Coalition of Californians for Olmstead
433 Hegenberger Road, Suite 220
Oakland, CA 94621-1448
Telephone: (510) 430-8033 Fax: (510) 430-8246
Toll Free: (800) 776-5746 TTY/TDD: (800) 649-0154
ADAPT/LAGUNA HONDA HOSPITAL
OCTOBER 21-25, 2001
SAN FRANCISCO FACT SHEET
San Francisco Long Term Care (SF LTC) budget currently:
It currently costs over $100,000 per resident/per year to provide care at Laguna Honda Hospital (LHH)
The annual operation budget of LHH is $165 million
Of the total SF LTC budget: 62% of LTC budget goes to LHH to serve approximately 1000 residents; 38% goes to the rest of the community-based LTC services and other community services to disabled and aged populations.
The cost of providing care to residents at LHH ($100,000 per person/per year) could easily provide care at home or in the community to the vast majority of residents who live there. For example, people with significant disabilities are currently being served in the community through the Nursing Facility waiver, In-Home Supportive Services program (IHSS), Department of Developmental Services' waiver and On-Lok programs for a fraction of that cost.
Percentage of long-term care population to be served by rebuild of Laguna Honda into a 1200-bed institution: between 2% - 10% (depending on overall number of persons projected to need long term care).
Nursing facilities, like LHH, are required to employ nursing staff to provide a daily average of 3.2 hours of nursing care per day per resident, under state licensing regulations. This includes both nursing care and personal attendant care for activities of daily living (e.g. eating, transferring, grooming). People do not receive anywhere near 24-hours of nursing care.
The Day Health Housing Project is one good example of a community-based alternative to institutional care. "Presentation Senior Community" located in San Francisco's Tenderloin features small apartments designed for frail elders and persons with disabilities on SSI paying no more than one-third of their income in rent. A coalition of service providers offers adult day health, primary medical care, case management, in-home supportive services, and meals to the residents, just as they do now to frail elders scattered throughout the neighborhood. The availability of all these services under one roof prevents unnecessary institutionalization for many of the residents and provides for more efficient use of start-up ($185,000 per person) and service dollars.
Current estimates of elderly and disabled persons in San Francisco who need long-term care vary widely, from 11,604 – 20,000 (SF County Report of the Long-Term Care Integration Pilot Project, April 18, 2000) to 57,000 (Options For Laguna Honda Hospital White Paper, by Mitchell H. Katz, M.D., Director, Dept. of Public Health, 12/10/98)
According to the State Department of Finance, San Francisco's 65 and over population is expected to increase from 116,080 in 2000 to 129,787 in 2010, and to 181,981 in 2020—an increase of 57%. Similarly, San Francisco's population of persons 75 and over will increase from 59,523 in 2000 to 66,483 in 2010, and to 75,346 in 2020—an increase of 26%. Our population of persons 85 and over will increase from 17,718 in 2000 to 23,958 in 2010 to 26,832 in 2020—an increase of 50%. (Options For Laguna Honda Hospital White Paper, by Mitchell H. Katz, M.D., Director, Dept. of Public Health, 12/10/98)
San Francisco now experiences a significant demand for long-term care services. At present, approximately 50% of San Francisco's Medi-Cal population is either aged, blind or disabled, in comparison with the Statewide average of 24%. In 1996, 37% of all Medi-Cal expenditures in San Francisco were for long-term care, in comparison with 22% State-wide. (Concept Paper for San Francisco's Long-Term Care Integration Pilot Project: Main Report, by the Long-Term Care Pilot Project Task Force, DRAFT: 8/26/98)
Expenditures for institutional services in the City and County of San Francisco in 1999: $100,000 per year per person at Laguna Honda Hospital. Cost of re-build of Laguna Honda as per bond measure is $401,000,000 or $333,000 per person served. At this price, San Franciscans could purchase a $400,000 condominium for every patient at LHH. ("Compassion At A Price Too High: Laguna Honda Bond Could Break Us", by Ken Garcia, SF Chronicle, 10/28/99 and "Angry Voters Spit in Eye of Reason: Election Results Reflect Frustration", by Ken Garcia, SF Chronicle, 11/6/99)