HispanicBusiness

"I said, 'You're out of your mind,'" Dr. Hernandez recalls. "But we did it. It was pretty extraordinary. Everybody was motivated and contributed something to it."

Her skill in bringing people together for a common cause enabled her to steer through controversy and solve big problems, says Fred Naranjo, president of the Scarborough Insurance Agency and a member of the universal health care council.

"Sandra is a remarkable woman," Mr. Naranjo observes. "She gets people to buy into things. She knows how to develop trust. People don't see her just as a Latina. They see her as an individual who has great ideas and knows how to get things done. And she has been a champion of people of color and the underserved."

In her push for universal health care, Dr. Hernandez came under fire from San Francisco businesses that supported the concept but did not want to pay into the plan. Local employers with 20 or more employees are expected to pay about $38 million of the $200 million cost for the first year. The fees range from $1.17 to $1.76 per hour per employee, depending on the size of the business.

The Golden Gate Restaurant Association, representing 800 members, filed suit to overturn the mandatory fees, alleging that they were illegal. The association won in U.S. District Court, but the 9th Circuit U.S. Court of Appeals allowed the city to begin enrolling clients and collecting fees in January, pending a final decision. The judges said the city's case showed a "strong likelihood of success on the merits."

"We hope this will be a national model," says San Francisco Health Commissioner David Sanchez. "Sandra continues to play a critical, leading role in health policy, not only in San Francisco, but nationally. She's setting the benchmark to be inclusive, find new pathways and protocols, and make long-range changes."

Armed with personal conviction and professional data, Dr. Hernandez has successfully confronted more than her share of skeptics on the road to change. "People told us we couldn't get health reform," she says. "They said Nixon tried and failed, and Clinton tried and failed. But if you come from a family of immigrants, you believe in your soul that things can and should be better."

The granddaughter of Mexican immigrants who settled in the Southwest to work on the Southern Pacific Railroad, she grew up in Tuscon, Arizona. Her father was a hard-working machinist who believed in civic responsibility and always volunteered to work at the polls on election day. Both he and her mother were strong role models. Her mother took care of the family, and she also worked at a women's clothing store.

Because she earned an income, Dr. Hernandez says, her mother was seen as an independent woman, and her friends sought out her advice on parenting and money management. She taught every woman on the block to drive, believing that only then could they participate in the economy.

Her parents believed strongly in the importance of education and worked nights and weekends so their five children could go to college. She and her siblings were taught not only to lift themselves up economically, but that they needed to lift others as well. She attended Yale University, where she discovered that the only Hispanics her roommate knew were the family servants. But, Dr. Hernandez has always viewed her own upbringing as an advantage, not a disadvantage.

Whenever she encountered prejudice, she was undeterred. Sometimes things happened that would never have happened to a man, she says, or perhaps they happened because she was Hispanic. "You get tested by people with biases and preconceptions, and it refl ects poorly on them," she remarks. "It's always been clear to me that you have to be a little better and work a little harder. It makes you stronger and sharper. Over time, you get to a place where it doesn't shake you to your core."

As the head of the San Francisco Foundation, she is now researching how to help the Presidio of San Francisco issue $50 million in bonds to renovate its crumbling barracks for public use. The Presidio is a former army base that has since been acquired as part of the Presidio National Park. "My reading material currently is bond financing for public entities," she says with a smile. "They don't teach you that in medical school."

She resides in San Francisco with her seven-year-old daughter, Maya, who has a knack for math. Dr. Hernandez tries to stay fit by running for exercise, mindful that her own brother died at a young age from overwork. She tends the bougainvillea in her garden, just as her mother once did. For her, it is like coming full circle.

Today, she lives by the creed of the Hopi Elders' Poem, a work she sometimes reads during her many public presentations. It reads, in part: You must go back and tell the people that this is the hour . . . Banish the word 'struggle' from your attitude and vocabulary. All that we do now must be done in a sacred manner and in celebration. We are the ones we have been waiting for. "Don't wait for somebody else to be the leader," Dr. Hernandez says.