Critical care - Page 4

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

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."