• The San Francisco Department of Public Health (DPH) reviews the Minimum Standards at least once every two years to ensure that they stay current with the state and federal regulations and existing health benefits practices. See the HCAO Minimum Standards 2017-2018.

• 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, 2018, covered employers who make payments to San Francisco General Hospital to satisfy the requirements of the HCAO must pay $5.15 per hour, capped at $206.00 per work week. This rate is adjusted for inflation annually on July 1.

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)

For Employers

• HCAO Minimum Standards 2017-2018 Effective 1/1/2017
• HCAO Employee Notice (PDFs) - Must be displayed at each workplace
  English
• HCAO Employee Know Your Rights - Employers must maintain copies signed by employees.
  English
• HCAO Voluntary Waiver Form 
  • English HCAO Waiver Form 2017-2018
  • Spanish HCAO Waiver Form 2017-2018
  • Chinese HCAO Waiver Form 2017-2018
  • Filipino/Tagalog HCAO Waiver Form 2017-2018
• HCAO Payment Option Form FY17-18 (Excel)
• 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 for download:
  • MCO/HCAO information packet for City Contractors - Effective July 1, 2018
  • MCO/HCAO information packet for SFO Contractors - Effective July 1, 2018
  • MCO/HCAO information packet for SFO Concessions and Leases - Effective July 1, 2018
• Historical Documents
  • Previous Minimum Standards for Health Plan Benefits
  • HCAO Fee Option Rates Over Time (since 2001)

For Employees

• Employee Complaint Form (PDFs)
  English  Spanish  Chinese  Russian  Vietnamese

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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