Advocates upset SF bond measure omits City Clinic relocation funds

  • by Matthew S. Bajko, Assistant Editor
  • Tuesday April 30, 2024
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Staff from City Clinic, muralists, and others from the Department of Public Health celebrated the dedication of a new mural, "Sanctuary for Health," on the facade of the clinic's building in November 2022. The clinic is considered dilapidated by city officials, who want to relocate it, but money to do so is not currently in a bond proposal released Monday by Mayor London Breed. Photo: Rick Gerharter
Staff from City Clinic, muralists, and others from the Department of Public Health celebrated the dedication of a new mural, "Sanctuary for Health," on the facade of the clinic's building in November 2022. The clinic is considered dilapidated by city officials, who want to relocate it, but money to do so is not currently in a bond proposal released Monday by Mayor London Breed. Photo: Rick Gerharter

LGBTQ advocates are criticizing the omission in a proposed San Francisco bond measure funds to relocate a public health clinic that has long played a central role in the city's provision of care for HIV and other sexually transmitted infections.

The Department of Public Health's City Clinic is currently housed in a two-story industrial building in the South of Market neighborhood at 356 Seventh Street. It sees roughly 85 patients per day and accounts for more than 18,000 visits annually.

The site includes clinical laboratory facilities and medication storage in addition to the rooms to treat patients and office areas for staff. Built in 1912, it was originally a fire station.

As the Bay Area Reporter covered in 2019, the clinic received a $500,000 renovation to its waiting area and seven exam rooms. The location is City Clinic's fourth since its founding in 1911.

Yet, the city considers the building to be "functionally obsolete" and for years has eyed relocating the STI clinic a fifth time. Estimated to cost $28.5 million to do so, moving City Clinic was included in the "City and County of San Francisco Capital Plan Fiscal Years 2024-2033" that was adopted last May 9.

"The current location is in poor condition, and a relocation would allow the department to modernize and streamline the operations of this vital service. The project budget is estimated at $28.5 million, planned to be funded by the 2024 Public Health G.O. Bond, pending voter approval," states the document.

Thus, LGBTQ advocates were dismayed to learn Monday that the funding for the clinic's planned move was not included in the $360 million bond measure that Mayor London Breed announced she wants to place before voters in November. As the B.A.R. first reported online, it did set aside $25 million for the project to reimagine Harvey Milk Plaza in the city's LGBTQ Castro district.

The bond document released in 2023 refers to the Milk plaza redo among several "emerging projects." It noted, "private fundraising and grants are expected to provide the majority of funding for this project," which is estimated to cost a total of $35 million.

The bond would also fund $167 million in public health infrastructure, including renovating and expanding the Chinatown Health Clinic, Zuckerberg San Francisco General Hospital and Trauma Center, and Laguna Honda Hospital. The city's Homelessness Response System would receive $50 million to increase its capacity to house homeless families.

Another $70 million would go toward street safety projects and road repaving. Money would also be allocated toward improving Hallidie Plaza and repairing the elevator at the entrance into the Powell Street subway station.

"Never once before was Harvey Milk Plaza or Great Highway or $70 million for downtown renovations or Hallidie Plaza mentioned for the bond measure — that's not how capital projects and general obligation bonds work," Jeffrey Kwong, a gay man who is president of the Harvey Milk LGBTQ Democratic Club, told the B.A.R. "I 100% support Harvey Milk Plaza but that's no excuse for cutting the $29 million planned for critical capital improvements at the City Clinic — which has been in the plans for years."

He described City Clinic's building as "dilapidated," adding that he and others "were not happy" to see it missing from the list of projects the bond would fund that Breed announced.

"It is not acceptable to all of us to have the building get dilapidated but continually be on the front line of serving the queer community. It is one of the places that offered the monkeypox vaccine," said Kwong, referring to the disease that broke out among gay and bi men in the spring of 2022.

Speaking at the April 29 meeting of the city's Capital Planning Committee, Kwong called on it to include the funds for the health clinic. Vince Crisostomo, a queer Chamorro man who's the director of aging services at the San Francisco AIDS Foundation, also showed up to speak after receiving worrying texts from people afraid the city was "cutting" the public health clinic.

"For people of my generation, I am 63 years old, City Clinic has been a huge part of our history. It is a big part of why most of us have healthy lives today," said Crisostomo, who serves on the LGBTQ advisory body for the San Francisco Human Rights Commission. "The idea it is on the chopping block is really appalling."

With the rise in various STDs, from mpox to syphilis, City Clinic is needed "more than ever," he told the committee members.

"I do think the people of my generation, if they had to choose between their sexual health and making the plaza pretty, they would choose their sexual health," said Crisostomo.

The health department has not responded to the B.A.R.'s questions about the omission of City Clinic from the bond measure or if there are safety concerns with its current location. An emailed reply from an unnamed department spokesperson, sent after the B.A.R.'s article had been posted online Tuesday, didn't once mention City Clinic.

"SFDPH operates a robust health care system and continually addresses ongoing infrastructure and capital needs. The Department will continue to thoughtfully and proactively improve its infrastructure, so that we can methodically meet the healthcare needs in our system," according to the statement.

Breed spokesperson Jeff Cretan told the B.A.R. that her administration is looking for other ways to fund City Clinic's relocation. He stressed there are no plans to shutter the public health amenity.

"The City Clinic is an important public health resource and we are exploring options for the future of the clinic. Some have said the clinic is being closed or shut down, which is not true," Cretan told the B.A.R. "It will continue to operate and we will continue to work with DPH on investments to improve the patient experience."

In terms of the bond measure, Cretan said there are no guarantees that funding priorities listed in the capital plan will be part of a final bond measure.

"We often make adjustments when it becomes time to move a bond forward," stated Cretan. "We are exploring options for the future of City Clinic. But it does remain open and operating while we look at different options."

Peskin speaks out

The bond oversight committee includes various city department heads and Board of Supervisors President Aaron Peskin, who represents District 3 and is challenging Breed for mayor this year. It will vote on the bond measure at its meeting Monday, May 6.

It must then secure eight votes from the Board of Supervisors by July 26 to be added to the November 5 ballot. It will then need two-thirds approval from voters in order to pass.

The supervisors can make adjustments to what is included in the bond measure but must stay within the $360 million figure so as not to increase property owners' tax bills. The board's budget and finance committee will first take up the proposal in May.

Peskin told the B.A.R. he "100%" expects to see the funding for City Clinic to be added to the bond measure by the supervisors. Ensuring the longevity of the public health resource should take priority over streetscape improvements, he argued.

"The bottom line is that San Francisco's capital plan has been very well thought out and has been the subject of years of policy discussions, and there's a reason that the most important projects have risen to the top of the list for funding like City Clinic," said Peskin. "To, at the last minute, start rearranging the capital plan for other nice ... don't get me wrong, Harvey Milk Plaza is a nice amenity and, by the way, it is not just Harvey Milk Plaza, there is $15 million in there basically for a new entryway to the San Francisco Zoo to get it all ready for pandas.

"If I have to pick between people and a plaza, or people and pandas, I am going to pick people every time. It is just that simple," added Peskin, referring to Breed's sealing a deal for the city zoological park to receive two pandas during her recent visit to China.

Cleve Jones, a close confidante to Milk who has been a vocal supporter of the plaza project, was quoted in support of the bond measure funding for it in a news release Breed's office sent to media outlets April 29. Tuesday, he told the B.A.R. that he and other proponents of the plaza redo were not aware funding it in the bond would impact City Clinic.

"We did not ask for this. We did not lobby for it. We, frankly, didn't know anything about it," said Jones, a gay civil rights and union leader, who added he was first contacted by the mayor's office April 26 regarding the bond measure. "We were told the mayor was adding this money to the bond and we were, of course, delighted. Monday we found out these were, clearly, funds designated for other agencies."

He stressed that no one with the Friends of Harvey Milk Plaza group had advocated that funds designated for another project, such as City Clinic, be redirected to the public parklet redo.

"No one involved in Harvey Milk Plaza would ever engage in any effort to take funding away from another agency and, particularly, City Clinic for goodness sake," said Jones.

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