particularly each different, i know there are needs and challenges for each locations and to have a group responsive to that would be great. i am curious because the overall project 33 percent less beds, i want to understand what changed . sit -- is it because of health care reform that changed the number of beds. we also do not want to not have enough beds. >> good afternoon, commissioners. i'm jenny lee. a member of the regional management team for cpm c. in terms of the how we came up with the revised plan, i think

we are one of the key drivers is health care reform. as mr. antonini indicated. there are definitely from a health care planning and demographic perspective a support for our fairly flat line in terms of utilization of hospitalization in the bay area. so today, on average we have about 400 patients in our campuses throughout our entire campus. in the future, we hope to be able to move forward. we will have about 500 beds. given with health care reform and collateral investment and outpatient services and community base services i think that will keep a lid on otherwise rising hospitalization. that plug fairly motion modest

demographic growth will limit the number of beds. we have 400 hospitalized patients on any given day. we don't expect that to dramatically increase. in fact we see stability over the foreseeable future. >> great. thank you for that answer. >> i think this goes a long way in a lot of the right directions. i think everyone talked about making saint luke's a more function at facility and the utilization rate makes a lot more sense. why should they have more beds, and it makes more sense. i like the change in the jobs. i remember having that conversation about 40 jobs per year and i understand there are a lot of people moving from existing facility to new facility and there may not be a

large amount of new jobs but i always thought a percent made sense. i do feel this is fought -- thoughtful in an a lot of different ways. i look forward to seeing the plans and some of the drawings because i know in general we had some building forms and other issues with previous reiterations of the projects. in terms of what has come up with, i think it addresses a lot of the issues that were out stand federal -- from the time at the commission and we are working with the community to work with the project that a lot of people can feel very proud to be proud of and i look forward to the next conversation around moving forward in the future the collateral agreements and other things. more than other things, i want to say i do support

initiation but do look forward to seeing more of the details. thank you. >> commissioner wu? >> thanks. i'm very impressed by the work of lou gerardo. all the changes so far. it's so great to hear public comment. i remember the last time around and this feeling is very different. i appreciate seeing the changes in housing and transportation the most. i'm glad that what was it a b m r program is gone and i think it's more clear than what the benefit to the city is. and then wanted to say i do support. i'm not sure if this is a collateral agreement. it sounds like the coalition is invested in the idea of collateral agreement and maybe you can bring the information forward at the next hearing about that.

commissioner moore? >> this is indeed a remarkable effort with a capital r. i have never seen anything quite like it. it speaks to the ability of peak to -- people to stay in a project. i would like to congratulate everybody. it's amazing. i am very pleased to hear that the environment preferred alternatives chosen which does not make us consider variations or modification but there is something solid that has been examined for those aspects which indeed give us the ability to support and eir or not. i'm comfortable with that. on my part there would be an on going involvement for monitoring the collateral agreement as mr. rich said. the issues are so complex but i do

believe that more ears and eyes which are more familiar with the negotiations should stay involved and i actually commend those who are willing to do this. this is extra time and extra effort. this will take ten years or more of really being proactive and monitoring those involved and not those just volunteering to being involved. none of them have a personal benefit over this whatsoever. i would like to speak about one small aspect and it might be in the nature of having to push out this complex document. you touched briefly on it that there is no physical manifestation of what it will be we are supporting today. there is none and it concerned me that there is a certain amount of vagueness in the way that you are wanting to

extend non-specific approval mechanisms which are in approving or denying a project in a development agreement. i want to ask mr. rich to make notice of what i'm saying. in the text -- as referenced toast to the unique requirement of medical centers. they are normal buildings except they are in this case regular -- regulated by s b requirements and what is typical for california which are parts standard which deals with the health program and development standards which primarily address how the hospital functions on the interior and how it delivers services without getting too specific of what it is. i see references in

here which concern me of their vagueness that might change leverage to the building that might affect the public. over hangs, facade, i'm making them up. they are unnecessary of using the justification of a medical center, this is not even a medical center are unique buildings. they are unique buildings for reasons that i say but not enough architecturally to allows those kind of lenience. i urge you to speak to the architects, that lenience is a concern to me. all of us for the next 50 or 75 years will be the public

recipient of a building that still needs to be appropriate architecturally good, whatever the add -- adjective to use. it needs to be a good building and it can't fit things which don't fit the rules to apply to the other things. i would like you to consider how you describe that and where you want to give lenience and not. that is a personal concern to me and i would like to put that to public record. thank you. >> antonini? >> i'm not going to dispute the sutter health but being in the health care field and through the advent of dental insurance, but being covered in a significant part of it is over a part of the utilization fact. i think the percentage of

utilization in dentistry is the same as it was in the beginning of dental insurance in the 70s. a lot of people don't a veil themselves for the benefits other than the cost. i hope people will take advantage of preventative care and reach other health care professionals early in their treatment so they can be treated for outpatient so we won't need the number of beds. so i'm not argue ing with that. we have seen large population and particularly job growth in the bay area with particular evidence on san francisco bay. i think we are going to see more people in the bay area and in future years and even if areas where people think they are being set to san francisco

presumably for the care they may need if they have a special condition. i'm not saying you won't in the future need more beds, but i want to make sure we have not precluded the ability to expand if that's ever necessary. my other question is the monitoring, the question about other groups having input as to monitoring. what is the monitoring? is it going to be by the mayor's office, cal pacific, who is going to monitor and make sure these things are done? >> the way that chapter 56 of the administrative code reads is planning director is responsible for monitoring. if you tried development agreement it acknowledges the predominance of health care related obligation of the

health care monitoring and includes the health department in the process of monitoring. we have met with the community coalition about the report about the complexity of the monitoring needed an the desire to have a community role. we are working on a response to that at the end of the day, the primary responsibility unless we change will still be by the planning director but i think we all recognize that we need to build a more robust plan around it. >> commissioner hillis? >> i just want to elaborate on that. can you talk about the collateral agreement. i don't think we have done that before. we don't have many d. a.'s. >> it's in chapter --

>> do you know why it's put there. >> i just want to let you know we've been talk together city attorney to talk about what this means. we are definitely working on it. >> i agree with you. this is more complex than what we have used d. a. for. it back in the olden days when we have had redevelopment. >> it seems like something should be done. and on the parking, you didn't quite finish. why was supervisor chiu interested in that? >> i think that a large park offering a lot of parking that

probably would be mostly available in the evening would attract a lot of traffic that would park there for the bars and restaurants. again, i hope i'm getting this right. they are concerned about a lot of traffic generated to the neighborhood in the evening hours by such a generator. >> yeah. why 7 p.m.? >> it's the evening. >> okay. on the affordable housing funding, it says in your term sheet. forgive me, this may have been discussed prior to. is there a geographic limitation to where the housing of funds? >> there are not a limitation to where the funds can be used.

the reference there and probably your colleagues don't want me to spend the 45 minutes of this whole thing. this requires the cu to not have housing as part of the medical project. so it's about providing, bringing in the ability to provide affordable housing that is again generated by the project. >> the tunnel under van ness was part of the project? >> it's not new. it's been a part of the project. the approval was dealt with cal trans long since basically waiting for that project to be an approved. >> that was the patient >> yes. it's not open to the public. it's just for transporting patients across the street.

>> the development agreement ordinance was designed to deal with mission bay. at the time they did not want it to be a redevelopment area. he did not redevelopment, they did not want anything to do with redevelopment. that was sold to a national housing developer and in fact abandoned the old redevelopment agreement and it became a redevelopment area. the development particularly developed for mission bay which had a series of open space. there were in fact 3 collateral agreements reached with with city and the community based

groups. the neighborhood house was made the center of collaboration and community based to over see the employment development commitment made by the original development agreement for mission bay. an open space conservancy that now pretty much exist as the mission bay creek association was over seeing some 35 acres of new open space development for mission bay. the housing community housing organization was december made to over see the application of the affordable housing agreements in the original mission bay development agreement. the principle issue was how to deal with, remember these development agreements are supposed to last. this one is projected last 14 years.

mission bay, the original development agreement was expected to last for 25 years. there would be changed inevitably, changes would occur. and what the collateral agreement, what the community based groups that signed collateral agreements were to deal with were the language in the development agreement ordinance that drew a distinction between material changes and immaterial changes. the planning director can change with an agreement with the developer make small adjustments without going back to the commission or anybody else. if it is considered to be a material change in the development agreement, it has to come back to the planning commission and if there is a collateral agreement with a community group must go before, must reach an agreement with

that community group as well. so that was basically the notion of the collateral agreement. it was limited around affordable housing and other public amenities. there were in fact three signs in the original housing development for mission bay when it was aggregated and what replaced it was a project area, redevelopment area. you are functionally right. it is basically the same as cac. it has the basic function as the cac. cat l.a. did not want it redeveloped as a redevelopment area. in many ways the redevelopment ordinance, the power was invested in the planning department as opposed to the redevelopment agency.

the collateral agreement basically dealt with citizen participation. >> commissioner sugaya? >> yes. i guess mr. rich, during our hearings previous hearings on this development there were people who testified and also i think reactions from the commission revolving around psychiatric services. a lot of discussion around psychiatric services. i don't know if that's being addressed here or not. >> i will try to address that. i would like to caveat anything i say that i'm not the public health folk. i think we can certainly by the next hearing we can have them here and we have them elaborate on what i say. there is in the health care innovation fund which is

one of the requirements that cpm c funds to the tune of approximately $900 million, one of that is to provide outpatient psychiatric care to our community. she prefers to beef up the city's ability psychiatric outside of acute care hospital. if you add beds, psychiatric beds and there is no place for folks to go when they are discharged from the hospital, then they have to stay in the hospital, which isn't good for anyone. barbara prefers to see the beds outside of the hospital and that's what this is designed to do there is no provision in here for psychiatric beds ends the

hospital. >> it would be good if she or one of her representatives came. i think the question is going to come up again. also one of us who visited the psychiatric facilities, we were also given the same -- in addition to the need for additional beds. they also emphasized the need for community based services also. it would be good to hear from her. as long as you are standing there or maybe it's miss -- wadi. there is reference here, i would like to understand now or maybe later, on section 10425, where parking should not exceed 15 -- 125

percent of the planning code. why are we choosing 125 percent. does that mean that we can, i guess i need an explanation on what that means? >> i'm sorry about my memory. we may have to get back to you on that formula >> as part of that revised, we did reduce the percentage. >> with respect back to parking, cpm c is studying the best way to achieve the reduction of 237 spaces. i assume that study will be completed and will be incorporated in whatever new

design will be looking at. >> that maximum of 990 or 125 percent is for all 3 parking garages which are part of the cathedral hill project. i think what that means that cpm c doesn't know whether they should, how big each one should be, they just know it can't be bigger than those numbers total. >> okay. that includes the 1375 sutter building. was that always part of the deal here? >> okay. commissioner moore. >> questions which you might not be able to answer today but might have ready for the next presentation. in the previous discussions that it included garcia's conclusion, have we

acknowledged the emergency response. >> i would have to remind you that we still have at saint luke's the same size emergency room that we did before. the actual provision and i don't believe, i will double check with cpm c, i don't know if the one at cathedral hill is getting smaller or not. but the emergency access. >> in case of earthquake, the emergency response. >> i will get back to you on that. >> i was going to move to initiate. >> second. >> commissioner sugaya? >> yes. i should have said it when i had the mic before. i think i'm also in support of some kind of citizen participation and collateral agreement and c a c whatever

the manifestation is around the whole development agreement and it's provision. so. >> that was a motion to initiate both sites. on that motion, commissioners? that motion passes unanimously. it places you under public comment. i have no speaker cards. >> is there any public comment? the meeting is adjourned. >>