A Ragged Edge Online

San Francisco voters yesterday rejected a ballot measure that would have barred people with psychiatric disabilities from Laguna Honda Hospital, the controversial city-operated nursing home behemoth.

The measure was an odd one by many accounts.

"Rarely have two sides to a local political debate differed so much over the facts," wrote Randy Shaw on beyondChron.com on May 16. That seems to be the most accurate statement to be found about the ballot measure.

Proposition D, the "Laguna Honda Special Use District" ballot measure, would have added a section to the San Francisco Planning Code "limiting who is eligible for services at Laguna Honda Hospital," according to a memo issued in April by California's Protection & Advocacy, Inc. the state's "protection and advocacy" agency, a group mandated by federal law to protect and advocate for people with disabilities.

PAI called Proposition D "a blatant violation of federal and state law," saying its provision calling for barring "persons whose need for skilled nursing care is based on a primarily psychiatric or behavioral diagnosis" violates the Americans with Disabilities Act and state civil rights laws.

And, added the group, "California law specifically prohibits discrimination against individuals with psychiatric disabilities in the zoning of health facilities, and mandates that psychiatric treatment facilities must be allowed in any area zoned for hospitals or nursing facilities." (Read PAI's memo.)

Proposition D was placed on the ballot through a signature drive. The campaign for its passage was bankrolled by the Residential Builders Association, one of whose mailings highlighted a grey-haired senior with a big bruise over her eye and the headline "San Francisco's Shocking Secret": "The cover-up of physical abuse inflicted on elderly and frail patients at Laguna Honda."

In 1999, members of the SEIU -- the Service Employees International Union, many of whom worked at Laguna Honda -- joined the Residential Builders Association and neighborhood groups in a campaign to get voters to approve a measure to finance rebuilding the aging institution, reportedly the largest nursing home in the nation.

Ragged Edge readers may recall that disability rights groups fought that, taking the city to court under the Americans with Disabilities Act over the rebuilding of an institution rather than providing community based services.

Laguna Honda is situated in the midst of some of nation's most progressive neighborhoods. But voters there don't seem to understand why disability rights groups say institutions in and of themselves are bad policy, or why they insist rebuilding a nursing home should be illegal.

The 1999 campaign to rebuild the institution focused on the place as a home for elderly people -- a deceptive campaign, said opponents of the rebuilding effort. Backers made voters believe the public nursing home would be exclusively for frail seniors. News reports now suggest the current effort was prompted when voters realized that no, Laguna Honda was not serving just elderly people, but was admitting people with psychiatric disabilities as well as younger people. Voters backing Proposition D now say they want to insure that the institution is kept "safe" for senior residents.

But the Laguna Honda problem was only the tip of the iceberg. Opponents insisted that Proposition, if OK'd by voters, would open up all land zoned for public use -- about 1,600 lots in all -- to the development of privately owned nursing homes, something they consider unconscionable. They point to the fact that the Residential Builders Association, which represents about 700 builders, was bankrolling the campaign, just as they bankrolled the 1999 effort.

It appeared the city attorney's reading of the measure agreed that this could have happened.

From a story in the San Francisco Chronicle:

According to analyses by the city attorney's office and the Planning Department, [Proposition D would] allow private builders to apply for conditional use permits to build nursing homes on publicly zoned lands and in residential areas. Public lots are zoned for public use, including for parks, schools and hospitals; they also include right-of-way spaces.

According to the Planning Department, there are nearly 1,600 publicly zoned lots in San Francisco, though 417 -- including Golden Gate Park -- are also zoned as open space and would be impossible to develop.

Others, such as the 11 schools closed or slated for closure, could easily be leased for nursing home development. . . (read story Land use changes tucked in Prop. D / Laguna Honda plan opens public lots to nursing homes ).

According to a story in the May 29 San Francisco Chronicle, City Controller Ed Harrington estimated Proposition D "would cost the city $27 million annually, with much of that cost stemming from having to send Laguna Honda patients who suffer from dementia and other conditions to other facilities."

Here are a few of the stories and opinion pieces on Proposition D:

CAMPAIGN 2006: Proposition D San Francisco Chronicle, May 29, 2006
Prop. D will keep National City safe and strong San Diego Union Tribune, June 1, 2006
Guest Editorial: Proposition D is Very Deceptive Beyond Chron, May 3, 2006
Doctors Support Proposition D Beyond Chron, May 3, 2006
The Desperate Misinformation From Prop. D's Opponents Bay Area Indymedia, Jun 1, 2006
Laguna Hospital Prop D opponents cite measure as land grab SanFranciscoSentinel.com, May 26, 2006
Guest Editorial: Alzheimer’s Advocates Should Support Prop D Beyond Chron, May 17, 2006
Mental Health Community Opposes Prop D Beyond Chron, May 17, 2006
Prop. D's misinformation campaign San Francisco Bay Guardian, May 30, 2006
Prop. D's effects on patients disputed Bay Area Reporter, May 11, 2006