Critical care - Page 5

How the debate over CPMC's controversial multi-hospital project revived the idea of healthcare planning in San Francisco

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A big health care outfit has giant plans to transform SF's hospital infrastructure -- unless the city can demand a better plan
GUARDIAN ILLUSTRATION BY JOHN UELAND

Michelucci says the dispute over St. Luke's came to a head three years ago, when nurses began to suspect that CPMC was planning to let the facility fail, suspicions that intensified when CPMC closed St. Luke's neonatal intensive care unit 18 months ago.

"Now the babies who need neonatal special care are transported to CPMC's California campus, which is in the Richmond," Michelucci said. "But the moms may be discharged and most of them live in the Mission or Bayview-Hunters Point."

Michelucchi still fears that CPMC will wage "a horrific campaign" against the California's Nurses Association as it continues to push the plan for its megahospital. "CPMC wants to be in complete control of the registered nurses," she said. "We, unfortunately, are their conscience, while they are a business model in the business of healthcare. The decisions they make about healthcare are not in the interests of patients or nurses, and we are the thorn in their side."

All this is happening against the backdrop of the worst economic recession since the Great Depression, and for construction workers facing high unemployment rates in San Francisco, CPMC's megaproject clearly represents light at the end of a very dark tunnel.

"CPMC is my future," William Hestor, a 28-year-old father of two and member of SEIU-United Healthcare Workers, said at the Nov. 15 hearing. "We worked hard on a contract and we just want to make sure our hospital is built on time."

CPMC media spokesperson Kevin McCormack told the Guardian that the real issue between CPMC and the CNA is union membership at CPMC's Cathedral Hill facility. "CPMC is reducing beds at St. Luke's because the beds aren't in use, but the facility will be able to take care of 90 percent of patients' needs and if you need specialist care, a shuttle will take you to Cathedral Hill," McCormack said. "This centralized arrangement is the best way to attract the best staff and equipment."

McCormack noted that there are union members and 1,200 nonunion nurses working at CPMC facilities in San Francisco. "We are bringing together nonunion and union nurses together at this facility, and we don't feel we have the right to force our nonunion nurses to join," he said, adding that since the Teamsters, the Carpenters, and SEIU-United Healthcare Workers (UHW) are already unionized at the Pacific and California campuses, they'll be allowed to unionize at Cathedral Hill.

CNA member Eileen Prendiville, who has worked in San Francisco as a registered nurse for decades, recalls the negative changes she has already seen at CPMC's facilities, including eliminating registered nurses and specialty services.

"If you pull services, as they have, of course you'll have fewer patients. And the physicians start leaving, so it's a vicious cycle," she said. "St. Luke's was a small community hospital but now it's all about corporate medicine."

Sup. Eric Mar sided with those seeking to exempt current projects from the city's health care services master plan. But Sup. Sophie Maxwell noted that the Planning Commission will take a facility's historical role into account in determining whether projects are consistent with the city's health care services plan.

"We believe that addressed community concerns," Maxwell said. "St. Luke's would never have been targeted for closure had this legislation been on the books in the past."

Campos insists his legislation is not simply about CPMC. "Ultimately this legislation stems from a number of pleas we have heard in the last couple of years from people throughout the city," he said. "It takes the institutional master planning process to the next level. We have tried to consolidate the appeal process under existing law. Important as the legislation is, it's key to make sure we have the right master plan because that's where the heavy lifting will take place."