Max Gara presents San Francisco Charity Care Report showing rise in charity care patients

The San Francisco City Health Commission convened on July 4, 2025, to discuss the Charity Care Report, presented by Max Gara from the Office of Policy and Planning. This meeting focused on the final report for the years 2018 and 2019, which was delayed due to the COVID-19 pandemic and combines two years of data.

Gara began by providing background on the charity care ordinance established in 2001, which mandates hospitals to report charity care data to the Department of Public Health (DPH) annually. Eight hospitals participate in this reporting, with five required by the ordinance and three voluntarily contributing data. The report aims to enhance transparency and accountability regarding charity care services in San Francisco.

Key findings from the report indicated a notable increase in charity care patients for the first time since the implementation of the Affordable Care Act (ACA), with a 51% rise in patients over the previous two years. The report also highlighted differences between Healthy San Francisco patients and traditional charity care patients, noting that the latter group relies more heavily on emergency services.

Gara explained that various factors contributed to the increase in charity care, including rising healthcare costs and changes in hospital policies that expanded patient eligibility for charity care programs. The report also provided demographic insights, revealing that a significant portion of charity care recipients are residents of lower-income neighborhoods and that many patients have some form of health coverage but still face financial barriers to care.

Commissioners expressed gratitude for the detailed report and acknowledged the ongoing efforts of hospital partners in providing charity care. They emphasized the importance of understanding the evolving landscape of healthcare access, particularly in light of the economic impacts of the pandemic and changes in federal healthcare policies.

The meeting concluded without public comments, and the commissioners moved on to the next agenda item, which was the second quarter financial report. The discussions underscored the critical role of charity care in addressing health inequities in San Francisco and the need for continued monitoring and support for vulnerable populations.