Tuesday’s Board of Supervisors meeting ended with members approving the settlement deal allowing beleaguered Laguna Honda Hospital to keep operating and began with a call for political peace in the wake of the attack on Paul Pelosi. In between were new calls for scrutiny over city government, a lone objection to a sideshow crackdown and a call for commissioners to go to school.
Laguna Honda: An Optimistic Update, Settlement Approved
The Board of Supervisors heard another update on the remediation of problems at Laguna Honda Hospital, and also approved the settlement made by City Attorney David Chiu and the U.S. Department of Health and Human Services to resume funding for the hospital, in exchange for contracting with a quality-improvement expert to work with the hospital in its recertification process.
During the update, Laguna Honda interim CEO Roland Pickens outlined the terms of the settlement, where the Center for Medical and Medicaid Services will continue to pay for resident care needs until Nov. 13 of next year and pause involuntary discharges until February.
“We’re in a good place,” Pickens said.
Meanwhile, Laguna Honda is working with a quality-improvement expert to complete a “root cause analysis” of factors that led to the facility’s decertification last April. Pickens told the board that most of the more than 100 deficiencies the expert identified were already taken care of. The rest would soon follow, as well as validation of those fixes.
Laguna Honda is now also operating with only two beds per room instead of three, in accordance with federal standards.
However, a number of public commenters expressed concern over how that new policy—as well as "cohorting" in order to minimize negative interactions between legacy convalescent and behavioral health patients—may have an adverse effect on hospital capacity.
Questioning from supervisors revealed that 57 patients had been transferred to other facilities, often far away from San Francisco, before involuntary discharges were stopped in July. Once the facility is recertified, they can be readmitted ahead of new patients.
After the hearing, supervisors unanimously approved the settlement after a brief closed session.
Pelosi Attack Addressed in Context of National Crisis
Tuesday’s meeting began with a statement by Board President Shamann Walton on last week’s attack on Paul Pelosi, husband of House Speaker Nancy Pelosi. Walton condemned the attack, attributing it to similar political motivations that sparked the Jan. 6, 2021, insurrection at the U.S. Capitol.
“These threats to our democracy are real, and as long as we continue to support narratives that support divisiveness and ignorance, we are all in danger,” Walton said.
Grand Jury Report: HSH Making Progress
Supervisors also approved a resolution urging Mayor London Breed to implement recommendations from a progress report from the Civil Grand Jury on management improvements at the Department of Homelessness and Supportive Housing (HSH).
Government Audit and Oversight Committee Chair Dean Preston described the report and its findings as “not particularly controversial.”
The report gave HSH a middling grade, acknowledging that the agency has made progress on staffing shortages and other issues, but still lacks strong oversight and data management capabilities.
The report also recommends establishing an oversight commission for HSH, which was one of a handful Breed disagreed with. San Francisco voters will be deciding on that issue in next Tuesday’s midterm election as a result of a ballot measure submitted by the supervisors.
The report and its findings belie increased calls for scrutiny of the city’s public services departments and their nonprofit partners, especially in light of a double-dipping scandal involving a top employee of the Department of Public Health and troubled nonprofit behavioral health provider Baker Places.
Breaks for New Businesses; Preston Objects to Sideshow Crackdown
Supervisors also unanimously passed an extension and expansion of the “First Year Free” fee waiver program for small businesses that open up a new storefront in the city.
A resolution urging the state to increase penalties for the unauthorized speed and stunt driving events, or sideshows, which have greatly increased since the onset of the pandemic, passed by a vote of 10-1 as Preston objected.
The supervisor expressed concerns that increasing penalties or stronger measures such as withholding vehicle registrations “weren’t justified, nor would they be an effective deterrent to the behavior.”
Roll Call: Retail Crime, Labor and Keeping Commissioners Up to Speed
Preston introduced a motion directing the Budget and Legislative Analyst to audit the procurement practices of city departments such as the Metropolitan Transportation Agency, airport and Department of Public Works, which have delegated authority to make large contracts, as well as city practices around conflicts of interest. Preston characterized these moves as a “proactive response” to recent scandals.
Supervisor Ahsha Safaí addressed organized retail crime again, this time by introducing an ordinance that would mandate paid time off for front-line workers such as cashiers who have witnessed retail crimes who need to testify in court, aid investigations or make use of victim- and witness-support services.
Supervisor Connie Chan announced that she will request that the city attorney draft an ordinance requiring all city contractors to maintain labor harmony agreements. This is partially in response to a recent hearing over labor abuses at the Felton Institute, a major city child care contractor.
Supervisor Gordon Mar introduced an ordinance requiring large employers to provide at least 30-days pay to their military reservist workers who are called to active duty.
Supervisor Aaron Peskin requested drafting amendments to the city’s Administrative Code that would require training of city commissioners in their duties, after noting that on many occasions he would hear from commissioners who were “unaware of all of the powers and authorities of the commissions they sit on.”
San Francisco has over 100 commissions.