San Francisco County Grand Jury

2001-2002

7 reports

Findings & Recommendations 1 findings
F2000: CGJ has found this count lacking in consistent, scientific methodology. MOOH has no direct accountability to the Board of Supervisors, the Local Board or City departments for its actions, directives, or decisions. CGJ has found this office to be ineffectual and inconsistent in its relations with other City departments and the Local Board. As a result, CGJ has strong concerns regarding the use of City resources for this office. The Local Board - Findings The Local Board is comprised of a broad range of committed, sincere, and experienced people, including members of City departments, advocates, service providers, homeless, and formerly homeless individuals. Though the Local Board develops an annual work plan and fiscal budget to coincide with the City budget-planning process, it has not produced an overall fiscal projection for the entire five-year plan. The Local Board lacks staffing, training, and funding to fulfill its entire mandate. As a result, it does not have the capability or the necessary skills to provide fiscal and legislative analyses. In addition, there is no accountability within the current organizational structure for the recommendations of the Local Board, or for its relation to the development of policy and legislation by the Board of Supervisors. The Local Board lacks representation from state or federal officials. Without representation from these key sectors, the Local Board is not able to effectively establish and analyze homeless policy, or successfully advocate at a state and federal level. The Local Board has difficulty in maintaining consistent attendance for its meetings, often resulting in an inability to take action due to a lack of a quorum of its members. CGJ found that the Local Board has failed to encourage consistent participation and membership from the business community. In addition, CGJ believes that the Local Board has not done enough to encourage the participation of homeless, formerly homeless, and extremely low-income people on the Local Board. CGJ believes that involvement from both of these sectors is crucial for a full, representative public process. The Civil Grand Jury concurs with the Department of Public Health, the Department of Human Services, and the Mayor's Office on Homelessness that a new Department of Homelessness would not improve homeless services. (Attachment B) However, the Civil Grand Jury has consistently found a lack of accountability in decision-making, leadership, and management. These findings have led the Civil Grand Jury to recommend changing the organizational structure to create a visible, public, and accountable process that is comparable to the scale of homelessness. The Civil Grand Jury believes that the current structure must change.
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Additional Recommendations 18

Not linked to specific findings.

R1a: The Board of Supervisors should initiate a Charter Amendment to create a department- level, seven-member Commission on Homelessness. The Commission would be charged, but not limited, to do the following:  Direct and oversee the implementation and monitoring of the Continuum of Care.  Provide oversight and accountability for the Local Board and the Mayor's Office on Homelessness.  Assume the responsibilities and duties of the current Mayor's Office on Homelessness. In addition, the Commission would be responsible for the hiring of a director of this new Office on Homelessness and of monitoring the activities of that Office. The Office on Homelessness would continue the current responsibilities of MOOH, but with a greater focus on implementing the Continuum of Care, and would provide staffing to the Local Board and the Commission.  Establish a clear, accountable, and public decision-making process for residents, the members of the Local Board, City departments, service providers, and the City and County of San Francisco.  Provide fiscal accountability by reviewing any General Fund expenditures earmarked for homeless programs. This would be mandated and the DPH, DHS, and all applicable departments that fund homeless programs or services would be required to submit information to the Commission for its review. The Commission on Homelessness would include other aspects:  The Local Board would act as the representative body of this Commission and would continue with its current mandate, including the management of the federal McKinney funding. Through its debate and valuable public process, the Local Board would make recommendations to the Commission for final action.  Appointments to this Commission would be split between the Board of Supervisors and the Mayor, with at least one member being homeless or formerly homeless.  The Commission would not take over the administration of any homeless programs, which would remain with the current departments.  The Commission would have sufficient staff to provide it with the capability to conduct fiscal and policy analyses of programs and legislation.
R1b: Because of the long-term nature of solving homelessness, the Mayor and the Board of Supervisors should consider the establishment of a dedicated source of funding for homeless services and for low-income, affordable housing. This funding stream could be modeled on 1998's Proposition E which established baseline funding for MUNI, or on the hotel tax which provides funding for the arts. Required Responses --  Board of Supervisors - 90 days  Local Homeless Coordinating Board - 60 days  Mayor's Office on Homelessness - 60 days  Office of the Mayor - 60 days
R2a: The Mayor and the Board of Supervisors should fund the Local Board to a level that would allow it to effectively fulfill its mandate. This would include mandatory training for members, the hiring of full-time dedicated staff, and the increasing of its capacity to conduct fiscal and policy analysis.
R2b: The Local Board should prepare an annual report on the state of homelessness in the City, including, but not be limited to:  identifying gaps in services provided by the City  providing information on the current needs of the homeless population  providing documentation on the services that are provided.
R2c: The Local Board, in coordination with other City departments, should take responsibility for the performance and execution of a broad-based census, using consistent, scientific methodology, of the homeless population in San Francisco.
R2d: The Local Board should develop a common methodology of budgetary reporting, with regard to homeless services, from all applicable City departments. The Local Board should develop a five-year fiscal projection for the Continuum of Care.
R2e: Consistent with the Continuum of Care, the City should pay all members of the Local Board who earn less than $25,000 per year a living-wage stipend for their time on the Board. CGJ believes that this is necessary to facilitate and to encourage the participation of people who are homeless, formerly homeless, and low-income (3).
R2f: The Local Board should identify all information, data, and resources needed to fulfill its entire mandate. Responsibility should be specifically assigned to City departments for the timely gathering and submission of this information.
R2g: The Local Board should have seats for involved state and federal officials. Additional seats could include a representative from HUD.
R2h: Appointments to the Local Board should be distributed between the Mayor and the Board of Supervisors.
R3: The City should develop an integrated informational system that can track participants and provide the homeless population with improved and focused services from the City and from service providers. CGJ recognizes that information sharing of this type is controversial. It is the view of the CGJ that serious consideration should be given to a system similar to DPH's "Reggie" system. That extensive system has the capability of safeguarding extremely sensitive, private information; participation in the program is voluntary. Such a system would have several goals:  Provide a higher level of integrated service for homeless individuals, children, and families.  Provide a way of assessing what needs are being addressed and where more resources are needed.  Reduce duplication of services.  Provide consistent, accurate, and accessible information on homeless services.  Ensure compliance with HUD's required implementation of an HMIS.
R4a: The City and the Local Board should convene involved departments, homeless advocates, and service providers in order to develop an integrated, central database of available beds. A city-wide referral system would improve access to the location of available beds on any given night.
R4b: The Local Board and City departments should develop minimum standards of operation for all homeless shelters.
R4c: The Local Board and City departments should develop a standard "Bill of Rights" for all shelter participants, inform participants of these rights, and create standard system-wide operating policies.
R4d: The Local Board and City departments should develop minimum standards of training for all shelter staff and establish minimum client-staff ratios throughout the entire shelter system.
R4e: The Local Board and City departments should work with the Mayor's Office on Disability to ensure that all shelters, including the expanded winter shelters, are architecturally ADA compliant in addition to ensuring reasonable programmatic access at each site (5). In addition, CGJ recommends that the Office of Contract Administration work with the MOD to ensure that all homeless service contracts include these provisions.
R4f: CGJ concurs with the Continuum of Care and strongly recommends that the Local Board and City departments convene a system-wide shelter monitoring committee to provide oversight for shelter conditions and standards of care (3). Required Responses --  Department of Human Services - 60 days  Department of Public Health - 60 days  Local Homeless Coordinating Board - 60 days  Mayor's Office on Disability - 60 days  Mayor's Office on Homelessness - 60 days  Office of Contract Administration - 60 days PUBLIC EDUCATION
R5: The Mayor, Local Board, Board of Supervisors, advocates, service providers, and major City departments need to initiate a major public education effort about homelessness and the reality of poverty in San Francisco. This campaign should cover but not be limited to the following areas:  the historical and root causes of poverty and homelessness  the history and status of the City's past and current efforts in combating homelessness  the involvement of the public in developing solutions. Required Responses --  Board of Supervisors - 90 days  Department of Human Services - 60 days  Department of Public Health - 60 days  Local Homeless Coordinating Board - 60 days  Mayor's Office on Homelessness - 60 days  Office of the Mayor - 60 days Summary of Required Responses  Board of Supervisors - Recommendations 1a, 1b, 2a, 2h, and 5  Department of Public Health - Recommendations 1a, 3, 4b, 4c, 4d, 4e, 4f, and 5  Department of Human Services - Recommendations 1a, 4b, 4c, 4d, 4e, 4f, and 5  Office of the Mayor - Recommendations 1a, 1b, 2a, 2h, and 5  Local Homeless Coordinating Board - Recommendations 1a, 2a, 2b, 2c, 2d, 2e, 2f, 2g, 2h, 3, 4a, 4b, 4c, 4d, 4e, 4f, and 5  Mayor's Office on Disability - 4e  Mayor's Office on Homelessness - 1a, 2a, 3, 4a, 4b, 4c, 4d, and 4f  Office of Contract Administration - 4e ATTACHMENT A - SOURCES 1 Homeless Deaths Identified from Medical Examiner Records December 1997-November 1998 http://www.dph.sf.ca.us/Reports/Homeless/RptHomeless98.pdf December 1996-November 1997 http://www.dph.sf.ca.us/Reports/Homeless/RptHomeless97.pdf 2 Homeless Survey 2001-2002, Budget Analyst http://sfgov.org/budanalyst/homeless/homeless_survey2001-02.htm 3 Continuum of Care: A Five-Year Strategic Plan for Homeless Services 2001-2006 http://sfgov.org/lhcb/reports/coc032301.htm 4 Mayor's Office on Homelessness - Homeless Count Report http://sfgov.org/homeless/count.htm 5 Mayor's Office on Disability pamphlet Americans with Disabilities Act - An Overview of Programmatic Access Requirements for City Contractors OTHER INFORMATIONAL INTERNET LINKS Controller's Office: Performance Audit of Homeless Services (May 2002) http://sfgov.org/controller/Audits/hs.pdf Letter from Budget Analyst to Local Board http://sfgov.org/budanalyst/letterlhcb/index.htm Local Homeless Coordinating Board http://sfgov.org/lhcb/ Mayor's Office on Homelessness http://sfgov.org/homeless/
Findings & Recommendations 4 findings
F1: In San Francisco the budgets for different parts of the criminal justice system (i.e., Judicial, District Attorney, Public Defender, Police Department, Sheriff's Department, Adult Probation Department, and Juvenile Probation Department) are viewed and funded separately, whereas national best practices suggest a more integrated approach. Functions, such as probation, that can reduce recidivism if appropriately funded can also reduce costs for the police, the jails, and the court system.
Related Recommendations (1)
R1: In the budget process, the Mayor and the Board of Supervisors should consider the total amount needed to fund all parts of the criminal justice system; increases for APD should be offset by reductions elsewhere in the criminal justice budget.
F2: National best practices suggest that community-based probation programs provide the best chance for successful rehabilitation of offenders. San Francisco has made some moves toward this change; however, adult probation continues to be centralized at the Hall of Justice, i.e., all POs are located at 850 Bryant, and nearly all probation visits take place at 850 Bryant.
Related Recommendations (1)
R2: The Mayor and the Board of Supervisors should support APD in accelerating a commitment toward community-located probation activities. APD should reassign probation caseloads by socioeconomic and geographic neighborhoods, based on input from the public, CBOs working with APD, and the Police Department. Required Responses --  Adult Probation Department - 60 days  Board of Supervisors - 90 days  Office of the Mayor - 60 days
F3: San Francisco does not have enough bilingual, Spanish-speaking POs. There are 16 bilingual Spanish-speaking POs. Among these 16 POs, only 5 are assigned to the Community Unit of APD (i.e., the unit that currently deals with 800 Spanish-speaking offenders and whose supervisor is also a bilingual, Spanish speaker). Of the 800 Spanish-speaking offenders, 533 are monolingual Spanish speakers.
Related Recommendations (1)
R3: The Mayor and the Board of Supervisors should make a commitment to assist APD in hiring additional Spanish-speaking POs by providing additional slots that require Spanish fluency, and by allowing retirement/attrition of current probation officers to bring department staffing to its authorized level. Required Responses -  Adult Probation Department - 60 days  Board of Supervisors - 90 days  Office of the Mayor - 60 days
F4: Currently, an offender who is re-arrested has no assurance that he/she will be assigned the same judge and the same PO as for the initial offense According to POs, CBOs, and probationers, assignment consistency improves the likelihood of successful rehabilitation for offenders.
Related Recommendations (1)
R4: APD and the court should adopt measures to ensure that POs and judges are, whenever possible, assigned to offenders from the time of their initial arrest through any re-offenses. Required Responses -  Adult Probation Department- 60 days Summary of Required Responses -  Adult Probation Department - Recommendations 2, 3, and 4  Board of Supervisors - Recommendations 1, 2, and 3  Office of the Mayor - Recommendations 1, 2, and 3 ATTACHMENT 1 - SOURCES 1 Corbett, Ronald P., et al. Transforming Probation Through Leadership: The "Broken Windows" Model, (2000). http://www.manhattan-institute.org/html/broken_windows.htm 2 San Francisco Controller's Report on Adult Probation, (October 2, 2000). Office of the Attorney General, Criminal Justice Statistics Center, p. 43. http://caag.state.ca.us/cjsc/publications/misc/cinc/5cost.pdf 4 Clear, T.R. and G.F. Cole. American Corrections, Second Edition. Pacific Grove, CA: Brooks/Cole. (1990) 5 Langan, P.A. Losing Legitimacy: Street Crime and the Decline of Social Institutions in America. Boulder, CO: Westview. (1994). Rennison, M. Criminal Victimization 1998: Changes 1997-98 with Trends 1992-98. National Crime Victimization Survey. Washington, DC, Bureau of Justice Statistics. (1999)
Findings & Recommendations 6 findings
F1: Three buildings within the SFGH complex are rated SPC-1: the main acute care hospital, the out-patient/clinical laboratory, and the central power plant. Those buildings must (1) be rebuilt, (2) be retrofitted, or (3) cease to provide or be involved in the direct provision of hospital services after 2008 (or 2013 if an extension is granted). Should SFGH cease to provide hospital services to its citizens, State law requires San Francisco to contract out for those services with other licensed and compliant, acute care facilities. CGJ interviewed -- • staff from San Francisco General Hospital • staff from the University of California at San Francisco • staff from the San Francisco Department of Public Health • staff from the Community Health Network • staff from the San Francisco Health Commission • members of the San Francisco Medical Society • members of the California Health Care Association • members of the San Francisco Chamber of Commerce • members of Bay Area architectural and engineering firms • members of SEIU local 790 (health care workers) • representatives of the Office of Statewide Health Planning and Development Without exception, all persons interviewed indicated unequivocally that SFGH should be rebuilt.
Related Recommendations (1)
R1: REBUILD SAN FRANCISCO GENERAL HOSPITAL. The existence of SFGH to ensure the delivery of the best possible health care -- such as acute care services, trauma care, and wellness -- is essential to the overall quality of life in San Francisco. Rebuilding SFGH’s acute hospital facilities, rather than the other available options, not only serves to maintain the highest level of health care for San Francisco citizens, but also, is the most cost-effective solution to providing those required services. CGJ takes no position regarding where or how SFGH should be rebuilt. Required Responses – Board of Supervisors -- 90 days Health Commission -- 60 days Office of the Mayor -- 60 days
F2: The Office may grant the hospital owner a delay to Section 1.5.1 if compliance will result in diminished health capacity which cannot be provided by other general acute care hospitals within a reasonable proximity. 2.1 Hospital owners seeking a delay must submit a written request to the Office including a statement with supporting documentation regarding the reason for noncompliance with subdivision 1.5.1 and a schedule indicating when compliance will be obtained. A delay request and compliance schedule may be submitted simultaneously with the hospital’s evaluation and compliance plan pursuant to the requirements of this article. If a delay request is submitted after the seismic evaluation report, compliance plan and schedule, the request must include an amended compliance schedule and must be submitted to the Office no later than January 1, 2007. 2.2 The time extension for compliance shall be granted in one year increments, up to a maximum of five (5) years, beyond the mandated year of compliance. The facility requesting the extension shall provide evidence of efforts to implement an approved Compliance Plan which may include design/construction contracts and schedules which demonstrate efforts to implement the compliance measures within the requested period of extension. SB 1953 OVERVIEW – Passed in 1994, SB1953 is an amendment to the Alfred E. Alquist Seismic Safety Act of 1983 (See Attachment 1). It was enacted in the wake of the 1994 Northridge earthquake which caused significant damage to health care facilities in California. SB1953, and implementing regulations promulgated by OSHPD, prescribe new architectural and engineering standards for acute care hospitals. “With the intent of ensuring that all general acute care hospitals in California will be reasonably capable of providing services to the public after a seismic event, SB1953 requires that by January 1, 2030, all licensed general acute care hospitals in the State of California must be compliant with the Hospital Facilities Seismic Safety Act. “SB1953 mandates specific seismic evaluation procedures which all licensed general acute care hospital facilities must use to determine their respective structural and nonstructural performance categories. Upon completion of the structural and non- structural evaluations, and after determination of the appropriate performance categories, all general acute care hospitals must then formulate a compliance plan that shall indicate the hospital’s intent to do any of the following with their non-complying facilities: • Retrofit for compliance with SB1953 for continued acute care operation beyond the year 2030; • Partial retrofit for initial compliance, with closure or replacement planned by the years 2002, 2008 and/or 2030; • Remove from licensed acute care service with conversion to non-acute care health facility use; • No action – Building to be closed, demolished or replaced.” [AIA California Council Guidelines to SB 1953] Seismic evaluation, determining the structural performance category (SPC) and submitting compliance plans to OSHPD were among the first steps in the process. The SPC system rates the risk of the building structural frame and ranges from SPC-1 through SPC-5. SPC-1 is the highest risk rating. All building systems must be evaluated as well (the NPC or “non-structural performance category”, again ranging from NPC-1 through NPC-5, with NPC-1 being the highest risk rating).
Related Recommendations (3)
R2: The Office may grant the hospital owner a delay to Section 1.5.1 if compliance will result in diminished health capacity which cannot be provided by other general acute care hospitals within a reasonable proximity. 2.1 Hospital owners seeking a delay must submit a written request to the Office including a statement with supporting documentation regarding the reason for noncompliance with subdivision 1.5.1 and a schedule indicating when compliance will be obtained. A delay request and compliance schedule may be submitted simultaneously with the hospital’s evaluation and compliance plan pursuant to the requirements of this article. If a delay request is submitted after the seismic evaluation report, compliance plan and schedule, the request must include an amended compliance schedule and must be submitted to the Office no later than January 1, 2007. 2.2 The time extension for compliance shall be granted in one year increments, up to a maximum of five (5) years, beyond the mandated year of compliance. The facility requesting the extension shall provide evidence of efforts to implement an approved Compliance Plan which may include design/construction contracts and schedules which demonstrate efforts to implement the compliance measures within the requested period of extension. SB 1953 OVERVIEW – Passed in 1994, SB1953 is an amendment to the Alfred E. Alquist Seismic Safety Act of 1983 (See Attachment 1). It was enacted in the wake of the 1994 Northridge earthquake which caused significant damage to health care facilities in California. SB1953, and implementing regulations promulgated by OSHPD, prescribe new architectural and engineering standards for acute care hospitals. “With the intent of ensuring that all general acute care hospitals in California will be reasonably capable of providing services to the public after a seismic event, SB1953 requires that by January 1, 2030, all licensed general acute care hospitals in the State of California must be compliant with the Hospital Facilities Seismic Safety Act. “SB1953 mandates specific seismic evaluation procedures which all licensed general acute care hospital facilities must use to determine their respective structural and nonstructural performance categories. Upon completion of the structural and non- structural evaluations, and after determination of the appropriate performance categories, all general acute care hospitals must then formulate a compliance plan that shall indicate the hospital’s intent to do any of the following with their non-complying facilities: • Retrofit for compliance with SB1953 for continued acute care operation beyond the year 2030; • Partial retrofit for initial compliance, with closure or replacement planned by the years 2002, 2008 and/or 2030; • Remove from licensed acute care service with conversion to non-acute care health facility use; • No action – Building to be closed, demolished or replaced.” [AIA California Council Guidelines to SB 1953] Seismic evaluation, determining the structural performance category (SPC) and submitting compliance plans to OSHPD were among the first steps in the process. The SPC system rates the risk of the building structural frame and ranges from SPC-1 through SPC-5. SPC-1 is the highest risk rating. All building systems must be evaluated as well (the NPC or “non-structural performance category”, again ranging from NPC-1 through NPC-5, with NPC-1 being the highest risk rating).
R2a: In order to take appropriate actions to implement the State’s seismic safety mandates, San Francisco should complete a master plan for SFGH. Required Response – Health Commission -- 60 days
R2b: QUICKLY DEVELOP A SHARED VISION AND INTRODUCE A BOND MEASURE that will have the greatest chance of voter approval. All involved parties -- the Mayor, Board of Supervisors, Health Commission, Director of Public Health -- must develop a shared vision for San Francisco’s health care needs, including the location and configuration of services and the role SFGH will play in meeting those needs. This must be concluded expeditiously so that the financial impact and the appropriate form and amount of financing for rebuilding SFGH may be determined. If a bond is required, the type should be determined. If voter approval is required, the measure should be placed on the ballot at the earliest possible time -- this will permit necessary adjustments and re- introduction should voters fail to approve it. Creative alternative financing, including a revenue bond, should be considered. CGJ strongly encourages all appointed and elected officials to put politics aside to ensure that adequate time and money are available for completion of the construction prior to the legislated deadline (which, with an approved extension, is 2013, at the latest). CGJ is concerned about the implied assumption of San Francisco officials that all extensions will be approved. This could place in peril the continued existence of SFGH. Required Responses – Board of Supervisors -- 90 days Health Commission -- 60 days Office of the Mayor -- 60 days
F2a: Although a master planning process, as it relates to the seismic-safety mandate, was started for the SFGH campus, San Francisco does not have a current master plan for SFGH that takes the impact of SB1953 into consideration or that maps out all contingencies and alternatives. The most recent Master Plan is dated 1987.
F2b: Due to the anticipated closure of one or more privately owned hospitals in San Francisco, as well as new State regulations for nurse-staffing ratios, it is almost a certainty that San Francisco will face the loss of a substantial number of hospital beds in the near future. This will increase the already high incidence of emergency-room diversions, as well as seriously exacerbate the existing bed shortage in San Francisco. Additionally, ongoing international incidents and the threat of bio-terrorism have heightened awareness of the need for an appropriate infrastructure to improve emergency preparedness. Representatives of CHA, OSHPD, and Bay Area architectural and engineering firms, as well as the San Francisco Business Times (February 15, 2002), have stated that it takes a minimum of 10 years to design, approve, fund, and construct a new hospital. The CGJ could find no evidence that San Francisco has adequately planned a bond issue to implement the financing required for SFGH to comply with SB1953. Interviews and discussions with representatives of DPH and with others indicate that “political considerations” are significantly impacting the decision of when to introduce a bond measure for funding the construction of a new hospital. DPH staff is sanguine about obtaining voter approval of a bond measure for the SFGH rebuilding project; they have indicated that they cannot envision possible voter rejection of what may be the largest bond measure yet presented to citizens of San Francisco.
F3: Both SFGH and UCSF Hospital must comply with SB1953. Because of the renown of UCSF, SFGH is able to attract internationally recognized physicians and researchers to staff its hospital, thereby providing the highest quality health care to the citizens of San Francisco. It is the consensus of all persons interviewed at UCSF, SFGH, DPH, the San Francisco Medical Society, the San Francisco Chamber of Commerce, members of SEIU local 790, and members of the CHA, that, regardless of the method of compliance with SB 1953, the relationship between SFGH and UCSF must be maintained.
Related Recommendations (1)
R3: MAINTAIN THE MUTUALLY BENEFICIAL SFGH-UCSF AFFILIATION. As SFGH goes forward with its plans to rebuild, it must consider seriously the requirements and needs of UCSF as they relate to research, facilities, access to patients, and compliance with UC regents’ policy. Required Response – Health Commission -- 60 days
F4: To rebuild SFGH, funding must be approved by the citizens of San Francisco. Many citizens may not be aware of the extent to which SFGH serves the general population. While the hospital does provide services to the indigent and uninsured populations, it also serves the rest of the City and the Bay Area through its trauma center. It is, in fact, every citizen’s hospital.
Related Recommendations (1)
R4: EDUCATE THE PUBLIC ON THE ROLE OF SFGH IN THE COMMUNITY. Mount a public service campaign to inform the citizens of San Francisco of the significance of SFGH and its Level 1 Trauma Center in our midst. Required Responses – Board of Supervisors -- 90 days Health Commission -- 60 days Office of the Mayor -- 60 days Summary of Required Responses – Board of Supervisors -- Recommendations 1,2b, and 4 Health Commission -- Recommendations 1, 2a, 2b, 3, and 4 Office of the Mayor -- Recommendations 1, 2b, and 4 ATTACHMENT 1 -- TERMINOLOGY An ACUTE CARE HOSPITAL is defined as one which renders medical treatment to individuals whose illnesses or health problems are of a short term or episodic nature. LEVEL 1 TRAUMA CENTER is defined as an institution that “must provide 24 hours a day/7 days a week trauma, surgical and emergency services.” It is the highest designation available for trauma centers and signifies an institution that: cares for a high volume of seriously injured patients (at least 1,000 per year), provides in-house surgical staff and all necessary specialists who are immediately available, provides training and education for health professionals in trauma care and maintains a program for trauma research. DIMINISHED HEALTH CAPACITY as defined in the California Health and Safety Code section 130060(a): “After January 1, 2008, any general acute care hospital building that is determined to be at potential risk of collapse or pose significant loss of life shall only be used for non-acute care hospital purposes. A delay in this deadline may be granted by the office upon a demonstration by the owner that compliance will result in a loss of health care capacity that may not be provided by other general acute care hospitals within a reasonable proximity.” Implementing regulations for OSHPD (Part 1, Title 24) state: 1.5 Delay in Compliance 1. After January 1, 2008, any general acute care hospital which continues acute care operation must be at a minimum of an SPC 2 facility as defined in Article 2, Table 2.5.3 or shall no longer provide acute care services. 2. The Office may grant the hospital owner a delay to Section 1.5.1 if compliance will result in diminished health capacity which cannot be provided by other general acute care hospitals within a reasonable proximity. 2.1 Hospital owners seeking a delay must submit a written request to the Office including a statement with supporting documentation regarding the reason for noncompliance with subdivision 1.5.1 and a schedule indicating when compliance will be obtained. A delay request and compliance schedule may be submitted simultaneously with the hospital’s evaluation and compliance plan pursuant to the requirements of this article. If a delay request is submitted after the seismic evaluation report, compliance plan and schedule, the request must include an amended compliance schedule and must be submitted to the Office no later than January 1, 2007. 2.2 The time extension for compliance shall be granted in one year increments, up to a maximum of five (5) years, beyond the mandated year of compliance. The facility requesting the extension shall provide evidence of efforts to implement an approved Compliance Plan which may include design/construction contracts and schedules which demonstrate efforts to implement the compliance measures within the requested period of extension. SB 1953 OVERVIEW – Passed in 1994, SB1953 is an amendment to the Alfred E. Alquist Seismic Safety Act of 1983 (See Attachment 1). It was enacted in the wake of the 1994 Northridge earthquake which caused significant damage to health care facilities in California. SB1953, and implementing regulations promulgated by OSHPD, prescribe new architectural and engineering standards for acute care hospitals. “With the intent of ensuring that all general acute care hospitals in California will be reasonably capable of providing services to the public after a seismic event, SB1953 requires that by January 1, 2030, all licensed general acute care hospitals in the State of California must be compliant with the Hospital Facilities Seismic Safety Act. “SB1953 mandates specific seismic evaluation procedures which all licensed general acute care hospital facilities must use to determine their respective structural and nonstructural performance categories. Upon completion of the structural and non- structural evaluations, and after determination of the appropriate performance categories, all general acute care hospitals must then formulate a compliance plan that shall indicate the hospital’s intent to do any of the following with their non-complying facilities: • Retrofit for compliance with SB1953 for continued acute care operation beyond the year 2030; • Partial retrofit for initial compliance, with closure or replacement planned by the years 2002, 2008 and/or 2030; • Remove from licensed acute care service with conversion to non-acute care health facility use; • No action – Building to be closed, demolished or replaced.” [AIA California Council Guidelines to SB 1953] Seismic evaluation, determining the structural performance category (SPC) and submitting compliance plans to OSHPD were among the first steps in the process. The SPC system rates the risk of the building structural frame and ranges from SPC-1 through SPC-5. SPC-1 is the highest risk rating. All building systems must be evaluated as well (the NPC or “non-structural performance category”, again ranging from NPC-1 through NPC-5, with NPC-1 being the highest risk rating).
Findings & Recommendations 3 findings
F1: Purchasing regulations governing Professional Services contracts have not been updated significantly since 1989. As a result, purchasing regulations do not reflect 1996 Charter revisions which affect contracting or 1999 revisions to Chapter 21 of the Code which governs purchasing of commodities and services. Thus, there is no current direction from Purchasing to the departments relative to procedures for contracts below $50,000 or sole source contracts.
Related Recommendations (1)
R1: The Purchasing division within the Office of Contract Administration should update Chapter 900 (Personal Services and Lease Contracts) of the "Guide to Ordering Goods and Services" manual to specifically address contracts under $50,000 and "sole source" contracts. This update should be consistent with HRC requirements. Required Response -  Office of Contract Administration - 60 days
F2: CGJ found that there is a widespread practice of awarding Professional Services Contracts below $50,000 without following a competitive solicitation process. Generally, departments believe that the absence of Purchasing regulations for contracts under $50,000 negates any requirement for competitive solicitation or, in many cases, HRC review. Several contracts for Professional Services were also found to have been developed using questionable practices relating to contract amendments. In those cases, the departments initially awarded contracts for less than $50,000 which excluded items integral to the contract, in order to stay below the $50,000 threshold. Once the contract was signed, amendments were provided that increased the contract beyond $50,000 - without a new competitive solicitation process (and, at times, without HRC review). A significant number of contracts with one or more of the problems found above were for public affairs and public relations consultants.
Related Recommendations (1)
R2: The Controller should conduct an audit of all Professional Services contracts below $50,000 to ensure compliance with HRC and Purchasing requirements. Special attention should be placed on public relations contracts and those contracts which have not included a well defined scope of work and where amendments subsequently include items such as printing and materials. Required Response  Controller - 60 days
F3: Sole source exemptions are frequently declared by the contracting departments on an assumption that there will not be other bidders, and often without documentation of a rationale. Validation - that the service provider is compliant with HRC rules, minimum compensation, and health-care accountability requirements - is generally taken as the only requirement necessary to allow declaration of a "sole source" circumstance. This is a frequent practice in the human services area, as well as in others.
Related Recommendations (1)
R3: The Controller should provide an annual report to the Mayor and to the Board of Supervisors on the number, dollar value, and rationale of "sole source" contracts for each department. Required Response  Controller - 60 days Summary of Required Responses:  Office of Contract Administration - Recommendation 1  Controller - Recommendations 2 and 3
Findings & Recommendations 3 findings
F1: Purchasing regulations governing Professional Services contracts have not been updated significantly since 1989. As a result, purchasing regulations do not reflect 1996 Charter revisions which affect contracting or 1999 revisions to Chapter 21 of the Code which governs purchasing of commodities and services. Thus, there is no current direction from Purchasing to the departments relative to procedures for contracts below $50,000 or sole source contracts.
Related Recommendations (1)
R1: The Purchasing division within the Office of Contract Administration should update Chapter 900 (Personal Services and Lease Contracts) of the "Guide to Ordering Goods and Services" manual to specifically address contracts under $50,000 and "sole source" contracts. This update should be consistent with HRC requirements. Required Response -  Office of Contract Administration - 60 days
F2: CGJ found that there is a widespread practice of awarding Professional Services Contracts below $50,000 without following a competitive solicitation process. Generally, departments believe that the absence of Purchasing regulations for contracts under $50,000 negates any requirement for competitive solicitation or, in many cases, HRC review. Several contracts for Professional Services were also found to have been developed using questionable practices relating to contract amendments. In those cases, the departments initially awarded contracts for less than $50,000 which excluded items integral to the contract, in order to stay below the $50,000 threshold. Once the contract was signed, amendments were provided that increased the contract beyond $50,000 - without a new competitive solicitation process (and, at times, without HRC review). A significant number of contracts with one or more of the problems found above were for public affairs and public relations consultants.
Related Recommendations (1)
R2: The Controller should conduct an audit of all Professional Services contracts below $50,000 to ensure compliance with HRC and Purchasing requirements. Special attention should be placed on public relations contracts and those contracts which have not included a well defined scope of work and where amendments subsequently include items such as printing and materials. Required Response  Controller - 60 days
F3: Sole source exemptions are frequently declared by the contracting departments on an assumption that there will not be other bidders, and often without documentation of a rationale. Validation - that the service provider is compliant with HRC rules, minimum compensation, and health-care accountability requirements - is generally taken as the only requirement necessary to allow declaration of a "sole source" circumstance. This is a frequent practice in the human services area, as well as in others.
Related Recommendations (1)
R3: The Controller should provide an annual report to the Mayor and to the Board of Supervisors on the number, dollar value, and rationale of "sole source" contracts for each department. Required Response  Controller - 60 days Summary of Required Responses:  Office of Contract Administration - Recommendation 1  Controller - Recommendations 2 and 3
Findings & Recommendations 6 findings
F1: The CPD budget does not contain an allocation for the enforcement of outdoor advertising. The June 2001 legislation provides for extensive fines of up to $2,500 per day for not removing those billboards without permits; although that money is designated to pay for enforcement, such fines are not a dependable source of income. Reliable and permanent funding is needed to pay for efficient enforcement. The economic incentives for scofflaw sign companies will increase as the combination of the new billboard ban and the number of legal existing sites begins to dwindle by attrition. Lack of steady enforcement measures would effectively negate the voter- approved ban.
Related Recommendations (1)
R1: Additional funds could be generated for enforcement by requiring annual renewal of permits and by inspection of existing billboard signs, with a yearly charge per sign. This would facilitate and pay for discovering sites without permits, illegally altered sites, and illegal new installations. Required Response – City Planning Department – 60 days
F2: CPD and DBI electronic files are unable to distinguish outdoor advertising signs (those which do not pertain to an on-site enterprise) from standard signs (those with information concerning activity on the immediate premises). CPD has no way to determine with any accuracy how many legal billboards exist; any change to a legal, grandfathered billboard which affects size, location, direction, and the like requires a new building permit and triggers proof of the grandfathered status (permitted and in place prior to the March 2002 ban.)
Related Recommendations (2)
R2a: Assign a separate and distinct numerical designation to all existing, active, legal outdoor advertising sign permits (to distinguish them from all other sign permits) for entry into the computer system. Flag each for automatic periodic site reviews by CPD. Required Response – City Planning Department – 60 days
R2b: Conduct a city-wide count and permit history of every existing billboard sign. Many of the originally grandfathered signs (prior to 1966) have no permits on file. Researching ownership (which may have changed repeatedly over time); checking the existence of permits or verifying legal status with other evidence, such as dated photos; and entering this information into the database, under the applicable numerical code, would allow staff a way to monitor continued use and to eliminate billboards without permits in a timely manner. Required Response – City Planning Department – 60 days
F3: The City Planning Department at present has neither budget nor experienced staff with time to conduct the much needed census of billboards in San Francisco.
Related Recommendations (1)
R3: The Planning Director should hire a temporary staff person -- with special expertise to conduct a city-wide survey of all extant billboards -- to enter the information into the electronic database described Recommendation 2a. Under the direction of a professional who has knowledge of San Francisco's billboard history, collegiate Urban Planning interns who are periodically invited to train in the CPD might assist with the accurate, professional completion of such an effort at minimum cost to the City. Required Response – City Planning Department – 60 days
F4: CalTrans requires permits for any billboards within 600 feet of all Interstate and Primary Highways, several of which run through San Francisco’s jurisdiction. No efficient process has existed in the past for coordination between the State and San Francisco outdoor advertising sign permitting and regulating offices. By law the State billboard permits may not violate any City regulations; therefore, the March 2002 city-wide ban now prohibits all new billboards, including those within CalTrans jurisdiction.
Related Recommendations (1)
R4: CPD staff and CalTrans Right of Way staff should coordinate immediately to enforce the new ban within the 600 ft. corridor, so that no Cal Trans permits are issued. Failure to do so will cause confusion among billboard businesses and could evolve into costly regulatory procedures. Pertinent billboard census information should be shared regularly between the two agencies. Required Response – City Planning Department – 60 days
F5: There is no comprehensive, easily understood guide to the maze of laws, regulations, policies, and procedures pertaining to outdoor advertising signs. This lack becomes even more significant with the recent ban on new billboards.
Related Recommendations (1)
R5: CPD should prepare a pamphlet containing an explanation of the relevant rules for sign regulation, as well as a complaint form to help citizens identify suspected billboard signs without valid permits. That same information should be added to CPD web site. Required Response – City Planning Department – 60 days
F6: Citizen complaints concerning illegal signs are filed with all other citizen complaints received at the CPD and DBI. As a result of this commingling of complaints, response to the questionable signs is frequently delayed. The potential for profit during the delay period can represent an incentive for those wishing to create new signs.
Related Recommendations (1)
R6: To help each CPD Quadrant Senior Planner quickly identify possible non-compliance situations, CPD should set up a 24-hour call line for billboard complaints only; this phone number should be listed in CPD’s white page telephone directory. CPD should disseminate information to the public by other means, such as placing the public information pamphlet, suggested in Recommendation 5 above, in public places, on MUNI placards (for example, "See an illegal sign? Call XXXX"), and on posters in government offices. Required Response – City Planning Department – 60 days Source References In 2001 an independent professional public opinion survey, by a non-profit organization, reported that 65% of San Francisco voters would approve a billboard ban, and that 15% were undecided. Election results, March 2002 ballot -- voters approved the billboard ban by 79.3%, the second highest Proposition victory margin in city history. (First was the vote for the new Main Library by 80%). Documents Examined CITY PLANNING DEPARTMENT • Department Codes: Article 6 (Including Department Code interpretations by the Zoning Administrator and the most recent amendments under the Leno Law), Article 7, Article 9, Article 11 • Zoning maps, showing boundaries of special sign districts • Written statement from the Director to the Grand Jury describing his position on sign regulation • Citizens' Guide to Sign Regulations, Department draft version • March 2002 Ballot Measure, outdoor advertising sign ban BUILDING DEPARTMENT • Department Codes 106.4.1.1 through 106.4.4 • The track of a permit for a sign in the Department tracking system • A Department Job Card STATE DEPARTMENT OF TRANSPORTATION (CALTRANS) • Instructions for Sign Permit Applicants • Billboard Sign Violations roster, cited since October 1998 along the State right of way through Routes 80 and 101 within San Francisco City and County jurisdiction • State Outdoor Advertising Act, full text, effective 1 January 2000 • California Code of Regulations, Title 4, Chapter 6, concerning outdoor advertising.
Findings & Recommendations 4 findings
F1: RAB, CAC, and PAC do not work together and do not have a direct process for communication. This lack of a coordinated communications mechanism weakens the information flow to the community, and often leads to disorganized and ineffective public outreach efforts. This situation contributes to community mistrust and a lack of understanding of issues, including knowledge about progress and positive efforts toward reuse.
Related Recommendations (1)
R1: The City should immediately establish a permanent economic development and public information office, and should locate this office at the gates to the shipyard. (CGJ notes that Building 19 is of a size and location suitable for this purpose.) This office should act as a clearinghouse to facilitate information and communication between employers and job seekers, and to provide referrals to sources for technical training, as well as for business education and financing. This center could serve as the hub for obtaining progress reports, media releases, information, and notices of site tours, as well as providing space for community outreach. Required Responses -  Board of Supervisors - 90 days  Mayor's Office of Economic Development - 60 days  San Francisco Redevelopment Agency - 60 days
F2: The development of HPS - bordered by one of the most economically depressed areas of San Francisco - could bring jobs and economic benefit to the community. There need to be strong assurances that BVHP residents are not locked out of the jobs, contracts, and ownership that are part of the development of homes and businesses. Some efforts have been made to encourage local training and hiring by on-site contractors; however, these efforts should be strengthened. Jobs in the planned industrial development at HPS would provide the means for some BVHP residents to afford homes in the planned residential developments
Related Recommendations (2)
R2a: Policies and Objectives 18 and 19 - as proposed in the HPS Area Plan of the General Plan of the City and County of San Francisco, Draft, April 8, 1997 - i.e., "Provide employment, business and entrepreneurial opportunities for Bayview Hunters Point residents and businesses" and "Provide education and job training opportunities for Bayview Hunter Point residents," must be implemented. The City should ensure job availability for BVHP residents - at both industrial and residential developments at HPS - and commit to accessibility of business and affordable residential opportunities. The parcel-by-parcel conveyance and development should proceed only with an understanding of the interrelationships of the development and reuse of the parcels. Economic development should be timed so that BVHP workers are able to afford some of the new housing in their community. Required Responses -  Mayor's Office of Economic Development - 60 days  San Francisco Redevelopment Agency - 60 days
R2b: The MOA between the Navy and the City should be amended to include training and hiring for the community to ensure employment in clean-up and development activities. Required Responses -  Mayor's Office of Economic Development - 60 days
F3: Concerning the nature and extent of health hazards at HPS, there appears to be no agreement among DPH, the Federal and State agencies, community organizations, and the media. Direct communication among all governmental agencies needs strengthening. Lack of complete data and incomplete documentation of the extent of toxics (known as "site characterization") exacerbates the level of community mistrust. The Navy has recently (March 2002) released a draft of an assessment report on the historical programs of the former Naval Radiological Laboratory at HPS, which is suspected of careless handling of radioactive materials. Full public vetting of this report has not occurred.
Related Recommendations (1)
R3: DPH should review what testing and monitoring of the HPS site has been completed or is underway, and should identify what additional evaluations must be made. Using federal and state expertise and information, the City should work with the Navy and environmental regulators to review available test data in determining whether collection, ventilation, and/or treatment systems are warranted at the site. Further, the City should clarify issues, such as -  what effect the cap on the landfill has had on pathways for methane gas and/or other contaminants or compounds  whether public health and/or the environment might be adversely impacted by the landfill cap. DEnv, MOED and SFRA should work with the Navy and environmental regulators to complete a comprehensive site characterization. A clear schedule for this effort should be provided to the public. A full discussion of the Navy's Historical Radiological Assessment (Volume II Draft, March 2002) is needed. The community should be provided with information and practical advice in layman's language. There should be continuing efforts to strengthen community understanding of the goals, principles, and limitations of risk assessment. Expert testimony must be so presented that it empowers residents to become informed decision makers; media inaccuracies must be promptly rebutted. The National Institutes of Health's "Consensus Development Program" is suggested as a model to guide these efforts. Required Responses -  Department of the Environment - 60 days  Department of Public Health - 60 days  Mayor's Office of Economic Development - 60 days  San Francisco Redevelopment Agency - 60 days
F4: The complexities of the clean up, transfer, and reuse of the closed HPS offer a wide range of opportunities to the City of San Francisco and its citizens. The residents of the City, including the environmentally and economically impacted BVHP, have the right to maximum health and environmental protection as a result of the return of HPS to civilian use. HPS, in a prime urban location along the San Francisco Bay, must never again experience the environmental degradation of past uses
Related Recommendations (1)
R4: DEnv, MOED, and SFRA should require that new businesses in HPS comply with all environmental regulations, and the City should strictly enforce compliance (including imposing monetary penalties). The City and the community must be assured that the legacy of toxic contamination at HPS is not repeated. All proposed reuses, both residential and industrial, must be required by the City to commit to environmental compliance and pollution prevention; this commitment must be required of all developers and their contractors. A public process for evaluating industrial facilities wishing to locate at HPS should be established in order to provide answers to questions related to a company's environmental record and potential economic and environmental impact on BVHP. Required Response -  Department of the Environment - 60 days  Mayor's Office of Economic Development - 60 days  San Francisco Redevelopment Agency - 60 day Summary of Required Responses -  Mayor's Office of Economic Development - Recommendations 1, 2a, 2b, 3, and 4  Board of Supervisors - Recommendation 1  Department of the Environment - Recommendations 3 and 4  Department of Public Health - Recommendation 3  Redevelopment Agency - Recommendations 1, 2a, 3, and 4 ATTACHMENT 1 -