Guest Column                                       Return to "News Stories about LHH and SFGH" Index
West of Twin Peaks Observer
September 2008

Boodoggle II: General Hospital
by George Wooding

The San Francisco General Hospital (SFGH) rebuild — Proposition A on this November’s — is being aggressively marketed to San Francisco voters.

Almost every political organization, local politician, union, and special interest group in town will either endorse Proposition A, or will be pressured into not being “against” the bond measure. The City, already worried about the tremendous $1.7 billion cost of this bond, has gone to great lengths to ensure the SFGH rebuild is the only general obligation bond measure on the ballot.

One of the Red-brick Buildings  

Officially, San Francisco is claiming that the bond will “only” cost $887.4 million. But additional, remaining hidden costs haven’t been considered or discussed publicly: $30 million preparing the bond; $640 million to service the debt repaying interest; and $157 million for furniture, fixtures and equipment — all of which seem to have been forgotten.

The future costs of seismically retrofitting the rest of the hospital campus haven’t been mentioned. And bond costs are open-ended because by the City’s own admission, the project may be underfunded by $55.6 million, if the City’s projections that construction costs may reach $943 million prove accurate.

Voters who own property will be annually taxed $59 for every $100,000 of property assessments over the next 23 years. Due to a 50% pass through clause, renters face annual $100 to $300 rent increases.

The City’s public relations machine is set to inundate voters with slick brochures, mailers, and automated phone messages. The local media will start placing favorable SFGH stories between September and the November 4 election. The City’s main arguments to voters will be emotional, because the facts and the City’s numbers simply don’t add up. Voters are going to be hearing a lot of public relations propaganda about “Compassion,” “desperately needed,” “no time left,” and “State law requires.”

Has anyone heard that the Titanic is about to leave the dock?

Voters should support SFGH’s healthcare mission and want a seismically-safe hospital. But the proposed SFGH rebuild is a poorly planned, poorly located, and an overpriced “trophy” hospital. The project should be re-thought, and re-designed, before asking voters to approve bond financing.

In 1994, state law SB1953 created new seismic standards for hospitals. Current California standards require hospitals should be able to withstand an earthquake without collapsing. But SB1953 created a second, higher compliance standard that requires hospitals to also be able to continue to operate, and function, after an earthquake.

The proposed new, 90-foot-high, glass-walled SFGH hospital will be wedged forty feet, or less, between two non-seismically retrofitted brick buildings built in 1915. The 93-year-old brick buildings are 85 feet high, and aren’t scheduled to be retrofitted until sometime after the year 2015. The proposed hospital sits within the fall-zone of both brick buildings. In the event of a catastrophic earthquake, the brick buildings will collapse on the new hospital and render it inoperable.

The City is claiming that a large basement underneath the hospital called a “super-floor” will supposedly allow them to build the hospital at this location. This super-floor does not actually retrofit the two red brick buildings.

When asked about the strength of the non-retrofitted brick buildings, Gene O’Connell, SFGH’s CEO, stated on August 13 that “the brick buildings did not collapse during the 1989 Loma Prieta earthquake,” and said she felt that they would not collapse in a future earthquake1. The City needs to retrofit the adjacent red brick buildings before building the proposed replacement hospital.

In 2006, the proposed design for the SFGH replacement was a rectangular building, estimated to cost $622 million. The Department of Public Health then reconsidered the design, and chose a more aesthetic, oval shaped hospital with glass walls. The re-designed building added $265 million dollars, including $7 million for art.

The proposed hospital’s bed capacity is insufficient for future needs. The project only adds an additional 32 beds, increasing 19 neonatal ICU and pediatric beds, and eliminating 16 medical/surgical beds. The City’s final project report does NOT discuss emergency room capacity. The hospital was designed before the DPH’s commissioned Lewin report cited a citywide shortage of 533 acute hospital beds by 2030, 24% below the City’s projected needs.

The same DPH administrators who planned the disastrous Laguna Honda Hospital (LHH) rebuild are also in charge of the SFGH rebuild. This should give voters absolutely no confidence that the SFGH rebuild is well planned. LHH’s ten-year rebuild is currently $241 million (60%) over budget and 420 beds (35%) smaller than originally promised.

Voters were lead to believe that LHH’s primary mission would be to provide long-term care for our frail elderly and severely disabled. Suddenly, LHH’s new primary mission will be to provide 90-day stay short-term and rehabilitative care.

The City and the DPH have no accountability to voters. Who knows what the DPH will do or accomplish with the SFGH rebuild money, given its track record.

The 2013 deadline for completing the hospital is manmade. Senate Bill 306 (October 2007) provides building extensions to 2020 and beyond.

The City should take the time to correct project flaws before constructing the replacement hospital. The City must reconsider using the original plans for the rectangular hospital, increase bed capacity, and retrofit the brick buildings adjacent to the proposed SFGH hospital location.

Vote No on Proposition A. It’s a poorly planned, poorly located, and overpriced hospital bond measure.

George Wooding
Mid-Town Terrace Home Owners Association

1 Editor's Note:
Among other issues, Gene O’Connell failed to mention that the 1989 Loma Prieta earthquake registered 6.9 magnitude (on the more-precise “moment magnitude” scale, superior to the Richter scale). She avoided mentioning the Loma Prieta quake lasted approximately 15 seconds, was 11 miles deep, and was centered in Santa Cruz County on the San Andreas fault.

      O’Connell cleverly failed to discuss whether the two red brick buildings on SFGH’s campus could withstand a longer, 30-second event exceeding a 6.9 moment-magnitude, or higher, quake further up the coast, say in Daly City on the San Andreas fault line, or if less than 11 miles to the surface. She failed to discuss the impact of a greater magnitude, or a multi-factorial, quake. Former City safety employees knowledgeable about SFGH’s structural issues are not as optimistic as Ms. O’Connell is; they, frankly, disagree with her blind-faith pronouncement the red-brick buildings will withstand a catastrophic quake.

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