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Residents urge SFHSS to address out-of-county skilled-nursing discharges; Blue Shield and Providence issues noted
Summary
Public commenters and staff raised concerns about Kaiser and Blue Shield contracting with skilled-nursing facilities, citing out-of-county discharges and restrictive rehab authorizations; Blue Shield and Providence clarified a mistaken mailing to retirees and staff said they would track contracting issues for future discussion.
Members of the public urged the San Francisco Health Service System board to tackle what they said are systemic problems that push city retirees into out-of-county skilled-nursing placements and short, suboptimal rehab stays.
Dr. Teresa Palmer, a city retiree and geriatrician, told the board patients were being discharged out of county to skilled nursing facilities where families cannot visit and advocate. "If you're not close to home, your family can't stay with you and support and advocate for you on a daily basis," she said during public comment and asked the board to place the issue on a future agenda.
Fred Sanchez asked the board to convene a special stakeholder meeting with supervisors, insurers, skilled-nursing facilities and state managed-care regulators so parties could "speak freely" and improve placement and in-city availability.
During contract-representative updates, Blue Shields Liz Canopy said about 800 SFHSS retirees received a Providence mailing incorrectly indicating coverage termination; Providence attributed the mailing to a broker-relations error tied to UnitedHealthcare and did not send corrective mailings, opting instead to update call-center staff. Blue Shield said it has not seen ongoing member calls on the issue and considered the matter closed.
A public commenter later raised a separate contracting concern, saying Blue Shields short permitted rehab authorizations discouraged facility admissions and may be forcing city retirees into out-of-county rehab placements; the board said it would note the concern for follow-up.
Board and staff did not take direct action at the meeting but acknowledged the public concerns and described available next steps, including targeted discussion with carriers and possible future agenda items.
