Apparently the minor earth quake that rattled the Bay area and Sf must have been the eyeopener to the desperate condition of the City's most important medical facility and the associated trauma centre. The Richter 4.0 magnitude earthquake must have told the governing authorities what a much stronger earth quake could do to the " now standing" hospital. There are few proposals as of what actions to take and one of them is as discussed below !
To fix the extreme risk posed to the city's public health system and comply with a state law, the city wants voters to approve Proposition A. The $887.4 million bond measure would pay for construction of a new hospital that meets current seismic standards, accommodates more patients and makes room for new medical equipment.
The proposed nine-story building, with two of those levels located below ground, would border Potrero Avenue on the west lawn of the hospital campus. It would feature 32 additional beds, raising capacity to 284, and also increase space for emergency patients. Its circular design is intended to give nurses a better view of patients and maximize space.
"The San Francisco General trauma center requires a lot of operating room," said Hospital chief executive Gene Marie O'Connell. "We have a large emergency demand, and we need more critical-care beds. ... This will make a big difference and account for changes in the past few decades."
Under a 1994 state law, all acute-care hospitals must be seismically safe by 2013. If there are no plans to upgrade the hospitals, they must close by the end of this year. Hospitals may ask for extensions on the 2013 deadline if they are in the process of retrofitting.
The city already has spent $25 million studying how to replace the current hospital that was built in 1976 before new, more stringent building codes took effect. While the large bond amount is believed to be unprecedented, O'Connell said it is probably cheaper to build a new hospital than retrofit the existing one. It also will allow the hospital to stay open until the new one is built.
San Francisco General treats 1,500 patients daily, 85 percent of whom are uninsured or receive government-subsidized health care.
The hospital also houses a level 1 trauma center, meaning it has a full range of specialists and equipment available 24 hours a day and can treat the most critically injured patients. The next closest level 1 trauma centers are in Davis and at Stanford, hospital officials said.
As part of the bond development plan, the old hospital will stay in operation during the six-year construction period between 2009 and 2015. The current hospital, which will not undergo any retrofitting for now, will continue to house outpatient clinics and other services indefinitely.
The bond measure needs approval from two-thirds of city voters on Nov. 4. It enjoys support from the San Francisco political establishment and union groups. It has little formal opposition.
One group and one individual have filed formal statements against the proposition with the city's Department of Elections. They argue that the plan does not add enough new beds and that the projected costs need more scrutiny.
Nine years ago, voters approved a $299 million bond to rebuild Laguna Honda Hospital. While it is expected to be complete next year, the costs have more than doubled.
In the case of Laguna Honda, no planning or design work had been completed before the bond measure was presented to voters. In the five years it took to complete the plans, construction costs skyrocketed.
City officials hope that the $25 million in advanced planning for a new San Francisco General will alleviate that problem.
Residents will see little or no tax increases associated with the bond because the city's current debt will be paid off before the hospital bond debt kicks in, according to the city controller's office.
San Francisco General has been in existence since 1872. Its current acute-care hospital is a concrete building with weaker beams and walls than are demanded today. Instead of twisting and bending in an earthquake, its supports might crumble and even explode under too much pressure.
Fred Turner with the state Seismic Safety Commission said San Francisco General's design and materials make it very vulnerable in an earthquake.
"These kinds of buildings are in the lowest earthquake performance category," he said.
State figures show that out of the 419 hospitals subject to the state seismic legislation, 118 have met the requirements.
Proposition A
What it is: An $887.4 million bond for a new San Francisco General Hospital and trauma center
Who's for it: Mayor Gavin Newsom, Sen. Dianne Feinstein, all 11 city supervisors, labor groups and others
Arguments in support: The current hospital is vulnerable to damage or collapse in an earthquake. Supporters say the city needs to build the hospital to meet the region's public health needs and to comply with state law.
Who's against it: Concerned Patients of San Francisco General Hospital and city resident Patrick Monette-Shaw.
Arguments against: Critics say the new hospital would get only an extra 32 beds, and the bond financing needs closer scrutiny.
