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


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Controller Ben Rosenfeild
Rendering of the  proposed UCSF Medical Center at Parnassus / Illust. Courtesy
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 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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