TO: Honorable Members of the Board of Supervisors

FROM: Office of the Legislative Analyst

SUBJECT: Employee Suggestion No. 7: Consolidating and/or Eliminating Food Services Positions at Laguna Honda Hospital

Laguna Honda Hospital and Rehabilitation Center (LHH) is a long-term care facility owned and operated by the City and County of San Francisco. The employee suggests that positions in Food Services at LHH could be consolidated and/or eliminated to reduce the City’s human resources expenditures.

Data from the past 5 years indicates that LHH Food Services has experienced staffing reductions while the overall patient population has remained constant. In addition, Food Services already appears to be strained for resources given the complexity of patient nutritional need and legal reporting requirements. Further Food Services staffing cuts are not advised.

The employee claims that over the years, the number of patients at LHH has decreased while the staff size of Food Services has grown. The employee believes that the current number of positions in the department is wasteful. According to the Director of Food Services, however, the patient population at LHH has remained relatively steady over time and positions in Food Services have been cut progressively.

The Director of the Admissions at LHH confirmed that the number of patients in residence has been constant. Over the past 5 years, the most this figure has varied is by 27.7 patients. Notably, LHH has never housed more than about 1,290 patients. In addition, a review of the Annual Salary Ordinance from the past 5 years indicates that Food Services has experienced staffing cuts. During FY 01/02, there were 76 FTE Food Service Workers. During FY 02/03, that number was reduced to 70.5 FTE and the following fiscal year to 69.5 FTE. The number of Cooks also dropped from 8 to 7 between FY 01/02 and FY 02/03.

Also worth noting is that state and federal reporting requirements imposed on long-term care facilities have increased over the years. Depending on the status of the patient – the level of nutritional care s/he requires, and the manner in which the patient is fed (eats independently, eats with assistance, requires tube feeding, etc.) –reporting requirements may be quite onerous. This significantly adds to the workload of Food Services staff. Finally, volunteers are heavily relied upon to assist in meeting the nutritional needs of LHH patients. This suggests that the Food Services staff is already stretched thin and should not be further reduced.

In summary, the employee’s facts are inaccurate. The number of patients at LHH has remained relatively constant, while the Food Services staff has been progressively reduced. Within this context, the Office of the Legislative Analyst believes that LHH Food Services should not be cut as a money saving device for the City.