If you ask the neighbors who reside in the blocks right around Cesar Chavez Street near St. Luke’s Hospital what city district they live in, chances are you’ll be greeted with a blank stare or a laugh.
They don’t really consider it the Mission, and it’s too far away to be called Bernal Heights. And it’s certainly not Noe Valley, because that nearby neighborhood is trendy and there’s nothing trendy about a community filled with dead blocks.
It’s a perception not lost on those who have tried to represent it. Last year during a typically raucous campaign for supervisor, one of the candidates started referring to the area as the “trans-Mission.” And for a neighborhood that’s been in a constant downshift for about 50 years, that’s not far off.
San Francisco planners, in their infinite wisdom, declared this part of San Francisco “blighted” during the 1950s and, as was the urban trend at the time, sought to redevelop huge swaths of it — a fate that bulldozed giant sections of the Western Addition and Japantown decades later.
Cesar Chavez Street, formerly known as Army Street, was penciled in as a future freeway by those challenged urban thinkers — yet another section of The City to be paved over and passed through by travelers on their way somewhere else.
But the freeway never was built, even though hundreds of homes were moved to make way for it. So it became an in-town highway, with all the trappings — a place filled with little industry, almost no retail space and blocks of homes and apartment buildings that seemed joined without purpose. And sadly, The City’s paralyzing political forces have conspired to keep it that way.
This is a section of San Francisco that has been so lost in translation that the people who live there aren’t even being allowed to weigh in on the future of St. Luke’s Hospital. And that’s because the largest development project to come down the pike there in years isn’t even about the local community; it’s about a more important project clear across town.
Such is the possible fate awaiting St. Luke’s, a medical center that’s been on life support for much of its existence — one that has experienced dramatic shifts in demographics and health care trends that caused its insured-patients populace to flee. Still, it remains, largely because of one old-line tradition in San Francisco: labor muscle, flexed without restraint, without fear and certainly without the involvement of the people who would suffer most from its failing.
And fail St. Luke’s almost certainly will under a current proposal that’s asking its parent company to rebuild the hospital in a way that doesn’t adequately serve the local neighborhood but would meet some demands of its unionized health care workers. This week, that model will be on display when the Planning Commission looks at the business plan being pushed by California Pacific Medical Center, which is desperate to build a central, 555-bed hospital on Cathedral Hill.
In order to achieve that goal, CPMC agreed to rebuild St. Luke’s as an 86-bed inpatient facility, even though the average daily census there is only about 50 beds. Unions, led by the California Nurses Association, are demanding a 300-bed hospital. The size clearly has nothing to do with reality; it’s based on filling labor jobs because St. Luke’s has union contracts while the new Cathedral Hill facility will not.
Yet, what ails the St. Luke’s community is that neighbors most affected by the new Mission-area hospital have been shut out of the process. Residents surrounding the facility haven’t been invited to community hearings. When they showed up, they were told that if they wanted to stay, they would have to agree to the terms outlined by the Coalition for Health Planning, a group controlled by local nurses association organizer Nato Green.
Among the coalition’s demands are maintaining acute-care beds at St. Luke’s for another 40 years and keeping all the facility’s Medi-Cal contracts — in essence maximizing nursing jobs instead of the community’s hospital needs.
The neighbors around St. Luke’s aren’t opposed to a new hospital, they just want it to have the kind of outpatient facilities that will exist in other CPMC facilities across town, just not down the street. They want a place where they can go to have a physical or take their children to be treated for a midnight earache; a hospital that doubles as a neighborhood clinic.
“The hospital has a tenuous future because it’s not connected to anything that drives it,” local activist Gillian Gillett said. “It doesn’t serve a broad spectrum of people, so it won’t attract doctor groups that will keep investing in it. The current plan won’t translate into a modern, attractive facility.”
The neighborhood is being passed by, freewaylike, once again.