Proposition F - Health Service Board Elections

Voter Guide
This measure appeared on the November 2010 San Francisco ballot.

What it does

The Health Service System Board is a board established by the San Francisco City Charter. It is responsible for overseeing the city's Health Service System. The system provides medical, dental and vision benefits, flexible spending accounts, employee assistance programs, and other health insurance services to over 110,000 current and former City, school district, and City College employees and their families. The Health Service Board also conducts an annual review of health benefit costs and is responsible for ensuring the fair provision of benefits.

Four of the seven members of the Health Service Board are elected to five-year terms by the active and retired members of the system. The other three board members include one member of the Board of Supervisors and two mayoral appointees, both of whom must be in the medical field (and one of whom must be a medical doctor). The elected member terms are staggered over a five-year period, with one Health Service Board member being elected in each of four years.

Proposition F would change the elections of the four elected Health Service Board members. The new process would eliminate the staggered elections and replace it with a system where two members would be elected to five-year terms at the same time. This would reduce the number of elections within a five-year period from four to two. It would also shorten the terms of two future members in order to accomplish paired elections. Specifically, it shortens the terms for the members elected in 2011 and 2013 to three and two years, respectively.

Why it's on the ballot

This measure was put on the ballot by a 9-2 vote of the Board of Supervisors and was sponsored by Supervisor Sean Elsbernd "” a former member of the Health Service Board who served in the Board of Supervisors' seat. The process for electing Health Service Board members is contained in Charter Section 12.200 of the city charter, and the charter may be changed only by voters.


  • Reducing the number of elections in a five-year period from four to two could save the city about $150,000 "” an average of $30,000 a year.
  • Administrative expenses of the Health Service System are paid for by the City, so any reduction or cost avoidance may make additional City funds available for other purposes, including administrative expenses of the Health Service System.
  • The Health Service System might be able to use funds not expended in annual elections for improved customer service to employees and retirees.
  • Less-frequent elections for seats on the Health Service Board could increase people's perception of the value of these seats, potentially leading to greater competitiveness among candidates and increasing voter turnout.


  • Shortening the terms of two future elected members may deprive the Health Service Board of institutional knowledge needed to deal with the administration of changing health benefits.
  • Electing two members at once may make the learning curve for Health Service Board members more difficult, compared to adding only one new board member a year.
  • The terms of the members elected in 2011 and 2013 will be much shorter than those elected in other years, which could reduce interest in and competitiveness for those seats among prospective candidates.
  • Having elections only twice in a five year period may diminish the opportunity for prospective candidates to seek election.

SPUR's analysis

This measure seeks to save the City a modest amount of money during very difficult financial times. Although it is not a significant amount of money, there is no reason not to scrutinize every expenditure of City funds and create savings where possible. The savings could be used to improve the administration of the Health Service System, or other city needs. Reducing the number of elections in a five-year period also streamlines the process of both administering and participating in these elections.

The measure does not affect current holders of these board seats, but should existing members choose to twice run for re-election in the future "” such as for the seat that would expire in 2011 and again in 2014 "” it could cost them extra personal resources. According to opponents of this measure, it costs $5,000 to $10,000 to campaign each time for a seat on the board.

On balance, this one-time term adjustment and one-time extra expense for future candidates to pair elections in the future will lead to a steady stream of modest savings for the City. Unlike the way budget cuts are affecting some City departments, we believe that these savings could be achieved without reducing levels of service to the members of the Health Service System, and could even improve them.

SPUR recommends a "Yes" vote on Prop. F.