>> thank you. are there any further public comment on this item? yes, good afternoon. my name is hiroshi fakuda. just a few comments in regard to the healthy s.f. master plan. i'm not sure there is enough emphasis being put on mental health services. i saw a line in connection with behavioral health medical services. and i think there needs to be a stronger emphasis on the mental health aspect. it is a major problem in the country. we're having a number of veterans returning from the war and i don't think it's being addressed enough. for example, the cpmc matter, they tried to i think reduce the number of mental health beds. in fact, they should be

increasing them for the future. now, in regards to the western side of the hospital -- the western side of the city, there are very few -- there's no hospitals on the western side of the city except for the veterans hospital. they're not capable of doing emergency services and i think there has to be a plan in the future for some type of emergency services in the event of an earthquake. we know that it's going to happen some time, and we don't have a plan for that type thing. when there is an earthquake, the west side of the city will be cut off because -- well, because of the quake and the problem [speaker not understood] traffic and the streets. so, i think those things have to be considered in the future. thank you. >> thank you. good afternoon. thank you. my name is cindy young with california nurses association and i'd like to really thank

the planning commission, department of public health fo the great work that they've done on putting together the planning document for medical services in san francisco. we want to echo the comments that were made by the chinese progressive association folks as well as supervisors campos' office around looking at the consistency requirement as a whole. and then just as a nurse, i want to say that the elimination of the or not including the healthy san francisco program as a part of the critical need is very short-sighted. when we see uninsured patients come into the emergency room or come into the medical services, they are, you know, so sick by the time they get there, the cost to treat them is twice as expensive. that program is absolutely critical. the employer spending requirement is critical and we should absolutely keep that program in place to save the patients of san francisco. so, i'd ask for your consideration on that. thank you very much.

>> thank you. any further public comment? okay. seeing none, public comment is closed. commissioner sugaya. >> yes, thank you. i think this is really great. back when we wtinyes and years lot of discussion about how that facility fit within the -- within providing health care in san francisco and there was no master plan at that time. regrettably, the cpmc has now moved forward and we didn't have the tool at that time to actually apply what this plan is presenting to us to that particular project. and perhaps if that had been around -- if the plan had been around, we would have had more tools to evaluate the desirability of the cpmc proposal. so, i'm particularly glad that

this is coming forward. in terms of mental health, we also raised mental health issues and psych beds and psych wards and everything. during the cpmc heari and it seems like even though we raised the issue, it has not been getting a lot of attention even in this plan as was just mentioned by mr. fakuda. i think several of us or more than several of us have visited the psych -- emergency psych unit at general hospital and also set foot within the sheriff's department mental health ward also at san francisco general. and it's quite surprising and eye opening, i think, as to what the issues are. when we raise the issue with respect to mental health at the cpmc hearing, cpmc does have, i

think, as i recall, 18 beds over on the california campus or one of the campuses. when we asked the question whether or not those would remain and what part of the plan, in essence, we were stone walled. and there was no promise that any beds would be provided by cpmc. so, i think it's extremely important that the plan have some emphasis within it not only for mental health services at hospitals or clinics, but also the other important part, which was emphasized by director garcia, was the provision of community facilities within san francisco for mental health patients. and, so, i think all of those need to be perhaps strengthened within the plan. healthy san francisco, i have a quick question on the slide

that says 30,000 people are estimated number of new medi-cal beneficiaries. are those currently healthy san francisco enrollees, or is that in addition to? >> they are currently -- they are currently primarily healthy san francisco enrollees, but not entirely. so, right now 94% of adults -- 94% of san franciscans age 0 to 64 either have health insurance or are enrolled in healthy san francisco or a subplan called sf path. the remaining 6% we -- are not enrolled in a program. [speaker not understood] but not entirely. >> and in terms of the comments that were made about healthy san francisco and its retention, i don't see anywhere in here that it isn't going to be retained. >> it absolutely will be retained and will be here for the people who do not qualify

for health insurance under health reform. >> all right, thank you. and then ms. flores, i have a question -- not a question, a comment. with respect to the flagged 31 in which it says public comment starts july 11th, ends no earlier than august 22nd. the public comment that you're referring to is with respect to public comment on the master plan itself? whether this hearing or through public comment, written comment and that kind of thing? >> yes, that is an important clarification. it's on the draft plan which was released and posted on july 11th. >> right. and that's not -- so that the public doesn't get confused, that's different than the -- there is no public comment with respect to the preliminary negative declaration, and there is only an appeal. is that correct? >> that's correct, yeah. that is an important distinction.

so, when the preliminary negative declaration gets released, they will be a statement about the ability to appeal, but not necessarily a public comment period. >> okay, thank you. i think that's just to clarify that usually public comment is mentioned in terms of an environmental impact report. and, so, [speaker not understood]. it's an nd. there is no public comment per se. >> that's correct, because it was largely a policy document, we landed on a negative declaration -- preliminary negative declaration. >> okay, thank you. >> commissioner antonini. >> thank you. a very interesting presentation. as a health care professional with over 45 years in health care field, being dentistry, i have some questions and concerns. my first concern has to do with the consistency determination because obviously i have no

question that any city-owned facilities would have to have their subscribers or members abide by whatever they're asked to do. but we're dealing with privately owned or state-owned facilities. and, you know, medical professionals still have the right to decide who they're going to accept as patients even under the national health coming before us. and many facilities in san francisco have high percentages of patients who don't reside in san francisco. and, so, their patient base who they owe equal treatment care, those outside of san francisco, they have to address that, too. so, and some of these can be as small as 5,000 square feet. so, i would be a little bit concerned about trying to be too strict about geographic locations or the other requirements that you tried to

put onto these facilities because along as they're running a medical facility which is reputable and the care is high level care, they're a benefit for our city, regardless of who their patient base may be. and as was pointed out, we do have a small city, and i guess the furthest anyone is from even a major hospital is about 2-1/2 miles, might be 3 miles in san francisco. so, compared to places in the east bay and the central valley, you travel much further. and the other thing' more important more so than the hospital is the outpatient treatment centers because most of the care is going to be done there. hospitalization is where it's more serious or a emergency type condition. but people do need facilities to be closer to them and easily accessible where they can get preventive health and -- or outpatient type services. and probably the most important factor of all is to motivate

the patient, actually avail him or herself of the services which is probably the most frequent reason people don't get health care, even more so than cost or availability or location is the fact that a lot of people just don't want to deal with it. they don't want to take the time. they don't think it matters. and they don't do anything until they're in an emergency state. so, that's a factor that you really have to put a lot of emphasis in. another thing i would look at is best practices in other cities that have similar situations like ours and see what they're doing just because this proposal is put together this way doesn't mean it's the best way to do it and there are a lot of other cities similar to san francisco in terms of their geography or their demographics and see what they've been doing and some are quite successful, i would think. so, look at best practices. and another factor that i didn't hear anything about is the accessibility in terms of times.

i mean, if a medical facility is available on evenings or weekends, it's a lot -- more easily accessible for patients. so, that's something that you should have as a determining factor when you're looking at whether these facilities will be compliant with the plan. but my biggest concern would be i would feel uncomfortable being obliged to vote a certain way by whether they comply or not with this plan. i mean, as i mentioned, they may be very beneficial medical facility even if they don't meet the guidelines that you've put forward. when we see what those guidelines are, we'll know a little bit more. but i think more high-quality health facilities benefit everybody. >> commissioner wu. >> thanks. i want to thank dph staff and planning staff for what was really a very thorough process. i think that this is really a model of outreach that i hope we can use for other plans at the planning department likes.

i'm also encouraged to see equity as part of the framework for land use plan. i think that that's something that i've been vocal about and something that is just -- i'm happy to see a success in that. there was a lot of public comment about priority 3, increased access for vulnerable populations. i want to lend my support to that, especially with language interpretation. as for land use issues, i think that's a question of transportation access is really important. it looks like there is starting to be some sort of trend towards just looking at the number of trips that are taken on a certain line. to some extent that makes sense, but i think what it's doing is it's prioritizing commuter lines over neighborhood and neighborhoods trips. the neighborhood to neighborhood trips are about going to school, going to the doctor, other everyday activities as opposed to just going to work. so, i think that that's something that we need to watch out for as the tp is coming forward.

there is also something in the plan about supporting healthy urban growth. and i think that one component that i should be added to framework is about displacement also. ~ i think that if -- you know, if you have healthy growth, you can't have it without considering if people get displaced through that development and what that would mean for those communities. >> commissioner moore. >> this is a very timely and important piece. i think it is actually the original discussions about cpmc which prompted this to happen. i am not as concerned about how cpmc got [speaker not understood] because i think the development of policy and the specific design of the hospital helped each other focus on what we need to do. i'm particularly acknowledging ms. [speaker not understood] because she had her foot in both camps. and i think it helps [speaker

not understood] including developing baseline data by which we more thoroughly could not [speaker not understood] how baseline guides policy. i am very impressed by the presentations and comments raised by the chinese progressive association. i support all of them, including what mr. fakuda as well as hillary rhonan on behalf of supervisor campos said, on the issue of mental health is somewhat not clearly addressed. and i do hope that we find baseline data which bring that component fully into realization implementation of this plan. just the day before yesterday there was a strong editorial about san francisco's mental health crisis in the examiner and it listed numbers of the increase and incidences between 2009 and 2012 and the numbers

were quite staggering and i will pass them on to [speaker not understood] or [speaker not understood], either way i strongly urge that that becomes a vital ingredient and spells out policy and not just a vague reference to the list of service which at this moment is unspecified. i am equally concerned about transportation and access equity as expressed by commissioner wu. and in that sense would strongly urge you to help see san francisco program be maintained until we fully have reached a balanced network of [speaker not understood] and as we are able to monitor how the yet to be determined and yet to be implemented health care change out of washington really take hold. every day there is another interpretation that is being

challenged and as long as it's being challenged and not implemented, we are doing better than many other cities in this country and should maintain what we have. >> director ram. >> i just wanted to add my thanks to the staff, to both departments. i do think it was very interesting because we were able to learn a lot more about each other's businesses and that was a very interesting side effect of this whole process. but i did want to just reiterate the request that ms. flores made about whether we want to consider additional hearings. there is a required hearing of both -- joint hearing of both commissions to take action on the plan. but the question is whether you feel the need for additional informational hearings or whether you'd just like us to schedule that joint hearing and consider action, probably in the fall at this point. >> i'd say go ahead and schedule the joint hearing. and if there are any significant changes via memo, you can send it to this

commission. >> at this time that joint hearing is actually scheduled for september 19th. >> okay, great. commissioner sugaya. >> yes, just one comment on the healthy san francisco. i think the assurance that it's going to continue is great, but perhaps as the health reform begins to take shape a little bit more concretely and the program is running in letter of form, it ends up -- and especially here in california, i think that there should be consideration -- monitoring and then consideration given to how the program might change and embrace gaps that the health reform does not cover. you know, i have absolutely no idea what that is at the moment, but we should be keeping our eyes and ears open and tweaking and reforming healthy san francisco as needed to assure that health delivery

is at the optimum here in the city. >> commissioner moore. >> as we are having another joint meeting, perhaps that would be an opportunity to briefly summarize overall locational deficiencies, constraints within -- where the deficiencies are, how to resolve them. policies are great. policies are only as good as you can face them [speaker not understood] and create strategies which address them. obviously the ability to prioritize deficiencies based on other factors, funding, et cetera, et cetera. so, i would be very interested at least in a broad brush to get a specific feel of where we are on that. >> okay, any further comments? okay, great work. thank you very much and look forward to hearing next steps. >> commissioners, next on your agenda is item 7, case no. 2013.0808u, japantown cultural,

heritage and economic sustainability strategy. better known as jches, informational update. >> good afternoon, commissioners. [speaker not understood],

planning department staff. here to talk to you today about the japantown cultural heritage and economic sustainability strategy referred to as the jches. this is an informational presentation, we're here to give you a feel for the process, content. our goal is to come back in september for resolution of endorsement from this body, from the hpc and from the board of supervisors. it this has been a collaborative effort all along. we've been working super closely with the japantown community and economic work force development. i'll be joined later by [speaker not understood] and [speaker not understood] to speak on behalf of those groups. and just want to start a caveat, the course of any multi-year process, we can't convey everything that's been considered in a short presentation. so, if you'll bear with us, if there is something that is not clear or something you think we've missed, please ask. it is likely we've considered it. so, how the process began. it began in the late '90s, planning has been going on in japantown within the community

and with the redevelopment agency. planning department engagement started in 2007 with the better neighborhoods plan. the bmp as it was called additional area plan looked at changes that can be made in neighborhoods -- in the neighborhoods to meet both local and city-wide goals. as many of you will recall because you were sitting up there at the time, the planning commission did not accept the proposed zoning heights and requested that staff go back and complete a business retention plan and cultural resource plan before returning. so, here we are four years later. what did we do in that time? in sum, we kept the good parts of the better neighborhoods plan and jettisoned the rest. [speaker not understood]. which would have created incentive to demolish those existing buildings. the commission also felt that the better neighborhoods plan was brought to the planning commission too quickly and needed some more work on such issues as business retention and cultural resources. that being said there was a lot that everyone liked about the better neighborhoods plan including the core principal

such as vision, goals and objectives. as such we used those at the starting point for our plan. so, start describing the vision of the jches, the japantown would thrive as a culturally rich economic neighborhood apart of the japanese and japanese communities for generations to come. next let's talk about the goals and objectives. these are 100% the same as are in -- were in the better neighborhoods plan. here are the goal. secure japantown's future as historical and can you recall turrell heart of the japanese and japanese community. [speaker not understood] thriving retail district, [speaker not understood] community based organizations, secure japantown's future as a physically attractive and vibrant environment. how does j chess differ from the visions, goals and objectives? ~ [speaker not understood].

its greatest asset and most at risk, its cultural resources. the results, which is the j chess which is a unique and precedent setting document looks at the [speaker not understood]. why is this important for japantown? japantown has been the heart of the city and region's japanese american community for over 100 years. it is one of three japantowns in the country, the other being san jose and hose loss. and over that time it's become home to incredibly dense byness he and social [speaker not understood] arts activities, cultural events, et cetera. ~ los angeles why is this important to the city? in the city we've done a good job of preserving important historic buildings. until now we haven't thought systematically about what goes on inside. in times of intense systematic demographics, unless you strategize these things are likely to go away. so, what do we do? the first step was identify the cultural -- the risks to cultural resources in japantown. we thought about this both in terms of categories of cultural

resources and in terms of individual resources. so, in terms of categories, we thought of them in terms of buildings, organizations, institutions, businesses and cultural events, activities and events as well as the people [speaker not understood]. we looked at the existing conditions in the neighborhood within these categories and with that identified 23 areas of concern related to the long-term well-being of japantown's resources. and as always, when i say with, this is mostly a community-led effort. so, we looked at the areas of concern and and what the community is concerned about. the first is related to the people. the first concern is difficult to maintain japantown's critical mass as a community hub. only 5% of the residents are of japanese heritage. also japanese immigration is much lower than in other groups. so, there is an ongoing concern about how to keep the critical mass and sustain the businesses in this neighborhood. not all age groups have an equal stake in the community. this is from the youth and

young adults have not been given a full seat at the table. lack of cultural pareder vation, kind of gets at the heart of the matter. groups have not historically worked together to preserve their resource he and they need to start thinking about that in a systematic way. related to the land, concern about utilization of developable parcels. even though japantown is conceived as a delta neighborhood, there is capacity for a lot of new development, up to 2700 new housing units and 100,000 square feet of commercial development. based on existing zoning and existing heights and community voiced strong interest in seeing those sites be developed to their capacity under existing zoning. related to the buildings, concern about competitive architectural style. a lot of buildings in japantown are reaching the end of their life cycle and want to make sure that the new buildings on the developable sites and replacing old buildings are compatible. lack of pedestrian scale especially during redevelopment era, a lot of development was done that was not walkable or pedestrian scale.

preservation of historic buildings and structures like everywhere in the city without proper maintenance and upkeep, those buildings will not be maintained. more areas of concern, we have capacity challenges for community serving organizations and institutions. of course there is always a need for money and space for these organizations and there is also concern it is possible saturation in japantown of nonprofits. lack of space for organizations straightforward [speaker not understood]. in terms of businesses, business viability, there is always demand for more people that come to japantown, especially japantown doesn't really draw in the tourist dollars that other neighborhoods do. finding and attracting culturally relevant businesses, a desire to bring those in, but how do you find them? when you find them, many probably never consider japantown even though [speaker not understood]. attractiveness of the shopping district like all shopping neighborhoods questionederctionv trash, graffiti, street names and landscaping.

skip the one on ownership transition. that's the one -- you've had hundred years of families running these businesses. a lot of times the youngest generation isn't interested in taking it over. [speaker not understood] of course when a business succeeds rents go up and there is risk inherent. one of the internal conflicts of planning in this neighborhood is, well, you want businesses to thrive, but it also creates risks to other ones. future of japan center, japan center is the economic heart of the neighborhood. home to dozens of unique businesses and restaurants. yet the building was aging, never designed for retail, inwardly facing instead of being welcoming to the community. it is owned by an outside entity that showed little desire to engage with the city. parking garage sits under the mall, is aging and needs a lot of seismic work. but the loss of parking is seen as a major concern considering people come from all over the region to japantown. concern related to cultural

events and activities, limited space for community activities, similar concern to the organizations is a lack of space. it is also difficulty in acquiring permits for festival, [speaker not understood] onerous process. in the public realm [speaker not understood]. managed by rec and park. redesigned in 2000. and concerned it is not inviting. not good landscaping or seating options and it could use some activation. similar to buchanan mall, it could use some activation. that is a pedestrian mall that runs one block between post and sutter on buchanan. the fountains on there that are historic haven't worked in a long time, other concern. streetscape maintenance, landscaping, lighting street furnishings, these are concerns about the public realm in japantown. signage, people want to see better signage to get to and within japantown. so new york ~ now we discussed what we talked about cultural resource he. this is what we did about

individual resources. [speaker not understood] implementation of the j chess and similar processes elsewhere in the city and beyond. so, the community first developed a list of important resources, 279 resource he they came to us with. and working with the community [speaker not understood] we rounded out that list by reviewing all available literature. ~ we now have a list of 318 resources that are considered important. that list has been on our website for sometime. just want to show you the mapping that we did. these maps come out of the j chess. compendium list of all the related -- so this one, the building structures. i don't want to show you the list of the final b tiny, but this is a list of what's in the j chess. organizations and institutions have been mapped in the neighborhood. the businesses obviously clustered around the mall, buchanan mall. and the cultural resource he and activities are focused on the malls themselves.