In the mid-1990s, when California Governor, Pete Wilson, denied prenatal care to undocumented immigrant women, Dr. Sandra Hernandez said politely, "No thank you, Governor." Believing that the order was misguided policy and morally wrong, she stood up. As the first Hispanic and first woman to serve as public health director for the city and county of San Francisco, she risked her position and her career by sending her staff out into the city's heavily immigrant Mission District to reassure women that local clinics would not turn them away. The doctor's bold actions helped convince city officials to join a coalition that successfully sued to block Gov. Wilson's plan.
As public health director, Dr. Hernandez also helped create a public HMO to handle an indigent population and implemented the country's first needle-exchange program with drug users. In another groundbreaking move, Dr. Hernandez convinced San Francisco City officials to join with philanthropic organizations to provide supervised housing in residential hotels for chronically ill homeless patients
Today, as a medical doctor and relentless supporter of the poor and uninsured, even in the face of great opposition, she not only continues her fight for them – she continues to win. As chief executive officer of the San Francisco Foundation -- where again she was the first woman and Hispanic in the post -- she is furthering her pioneering work in health care reform. The foundation, which distributes $60 million yearly, is dedicated to improving access and quality health care for the underserved.
The Foundation provides aid to low-income immigrant parents, foster children, nurse educators, ethnic dance choreographers, disaster victims, environmentalists and religious leaders. One of the ten largest nonprofi ts in the U.S., it also aids literacy eff orts, aff ordable housing projects, wetland cleanups and voter registration drives.
"It is a phenomenal place to do public service," she says. "We have a large endowment and fl exible resources that allow us to react quickly to solve problems."
In recognition for her exemplary work, Hispanic Business Magazine has named Dr. Hernandez the 2008 Woman of the Year.
Dr. Hernandez's "keen leadership" makes her an ideal winner of the award, says Jesus Chavarria, the publisher and founding editor of Hispanic Business magazine.
"She is obviously a very seasoned advocate of health care ideas that will advance the national debate," he says. "She has demonstrated an incredible drive and acquisition of knowledge and skills, not only focused on doing good, but on developing opportunities for producing public good."
In typical fashion, Dr. Hernandez, who earned her medical degree at Tuft s University School of Medicine, downplays her career accomplishments.
"This is the right thing to do," she says. But even as she answers, she is involved with yet another high-profile health-care battle.
In 2006, she was tapped by San Francisco Mayor Gavin Newsom to co-chair a council on universal health care. The resulting $200 million annual plan, called "Healthy San Francisco," will provide comprehensive health care services for 82,000 uninsured adults, more than half of whom have jobs. It is the first program of its kind for an American city.
The real challenge came when Mr. Newsom appointed 40 people to the universal health care council, representing city government, local businesses, unions, clinics, hospitals, churches, insurance agencies, and advocacy groups for minimum wage earners and the homeless. It was not, seemingly, a group of people that could agree on much of anything. Mayor Newsom gave them 100 days to come up with a plan.
"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.
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