Board committee advances citywide Transportation Sustainability Fee despite hospitals' plea for exemption

San Francisco's Land Use Committee voted to forward an ordinance that establishes a new citywide Transportation Sustainability Fee (TSF) and suspends the existing transit impact development fee, even as hospital representatives urged supervisors to reinstate a charitable exemption for nonprofit hospitals.

Corey Teague of the San Francisco Planning Department told the committee the latest package includes mainly technical clarifications: revised grandfathering language, a proportional methodology for applying a tiered residential fee, and clarified wording for feasibility studies. "The amendments we are proposing are not substantive. They are, for clarification purposes," Teague said.

During public comment, a coalition of hospital representatives argued the change would harm community health providers. David Serrano Sewell, hospital counsel, said the removal of a hospital charitable exemption is "bad public policy" and warned it would raise costs for hospitals and their patients. Abby Yant of Saint Francis Memorial Hospital and Elizabeth Ferber of Kaiser Permanente asked the committee to "reinstate the hospital exemption," saying seismic‑related expansions increase building footprint without increasing trips. "Modern hospital construction requires...single private rooms," Ferber said, arguing larger rooms and more equipment do not necessarily mean more vehicle trips.

Didi Workman of the San Francisco Chamber of Commerce also urged that hospitals be left under the charitable exemption, arguing that hospitals provide substantial community benefit and that removing the exemption is a departure from precedent.

In committee debate Supervisor Scott Weiner noted a prior committee vote where the chair and another supervisor had voted to remove the exemption; he asked whether Supervisor Jane Kim would support reinstating it. Kim said she was "not prepared to support an amendment" to reinstate the exemption at this time. Weiner then moved to forward the measure with a positive recommendation to the full Board. The committee took a roll call and the motion passed to forward the ordinance for Board consideration on Nov. 3.

The committee's record shows the matter will return to the full Board, where proponents and opponents will have another opportunity to press their positions. The ordinance text includes the clarified fee calculation and exemptions; the Planning Department said the changes are primarily technical. The committee did not adopt an amendment to restore the charitable exemption for hospitals.

What happens next: The ordinance will be considered by the full Board of Supervisors on Nov. 3. If members seek to restore a hospital exemption, they can introduce amendments at or before that hearing.