November 4 , 2006

Helipad or No Helipad: That is Still the Question

By Robynne Boyd
Special to the Neighborhood Newswire

Neighborhoods surrounding San Francisco General Hospital (SFGH) have debated whether a helipad should perch atop the City’s number one trauma center for almost two decades. The controversy was re-sparked in 2003 after the San Francisco Health Commission approved a feasibility study that found that a helipad was necessary to address weaknesses in the City’s emergency response system; specifically, geographic isolation and traffic congestion. The Health Commission directed the Hospital to complete an environmental impact report for a proposed helipad, which is due out by the end of the year.

The Potrero Boosters Neighborhood Association, Potrero Hill Association of Merchants and Businesses, East Mission Improvement Association, and Lower 24th Street Neighborhood Association are officially opposed to the helipad.  Concerns focus on helicopter noise and safety; potential adverse impacts on property values; the likelihood that out-of-area helipad patients will push-out lower income patients from the surrounding community from receiving needed care; and distrust of SFGH’s motivations and relationship with the surrounding communities.

“First of all, the hospital hasn’t said what the purpose is for the helipad, said Keith Goldstein, President of the Potrero Hill Association of Merchants and Businesses, “It seems that it will be servicing people from out of town,” Goldstein continued “I understand that the emergency room and trauma unit are already full, and that by bringing in high-paying patients from the suburbs, lower income San Francisco residents will be pushed out of the emergency room.”

Christine Wachsmuth, Project Manager for the helipad project, says the emergency room and trauma center are two separate entities.  The trauma center is comprised of the totality of services provided to critically injured patients, with the emergency room being just one component of these. While it’s true that patients are sometimes diverted from the emergency room, trauma patients are never diverted, said Wachsmuth.

Wachsmuth says that the helipad will serve trauma patients, as well as become an important component of a regional trauma support network.  If approved, according to Wachsmuth, the helipad would be used for approximately 693 flights annually, or less than two a day.  Of these, 53 patients would be rescued directly from a trauma scene; 400 would be transferred from lower-level trauma centers or community hospitals to SFGH due to complicated injuries; six would be children under the age of five that need to be stabilized before being flown to dedicated children’s trauma centers; and the remaining 240 patients would be those usually flown into SFO and then driven by ambulance to the University of California, San Francisco’s hospital for maternal child service, Davies Hospital for limb-re-implantation or St. Francis Hospital for burn treatment.

With an anticipated 453 additional patients each year, equaling approximately one to two extra patients per day, SFGH doesn’t foresee any crowding problems, said Wachsmuth. Wachsmuth also emphasized the helipad’s value during disasters, especially since the City is surrounded by water on three sides, relies heavily on bridges for access, and is in a high-risk seismic zone.

“After the Katrina debacle, you must look at how you can best serve the people who live in your region – there are only three level one trauma centers:  Santa Clara, Stanford, SFGH.”   Wachsmuth pointed-out that every one of the 50 most populated cities in the U.S., ranging from New York City, New York, to Arlington, Virginia, has at least one medical helipad, except San Francisco.

Tony Kelly, President of the Potrero Boosters Neighborhood Association, doesn’t accept the disaster rationale. “I can speak specifically to the lack of straight talk from the hospital…[which] has poisoned their relationship with the neighborhood.” Kelly continued, “I would love to have a serious conversation with the hospital about how the neighborhood can better serve their operations.  But if the helipad is about improving their revenue stream, they need to say so. Only then can we have an honest discussion about it, instead of talking about the issue as if it’s only about addressing emergencies.”

Wachsmuth readily acknowledges that people have asked whether the hospital is building the helipad just to make money. “We don’t ask people whether they have the money for the flight to take the flight – I think its illegal - we take everyone who requires level one trauma care,” said Wachsmuth, “No, we’re not doing this just to make money, but if money can be made and can be billed for we’ll bill for those services.”

While the cost of helicopter flights will fall to the hospital, insurance companies, and/or patients, the cost of building the helipad, an estimated $2.5 million, will be paid by the SFGH Foundation, a non-profit formed 15 years ago.

Community feelings are strong enough on the issue that a group called “Stop the Helipad” has formed to disseminate information through its website. Rebecca Sawyer, a Stop the Helipad member, stresses that building the helipad, “Is not about saving lives.” Sawyer said the project’s real purpose is detailed in the 2003 Helipad Feasibility Study, “…[A]n influx of air transport patients from the broader suburban and rural regions of Northern California…..will contribute to a beneficial payer mix at the hospital.” 

Not all residents who would be impacted by the helipad are opposed to its construction. One longtime Potrero Hill resident who prefers to remain anonymous said, “When looking at the issue from the urban planning perspective, in dense urban areas there are necessities for disaster preparedness, and the helipad seems like an important thing.” The resident insisted that one way to ensure that the helipad was used solely to save lives was to limit and define the helipad’s terms of use, “I don’t look forward to a helicopter flying over my head, but if it’s a matter of saving a life it’s not a question.”

Not surprisingly, noise is the only aspect of the helipad issue that seems to have consensus. All agree that helicopters are loud, disruptive, and an assault to personal lifestyle. Yet agreement ends when people discuss whether the project represents a worthwhile sacrifice.

If the helipad were to be approved, the state Emergency Medical Service Agency would be responsible for establishing how it would be used. The San Francisco Planning Department can also require SFGH to undertake specific mitigations to operate the helipad.

The main reason the helipad should be built is “to allow the City and County of San Francisco to participate in a larger community response system for emergency care,” said Dr. Robert Mackersie, SFGH’s Head of Trauma Services. “Every other benefit derives from that, including those to patients, and the hospital.