As lawmakers in Washington DC struggle to figure out the strategies for healthcare reform, two of San Francisco’s busiest and most relied upon hospitals push forward to renovate and rebuild.
 
Both San Francisco General and St. Luke’s which have been serving the Mission District and surrounding areas for over 100 years have plans in the works that will impact the community for decades to come.
 
Yet these plans for renovation and rebuilding are long-over due as new technology and mandatory seismic upgrade regulations have set higher and at times more complex standards than ever before.
 
SF General is the only trauma center in The City. Almost 30 percent of all ambulances go to SF General, as it provides 20 percent of all inpatient care in San Francisco. On average SF General serves 100,000 patients annually.
 
San Francisco General Hospital also provides the only emergency psychiatric care in The City and it offers the largest in-patient psychiatric facility.
 
St. Luke’s has about 28,000 emergency visits per year. And, just like SF General is stretched to its limits trying to meet the needs of a diverse community.
 
With almost half the US population under-insured or with no health insurance at all, the need for state-of-the-art hospitals is critical. Both St. Luke’s and SF General are situated in a very difficult position. These two hospitals serve most of the people in San Francisco. And, like current statistics illustrate nationwide, most of the patients served are either partially covered or have no health insurance.
 
This is alarming for health care providers because it places a tremendous strain on the quality of care available to all patients. Yet as policy-makers at our nation’s capital work with President Obama’s administration to try to implement a feasible and affordable healthcare system for all the cost of technology will no doubt play an increasing role.
 
Some experts and researchers believe that apart from the policy practices of health insurance companies it is because of the ever-increasing use and dependence upon technology that the cost of health care has increased. This can be debated further. And, most likely will go on as healthcare reform continues to become part of the political and social-economic agenda.
 
But as it is now, our hospitals must be able to meet the demands of the 21^st Century. This past spring SF General launched its six-year rebuilding project made possible with the Prop. A bond measure approved by SF voters in 2008.
 
The rebuilt SF General will be located on the front lawn of the current medical campus on Protrero Ave. between 22^nd and 23^rd streets. The cost to rebuild is estimated at over $887 million from general obligation bonds financed by The City.
 
The non-profit SF General Hospital Foundation will lead a separate effort to raise money to furnish the rebuilt hospital with furniture, supplies and equipment. The City’s budget will continue to pay SF General’s operating costs.
 
As the plans are now, a curved architectural design for the new SF General will consist of nine floors. Two of the floors will be below ground.  The new curved design will accommodate 284 beds using the latest principles incorporating patient safety and certified environmental standards.
 
St. Luke’s Hospital
As reported in previous Mission Dispatch issues, St. Luke’s Hospital will be part of the Master Plan for California Pacific Medical Center’s vision for the future of healthcare in The City.
 
Community groups and neighborhood organizers worked feverishly to keep St. Luke’s from closing when CPMC announced it wanted to close the century-old hospital that had been founded and operated by the Episcopalian Church of San Francisco, until corporate entities like Sutter Health and then CPMC took over.
 
With the help of the SF Board of Supervisors and the establishment of a formidable Blue Ribbon Committee, CPMC agreed to keep St. Luke’s and incorporate it into its Master Plan of upgrading and building a network of inter-connected facilities serving San Francisco. 
 
As part of the directives of the Blue Ribbon Committee, CPMC has hosted a series of community meetings to present their plans and to gather input from the people.
 
The dialog so far has been sincere and ongoing. But like any ambitious endeavor, the Mission District community has been vocal to point out some of the shortsighted aspects of the long-range plans.
 
CPMC media Rep Kevin McCormack summarized the most recent forum held on June 23^rd at the school cafeteria of St. Anthony’s on Precita Street.
 
“We presented our plans about the new St. Luke's hospital building to neighbors and community members. This was the first time many of those in attendance had a chance to see the new design plans for the hospital, to see how it fit in with the neighborhood,” said McCormack.
 
He noted that the response was encouraging. “Many called it a big improvement on the first drafts, and considered it a good step forward. But they also expressed there were still more changes that needed to be made,” McCormack said.
 
“St. Luke's chief administrative officer Dionne Miller, and our design coordinator Geoffrey Nelson made the presentation to the audience.
 
They explained the vision for the new St. Luke’s and answered questions about size, layout, noise and parking. These were key concerns of those attending previous community/forum meetings.
 
 Chief administrative officer Miller and design coordinator Nelson discussed with the audience why they felt this plan was best, not just for CPMC but also for the community and the city.
 
Miller and Nelson also stressed that the plan was far from complete, noted McCormack. And that the community still had an important role to play in helping CPMC refine the design of the campus even further; so that it better reflected their desires for their neighborhood.
 
According to McCormack, most of the concerns from neighbors centered upon the size of the building and the shadow it might cast on their homes. Also of concern to residents and neighbors was the location of the loading docks and the impact the dirt/noise and general disruption to the neighborhood during construction.
 
Parking during and after construction was also discussed as well as the importance of making the campus community-focused. In previous meetings community leaders expressed fears that CPMC was simply extending its corporate power to make healthcare into a more profitable “business venture.”
 
A call for more outreach into the community to increase awareness of the plans and the dates/times of future meetings was also articulated.
 
Dionne and Geoffrey assured the audience that CPMC is committed to working with community to develop a campus that will not just be a medical home to the people South of Market but will also help revitalize the neighborhood.
 
McCormack also noted that Miller and Nelson said that design plans will have a strong 'green' element, making it as environmentally friendly as possible.
 
CPMC sees these meetings as a starting point in the dialogue about St. Luke's, and that CPMC looks forward to the community’s comments, ideas and suggestions on how to improve the design and make it an integral part of the community.
 
For more information about St. Luke’s Hospital visit: http://www.stlukes-sf.sutterhealth.org/
 
SF General anticipates the rebuild project to be completed by 2015.
 
For more information about San Francisco General Hospital’s plans to rebuild visit: http://www.sfdph.org/dph/RebuildSFGH/
 
Or call the 24-hour Rebuild Hotline at (415) 206-5784.