>> this is a special joint hearing of the san francisco planning commission and public health commission for thursday, march 10th, 2011.

i am not sure if anyone is in the overflow. if your name is called, we will give you time to come up so you can participate. because the room is crowded, let me ask everyone to turn off your phones, and the electronic devices that can sound off during the proceedings.

please take your discussions outside. it becomes extremely disruptive to the process and the commissioners cannot hear adequately if you feel the need to engage in another discussion. the commissioners will not tolerate any discussions. we ask that you respect the process and we will respect your rights to participate in the process. >> i wanted to announce for the individuals and groups downstairs that after -- makes their presentation, then there were two groups that requested 10 minute blocks of time. we will hear them afterwards. and then after that, we will hear from those who have asked for reasonable accommodation.

then we will go to general public comment. >> and we are limiting the time to two minutes to address the joint body. >> as you know, this is regarding the california pacific medical center long-range development and tonight's meeting is the first of three meetings to cover the detail of the upcoming development

project. if there was three hearings in the fall of 2009 including one joint hearing of the to the institutional master plan which included discussion about their proposed projects under review. there is also one hearing regarding the draft eir. the goal of this series is to provide a more in-depth and up- to-date discussion about these projects and the progress made on some topics since the hearings. we would like to remind people that these are not for making comments on the draft eir and we would like to everyone to focus -- have their comments focus on the informational hearing. we will present a high level overview of the project, the strategy for complying with the seismic safety laws and the plan for health care delivery. the director of public works is here. the goal is to hope is on the

health-care delivery plans, not delivery themselves. at the next hearing, we are proposing to discuss the architecture. the new buildings include a new hospital to oust the existing acute-care services. these will be a specialized neurosciences institute and a new hospital that will replace the existing hospital and provide for new medical office space or expansion space. we also propose to discuss a detailed overview of the rounds surrounding the improvements. at the third and final informational hearing, we are proposing to look at the development agreement. this is a vehicle for moralizing a series of -- that can easily be dealt with through standard

use of approval. this is through workforce development, housing, transportation, health care agreements. -- will provide the documents at may 12th. we proposed a presentation on the request followed by initiation of the general plan amendments. certification and action is currently scheduled for about a month on june 9th. if there is a topic we have not included in the schedule that you think would be helpful for the commission and public to understand the project, please let me know. that concludes my presentation.

>> good evening. this will not be the last time that we will be meeting together in joint commission because of the roles we have in our master health plan. i want to mention that -- and his staff have been great in working with us. i wanted to let you know. we are working together and this will be an item that we will put together. included in your packets are two resolution passed by the commission which provides the framework for the department of health position on the brief. those are resolutions number 1009 and this resolution generally supported the facilities.

one of the recommendations was to create a health commission and to their loved out details. the task force met 8 times. the work resulted in this second help commission that is in your packet. this was passed in march 16th of 2010. what we wanted to do is to submit to the full report to not only here the comments. that report will be released.

>> i am the ceo at california pacific medical center and i am delighted to address you and present the plan for rebuilding. accompanying me is the project staff but also the cheek administrative officers. they will be around to make comments. many of you know that we have been in san francisco for many years, and fact more than a hundred and 50 years ago beginning with a german hospital which is now our davies

campus. in 1871, the episcopal diocese opened. in 1895, more than a hundred years ago, -- opened at what is now our pacific campus. we have been with san francisco through thick and thin. in the late 1890's, the california campus created a contagious cottage before there was treatment for diseases like it. and tuberculosis. st. luke's was one of the pioneers in the use of radiation therapy to treat cancer. for many years, are pediatricians struggled against discourage of polio including the development of some of the most advanced treatments at the time.

we remember the days when the davies' campus was a place where some many young men and people of color came for treatment. we have a system of care as represented here. this does not mean more important, it means more acute. that includes outpatient care and the blue services. we provide a comprehensive set of services to the residence of san francisco. this is no longer just delivered in hospitals, this is delivered in thousands of offices and clinics. if we looking more details about what we provide for outpatient care, you can see not only

physician offices but a community clinics like our family health center. this is in our diabetes centers. of course, urgent care. we provide about 40% of all of the hospital care in san francisco and we are proud to deliver half of every baby born. a third of the emergency room visits. 70% of what we do is taking care of san franciscans, the other comes from people who -- from people who come outside of the city. we are proud to partner with other hospitals in the city, usually chinese hospitals.

the purple here represents rehabilitation and recover care and services that we provide insight i treat including an inpatient unit, the nursing facilities which are the only hospitals that continue to do that. home care and hospice. truly, the entire spectrum of what a delivery system should do. we have been here a long time and we will be here for a much longer time in the future and this is to build seismically- safe hospitals. our facilities can remain operations. we designed this plan so we can improve the quality of care we provide without interrupting the

current care that we provide any of our campuses. this is having a construction project at a hospital site which is a difficult thing. we will be able to maintain our regional centers of excellence in san francisco. we will help to control the rising health-care costs. we have committed to build a two major facilities simultaneously. we will pull this off, i promise. we have made many commitments that i will review which will provide important benefits. last but not least, we will retain well paying jobs in san francisco.

i want to take a minute to review the status in san francisco because this is not a pretty picture. this is a map of san francisco. this represents market street and traditionally, this is used to divide the city into north of market and south of market. what you can see is that right now, most of the hospital beds are actually north of market although the population is split relatively even. none of these facilities meets the highest standard of seismic safety. we don't know how we will provide care at the time of greatest need in the city. our proposal and the proposals of other hospitals are remarkable.

by 2015 or 2016, san francisco will have five new -- hospitals. chinese hospitals north of market and then a three hospitals south of market. the new mission bay hospital, san francisco general, and our new campus. these will be taken from the facilities that will withstand a major earthquake. i showed this next slide with trepidation. i am disclosing something that we all know which is right now, we don't have seismically safe service facilities. our campus signifies a significant risk of collapse in the event of a major earthquake. our california of buildings range from one to three.

we're having to do some more right now on the building just to keep its standing. the campus is the most seismically -- facility. this will be allowed to remain operational until 23. -- 2030. this reviews the state -- which dictates the size and safety. this was actually enacted in 1994. this is shocking almost 17 years ago and it requires all of california hospitals to meet these standards. this has been an enormous undertaking. you can see there has been a sequential modifications of the requirements. the bottom line remains that we are expected to be in compliance with the seismic standards by

2015 or 2016 according to the state law. our plans are not just about rebuilding. we will eliminate transferand. , it's talwe will avoid the lif- threatening delays that we have. one of the things we have learned is that the volume matters. we would like to see enough patience with a particular disease so we can provide the highest quality of care to those patients. we have many regional centers of

excellence where patients come from northern california to get care for surgery, transplants, neurosciences, and we're very proud of our obstetrics program. this is an opportunity for us to build much nicer facilities, better healing environments for patients. they will all be private rooms. they will have the ability to -- this is a picture of what we hope the new st. luke's will look like. we recognize the need to control rising health care costs, consolidation of two of our campuses will help us do that by reducing duplication of expensive equipment, having a more energy-efficient building,

reducing administrative function. we would like to optimize the distribution of care throughout san francisco and the integrated delivery system. we would like to quote of the former -- and this will not exist in the city because there are not enough specialists and to be very good at something, you have to do a lot of it. here is our construction schedule. you will note that it has us starting in 2011 with completion of the campus which is a slightly easier campus to build. that will enable us to be in compliance with the current law.

i know the whole commissioners will remember this. i would like to review these because i think we have made substantial progress. we promise to increase our charity care and the amount of care we provide for medi-cal patients. there was a 43% increase. the subsequent increases were 34%. we have continued to provide substantial amounts of shortfall which is the fact that they reimburse every hospital in the city with a couple of exceptions. this is roughly $60 million a year. we will also provide $10 million a year and other benefits such a year and other benefits such as support of to the agencies.