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Supervisors Approve Health Services Master Plan

San Francisco Supervisors Chris Daly and David Campos, foreground, and David Chiu and John Avalos talk before the Board of Supervisors meeting Nov. 16, 2010
San Francisco Supervisors Chris Daly and David Campos, foreground, and David Chiu and John Avalos talk before the Board of Supervisors meeting Nov. 16, 2010
New guidelines would mean major changes for hospital expansions and could threaten planned 'mega hospital' on Cathedral Hill

San Francisco supervisors on Tuesday paved the way for the creation of a Health Services Master Plan, a set of guidelines for the city to determine where future medical facilities may be placed and what services they must provide.

The ordinance, which passed a preliminary vote before the full board on Tuesday, could threaten the “mega-hospital” project on Cathedral Hill proposed by California Pacific Medical Center and significantly alter the calculus for how major health care providers like Kaiser Permanente carry out future expansions within the city.

Supervisor David Campos, who proposed the legislation, said a broad blueprint was needed to ensure that the city’s various neighborhoods and socioeconomic constituencies have adequate access to medical services.

“It’s a historic step in San Francisco,” Campos said after the vote. “We’re leading the country in medical access and equity.”

Campos put forward the measure while debate continues in the city over CPMC’s $2.5 billion project to consolidate its facilities and build a state-of-the-art medical center at Van Ness Avenue and Geary Street. The project has attracted some criticism because it would sharply downsize or revamp four smaller facilities scattered around the city that serve low-income and minority patients — including St. Luke’s hospital in the Outer Mission, in Campos’s district. (Campos has maintained that his ordinance was not meant to directly target CPMC.)

The measure passed 8 to 3 on Tuesday, with Supervisors Sean Elsbernd, Michela Alioto-Pier and Carmen Chu voting in dissent.

Elsbernd warned that the ordinance was unnecessary and would politicize medical care. Currently, Elsbernd said, opponents of certain development projects can pursue two avenues: environmental impact reviews and conditional-use permit reviews. These two appeals processes could be amended to also include health care provision standards, he argued, without creating a new tool to stymie hospital expansions.

“This is largely about obstructing and slowing projects,” Elsbernd said, adding that he was concerned about how it would affect Kaiser “10 years down the road.”

Alioto-Pier, who sided with Elsbernd, added that she was concerned about the measure’s impact on future expansions for Saint Francis Memorial Hospital and Catholic Healthcare West.

The board will need to vote once more to ratify the ordinance. If the legislation survives a potential veto from Mayor Gavin Newsom, the Planning Department and the Department of Public Health will immediately begin to draft the guidelines. Officials from the two departments have not yet given any indication of what metrics the master plan would take into account.

The master plan will take effect around the beginning of 2013, City Hall staff said.

Mayor Gavin Newsom did not indicate whether or not he would back the measure, which has been amended by Campos.

“As it was originally drafted, the mayor was opposed to it as it created too many new hurdles and further politicized health care facility decisions in the city,” said Tony Winnicker, Newsom’s spokesman. “The legislation has been improved through the amendment process, but the mayor will want to take time to review it fully before deciding whether to allow it to become law.”

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