rental tents whatever fee they charge themselves. there are actual no resident members although they are bar oranges. it has no residents at all. they are the ones who have wrecked the area. at the hearings on the polk improvement, people from other districts said that area is dangerous. it's dirty. they are the ones who did that. >> next speaker. >> good afternoon commissioners. my name is gordon. we are here to express our support for the new project that is being presented and

will be going through the public process. we want to really acknowledge all the hard work and good work that went into the new project proposal by the mayor ken rich and other city staff and the board of supervisors and cpm c. our coalition has been working for the last three plus years to ensure cpm c is built in the right way and we are proud to have played no small role in the much improved term sheet. think other speakers noted that we are interested in committed to continue to be part of the process to ensure that particularly the community benefits are really going to be delivered and realized in the communities here that need it in terms of the health care benefits, housing and work

force and job benefits and the neighborhood and pedestrian and traffic and public transit i am improvements. we in terms of the work force issues, which i as a director of jobs of justice and part of the coalition have more focused on a real community voice in the implementation of the work force commitment both the local higher commitment and the $4 million that cpm c is committing to support work force development. there is a lot of projects that come before you and the board of supervisors that come around you particularly in local higher. you remember fresh and easy, projects making promises of local hire in their store where the reality they have not

met that at all. and there has been very little enforcement and monitoring and holding fresh and easy accountable just as an example. i think we want to be a resource for the city to ensure that work force commitment and particularly the local hire and the job training that is being provided is realized. thanks again, commissioners for your work on this. >> good afternoon, commissioners. jim lazere ritsdz. thank you for reaching and historic agreement for reaching the health care facilities in san francisco. from day one the chamber has supported not only this project but other projects in san

francisco. whether it's general hospital, chinese hospital, u c s f mission bay. for reasons, public health and safety, no. 1 but no. 2 the health care facility is key for our growth. medical education, medical research, clinics, hospitals and medical professionals comprise in dollar value the largest segment of the city's diverse economy. we always said the diversity is always our business. in total dollar value is medicine in our number one business. a medical destination because of the facilities we have here and will continue to be that destination because of actions of city we strongly urge be taken over the next few

months to initiate this general plan amendment today to move this project to final improvement fort from the board of supervisors by this summer, thank you. >> my name is ramirez. i'm representing the hotel and the van ness corridor situation. thank you for letting us speak. we are very much in support of this project. we are right across the street from the cathedral hill property and we want to see that built and filled and have something there to build the community around and to really support our businesses. thank you for your time. thank you. i'm so excited

to be back here in front of you in support of cpm c. i'm here to ask you to please prove approve the development. i'm a project engineer and the general contract that is going to be building this hospital. i was unemployed for 2 years before i came to work on this project. and i have found full time employment with them. it is a great feeling to know that to say that and now i can provide for my family. today i have to tell you that i'm feeling hopeful and optimistic. knowing that you are considering this project. i'm happy to be supporting a vision that is a reality. i am also happy that we'll be able to happy hire men and women in

the construction industry. it will bring benefit to jobs and health care. we'll thrive while we go into construction and well after completion. let me thank you for working hard and considering this project again. you have the power to change people's lives. please support this project and approve the development agreement. thank you. >> good afternoon. i'm the director of coming home hospice . cpm c has been providing residential hospice care at an affordable price for the community. i have worked with

cpm c now and i remember my orientation as a new employment was hearing the exciting news about the hospital that was about to be built in san francisco. that was 10 years ago. our patients and staff have been waiting for the new hospital and cannot and should not have to wait any longer. the project is about bringing seismically developed hospitals. there is no reason to delay this project. i urge the planning commission to approve this project so the community can benefit from such a medical facility. thank you. >> president fong, commissioners, my name is calvin welch and i'm you from

the housing community organization representative to the community coalition of san franciscans for health care. we are requesting the development agreement include a collateral agreement, council community housing organization helps negotiate when dinosaurs roamed the earth a developmental agreement and allowing for community participation through collateral arrangements and we are seeking through departments in order to look at 3 in particular and provide in 3 particular areas health care, the health care aspects of this proposed development agreement, the transportation of traffic elements and the work force elements. it's important to

understand without tripping over anybody else's narrative. how it is that we came where we are today. on july 31st that you approved, it was dead. there was no deal. i hope you don't think that mr. gerardo fell off the back of a baking truck. the point i'm trying to make the notion of an approving a negotiator with complex issues with the board of supervisors being a participant and a very broad selection of board of supervisors, president chiu, supervisor campos and

supervisor ferrel, each expressed an interest, supervisor choou with transportation issues and campos with the longevity of the hospital and supervisor ferrel concerned with the financial impact on health care cost to the city and county of san francisco of the deal was all put together with lou gerardo by the request of this coalition. what was followed, the development agreement important elements of the development agreement by this commission by this coalition. we are aware of the dynamics of this project and we are requesting the collateral agreements to be involved in the actual implementation of this project. i think the coalition has demonstrated it's ability to solve problems. we

want to continue to solve problems. thank you. >> any additional public comment? okay. seeing none, public comment is close. commissioner antonini? >> i am supportive of this here but i very much liked the original plan and i'm not quite sure why we need to approve a hospital that was what it was originally. i believe this is a regional medical center of the caliber of stanford from south bay where you put your best and brightest and all throughout the system where people have special needs and need the best of care, they are sent to the van ness hospital. so i hope that's still going to be the case and i remember the whole process we went through and i know very much about the

packard hospital approval and stanford and what they gave to san mateo county and it was a lot less than sutter to san francisco on this project. those are things that have to be worked out politically. i do have some specific questions for mr. rich first of all. the 75 percent utilization rate for saint luke's before cal pacific can increase their van ness hospital by 30 more beds. isn't that arbitrary? it depends on how many people are ill. >> let me give you that background. one that was not on the current agreement, a 20-year guarantee to keep saint luke's open. that was replaced

to the better satisfaction of everyone. not only did saint luke's get bigger but cathedral hill got smaller. it is the fact that now saint luke's is 25 percent of the total beds in the system that gives everyone the confidence that it's not something that cpm c would be able to close. it's too big a part of the system. that is a very difficult situation to negotiate around and we had negotiated those respective sizes, 274 beds which results to staying to the same number of beds. cpm c came back and said we want to go a little bit bigger. that might start to upset that balance but to get around it2s guarantee that

saint luke's was using all it's beds and looking into the matter we discovered that the practical maximum daily usage in any hospital is about 80 percent of the beds because of swing states. we all believe that if saint luke's is using 75 percent of it's beds, that would mean saint luke's is fully utilize. that space can be built and used for patient rooms. the only trigger attached to it is they can be made for rooms and lab space and not for patient rooms until it's at that operating level. >> thank you, mr. rich. i have some concerns because one of the justifications for the hospital to be smaller with the theory that with obama care and

broader care people would need hospitalization. i'm not sure that's going to be the case. if that is the case, where saint luke's would have the same lower utilization if we need fewer beds. >> i think the best response i can give you is the number of beds came out of cpm c, not really the city during these discussions. this is the program that cpm c came and said this works for us. there is nobody better to decide that. in the other thing maybe you can answer this next question or i may have to talk to a representative from cal pacific. i heard from your presentation that cal pacific is determined from what's going to happen there. that is an option that could remain an acute care hospital. >> i would refer to a cpm c

representative. i would say that hasn't changed since the last time. the general feeling last time was that cal would not be maintained but they are not saying that definitely. i do know the california campus cannot remain an acute care facility without a lot of seismic. >> i understand that. i didn't think you needed to reduce van ness to do that. the other thing never bothered me too much about the fears that saint luke's would be close is that you have a brand new seismically sound hospital that could always be acquired by the city and county or another provider that would provide the same service if the sutter system didn't want to do it. i don't really understand why we have to play one hospital against the other. i'm not being critical, just my points

of view. you are saying if for some reason you build it and you don't want to operate it then the city can acquire it. that same philosophy could apply to that. i have another question about our charity case. that a number of thousand of charity cases and medi-cal but you are saying in addition to that there is going to be another 5400 medi-cal patients to another 5 million. i don't understand that. >> that's parallel to the first time around. you recall the first time around we set a baseline, we said we want you to keep doing what you are doing and we want to in terms of the ways you do more, we want to you take care of medi-cal management lives through health care reform. we are going to see as health care reform causes medi-cal to cover

more san franciscans, they will come into the system as managed care beneficiaries. we originally had a dollar amount to keep doing what you are doing and another number with a 10,000 over an agreement that you have to do over and above that. so what's changed on that, in other words to keep doing what you are doing is now counted in a number of patients which works better because you don't have to worry about inflation and we just say we are in the process of now beginning an audit of cpm c to look at their average on duplicated patients as to who qualifies as medi-cal or charity care. we think that must be will be around 30,000. we'll confirm it with this audit in the few weeks. that's the base number and how many patients are tried -- treated in the hospital every year. cpm

c needs to be the hospital partner for an additional 400 managed care patients. as we get more patients through the health care reform, they will be covered under different primary care providers and cpm c needs to be the hospital providers. so whenever they need to come to the hospital. cpm c providers the care. not all will go to the hospital. you can't add that 30,000 because it's how many people go to the hospital every year. the 5400 that cpm c over and above is responsible for those that go to the hospital for care. the 30,000 number is out and inpatient cared for directly by cpm c. the 5400, think of it

like insurance. in whether it's one or 53 hundred in a given year, cpm c has to provide care for them. it's a managed care model. >> there are some similarities. remember if there was a concern if you made it medi-cal lives only and there were fewer med patients then their charitable contribution would have been less. i have a couple more questions about parking. there is less parking now. it seems to me if there are concerned about congestion because you are on us 101, on a congested area, if people are utilizing the hospital either visitors or staff members or others you would have them pull into a parking place and circling around. i don't know what this is supposed to gain us. >> i think basically we just --

and i will note that the saint luke's project even though it got bigger did not add more parking spaces. cathedral hill, is basically just reducing the size of the garages more or less proportionally with the size of the buildings. it's nothing more complicated than that. >> one of the final things is you didn't mention the elimination of down payment assistance which i believe was one of the most brilliant parts of the original plan because everybody is always yelling about middle income housing and this is an opportunity to get it built and now it's not there anymore. i'm not sure why that's there. >> as we struggled with the difficult task of looking at a finite source that it could legitimately used, that's one of the things that didn't come out through the other end and

turned out in order to balance everything it was the way we did it. i don't have a scientific answer for you on that >> commissioner borden? >> yes. thank you for this presentation. we spent a lot of time on cpm c and happy to see some of the issues we had discussed previously even though i did support the plan before there were a lot of issues that we didn't feel got resolved at the commission but felt it was a point that we needed to pass it on the to the board of supervisors to get it across the goal line. in terms of the transportation dollars, what is the change in that what now is the transportation of what was going to be paid into transportation before? >> i'm doing this out of my head. there were 3 main pots of money before. they are still

there. they were funding for the van ness and b r t project. there was funding in lieu of t i dvment df. and then there was the parking fee and we and this is really just a guesstimate where we estimated 500,000 a year. we are now estimating 300,000 a year. it's a little low because the parking lot went down by less than 2/5. the change this transportation funding is reflecting the smaller size of the building. i would also note there is some new sources of transportation funding that

appear here that are funds which the city can ask cpm c to monitor congestion level at cathedral hill. if they are not acceptable levels there is a small amount of funding that we can help to ameliorate that. >> and maybe you can talk about the anticipated timeline assuming this gets an approved and the timeline for the cathedral campus winds up for the project? >> construction? we are going to sit down. i will have a better answer for that and i will be happy to get to you. we'll get down next week and with city experts to look at the construction schedule. i'm told by cpm c they expect to have construction finished by 2018. in talking to them about when they wanted the funding for b r t, they gave me

2015-2016. i know you had that concern last time and we revisit the confluence on the hospital with b r t with you. >> that would be ideal. with b r t would come online with the same time with the hospital. if you are tearing things up or building a tunnel where all could overlap nicely and we can coordinate and maybe as part of the next consideration of any conversation anything formalized will make sense to me. you also mentioned no parking during the daytime. i don't understand that? >> this was something that was

particularly recommended by supervisor chiu and talking to cpm c, just to remind everybody. it doesn't affect patients or staff of cpm c, it only facts of the ability of other people parking in the garage. >> i thought if you are trying to encourage people. >> patients and staff can always park in the garage. >> okay. fine. in terms of drawings when are we going to see the new drawings for the projects and because i think that's what a lot of people will want to see. it gets distributed in a packet. i know there is a thoughtful revision

to reflect the changes and side. we are still working with the same vocabulary of building and the same general material palette. we are definitely going to have them put some thought into how they adjust the building into reflect those changes. >> i have a couple more questions. in the last conversation we talked about a community advisory committee and if there has been a conversation about this collateral agreement. but i know this is a little different because of other neighborhood plans there is impact fees and there is money for that discrete group to oversee. can you talk about that. we talked about community advisory communities. >> i want to separate a few things. the d. a. had that.

that's not what was discussed by the speakers today. we did meet with the community coalition a couple days ago. i know they have requested a meeting with the planning director and we are working through how to address those. it's premature to have an answer only it was a couple days ago. i will say i think it's pretty clear this is a very complex agreement to monitor. it involves instead of mostly development agreement or mostly monitored by their planning department issues that are monitored, these are public health transportation work force issues, really more than they are planning department issues. the planning director is invested with the responsibility to monitor and this is a job to do so we are working with how to respond to that clear need. >> i