New! HCAO Fee Rate
Effective July 1, 2022, the HCAO fee rate is $6.10 per hour, capped at $244.00 per week.

HCAO Amendment & Mayoral Directive

• Healthy Airport Ordinance (HCAO Amendment for SFO Quality Standards Program Employees)
   
• Health Plan Requirements for Specified COVID-Related Essential Services Contracts
   

 Email list Sign up to receive periodic email updates about the Health Care Accountability Ordinance (HCAO) and the Minimum Compensation Ordinance (MCO).

Overview

The Health Care Accountability Ordinance (HCAO) applies to most City contractors and tenants (including those at the San Francisco International Airport and the Port of San Francisco). The HCAO requires employers to offer health plan benefits to their covered employees, to make payments to the City for use by the Department of Public Health, or, under limited circumstances, to make payments directly to their covered employees.

Effective July 1, 2022, covered employers who make payments to San Francisco General Hospital to satisfy the requirements of the HCAO must pay $6.10 per hour, capped at $244.00 per work week. This rate is adjusted for inflation annually on July 1.

• Understanding the HCAO Video

If you have questions about the San Francisco Health Care Accountability Ordinance or wish to report a violation of the law, call 415-554-7903 or email hcao@sfgov.org.
 

Statutory Authority

The San Francisco Board of Supervisors passed the Health Care Accountability Ordinance in 2001.

• Health Care Accountability Ordinance, SF Admin Code, Chapter 12Q

• Regulations Implementing the HCAO (PDF)

Forms and Documents - For Employers

HCAO Minimum Standards and Guidance

• HCAO Minimum Standards and Guidance
       Effective January 2022
   
• Previous HCAO Minimum Standards for Health Plan Benefits

HCAO Poster

• HCAO Poster (PDFs) - Must be displayed at each workplace
  English Spanish Chinese Filipino
   

HCAO Employee Know Your Rights 

• Employers must maintain copies signed by employees
  English Spanish Chinese Filipino
   

HCAO Voluntary Waiver Form

• English  Spanish  Chinese   Filipino

HCAO Payment Form

• HCAO Payment Form FY21-22
• HCAO Payment Form FY22-23

HCAO Fee Rates

• HCAO Fee Option Rates Over Time (since 2001)

HCAO Subcontractor Information Form 

• HCAO Subcontractor Information Form - This form must be filled out by the Prime Contractor, who is responsible for the Subcontractor's compliance.

Complete MCO/HCAO resource packets to download

• MCO-HCAO Packet for City Contractors

• MCO-HCAO Packet for SFO Contractors

• ​ MCO-HCAO Packet for SFO Leases and Concessions
   

HCAO Webinars​

• MCO and HCAO for SFO Food and Retail Concessionaires - Effective July 1, 2021​​​​
  - Password: OLSEwebinars01
  -  PowerPoint Slides
   
• HCAO Minimum Standards Webinar - August 26,2020
  Effective January 1, 2021, there are NEW HCAO Minimum Standards.
   - Slides and Handout.
   
• MCO & HCAO Webinar - July 1, 2020
   -  PowerPoint Slides
   
• HCAO Webinar FAQs - July 1, 2020
   -  PowerPoint Slides
  MCO & HCAO Chart Chapters and Times 
  We strongly encourage you to watch the entire webinar and take notes. However if you would like to go directly to a topic, you can view the chapter and times chart to the MCO & HCAO webinar
   
• HCAO Minimum Standards Webinar: located on the OLSE's Trainings & Webinars webpage - September 19, 201

Hearing Officer Decisions

• Hearing Officer Decisions

Filing a Complaint - For Employees

Employee Complaint Form
English  Spanish  Chinese  Russian  Vietnamese  Filipino

For City Departments

• HCAO Contractor Compliance Declaration Word  PDF
• List of Exemptions for the HCAO (PDF)

The following forms may be found on the City's Intranet:

• MCO Form P-360 Exemption & Waiver
• HCAO Form P-365 Exemption & Waiver

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