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Planned Expansion at UCSF Parnassus
Rendering of proposed 15-story hospital (left) at UCSF Medical Center in the Inner Sunset neighborhood.

UCSF Plans Remain on Hold as Judge Considers Neighborhood Objections

An appeal is anticipated regardless of court’s ruling

Citizen Petition

Sign the Parnassus Neighbors' Petition

Please sign the petition to the UC Regents and other influential persons urging them to comply with their long standing and frequently reaffirmed commitment to limit growth at the Parnassus campus.

Iwill draft an opinion and get it out,” Alameda County Superior Court Judge Frank Roesch said, “knowing full well that no matter what I decide the First District will be making perhaps the final word on it.” He referred to the likely appeal that either side would lodge as he took the arguments under submission.

Petitions for Mandamus filed by the Parnassus Neighborhood Coalition, San Franciscans for Balanced and Livable Communities, and Yerba Buena Neighborhood Consortium contend that the proposed project — the size of two Transamerica Pyramids — is inappropriate for the tiny neighborhood squeezed between Golden Gate Park and Mt. Sutro Open Space Preserve, and it fails to meet California Environmental Quality Act (CEQA) standards. Complainants urged the court to reject UCSF’s environmental study sighting current overcrowded conditions, the “campus is already too congested to handle a 2 million-square-foot hospital and research complex.”

The $3 billion planned 30-year expansion would replace the current 70-year-old hospital and includes close to 1,200 units of student and faculty housing. Senate Bill 1953 compels the hospital to be retrofitted or decommissioned for inpatient care by 2030.

quote marks

In 1976, in order to persuade a neighborhood group to withdraw a lawsuit opposing its proposed expansion, the Board of Regents adopted a resolution permanently establishing a Space Ceiling of 3.55 million square feet on the space it would occupy at that campus...”

At the hearing, which lasted two days, the university failed to consider one of its other 12 sites, lawyers argued, to meet its medical and research needs, as well as the housing and transportation requirements that the increased manpower that would result from such a plan would need to maintain it at the Parnassus location.

Alternative sites not fully explored

Susan Brandt Hawley
Susan Brandt Hawley

Attorney for Petitioner Yerba Buena Neighborhood Consortium, Susan Brandt-Hawley, a preservation attorney who has argued many CEQA cases noted “… UC has multiple campuses around the city,” and unlike other locations to be considered, the Parnassus Heights location is “highly inappropriate” for a massive development of the nature that UCSF seeks.

She pointed out that UC justified building at Mission Bay and Mt. Zion, with the caveat that Parnassus was too constrained to handle more development, yet flip-floped without explanation, to expand in a major way at the very site it professed to protect.

“They made no effort to see how they could try to accomplish their objectives at any of the other sites. That’s a blatant error,” Brandt-Hawley said.

UCSF’s environmental impact report is deficient because of the failure to consider underused alternative sites required by CEQA, she argued, a law implemented in 1970 that requires environmental effects — including alternative sites — are fully explored before projects are approved.

Charles Olson, representing the project, acknowledged UC’s 1976 agreement with the surrounding neighborhood organizations to promising to limit the size of the Parnassus campus that led to the construction of a new hospital at Mission Bay in 2015, but internal “studies” he said, revealed a “desperate need” for more beds at Parnassus though he did not explain why they could not be built elsewhere.

He argued that Parnassus’ primary focus was adult care and depended on the medical schools at that site, whereas the hospitals at Mission Bay are for children, women and cancer. Avoiding the question — why adult care could not be built at that site — he concentrated his arguments on the patients that are being turned away from the Parnassus facility, and he asserted that the university had been studying the problem for 20 years.

He asserted that educational objectives and fundamental research could only be done at the Parnassus site.

Neighborhood Objections

In 1976, in order to persuade a neighborhood group to withdraw a lawsuit opposing its proposed expansion, the Board of Regents adopted a resolution permanently establishing a Space Ceiling of 3.55 million square feet on the space it would occupy at that campus:

“The total structures within the campus boundaries shall not exceed 3.55 million gross square feet (not including space committed to residential use …) and this limit shall be permanent.”

Current plans for the Parnassus site would increase the Space Ceiling by 42% to 5.05 million square feet.

Housing and transportation impacts

Thomas Lippe
Thomas Lippe

Environmental Attorney Thomas Lippe, of San Franciscans for Balanced and Livable Communities, said the UC’s report failed to analyze the environmental consequence that construction of new housing in the constrained Inner Sunset neighborhood as a result of the escalating demand from new workers who would flock to the area.

“Here there is a very clear impact on the physical environment which is you’re bringing lots of people to this campus who are going to have jobs and they’re going to need a place to live. So there’s going to have to be housing that’s built for them. And the EIR doesn’t look at the impact of that. It says, well that’s speculative because it says we don’t know where that housing is going to be built,” he said. “They can’t just say it’s speculative and then move on.”

A significant failure or UC’s report was its analysis of transit overcrowding and delays, neighbors object, though UC’s attorney argued that transit does not fall within the scope of CEQA, adding that university transit experts concluded that the site is located within 1/2 mile of several transit stops, and therefore “presumptively has less of an impact on transportation.”

20 years of noise pollution

Patrick Soluri
Patrick Soluri

“The EIR acknowledges that there will be extremely high construction noise to neighbors for years. We’re talking about at least 20 years,” Patrick Soluri, an attorney for the Parnassus Neighborhood Coalition, told the court. Neighborhood residents will be subjected to extreme levels of demolition and construction noise when the final phase of the project is expected to be completed in 2050.

“So we’re talking about a long period of time. We typically see construction noise, emissions dismissed as short term, a few weeks or a few months. That’s not what is happening here.”

The university failed to specify at what noise level and over what exposure period adverse physiological and cognitive effects can occur, “We just don’t know,” Soluri said, even though it acknowledges the human health impacts of noise. “Few people are seriously annoyed by activities with noise levels below 55 decibels. What level causes most people to be annoyed? These questions are relevant because we will literally have noise decibels of up to 80 for these residents for an unspecified number of years. The EIR has a duty to analyze and correlate those identified health risks or explain why it is infeasible to do so and it has not done so here.”

Neighborhood Update

Parnassus Neighborhood Coalition Newsletter:

A hearing on our California Environmental Quality Act claims was held on Friday April 1 and Monday April 4. As you can see in the linked article on the hearing, Judge Roesch expects that the claims will eventually be decided on appeal. At whatever level the case is ultimately decided, our lawyers, and those of our co-plaintiffs, continue to believe that we have strong claims on the CEQA issues.

They are also optimistic that the 1976 Regents’ Resolution limiting growth at Parnassus will be held to be a binding agreement. Last month our lawyers took the deposition of UCSF’s former Vice Chancellor for Advancement and Planning. He testified that in 1998 he conducted extensive research and concluded that the word “permanent” in the Regents Resolution meant permanent and that the 3.55 million square foot limit on the amount of UCSF’s space at Parnassus was inextricably intertwined with the concept of the limitation being “permanent.” He also testified that the Regents authorized him to represent “hundreds of times” to third party neighborhood groups and public agencies that the 3.55 million square foot limitation was permanent. These representations were made in order to obtain benefits for UCSF in the form of public support for expansion projects and, in the case of Mission Bay, valuable property donations from the City and Catellus.

Judge Frank Roesch

Frank Roesch
Judge Frank Foesch named Trial Judge of the Year for Alameda County in 2011Photo courtesy of THE Verdict

When asked by THE Verdict, a publication of the Alameda Contra Costa Trial Lawyers’ Association, what motivated him to become an attorney? He replied: “Well, I think there were two motivations. One was to help people. The other was that I wanted to change the world.” He added, “I’d like to think that I helped to make it a better place, both in practice and on the bench.”

While Judge Roesch may not have the final word on UC’s expansion plans, neighbors hope to keep their community as livable as possible considering the giant that is their neighbor and the important work they do.

Doug Comstock lives near the Parnassus campus and also serves as Editor of the Westside Observer.

April 2022

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Neighbors of UCSF expansion win a temporary delay in construction "
Judge Halts UCSF Construction

The plan to increase its size by the equivalent of two Transamerica Pyramids in the middle of two overcrowded neighborhoods has neighbors on edge

Judge Frank Roesch, of Alameda Superior Court has ordered all construction activity on UCSF’s plan to balloon itself by 50% at its Parnassus campus halted, not because it is inconsiderate of its neighbors, not because it violates its agreement to contain its current envelope limits, nor because it infringes on the existing natural area it abuts. Nope, it’s because Toland Hall, which it seeks to demolish, contains an historically significant WPA mural, which may not be movable. Bernard Zakheim, a student of Diego Rivera, and his assistant Phyllis Wrightson painted the murals, fresco style—directly into the wet plaster walls of Toland Hall from 1935 to 1938, which murals, UCSF itself concluded, after consultation with two historic preservation firms, could not be moved because “20 to 30%” would be irreparably damaged.

toland hall
Toland Hall is the home of the Zakheim murals since 1938. It is currently closed to the public because the University deems it "seismically unsafe"

The temporary restraining order granted to San Franciscans for Balanced and Livable Communities (SFBLC) halts the project while a separate lawsuit questioning that project's environmental impacts plays out.

Toland Medical School
Toland Medical School was donated
to UCSF in 1864, by Dr. Hugh Toland.
Adolph Sutro donated the land
for the current campus

Three lawsuits have been brought by neighborhood groups under a state law, the California Environmental Quality Act (CEQA), that allows third parties to sue if they believe the environmental impacts of a project haven't been studied enough. CEQA requires government agencies to study the environmental impacts of projects including everything from traffic and air quality to the effects on historic resources.

Prior to the current plan to move the murals, UCSF had previously planned to demolish the mural along with the building to make way for construction of a replacement building.

Toland Hall has served as a lecture room within UC Hall a 104-year-old building that the university says is seismically unsafe and the murals have been used as a teaching aid, studied by hundreds of thousands of doctors and medical workers for over 80 years. (Apart from the 20-year period when they were wallpapered over, because a professor objected that they were “distracting.” See below for more information about the murals.)

Looming Construction Overwhelms Local Neighborhood

While there is considerable agreement about the murals, it is the decision by the Regents to construct an immense building to replace UC Hall that remains the strongest dispute among neighbors.

San Franciscans for Balanced and Livable Communities The petition that restrains UCSF’s project, San Franciscans for Balanced and Livable Communities v The Regents of the Univ. of CA, et al, requests that UCSF “complete adequate environmental review of the Project’s environmental effects.” The SFBLC petition complains that UCSF’s CEQA Environmental Impact Report (EIR) does not adequately study the effects on housing, transit, air quality, and neighborhood aesthetics — as well as any potential harm to wildlife in the nearby Mount Sutro Forest.

Dennis Antenore
Dennis Antenore,
San Franciscans for Balanced
and Livable Communities

“This is still at a very early stage of the litigation,” said former Planning Commissioner Dennis Antenore, a neighbor of the Parnassus project and member of SFBLC, “until now we have been met with an impregnable wall of arrogance. We hope that we are beginning to get their attention. UCSF treats neighborhood issues and concerns with cynical lip service, all the while presenting a public face of concern and paying attention. This project represents a repudiation of decades of promises and commitments to the community. They intend to add some 2 million square feet of space, almost doubling its size, to a site that is in the middle of two established neighborhoods. UCSF has for decades repeatedly promised and committed to “decompressing” this crowded site. While pretending to listen to and consider neighborhood concerns in their planning, they adopted a plan and then presented it to the community. There are numerous issues including the lack of affordable housing for its workforce, and an overly burdened transportation system, which is at times dysfunctional. Not to mention the fact that it will cast significant shadows over Golden Gate Park, including the baseball diamonds at Big Rec, Kezar Stadium and an important park nursery.  In addition, it would cast shadows over a playground, two schools and entire portions of both the Inner Sunset and Cole Valley Neighborhoods.  We hope this small victory is a step towards being listened to.”

Zakheim and his murals
"The History of Medicine in California" panel and Bernard Zakheim at work Photos; UCSF Archeive

Two other public interest groups have filed to stop the project as it is currently designed.

Calvin Welch,<br> Parnassus Neighborhood Coalition
Calvin Welch,
Parnassus Neighborhood

The Parnassus Neighborhood Coalition and housing activist Calvin Welch filed a petition seeking to enforce an agreement the regents made with neighbors in 1976 for a permanent ceiling on the size of the Parnassus campus at 3.55 million square feet, an agreement that resolved a lawsuit brought by its neighbors. That agreement was reiterated in UCSF’s 2014 Long Range Development Plan that envisioned no significant increase in campus size.

“Euphemistically referred to as a ‘revitalization,’ the Project proposes a dramatic increase in development density at the Parnassus Heights Campus - including development of approximately 2.9 million gross square feel of new building space at Parnassus Heights. The total amount of campus space at Parnassus Heights upon full implementation of the CPHP [Comprehensive Parnassus Heights Plan] would be 6.0 million gsf,” the Coalition petition attests. “This 6.0 million gsf flagrantly violates the Regents’ permanent development space ceiling of 3.55 million square feet for the Parnassus Heights Campus (“Space Ceiling”). The Space Ceiling was a part of the bargained-for exchange back in 1976, and has been repeatedly affirmed by the Regents (to their benefit) and relied upon by others for decades.


CEQA mandates ... that “the key question and first step” in analysis of alternate sites is whether any of a projects’ significant effects “would be avoided or substantially lessened by putting the project in another location.”

“The Regents compound the CPHP’s harm to the community by preparing and certifying an Environmental Impact Report (“EIR”) that fails to disclose the CPHP’s significant impacts, provide adequate mitigation measures, and analyze all feasible project alternatives, among other detects. Thus, in certifying the EIR and approving the CPHP, the Regents prejudicially abused their discretion and failed to proceed in the manner required by law…”

John Eberling,<br>Yerba Buena Consortium
John Eberling,
Yerba Buena Consortium

Yerba Buena Neighborhood Consortium also filed a petition to stop the expansion, which also discredits the EIR “… failed to identify and adequately analyze potentially-feasible mitigation measures and potentially-feasible alternatives, including locating a portion of the Parnassus Plan off-site as suggested by the Consortium and others.” John Eberling, Director of the consortium indicated four locations as better alternatives for the expansion: Mission Bay hospital, at one of four sites: Pier 70, the Potrero Power Plant, Candlestick Point or Mission Rock, near Oracle Park. “All four of these very large master planned projects are in early/planning stages of development and could be readily modified to fully accommodate expanded UCSF development of this scale and meet fundamental project objectives… All four of these sites are inarguably environmentally superior because they are much closer to the Mission Bay campus and directly connect to it by the existing MUNI Metro Third Street route that has far more potential capacity than is now being utilized. UCSF expansion would be accommodated by supplanting and replacing an equal amount of the commercial development currently-proposed on any of these four sites. There would be little or no net new environmental impacts at the four existing development sites, and the very significant environmental impacts of net new development at the constrained Parnassus Heights campus would be avoided. CEQA mandates no less: Guidelines section 15126.6 (f)(2) pronounces that “the key question and first step” in analysis of alternate sites is whether any of a project's significant effects "would be avoided or substantially lessened by putting the project in another location. Otherwise, the current UCSF proposal in Parnassus Heights is absolutely insane.”

Supervisor Myrna Melgar told the Westside Observer: “there are still many issues with the project that UCSF needs to work out. They need to listen to the neighbors and their concerns, and I hope they understand their questions around CEQA and I encourage them to listen to neighbors.”

However, she added, “the 1976 agreement with neighbors is not an issue that I am pushing. 1976 is a long time ago, I did not even live here then. Medicine has changed a good deal since then. Most people were visiting their own doctors, not anything like it is now, and there are fewer hospitals in the City then there were in ‘76. I do not support moving services to Mission Bay because UCSF is the only hospital on the West side, and we need to be sure it is sustainable.

Zakheim's Mural Purpose
Featured in one mural panel

Dennis Antenore, a long-time member of the Community Advisory Group to UCSF, was not persuaded that the 1976 agreement was not binding. “The university has planned for well over a decade to seismically retrofit UC Hall and convert it to housing. Most recently, this was confirmed in 2014 Long Range Development Plan, which was only amended in February. Under those plans the murals would be left totally intact within a preserved Tolland Hall. Tolland Hall itself is also an important historic resource.

“For many decades the University has acknowledged the binding nature of the "space ceiling" of 3.55 million square. Most recently, the 2014 Long Range Development Plan provided for a replacement hospital at the same time as setting forth the actions it would take to comply with the ceiling. That acknowledgment was arbitrarily repudiated in February without any real analysis of the issue.”

Preserve the Zakheim Murals

Lorri Ungaretti
Lorri Ungaretti
SF Historical Society

“How does a significant piece of public art” Jewish Weekly asks, “go from being the “jewel of the University’s art collection” to a work designated for the wrecking ball in just five years?”

“The creation of the murals was one of the New Deal's first Federal Arts Projects,” SF Historical Society’s Lorri Ungaretti said, they tell ‘The History of Medicine in California,’ with 5 murals depicting events in northern California and 5 in southern California. ‘The History of Medicine in California’ is one of only a few frescoes created in the Bay Area. Bernard Zakheim's murals show often difficult aspects of medicine—including quackery, early forms of health and health care, amputation, autopsy, and more—and show actual Californians who contributed to medicine in the early days of this state.”

UCSF, “Synapse,” Newspaper: Wednesday, November 18, 1964

Ungaretti's You Tube Presentation discusses the Zakheim murals in detail and includes dialogue with Nathan Zakheim and Dr. Robert Sherins, who wrote a History of Medicine In California, Articulated in Frescoes. The Story Behind the Murals of Cole and Toland Halls available as a illustrated PDF. The Westside Observer is grateful for their contributions to this article.

Herb Caen Logo

Excerpt from San Francisco Chronicle Herb Caen column

“A few weeks ago, Artist Bernard Zakheim’s huge murals in the U.C. Med School on Parnassus were ordered covered with wallpaper, because they were allegedly distracting students. The famed Dr. Howard Nafziger, one of the medicos who ordered the wallpapering, asked a classroom of 60 students, which they preferred: the mural or plain wallpaper. Fifty-six voted for the mural. But, the wallpaper will stay where it is. ‘We were just curious,’ said Dr Nafziger.

‘HE is curious?’

Dr. Lynch, among others unhappy about the wallpapering, remarked at the time: ‘My God! That’s what we want! We want them to have something to come back to in twenty or thirty years, something they’ll remember, and want to come back for.’

‘I want the students’ undivided attention,’ said Dr. Nafziger.

Zakheim murals covered with wallpaper
Left-leaning Zakheim murals censored with wallpaper,
then painted over. In 1962, the murals were uncovered,
and were found severely damaged by a peeling of the
fresco surface caused primarily by the wallpaper paste

On June 18, 1964, the immutable Chronicler, Herb Caen, again reported:

‘The Journal of the American Medical Association convention reproduced on its cover one of artist Bernard Zakheim’s frescoes in Toland hall in the U.C. Med Center, a belated tribute.’

Back in 1948, Zakheim painted ten striking and expensive frescoes in the lecture hall, which certain powerful medics led by the late Dr Howard Nafziger, found ‘too distracting.’ Despite protests by the artists’ community, four of them were covered with wallpaper, behind which they remain covered to this day. As for Zakheim, who now lives in Sebastopol, he has had a tough time of it ever since. ‘All of a sudden,’ he says, ‘nobody had a job for a controversial frescoe painter.’

The artist, Bernard Zakheim, recorded a medical history of the west in the Toland Hall murals, reminiscent of [Diego] Rivera’s. One panel illustrates the chaotic condition of medicine as it was practiced in the San Francisco of those years; Dr. Elbert P. Jones (for whom Jones Street is named); Dr. Townsend opens the first San Francisco medical office in 1846; Dr. Fourgeaud, another of the early physician-pioneers and his family; Dr. Clappe amputates miner’s leg while another pours whiskey for anesthesia; Dr. Toland on horseback, with saddle bags bulging and plans in hand for his Medical School; Dr. Willis shoots drunken Dr. Hullings for tearing up his diploma.

Obituary for Zakheim

UCSF Proposes Destruction of the Murals

In a letter to Nathan Zakheim, a descendant of the artist, UCSF wrote “UCSF has decided not to use public funds to physically preserve the murals, especially at a time when the UC system faces financial challenges in the wake of Covid-19. This decision in no way has to do with any complaints about the murals.” They estimated that removing the murals would cost $8 million and offered the family a 90-day period to make a proposal to save the murals at their own expense.

Board of Supervisors Intervenes

Zakheim self-portrait at 25
Zakheim self-portrait at 25

“This is the beginning of what is going to be a lengthy process,” Supervisor Aaron Peskin said, “hopefully to confer landmark designation, which in this instance is honorific, unlike landmark designations on other properties in San Francisco and I want to be clear about this: the State of California, the University of California … is not subject to our local laws, but I believe that these incredible, radical, 10-part murals, frescos deserve that level of honor, deserve that protection.”

Though Supervisor Melgar supports the projected expansion itself, she said, “I want the murals to come back on campus, they are a part of the history, I made a request that UCSF reconsider their plan to move them, though I support what UCSF is planning to do to make the hospital and campus more usable.”

The Supervisors unanimously approved a resolution on July 31, 2020 requesting “…the Planning Department prepare a Landmark Designation Report to submit to the Historic Preservation Commission for its consideration of the special historical, architectural, and aesthetic interest and value of Zakheim’s History of Medicine in California frescoes.” The Historical Preservation Commission heard the matter on August 19, 2020 and unanimously “Adopted a Recommendation for Landmark Designation as amended that the murals remain together on Parnassus.”

The fate of the murals, as well as the quiet Inner Sunset neighborhood where they live lies in the breach.

Doug Comstock lives near the Parnassus campus and also serves as Editor of the Westside Observer.

August 2021

Aerial View of UCSF
UCSF's Neighbors File CEQA Lawsuit

Local residents oppose UCSF Parnassus expansion that would tower over the neighborhood and Golden Gate Park 

Neighborhood groups filed a Petition February 19th in Alameda County Superior Court challenging UC’s Environmental Impact Report for the massive UCSF Parnassus expansion proposal.

UC proposes a project that would add over 2 million square feet to the currently over-built campus — the equivalent of a Sales Force Tower and the TransAmerica Pyramid combined. The oversized project would be thrust between two mature neighborhoods – contrary to a 40-year commitment by the university to strictly adhere to the current envelope of the Parnassus complex. Neighborhood organizations and the San Francisco Bay Chapter of the Sierra Club as well as the Affordable Housing Alliance have concerns about the project’s effects on housing, transit, Golden Gate Park, and wildlife, as well as the failure to keep promises to the community it “serves.”


UC proposes a project that would add over 2 million square feet to the currently over-built campus — the equivalent of a Sales Force Tower and the TransAmerica Pyramid combined.”

“UCSF understated and misrepresented the project’s environmental impacts, including detrimental effects on housing, transit, air quality and resulting health impacts to residents, protected wildlife on Mount Sutro, and aesthetics near the UCSF Campus,” the neighbors maintain.

Dennis Antenore
Dennis Antenore

Dennis Antenore, a neighbor and a long-time member of the Community Advisory Group to UCSF said that "the objective of the suit is not to oppose the development of a new hospital that complies with Seismic Safety Standards coming into effect in 2030, but accomplish a return to the 2014 Long Range Development Plan (LRDP).” The 2014 plan called for a smaller hospital to serve the San Francisco Community. The proposed expansion includes a massive hospital of almost one million square feet. “Over four decades the University has repeatedly promised the community that it would it would take steps to decompress the Parnassus Campus,” Antenore, a former Planning Commissioner said. “In exchange the community has enthusiastically supported expansion to other locations, most notably the new campus at Mission Bay, which alone almost doubled the size of the University.”

“The aim of the lawsuits is not to stop this project,” former Mayor Art Agnos said, “but to make it work for all of us.” Agnos has joined neighborhood leaders pursuing citywide efforts to improve the plan. “We need to reimagine this hospital rebuild so that it serves all San Francisco communities, much like the Board of Supervisors did with CPMC several years ago that resulted in a smaller Van Ness hospital and a revitalized St. Luke’s in the Mission.”

Much of the anger from neighbors comes from UC reneging on the 1976 agreement the UC Regents made with them. The lawsuit also seeks to enforce that agreement which was made as settlement to a series of lawsuits challenging plans at that time to massively increase the Parnassus campus. The agreement was made in order to settle those lawsuits as well as to obtain critical State funding from the Legislature — the Regents agreed to a permanent cap on the size of the UCSF Parnassus campus. The Regents have repeatedly referred to that cap over the decades to justify expansion into other parts of San Francisco, such as Mission Bay.  

“The courts will ultimately decide whether UC has met its burden under CEQA to properly examine the impacts to the environment of their project. That being said,”Supervisor Melgar, whose District 7 neighbors would be affected said, “I support UCSF's efforts to become a sustainable, modern hospital and research facility. 1976 was a long time ago, and modern health care delivery, the needs of the hospital, as well as San Francisco's needs for healthcare and housing have all dramatically changed.

“UCSF is the only acute care hospital on the Westside, and I want it to remain accessible and functional, while continuing to provide our residents with the high-quality healthcare services it is known for around the world. I am encouraged that they have negotiated good union jobs and affordable housing for their workforce as part of this agreement. As we enter the next phase of this process, I strongly encourage the UCSF team to work with the community in genuine and transparent ways to incorporate and address the needs of the surrounding community in the design phase of the hospital.”

A long-time neighborhood activist who was involved in the lawsuits against UCSF in the 70s, Calvin Welch, has joined the lawsuit to enforce the 1976 agreement which would prevent UC’s first attempt to break its agreement. He recalled the 1976 discussions with Chancellor Sooy, who assured him that the space cap was in fact intended to be permanent.

Doug Comstock lives near the Parnassus campus and also serves as Editor of the Westside Observer.

February 2021

Controller Ben Rosenfeild
Rendering of the  proposed UCSF Medical Center at Parnassus / Illust. Courtesy SocketSite.com
Supervisor Gordon Mar
Chancellor Sam Hawgood
Supes to Regents: Hold on a minute buckaroo ...

UCSF to the Board of Supervisors:
With all due respect … fuggetaboutit!

Notwithstanding the outcome of the full Board of Supervisors meeting, the skirmish between UCSF and the Board regarding the postponement of the highly controversial plan to add nearly 2 million square feet for new office, medical and research space — bringing its total footprint to 5 million square feet, including a 300 foot tower — was well defined at the first meeting of the year of the Land Use and Transportation Committee, with newly elected Supervisor Myrna Melgar serving as its newly appointed Chair throughout the seven and a half hour item.

Myrna Melgar
Supervisor Myrna Melgar

The hearing was on the Memorandum of Understanding (MOU) between the City and the hospital and a second item, urging the California Regents to postpone consideration of the approval of the expansion’s EIR until its March meeting, both were called together.

Supervisor Dean Preston, Vice-Chair of the committee, authored the legislation and explained that “by any measure, this is a major expansion that will impact, not only the surrounding neighborhoods, but all parts of the city. A private development of this scale would require substantial review and approval by city departments and by this Board of Supervisors. But, because UCSF is a state agency, our normal city processes, that provide for public input and feedback, don't really apply to this plan.”

Dean Preston
Supervisor Dean Preston

Preston noted that the three areas for consideration are the merits of the expansion plan, the Environmental Impact Report (EIR) and the MOU between the planning commission and UCSF. He also questioned the timeline for approvals and the lack of public participation in the plan.
Specifically, community involvement allowed only two public reviews, the first was on September 29th. “At the second meeting on December 9th, a slide show summarizing the terms of an earlier draft MOU was presented. The third was held on Wednesday, January 6th, five days after the draft MOU was made available to the public. Eight days from today, I believe it's eight days from today, UCSF intends to ask the California Regents to approve the expansion plan EIR, as well as an amendment to their 2014 long-range development plan,” Preston said. And he asserted that the existing plans “expand dramatically beyond the existing space cap and beyond their decades-long commitment to permanently abide by that space cap.”

quote marks

...it ignores and disrespects neighbors' concerns by deciding without consultation to blow through the limit of 3.55 million square feet for the Parnassus campus. UCSF agreed to that limit in response to the Parnassus neighbors' objections to UCSF's aggressive expansion, at the expense of the neighborhood, in the 1970's.”

Cynthia Travis’ letter to the committee summarized the views of the neighbors who are aware of the plan: “Please ask UCSF to scale back its plan for a monstrous new hospital on the Parnassus site. It is cruel and insensitive to propose adding almost 3 million square feet of new building space, and many thousands of people and cars, to the already-overcrowded campus and residential neighborhood. The plan violates UCSF's pledge in the CPHP to ‘Create building massing to have respectful relationships with neighboring structures and natural features...(and) maintain a similar scale to surrounding structures...(and) create neighborly relations with existing structures at the campus boundaries.’ It also fails to mitigate what will become a dramatic exacerbation of the current parking and public transportation problems all around the Parnassus campus. Finally, it ignores and disrespects neighbors' concerns by deciding without consultation to blow through the limit of 3.55 million square feet for the Parnassus campus. UCSF agreed to that limit in response to the Parnassus neighbors' objections to UCSF's aggressive expansion, at the expense of the neighborhood, in the 1970's. That agreement does not anticipate an ending date, and the neighbors’ concerns have not changed.”

aerial photo of the current UCSF Parnassus campus
UCSF Parnassus Heights campus current footprint

Enforceable MOU

Aaron Peskin
Supervisor Aaron Peskin

“The issue is enforceability,” Supervisor Aaron Peskin remarked at the outset, and it became a major contention point that was central to the discussion, since an MOU is merely an agreement to agree, as the Deputy City Attorney, Charles Sullivan, pointed out. “It's not enforceable in a court of law. It's a long-standing partnership between the city and UC.” The Board of Supervisors has no direct authority over the agreement which could be set in motion by the Planning Department and the Mayor’s Office, bypassing review by the Board of Supervisors. “I am not aware of a reason why UCSF would not be able to enter into a binding contract here. I do know that you've asked them that question and I look forward to their response, Sullivan said.”

Jeff Buckley, the Mayor’s Senior Advisor on Housing Policy, noted that any permits required for the development could be withheld by the city “Certainly what we have before you, as far as enforceability, really includes the ability to withhold our permits that would be required in this case, if the housing and transit obligations are not met.”

Preston pressed the Chancellor on the Peskin’s question regarding an “enforceable agreement” or an “enforceable provision in the MOU.”

Chancellor Sam Hawgood responded that he would raise the question with counsel but, “I'm pretty clear that I've been instructed that that is not possible for the university to enter into such an agreement. I would only add the additional comment that all of the items in the MOU make perfect business sense for the university. It makes sense for us to provide housing for our employees. It makes sense for us from a pure business perspective to improve transit through the university. It makes sense for us to deal with open space and as our commitment as an anchor institution, in the City of San Francisco, it makes sense for us to commit to workforce. So, there's nothing in this MOU that is a difficult obligation for us to commit to.”

Preston continued with the notion of a “binding contract.” He raised the question again; “while there's a lot of good will that does exist between UCSF and the City and community, we're having an entire discussion which is premised on lifting a space ceiling that was promised to the community that it was a permanent space ceiling. Regardless of the permits of whether it should be raised or not, it's absolutely fair, I believe, for the community, in particular, on the eve of that being lifted—so what about these other restrictions? What happens if Chancellor Hawgood retires and we're 20 years in the future and someone else looks at the bottom line and says it makes more business sense to rent these units at market rate than it does at half of market rate. What recourse does the city have?”

Hawgood: “I would just echo again, that the city can withhold permits for building on the campus if they feel we are not honoring the intent as well as the letter of the MOU.”

Peskin pushed the question further: “It's a question for City staff and the City Attorney is whether or not…  are major encroachment permits — whether or not those permits can be conditional or revocable. We should consider as we noodle through this, so I want to throw that on the table. I believe and again I am not an attorney but as a matter of charter law, we could actually pass, by ordinance a measure wherein the Board of Supervisors would have to approve the MOU, all be it, timing for that is probably quite short.”

Proposed development
Proposed development increases by almost 3 million sq ft, including a 30 story tower and adds 8000, mostly commuter, employees with little transit mitigation. It encroaches on an already crowded neighborhood and essential green space. The illustration from UCSF is not intended to represent the design.


Preston suggested that the requested postponement “to delay by two months to the next regent’s meeting … maybe to clarify the practical matter with the hospital EIR scheduled for the summer, this is not going to impact when you would break ground or move forward with this? What is the practical impact of this?”

Hawgood: “My concern is that much further delay puts the entire project in jeopardy and I'm not disputing that a two-month delay would change the date we put a shovel in the ground, but we've been working on this now for years and years with a lot of public comment and these dates have been known for years.”

Melgar: “Is it fair to say that, if the regents do go ahead and vote on this at the end of the month, the MOU can still continue to be negotiated? Is that what you are saying?”

Hawgood: “In theory, yes. They want to know we have a good relationship with the city around this project. As a finalized MOU is the strongest signal that I can send to the regents that we have a good understanding with the city about the consequences of this project. To further negotiate the MOU — the MOU won't be signed until after the regents approve the EIR because, it's contingent if they, for whatever reason, say they are not comfortable in us going forward with any of these projects, then there's no MOU, so it won't be signed at the date of the regent’s meeting and to open it up for further on-going negotiation, unless it's a minor point, I think we have in good faith negotiated this for 12 months now.”

Preston: “I still don't see any actual impact on timelines here and I do want to just recognize that it's no one's fault (other than COVID) that the MOU process took longer than anticipated for the public to see it and that is part of what contributes to my strong, strong belief it would not be appropriate to be heard. “

Skilled Nursing Facilities (SNFs)

Patient waiting for transfer

Supervisor Melgar broached the subject of the City’s lack of SNFs, which has been clearly identified in the Medical Services Master Plan, and the possibility of inserting more skilled nursing beds in the plan. “I appreciate UCSF because it's our only hospital easily accessible on the west side and yet for a lot of folks who have seen this issue of skilled nursing beds in our city and who care about issues of seniors and long-term care and families who have to access that service at the end of life of their loved ones … I was involved at the Planning Commission when we negotiated the benefits agreement for California Pacific Medical Center and it (SNFs) didn't make it and now we have this and I'm hearing from a lot of community members who are alarmed that this plan does not include that?”

Hawgood: “Skilled nursing facilities are complex entities to run and manage and they're not in our core competency, if you like, so we have partnered with skilled nursing providers rather than try to run them themselves much similarly to the things like in-house hospices, et cetera.”

Melgar pressed the issue: “We are talking about expanding the space by 40% or about that, probably a little bit more, and so, clinical providers adapt to new needs all the time and we're talking about the next 50 years at the hospital. So, are you saying that it's just not possible to think about, at some point, adapting the new space to this use? Because you don't have it right now?”

Hawgood: “The space increase that we're asking for is all programmed. It's not that we're banking an additional space. To be honest, when we started this process, we asked the question of, should we try not to have a space ceiling? We will continue to have a space ceiling, it's just a larger one than it is now. So is any of that additional two million square feet available for a skilled nursing facility on the campus? The answer is no, unless we went back and didn't do something that we think is mission critical.”

Retired geriatrician Teresa Palmer commented: … I find it very cynical that, under the cover of fear of COVID that UC is trying to push a plan through for a huge footprint of care that is not necessarily needed in this location … the clinical care that is offered in this hospital will not be what the people actually need. And what we need in San Francisco is long-term subacute care in a hospital campus, which isn’t as profitable as short stay acute care. But what you see is competing for market share of short stay acute care, which is the most profitable but not the most needed in San Francisco … the types of care offered are not going to help the aging population surrounding UCSF.”

Community Engagement

In addition to Preston’s concern, much of the public comment revolved around public input into the plan’s community process. Comments, which began about one-hour and forty-seven minutes after the meeting began, listed 66 speakers in the queue.

Dennis Antenore
Dennis Antenore

Former Planning Commissioner and neighbor Dennis Antenori commented: “I have been a 30-year member of the community advisory group to UCSF and I have literally spent thousands of hours of my time contributing to the planning processes at UCSF. I have always been proud of my involvement and happy that the university has been able and willing to listen to the input of the UC advisory group over all of these years. However, with this project, they have abandoned that possibility. They have abandoned us, and they have left us in the lurch. They keep talking about how much they have engaged the public in this process. There's not even been one meeting on the underlying project. The plan itself has never been reviewed by any public body or by any group of advisors. The only thing that has been presented to people are community benefits, but there's never been any underlying discussion of the overall project at all — not even one minute of it — despite repeated requests and the demands by the members of the group. I also need to talk about this idea of a delay. First of all, it needs to be known that the current Environmental Impact Report was issued today (1/11/21). It is well in excess of 5,000 pages. It is impossible to analyze and to respond to it between now and the regents meeting. That's another reason that there should be a delay because we need to have a real look at the impacts and, in fact, the regents need to take time to look at that document as well. That's their job to actually to take that document into consideration before deciding when it's going to approve or not approve. So, I don't see how that is even possible within the time that is remaining. Secondly, the claim that there's a lot of housing in this project begets the fact that there are numerous — numerous units in this project that are way in the future in some distant vague plan to build a new 4th Avenue and to build new high-rises between 4th and 5th Avenue.

Hawgood, on the other hand, said that there had been two years of community engagement. “I understand that you have concerns that we have not provided community input on this project, but this is inaccurate. Over the past two-and-a half-years, we've partnered with thousands of neighbors in more than 28 community meetings to develop the Parnassus Heights plan and the community investments that are memorialized in the MOU. I have personally met with Supervisors Dean Preston, Norman Yee and more recently Melgar… As part of our two plus year community engagement efforts, I also met with neighbors on Edgewood Avenue, the street that backs up to the site of the new hospital to hear their concerns. Our community process is ongoing and we will continue to partner with our neighborhood.”

Tes Welborn, from the Haight Ashbury summed it up: “Many of the neighbors still don’t know about UCSF’s expansion plans, and many who do know have reservations or oppose them ... Cole Valley Improvement Association, has written a letter opposing the project to the regents. Today opponents include the Haight Ashbury Neighborhood Council (HANC) which opposes amendment to the 2014 Long Range Development Plan (LRDP) which includes a new hospital. This LRDP, approved in 2014 … and yes, it will be 300 feet tall … he (Hawgood) is kind of been taking the attitude this is what we want and now we'll talk about how to make you feel happier about it and the ice cream cone. Instead, we'd like UCSF to talk about trade-offs that they are willing to make so that we can preserve our neighborhoods and keep it good for all people. HANC also supports the resolution to ask for that two-month delay for more time and I would also point out that the Sierra Club has pointed out a very large number of concerns with the project and urges UCSF to rethink the parameter and create a more environmentally sustainable equitable and neighborhood friendly project. So, it's time to actually sit at table and talk about what is good and make sure that neighbors actually have information.”

Gary Dressler with the San Francisco Land Use Coalition said, “The proposed development of a 30-story hospital at the UCSF Parnassus Heights campus while the underutilized St. Mary’s Medical Center campus is a five-minute walk away makes no sense. It has two parking structures and is on major muni bus lines and the hospital had a daily census of 500 beds and it's currently operating with a daily census below 100 beds. Acquiring and expanding the existing St. Mary’s campus could provide an ideal solution that substantially reduces UCSF’s three billion dollar project cost and the negative environmental and transportation impact of the proposed project. The proposed housing plan and twenty million dollar contribution solving the anticipated congestion problems is a weak attempt to window dress the proposal that violates the hospital's existing agreement to limit future expansion.”

Kathryn Howard of the Sierra Club commented: “The Sierra Club supports the resolution to delay the consideration of this plan to March 2021. We understand the importance of up-to-date medical facilities, however, we put forward the idea that a healthy environment is important for the well-being of communities and to combat climate change. This needs to better address its environmental and social equity impacts. The project's massive increase in square footage, resulting in a much larger campus and the patient workforce commuter population as well as the addition of a 300-foot-tall building on a hillside in the middle of a residential community where parks, schools and other open space will be shadowed are major factors of the negative environmental impact of this project on this section of San Francisco.”

New Deal-era Murals

Bernard Zakheim's "The History of Medicine in California" murals in Toland Hall

Supervisor Aaron Peskin expressed his concern that the MOU include the fate of the 10 New Deal-era murals, The History of Medicine in California, by Bernard Zakheim, “particularly as it relates to the relocation and while I'm grateful that those murals will not be destroyed and it appears will be removed, there's no plan for them to be publicly displayed.”

Hawgood responded that the MOU does not address the murals, “it is in the revised EIR that has been submitted after the requisite public comment period.” Hawgood noted that UCSF had contracted with ARG Conservation Services (ARG/CS), a San Francisco-based general contracting conservation firm specializing in historic preservation to remove the murals and place them in storage. “We then have committed to putting together a task force including making sure they are placed in a home whether it's on the university to maintain them appropriately. They are very fragile and that obviously is not our sweet spot but we will put together a task force over the coming year to determine their display? Is that adequate?”


Public comment also focused on green space and open space preservation as well as automobile congestion and air quality.


Seven and a half hours later, when the public testimony ended, the Land Use and Transportation Committee voted unanimously to support the postponement. The next day the resolution moved to the full Board of Supervisors, where members spent 19 minutes to approve the resolution, eleven to one. Supervisors Chan, Melgar and Preston spoke in favor, as well as Supervisor Safai, who noted his desire to include subacute nursing facilities (at least 20 beds) in the project. Both new supervisors, Supervisor Melgar and Supervisor Chan aligned with the majority, while Supervisor Stefani was the singular dissenting vote.

The focus now will be on the Regents meetings beginning tomorrow, January 19th. Open sessions will be live broadcast via teleconference. The meetings can be accessed at the link above.

Doug Comstock lives near the Parnassus campus and also serves as Editor of the Westside Observer.

January 2021

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