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Health Commission holds Prop Q hearing after St. Mary's wound clinic closed without timely notice
Summary
At a first Proposition Q hearing, St. Mary's Medical Center's new leadership apologized for failing to give timely notice before closing its PROS and Wound Care Clinic in August 2016; commissioners asked the hospital and department staff to track where patients were referred and to return with data.
The San Francisco Health Commission held a Proposition Q hearing on the closure of St. Mary's PROS and Wound Care Wound Clinic, learning that the clinic closed in August 2016 and the hospital notified the Department of Public Health on Feb. 7, 2017.
Christian Patel, a planner in the Department's Office of Policy and Planning, told commissioners that the clinic served about 437 patients in mid-2016 and that St. Mary's provided additional data to the department on May 17. Commission staff said the delay in notification and the time gap make it difficult to determine the full impact of the closure on patients.
Representatives of St. Mary's acknowledged the lapse. The hospital's new president (name not stated) apologized and said turnover in leadership contributed to the failure to follow Prop Q notice requirements. "We will work in partnership with the needs of the community," the president said, and committed to reassess the program and engage community partners going forward.
Dr. Barbara Murray, who identified herself as St. Mary's chief medical officer, described the clinic's history and the types of complex care it provided, including surgical and vascular procedures intended to avoid amputations. "Wound care is very difficult; it's a specialized area," Murray said, noting some care required operating-room procedures and complex vascular work performed in partnership with UCSF and other providers.
Commissioners pressed the hospital for follow-up information. They asked whether patients were placed elsewhere in the St. Mary's system, whether the hospital could trace patients who were referred to outside clinics, and whether the department could sample patient records to confirm continuity of care. St. Mary's said most employees affected by the closure were placed in other hospital programs and that a small number received severance; the hospital identified two staff who chose severance and one involuntary separation.
Department Director Garcia and hospital leadership agreed to perform a retrospective review to locate referred patients and report a sample of follow-up findings to the commission at the next meeting. Commissioners also flagged concern about the disproportionate number of older adults among the clinic's patients and asked staff to include demographic detail, referral mechanisms, and whether alternate providers were accessible in city languages.
No formal resolution was considered at this first hearing; staff said a draft resolution will be circulated for the commission's consideration at the next meeting. The Prop Q process requires the commission to determine whether a private hospital's closure of services adversely affected the health of the city and whether additional action is warranted.
Next steps: St. Mary's and DPH will conduct a retrospective patient-tracking review and return to the commission with sample data and demographic details at the scheduled follow-up hearing.
