Critical care - Page 2

How the debate over CPMC's controversial multi-hospital project revived the idea of healthcare planning in San Francisco

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A big health care outfit has giant plans to transform SF's hospital infrastructure -- unless the city can demand a better plan
GUARDIAN ILLUSTRATION BY JOHN UELAND

"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.

Comments

Thanks to the guardian, I am now aware that the new facility - excuse me - MEGA facility - on cathedral hill will be checking income levels before anyone is treated there.
Clearly the median income on cathedral hill = that of pacific heights so any MEGA facility built there will only be for the most massively rich people.

Posted by Guest on Nov. 24, 2010 @ 10:21 am

My friend J. recently developed acute appendicitis and had an appendectomy at one of the hospitals in this group. Without complications it cost him sixty thousand dollars. This is predatory health care and a disgrace to basic human decency. San Francisco doesn't need it. Neither does America.

Posted by Private Citizen on Nov. 24, 2010 @ 8:55 pm

Thanks to the Guardian, I am now filled with dread, fear, panic and anger—over unneeded involvement from an inept City Hall. If the vocal activist minority becomes even more vocal and stirs up enough worry and tsuris with absurd hypotheticals, enough people will freak out and demand... something, anything. And wannabe-Mayor Campos can win the day for just creating more committees, have lots of meetings, pull out the red tape and especially get lots and lots of "community meetings" where 20-30 people can shout all night, validating themselves in one big activist circle jerk.

Just think—everything we hate about centralized municipal transportation planning in San Francisco, now applied to centrally planned healthcare delivery. Maybe the Nurses Association should start learning how to become MUNI bus drivers. In a popularity contest, it's pretty neck-and-neck who San Franciscans are starting to hate more.

Jesus, just move these hospital projects along. Perfection is the enemy of progress. But maybe we need one more community outreach program.

Posted by Guest on Nov. 26, 2010 @ 1:22 pm

That is NEVER a good sign.

Posted by Lucretia Snapples on Nov. 26, 2010 @ 6:11 pm

What good has come from central planning in general in SF? Muni? This system of non-English speaking bureaucrats seems pretty inept on every level. Since the last big earthquake, a number of SF's few hospitals have been closed, including Childrens and Letterman. Where was the planning commission and the Bay Guardian then?

This juvenile sniping at the Van Ness hospital, which replaces the ugliest building in the City with a very valuable asset that will be essential during the next earthquake or major disaster, is absolutely absurd, particularly coming from the SUV driving, Starbucks latte swilling, white-guilt/self-righteous writers of this communist rag.

I'm all for socialism, but SF's government is far too incompetent to be insisting on 5 Year Plan micromanagement of industries it has little capacity to benefit. I've been to the People's SFGH several times, and ring up $40-70,000 bills related to a single broken bone or two. Healthcare costs are ridiculous everywhere, not just private hospitals.

If SF wants to micromanage other hospital systems, perhaps it should start with its own DPH, which isn't exactly a model of good stewardship. It's worse than many third world clinics I've visited, and costs more than the supposedly evil (non-union) private hospitals doing business in the City.

Posted by Daniel Eran on Nov. 27, 2010 @ 10:51 am