Frequently Asked Questions
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Proposed campus at Van Ness & Geary
- Why is CPMC building a very large, very expensive new campus when you already have 4 hospitals spread throughout San Francisco?
- Why was the site at Van Ness & Geary chosen as the proposed site?
- Won’t centralizing services at the Van Ness & Geary campus mean more travel time for patients and visitors?
- Is it necessary to build such a large facility rather than retrofit and/or reconstruct the other hospitals?
- Why do Women’s and Children’s services need to be at the Van Ness & Geary location? Why consolidate?
- Why not move existing services to a temporary location and retrofit existing facilities?
- How about the scenario favored by some to have two hospitals, one 250 bed facility at Van Ness & Geary and a 250 bed hospital at St. Luke's?
- Why build in capacity to serve patients from beyond the City and County of San Francisco?
- Won’t access to the new campus (and its ED) be impeded by the already very dense traffic on Van Ness & Geary? Won’t it just make this worse?
- What will be done to make sure the new campus is not intimidating/is ‘friendly’ for members of San Francisco’s diverse cultural and ethnic population?
- Will there be a continuing role for the other four campuses?
- How will the campuses work together in an integrated manner?
- Why was the current site chosen for the St. Luke's rebuild?
- What is the timeline of hospital changes--closures, reconstruction schedules, openings?
- How much will all of this cost? How will it all be paid for?
- How will CPMC's plan affect employment in the city and region?
- Are the individual neighborhoods directly impacted by the changes involved in planning?
- How has CPMC addressed neighborhood concerns? What are some of those mitigating measures?
Proposed campus at Van Ness & Geary
Why is CPMC building a very large, very expensive new campus when you already have 4 hospitals spread throughout San Francisco?When State lawmakers passed Senate Bill 1953 after the Northridge earthquake in 1994, all hospitals in California were required to upgrade their facilities so they could not only withstand but also remain open and functioning after a major earthquake.
CPMC spent two years and several million dollars studying the feasibility of upgrading our existing campuses to meet the new standards, whilst keeping the hospitals open and serving patients. It quickly became evident that because of the building mix at our various campuses this was going to be disruptive, costly and time consuming and would not allow us to make essential improvements, such as having private rooms for every patient. Even once it was completed this retrofit would only be good until 2030, at which time new facilities would have to be built.
The only feasible alternative was to find a new site for a brand new, state-of-the-art facility that met the highest seismic safety standards while offering our patients and staff a world class facility in which to get and give health care for generations to come.
In our city-wide plan, California Pacific Medical Center will develop new facilities at our Van Ness & Geary location and St. Luke’s campus. The Davies campus has already been retrofitted and the Pacific campus will become an outpatient care site, with reduced impact on the surrounding neighborhood. We have not yet reached any final determination on what services will be offered at the California campus.
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Why was the site at Van Ness & Geary chosen as the proposed site?
The Van Ness & Geary site meets all requirements:
- Central location
- Seismically appropriate (appropriate soil/bearing conditions)
- Close to physicians who provide the care
- Adequate size
- Available for purchase
- Good public transportation links to make it readily accessible
- Avoids discontinuing existing services during construction
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Won’t centralizing services at the Van Ness & Geary campus mean more travel time for patients and visitors?
No. Because it is more centrally located travel time for the average patient will be no greater than today; in fact, in many cases it should be less. By locating many services in one building and coordinating scheduling we will also be able to cut down on patients having to travel between different campuses for doctor’s visits, as well as waiting time within our facilities.
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Is it necessary to build such a large facility rather than retrofit and/or reconstruct the other hospitals?
The Davies campus is the only facility where it was feasible to retrofit, and this is now complete.
The California and Pacific campus buildings require more extensive, costly and disruptive construction work for only a short-term gain and, even then, no gains in achieving modern hospital facility needs such as technology and private rooms.
Planners used sophisticated forecasting models to study the appropriate size for the new campuses at Van Ness & Geary as well as at St. Luke’s, including how many beds would be needed at each location so that these new hospitals would be no bigger than necessary.
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Why do Women’s and Children’s services need to be at the Van Ness & Geary location?Why consolidate?
Treating more patients in one location improves the outcome for patients and makes the hospital more efficient, particularly for specialized medical care. Concentrating these service lines at one facility will lead to a greater diversity and availability of specialists, health providers and resources. This creates synergies, with staff and teams from different areas of expertise working together to create better outcomes for patients.
The hospital at Van Ness & Geary will become a regional Center of Excellence in providing highly specialized care. At 556 beds, this facility is sized appropriately to support whatever level of care is needed.
St. Luke's has an excellent history of providing birthing services to its community. This service will continue in the new hospital at St. Luke’s, but with the added benefit of access to our specialized staff at the Van Ness & Geary campus for at-risk pregnancies. The intimate scale of birthing services at St. Luke's provides new mothers a desirable service South of Market.
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Why not move existing services to a temporary location and retrofit existing facilities?
Hospitals have unique requirements under the State’s regulatory body known as OSHPD Office of Statewide Health Planning and Development. It would be equally costly to prepare temporary facilities as it would be to rebuild them.
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How about the scenario favored by some to have two hospitals, one 250 bed facility at Van Ness & Geary and a 250 bed hospital at St. Luke's?
The scenario favored by some has several fatal flaws:
- The neighborhood and site of St. Luke’s cannot sustain the impact of a 250 bed hospital.
- Having two smaller hospitals means neither would have enough patients to support the specialist clinical teams, physicians and staff needed to provide the highest quality care.
- Two 250-bed hospitals would dilute specialized service lines across two sites and negatively impact the quality of care for the sickest patients. It also increases costs.
- Most importantly, without the economic “engine” of a large-volume, specialized service hospital it will be impossible for CPMC to cover the cost of rebuilding St. Luke’s and supporting many other community-based health care programs.
Why build in capacity to serve patients from beyond the City and County of San Francisco?
- To help attract the world-class specialists for advanced tertiary and quaternary care that we also need to serve San Franciscans.
- To improve outcomes for San Franciscans by allowing these specialists to practice on the basis of higher volumes of rare and advanced procedures.
- To help provide the extra income we need to allow us to serve under- and un-insured San Franciscans.
- To allow us to provide more health care jobs for San Franciscans.
- To bring more visitor income to the city.
Won’t access to the new campus (and its ED) be impeded by the already very dense traffic on Van Ness & Geary? Won’t it just make this worse?
Any potential traffic impacts created by this project will be analyzed in the Environmental Impact Report which is being prepared now under the direction of the San Francisco Planning Department.
Under the California Environmental Quality Act (CEQA) if the impact of the project exceeds a certain level then we will have to take action to reduce that. Because our new acute care hospital is going to be located at the intersection of several MUNI bus lines as well as two new MUNI Bus Rapid Transit stations we are already developing a robust transit management plan that will benefit employees, visitors and staff.
The garage to the proposed hospital will be accessed from both Post and Geary, therefore, it will effectively be accessible from all directions. It should also be noted that most of these streets are free flow during the non-peak hours, when many patients and visitors would be traveling to and from the campus.
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What will be done to make sure the new campus is not intimidating/is ‘friendly’ for members of San Francisco’s diverse cultural and ethnic population?
California Pacific has many years of experience in making all our facilities friendly and welcoming to all our patients regardless of ethnicity or language. Our new campus will build on that experience. In fact, one of the guiding principles in the design of the new campus was: “All decisions will reflect an awareness of diversity of culture, language, age and lifestyle.”
We employ full time clinical interpreters for Cantonese, Mandarin, Korean, Japanese, Russian and Spanish. If a patient or visitor speaks a language that we do not have a translator for we use a phone service that will provide us with the appropriate translator immediately, day or night. We also make sure that directories and way finding signs are translated into Chinese and Spanish throughout our facilities.
Single patient rooms will allow greater privacy and control over their own environment for all patients and their families.
Our cafeterias serve culturally sensitive foods and we of course allow patients to bring specialized foods if we cannot meet their dietary needs (i.e. kosher).
There will be shared family serving stations where family and friends have access to refrigerators, juice machines, ice, microwaves and space for food prep. This allows family and friends to be more involved in care giving and provides the opportunity for patients and visitors to feel more at home.
Our staff is also incredibly diverse. Approximately 25 percent of our staff members are Asian and ten percent are Latinos so we are always conscious of the need to be culturally and ethnically sensitive in everything we do.
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Other Campuses
Will there be a continuing role for the other four campuses?CPMC’s citywide plan, as developed over the last ten years, is a comprehensive health care delivery system for the entire city and region.
Existing campuses will be renovated and improved to become convenient primary care sites throughout the city and two neighborhood hospitals (the retrofitted and expanded Davies and the entirely rebuilt St. Luke’s) with specialized services.
Facilities will be integrated to guarantee the best comprehensive medical care available in the U.S. Planning for our California campus is still under consideration.
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How will the campuses work together in an integrated manner?
Because the various campuses have a different focus we will be able to offer our patients a continuum of care across our multi-campus, city-wide system.
We already have many years of experience integrating services across three campuses (Pacific, California and Davies) and in the past two years we have been integrating St. Luke’s into our system.
Building a new hospital at the Van Ness & Geary site will simply extend that integration across one more location.
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St. Luke’s Campus
Why was the current site chosen for the St. Luke's rebuild?The Blue Ribbon Panel’s vision for St. Luke’s was for an outstanding community hospital focused in two areas – obstetrics and senior services. While they did not specify bed size, they recognized that the number of beds would be a result of need based on these services.
A key principle for the Panel was the requirement for the current hospital at St. Luke’s to remain open while a new hospital was being built. To shut it down for a couple of years while a new facility was being constructed would have placed an enormous additional burden on SF General, which is already struggling to cope with demand. In addition, closing the hospital would inconvenience patients. Many physicians and staff would need to relocate during that time and it might be hard to get them to return to the newly built facility.
Keeping the hospital open during construction constrained the options as to where to site the new hospital. The Panel chose a site that it determined would provide the most flexibility in creating a hospital that met the needs of the community, not just for today, but for decades to come.
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Timing
What is the timeline of hospital changes--closures, reconstruction schedules, openings?In order to meet state-mandated retrofit and reconstruction deadlines, our goal is to begin construction as soon as the necessary permits and approvals are issued, which is projected to be June 2010.
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Cost
How much will all of this cost?How will it all be paid for?CPMC currently estimates that the total cost of building new hospitals at the Van Ness & Geary site and at St. Luke’s, as well as retrofitting our Davies campus and doing seismic upgrades to other facilities, to be in the region of $2.5 billion. This will be paid for by Sutter Health and CPMC, without any cost to the taxpayer.
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Jobs
How will CPMC's plan affect employment in the city and region?CPMC is currently the second largest private employer in San Francisco, with 6,600 employees and 1,200 physicians on its medical staff. These are great jobs with an average non-physician salary of $95,000/year. The new CPMC is expected to generate additional health care and support jobs throughout the city, especially in the new ambulatory care sites.
In addition, building the Van Ness & Geary and St. Luke’s hospitals will create around 1,500 construction-related jobs, many of them high-paying union jobs, and inject a huge amount of cash into the community during this time of economic uncertainty.
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Neighbors
Are the individual neighborhoods directly impacted by the changes involved in planning?CPMC is proud of its track record of engaging neighbors in its planning. At the Davies Campus, hundreds of hours were dedicated to listening and problem solving so that the proposed new medical office building could meet neighbor needs. We have also begun an extensive series of conversations and meetings with the neighbors in and around the proposed new hospitals at Van Ness & Geary and St. Luke’s. Understanding their specific concerns helps us better address them. [See sidebar for list of outreach meetings]
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How has CPMC addressed neighborhood concerns? What are some of those mitigating measures?
CPMC has already held, and will continue to hold, meetings in which we ask neighbors to identify their specific concerns so we can more accurately address them. In response to some of those concerns about the Van Ness & Geary site, we have already reduced the height of the building by 50 feet and the size by some 380,000 square feet. We have changed the location of both the loading dock area and the ambulance entrance to our Emergency Department to cause less disruption to neighbors and traffic. Additionally, the building has been set back on the Post Street side reducing the mass and shading on nearby residential properties and it has also undergone greening.
We recently held a very well attended meeting with our neighbors at St. Luke’s and are currently in the process of studying how we can address the key issues raised by neighbors, staff and the community.
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Citywide Planning
How do the CPMC plans fit in with the overall health care planning for the City and County of San Francisco?CPMC plays a key role in delivering health care to all of San Francisco.
- Through our four campuses we handle one third of all the hospitalizations in the city, one third of the ED visits, and one half of all births.
- We take our role as part of the overall health care planning for San Francisco very seriously and have been working closely with Dr. Mitch Katz, the director of the Department of Health.
- Part of the reasoning of the Blue Ribbon Panel and CPMC in deciding to rebuild St. Luke’s was that without it, San Francisco General – the only other hospital South of Market – would be overwhelmed, which could have devastating consequences for the overall health of the community in that corner of the city.
- The Hospital Council is taking a leadership role in coordinating activities in areas such as African American breast health and prostate cancer.
- CPMC is working diligently with the Dept. of Public Health’s Anne Kronenberg (deputy health director) and other non-profits on the Charity Care project.
- All hospitals are also working jointly to study how best to ensure that the needs ofthe community are met, and how we can complement our activities with those of the Department of Public Health and other non-profit, non-government organizations.
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Community Benefit
Does CPMC take any responsibility for providing health care to disenfranchised populations within San Francisco?We are well aware that some communities still have inadequate health care services, which is why we have made strategic investments in several areas to positively impact the health of San Franciscans who can least afford care.
- Our Child Development Center serves close to 1,500 children yearly, regardless of their ability to pay.
- The Bayview Child Health Center was created to meet the needs of families in the Bayview Hunters Point district.
- The African American Breast Health and Sister to Sister programs offer free mammograms, and if necessary free treatment, for African American women and members of the LGBT community.
In 2007, the latest year for which figures are available, we provided more than $86 million in community benefit and charity care for the people of San Francisco.
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