Board hears progress report on ‘Healthy San Francisco’ coverage plan

The San Francisco Board of Supervisors held a public hearing May 8 to review the city—s implementation of Healthy San Francisco, the program designed to expand access to primary care and prevention services for uninsured residents.

Department of Public Health representative Dr. Katz told the board the city won a three‑year state grant of $73,000,000 to support a multi‑year effort and that the initial implementation budget approved by the Health Commission and included in the mayor—s submission totaled about $23.1 million for the first year. "We received $73,000,000 for 3 years," Dr. Katz said during his presentation.

The program will combine existing public clinics and nonprofit providers under a common eligibility and enrollment system, Dr. Katz said, with technical steps including a shared electronic intake (referred to as 1EAP) and an inquiry call center. He described a phased roll‑out: a limited July start enrolling existing patients at two pilot clinics, a larger September launch, and employer‑based enrollment beginning in January of the next calendar year.

Donna Levitt of the Office of Labor Standards Enforcement summarized work on the Health Care Security Ordinance rules and employer outreach. She said the office has sent notices to roughly 90,000 employers, established a dedicated phone line and published a draft of rules and regulations that will be subject to public hearings. "The rates will be $1.76 per hour for every hour paid to the employee, that works for an employer with 50 or more employees," Levitt said when reviewing the City—s employer spending schedule for 2008.

Supervisors and public speakers focused on program sustainability and operational details. Supervisor Elsbergn asked how the city would sustain services if the three‑year state funds were not renewed; Dr. Katz said the program design attempts to use the new dollars to strengthen persistent parts of the delivery system (for example, improving eligibility systems and clinic access) so the system could continue to function if a funding source changed.

Supervisor Amiano and several members asked about hospitals and specialty care, particularly for pregnant women. Dr. Katz said San Francisco General Hospital will be part of the hospital network for specialty and inpatient services and that pregnant women may select an obstetrician/gynecologist as their primary care home. The program—s benefit package, he added, is intended to be broad and to include the range of prenatal care services that are ordinarily part of primary care.

Public commenters included representatives of the San Francisco Community Clinic Consortium, San Francisco General staff and others. The consortium said its clinics are integrating with the health department—s electronic records and have signed a memorandum of understanding to coordinate primary care for the safety‑net population.

Several public speakers urged caution. Douglas Yip asked the Board to consider a formal audit of the Department of Public Health before implementation. Dr. Katz and other department representatives responded that DPH is working to strengthen systems and coordination across providers.

No ordinance vote was required at the hearing; the session was informational and intended to allow the Board to ask questions about implementation steps, funding assumptions and program timelines.

The Board scheduled no additional action at the hearing but multiple supervisors said they would continue oversight as implementation proceeds.