St. Luke's Hospital's future remains uncertain

By John Han

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 hospital services.

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 CPMC campuses.

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. Luke's.

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.

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