City Approves UCSF Research Building at General Hospital

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On January 31, the San Francisco Board of Supervisors unanimously approved a Ground Lease and Lease Deposition and Development Agreement that’ll allow the University of California, San Francisco to construct a new research and academic facility at Zuckerberg San Francisco General Hospital and Trauma Center.

Operated by the San Francisco Department of Public Health, ZSFG is a public hospital whose physicians are provided entirely by UCSF, with which it has partnered for nearly 150 years. More than 800 researchers and staff from UCSF’s four professional schools – Medicine, Dentistry, Nursing, and Pharmacy – who work at ZSFG occupy several buildings that don’t meet UC’s seismic standards. The new $200 million structure will concentrate these UCSF personnel in a modern facility within the ZSFG campus, supporting an extensive UCSF research program that, according to vice dean Sue Carlisle, “not only benefits the world, but directly benefits our community as well,” by advancing treatments for individuals with HIV/AIDS, heart disease, diabetes, and traumatic brain injury, among other conditions.

Plans for the new UCSF building at ZSFG have been in the works for at least five years. Last fall, the UC Board of Regents certified the project’s Final Environmental Impact Report; approval from the San Francisco Health Commission followed in December. Before sending it to the full body, the Board of Supervisors Budget and Finance Committee reviewed the facility proposal, consenting to its terms despite reservations about parking issues posed by its construction, which’ll displace 130 patient spaces from an area known as the B/C Lot. Parking concerns dominated the conversation at the full board meeting as well.

To address the lost spaces, and an existing parking deficit at ZSFG, UCSF is developing a parking relief plan that hinges, in part, on expansion of the 23rd Street Parking Garage, where the Department of Public Health, in conjunction with the San Francisco Municipal Transit Authority, expects to add 307 spaces. The cost of this enlargement is estimated at $32 million, of which UCSF has pledged $10 million. No specific financing plan has emerged to close the gap. Greg Wagner, SFDPH’s chief financial officer, floated “the concept of a revenue bond, where you would essentially take the incremental revenues from the new spaces that are created through the construction of the garage” to repay SFMTA for the expansion. “We’re working with the MTA, but have not gotten to a financial model that works,” said Wagner.

In an exchange with Mark Primeau, of SFDPH, District 7 Supervisor Norman Yee observed that once the vacated buildings at ZSFG are seismically upgraded – as financed by a general obligation bond, with an expected delivery date of 2020 – and reclaimed by the City or other entity, as Primeau put it, that “would make sense to be collocated on campus,” such as the Blood Centers of the Pacific, garage expansion might still be insufficient to accommodate workers and patients. Primeau, however, promised an intensified transportation demand management (or “TDM”) program that’d mitigate the need for parking by “increasing shuttles” and bicycle lockers at ZSFG and promoting carpooling. John Updike, director of real estate for the City and County of San Francisco, mentioned “conversations with our colleagues at DPH and those who might have lots or availability that we know that could serve as excellent remote lots [for UCSF’s ZSFG staff], either within the City or immediately south of the City.”

District 4 Supervisor Katy Tang, while emphasizing that neither she “nor any of my colleagues believe that parking is more important than the work” done by UCSF, expressed her disappointment, acknowledging that while reading the Development Agreement it “caught me by surprise that, despite three years of negotiation between the City and UCSF, we still hadn’t solved for the issue of parking management, and that the parking management plan was not going to be required until, essentially, the close of escrow or start of construction. So that did not rest well with me, the fact that we were going to try to solve this problem later on down the road.” She suggested that UCSF’s $10 million contribution might be increased, but didn’t press the point.

District 11 Supervisor Ahsha Safaí and District 6 Supervisor Jane Kim requested that the Department of Public Health report back to the Board within 30 and 90 days to discuss parking solutions and associated financing. Kim also asked City Controller Ben Rosenfeld to place on Budget and Finance Reserve the $10 million contributed by UCSF for the garage addition, to ensure “that the Budget Committee gets a presentation of the DPH’s spend-down of the $10 million before they spend it down.” This would “allow the public and our constituents to give feedback on components that might be missing, things that they’d like strengthened, or even prioritization of which parts of the plan get funded first, because clearly the $10 million will not fund the entire plan.”

District 9 Supervisor Hillary Ronen insisted on “a motion to amend the ordinance to reflect that UCSF will permanently maintain 130 spaces for its [ZSFG-based] faculty and staff at the Mission Bay campus to offset the 130 spaces that will be removed from ZSFG’s campus.” The idea of using Mission Bay parking for UCSF’s ZSFG workers, with a shuttle traversing the distance between, was suggested by UCSF as a temporary solution for the construction period only.

Parking challenges were counter-balanced by the desire for the research facility, as affirmed in testimonials by doctors and ZSFG administrators.  Dr. Dean Schillinger noted the importance of maintaining UCSF’s research presence at ZSFG.  “Being situated in a context in which, on any given day, I can be doing my research for two and a half hours [and then] get a call from the nursing staff and run down the stairs and go across the street to the clinic and take care of my patients, provides tremendous added value in terms of efficiencies and economies of scale and really keeps us grounded in the mission.”

Dr. Jim Marks pointed out that without a research component ZSFG would lose its Level 1 Trauma Care designation, and struggle to attract top-level staff; it’s San Francisco’s only Level 1 Trauma Center. Dr. Monica Gandhi professed her belief that, in the new facility, UCSF researchers will find a cure for HIV.

District 8 Supervisor Jeff Sheehy remarked, “It is rare for a major academic research institution to devote resources to studying diseases that impact people living in poverty, people who can’t afford insurance. People talk about UCSF and all the money that has come in for research at Mission Bay, and that really tends to look at a different set of diseases than those that are found at San Francisco General.” Sheehy felt it was imperative not to postpone project approval. “Every week’s delay means that a cure for someone who gets care at San Francisco General is one week [further] away. I just think it’s really important to remember the urgency of patients who need this vital research in order to save their lives, to alleviate their suffering.”

The new research and academic building is expected to be five stories tall, with roughly 175,000 gross square feet, paid for by UCSF. According to the Final Environmental Impact Report, the “architectural style of the proposed research building has not been developed,” but the report takes note of the “prevalence of brick within the SFGH Historic District” and surmises that “the use of masonry (including brick and terra cotta) exclusively or in combination with other exterior cladding materials” would be “encouraged” during the design process.