Located in San Francisco’s Mission District, San Francisco General Hospital (SFGH) is the City’s safety net hospital and serves all people, regardless of income or insurance status. SFGH provides comprehensive medical care, from primary care and prevention to sub-specialties, emergency and disaster response. SFGH is San Francisco’s only Level 1 Trauma Center, as well as the only psychiatric emergency service.
In FY 2006/07, SFGH admitted over 16,000 inpatients and handled over 506,000 outpatient visits through its ambulatory care clinics. The Emergency Department at SFGH is San Francisco’s busiest, and saw 52,000 visits last fiscal year.
THE UCSF-SFGH AFFILIATION AGREMEENT
The City & County of San Francisco and the University of California, San Francisco (UCSF) have been partners in providing health care since 1873. The current Affiliation Agreement was signed in 1994, and it embodies UCSF’s commitment to the provision of health care services to the public.
Under the terms of the Affiliation Agreement, UCSF provides all physician services at SFGH, which also serves as a crucial training ground for UCSF medical students and residents. UCSF physicians and other health care professionals work alongside City nurses, administrators and health care workers employed by the San Francisco Department of Public Health.
EDUCATION, TRAINING, AND RESEARCH AT SFGH
"The physician services and medical education that UCSF faculty provide at San Francisco General are a core of UCSF's health care mission," says Sam Hawgood, MB BS, interim dean of the UCSF School of Medicine. "There is no better way for our trainees to learn how to address the diversity of medical need in our community, and patients benefit because our faculty are able to apply lessons from UCSF’s latest research to patient care every day."
There are approximately 1,400 UCSF faculty and staff at SFGH who support the University’s clinical, teaching, and research missions, with another 600 UCSF employees located at other SFGH-affiliated sites. UCSF contributes the talent of its faculty, residents and students, who provide high-quality patient care services and conduct cutting-edge clinical and basic research, from pioneering treatment for HIV/AIDS to detecting drug-resistant strains of Staphylococcus. Their groundbreaking discoveries and innovations are often translated into improved health practices, protocols and policies around the world.
The UCSF School of Medicine, as well as the schools of Nursing, Pharmacy, and Dentistry, benefit from access to SFGH for training in clinical care. With an exceptionally diverse patient population, SFGH affords UCSF faculty and residents unique opportunities to develop culturally competent models of care. On any given day, about one-third of UCSF’s resident physicians work at SFGH, making it an essential component of UCSF’s mission to train the next generation of physicians. In addition, students and residents from the schools of Dentistry, Nursing and Pharmacy work at SFGH every day.
In addition, the robust UCSF research programs at SFGH attract physicians committed to public health and medical advancement. The SFGH campus is home to more than 20 UCSF research centers, affiliated institutes, and major laboratories. More than 160 UCSF principal investigators conduct research through programs based at SFGH with an annual budget over $100 million from sources such as the National Institutes of Health.
THE NEED TO REBUILD
State law requires that SFGH be rebuilt to meet seismic safety concerns no later than 2015. The San Francisco Department of Public Health has begun planning and design for a replacement hospital in order to meet this deadline. The University of California Board of Regents requires that space occupied by University employees meet a minimum seismic safety standard. UCSF physicians and staff may not be able to continue to work at SFGH if the hospital rebuild project is not completed by 2015, as planned.
San Francisco voters will be asked to approve an $887.4m general obligation bond in November 2008 to fund the construction of a replacement hospital at the existing Potrero Avenue campus.
When complete, the new hospital would have 284 beds, with an increase in the number of private rooms and critical care beds to meet community needs. The rebuilt facility will also provide expanded capacity in the Emergency Department.
- The proposed hospital is too big to construct between two 85-foot-high, non-retrofitted, 93-year-old brick buildings. A catastrophic earthquake could crush the new hospital. State law requires both seismic safety and continued operations following earthquakes.
- Hospitals in other jurisdictions, including San Diego, chose, and/or completed, seismic retrofits, but San Francisco inadequately explored retrofitting SFGH. DPH officials offer conflicting excuses why retrofitting to non-structural Level 2 (NPC-3) standards, a viable option, wasn’t considered.
- The oval hospital design costs $265 million over the original rectangular design, including $7 million for art.
- Bed capacity is insufficient for future needs: The project adds 32 beds, increasing 19 neonatal ICU and pediatric beds, and eliminating 16 medical/surgical beds. The 2007 Lewin report cited a citywide shortage of 533 acute hospital beds by 2030, 24% below projected needs.
- Laguna Honda Hospital’s delayed, ten-year rebuild is $241 million (60%) over budget and 420 beds (35%) smaller than originally promised.
- The project’s minimum cost is $1.7 billion, including planning; construction; debt service; and furniture, fixtures, and equipment.
- Property owners will be annually taxed $59 for every $100,000 of property assessments over the next 23 years. Due to a 50% pass-through clause, renters face annual $100 to $300 rent increases.
- The City’s final project report doesn’t discuss Emergency Room capacity. Estimated construction costs may reach $943 million, possibly under-funding the bond by $55.6 million, even before inevitable cost overruns. Supplemental funding will be used without voter approval. A 2008 Grand Jury Report concluded fiscal accountability and oversight of capital projects remain ongoing problems.
- The 2013 deadline is man-made: Senate Bill 306 (October 2007) provides extensions to 2020. More time is needed to correct project flaws and increase bed capacity.
- The Civil Grand Jury’s 6/26/2008 report documents City bond oversight, concluding: “The ultimate response to the lack of accountability and oversight is for the voters to demand better governance from City officials. In the meantime, there are no standard operating procedures to hold departments and commissions accountable [for bonds] and, by extension, no accountability by the Board of Supervisors, [the Controller], or the Mayor’s Office.”
- A helipad remains under consideration.
More information may be found at http://www.sfdph.org/dph/RebuildSFGH/
INDIVIDUAL UCSF FACULTY AND STAFF ENDORSEMENTS*
J. Michael Bishop – Chancellor, UCSF
Sue Carlisle – Associate Dean, SFGH, UCSF School of Medicine
Kathy Dracup – Dean, UCSF School of Nursing
John Featherstone – Interim Dean, UCSF School of Dentistry
Barbara French – Associate Vice Chancellor, University Relations
Sam Hawgood – Interim Dean, UCSF School of Medicine
Talmadge King – Chair, Department of Medicine, UCSF School of Medicine
Mary Anne Koda-Kimble – Dean, UCSF School of Pharmacy
Mark Laret – CEO, UCSF Medical Center
Bruce Spaulding – Senior Vice Chancellor, University Advancement & Planning
*titles and affiliations for identification purposes only
ELECTED OFFICIAL ENDORSEMENTS
Senator Dianne Feinstein
Speaker of the U.S. House of Representatives Nancy Pelosi
Congressman Mike Thompson
Senator Carole Migden
Senator Leland Yee
Assemblyman Mark Leno
Assemblywoman Fiona Ma
Mayor Gavin Newsom
Former Mayor Willie Brown
Assessor-Recorder Phil Ting
Treasurer José Cisneros
Sheriff Michael Hennessey
Public Defender Jeff Adachi
Supervisor Jake McGoldrick
Supervisor Michela Alioto-Pier
Supervisor Aaron Peskin
Supervisor Carmen Chu
Supervisor Ross Mirkarimi
Supervisor Chris Daly
Supervisor Sean Elsbernd
Supervisor Bevan Dufty
Supervisor Tom Ammiano
Supervisor Sophie Maxwell
Supervisor Gerardo Sandoval
Mark Sanchez, President, Board of Education
Norman Yee, Board of Education
Eric Mar, Board of Education
Kim-Shree Maufas, Board of Education
Hydra Mendoza, Board of Education
Jill Wynns, Board of Education
Jane Kim, Board of Education
Lawrence Wong, President, San Francisco Community College Board
Natalie Berg, Vice President, San Francisco Community College Board
Anita Grier, San Francisco Community College Board
Milton Marks, San Francisco Community College Board
John Rizzo, San Francisco Community College Board
Rodel Rodis, San Francisco Community College Board
COMMUNITY LEADER ENDORSEMENTS
James M. Illig, President, San Francisco Health Commission
Edward A. Chow, Health Commissioner
Margine Sako, Health Commissioner
David J. Sanchez, Jr., PhD, Health Commissioner
Steven Tierney, Health Commissioner
Roma Guy, former Health Commissioner
Markus Watson, D.D.S., former Health Commissioner
Ann Blumlein Lazarus, former Co-chair and founder, Human Services Network
Jim Lazarus, Senior Vice President, SF Chamber of Commerce
Tom Nolan, Executive Director, Project Open Hand; Vice President, Municipal Transit Agency Board of Directors*
Sister M. Ellene Egan, Chair, St. Mary’s Medical Center Board*
Anna Cheung, President, St. Mary’s Medical Center*
Theresa Sparks, President, Police Commission; Former Co-chair, Alice B. Toklas LGBT Democratic Club*
Martha Knutzen, Former Co-chair, Alice B. Toklas LGBT Democratic Club*
Anni Chung, Community Leader
Fran Kipnis, Emeritus Board, Alice B. Toklas LGBT Democratic Club*
Scott Wiener, San Francisco Democratic County Central Committee*
Donna Calame, Executive Director, In Home Supportive Services Public Authority*
Joanne Hayes-White, Chief, San Francisco Fire Department*
Harrison Lim, Board of Director, Chinese Consolidated Benevolent Association*
Dennis Kelly, President, UESF*
David Chiu, Small Business Commissioner; chair, Lower Polk Neighbors
Nancy Yim Lee, Program Director, Chinatown Child Development Center*
Mai-Mai Ho, Executive Director, Asian Perinatal Advocates*
Dr. Rolland Lowe, Retired, Chinatown Community Physician*
Frances Lee, Provost Emeritus, San Francisco City College*
Henry Der, Former California Deputy Superintendent of Public Instruction*
Kent Woo, ED, NICOS Chinese Health Coalition*
Mary Lou Licwinko, Executive Director, San Francisco Medical Society
Alice Wong, President, IHSS Public Authority Governing Board
*titles and affiliations for identification purposes only
San Francisco Democratic Party
San Francisco Republican Party
San Francisco Chamber of Commerce
Golden Gate Restaurant Association
San Francisco General Hospital Foundation
California Medical Association
San Francisco HIV Health Services Planning Council
Harvey Milk LGBT Democratic Club
San Francisco Medical Society