CPMC Archives — Page 4 of 4 — San Francisco Bay Guardian Archive 1966

Critical care

Jesse Hawthorne Ficks

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November 23, 2010

Sarah@sfbg.com

A complex and controversial project that would involve five San Francisco hospitals — including building a huge showcase facility for the wealthy atop Cathedral Hill — has prompted a debate about what average city residents need from the health care system.

California Pacific Medical Center, an affiliate of Sutter Health, proposes to downsize St. Luke’s Hospital, which primarily serves a low-income population in the Mission District, as part of a $2.5 billion proposal to renovate and retrofit three existing medical campuses, close another one, and build housing and a megahospital on Cathedral Hill that would draw patients from around the country.

CPMC’s grandiose plan was being considered strictly as a land use decision, despite its far-reaching impact on the city’s health care system. So Sup. David Campos created legislation calling for the city to create a citywide health services master plan and to use that as another tool for gauging future medical projects.

Debate over that legislation left some activists on both sides unhappy, with progressives disappointed that it won’t be able to stop a CPMC project they see as neglectful of the poor, and moderates wary of creating a new way to challenge development projects in the face of widespread unemployment in the construction industry.

But it struck a fine enough balance to win 8-3 approval by the board Nov. 16, enough to override a threatened mayoral veto. “I’m really happy and excited about the passage of this legislation,” Campos told the Guardian after the vote.

The legislation has a two-part mandate, with the first part kicking in as soon as it has final approval. It requires the Planning Department, with input from the Department of Public Health, to prepare a health care services master plan to identify current and projected needs for health care services and where they should be provided.

The second part, which begins in 2013, requires Planning to determine whether medical projects are consistent with the findings of this plan. That delay is credited to a last-minute amendment Campos granted during a Nov. 15 committee hearing after the hospital industry complained that the process could jeopardize its ability to meet state-mandated seismic retrofitting deadlines for projects already in the planning pipeline.

The passage of Campos’ legislation comes eight months after President Barack Obama signed the Patient Protection and Affordable Care Act. Hailed by its supporters as the most significant change to the U.S. health care delivery systems in 40 years, the reform package has also been greeted with criticism on both ends of the political spectrum. Progressives complain that it relies too heavily on private insurance companies and medical providers, while Tea Party supporters says that it’s government run amok and they have vowed to “kill the bill.” Senate Minority Leader Mitch McConnell (R-Ky) recently compared so-called Obamacare to “tyranny” in a speech to conservative legal scholars.

But here in San Francisco, the debate over Campos’ legislation — as heated and divisive as it was at times — yielded a surprising amount of consensus around the long-neglected idea that government should play a role in health care planning.

PULLING THE PLUG

The passage of Campos’ legislation marks the first time in 30 years that a government entity has mandated health care services planning in California. That approach West Bay Health Systems Agency, whose creation he opposed as governor of California.

Lucy Johns, a San Francisco-based health care planning consultant who wrote the only health care services master plan California has ever had, recalls what happened in the mid-1970s after President Gerald Ford signed legislation that established health system agencies nationwide.

“California established 14 health systems agencies, including the West Bay Health System Agency, which governed the nine Bay Area counties,” Johns told the Guardian. “The legislation mandated that they be established by every state, with the federal government providing the funding. So every state had to decide how many, how big, and how structured the health system agencies would be.”

Johns notes that state legislators were constrained when it came to the decisions these health service agencies made. “The governing bodies of the health systems agencies had to have a membership that was 51 percent consumer and 49 percent healthcare provider, which included doctors, nurses, and hospital administrators,” she said.

That history served as a backdrop for discussion of the Campos legislation, with the Planning Department staff report noting, “With the elimination of the West Bay Health Systems Agency in 1981, there is no longer a routine or comprehensive analysis of health service resources, needs, trends, and local impacts conducted for changes to or within medical uses.”

“It’s truly a historic moment for San Francisco,” Campos said after his legislation passed its Nov. 16 first reading (the second and final reading is set for Nov. 23, after Guardian press time). “We are the first city in the country to make sure land use decisions are aligned to our health care needs. That’s an unprecedented step that will shape the future of healthcare planning for years to come.”

Campos acknowledged that the passage of Obama’s heath reform package — which includes a mandate to purchase private health insurance beginning in 2014 — was also a catalyst for his legislation, along with the CPMC project.

“But it had more to do with seeing that the city didn’t have the tools it needed to evaluate projects in terms of whether they met the city’s healthcare needs and how they might impact people’s access to healthcare,” Campos said. “The main catalyst came from the community, which felt it was being asked to make decisions that will have long-lasting health care implications, but didn’t have any way to understand those needs. Those concerns were compounded by changes at the national level — and the recognition that these changes offer us an opportunity to engage in planning.”

Campos’ legislative victory came two months after members of the Cathedral Hill Neighbors Association joined nurses, medical workers, patients, and community groups in voicing concerns at a Sept. 23 public hearing about the draft environmental impact report for CPMC’s Cathedral Hill hospital and the other facilities that are part of its proposal.

These groups collectively expressed fear that downsizing St. Luke’s, closing the CPMC California campus, and transforming CPMC Pacific campus to an outpatient-only hospital will force low-income people to travel farther to access health care services while offering better service to the wealthy at Cathedral Hill. And neighbors worried that the proposed complex would increase traffic and require the demolition of rent-controlled apartments.

Formed in 1991 through the merger of Pacific-Presbyterian Medical Center and Children’s Hospital of San Francisco, CPMC has been affiliated with Sutter Health since 1996 and currently has four medical campuses in San Francisco: Pacific in Pacific Heights, California in Presidio Heights, Davies in the Duboce Triangle, and St. Luke’s in the Mission.

But CPMC’s longtime goal was to build a facility intended to be like the Mayo Clinic of the West Coast, a 15-story, 555-bed full-service hospital and specialty care facility at the corner of Van Ness Avenue and Geary Boulevard. Company officials have made approval for that project conditional on keeping St. Luke’s open in the face of the state’s deadline on seismic safety standards that the hospital doesn’t now meet.

“St. Luke’s Hospital was the big issue that got our attention,” Le Tim Ly, lead organizer for the Chinese Progressive Association, told the Guardian. His group has worked with residents in the city’s southeast sector around environmental justice, air quality, and pollution issues when they became aware of the threat to St. Luke’s. “All this, coupled with efforts to downsize Luke’s, left us alarmed by the disproportionate impact on an already impacted area.”

But alarm over CPMC’s plans has now revived the idea of healthcare planning.

MAKING A PLAN

As recently as the beginning of November, representatives for the Hospital Council of Northern and Central California — whose members include CPMC, Chinese Hospital, Jewish Home, Kaiser Permanente, Laguna Honda, St Luke’s, St. Mary’s, San Francisco General Hospital, and Veterans Affairs Medical Center — seemed opposed to any change in the way healthcare planning is done in San Francisco.

At a Nov. 1 hearing on the Campos legislation at the board’s Land Use and Economic Development Committee, Ron Smith, the Hospital Council’s senior vice president for advocacy, said his organization favored maintaining the city’s current procedures. “We would like to propose that the Health Commission does the planning, the Planning Commission does the land use, and that there is a required determination process which is in the current legislation,” Smith said. “We’re proposing that that continue.”

But two weeks later, after Campos amended his legislation so projects now in the planning pipeline are exempt from having to comply with the city’s health care services master plan, some members of the Hospital Council seemed to have a change of heart.

CPMC’s Chief Executive Officer Warren Browner surprised just about everybody when he publicly stated in mid-November that CPMC supports health care planning. “We strongly support the efforts of the city — we are in favor of health planning,” Browner said at a Nov. 15 hearing on the legislation.

“That statement was extraordinary,” said Lucy Johns, recalling CPMC’s history of resisting government control. “The conversation about this legislation has already changed the discourse, at least in public.”

Linda Schumacher, chief executive officer of Chinese Hospital, a community-owned, not-for-profit facility, explained at the same hearing that her organization had been concerned that Campos’ legislation would affect her hospital’s ability to move ahead with a $150 million project that has been in the pipeline since 2003.

“We thank you for that amendment that allows the effective date to be changed,” she said.

“It shows how much progress had been made, even before this legislation goes into effect,” Campos said of the hospital industry’s apparent shift in attitude. “It’s a monumental step, something that was not expected as recently as a few months ago.”

But Ly of the Chinese Progressive Association said he believes the Hospital Council still doesn’t want to see the city getting involved. “As recently as a month ago, their folks were speaking out against any kind of legislation. But I think they started seeing the writing on the wall.”

Ly fretted about the potential negative impact of Campos’ last-minute amendments. “Sup. Campos’ plan represents a victory. But we could use that information as soon as possible. The 2013 deadline means the city will be handicapped: it will have information it can’t use yet.”

Ly ventures that the hospital industry’s approach will be to try to lessen the impact of the legislation. “As written, it still provides the Planning Commission and the board with the discretion to approve projects,” Ly said. “Ultimately, the struggle is about values. Just because there are plans and guidance doesn’t mean the healthcare needs of the community will become a top priority — it just provides us with tools to make an assessment.”

Campos counters that his bill will allow the city to create incentives for, and apply pressure on, the hospital industry. “If they truly want their projects to be expedited and approved before state-mandated seismic retrofitting deadlines kick in, they’ll propose plans that work for the community,” Campos explained.

But even as it publicly vows to be supportive, the Hospital Council continues to express concerns about the Campos legislation. “It’s the council’s job is to be supportive now that the board has approved Campos’ plan,” Smith said. “And Sup. Campos was very generous. He started talking to us in June. But we really didn’t get a handle on his proposal until much later. We think the idea of healthcare planning is very good. We still have concerns about the process, but now the board has voted on the legislation, our goal is to do our best to work with the law.”

Concerns that the legislation would be used to mire projects in repeated appeals and give too much weight to critics’ concerns was raised at the Nov. 16 hearing by Sup. Sean Elsbernd.

“Right now, if anyone has concerns, there’s a conditional use process and a CEQA [California Environmental Quality Act] process,” Elsbernd told the Guardian. “But this turns up a brand new appeal. It means the appeals are heard at the same time, but you’ve now created a third route.”

Campos responded to these concerns by amending the legislation to clarify that the board must act on consistency determination appeals at the same time it acts on other related appeals, so projects won’t be delayed.

Evidently this wasn’t enough to appease the San Francisco Chamber of Commerce. “We cannot be supportive of that piece of legislation,” Rob Black, the Chamber’s vice president of public policy, told the Guardian after the legislation was approved. “We believe appeals should be done at the Department of Public Health in conjunction with service providers, since San Francisco provides 20 percent of service, and private organizations provide the remaining 80 percent.”

Black says the Chamber was pleased Campos amended his legislation so as not to slow down projects that are currently in the planning pipeline. But he claimed Campos’ legislation could actually limit access to healthcare services. “The Chamber is concerned that Campos’ legislation will make it harder for doctors to pool together in pods, and if we don’t do that, it won’t make healthcare more available because services will be more expensive,” Black said. “But we absolutely think” the city should analyze gaps in providing health care to San Franciscans.

Campos’ aide Hillary Ronen confirmed that Black is correct in saying that anyone can appeal a hospital project’s consistency determination. “But the final analysis will revolve around asking if the proposed project meets the health care needs of San Francisco,” she said. “If it doesn’t, and the board doesn’t believe there’s a compelling public policy reason to approve the project, [the board] can override the approval.”

PATIENTS VS. PROFITS

Mary Michelucci, a registered nurse for 40 years and a member of the California Nurses Association, is hopeful that Campos’ legislation will rein in the hospital industry.

“I hope that any plan that would favor patient care over profit would be the way to go,” Michelucci said. “Running a hospital is expensive. But with the profits that Sutter and CPMC are making, they can afford this.”

Michelucci says the dispute over St. Luke’s came to a head three years ago, when nurses began to suspect that CPMC was planning to let the facility fail, suspicions that intensified when CPMC closed St. Luke’s neonatal intensive care unit 18 months ago.

“Now the babies who need neonatal special care are transported to CPMC’s California campus, which is in the Richmond,” Michelucci said. “But the moms may be discharged and most of them live in the Mission or Bayview-Hunters Point.”

Michelucchi still fears that CPMC will wage “a horrific campaign” against the California’s Nurses Association as it continues to push the plan for its megahospital. “CPMC wants to be in complete control of the registered nurses,” she said. “We, unfortunately, are their conscience, while they are a business model in the business of healthcare. The decisions they make about healthcare are not in the interests of patients or nurses, and we are the thorn in their side.”

All this is happening against the backdrop of the worst economic recession since the Great Depression, and for construction workers facing high unemployment rates in San Francisco, CPMC’s megaproject clearly represents light at the end of a very dark tunnel.

“CPMC is my future,” William Hestor, a 28-year-old father of two and member of SEIU-United Healthcare Workers, said at the Nov. 15 hearing. “We worked hard on a contract and we just want to make sure our hospital is built on time.”

CPMC media spokesperson Kevin McCormack told the Guardian that the real issue between CPMC and the CNA is union membership at CPMC’s Cathedral Hill facility. “CPMC is reducing beds at St. Luke’s because the beds aren’t in use, but the facility will be able to take care of 90 percent of patients’ needs and if you need specialist care, a shuttle will take you to Cathedral Hill,” McCormack said. “This centralized arrangement is the best way to attract the best staff and equipment.”

McCormack noted that there are union members and 1,200 nonunion nurses working at CPMC facilities in San Francisco. “We are bringing together nonunion and union nurses together at this facility, and we don’t feel we have the right to force our nonunion nurses to join,” he said, adding that since the Teamsters, the Carpenters, and SEIU-United Healthcare Workers (UHW) are already unionized at the Pacific and California campuses, they’ll be allowed to unionize at Cathedral Hill.

CNA member Eileen Prendiville, who has worked in San Francisco as a registered nurse for decades, recalls the negative changes she has already seen at CPMC’s facilities, including eliminating registered nurses and specialty services.

“If you pull services, as they have, of course you’ll have fewer patients. And the physicians start leaving, so it’s a vicious cycle,” she said. “St. Luke’s was a small community hospital but now it’s all about corporate medicine.”

Sup. Eric Mar sided with those seeking to exempt current projects from the city’s health care services master plan. But Sup. Sophie Maxwell noted that the Planning Commission will take a facility’s historical role into account in determining whether projects are consistent with the city’s health care services plan.

“We believe that addressed community concerns,” Maxwell said. “St. Luke’s would never have been targeted for closure had this legislation been on the books in the past.”

Campos insists his legislation is not simply about CPMC. “Ultimately this legislation stems from a number of pleas we have heard in the last couple of years from people throughout the city,” he said. “It takes the institutional master planning process to the next level. We have tried to consolidate the appeal process under existing law. Important as the legislation is, it’s key to make sure we have the right master plan because that’s where the heavy lifting will take place.”

Meanwhile, the final EIR is being completed for the CPMC project, which should go before the Board of Supervisors for approval early next year.

Cash not care

Andrew Lam

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October 26, 2010

5

sarah@sfbg.com

With the general election just days away, campaign disclosure reports show that downtown interests are spending huge amounts of money to create a more conservative San Francisco Board of Supervisors and to pass Proposition B, Public Defender Jeff Adachi’s effort to make city workers pay more for their pensions and health insurance.

Much of the spending is coming from sources hostile to programs designed to protect tenants in the city, including rent control and limits on the conversion on rental housing units to condominiums. An ideological flip of the board, which currently has a progressive majority, could also have big implications on who becomes the next mayor if Gavin Newsom wins his race for lieutenant governor.

At press time, downtown groups were far outspending their progressive counterparts through a series of independent expenditure committees, most of which are controlled by notorious local campaign attorney Jim Sutton (see “The political puppeteer,” 2/4/04) in support of supervisorial candidates Mark Farrell in District 2, Theresa Sparks in District 6, Scott Wiener in District 8, and Steve Moss in District 10.

Prop. B has also been a big recipient of downtown’s cash, although labor groups have pushed back strongly with their own spending to try to kill the measure, which is their main target in this election.

But the biggest spender in this election appears to be Thomas J. Coates, 56, a major investor in apartments and mobile homes and a demonstrated enemy of rent control. He alarmed progressive groups by giving at least $250,000 to groups that support Farrell, Sparks, Wiener, Moss, and Prop. G, legislation that Sup. Sean Elsbernd placed on the ballot to cut transit operator wages and change Muni work rules.

Although Coates declines to identify with a political party on his voter registration, he donated $2,000 to President George W. Bush in 2004. More significantly, he was the biggest individual donor in California’s November 2008 election, when he contributed $1 million to Prop. 98, which sought to repeal rent control in California and limit the government’s right to acquire private property by eminent domain.

Coates, who is also a yachting enthusiast and sits on San Francisco’s America’s Cup Organizing Committee (ACOC), donated $100,000 on Oct. 20 for Farrell, $45,000 for Sparks, $45,000 for Moss, and $10,000 for Wiener through third-party independent expenditure committees such as the Alliance for Jobs and Sustainable Growth.

The group has already received thousands of dollars in soft money from the San Francisco Police Officer’s Association, the Building Operators and Managers Association, the Golden Gate Restaurant Association, and SEIU-United Healthcare Workers, which supports a high-end hospital and housing complex on Cathedral Hill.

Those downtown groups have spent close to $200,000 on English and Chinese language mailers and robo calls in support of Sparks, Wiener, and Moss in hopes of securing a right-wing shift on the board.

Progressive groups including California Nurses Association, the San Francisco Tenants Union, and the SF Labor Council have tried to fight back in the supervisorial races. While downtown groups spent more than $100,000 promoting Sparks in D6, labor and progressive groups spent $13,000 opposing Sparks and $72,000 supporting progressive D6 candidate Debra Walker.

In D8, progressive groups that include teachers, nurses, and transit riders have outspent the downtown crowd, plunking down $40,000 to oppose Wiener and $90,000 to support progressive candidate Rafael Mandelman. So far, downtown groups have spent about $100,000 to support Wiener.

But in D10, the district with the biggest concentration of low-income families and communities of color, downtown interests spent $52,000 supporting Moss and $5,000 on Lynette Sweet while the Tenants Union was only able to summon $4,000 against Moss. The SF Building and Construction Trades Council spent $4,000 on Malia Cohen.

But that’s small potatoes compared to what downtown’s heavy-hitters are spending. The so-called Coalition for Sensible Government, which got a $100,000 donation from the San Francisco Association of Realtors, has already collectively spent $96,000 in support of Sparks, Wiener, Moss, Sweet, Rebecca Prozan in D8, Prop. G and Prop. L (sit-lie) and to oppose Prop. M (the progressive plan for police foot patrols) and Prop. N (a transfer tax on properties worth more than $5 million).

The Coalition for Responsible Growth, founded by Anthony Guilfoyle, the father of Mayor Gavin Newsom’s ex-wife, Kimberly Guilfoyle (who now works as a Fox News personality), has received $85,000 from the Committee on Jobs, $60,000 from the Realtors, and $35,000 from SF Forward. It has focused on spending in support of Prop. G and producing a voter guide for Plan C, the conservative group that supports Sparks, Wiener, Sweet, and Moss

Coates’ donations raise questions about his preferred slate’s views on tenant and landlord rights. A principal in Jackson Square Properties, which specializes in apartments and mobile homes, Coates is the founding partner of Arroya & Coates, a commercial real estate firm whose clients include Walgreens, Circuit City, and J.P. Morgan Investment Management. In 2008, when he backed Prop. 98, Coates told the San Francisco Chronicle that rent control “doesn’t work.”

Ted Gullicksen, director of the SF Tenants Union (SFTU), which has collectively spent $30,000 opposing Sparks, Wiener, and Moss, is disturbed that Coates spent so much in support of this trio.

“Coates was the main funder of Prop. 98,” Gullicksen explained. “His property is in Southern California. He’s pumping a lot of money into supervisors. And he clearly has an agenda that we fear Moss, Sparks, and Wiener share — which is to make the existence of rent control an issue they will take up in the future if elected to the board.”

That threat got progressive and labor groups to organize an Oct. 26 protest outside Coates’ San Francisco law office, with invitations to the event warning, “Be there or be evicted!”

Sparks, Moss, and Wiener all claim to support rent control, despite their support by someone who seeks to abolish it. “I answered such on my questionnaire to the SFTU, which chose to ignore it,” Sparks told the Guardian via text message. “In addition, I’ve been put out of apartments twice in SF, once due to the Ellis Act. They ignore that fact as well.”

Records show that in May 2009, Moss — who bought a rent-controlled apartment building near Dolores Park in D8 for $1.6 million and he lived there from the end of 2007 to the 2010, when he decided to run for office in D10 — served a “notice to quit or cure” on a tenant who complained about the noise from Moss’ apartment. Ultimately, Moss settled without actually evicting his tenant.

“I read about Coats’ [sic] contribution in Bay Citizen,” Moss wrote in an e-mail to the Guardian. “This donation was made to an independent expenditure committee over which I have no control and almost no knowledge. I have stated throughout the campaign, and directly to the Tenants Union, that I believe current rent control policy should remain unmolested.”

But Moss is with downtown on other key issues. He supports Newsom’s sit-lie legislation and the rabidly anti-tenant Small Property Owners Association, whose endorsement he previously called a “mistake.”

Yet Moss, who sold a condo on Potrero Hill in 2007 for the same price he paid for the entire building in 2001, seems to voice more sympathy for property owners than renters, who make up about two-thirds of city residents. He told us, “Landlords feel that they are responsible for maintaining costly older buildings and that they are not provided with ways to upgrade their units in ways that share costs with tenants.”

Another realm where downtown seems to be trying to flip the Board of Supervisors on a significant agenda item is on health care, particularly the California Pacific Medical Center proposal to build a high-end hospital and housing project on Cathedral Hill in exchange for rebuilding St. Luke’s Hospital in the Mission.

The project has divided local labor unions. UHW supports the project and a slate of candidates that its parent union, Service Employees International Union, is opposing through SEIU Local 1021, which is supporting more progressive candidates. The California Nurses Association also opposes the project and candidates such as Wiener who back it.

“A recent mailer by CNA falsely says that CPMC is closing St. Luke’s and Davies,” CPMC CEO Warren Browner recently complained in a letter to the Board of Supervisors. “We are not. We are committed to building a state-of-the-art, high-quality replacement hospital at St. Luke’s and continuing to upgrade Davies.”

But the CPMC rebuild is contingent on the board approving the Cathedral Hill project. So the CNA mailer focused on what could happen if the city rejects the CPMC project: “We could lose two San Francisco hospitals if Scott Wiener is elected supervisor.”

SEIU-UHW’s alliance with downtown groups and its use of member dues to attack progressive candidates places it at odds with SEIU Local 1021 and the SF Labor Council, which has endorsed Janet Reilly in D2, Walker in D6, Mandelman in D8, and Cohen (first choice) and Chris Jackson (second choice) in D10.

“We’re really disappointed that there are labor organizations that feel they have to team up with Golden Gate Restaurant Association, which is against health care [it challenged the city’s Healthy San Francisco program all the way to the U.S. Supreme Court], and with CPMC, which is working to keep nurses from joining a union,” Labor Council Director Tim Paulson said. “This alliance does not reflect what the San Francisco labor movement is about.”

Paulson said that the Labor Council values “sharing the wealth … So we don’t want Measure B [Jeff Adachi’s pension reform] or K [Newsom’s hotel tax loophole closure, which has a poison pill that would kill Prop. J, the hotel tax increase pushed by labor] or L [Newsom’s sit-lie legislation],” Paulson said.

CPMC’s plan is headed to the board in the next couple months, although Sup. David Campos is proposing that the city create a health services master plan that would determine what city residents actually need. Hospital projects would then be considered based on that health needs assessment, rather than making it simply a land use decision as it is now.

Moss told the Guardian that UHW endorsed him because of his positions on politicians and unions. “I agreed that politicians should get not involved in union politics,” Moss said. “The United Healthcare Workers seem to be a worthy group,” he added. “All they said was that they wanted to make sure that they had access.”

But CNA member Eileen Prendiville, who has been a registered nurse for 33 years, says she was horrified to see UHW members recently oppose Campos’ healthcare legislation. “I was shocked that they were siding with management,” she said.

Prendiville believes UHW is obliged to support CPMC’s Cathedral Hill plan, which is why it is meddling in local politics. In his letter to the board, Browner noted that his company and its parent company, Sutter Health, can’t legally do so directly. “The fact is that CPMC and Sutter Health are 501(c)(3) not-for-profit, nonpartisan organizations, and we neither endorse nor contribute to candidates,” Browner wrote.

“When UHW settled its contract with its members [as part of its fight with the rival National Union of Healthcare Workers], they had to publicly lobby for Cathedral Hill,” Prendiville claimed.

SEIU 1021 member Ed Kinchley, who works in the emergency room at SF General Hospital, is also furious that UHW is pouring money into downtown’s candidates and measures. “UHW isn’t participating in the Labor Council, it’s doing its own thing,” he said.

Kinchley said UHW, which is currently in trusteeship after a power struggle with its former elected leaders, is being controlled by SEIU’s national leaders, not its local membership, which explains why it’s aligned with downtown groups that have long been the enemy of labor.

“Sutter wants a monopoly on private healthcare and people like Rafael Mandelman and Debra Walker have been strong supporters of public healthcare,” Kinchley said. “I want someone who can straight-up say, here’s what’s important for families in San Francisco, especially something as important as healthcare. But it sounds like UHW is teaming up with the Chamber and supporting people who are not progressive.”

Downtown massively outspends progressives

Mary Magee

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October 12, 2010

17

Downtown massively outspends progressives

With only three weeks until the election, downtown interests are massively outspending progressive groups.(Conservative estimates suggest a 5:1 ratio, based on an analysis of campaign finance disclosures at the Ethics Commission.) And these downtown interests have plenty in reserve, as cash is funneled into a bunch of improbably-named political action committees that hope to influence the outcome of district elections and local measures on the fall ballot.

The Alliance for Jobs and Sustainable Growth, which is backed by the Chamber of Commerce, the SF Police Officers Association, and United Health Care Workers, recently got an infusion of cash from the conservative-minded Building Owners and Managers Association and Golden Gate Restaurant Association. And the alliance is already spending gobs of money in support of Theresa Sparks in D6, Scott Wiener in D8 and Steve Moss in D10.

The Coalition for Sensible Government, which recently received a $100,000 injection of cash from the SF Association of Realtors, is spending in support of Sparks in D6, Wiener and Rebecca Prozan in D8, and Lynette Sweet and Moss in D10. The coalition is also spending in support of Proposition G (transit operator wages) and Prop. L (Newsom’s sit-lie legislation) and in opposition to Prop. M (community policing/ foot patrols) and Prop N (property transfer tax).

And a PAC consisting of the Coalition for Responsible Growth, Plan C, San Franciscans for a Better Muni, SF Forward (sponsored by the SF Chamber of Commerce and SPUR) received $85,000 from the Committee on Jobs, $60,000 from the SF Association of Realtors, and $35,000 from SF Forward.

This PAC, which has already spent $466,000 this year, recently plunked down $1,000 to produce a voter guide for Plan C–a group that focuses on condo conversions and is endorsing Sparks in D6, Wiener in D8, and Sweet (as its first ranked choice) and Moss (as its second ranked choice) in D10.

It isn’t surprising that downtown PACs have deep pockets and almost identical slates. But it is a bit of a shocker that their slates are apparently almost identical to the Small Business Advocates, a group that has somewhat differing values and only a couple hundred members.

Reached by phone, SBA director Scott Hauge said the group has a couple hundred members–and claimed that SBA’s Board supports Sparks in D6, Moss in D10, and supports Measures G, K, L and opposes Measures J, M & N.

Hauge acknowledged that these positions are identical to those of downtown interests.
“We have been working with large companies,” Hauge said, claiming that small and big business’ interests are “the same” in this particular election cycle.

To date, neither the Chamber’s Steve Falk nor UHW’s Leon Chow have replied to the Guardian’s calls about the genesis of their so-called Alliance for Jobs and Sustainable Growth (Chow posted a comment on our politics blog and that is really not the same as a live conversation.)

But Tim Paulson, executive director of the San Francisco Labor Council wasn’t afraid to go on record in opposition to the Alliance and its 2010 slate.

“We’re really disappointed that there are labor organizations that feel they have to team up with Golden Gate Restaurant Association, which is against healthcare, and with CPMC [California Pacific Medical Center], which is working to keep nurses from joining a union,” Paulson said. “This alliance does not reflect what the San Francisco labor movement is about.”

A door hanger that the Labor Council distributed in conjunction with the SF Democratic Party confirms that both organizations support Debra Walker in D6 and Rafael Mandelman in D8. But while the Dem Party supports DeWitt Lacy, Malia Cohen and Eric Smith (in that order) in D10, the Labor Council only supports Cohen and Chris Jackson (in that order) in D10.

But despite their differing D10 candidate slate, both these progressive groups support Measures J, M and N, and oppose Measures B, K and L.

“When we see the Hotel Council stoop to attack Mike Casey, one of the greatest labor leaders in SF history, for fighting hotels who want to take away healthcare and diminish the retirement benefits for workers who make $25K to $30K a year, that’s really disturbing,” Paulson said, referring to a recent op-ed in the SF Examiner that was written by Patricia Breslin, executive director of the Hotel Council.

“And any union that makes an alignment with groups that don’t share the values of the San Francisco Labor Council, that’s really disturbing to me and the Labor Council,” Paulson said.

Noting that downtown is spending buckets of money on the election, Paulson observed that the Labor Council’s values are about “sharing the wealth.”

“So we don’t want Measure B [Jeff Adachi’s pension reform] or K (Newsom’s hotel tax) or L (Newsom’s sit-lie legislation),” Paulson concluded. “And we have three solid weeks to do this.”

Downtown money hits district races

Zelda Bronstein

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October 1, 2010

42

Downtown cash is pouring into the district supervisorial races.

Ethics Department filings show that an alliance backed by the Chamber of Commerce, the SF Police Officers Association and United Health Care Workers West is dropping major money on Steve Moss in D10, Scott Wiener in D8 and Theresa Sparks in D6.

Called the “Alliance for Jobs and Sustainable Growth,” the coalition supports the building of a mega-hospital on Cathedral Hill.

The independent expenditure alliance puts UHW, part of the Service Employees International Union, in the odd position of using membership money to attack progressive politics in San Francisco – potentially undermining years of work by another SEIU affiliate, Local 1021.

Campaign disclosure forms show that the Chamber-Police-UHW alliance has spent $20,000 on bilingual (English/Chinese) door hangers for Moss that feature photos of Chamber of Commerce President Steve Falk and United Healthcare Workers political director Leon Chow.

These same interests also spent $20,000 on robo-calls for Moss, with a heavy focus on Visitacion Valley in an effort to secure the Asian vote in the crowded D10, where there is a strong likelihood that the race will be decided by second and third place votes

Word on the street in the Bayview is that former Mayor Willie Brown is pissed off that the Chamber is backing Moss, instead of African American candidate Lynette Sweet, and that termed out D10 Sup. Sophie Maxwell is angry that big corporations are trying to buy an election in the poorest and most ethnically diverse district in town.

But unlike the rumor mill, the money trail doesn’t lie. And from that perspective this is looking like a replay of the June 2008 election, when big businesses bought support for Lennar’s Candlestick Point/shipyard development by claiming it would create thousands of jobs building condos that most workers can’t afford—jobs that have yet to materialize.

This time the battle cry is for jobs building a massive hospital, even though few workers will likely get service from this hospital, which is designed to serve as a regional center for high-end health care.

So far, the same alliance of police and corporate money has plunked down $17,000 for bilingual (English and Chinese) door hangers in support of Theresa Sparks in D6 and another $17,000 for bilingual robo-calls in support of Sparks.

And so far, Scott Wiener has gotten the relatively short end of the corporate money stick: the Alliance has only spent $15,000 on a door hanger in support of Wiener.

This means that the alliance spent $90,000 in a two-week period in September. The numbers lend credence to DCCC Chair Aaron Peskin’s belief that the alliance has a war chest of $800,000, which it intends to use to put pro-downtown candidates into power.

Asked about the support of this alliance, Sparks, Wiener and Moss gave markedly different replies that reveal as much about each candidate as the money behind them.

D6 candidate Theresa Sparks suggested that the Alliance was spending more on her and Moss’ D10 campaign, because it felt Wiener was further ahead in the D8 race than she is in D6 or Moss is in D10.

And Sparks was openly supportive of the Cathedral Hill hospital project. “I’ve been very supportive of that project,” Sparks told us.

Sparks also observed that it was logical that the Chamber would support her.

“D6 has one of the largest numbers of small businesses and one of my biggest platforms has been economic growth, and I think the Chamber has been very supportive of job creation,” Sparks said.

By comparison, Scott Wiener told the Guardian that he has not taken a position on CPMC’s proposed mega hospital on Cathedral Hill.

“Those kind of issues could come before the Board, in terms of CEQA issues, and so I could be conflicted out,” Wiener said.

When the Guardian noted that the Alliance has so far not spent any money on phone banking for Wiener in D8, Wiener said, “I have volunteers doing phone banking.”

As for Moss, he told the Guardian that said he doesn’t have a position on the mega-hospital.

“I haven’t seen the plan,” Moss said. “But I understand that there seems to be an agreement that would maintain St. Luke’s with about 300 beds, but that there is a deep suspicion among the nurses that it’s not economically viable. And there seems to be a much greater need for a hospital in the southeast.”

Moss, however, is with downtown on other key issues: He supports the sit-lie legislation on the November ballot. He also reiterated that he likes the rabidly anti-tenant Small Property Owners Association, whose endorsement he called a “mistake” during a previous interview with the Guardian.

“Landlords feel that they are responsible for maintaining costly older buildings and that they are not provided with ways to upgrade their units in ways that share costs with tenants,” Moss, who sold a condo on Potrero Hill in 2007 for the same price that he paid for the entire building in 2001, and owns a 4-floor rent-controlled apartment building in D8, near Dolores Park, that he bought for $1.6 million in 2007, and where he lived from December 2007 to February 2010.

Moss refused to provide a copy of the lease on his current rental at Vermont and 18th St—something that the Guardian requested in light of an email from his wife that indicated that the family intended to move back to Dolores Park of Moss loses the race.
‘That’s private information,” Moss said, claiming that he does not plan to move back into his apartment building in D8, if he loses in November.

Moss claimed that UHW endorsed him because his position on politicians and unions.
“I agreed that politicians should get not involved in union politics,” Moss said. “The United Healthcare Workers seem to be a worthy group,” he added. “All they said was that they wanted to make sure that they had access.”

All this campaign money drama is playing out against the backdrop of a punishing battle between United Healthcare Workers West and the rest of SEIU. And as these recent filings show, UHW is spending a huge amount of its membership dues to undermine the city’s progressive infrastructure by trying to elect candidates who are not progressive, even though its progressive sister union has endorsed Rafael Mandelman in D8.

SEIU 1021 member Ed Kinchley, who works in the Emergency Room at SF General Hospital, is furious that UHW is pouring all its money into downtown candidates like Moss, Sparks and Wiener and trying to undermine everything that its progressive sister union is trying to do.

“UHW basically isn’t participating in the Labor Council, it’s just doing its own thing,” Kinchley said.

Kinchley noted that UHW is currently in trusteeship, and is being controlled by its International, and not its local membership, thus explaining why it’s doing this dance with forces like the Chamber and the Building Owners and Managers Association, which have long been the enemy of labor.

“Sutter wants a monopoly on private healthcare, and people like Rafael Mandelman in and Debra Walker have been strong supporters of public healthcare,” Kinchley said, Kinchley also noted that he wants supervisors who are willing to state their support for public health care, rather than dodging the issue and hedging their bets, right now.

“I want someone who can straight-up say, here’s what’s important for families in San Francisco, especially something as important as healthcare,” Kinchley said. “but it sounds like UHW is teaming up with the Chamber and supporting people who are not progressive.”

“And it’s not OK for somebody in D10 to say they haven’t seen CPMC’s plans, when people from D10 use St. Luke’s all the time for healthcare, because it sounds like Sutter wants to change St. Luke’s into an out-patient clinic for paying customers,” he continued.

SEIU 1021 activist Gabriel Haaland accused the Chamber, the Building Owners and Managers Association, UHW and the Police Officers Association of putting together a massive political action committee, “to try and steal the election through corporate spending.”

All this leaves the Guardian wondering how Leon Chow, the political director of UHW, who has done good work in the past on health care issues, is feeling about seeing his photograph spreads all over town alongside that of Chamber of Commerce President Steve Falk on door hangers in support of Sparks, Wiener and Moss.

As of press time, Chow had not returned our calls, but if he does, we’ll update this post.

Who’s trying to fast-track Parkmerced?

Sasha Cuttler And Mary Magee

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October 1, 2010

6

At a Sept. 30 Planning Commission meeting, several commissioners and community members raised concerns that project approval for Parkmerced, a development that will add thousands of new housing units to an existing residential complex, had been scheduled before anyone was really prepared to discuss it. It’s since been pushed back, but the attempt to rush it through drew fire nonetheless.

Land use attorney Sue Hestor said she’d discovered the day before the Planning Commission meeting that a final project EIR would be made available Oct. 7, with an approval hearing scheduled just two weeks later, on Oct. 21. That came as a surprise even to Hestor, who closely monitors development projects. “You cannot just drop a complex legal document on people two weeks before the hearing and say that is sufficient,” Hestor said. “Two weeks for a staff report for this project is insulting.” Prior to this notice, the hearing on Parkmerced was widely expected later in the year.

Christina Olague, vice-president of the Planning Commission, said during the meeting that the accelerated timeline was highly unusual. “I was hearing that we were going to be attempting to initiate this project on the 7th of October with an approval calendared for the following week,” she said. “And I was concerned that it felt, at that point, that it was a little bit out of the hands of the planning commission. When it comes to projects of this size, I just felt like that was too much of a rush to get it through, especially given that we are in the middle of CPMC with comments due the 19th of October.”

Olague said the process made her uncomfortable. “I felt a lot of our say was being removed from our realm and there were outside forces … other departments in the city that were kind of influencing it in a way that didn’t feel comfortable to me,” she said. “Also, historically … we have never done it that way. Usually we calendar an item for one week and then there’s a 20-day noticing period that allows members of the public to digest the information and review the information.” She added, “I just didn’t want the public to get the impression that we were favoring one project over other projects.”

Calvin Welch, an affordable housing activist, noted that Parkmerced developers have a laudable goal of preserving onsite rent-controlled units at the housing complex — but he had yet to see a draft of a development agreement outlining the details of that plan. The planning commissioners hadn’t seen that document, either. Welch suggested more time was needed to review the terms of the agreement.

If the Planning Commission had approved Parkmerced on this accelerated schedule, it might have gone to the Board of Supervisors for approval before the end of the year, so the votes would’ve easier to count than if the project went before a new class of Supes in 2011.

The Guardian reported earlier this month that Mayor Gavin Newsom received a $1,000 campaign contribution for his bid for lieutenant governor from Craig Hartman, a design partner for Parkmerced, plus $2,000 from two executives associated with the project. AECOM, which is completing technical studies for the project, gave him campaign donations totaling $13,000.

Speaking to a crowd of real-estate professionals and representives from the business community a couple weeks ago, Newsom urged them to get involved in district elections in order to avoid “a dramatic shift” that would occur if the wrong people get elected to local office in November.

Did the mayor’s office lean on the planning department to rush the approval of Parkmerced in order to ensure a more predictable outcome? We emailed Newsom’s press secretary, Tony Winnicker, with questions, and we’ll be sure to post a response if we receive one.

Dollars or sense?

Jesse Hawthorne Ficks

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September 28, 2010

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rebeccab@sfbg.com

It’s no secret that San Francisco is a particularly costly place to live. It consistently ranks in the top 10 most expensive cities nationwide, and it isn’t uncommon to see people renting out their walk-in closets as makeshift bedrooms to make ends meet.

There’s ample evidence that the city’s market-rate housing is out of reach for many families, middle-class workers, and low-income populations, particularly during the recession. Yet the shortage of affordable housing is a problem that is going largely unaddressed at City Hall.

The city’s General Plan estimates that a full 61 percent of new housing would have to be affordable to satisfy the housing needs of city residents, but even the most demanding development standards fall far short, producing only about half that amount. And while most new affordable housing is built for low-income people, a sizable portion is intended for first-time homebuyers with salaries at the highest threshold of affordability. In recent years, about one-third of new “affordable housing” was built to sell to people with “moderate” incomes.

So as big plans are mapped out for new residential developments composed of mostly market-rate units, what’s the strategy for addressing the underlying affordability gap? And will it ever be enough to keep from further turning San Francisco into a city of rich people while its workers are forced to live elsewhere?

This map, which appears in San Francisco’s Five-Year Consolidated Plan, charts concentrations of low- and moderate-income households in the city using HUD 2000 income data. Under federal guidelines, people with low and moderate income could be eligible for affordable housing.

A San Francisco Unified School District proposal to create new housing for San Francisco teachers underscores just how mismatched housing prices are to income. The National Low Income Housing Coalition (NLIHC) estimates that San Francisco renters paying market rate in 2010 would have to earn $56,240 to afford rent a one-bedroom apartment, $70,400 for a two-bedroom unit, and $94,000 for a three-bedroom unit, assuming they spend no more than about one-third of their income on housing.

A starting teacher’s salary in San Francisco is $50,000, so early-career educators may feel the squeeze. A survey of teachers conducted for the proposal found that 81 percent of respondents were renters, most living with unrelated roommates. More than half had plans to relocate in five years to a city where they could afford to be homeowners.

Housing was a hot-button issue at the Sept. 16 Planning Commission hearing on the environmental impact review for a hospital and housing complex that California Pacific Medical Center wants to build near Van Ness Avenue.

“The CPMC EIR fails miserably to analyze the income of the CPMC work force, and where it’s supposed to be housed,” affordable housing advocate Calvin Welch told the Guardian. “It’s a profoundly important question. If they are [providing] jobs that produce incomes that are insufficient to pay for average market-rate housing in San Francisco, who’s responsibility is it going to be to build housing for that workforce?”

WHO CAN AFFORD IT?

San Francisco has a reputation as a diverse, politically engaged hub that supports emerging artists, independent thinkers, and advocates for youth, workers’ rights, healthy ecosystems, protections for the most vulnerable segments of society, and hundreds of other causes. Without economic diversity — which is only possible when housing is available to people with a range of incomes — it might be a different place.

NLIHC estimates that 65 percent of San Francisco households are renters, and a significant number are what the Mayor’s Office of Housing (MOH) calls “cost-burdened,” shelling out more than a third of their incomes on rent. To get by, tenants have been known to cram roommates in like sardines, or cling tenaciously to a rent-controlled unit.

In a thick report outlining affordable housing goals for 2010–14, MOH and two other city agencies clearly articulate the housing challenges facing low-income renters. For one thing, the report says rents are going up despite the economic recession and declining home prices. And most people’s salaries don’t stretch far enough to cover those high prices. Even though there are 16 billionaires and some fabulously wealthy CEOs residing in San Francisco, the majority of people work in more mundane occupations like waiting tables, retail, office work, nonprofit jobs, teaching, health care, or public service.

The MOH report notes that despite the city’s relatively high median income, there’s a widening gap between top earners and people on the lower end of the spectrum, so few households actually wind up in that middle zone. “In fact, over a quarter of San Francisco’s population earns under 50 percent of [area median income],” the report states. For individuals in 2010, this translates to one in four people earning $34,800 or less. Compounding that problem are recent unemployment figures indicating that nearly one in 10 is jobless.

About one half of San Francisco’s population is considered low- or moderate-income, the housing report notes, using the standards used to formulate affordable housing prices. MOH uses a tiered income matrix, calculated using federal guidelines, to determine who could qualify for housing below the market rate. If you make $20,900 or less, you’re counted as “extremely low income.” You’re “very low income” if you make between $21,000 and $34,800, “low income” if you earn between $35,496 and $55,700, and if you make between $56,376 and $83,500, you count as “moderate income.” Even these figures are skewed higher because they include data from wealthy Marin County. As a point of comparison, U.S. Census data estimates that the median income for American workers was $29,530 over the last several years.

Most of the new affordable housing constructed in San Francisco is aimed toward people in the lowest ranges, but in recent years one-third was built for those with moderate incomes, which could gentrify some parts of the city. “Supervisorial Districts 3, 6 and 10 had rates of more than 40 percent extremely low and low-income,” the MOH report notes. “These three districts make up the entire eastern part of the city.”

A Guardian analysis of Bureau of Labor Statistics occupational and wage estimates for 2009 suggests that about 71 percent of people who work in San Francisco (many commute from less expensive places) earned less than that highest “moderate” salary limit of $83,500. It suggests that the vast majority of the workforce could not afford market-rate housing unless they sought it in pairs or groups.

“A big issue is the inability of San Francisco’s employment market to produce jobs that pay people enough to afford housing,” Welch says. “There’s a mismatch between market-rate income and market-rate housing costs. We’re housing somebody else’s workforce.”

Another stab at assessing the affordable housing need gazes into the future. The Housing Element of the San Francisco General Plan includes an estimate for the city’s future housing needs for the better part of the decade. The city should build 31,200 new housing units to meet its need, the General Plan says, and “at least 39 percent of these new units must be affordable to very low and low-income households. Another 22 percent should be affordable to households with moderate incomes.”

What this adds up to is a full 61 percent of new residential development in San Francisco ought to be dedicated to some form of affordable housing. The calculation reveals a lot about the condition San Francisco is in, but it might as well be chalked up as a hollow academic exercise. Indeed, the report deems this goal “unrealistic.” The reality of the market and chronic government deficits ensures that there will not even be an attempt to meet it.

IF YOU BUILD IT

The trouble with affordable housing is that developers won’t build it unless there is a financial incentive. “The only way it works is not in the marketplace,” Welch said. “There’s no such thing as affordable land, affordable sheetrock, affordable architects, or affordable engineers. The profound condition … is that the market cannot produce affordable housing.” As long as developers can make higher profits building market-rate, they will.

That’s why government steps in to subsidize or mandate new affordable housing construction or preserve existing stock. Under the Inclusionary Housing Ordinance, if developers decide not to build the required 15 percent of affordable units, they must pay an in-lieu fee that gets funneled into an affordable housing fund.

In a good year, MOH Executive Director Douglas Shoemaker told the Guardian, the city receives $10 to $15 million from these fees, which is used in partnership with developers to build affordable projects. That system hasn’t worked so well lately. Last year funds for affordable housing were depleted instead of bolstered. Developers who paid their fees in anticipation of building new projects requested refunds after their projects were stalled, Shoemaker told the Guardian, so MOH gave back up to $12 million to developers instead of using that money to build new affordable housing.

This year, Mayor Gavin Newsom introduced what he called an “economic stimulus” program that allowed developers to defer payment of in-lieu fees. This guarantees that it will be a long, long time before new affordable housing can be built using those funds. So as it stands, the inclusionary housing law isn’t so effective at producing new affordable housing.

Projects done in conjunction with the San Francisco Redevelopment Agency, meanwhile, do include higher portions of affordable housing. With all of the planned Redevelopment projects combined — Treasure Island, the Hunter’s Point shipyard, and others — the city can expect to see perhaps 7,000 new affordable housing units in coming years, a portion of which will be condos meant for people in the “moderate” income range. It may well be better than other cities have offered, but it doesn’t begin to address the true need for more than 19,000 units outlined in the General Plan.

Shoemaker noted that San Francisco is a cut above the rest when it comes to affordable-housing requirements. “I just don’t think you could find a city that has more aggressive goals,” he said, noting that in major redevelopment areas, “We’re getting like 30 percent of homes to be affordable on some level.” Yet Shoemaker acknowledged, “the need is intense,” and “there’s more people we would like to serve.”

Olson Lee, deputy executive director of the San Francisco Redevelopment Agency, also described San Francisco as taking a very aggressive stance on affordable housing. Redevelopment devotes 50 percent of its tax-increment financing to affordable housing, where the state requires just 20 percent, Lee said. And some Redevelopment project areas include twice as much affordable housing as is required by state law, he added. “The city has done a tremendous amount of affordable housing,” he said. However, “the fact of the matter is, there’s a greater demand for affordable housing than the number of units.”

From 2005 to 2009, there were 3,607 new affordable housing units constructed, mostly for people at the lowest end of the pay scale, MOH reports. But in that same time frame, 3,465 rental units were converted to condominiums. One could argue that the city essentially broke even with its affordable housing stock in a decade where housing prices almost doubled. As San Francisco housing prices skyrocketed, the city’s 170,000 rent-controlled units served as the saving grace for the majority who couldn’t afford market-rate, and condo conversions continue to threaten the erosion of that very significant housing stock.

Debra Walker, a candidate for District 6 and a tenant representative on the Building Inspection Commission, told the Guardian that she believes a new financing system is needed for affordable housing. “The argument for development is that we get affordable housing money out of it,” she said, but “the inclusionary doesn’t get us enough housing. We cannot include affordable in those high-rises, because they’re so expensive to build.”

She has talked up the idea of a real estate transfer tax that would create a dedicated fund that could then be used in partnerships with affordable-housing developers. Shoemaker, for his part, noted that having a dedicated revenue stream for affordable housing would be very helpful. A committee comprised of the San Francisco Planning and Urban Research Association, Welch, developer Oz Erickson, and Shoemaker was formed earlier this year and actually arrived at a deal, but Newsom ultimately rejected it. Other creative solutions, Walker says, might include reusing shuttered commercial properties or building cheaper by design using different building materials. “It’s about looking at what it is we need,” she said, “and realizing people are in a pinch.”

The greatest complicating factor of the current system, in which the city relies on market-rate development to get new affordable housing, is that even though there a some 40,000 new residential units in the pipeline, developers can’t secure financing to start building them. For now, in the down economy, they only exist on paper.

“They’ll never get built,” Welch predicts, and as long as Newsom continues to extend entitlements for those planned projects in hopes that the market will get a jump, “it’s freezing September 2008 conditions, evidently forever,” limiting opportunities to build something more reasonable.

“They’re zombies,” Welch added. “Who the fuck is going to pay $2 million for a new condo when they can buy a $4 million building for $1 million in foreclosure?” But if the need for affordable housing began to be addressed, he said, something might start to happen. “If you converted half the pipeline units to rental,” he theorized, “they might get built.”

Needed: a public health master plan

David Talbot

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September 28, 2010

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California Pacific Medical Center’s plan to build a massive new regional hospital on Van Ness shouldn’t be under the jurisdiction of the Planning Commission

EDITORIAL More than 100 people showed up at the Planning Commission Sept. 23 to oppose California Pacific Medical Center’s plan to build a massive new regional hospital on Van Ness Avenue. Most were neighborhood residents who raised an excellent point: what, exactly, would the shiny new $2.5 billion hospital offer for low-income people in the Tenderloin?

And that’s just the starting point for discussion. The new project is a piece of a much larger plan: CPMC wants to shut down part of its Laurel Heights campus, reduce the number of beds and the scope of service at St. Luke’s, turn Ralph K. Davis into a specialty facility, and reshape the way health care is provided in San Francisco.

That’s a huge deal — but right now, the city is looking at the projects piecemeal. That’s poor public health policy and poor land-use planning. In fact, there’s no real way to evaluate the Van Ness hospital in its proper context — the Planning Commission, which will rule on the development issues, is hardly the best venue in which to discuss the future of health care in San Francisco.

So new legislation by Sup. David Campos is critical to injecting some sanity into this, and the larger, health facilities debate. The Campos legislation would mandate a citywide Health Care Services Master Plan and would require that all new hospital development, public or private, be consistent with that plan. It’s a pretty basic concept, and it’s hard to imagine that nobody’s suggested this before.

San Francisco has a large, complex network of facilities providing health care — a big public hospital, a university hospital system (University of California San Francisco), a series of public and nonprofit community clinics, half a dozen private hospitals run by two competing chains (CPMC and Catholic Healthcare West), and one health maintenance organization (Kaiser). Some provide unique services, some provide competitive services — and there are some critical services that are hard to find anywhere.

It’s hard to say whether the city needs what CPMC is proposing — a gigantic medical center that some have described as the Mayo Clinic of the West, designed to attract patients from all over the region — without any sort of overall plan. How would the new facility and the CPMC restructuring affect services at St. Luke’s, a critical part of the health care infrastructure in the Mission? Where would patients who rely on Davies for emergency and clinical care in the Castro district wind up? How about all the medical office buildings and doctors’ offices situated near hospitals that are about to change?

How will CPMC’s moves affect low-income-patient care? How does the project fit in with the new Obama health care policies and the city’s own Healthy San Francisco program? Will a new hospital on Van Ness increase access to primary and emergency care for residents of the Tenderloin — or will they be shuttled somewhere else while the high-end facility caters to better-off patients seeking expensive specialty procedures?

Those aren’t land-use decisions — and while some Cathedral Hill residents argue that the new hospital will cause traffic problems, the biggest issues go beyond the scope and expertise of the city Planning Department.

Under the Campos bill, the Public Health Department would develop a master plan (which public health director Mitch Katz says can be done with existing resources), the Health Commission would review that plan, hold public hearings, and sign off on it — and city planners and health officials would have to make sure that new health-related development met existing and future public needs.

The supervisors should pass the bill and get the process going as quickly as possible. And they should refuse to sign off on any final version of the hospital plan until there’s a city framework in place — or at the very least, until CPMC can demonstrate that its citywide infrastructure plans are designed to meet public health needs. *

Needed: a public health master plan

David Talbot

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September 28, 2010

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