342

SEC. 342. HEALTH CARE SERVICES MASTER PLAN FINDINGS.

1. On March 23, 2010, President Barack Obama signed into law the "Patient Protection and Affordable Care Act," thereby initiating the most significant change to the health care delivery system that the United States has experienced in forty years. As the City and County of San Francisco ("City") works to implement this monumental law, it is an opportune moment to engage in a comprehensive planning effort for health care services in the City. 2. Section 4.110 of the City Charter ("Charter") provides that the Department of Public Health and Health Commission shall provide for the preservation, promotion and protection of the physical and mental health of the inhabitants of the City and County of San Francisco. 3. Section 4.105 of the Charter provides that the Planning Commission create and maintain a General Plan consisting of goals, policies and programs for the future development of the City and County that take into consideration social, economic and environmental factors. 4. Section 127340(a) of the California Health and Safety Code provides that "private not-for-profit hospitals meet certain needs of their communities through the provision of essential healthcare and other services. Public recognition of their unique status has led to favorable tax treatment by the government. In exchange, nonprofit hospitals assume a social obligation to provide community benefits in the public interests." 5. Implementation of Ordinance 279-07, requiring the Department of Public Health to analyze the relationship between the City's long term health care needs and facility planning for medical institutions, has revealed the need for a City-wide Health Care Services Master Plan so that the Planning Department has a tool to analyze individual institutional planning against a more comprehensive City plan. 6. A Health Care Services Master Plan will provide the Health Commission, the Planning Commission and Board of Supervisors with information and public policy recommendations to guide their decisions to promote the City's land use and policy goals developed in such Plan, such as distribution and access to health care services. 7. A Health Care Services Master Plan will also provide the Health Commission, the Planning Commission and Board of Supervisors with information essential to disaster planning for the City. 8. The San Francisco Department of Public Health is well situated to create a Health Care Services Master Plan, as it can draw upon the innovative work of Building a Healthier San Francisco, including "The Living Community Needs Assessment" which is an up-to-date, web-based, compilation of data about community health in neighborhoods throughout the City. (Added by Ord. 300-10, File No. 101057) SEC. 342.1. DEFINITIONS. As used in these Sections 342 to 342.10, “Medical Use” shall mean a use as defined in Section 890.114 or 890.44 of this Code or a Hospital or Health Service use as defined in Section 102 of this Code, excluding any housing operated by a medical provider. (Added by Ord. 300-10, File No. 101057; amended by Ord. 22-15, File No. 141253, App. 2/20/2015, Eff. 3/22/2015; Ord. 202-18, File No. 180557, App. 8/10/2018, Eff. 9/10/2018; Ord. 233-21, File No. 210381, App. 12/22/2021, Eff. 1/22/2022; Ord. 37-22, File No. 211263, App. 3/14/2022, Eff. 4/14/2022) AMENDMENT HISTORY Section amended; Ord. 22-15, Eff. 3/22/2015. Section amended; Ord. 202-18, Eff. 9/10/2018. Section amended; Ord. 233-21, Eff. 1/22/2022. Section amended; Ord. 37-22, Eff. 4/14/2022. SEC. 342.2. HEALTH CARE SERVICES MASTER PLAN: COMPONENTS. (a) The Department of Public Health and the Planning Department shall prepare a Health Care Services Master Plan that displays and analyzes information concerning the geography (including natural features of land, weather, and water supply), demography, epidemiology, economics/finance, neighborhood characteristics, intensity of use, workforce, technology, and governmental policy pertinent to distribution, access, quality and cost of health care services in the City, including the use of the health care services by patients from outside the City, and referral of patients from the City to medical institutions located outside the City limits. Based on this information, the Health Care Services Master Plan will identify existing and anticipated future needs for health care services compared to available and anticipated resources and potential impacts on neighborhoods, and make recommendations for improving the match between needs and resources, as well as where health care services may be located within an area of the City to minimize land use burden on particular neighborhoods. The Health Care Services Master Plan shall consider neighborhood density, uses, transit and infrastructure availability, traffic characteristics, including mode split among cars, public transit, bicycles and pedestrians. (b) The Health Care Services Master Plan shall, to the extent feasible, contain all of the following components: (1) Health System Trends Assessment. The Health Care Services Master Plan shall describe and analyze trends in health care services with respect to the City, including but not limited to: disease and population health status; governmental policy (at the national, state, regional levels); disaster planning; clinical technology; communications technology; payment for services; sources and uses of capital for investment in services; organization and delivery of services; workforce; community obligations of providers, and any other trends that, in the discretion of the Department of Public Health, may affect availability, location, access and use of services in the City. (2) Capacity Assessment. The Health Care Services Master Plan shall quantify the current and projected capacities of existing Medical Uses in San Francisco, including public and private facilities and for and non-profit organizations. The capacity assessment shall describe, analyze, and project resources available for emergency services, including trauma services; acute hospital services, including beds and services that require specialized facility accommodations; ambulatory care services including primary care; specialty physician services; hospital- based and free-standing urgent care services; rehabilitation, long term care and home health services; and behavioral health services including psychiatric emergency, services. In addition, the capacity assessment shall quantify "surge capacity" needs in the event of a disaster. (3) Land Use Assessment. The Health Care Services Master Plan shall assess the supply, need and demand for Medical Uses in the different neighborhoods of the City; the potential effects or land use burdens of locating such services in particular neighborhoods; and the potential for displacement of other neighborhood-serving uses that may occur as a result of the placement of Medical Uses (4) Gap Assessment. The Health Care Services Master Plan shall identify medical service gaps across the City and medically underserved areas for particular services with reference to geography, transportation/communication options, and unique barriers to accessing care, including but not limited to the absence of cultural competence, language, race, immigration status, gender identity, substance abuse, and public assistance. (5) Historical Role Assessment. The Health Care Services Master Plan shall take into consideration the historical role played, if any, by medical uses in the City to provide medical services to historically underserved groups, such as minority or low income communities. (6) Recommendations. The Health Care Services Master Plan shall include policy recommendations to promote an equitable and efficient distribution of healthcare services in the City; the elimination of healthcare service gaps and medically underserved areas; and the placement of Medical Uses within the City in a manner that is consistent with the character, needs and infrastructure of the different neighborhoods, and that promotes and protects the public health, safety, convenience and general welfare. (Added by Ord. 300-10, File No. 101057) SEC. 342.3. HEALTH CARE SERVICES MASTER PLAN PROCESS. (a) Timing for Health Care Services Master Plan Completion. The Department of Public Health, or its designated consultant, shall work with the Planning Department to complete a draft Health Care Services Master Plan within twelve (12) months of the effective date of this ordinance, which time may be extended upon request and by approval of the Board of Supervisors. (b) Preparation of the Health Care Services Master Plan. The Department of Public Health shall hold at least two publicly-noticed informational hearings and/or workshops during the course of the preparation of the draft Health Care Services Master Plan. The Planning Department shall participate in all hearings and/or workshops. (c) Upon completion of a draft Health Care Services Master Plan, the Department of Public Health shall provide public notice of the availability of the Health Care Services Master Plan draft for public review. The notice shall specify a period of no less than thirty (30) days during which written comments will be received by the Department of Public Health and the Planning Department on the draft Health Care Services Master Plan. (d) Public Hearing. After the close of the written public comment period, the Health Commission and Planning Commission shall hold a joint public hearing on the draft Health Care Services Master Plan: The Commissions shall set the time and date for the hearing within a reasonable period, but in no event shall the hearing date be more than thirty (30) days after the close of the written public comment period. The Commissions may recommend approval or may request additional information or revisions in the Health Care Services Master Plan. If the Health Commission or Planning Commission requests significant or material additional information or revisions for the Health Care Services Master Plan, then the Health Commission and Planning Commission shall hold additional public hearings to consider such changes, either jointly or separately.