September 13, 2022  Today was the day on which all the patients at Laguna Honda were supposed to have been evacuated and the hospital’s federal funding cut off. So it was decreed back in April by the Centers for Medicare and Medicaid Services (CMS), whose inspectors had been shocked by the hospital’s inability to control the resident drug addicts and deranged people –a significant subset of the patient population.
The task of finding other accommodations for 700 mostly frail, disabled people was almost mathematically impossible –there aren’t enough skilled nursing facilities in the region. By the end of July some 60 patients had been moved and four were known to have died as a result. (“Some put the number at 12,” says a reliable source, “but you can’t tell because some were so near the end they would have died if they’d stayed put.”)
On the Public Press website reporter Sylvie Sturm quoted a former Laguna Honda physician, Dr. Teresa Palmer, telling the dismayed San Francisco Board of Supervisors: “’This shutdown was predictable. Normally, a nursing home is filled with primarily women over 85. And now you have a nursing home, with predominantly men from 40 to 60. The city needs to provide funding and a place for people with substance use problems and conduct disorders.”

How did it happen that the nature of the Laguna Honda patient population changed so drastically?  

As of 2002 Mayor Willie Brown, the SF Chronicle, and the Chamber of Commerce had been trying to blame escalating social breakdown on District Attorney Hallinan’s supposed leniency. In 2003 Gavin Newsom ran for mayor pledging to end the crisis by providing “Care Not Cash” (a Clintonesque slogan from a Clintonesque politician).  To achieve visible results after he got elected, Newsom was enabled by Mitch Katz, director of the Department of Public Health. DPH instituted a  “Flow Project” to transfer incorrigible addicts and people with intractable “behavior problems” from San Francisco General Hospital to Laguna Honda. Administrators at the hospital protested that the program would undermine their ability to carry out their primary mission –caring for patients who were severely disabled and/or elderly and incapacitated. Katz, like a two-bit Stalin, replaced them with Administrators from SFGH.

According to a self-congratulatory DPH press release, “Removing barriers that impede patient flow allows patients to be cared for at the proper level of care… In 2004 (January through May), 78 percent of LHH’s patients were admitted to LHH from SFGH, 13 percent were admitted from other facilities and 9 percent from home.”

By February 2005 it was obvious that the “Flow Project”  had destroyed the equanimity that once prevailed at Laguna Honda, so Newsom cancelled it – but in name only. The all-important power to decide which patients are manageable at Laguna Honda continued to reside with the San Francisco Department of Public Health (DPH), which owns and oversees Laguna Honda. The hospital’s population had been 54% female. Today it is 63% male. 

San Francisco politicians pleaded with the Democratic Administration in Washington to cancel the evacuation order and give Laguna Honda more time to solve its problems. In July City Attorney David Chiu filed a suit to stay the feds’ hand. Mayor London Breed declared, “We are working hard to address issues that have been raised at Laguna Honda, and that important work will continue. But closing this facility and forcing residents and families to go through the trauma of transfers should not be part of that process. This facility provides care and support for some of the most vulnerable people in our City, and that support must continue to keep them healthy and safe.”

Such pleading resulted in only a two-month stay of execution; the hospital now has until November to pass muster. Why are the Democrat politicians in Washington not cutting their SF cronies more slack in this situation?  The only guess I’ve heard ventured was, “Laguna Honda sits on 62 acres west of Twin Peaks. That could mean millions for whoever gets to develop it.”

San Francisco’s DPH, which is run by Dr. Grant Colfax (formerly of Boonville), has spent $5.6 million on consultants who specialize in helping hospitals pass CMS inspections. The consultants completed a mock inspection last month and Laguna Honda did not pass. A second mock inspection is being conducted.  If and when the hospital gets the consultants’ thumbs up, re-certification by the feds will be requested. 

London Breed’s First Plum Job
 SF Chronicle sportswriter John Shea covered the groundbreaking on Treasure Island Sept. 6  for the San Francisco Glens Soccer Club new facility – a stadium with 1500 seats (plus locker rooms, concession stands and lights) and three practice fields. Shea described the scene as “windswept” and quoted Mayor London Breed saying, “You know what? The wind is just a part of San Francisco. We know it. This is what you practice in, so get used to it.”

The humility this woman seemed to exude when she first took office is long gone. Politically she is a Democratic Party hack, in perfect sync with her predecessors Ed Lee, Gavin Newsom and Willie Brown. I was surprised to come across her name when I was writing my disjointed memoir about working for Terence Hallinan some 20 years ago. As his press secretary and “liaison to the medical marijuana community,” I suggested that San Francisco should grow its own to provide medical users with an inexpensive, organically grown supply. The progressive DA was not adverse to the idea. One option I suggested as a site for the grow was Hunters’ Point Naval Shipyard, which had been decommissioned along with Treasure Island and the Presidio.

According to Kayo there had been a divvying up of the spoils, with Nancy Pelosi getting to decide the fate of the Presidio and Willie Brown making the big decisions on Hunters Point. “The Supervisors have some sway on Treasure Island” he said. He wanted T.I. to be the site of housing for those people living on the streets of the city or in vehicles who could fend for themselves, and a mental health hospital for the homeless who could not. I thought his idea was great but the real estate would prove too valuable. Kayo said, “You have no idea how miserable Treasure Island gets when the wind comes whipping off the bay —which is half the time.” He had me draft a press release emphasizing the suitability of T.I. for housing and treatment of San Francisco’s homeless population.

The city’s Treasure Island Development Authority was executive-directed by Annemarie Conroy, a rightwing former Supervisor. Conroy employed the young London Breed as a “development specialist.” Matier & Ross reported in the Chronicle, “Annemarie Conroy, Willie Brown’s commodore of Treasure Island, has two words for District Attorney Terence Hallinan’s much publicized ideas of setting up drug rehab centers out on the island. ‘No dice.’ And those are the nice words…

“‘Here we are, getting ready to hold a pre-bid conference for people interested in developing the island, and he comes out with idea of dumping drug rehab programs out here,’ Conroy fumed. ‘It’s a public relations nightmare.”

“Hallinan isn’t showing any signs of backing down. ‘Annemarie should keep in mind that Treasure Island belongs to the people of San Francisco not the developers,’ Hallinan said. ‘Its use will be decided by the Board of Supervisors not by Conroy or her staff…”

“It turns out that Hallinan’s office leases space out on the island for a check-bouncing program. ‘Those leases are up this week,’ Conroy told us ‘and I’m sending him a termination notice right now. As far as I’m concerned he’s been voted off the island.” 

Ol’ Terence is looking better and better in the rear-view mirror. His plan fro a Drug Rehab center on Treasure Island would have obviated the flow of active users into Laguna Honda. The city’s failure to provide adequate drug and psychiatric treatment programs under Brown, Newsom and Ed Lee led to the decertification under London Breed.

Mitch Katz, whose MD is in Psychology, left SF in 2010 to run the LA Department of Health Services. Then he tritzed off to New York to become President and CEO of the nation’s biggest public health bureaucracy. Gavin Newsom got elected Governor and aspires to be President of the United States of Amnesia. 


Begin forwarded message:
From: Fred Gardner <>
Subject: Two more gaffes
Date: September 12, 2022 at 9:28:29 PM PDT
To: bruce anderson <>
Cc: Mark Scaramella <>

Please correct if possible. 
SF Chronicle sportswriter John Shea covered the groundbreaking Sept. 6 of a “facility” on Treasure Island owned by the San Francisco Glens Soccer Club
Also, it was called the “Flow Project,” not Program.
Marci is about to start radiation for throat cancer.
Oi vey,