In a “David vs. Goliath” victory for healthcare justice this week, grassroots community pressure forced Sutter CPMC CEO Warren Browner to halt the planned eviction 28 severely ill patients from the St. Luke’s Hospital skilled nursing sub-acute unit. The patients, who are all elderly and disabled people of color on Medi-Cal, faced relocation to facilities as far away as Sacramento due to the lack of other sub-acute beds in San Francisco.
When We Fight, We Win
Over the past three months, the patients’ families organized to fight the eviction of their loved with support from San Franciscans for Healthcare, Housing, Jobs and Justice, a labor community coalition convened by JWJ along with Supervisors Ahsha Safai and Hilary Ronen and other healthcare advocates. The closure of the St. Luke’s skilled nursing sub-acute unit also threatened the jobs of 122 nurses and healthcare workers, and California Nurses Association and National Union of Healthcare Workers played key roles in the coalition. The victory was grounded in the courage and solidarity of the family members who stood up to a powerful healthcare corporation with $4 billion in assets. The coalition will continue to support the family members as they bargain with Sutter CPMC over the details of a final agreement that protects the welfare of their loved ones.
Broader Post-Acute Care Crisis
The families and coalition are also demanding that City leaders address the broader crisis in access to post-acute care of which the St. Luke’s struggle is merely the tip of the iceberg. Moreover, CPMC has not committed to admitting new patients to the skilled nursing unit. “We have won a victory for our family members, but the victory has not been won for anybody else,” said Laurie Anderson, the daughter of Richard Anderson. “Today it’s us, but tomorrow it could be any one of you.”
According to a fact sheet released by the coalition (view here):
- The number of licensed skilled nursing beds, including sub-acute beds, in San Francisco decreased from 3,502 in 2003 to 2,542 in 2013. Not all licensed beds are staffed so the number of available beds is even lower.
- There are only 40 sub-acute beds in San Francisco, all of which are at St. Luke’s. Most other California counties have more sub-acute beds. For example, Los Angeles County has 2,193 sub-acute beds, 55 times as many as SF despite having just 9.6 times as many discharges as SF.
Additionally, a 2016 comprehensive report prepared by the San Francisco Post-Acute Care Project for the San Francisco Public Health Commission projects a sharply increasing deficit of beds per 1,000 San Francisco residents: the report projects that San Francisco will need to increase the current supply of SNF beds by nearly 70% to meet future needs.
Coalition Proposals for Action for Board of Supervisors
On September 12th, the coalition presented to the Board of Supervisors a set of Proposals for Action Regarding the Loss and Demise of Post-Acute Care Beds in San Francisco (view here). The proposals include directing the Department of Public Health to take actions to develop both short-term and long-term solutions for insuring a sufficient number and range of post-acute care beds and facilities within the City and County of San Francisco. The coalition also proposed several new policies for the Board of Supervisors to explore:
- Cooperation agreements among private and public hospitals to operate and fund jointly hospital-based SNF including sub-acute care beds and facilities within the City and County of San Francisco;
- The enactment of local legislation requiring the imposition of fines whenever a private hospital or healthcare facility removes a SNF bed from service without guaranteeing beforehand the availability of a similarly staffed bed elsewhere within the City and County of San Francisco.
- The enactment of local legislation that mandates the minimum number of and range of hospital-based post-acute care beds that public and private hospitals within the City and County of San Francisco must create and maintain.
It is essential that the City leaders, the Public Health Department and community stakeholders lead the effort to create both short and long term solutions to the growing post-acute care crisis. Instead, the Health Department is apparently waiting for solutions to come from the hospital industry through the “Post Acute Care Collaborative,” a private entity controlled by healthcare corporations. As we’ve seen with the recent struggle over St. Luke’s services, community health can only be protected when we stand united to demand that patients’ needs trump corporate profits.