Campus Messages

An archive of email messages sent to the entire UCSF community by the Chancellor and members of the Chancellor's Cabinet.

UC Affiliations and Access to Care

Dear UCSF Colleagues:

I am writing to share with you a development in an important discussion taking place at the six UC campuses with medical centers and the Office of the President about UC’s affiliations with other health care systems.

After we shared with you last week the progress the University is making on amending our agreements with other health systems, UCSF received a letter from the American Civil Liberties Union (ACLU) asking UC to terminate its contracts with all Catholic health care organizations, and not enter into any new ones. The ACLU’s request cited the Ethical and Religious Directives for Catholic Health Care Services, which prohibit certain types of care—a set of policies that is at odds with UC values.

The unintended consequences of the ACLU’s request

The ACLU has made numerous contributions that have made our communities stronger, for which we should all be very thankful. However, the request to terminate all UC relationships with any Catholic health care organization may have consequences for access the ACLU does not intend. It would also weaken some of the University of California’s educational programs that rely on access to training rotations in a variety of health care settings and geographies across the state.

In straightforward terms, UC’s affiliations with other health systems enable us to train more students, advance our research mission, and serve the health care needs of more patients than we can alone.

Terminating all of our existing affiliations with Dignity Health and other Catholic health care organizations would cause sharp and widespread impact, felt in places like San Francisco where an existing affiliation allows UCSF care professionals to work at St. Mary’s Medical Center, a Dignity facility that has the only inpatient adolescent mental health services in a county that needs more expert mental health care. Without such affiliations, our professionals and trainees also would not have access to Saint Francis Memorial Hospital, which houses San Francisco’s only burn unit.

In addition, the ACLU’s request may violate federal and state laws that prohibit discrimination against religiously affiliated entities. While the University itself must remain free of political and sectarian influence, it cannot exclude entities from participating in University programs merely because of their religious status.

A better solution to serve more people with UC’s comprehensive and specialty care

A more reasonable solution is to update our affiliation agreements with other health systems, including faith-based systems, to clearly articulate UC’s values and expectations, and ensure they are understood by UC personnel working at non-UC facilities. We regret that numerous previously negotiated agreements between UC and other health systems unfortunately contain language that we are now aggressively working to amend.

The University has been pursuing these amendments with other health systems to ensure that our care professionals and trainees will be able to continue practicing medicine according to UC values and standards, including: 

  • Counseling patients on all of their health care options, including prescribing all appropriate medications and interventions
  • Referring patients to UC and other settings when the care patients need is not available at their location

Importantly, this encompasses the provision of comprehensive women’s reproductive health care, gender-affirming care, and end-of-life care. 

Ensuring UC values in care delivery—in all settings

At the University of California, we are bound by our collective commitment to a welcoming non-discriminatory environment for all of our community of patients, faculty, learners, staff, and trainees.

Thank you for your patience as the UC work group completes its work to reflect this commitment in our agreements with other health care systems. To continue fostering a respectful and transparent dialogue, I will share updates from the group as progress is made.

In the meantime, know that the University continues to engage the ACLU and members of the UC community, asking everyone to work together constructively and put the interests of all patients first.

With this shared focus, I am hopeful we will be able to continue to broaden access to care, reduce health care disparities, and improve health for millions of people across California, regardless of gender, orientation, or income.


Sam Hawgood, MBBS
Arthur and Toni Rembe Rock Distinguished Professor