Dr. Ahimsa Porter Sumchai

A Master Environmental Impact Report Must be Conducted for 19th Avenue Development ProjectsPhoto: 19th Ave at Sloat

San Francisco is a small densely populated seaport city located on the tip of a Peninsula surrounded on three sides by water. It’s day time population of 1.1 million people is packed into a city that is 7 feet square in area. Automobile congestion, high density residential development projects and a suboptimal public transit system have contributed to a growing incidence of pedestrian fatalities citywide. One of the cities busiest and most dangerous corridors is 19th Avenue - a state highway.


19th Avenue connects with the Golden Gate Bridge via Doyle Drive and the $1.1 billion reconstruction of the approach to the bridge will influence traffic congestion along its entire route. The intersection of 19th Avenue and Sloat Boulevard has been the scene of several horrific accidents and has been designated one of the city’s “deadliest” intersections. Traffic speeds may exceed 45 miles per hour.


In March, upgrades and improvements began at ten intersections along 19th Avenue designed to improve public safety including pedestrian countdown signals, curb ramps, and coordinated traffic signals to avoid red light runners. Enforcement of speed limits on 19th Avenue has always been controversial because the California Highway Patrol and the Taraval Police have shared jurisdiction over the region. Ideas for calming 19th Avenue traffic flow include a proposal to route traffic westward around the less congested Lake Merced Sunset Boulevard corridor.


The California Environmental Quality Act requires that development projects with the potential for resulting in physical change to the environment or requiring discretionary decisions by the City must undergo environmental review. CEQA environmental review for all departments and agencies of the City is conducted by the Major Environmental Analysis division of the Planning Department.


Special studies for environmental review include a consultant prepared Transportation Study when adverse impacts to existing traffic conditions can be anticipated or when the project generates new traffic impacts by increasing residential units, changes off street parking, bus stops or loading spaces, sites new driveways or pedestrian and vehicular access routes to the project site.


Additionally, CEQA Guidelines Section 21090 identifies that a master environmental impact report should be prepared when components of large development projects in the same region produce cumulative impacts that may be found insignificant if each development project is analyzed separately.


CEQA prohibits the “piecemealing” of environmental reviews for large development initiatives which, when considered as a whole in a master environmental impact report, may have significant cumulative unmitigated impacts.


The myriad of commercial and residential development projects that have been proposed along the 19th Avenue corridor is a clear example of the need for a master environmental impact report particularly with regard to the cumulative traffic impacts on pedestrian safety, schools, air quality and natural habitats.


Private developers, Republic Urban Properties, are working independently in preparation of a project design for the Arden Wood project, located at Wawona and 19th Avenue that includes an entry and exit to the development at 19th Avenue. Approval for development projects with entry and exits along 19th Avenue must be granted by the state transportation agency, CalTrans.


The private developers of Park Merced have proposed increasing their residential units by 6000 in a development surge that will increase automobile traffic along the southern tip of 19th at the intersection with southbound 280 and 101.


The SF State University Master Plan for development proposes a highrise at 19th avenue at the Stonestown shopping mall that will increase both pedestrian and automobile traffic.


Another private mixed use residential and commercial development project located at 47th avenue across from the Zoo and Ocean Beach is moving through the Planning Department.


The cumulative impact effects at the study intersections of the various projects proposed along 19th Avenue will only be seen with a master environmental impact report that includes a master analyis of traffic flow, circulation, public transporation level of service and pedestrian safety.


A master environmental impact report for the deadly intersection with Sloat Boulevard should be conducted as a matter of life and death.

Ahimsa Sumchai Porter, MD, West Portal

April 2008


SF General Hospital: Rebuild vs. Retrofit
Dr. Ahimsa Sumchai


The Environmental Review for SF General Hospital Seismic Compliance Hospital Replacement is slated for release to the public in March of 2008.

San Francisco General Hospital is a 130 year old institution. It is the only Level 1 Trauma center serving San Francisco and Northern San Mateo county. The hospital operates 282 acute medical and surgical beds that are filled to capacity 97% of the time. Ambulances are forced to divert to other hospitals in San Francisco over 20% of the time because of this critical shortage in bed capacity. The hospital is one of two located within the cities southeast sector, providing primary and emergency services to predominantly low income communities of color. St. Lukes Hospital is currently threatened with closure including its emergency services.

In 2004 a Blue Ribbon Committee recommended that a new acute care hospital be constructed on the West Lawn of the SFGH Medical Center campus facing Potrero Avenue. Other options were explored including the co-location of a new acute care hospital to the Mission Bay campus where UCSF is also planning to construct a new hospital that will be operational by 2014. The proposed new ÒGeneral HospitalÓ will increase its acute care bed capacity by one bed! The hospital will increase four times in area.The existing main hospital, like over 500 hospitals in the state of California, does not meet the seismic safety standards mandated by Senate Bill 1953. This legislation followed the collapse of a hospital in the aftermath of the 1994 Northridge earthquake. It requires all California acute care hospitals to remain intact and fully operational in the aftermath of a major earthquake.

SB 1953 does not require that SF General Hospital be rebuilt. It mandates that any hospital not retrofitted by this year that poses a risk of collapse or loss of life cannot be used for acute care until it has been stabilized. Because public funding does not exist to upgrade the stateÕs hospitals, many facilities have applied for a five year extension.

On November 4, 2008 SF voters will be asked to pass an $800 million dollar bond measure to fund the SFGH rebuild. Consider the following facts:
1. The expansion of bed capacity by one bed represents a serious overall reduction in services. The May 2006 report of the Civil Grand Jury on Disaster Medical Preparedness identified the need for up to 600 surge capacity beds in the setting of a major disaster or public health emergency. Additionally, an independent consultant retained by the Controllers Office, reported that half of SFÕs hospitals are operating at an 85% occupancy level and the city faces a 533 acute care bed shortage over the coming years.

2. The EIR for the SFGH rebuild may not adequately analyze the significant noise and safety impacts of the simultaneous construction of the new hospital on the West Lawn, while the existing hospital in Building 5 remains fully operational. The EIR proposes the relocation of a rooftop helipad from Building 5 to the new main hospital without an adequate analysis of noise, safety and flight arrival and departure routes. The EIR for the proposed rooftop helipad on Building 5 has yet to be released to the public. There is concern that the delay in release of the SFGH Helipad EIR is deliberate and intentional given the organized opposition to the citing of helipad at the hospital that has existed for over 20 years. Aeromedical helicopter crash rates have increased according to a USA Today data base. The noise, rotor wash and potential aviation disaster posed by a helipad cited in a dense, unaccepting urban neighborhood adjacent to freeways and within one mile of downtown San Francisco cannot be ignored.

3. The EIR for the SFGH rebuild may not adequately analyze the seismic retrofit alternative for the existing hospital given evidence that it may be more cost effective and less time intensive. Given the $227 million dollar budget shortfall and the $25 million dollars from the General Fund that will be encumbered by the Rebuild project in FY 2007-8, alternatives should be considered. These alternatives must also include a co-location of the planned UCSF acute care hospital and the SFGH acute care hospitals to the Mission Bay Campus.
Ahimsa Porter Sumchai, M.D. West Portal

March 2008