2026 - Health + Human Services: Emerging Projects

Emerging Projects

Project Name

Description

DPH – ZSFG Childcare Center

ZSFG is required to construct and operate a new childcare center for employees as a result of a union arbitration award. DPW has completed 100% schematic drawings for a potential site.

DPH – LHH C3 and C4-Wing Renovation

Further renovation of the C-Wing would allow relocation and consolidation of staff. Design documents are complete, and permits have been secured. Final cost estimate is pending.

DPH – LHH Administration Campus Power Transformers

Additional Hetch Hetchy power transformers for the Administration building will provide additional power that will enable future growth, meet power and cooling requirements, and enable IT upgrades.

DPH – LHH NPC 4 & 5 Regulatory Upgrades

DPH must comply with new state Non-Structural Compliance regulations by 2030. Failure to comply puts Laguna Honda Hospital at risk of non-compliance with state regulators. LHH must build capacity to hold 72 hours worth of sewage in the event of an emergency.  

DPH – LHH Hospital Balcony Safety Improvements

LHH has multiple balconies currently not in use due to safety concerns and past incidents. The facility needs to install safety barriers to allow for resident access to the spaces for programming and events.

DPH – ZSFG Relocation of Pathology

This project would relocate anatomical pathology to the 2nd floor of Building 3 to accommodate staff relocating from 101 Grove Street.

DPH – ZSFG Campus Security Enhancements

 

The ZSFG campus has many public entrances and doorways that are either mechanically keyed or have a non-networked combination badge card reader. To improve safety and security, this project would include installation of door card readers that are connected to the campus security network program. This project would also add security enhancements, including loading dock security at Building 5, campus perimeter fence repairs, door alarm hardware replacement, campus security duress button installations, and an ambulance bay security gate.

DPH – Occupational Health Safety (OHS) Clinic Relocation

The OHS clinic is currently located on the first floor of Building 9 and serves all City staff. The existing space is circa 1950 and does not provide adequate space and privacy to appropriately serve the increasing number of patients. Relocation to the recently vacated UCSF OTI Clinic on the 3rd floor will allow the clinic to support the increased patient volume.

DPH – Aging Infrastructure Projects

Outstanding DPH needs include seismically-deficient Buildings 1, 10, 20, 30, 40, and 100 at ZSFG; renovating remaining unoccupied buildings at LHH; addressing long outstanding needs at neighborhood clinics not covered by currently planned funding sources; and needs related to the Population Health Division City Clinic.

DPH – 101 Grove Street

Once Department of Public Health staff exit the offices at 101 Grove Street, the City will have to decide how to activate the building. The monumental Beaux Arts 101 Grove is part of the Civic Center Historic District and not eligible for replacement. The City will evaluate whether a sale, public-private partnership, or City-driven retrofit project will make for the best use of the space and funds required. No preliminary costing for any of these scenarios has been developed.

HSH – 260 Golden Gate Avenue Replacement Family Shelter

The 260 Golden Gate Family Shelter has been assessed with a Seismic Hazard Rating of 4 and would suffer significant damage from a major earthquake. HSH supports approximately 132 family emergency shelter and transitional housing beds at 260 Golden Gate Avenue, which was originally designed and operated as a fire station. Prior to the development of Prop B on the November 2024 ballot, HSH was planning to demolish the existing family shelter at 260 Golden Gate and rebuild the site to replace the existing adult shelter program at 1001 Polk St.

HSH – 525 5th Street Shelter

HSH is coordinating with Public Works to design and program an emergency adult shelter at 525 5th Street to replace the existing shelter and maximize the footprint of the site. Rather than retrofitting the existing building, which would require ongoing rehabilitation at a substantial cost, a new seismically safe and modern building would be designed to meet program requirements and maintain the number of shelter beds currently available to people experiencing homelessness in San Francisco.

HSH – 685 Ellis Street Adult Shelter Replacement Project

HSH acquired 685 Ellis, a 74-room, 6-story single room occupancy tourist hotel, in December 2022 and has been operating the building as a temporary adult shelter to eventually convert to supportive housing. In November 2023, the City was awarded an HCD Project Homekey Grant for the acquisition as well as the operation of the interim shelter and supportive housing conversion. The building was constructed circa 1927 and will require extensive rehabilitation, including a seismic retrofit, before transitioning to supportive housing.

 

2026 - Health + Human Services: Deferred Projects

Deferred Projects

Project Name

Description

DPH – ZSFG Building 80/90 Renovation & Seismic Retrofit

Constructed in 1934, Buildings 80/90 are seismically deficient red brick buildings at the ZSFG campus that house HIV, Behavioral Health and Substance Abuse clinics, staffed by both UCSF and DPH providers. These buildings do not meet UC seismic requirements for UC staff occupancy and must be upgraded by 2030 or UC staff will not be allowed to continue to occupy. Retrofitting Buildings 80/90 would allow DPH to relocate both DPH and UC staff into seismically safer buildings.

The total project cost is estimated to be over $200 million.

HSH – 1001 Polk Replacement Shelter

HSH is coordinating with Public Works to design and program an emergency adult shelter at 1001 Polk Street to replace the existing shelter and maximize the footprint of the site. Prior to the development of Measure B on the November 2024 ballot, HSH was planning to demolish the existing adult shelter at 1001 Polk, rebuild the site as a family shelter, and vacate the existing family shelter at 260 Golden Gate (a City-owned building with an SHR 4). The project was designed to include wrap-around services and provide a clinic, day care and afterschool programs, outdoor playground, community and meeting spaces, and flex dormitory space for emergency use.

The total project cost as scoped was estimated to be $115 million.

 

ZSFG Buildings 80/90
ZSFG Buildings 80/90

 

2026 - Health + Human Services: Enhancement Projects

Enhancement Projects

Project Name

Description

DPH – Chinatown Public Health Center Seismic Retrofit

Chinatown Public Health Center is one of DPH’s most seismically vulnerable clinics with a Seismic Hazard Rating of 4. This project addresses seismic issues and makes a number of critical renovations to allow the co-location and integration of primary care medical and mental health services, along with dental, social services, and other ancillary services. In addition, DPH will relocate a specialty mental health program from leased space into this clinic. The project includes infrastructure improvements such as modernization of outdated equipment, upgrades and retrofits of building automation systems, and repairs to HVAC controls. Construction documents for seismic renovation and modernization of the clinic are complete.

The project budget is estimated at $76.1 million, with $5 million from the Mental Health Services Act and the rest funded by the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond.

DPH – ZSFG Building 3 Retrofit
and Renovation

Building 3 on the ZSFG Campus is an aging and seismically deficient 6-story building originally constructed in 1964. This retrofit and renovation project includes a seismic upgrade to the upper floors, ADA improvements, and new finishes for administrative functions relocating from 101 Grove Street and other seismically vulnerable brick buildings on the ZSFG Campus. 

The project budget is estimated at $40 million and will be funded by the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond.

DPH – City Clinic Relocation

City Clinic is a vital sexual health resource for all San Franciscans, providing low barrier access to rapid HIV testing, HIV pre- and post-exposure prophylaxis, as well as sexually transmitted infections (STI) screening and treatment. The clinic also serves a central role in connecting patients to outside services.

City Clinic currently operates out of a nearly 100-year-old three-story converted firehouse that is not suited to clinic and patient needs. It is not conducive to optimal patient care, is unsafe, and is not fully accessible for employees and patients. The building has insufficient space for City Clinic’s lab, consultation rooms are non-ADA compliant, and the building lacks air conditioning meaning the clinic reaches unsafe temperatures during heat waves. Once the City Clinic relocation is completed, the City will evaluate whether a sale, public-private partnership, or City-driven retrofit project will make for the best use of the current space at 356 7th Street and funds required.

The project budget is estimated at $28 million and will be funded by the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond.

DPH – Critical Infrastructure Repairs

Both the LHH and ZSFG campuses continue to have several critical repair needs that are too large in scope for the City’s Pay-As-You-Go Program. At ZSFG, several buildings are over 100 years old and campus needs include exterior building repairs, IT infrastructure upgrades, electrical improvements, elevator repairs, clinical equipment upgrades, and security enhancements. At LHH, the new hospital building is beginning to show unanticipated renewal needs. The broader LHH campus requires critical infrastructure enhancements to improve onsite efficiency and ensure safe and appropriate conditions in staff and patient care areas. Needs include fuel line leak repairs, security enhancements, HVAC replacements, IT infrastructure upgrades, elevator repairs, and exterior building repairs.

These repair needs will receive $66 million from the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond.

DPH – Silver Avenue Family
Health Center Renovation

Built in the early 1960s, the current Silver Avenue Family Health Center is not conducive to a state-of-the-art collaborative working environment. This renovation will continue DPH’s efforts to modernize aging neighborhood health centers which began with the 2016 Public Health and Safety Bond, creating space for co-location and integration of primary care medical and mental health services, along with dental, social services, and other ancillary services.

The project budget is estimated at over $100 million, planned to be funded by the 2030 Public Health G.O. Bond, pending voter approval.

DPH – Treasure Island Residential Step-Down Facility

In collaboration with the Treasure Island Development Authority, the Mayor’s Office on Housing and Community Development, and Mercy Housing, DPH is initiating development of a Substance Use Disorder (SUD) Residential Step-Down Facility to be located on Treasure Island. This facility will add at least 70 beds to provide care for a period of one to two years in the most appropriate and least restrictive setting after clients complete their initial 90-day SUD medically necessary residential treatment. The Treasure Island Residential Step-Down Facility will help ensure that clients have the necessary continuation of support for them to maintain and strengthen their recovery. Construction documents for this project are complete and construction is expected to begin in mid-2026.

The project budget is estimated at $72 million, funded by Treasure Island developer fees, Prop C (Our City Our Home), and the 2020 Health & Recovery G.O. Bond.

HSA – Relocation of HSA Headquarter

Built in 1978 and home to a wide range of HSA programs, administrative and executive staff - as well as a public-facing service center - 170 Otis Street was deemed seismically deficient by DPW in 2018. Since that time, HSA has, in collaboration with a variety of City partners, pursued the acquisition of a new building in the southeast of the City, where a significant portion of its clients reside. DPW is performing a seismic evaluation on a space in the Bayview district which appears suitable for HSA. The site would provide space for both back-office and service center operations, as well as parking. The agency foresees placing staff there to serve the following programs/divisions: Medi-Cal and CalFresh eligibility, County Adult Assistance Program (CAAP), Family and Children’s Services, Workforce Development, Economic Support and Self-Sufficiency and Disability and Aging Services. The remaining administrative functions and executive offices at 170 Otis would be co-located with other HSA administrative functions moving to leased space at 1455 Market.

This project may be funded in part with revenues from the sale of 170 Otis. In addition, the City plans to issue $55 million in FY2026 Certificates of Participation to support the purchase of a new building and tenant improvement costs

HSH – 2024 Bond Project

Measure B on the November 2024 ballot includes funding to “acquire, construct, finance or improve shelter or interim housing sites to reduce unsheltered homelessness, particularly for families.” Potential projects could include 1) expansion of existing shelter sites to add bed capacity to the City’s homelessness response system, 2) acquisition and build out of one or more existing, structurally-improved buildings to add bed capacity and/or vacate one or more City-owned shelters with an SHR 4 ; 3) co-development and co-location of a shelter within a supportive housing project to leverage affordable housing financing and tax credits; and 4) a combination thereof to maximize bond proceeds and add shelter bed capacity.

These projects will receive $50 million from the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond.

 

170 Otis St
170 Otis St

City Gardens
City Gardens

2026 - Health + Human Services: Renewal Program

Renewal Program

The overall renewal needs for the City’s Health and Human Services facilities total $411 million over the next 10 years. The Capital Plan recommended funding level for these needs is $276 million as shown in Chart 9.1.

 

Chart 9.1

Chart 9.1

There are many outstanding needs for aging Public Health facilities, both at the Zuckerberg San Francisco General Hospital and Laguna Honda Hospital campuses, and also the neighborhood clinics. Given the large scale of the projects at ZSFG and LHH, they will receive funding from the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond. There are also several outstanding needs at the three City-owned shelters. While several life safety issues were addressed through the 2016 Public Health and Safety G.O. Bond, these facilities are seismically vulnerable and planning for future retrofits is in progress.

 

2026 - Health + Human Services

Health + Human Services
DPH: Department of Public Health
HSA: Human Services Agency
HSH: Department of Homelessness and Supportive Housing
Chinatown Clinic Rendering
Chinatown Clinic Rendering

 

San Francisco’s Health and Human Services programs are delivered at facilities throughout the city and reach many of San Francisco’s most vulnerable residents, including individuals and families experiencing homelessness. Providing high quality and accessible health care and human services is critical to eliminating racial disparities in health and welfare that affect San Franciscans, including stress, nutrition, heart disease, maternal mortality, life expectancy and more. Our medical campuses, neighborhood clinics, children’s resource centers, workforce and family support services offices, shelters, navigation centers, permanent supportive housing, and associated administrative space all play a part in providing these essential services.

Overview

San Francisco’s health and human services agencies provide high-quality, culturally sensitive services for residents in need of public care.

Public Health

The San Francisco Department of Public Health’s (DPH) mission is to protect and promote the health of all San Franciscans, and the department’s hospitals, clinics, and administrative offices all contribute to the success of that mission. DPH’s organization falls into two divisions, the San Francisco Health Network, which provides direct health services to insured and uninsured residents, and the Population Health Division, which addresses public health concerns including consumer safety and health promotion. The department’s central administrative functions support the work of both divisions and promote integration.

With the completion of the Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) in 2015, DPH is now focusing on the renovation of existing hospital campus buildings and community-based clinics, as well as the relocation of staff from the seismically vulnerable building at 101 Grove Street. The 2016 Public Health and Safety General Obligation (G.O.) funded the seismic strengthening of Building 5 at the ZSFG campus, as well as improvements at the Southeast, Castro- Mission, and Maxine Hall Health Centers. In 2016, DPH completed master planning efforts to move staff out of the building located at 101 Grove. The majority of this effort has been funded through the General Fund Debt Program, and the last piece will come from the 2024 Healthy, Safe and Vibrant San Francisco G.O. Bond. The proposed solution involves relocating some staff to the ZSFG and Laguna Honda (LHH) campuses, and the rest to City-owned properties in and around Civic Center. 

Human Services and Homelessness and Supportive Housing

San Francisco has two human services departments: The Human Services Agency (HSA) and the Department of Homelessness and Supportive Housing (HSH). Through assistance and supportive services programs, HSA promotes well-being and self-sufficiency among individuals, families, and communities. HSH strives to make homelessness in San Francisco rare, brief, and one-time through the provision of coordinated, compassionate, and high-quality services. HSH’s capital portfolio includes four City-owned shelters and a growing portfolio of Navigation Centers and other low-barrier temporary shelter sites that play a critical role in helping people experiencing homelessness exit the streets. HSH also administers locally and federally funded supportive housing to provide long-term affordable housing with on-site social services to people exiting chronic homelessness, known as Permanent Supportive Housing (PSH) and other housing options for PSH tenants who no longer require intensive case management services. HSH’s capital portfolio includes a variety of housing options, including renovated Single Room Occupancy hotels, newly constructed units operated by nonprofit organizations, and sites operating under a master-lease between private property owners and the City or City-funded nonprofit organization. HSH’s capital projects also encompass its administrative headquarters, a street outreach operations center, and a forthcoming health and wellness center for Transitional Age Youth experiencing homelessness. 

 

Permanent Supportive Housing at 42 Otis St
Permanent Supportive Housing at 42 Otis St

Division Circle Navigation Center
Division Circle Navigation Center

 

2026 - General Government: Emerging Projects

Emerging Projects

Project Name

Description

RED - Civic Center Office Space

RED continues to assess occupancy and space allocations within the Civic Center office space portfolio to seek opportunities for greater efficiencies and cost savings. With the recent leasing of 157,000 square feet over 5 floors at 1455 Market for City employees from 1155 Market and other locations, RED continues to seek further opportunities for future phasing of occupancy at this centrally located 22-story building. The purchase option in December of 2027 provides a unique opportunity for the City to meet its short-term cost savings goals as well as its long-term goal of consolidation through leasing or purchase. Other important objectives in this portfolio remain, including exiting the most seismically vulnerable buildings, ensuring that offices meet operational needs, and providing safe, healthy, and well-maintained offices for City workers. With the office real estate market currently in flux, the best long-term solution may take the form of a purchase or a lease. RED will also work with the Office of Economic and Workforce Development to explore joint development opportunities.

PW – Operation Yard

This project would redevelop and reorganize the Public Works Operations and Maintenance main yard at 2323 Cesar Chavez. The proposal includes building new offices and trade shops, as well as a new multi-story parking garage for the Operations and Maintenance fleet. It would also provide community space for Workforce Development and neighborhood public meetings.

OEWD – Market Zone Public Realm Improvements

Bayview’s northwest industrial district – referred to as the “Market Zone” due to the presence of the Wholesale Produce Market – needs improvements to public infrastructure. These infrastructure needs will be summarized in the Market Zone Improvement Plan, currently being drafted by OEWD.

 

2026 - General Government: Deferred Projects

Deferred Projects

Project Name

Description

DT – Fire Call Box Modernization

Due to age and wear, many of the City’s Fire Call Boxes are no longer functional, primarily due to damaged cabling, compromised conduits, and lack of support for copper communications lines. A proposed pilot project would modernize a portion of the Fire Call Boxes allowing the public to request emergency services through a robust network independent of any telephone network. The proposed new devices would be able to reach emergency services, 311, place calls, and communicate in other forms. DT is proposing a replacement of 200 call boxes at strategic locations with high numbers of visitors.

This pilot project will cost $3.6 million. 

RED – City Hall Dome and Roof Revitalization and Seismic Strengthening

Water leaks at City Hall have damaged the structure and interior of the building. Revitalization of the Dome, Drum, Lantern and Roof Levels of City Hall are needed to address active water leaks through masonry, skylights, and Dome waterproofing membranes. Deteriorating structural stone and steel also require repair. Seismic strengthening work is needed as well. Complete scaffolding around the Dome is required for implementation of all components of this project, which makes it desirable to address all issues at once.

The estimated project cost for these repairs and improvements is at least $22 million. In October 2021, the Board of Supervisors authorized the sale of Transfer Development Rights (TDR) which could generate between $40 million to $50 million dollars in the future to fund historic preservation work including the City Hall Dome and Roof Revitalization projects.

 

Civic Center Steam Loop Repair
Civic Center Steam Loop Repair

 

2026 - General Government: Enhancement Projects

Enhancement Projects

Project Name

Description

DT – Fiber for Public and Affordable Housing

This project will build a fiber broadband network to support free internet access to tenants in public and affordable housing sites, navigation centers, and homeless shelters. City investment to deliver fiber-based internet service to affordable housing is an important equity initiative, since the project seeks to provide very low-income residents and those struggling with homelessness with internet access that will open access to educational, health care and work resources. In partnership with MOHCD’s Digital Equity Program, DT has identified 212 additional sites that remain to be connected: 171 existing buildings and 41 new construction sites that will be completed in 2024 – 2028. DT Secured a Last Mile Federal Funding Account Grant from the California Public Utilities Commission which will allow the department to provide broadband service to unserved locations and affordable housing in the Bayview, Chinatown and Tenderloin neighborhoods. Due to the very limited term of this grant and resource constraints, DT will focus on the grant funded work in 2025 and 2026, which includes 43 affordable housing sites.

This project is expected to cost an additional $22.5 million over three years. To date, $12.5 million has been funded through the General Fund and FY2023 Certificates of Participation. 

DT – Fiber Backbone

This project aims to expand infrastructure that supports high-speed data communications for City fiber back haul and wireless networks. The benefits of pervasive connectivity include improved access to digital information and services, as well as expanding coverage to City departments and neighborhood institutions, serving underserved communities, and improving network performance for City services and infrastructure.

The Fiber Optic Backbone provides additional capacity and greater redundancy on the City's fiber network by installing additional fiber optic cables on key routes that serve critical public safety facilities and multiple City buildings. As demand for fiber optic connections to City facilities has grown, capacity on the City's key fiber optic routes has become exhausted. Fiber optic capacity has also been further constrained as the City migrates away from the legacy phone system to digital Voice Over IP (VoIP) technology.

This project has received $2.5 million from FY2022 Certificates of Participation and an additional $850,000 from the General Fund. The estimated cost for remaining work is $20.6 million.

MOD – ADA Barrier Removals

MOD will continue its oversight and prioritization of ongoing barrier removal efforts at public facilities throughout the City.

It is expected that $800,000 of the Recreation and Parks Department’s set-aside and approximately $1 million of General Fund will be devoted to barrier removal projects annually. General Fund allocations would depend on the shovel-readiness of needs identified and funds available. These funds are in addition to code compliance components of debt-funded projects, which appear in the relevant Service Area chapters for those programs.

RED – Wholesale Produce 

The San Francisco Wholesale Produce Market, or “SF Market”, has been a critical piece of San Francisco’s food infrastructure for well over 130 years, offering fresh produce to local and regional grocers, specialty retailers, restaurants, hotels, and caterers. Located on 23 acres of City land in the Bayview Hunters Point neighborhood since the early 1960s, the Market is in the midst of a multi-phase reinvestment and expansion plan designed to secure and modernize its physical plant, replace outdated facilities, improve worker safety, and ensure the Market’s place in the region’s foodshed through any crisis. As currently envisioned, the expansion project will increase the Market’s footprint by 25%. Phase I of the project—a new 82,000 square foot warehouse at 901 Rankin Street—was completed in 2015. The project will be implemented over a 20 to 30-year development horizon, supported by the Market’s long-term lease with the City, approved in 2012. While not primarily a publicly funded project, the expansion plan will rely on revenue from the Market’s subleases to its produce merchants, conventional bank loans, targeted City support, outside grants, New Market Tax Credits, and other sources. 

Project costs for the phases expected to be implemented during the timeframe of the FY2026-35 Capital Plan total approximately $140 million. This includes two new or renovated warehouse buildings, an improved marshalling yard, and associated site improvements. Per the terms of its lease with the City, the Market deposits net revenues into a development account, in lieu of paying rent to the City. In turn, these funds are directed back into the development of the reinvestment project, which helps offset the cost of individual phases.

 

2026 - General Government: Renewal Program

Renewal Program

The overall renewal needs for the City’s General Government facilities total $1 billion over the next 10 years. Given funding constraints, the Plan recommends $393 million from the General Fund to meet these needs, as shown in Chart 8.1.

 

Chart 8.1

Chart 8.1 - General Government Facilities

Large facilities within the RED portfolio continue to have significant renewal needs including fire safety, elevators, exterior repairs, and cooling needs.

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