San Francisco County Municipal Code Art. 121 Health Care Accountability

Sec. 121.1. Title. Sec. 121.2. Definitions. Sec. 121.3. Health Care Accountability Components. Sec. 121.4. Contractual Obligations. Sec. 121.5. Administration and Enforcement. Sec. 121.6. Additional Contract Requirements; Liquidated Damages. Sec. 121.7. Investigation and Determination of Violations. Sec. 121.8. Waivers by the Agency Director. Sec. 121.9. Special Waiver by the Public Utilities Commission. Sec. 121.10. Waiver Through Collective Bargaining. Sec. 121.11. Preemption. Sec. 121.12. Effective Date. Sec. 121.13. Period of Suspension.

*Editor’s Note: Former Administrative Code Chapter 12Q (“Health Care Accountability”) was redesignated as Labor and Employment Code Article 121 by Ord. 221-23, File No. 230835, approved November 3, 2023, effective December 4, 2023, and operative January 4, 2024.

This Article shall be known as the “San Francisco Health Care Accountability Ordinance.” (Added as Administrative Code Sec. 12Q.1 by Ord. 116-01, File No. 010848, App. 5/31/2001; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001; amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001; Ord. 49-06, File No. 051908, App. 3/24/2006)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001; Ord. 49-06, File No. 051908, App. 3/24/2006)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001; amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001; Ord. 49-06, File No. 051908, App. 3/24/2006; Ord. 69-09, File No. 090130, App. 5/1/2009; amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021) (Former Administrative Code Sec. 12Q.2.16 added by Ord. 116-01, File No. 010848, App. 5/31/2001; redesignated as Sec. 12Q.2.22 and amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added by Ord. 116-01, File No. 010848, App. 5/31/2001)

(Added as Administrative Code Sec. 12Q.2.16 by Ord. 116-01, File No. 010848, App. 5/31/2001; redesignated as Sec. 12Q.2.22 and amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021)

The General Manager of the Public Utilities Commission may waive the requirements of this Article where the Contractor or Subcontractor is providing to or on behalf of the San Francisco Public Utilities Commission services relating to: (a) The provision, conveyance or transmission of wholesale or bulk water, electricity or natural gas; or (b) Ancillary requirements such as spinning reserve, voltage control, or loading scheduling, as required for ensuring reliable services in accordance with good utility practice; provided, however: (1) The purchase of such services may not practically be accomplished through the City’s standard competitive bidding procedures; and (2) The Contractor or Subcontractor is not providing direct, retail services to end users within the geographic boundaries of the City. (Added as Administrative Code Sec. 12Q.7 by Ord. 116-01, File No. 010848, App. 5/31/2001; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)

All or any portion of the applicable requirements of this Article 121 may be waived in a bona fide collective bargaining agreement, provided that such waiver is explicitly set forth in such agreement in clear and unambiguous terms. (Added as Administrative Code Sec. 12Q.8 by Ord. 49-06, File No. 051908, App. 3/24/2006; amended by Ord. 235-20, File No. 201133, App. 11/20/2020, Eff. 12/21/2020, Oper. 3/21/2021; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024; amended by Ord. 234-25, File No. 250210, App. 11/28/2025, Eff. 12/29/2025, Oper. 2/27/2026)

Nothing in this Article shall be interpreted or applied so as to create any power or duty in conflict with any Federal or State law. (Added as Administrative Code Sec. 12Q.8 by Ord. 116-01, File No. 010848, App. 5/31/2001; renumbered as Administrative Code Sec. 12Q.9 by Ord. 49-06, File No. 051908, App. 3/24/2006; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)

This Article shall become effective, and its requirements shall be included in all covered Contracts, Subcontracts, Leases and Subleases, 30 days after it is adopted or July 1, 2001, whichever occurs later. This Article is intended to have prospective effect only. (Added as Administrative Code Sec. 12Q.9 by Ord. 116-01, File No. 010848, App. 5/31/2001; renumbered as Administrative Code Sec. 12Q.10 by Ord. 49-06, File No. 051908, App. 3/24/2006; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)

Contracting Parties shall not be required to provide any of the Health Care Accountability Components provided in Section 121.3 to their Covered Employees until such time as the Health Director has prepared, and the Health Commission has approved, minimum standards for health plan benefits pursuant to Section 121.3(a)(1). The Health Director and Health Commission shall proceed promptly to take these actions. From the date upon which the Health Commission approves such minimum standards forward, Contracting Parties shall provide the Health Care Accountability Components set forth in Section 121.3 to their Covered Employees. (Added as Administrative Code Sec. 12Q.10 by Ord. 116-01, File No. 010848, App. 5/31/2001; renumbered as Administrative Code Sec. 12Q.11 by Ord. 49-06, File No. 051908, App. 3/24/2006; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)

If any part or provision of this Article, or the application of this Article to any person, location or circumstance, is enjoined or held invalid by a court of law, the remainder of this Article, including the application of such part or provisions to other persons, locations or circumstances, shall not be affected by such action and shall continue in full force and effect. To this end, the provisions of this Article are severable. Further, to the extent Section 121.3(a)(2) may be enjoined or held invalid by a court of law, the Contracting Party may alternatively comply in accordance with Section 121.3(c)(2). (Added as Administrative Code Sec. 12Q.11 by Ord. 116-01, File No. 010848, App. 5/31/2001; renumbered as Administrative Code Sec. 12Q.12 by Ord. 49-06, File No. 051908, App. 3/24/2006; redesignated by Ord. 221-23, File No. 230835, App. 11/3/2023, Eff. 12/4/2023, Oper. 1/4/2024)