San Rafael begins environmental review for Kaiser hospital plan

May 9, 2026

Kaiser Permanente Hospital on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)
Kaiser Permanente Hospital on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)
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San Rafael is proceeding with an environmental review of a proposal to replace the Kaiser Permanente hospital in Terra Linda.

Kaiser must either retrofit or replace the hospital by 2030 to comply with state seismic safety law. It proposes to demolish the five-story, 116-bed hospital, which includes 79,325 square feet, and to construct in its place a six-story, 92-bed building of 232,559 square feet.

The city announced on April 30 it was beginning to prepare the state-required environmental impact report, or EIR, for the project at 99 Montecito Road. A scoping session to solicit comments from the public and the city Planning Commission is scheduled for 7 p.m. Tuesday.

“Over the coming months, we look forward to engaging with local agencies and connecting with the community through forums and listening sessions,” said Lena Howland, spokesperson for Kaiser Permanente Northern California.

“We will also collaborate with neighbors, community-based organizations, and partners across labor, business, and education to help ensure the new hospital reflects the needs and priorities of the community we serve,” she said.

“Kaiser has been an important part of our community for many years, both as a healthcare provider and community partner, and we appreciate its ongoing investment in serving local residents,” said San Rafael Mayor Kate Colin.

Colin said the meeting “will be a valuable opportunity for the public to engage, ask questions and help shape the conversation.”

The company is requesting an exception from San Rafael to allow it to exceed a height limit of 36 feet for the area. The new hospital would be more than 116 feet tall. The existing hospital is 85 feet tall.

Kaiser is also asking for a “bonus” to allow the usable floor area to cover 39.5% of the lot size. Zoning limits the floor area ratio to 30%.

The proposal was submitted to the city in December.

Kaiser Permanente Medical Center on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)
Kaiser Permanente Medical Center on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)

Last month, the City Council agreed to hire Environmental Science Associates to produce the environmental report at a cost of up to $457,648. All expenditures for the report are to be reimbursed by Kaiser.

In addition to the hospital, the Kaiser campus in Terra Linda includes six other main buildings totaling 168,765 square feet. According to the project narrative Kaiser submitted, the hospital construction would involve three phases.

First, Kaiser plans to demolish a general services building of more than 19,000 square feet. It includes a pharmacy; a cafeteria; pathology, radiology and cardiology services; a morgue; computer services; and nurse and hospital administration areas. They will be relocated elsewhere on the campus temporarily. Modular buildings and two imaging trailers in parking lot B also will be moved temporarily.

In the second phase, the new hospital will be built along with a pedestrian connection corridor.

In the third phase, crews will demolish the existing hospital and build a rotunda and an expanded cafeteria. The rotunda will operate as the main entrance to the new hospital on its third floor. The hospital dropoff area will be reconfigured to include a vehicle ramp.

“Plans for the new hospital include a thoughtfully designed facility with up to 92 private patient rooms, six operating rooms, advanced technology including MRI, CT, and specialty ultrasound, clinical lab services, inpatient pharmacy, and full cafeteria — reflecting today’s modern care and continuing to meet the needs of the community,” Howland said in an email.

“Beyond delivering health care, this project represents a meaningful investment in Marin’s future,” Howland said. “Construction of the new replacement hospital will generate hundreds of union construction jobs and spur real economic activity for local businesses.”

Howland said the current hospital, which is nearly 50 years old, will remain fully operational throughout construction. The goal is to complete the new hospital by 2030.

Kaiser Permanente Medical Center on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)
Kaiser Permanente Medical Center on Montecillo Road in San Rafael, Calif., on Tuesday, May 5, 2026. (Alan Dep/Marin Independent Journal)

The environmental report, required by the California Environmental Quality Act, or CEQA, will evaluate the potential impacts associated with the project, alternative designs and ways to reduce disturbances.

“Primary topics may include traffic and circulation as well as construction-related impacts, including air/noise/greenhouse gases,” city planning official Greg Minor said in an email. “In addition, issues like aesthetics and historical resources may also be of concern due to the taller building replacing the original hospital structure.”

Minor said the environmental consultant want to hear comments from the public about issues of local concern.

“For instance, studying certain intersections that are known to have accidents or concerns about construction timelines and duration,” he said.

Minor said no formal action will be taken at the Planning Commission meeting. He said the scoping session is part of the state-required process to satisfy CEQA, “but also an opportunity for the public to provide input and to hear about the project in general and the timeline for preparation of the document.”

The Planning Commission meeting will be in the council chambers at San Rafael City Hall at 1400 Fifth Ave. Planners are accepting written comments for the scoping period through 5 p.m. May 29. Written comments should be emailed to kaiserhospital@cityofsanrafael.org.

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