St. Luke's Hospital's future remains uncertain
October 26, 2007
Supervisors Michaela Alioto-Pier, Sophie Maxwell, Carmen Chu,
and Tom Ammiano listened to three and a half hours of testimony
Thursday during a Board of Supervisors hearing concerning California
Pacific Medical Center (CPMC) and its plan future to cut services
at St. Luke's Hospital.
San Francisco residents are outraged by CPMC's plans to close
St. Luke's in-patient and acute care services which would turn
the hospital into an outpatient-only clinic.
St. Luke's predominately serves low-income minorities in the
southeast sector of the city. Fifty percent of patients have MediCal
benefits and 20 percent are uninsured.
Hospital officials announced last week that they would begin
closure of its neo-natal intensive care unit and pediatric in-patient
services by mid-November.
But Supervisor Ammiano had cited them during the hearing on their
failure to comply with a state law. The law requires hospitals
to give city officials 90-days advance notice of plans to close
CPMC President Dr. Martin Brotman apologized at the hearing saying
the plans would be delayed.
"It's certainly an appropriate request, and we will comply
with it," Brotman said.
Brotman said after the hearing that he would "consider"
working with Department of Public Health Director Mitch Katz,
as well as doctors and nurses to see "what we could do differently
than our present plan that we have in place."
The plan that he was referring to is CPMC's $1.7 billion proposal
to build a new acute care hospital on the site of the Cathedral
Hill Hotel at Van Ness and Geary.
The plan includes building new urgent care and ambulatory care
facilities in the San Francisco's South of Market district, while
closing in-patient and acute-care services at St. Luke's and other
Critics of the plan say that would take away critical services
from underserved low-income patients, and move them to more affluent
areas north of Market Street.
The plan would consolidate in-patient and acute care services
from other of the four San Francisco CPMC campuses and move them
to the new hospital.
St. Luke's is included in that plan as the City's only other
in-patient and acute care service provider south of Market Street,
besides SF General Hospital.
Brotman called the plan "a process of evolution " and
afterwards described what he meant by that, and what CPMC plans
to do next.
"I heard enormous concerns about people who need healthcare
being deprived of healthcare," he said. "And now we
will go back and re-assess with Mitch Katz how we can work something
out that would meet [the needs of] what we heard today,"
Dr. Katz said during the hearing that he, as well as most other
doctors and nurses at the hearing, supported the building of more
ambulatory care clinics south of Market.
But he addressed CPMC's idea that building more urgent care and
ambulatory care clinics in those areas would provide "preventative
care", reducing the need for hospitalization in those areas.
Katz acknowledged the benefits of preventative care, and praised
CPMC for their proposal, but said their efforts wouldn't work
sufficiently enough to justify closing in-patient care at St.
He said best studies show that only a moderate decrease in hospitalization
could be expected.
"If you decreased hospitalization by 15 percent, I'd say
you're doing a great job," Katz said. "But fifteen percent
is not going to eliminate the need [for hospitalization]."
Brotman said after the hearing: "The question is, can we
work out a way that over time we can have a thriving hospital
at St. Luke's south of Market? I would very much like to do that."
He said that CPMC had "voluntarily took on a failed organization
at St. Luke's."
"But I can't sacrifice the whole institution for any part
of the institution," he said.