The new clinic space will allow the local nonprofit to significantly expand its free healthcare services for the Bay Area.
National interdisciplinary design firm, HGA, announced the completion of a new medical facility for Clinic by the Bay in San Francisco’s Excelsior / Outer Mission district. The nonprofit volunteer-powered free clinic moved its operations to the historic Alemany Emergency Hospital site, located at 35 Onondaga Avenue, with a renovation designed by HGA. The resulting 4,625-square-foot facility offers triple the square footage of Clinic by the Bay’s previous location, enabling the nonprofit to maximize impact through both expansion of services and increased operation days.
HGA’s design optimized the historic site to better serve the healthcare needs of low-income uninsured individuals in the Bay Area. The entire facility is dedicated to Clinic by the Bay’s provision of high-quality primary care to uninsured patients who don’t qualify for government assistance, but also do not earn enough to afford private insurance. The new clinic comprises four exam rooms for primary and specialty care, two consultation rooms for health coaching and mental wellness support, a medication room and a two-chair dental suite. In addition to a welcoming reception/waiting area, there are clinicians and staff working areas, and a breakroom for staff and volunteers.
Clinic by the Bay’s former space was shared with a chiropractic practice, requiring significant setup and breakdown each day, and with a limited operation of two days a week. The design of the new space is a marked improvement, incorporating modern features on par with leading national healthcare facilities across the region. Since moving into the new location, Clinic by the Bay has more than doubled their operations, providing comprehensive dignified care for their patients, five days a week.
A site rooted in healthcare history
The new clinic occupies one of two buildings on a historic landmark site owned by the City of San Francisco. Originally constructed in 1933 and designed by city architect Charles H. Sawyer, the buildings served as the former Alemany Emergency Hospital at 35 Onondaga Avenue and the former Alemany Health Center at 45 Onondaga Avenue. For more than four decades, the Emergency Hospital building functioned as one of six free emergency care hospitals throughout the City. It fell out of use as a hospital in the late 1970s, and later served as an ambulance dispatch center and then a senior activity center. The building closed in 2010, remaining shuttered until Clinic by the Bay took interest in the site and coordinated with the City to lease the space.
The design of the new clinic has brought the building into the 21st century, once again making it a critical healthcare provider for the City. Clinic by the Bay sought to honor the legacy of the site and reintroduce it as a valuable community resource, as the site has continued to hold importance for the Excelsior and Outer Mission neighborhoods since its inception.
“When it was in full operation, the Alemany Emergency Hospital was a part of a network of hospitals throughout San Francisco that was like nothing else of its time, and we hope that through this new clinic we’re able to memorialize this history as well as celebrate Clinic by the Bay’s own history in the region,” said Janet Reilly, co-founder and president of Clinic by the Bay’s board of directors. “We’ve always been a clinic for the community, and it was important for us to bring in an architect like HGA that implements an evidence-based approach to deeply understand what our patients and the broader neighborhood need most, all while respecting this historic site.”
HGA’s design carefully considered the existing design and programming elements of the structures. Much of the exterior of the building was left intact to preserve its character-defining brick façade with architectural terra cotta ornamentation. The original historic building entrance, with steps leading up to it, was preserved and a new accessible main entrance was added. Adjacent to the historic entrance, the new entry is located within the former ambulance entry bay at street level.
Historic design details throughout the facility were preserved and thoughtfully melded with the new modern features and equipment required of today’s healthcare environments. In particular, the original cream and aquamarine-colored tile wainscoting was preserved. New mechanical systems were implemented in a way that worked with these historic details. HGA also conducted substantial community research to ensure the redesign of the building fit within its rich context, translating into bright colors and more vibrant patterns in the remainder of the interior design, as well as the use of new materials like glazed tile.
The 1930s hospital structure included more than 25 skylights to provide light and reduce energy consumption, and HGA used many of these skylights for the same sustainable purpose in the redesign. With a smaller footprint than many healthcare clinics of today, much of the space’s programming had to be creatively reconfigured, while still meeting modern code requirements. One solution involved the addition of new partitions between service spaces to support patient privacy in exam rooms and increase administrative efficiency in work areas.
“It’s been an honor to design this new space for Clinic by the Bay. Their mission to provide critical healthcare services free of charge, with no compromise in care, continually inspired us throughout our design process for the new clinic,” said Kevin Day, design principal at HGA and the project’s lead. “Since 2017, we’ve been engaged with this project team to imagine how this site could be transformed to support Clinic by the Bay’s operations, and it’s exciting to see it come to fruition with an immediate positive impact for the community.”
In addition to Day, the HGA project team included Anna Kempf, project manager and Julie Mendoza-Lollar, medical planner and project coordinator.
HGA’s partners included engineering consultant, Mazzetti and Nibbi Brothers General Contractors
About HGA
HGA is an acclaimed interdisciplinary design firm committed to making a positive, lasting impact for our clients and communities through research-based, holistic solutions. We believe that great design requires a sense of curiosity—forming deep insight into our clients, their contexts, and the human condition. We are a collective of over 1,000 architects, engineers, interior designers, planners, researchers, and strategists, with 13 offices. Our national practice spans multiple markets, including corporate, cultural, education, local and federal government, healthcare, and science and technology. Visit HGA.com or follow us on Facebook, LinkedIn, and Instagram.
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