Proposition B — Bonds to Enhance Health Care Facilities and Public Spaces

Appears in the voter information pamphlet as “Proposition B: Community Health and Medical Facilities, Street Safety, Public Spaces, and Shelter to Reduce Homelessness Bond”

A woman walks out of the Chinatown Public Health Center.

Jason Winshell/San Francisco Public Press

If Proposition B passes, $390 million in bond revenue will let the city improve streets and public plazas, construct a homeless shelter and renovate community clinics and hospitals, including the Chinatown Public Health Center.

See our November 2024 SF Voter Guide for a nonpartisan analysis of measures on the San Francisco ballot, for the election occurring Nov. 5, 2024. The following measure is on that ballot.


Proposition B would let San Francisco borrow up to $390 million to carry out infrastructure and other projects, like upgrading health care facilities, creating homeless shelter, repaving roads and renovating Harvey Milk Plaza, the Castro neighborhood spot honoring the city’s first openly gay supervisor, who along with Mayor George Moscone was assassinated in 1978.

Listen to a summary of what this ballot measure would do.

Support

Mayor London Breed and the full Board of Supervisors support the bond measure, which they describe in the official proponent argument as a “critical investment” in public health and safety infrastructure.

Other supporters include numerous local groups such as NICOS Chinese Health Coalition, Self Help for the Elderly and the San Francisco General Hospital Foundation. State Sen. Scott Wiener backs the measure, as do the Alice B. Toklas LGBTQ Democratic Club, Harvey Milk LGBTQ Democratic Club and other political groups.

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Cost

If voters pass Proposition B, San Francisco may sell general obligation bonds to investors and use the funds for civic projects. The city would repay bondholders, with interest.

If all bonds were issued and sold, projected repayments would total $737 million, according to an analysis by the city controller. The city would fund repayments with property tax revenue, at an estimated rate of $6.90 per $100,000 of assessed property value.

Proposition B wouldn’t increase overall property taxes; it would replace taxes tied to a previous bond measure once they expired, after those bondholders were fully repaid. Moreover, landlords could pass half of their tax costs to tenants in the form of rent increases.

Opposition

The San Francisco Briones Society, a Republican group, opposes Proposition B. In the official argument against the measure, the group says the city should address issues like homelessness using its existing revenue rather than “burdening tax payers with additional debt.” Up to about 13% of the maximum bond revenue would pay for renovating and acquiring homeless shelters.

The San Francisco Apartment Association, which represents landlords and property owners, also opposes Proposition B. The group would like to see property taxes fall, rather than stay level due to a new bond measure, the group says in a paid argument.

What would it do

Most of Proposition B’s bond revenue would fund improvements at health care facilities, split almost equally among community health centers and hospitals.

If the sale of general obligation bonds produced the maximum expected revenue, about $71 million would pay for renovations at the Chinatown Public Health Center, which serves primarily low-income, uninsured, elderly and recent Asian immigrants in languages they understand. That would cover ventilation system upgrades and enable on-site mental health services. It would also fund the facility’s first major seismic upgrade since it was built over half a century ago; the center is one of San Francisco’s most earthquake-vulnerable clinics. During the construction work, services would move to the Chinese Hospital about two blocks away.

Additionally, $28 million would go toward acquiring property that would become the new site for the City Clinic, which provides treatment for HIV and other sexually transmitted diseases to youth and low-income residents.

Two hospitals would together receive $66 million in critical repairs and renovations, including fire-safety upgrades: Laguna Honda, which provides medical and rehabilitation services, and the Zuckerberg San Francisco General Hospital and Trauma Center, which handles 20% of the city’s inpatient care. The facilities would also get $40 million for seismic retrofits. At Zuckerberg hospital, the money would go to expanding mental health services.

The rest of the bond revenue would fund various other projects.

Public spaces would get $71 million in improvements. Of that, $41 million would help revitalize downtown by improving pedestrian areas and access to transit near Powell and Market streets. About $25 million would go toward Harvey Milk Plaza, enhancing accessibility for people with disabilities, upgrading the elevator at Castro Muni metro station and adding fixtures and landscaping. The remaining $5 million would improve infrastructure and recreational spaces at public parks.

About $64 million would pay for upgrading street traffic signs, redesigning arteries and sidewalks, repaving streets and adding roadway lighting.

Lastly, the city would use $50 million to acquire, construct and improve shelters for people experiencing homelessness.

An oversight committee would annually hold a public hearing on the fund’s implementation and report expenditures to the mayor and the Board of Supervisors.

Campaign finance

As of Oct. 7, the “Yes on B” campaign committee had raised $624,544, according to data from the San Francisco Ethics Commission. Contributors included health care organizations, with the greatest backing coming from the San Francisco General Hospital Foundation, which supports and funds the Zuckerberg hospital, at $100,000. Donations of $50,000 each came from Sutter Health, a nonprofit health care provider in California; Hudson Pacific Properties Inc., a real estate agency; and Diane Wilsey, a major Republican donor and the owner and chief executive officer of A. Wilsey Properties Co.

The “No on B” campaign committee had raised $172,000. The main contributor was the San Francisco Apartment Association Political Action Committee, which donated $50,000.

History and context

Over the past decade, San Francisco voters have approved three bond measures focused on bolstering public health facilities, including by upgrading outdated buildings.

Many of today’s needed improvements to health care facilities and infrastructure are described in the city’s latest 10-year capital plan, adopted last year, but Proposition B would not address them all. Proposition B’s architects excluded the renovation of the Silver Avenue Family Health Center, in the city’s southeast, from the measure’s funding targets because its cost projections exceeded earlier expectations, city staff explained at a public meeting in June.

The measure initially omitted the relocation of City Clinic, but drafters included it following community protest

Votes needed to pass

As a bond measure, Proposition B requires at least 66.67% “yes” votes to pass.

However, if voters this November approve California Proposition 5, which would reduce the threshold for passing housing and infrastructure bonds, Proposition B would need only 55% “yes” votes to pass.


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