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The Healthy San Francisco Program


San Francisco passed an ordinance called Healthy San Francisco. The city’s website states that Healthy San Francisco is a program that was created by the City to provide affordable medical care to uninsured people living in San Francisco. Participants choose a Medical Home to go to when they are sick, as well as for preventive care to help keep them healthy.

While the Healthy San Francisco Program provides basic and ongoing medical care, the program is not health insurance. Healthy San Francisco offers a limited network of health care providers.

In July 2006, the San Francisco Board of Supervisors passed the Health Care Security Ordinance, which created the Healthy San Francisco program and made San Francisco the first city in the nation to provide access to health care services for all adult residents without health insurance. Healthy San Francisco, a program of the San Francisco Department of Public Health (DPH), is “not a health insurance program, but it provides uninsured residents access to affordable basic and ongoing health care services, regardless of immigration status, employment status, or pre-existing medical conditions.”

Eligibility for the Healthy San Francisco Program

All San Francisco residents, ages 18-64, who have been uninsured for at least 90 days and who are ineligible for other public programs, are eligible for Healthy San Francisco. A key feature of Healthy San Francisco is the use of medical homes, designed to improve the quality and continuity of care. Upon enrollment, participants choose a medical home from among participating clinics.

Problems with the Healthy San Francisco Program

But Healthy San Francisco has its problems. While a recent Kaiser Family Foundation survey gave the program good reviews, other reports indicate that much of the money that is paid by the public ostensibly for the program does not actually go toward funding health care for employees. In addition, many employers contact me because they are extremely confused by the ordinance’s provisions and how to enforce them.

In any case, if you are an employer with employees based in San Francisco, it's important to understand the ordinance and to comply with it. In addition, it’s critical for SF employers to understand SF’s paid sick leave laws. For this reason, many of my posts will explain aspects of this ordinance and the SF paid sick leave.