Resolution: 14-05

Determining That the Closure of St. Luke’s Hospital Psychiatric/Behavioral Inpatient Unit Will Have a Detrimental Impact On the Health Care Service of the Community

WHEREAS, St. Luke’s Hospital maintains a 31-bed Psychiatric/Behavioral Health Inpatient Unit with a recent average census of approximately six patients per day; and,

WHEREAS, St. Luke’s Hospital plans to close its Psychiatric/Behavioral Health Inpatient Unit, effective September 30, 2005; and

WHEREAS, the San Francisco Health Commission, in accordance with the Community Health Care Planning Ordinance (Proposition Q) held a public hearing on September 6, 2005, regarding the closure of St. Luke’s Psychiatric/Behavioral Health Inpatient Unit; and

WHEREAS, DPH is relying less on hospitalization and more on community care to serve its patients; and

WHEREAS, the result has been that the private hospitals have reduced their inpatient beds and the accompanying services that were attached, and the use of St. Luke’s psychiatric inpatient unit has shrunk considerably over the last few years; and

WHEREAS, recently there has been unprecedented census and acuity in PES, which has partially resulted from a significant decrease in the number of inpatient psychiatric beds in San Francisco; and

WHEREAS, San Francisco Psychiatric Emergency Services has drafted a Condition Yellow and Condition Red Policy to inform the community when PES is above capacity or has acuity that makes clinical conditions in PES potentially unsafe, and a key component of the policy is other hospitals holding 5150s at their facilities; and

WHEREAS, St. Luke’s Hospital has solely expressed concrete plans to provide psychiatric services to those in acute need by saying that they would continue to hold 5150s in the emergency department for 48 hours, during which time they will stabilize them, have a physician assess their conditions, have appropriate 1:1 staffing for the protection of the patient and those around them and would make arrangements with the appropriate facility for transfer; and

WHEREAS, St. Luke’s Hospital has made no specific arrangements with other hospitals for caring for the patients currently served in its inpatient psychiatric unit; and

WHEREAS, in the course of the Proposition Q hearing to discuss the closure of St. Luke’s Psychiatric/Behavioral Health Inpatient Unit it became apparent that St. Luke’s Hospital is also planning to eliminate outpatient mental health services, which will immediately impact approximately 150 patients and an indeterminate number of potential future psychiatric outpatients from the Mission neighborhood and other San Francisco neighborhoods; and

WHEREAS, the Health Commission has received no written information from St. Luke’s Hospital as to the demographics of and potential impact upon the existing and foreseeable outpatient population of St. Luke’s Hospital; and

WHEREAS, the Community Health Care Planning Ordinance (Proposition Q) clearly states that prior to a hospital inpatient or outpatient facility eliminating or reducing the level of services provided, a hospital shall comply with the ordinance by providing public notice and informing the Health Commission of the proposed service reduction; and

WHEREAS, St. Luke’s elimination of outpatient mental health services clearly triggers the need for the hospital to comply with the Community Health Care Planning Ordinance, which it has not done; now, therefore, be it

RESOLVED, that the closure of the Psychiatric/Behavioral Health Inpatient Unit at St. Luke’s Hospital will have a detrimental impact on the health care service of the community; and be it

FURTHER RESOLVED, that the Health Commission advises St. Luke’s Hospital of its statutory obligation to newly provide public notice and written information to the Health Commission of the proposed outpatient service reduction, and that the Health Commission will schedule a Proposition Q hearing within 90 days.

I hereby certify that the San Francisco Health Commission at its meeting of September 20, 2005 adopted the foregoing resolution.

Michele M. Seaton, Executive Secretary to the Health Commission