D.
|Save Laguna Honda: Vote No on Prop D
Prop D will result in the forced discharge of up to 300 of Laguna Honda's most vulnerable Alzheimer's and Parkinson's patients. The City has no other facilities to accommodate these patients and may have to spend up to $27 million per year to arrange for their care.
For 140 years, Laguna Honda Hospital has cared for San Francisco's elderly, disabled and terminally ill. In 1999, San Franciscans voted overwhelmingly to save the crumbling, quakedamaged hospital and preserve its mission.
Now Laguna Honda is in trouble again, this time because of Prop D perhaps the most poorly drafted measure ever placed on the San Francisco ballot.
Prop D was written to allow privately owned health care facilities to be built on public lands. But Prod D is so poorly drafted, it jeopardizes the health care of hundreds of Laguna Honda's most vulnerable patients.
The unintended consequences of Prop D are dire:
The City's Public Health Director says that Prop D will require the City to discharge up to 300 patients suffering from Parkinson's, Alzheimer's and other diseases.
Prop D puts the City's Zoning Administrator in charge of patient admissions. In a recent letter, the Zoning Administrator said his department is completely unprepared to perform psychological evaluations on patients if the measure passes.
The City Controller estimates Prop D will cost the City $27 million per year to arrange outside care for existing patients discharged by the measure.
Please join me and the co-chairs of the original campaign to Save Laguna Honda, former City Attorney Louise Renne and Public Health Director Dr. Mitch Katz, and Vote NO on D.
Objective experts agree that Alzheimer's and other dementia patients are NOT dangerous and would continue to receive care at Laguna Honda as always. To infer that such patients are dangerous and need to be excluded unmasks the true intent of the Health Director - who cannot be so ignorant about geriatric medicine making Proposition D all the more necessary.
Prop D will not change the traditional Laguna Honda admissions rules - it will create a new Special Use District to protect vulnerable patients from the admission experiments of the Health Director.
Opponents' assertion that this measure will put the Zoning Administrator in charge of admissions is more than laughable, unless we are to believe that the Zoning Administrator currently performs similar duties in the Kaiser Hospital Special Use District, also created by voter signatures and approved by election in 1992. (Prop D was modeled after that successful initiative.)
The Controller's cost estimates are based in whole upon the Health Director's fabrications and are not even remotely reliable + "garbage in + garbage out."
Proposition D was written by two experienced land use attorneys in consultation with health care professionals, many with decades of experience at Laguna Honda.
Vote YES on D.
|Full Text of Proposition D|
|AMENDING ARTICLE 2 OF THE SAN FRANCISCO PLANNING CODE BY ADDING SECTION 249.27 THERETO ESTABLISHING THE LAGUNA HONDA HOSPITAL SPECIAL USE DISTRICT, DECLARING THE PURPOSES THEREOF, LIMITING THE HEALTH CARE SERVICES AUTHORIZED THEREIN AND AMENDING THE ZONING MAP OF THE CITY AND COUNTY OF SAN FRANCISCO TO DECLARE THE BOUNDARIES OF THE SPECIAL USE DISTRICT CONSISTING OF A PORTION OF LOT 7 OF ASSESSOR'S BLOCK 2842, BY ADDING SUBSECTION
(k) TO SECTION 209.3 THEREOF AUTHORIZING LICENSED SKILLED NURSING FACILITIES AS A DISTINCT AND SEPARATE USE FROM RESIDENTIAL CARE FACILITIES AND BY AMENDING SECTION 234.1 THEREOF AUTHORIZING ADDITIONAL USES WITHIN A P DISTRICT.
Note: Additions are italic text.
Be it ordained by the people of the City and County of San Francisco:
Section 1. The People of the City and County Find that: (a) Since being founded in 1866, Laguna Honda Hospital and Rehabilitation Center ("Laguna Honda") has become an important part of the health care delivery system of the city and county, providing long-term skilled nursing care, as well as specialized dementia, hospice, AIDS, physical rehabilitation and respite care services, to elderly, frail and physically disabled residents of San Francisco.
(b) The importance of Laguna Honda's health care services was both recognized and affirmed by the passage in 1999 of Proposition A on the municipal ballot which, among other things, authorized bonded indebtedness of $299 million to construct, reconstruct and repair the hospital's buildings and related facilities.
(c) Given the increasing number of elderly, frail and physically disabled San Francisco residents who need long-term skilled nursing care, dementia, hospice, AIDS, physical rehabilitation and respite care services, it is critical that Laguna Honda's staff and facilities remain committed to providing care for this patient population which the hospital has served, and continues to serve, so well.
(d) Accordingly, the establishment of a special use district as herein provided will protect, preserve and advance the mission of Laguna Honda while, at the same time, promoting the priority policies set forth in Section 101.1(b) of the Planning Code.
(e) The uses authorized in this special use district, together with the express and implied limitations thereon, will also serve to conserve valuable and irreplaceable health care facilities needed by and for the elderly, frail and physically disabled residents of the city and county who require long-term skilled nursing care. In this fashion, the will of the electors in approving the issuance of general obligation bonds for the purposes specified in 1999's Proposition A will be more nearly realized and the public interest goals and objectives expressed in that proposition more likely achieved.
Section 2. The San Francisco Planning Code is hereby amended by adding Section 249.27 thereto and amending Sections 209.3 and 234.1 thereof to read as follows:
Sec. 249.27. Laguna Honda Hospital Special Use District. (a) General. A special use district entitled the "Laguna Honda Hospital Special Use District" (the "District"), the boundaries of which are shown on Sectional Map No. 6 SU of the Zoning Map, is hereby established for the purposes set forth below.
(b) Purposes. In order to protect and enhance Laguna Honda's continued ability to provide adequate levels of quality long-term skilled nursing care, dementia, hospice, AIDS, physical rehabilitation and respite care services to elderly, frail and physically disabled residents of San Francisco, and to ensure the accomplishment of the goals and objectives of the electors in approving 1999's Proposition A on the municipal ballot, including without limitation the construction and operation of assisted living units for such residents, the following controls are imposed on the District:
(1) The permitted uses in this District are those uses permitted under Section 209.3(k) and subject further to the following limitations:
(A) Persons who pose a danger to themselves or to others, or who pose a threat to the maintenance of a safe environment at Laguna Honda, shall not be admitted or retained;
(B) Only persons whose need for skilled nursing care is based on a medical diagnosis that is not primarily psychiatric or behavioral shall be admitted;
(C) So long as there are qualified San Francisco residents in need of long-term skilled nursing care who are waiting for Laguna Honda beds, patients whose projected treatment is short-term shall not be admitted, except to specialty programs serving the elderly, frail and physically disabled residents of San Francisco;
(D) So long as there are qualified San Francisco residents who are waiting for Laguna Honda beds or admission to assisted living units, non-residents of San Francisco shall not be admitted; and
(E) Nothing shall prohibit construction and operation of assisted living units for elderly, frail and physically disabled persons who meet the applicable criteria for admission set forth herein.
(d) Definitions. As used in this section:
(1) "Long-term" means projected care or treatment that, on the date of admission, is expected to continue for at least six months continuous duration;
(2) "Physical rehabilitation" means physical therapy, occupational therapy, speech therapy and related disciplines;
(3) "Respite care" means admission, for a period not to exceed the time specified by applicable state law or regulation, of an elderly person or dependent adult who is being cared for at home, to allow caregivers temporary relief from their care-giving obligations;
(4) "Short-term" means projected care or treatment that, on the date of admission, is expected to continue for more than six days but less than six months continuous duration;
(5) "Skilled nursing care" means daily nursing and rehabilitative care that can be performed only by or under the supervision of skilled medical personnel as provided in applicable regulations of the United States Department of Health and Human Services and Title 22 of the California Code of Regulations; and
(6) "Assisted living" means personal care and services, including homemaker, chore, attendant care, medication oversight, transportation and therapeutic social programs furnished to clients residing in their own living units in a licensed community care facility providing 24-hour on-site response staff, as defined by the California Department of Health Services.
(e) Residence. San Francisco residence, as herein provided, shall be determined in accordance with the provisions of Sections 17100 through 17105 of the Welfare and Institutions Code.
Section 3. ZONING MAP
Sectional Map No. 6 SU of the Zoning Map of the City and County of San Francisco is hereby amended to declare, with the exception of any portion thereof not devoted to hospital and rehabilitation use, the boundaries of the Laguna Honda Hospital Special Use District to be coterminous with Lot 7, Assessor's Block No. 2842.
Section 209.3. Institutions.
(a) Hospital, medical center or other medical institution which includes facilities for inpatient care and may also include medical offices, clinics, laboratories, and employee or student dormitories and other housing, operated by and affiliated with the institution, which institution has met the applicable provisions of Section 304.5 of this Code concerning institutional master plans.
(b) Residential care facility providing lodging, board and care for a period of 24 hours or more to six or fewer persons in need of specialized aid by personnel licensed by the State of California. Such facility shall display nothing on or near the facility which gives an outward indication of the nature of the occupancy except for a sign as permitted by Article 6 of this Code, shall not provide outpatient services and shall be located in a structure which remains residential in character. Such facilities shall include but not necessarily be limited to a board and care home, family care home, long-term nursery, orphanage, rest home or home for the treatment of addictive, contagious or other diseases or psychological disorders.
(c) Residential care facility meeting all applicable requirements of Subsection 209.3(b) above but providing lodging, board and care as specified therein to seven or more persons.
(d) Social service or philanthropic facility providing assistance of a charitable or public service nature and not of a profitmaking or commercial nature. (With respect to RC Districts, see also Section 209.9(d).)
(e) Child-care facility providing less than 24-hour care for 12 or fewer children by licensed personnel and meeting the open-space and other requirements of the State of California and other authorities.
(f) Child-care facility providing less than 24-hour care for 13 or more children by licensed personnel and meeting the open-space and other requirements of the State of California and other authorities. (With respect to RC Districts, see also Section 209.9(d).)
(g) Elementary school, either public or private. Such institution may include employee or student dormitories and other housing operated by and affiliated with the institution. (With respect to RC Districts, see also Section 209.9(d).)
(h) Secondary school, either public or private, other than a school having industrial arts as its primary course of study. Such institution may include employee or student dormitories and other housing operated by and affiliated with the institution. (With respect to RC Districts, see also Section 209.9(d).)
(i) Post secondary educational institution for the purposes of academic, professional, business or fine arts education, which institution has met the applicable provisions of Section 304.5 of this Code concerning institutional master plans. Such institution may include employee or student dormitories and other housing operated by and affiliated with the institution. Such institution shall not have industrial arts as its primary course of study.
(j) Church or other religious institution which has a tax-exempt status as a religious institution granted by the United States Government, and which institution is used primarily for collective worship or ritual or observance of common religious beliefs. Such institution may include, on the same lot, the housing of persons who engage in supportive activity for the institution. (With respect to RC Districts, see also Section 209.9(d).)
(k) A facility licensed by the State of California to provide skilled nursing care to long-term patients as provided in applicable regulations of the United States Department of Health and Human Services and Title 22 of the California Code of Regulations.
Section 234.1. Principal Uses Permitted, P Districts.
(a) Structures and uses of governmental agencies not subject to regulation by this Code.
(b) Public structures and uses of the City and County of San Francisco, and of other governmental agencies that are subject to regulation by this Code, including accessory nonpublic uses, when in conformity with the Master Plan and the provisions of other applicable codes, laws, ordinances and regulations; provided, however, that on any lot in a P District, which lot is within 1/4 mile of the nearest NC-1 or Individual Area Neighborhood Commercial District or Restricted Use Subdistrict described in Article 7 of this Code, no accessory nonpublic use shall be permitted, unless such use or feature complies with the controls which are applicable in any NC-1 or Individual Area Neighborhood Commercial District located within 1/4 mile of the lot, excluding the provisions of zoning category .82, as defined in Section 790.80 of this Code.
(c) The uses and controls provided for in Section 249.27.
Section 4. Severability.
If any section, subsection, subdivision, paragraph, clause or phrase of this ordinance or any part thereof is, for any reason, held unconstitutional, invalid or ineffective by a court of competent jurisdiction, such decision shall not affect the validity or effectiveness of the remaining portions of the ordinance, or any part thereof. It is hereby declared that this ordinance, and each section, subsection, subdivision, paragraph, clause or phrase thereof, would have been passed irrespective of the fact that any one or more sections, subsections, subdivisions, paragraphs, clauses or phrases has been declared unconstitutional, invalid or ineffective.