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Rebuild San Francisco
General Hospital & Trauma Center

San Francisco Department of Public Health
Response to the 2002 Civil Grand Jury ReportSan Francisco Department of Public Health Response to the 2002 Civil Grand Jury Report

Rebuild of San Francisco General Hospital
Recommendation 1—Rebuild San Francisco General Hospital & Trauma Center
On January 9, 2001, the San Francisco Health Commission approved Resolution No. 1-01 (see attachment A), which supports the rebuilding of San Francisco General Hospital & Trauma Center (SFGH) by the year 2013. The Health Commission also called for the formation of a SFGH Rebuild Planning Committee to develop a plan to respond to the physical plant issues at SFGH in a timely manner.
Following the Resolution, the San Francisco Department of Public Health (SFDPH) initiated a 7-week preliminary planning process for rebuilding SFGH. This "first phase" of planning focused specifically on meeting SB 1953 seismic safety mandates. However, SB 1953 planning spurred the opportunity to re-think how to deliver health care services in the future (10-30 years from now) based on the projected future health needs of San Franciscans, the mission of the SFDPH, and the specific health care needs of the special populations the SFDPH serves. Thus, in January 2002, the second phase of planning—Long-range Service Delivery Plan--was initiated to help answer these broader issues. At the conclusion of this process, the SFDPH will have a plan for the array of programs for the future, with particular emphasis on programs that will impact the rebuilding of SFGH (see below for details).


Recommendation 2a—San Francisco should complete a master plan for SFGH.

Recommendation 2b—Quickly develop a shared vision and introduce a bond measure.
The submittal of a preliminary compliance plan to the Office of Statewide Health Planning Development (OSHPD) by January 2002 was a mandatory step under SB 1953. Although a compliance plan was submitted, an amended plan can be submitted until July 1, 2004.
Two other separate planning processes will define the revised compliance plan--the Long Range Service Delivery (LRSD) Plan and the SFGH Institutional Master Plan (IMP). The LRSD planning process will assess the long-range service priorities based on projected future client need of the SFDPH. The LRSD Plan will then serve as a basis to the development of the IMP, which will define the facility plans for the rebuilding of SFGH. Multiple options for healthcare service configuration and location will be considered, but ultimately, one recommended service delivery plan will be brought forward for adoption by the Health Commission. The Health Commission will consider these options at their regularly scheduled Health Commission meeting on July 16, 2002.
The rebuild of SFGH will take place over a 10-15 year timeframe. Thus, inherent to the overall planning processes is adaptability to future social, political, and economic events that may affect the rebuild.


The Long Range Service Delivery (LRSD) Plan

The LRSD planning project is concerned with the overall allocation of health services in order to optimally meet the future needs of the SFDPH’s service population. The goal is to develop a vision for the kinds of services SFDPH will be providing 10-30 years from now, as it impacts the plans for rebuilding SFGH.
Currently there are two planning groups involved in this process:

    1. an internal Department of Public Health Group (DPH Group), consisting of DPH administrative leaders and UCSF chiefs of service, and
    2. A Community Group with over 40 members who are representative of a diverse mix of San Francisco community leaders, neighbors, clients, other hospitals and health clinics, academia, church groups, labor, housing, consumers, the Board of Supervisors, the Mayor’s Office, UCSF, and other local groups.

These groups have been meeting both separately and jointly since January. At the conclusion of this phase of the planning process in June 2002, open questions about the size, configuration and location of services in the future will be decided. Recommendations will be forwarded to the Health Commission for approval in July and then be used as a basis for the SFGH Institutional Master Plan and SB 1953 Compliance Plan. For more information on the LRSD planning process, please visit http://www.dph.sf.ca.us/sfghrebuild/default.htm.


The SFGH Institutional Master Plan (IMP)

The SFGH Institutional Master Plan (IMP) will identify physical solutions to upgrade or replace seismically poor SFGH buildings. The study focuses on the existing SFGH campus but may also evaluate the potential for Mission Bay collocation scenarios. The IMP is a required element for any future development on the SFGH campus, as well as a required step for any new City hospital construction that may occur in San Francisco.
Consultants for the IMP planning process will begin work in June 2002 and conclude in April 2003, upon submission of the IMP to the San Francisco Planning Department. The following is an approximate deliverables timeline for the development of the IMP:


Institutional Master Plan
Deliverables Timeline

Jun-02

Strategic Healthcare Planning consultation confirming program statement

Jul-02

Institutional profile (background data on SFGH, neighborhoods)
Technical site studies

Aug-02

Conformity and Impacts Analysis
Utility Infrastructure Planning Matrix

Sep-02

Development Concepts for SFGH campus
Main Hospital Re-classification Options
Historic Preservation report and guidelines

Oct-02

Alternatives and Mitigations Assessment
New development report and matrix
Parking and Traffic Evaluation

Nov-02

First draft of IMP document

Jan-03

Final draft of IMP document
Visual Exhibits

April-03

Institutional Master Plan for submission to Planning Department

Members from the LRSD Group and the IMP consultants will meet on a monthly basis to ensure an integrative planning approach to the development of the IMP. (See Attachment on Integration of the LRSD and IMP.)


Recommendation 3—Maintain the mutually beneficial SFGH-UCSF affiliation.

For over one hundred years, SFGH has maintained a vital partnership with the University of California at San Francisco (UCSF). As a teaching hospital for UCSF, SFGH’s entire medical staff is comprised of UCSF physicians who provide patients with the highest quality of medical care, and conduct cutting edge research at the SFGH campus. SFGH, through its long-standing affiliation with UCSF, has been the nucleus for medical research in the areas of AIDS/HIV, lung biology, infectious diseases, neurology, and other healthcare concerns vital to the citizens of San Francisco. Throughout the LRSD planning process, preservation of this important relationship has been prioritized as one of the necessary conditions of a rebuilt SFGH.
SFDPH and UCSF have been meeting since the Fall 2001 to explore various options for co-locating facilities at Mission Bay as well as joint programming. SFDPH and UCSF have also been meeting together to determine how to ensure space for UCSF occupants (particularly research) in seismically safe buildings at SFGH. A plan will be submitted to the UC Office of the President to demonstrate that UCSF can address existing and future seismic issues.


Recommendation 4—Educate the public on the role of SFGH in the community.

As one of the nation’s leading public hospitals, SFGH has continuously provided a wide range of ambulatory and acute care services to generations of San Francisco residents for over one hundred years. As part of the SFDPH Community Health Network, SFGH is one part of the continuum of care that provides services for San Franciscans, especially those who no other choice for care. SFGH has received national and international recognition for excellence in services, such as AIDS care, primary care, specialty care, women and children’s services, psychiatric services, trauma, clinical research and teaching.
SFGH has the only trauma center in San Francisco, and serves as a regional resource center caring for high numbers of the most complex and severely injured patients. Level 1 centers have the highest designation for trauma centers, and provide total care for all aspects of injury, from prevention through rehabilitation, and take on a leadership role in education, research, and system planning.
As San Francisco’s only public acute care hospital, SFGH has a vital role in providing quality, culturally-appropriate health care services to underserved populations. Patients who are lower-income, homeless, and uninsured depend on SFGH for their health care needs.
Efforts to educate the public on the vital role of SFGH are on-going and continuous. However, city workers are precluded to work on campaign issues that are slated to go to the voters during work hours. The passage of a bond measure to rebuild SFGH in the March 2003 election will require wide support and assistance to launch an effective campaign to educate the public on the importance of SFGH to the City of San Francisco.