management company. this manages the health care project and construction including several hospitals. >> i have had an opportunity to review the impact report mitigation plans this is that the various sites. this is the construction ordination plan. this has been fully disclosed in a very professional manner.

this has been addressed in a very major way entities have been addressed. must mitigation measures are in keeping with the practices to address the concerns of neighbors especially at the cathedral hill site. also the use of equipment that generates the least amount of noise pollution, staging that reduces noise and to the extent possible. the manager can quickly and authoritatively rise.

and you very much.

this is the tenderloin area that i -- >> i have lived in the tenderloin area for the past six years. i knew that they were coming into the area and knowing that we thought that the area was probably for business. this was not brilliant positive. we took the opportunity to look at the business.

the area will be good for customers and tourists. i urge you to support this project.

>> i represent over 3000 members local. i am urging new -- urging you to support this project. we are facing a low down and work. thank you.

>> we are a community-based organization here in the mission of san francisco. we are hoping to enforce the liberal laws. this has been analyzed by the

draft environmental impact report. the document discloses the project impact. this will be a project that is a very good thing for san francisco. this is in terms of the employment creation. we are big supporters of green building projects. we also echo the comments from the building trades council.

this has been approved by the state office and health services. i urge you to approve the draft and firm. impact report. -- i urge you to approve the draft environmental impact report. >> i have been delivering babies for 11 years. the planning department has done a thorough job evaluating this report.

while the majority of deliveries occur, severe complications can arrive quickly and unexpectedly. we have reduced the rate of mortality. the california mortality has tripled from 5.6 per 100,000 to 16.9 per 100,000. -- cannot be with us because he is in washington d.c. and he is looking to reduce complications. this identifies the need for acute care services for pregnant women. whether this is intensive care, surgical support, laboratory,

and services are critical for protecting mother and child. there are higher rates of multiple just asians. it is unacceptable and unsafe to transfer these patients across town for emergency or critical care services. i am full -- i am in full support of community-based medicine. they could not keep up with the technology or maintain the staffing. our patients are cared for at our california campus unit and we have the resources, tools and support to maintain the health and safety. we will continue to do so in a

new facility. thank you. >> thank you. >> i am one of the owners of cocoa cocktails. i'm here to acknowledge and thank the california pacific medical center for working with me and my staff.

i need to take this opportunity of this if they have not settled. we have at this time no opportunity to earn more income. i would like to see them in sure that they have a place to live for the rest of their lives. i also lives five blocks from the piarist -- from the proposed project and i would like to see the good neighbor coalition ensure that there are active members of our community and they don't just pop down and not be involved.

th >> good afternoon. tonight them a primary-care physician and also the director of the medical services. we are the largest at federally administered health center in san francisco. we have been serving for almost 38 years. i believe every resident should have access to the best medical care. we have collaborated to provide specialty care services to are underserved population including

the delivery of 400 babies each year. the location for the new campus at van ness and. will be in closer proximity to the patients that we surf. this means less bus trips, people taking public transparent and also more access to health care. the proposed campus also locates a full-service pediatric emergency and also an inpatient hospital and the highest density of these patients in the city. additionally, they have developed a referral process for care, for all of the patience.

this is roughly 25% of the overall program population. they also announced that they are expanding their commitment to the healthy san francisco program. i who want to thank you for your time and i would urge that you except this request. >> is there anyone else whose name i called? >> could afternoon. -- good afternoon. i indeed second director of the asian american and pacific -- we have two offices in the

tenderloin, one that focuses on transgendered help. i am here to support the long- range development plan. i believe that the planning department did a comprehensive job analyzing the project and its alternatives. the proposed location for the new campus is within two blocks of my agency where many of my clients and patients reside. this is a neighborhood that is composed of many asians and pacific islanders as well as the transgendered community. this would allow for increased access for many of our clients and patience as well as providing more accessible health care options. the health care center is expanding by becoming a free health care community clinic and

we have been working with cpmc who has been supporting our efforts. they have been providing us with support to provide a needs assessment in the tenderloin to better understand the health care needs. the proposed location provides a platform for cpmc to expand existing programs and i see that their long-term engagement with us and are theses in the tenderloin will ensure that cpmc is attentive to community needs.

president miguel: jane martha. >> good afternoon, commissioners, joseph smith, coalition for health planning, san francisco. breaking down simply that cpmc has four campuses which are basically hospitals with associated services. what cpmc plans to do is phase out the california campus, concentrate outpatient services at their pacific campus and concentrate inpatient services at the new facility at van ness

and geary on cathedral hill. the description of st. luke's, however, in the project plan, focuses on a new medical building and a new hospital building that is significantly smaller than the existing hospital. what we see in the d.i.r. is that there is no vision for st. luke's, no anchor. functionally, it reads as though it is an access point for specialty services provided at cathedral hill or pacific campus. st. luke's operated as a full-service hospital primarily providing charity care for well over 100 years until sudder health took over. st. luke's, this takeover happened a few years ago. instead of using its financial strength to build on the tradition of charity care, sutter and cpmc have been systematically dismantling the charity care that's existed at

st. luke's. we're asking that the e.i.r. study the alternative or an alternative to what's presented as alternative 3a., the reason is that there was a demand of the community for st. luke's to stay open and what we're seeing is that there are signs there will be continued dismantling of the charity care and commitment to the southeast neighborhoods and the care that's necessary in those neighborhoods by cpmc. what alternative 3a. does, it shifts services and beds from other campuses to, instead of everything going to the inpatient facility on cathedral hill, that some of those beds would be shifted to st. luke's. what we don't like is they're just women's and children's services. a lot of those services need to be dispersed throughout the neighborhoods of san francisco. we want to see not just a dispersing of services that are

equitable and accessible in different communities throughout the city but also there be an anchor that's more of an emergency department and women's and children's services at st. luke's. there needs to be a vision around st. luke's because we don't trust it will be open. we needed to create a blue ribbon panel to keep it open and before that panel, sutter said they would keep it open and after the panel, they admitted they intended to close it. we want to make sure it's a viable hospital for the future. [applause] president miguel: thank you. >> my name is jane marn, i'm with the california nurse's association and on the board that's a member for the coalition of healthcare planning. there's a huge problem with the environmental impact report and that's that it fails to analyze the healthcare applications of the plan. we support the primarily better

alternative with a clinical anchor. that is environmental superior in terms of traffic in the analysis that's done and better for healthcare. the e.i.r. does not analyze the burden on city services for the services cpmc will no longer provide. cpmc has closed over 70% of psychiatric services despite a growing need for those services and instead those psyche patients are shifted to other providers. cpmc plans to close long-term care for the disabled and elderly. all of these would impact on the city's healthcare system. the e.i.r. does not analyze sutter's regionallization. sutter's business plan would entail ridding itself of 1,300 hospital beds in the bay area in a way that anticipates a transfer of patients between cities. cpmc's plan is part of the same business plan as sutter's operations all over the bay area

and should be analyzed in terms of the cumulative effects of those plans. we encourage cpmc to come to the table and engage in a substantive dialogue around healthcare impacts, the size of st. luke's, jobs, affordable housing. but we really need an environmental impact review that looks at the healthcare impacts and it shouldn't be approved the way it is right now. thank you. president miguel: thank you. [applause] please. it only takes up time. >> good afternoon, commissioners. my name is paul warmer and i'm here wearing heights of both pacific heights residence association and the neighbor's coalition which is a group that has worked with the pacific site facility since 2002 on planning the new activities as well as locate operational issues. i would start by saying something new which is that we do appreciate the outreach cpmc has begun to our neighborhood on

plans for that site so with luck when the project level e.i.r. for that activity comes forward, we won't have so much to bicker about. there's been a lot of discussion about traffic. and the d.i.r. traffic and circulation analysis is in fact significantly inadequate. it deals with the conventional sequa application of looking at commute traffic at peak hours. however, sequa does not say "thou shalt not consider other impacts." in fact, if you read the enabling legislation, it talks about quality of life as the driver and how the environment is important for a healthy quality of life. by the way, i'm not a lawyer. but i do try to read some of the source material to understand why something may be so.

so the problem is, it looks only in many cases that the peak p.m. traffic. that's not when the worst impacts occur in many neighborhoods. the schools are letting out at about 3:00 p.m., there are peak traffic delivers at that time. the concerns in the tenderloin with traffic in schools. increasing traffic outside of the peak p.m. period will have a direct impact on the residential environment. that's nod -- not considered in this document. the data used for the pacific site was comparing daily averages but you're comparing daily averageof visitors on a 24-hour operation to something that's moving to a daytime operation. very difficult to make sense out of that. it doesn't leave us comfortable and it's a data gap. the assessment of the bicycle and pedestrian impacts is inadequate. it looks at how pedestrians fit

on the sidewalk, it doesn't look at the vehicle interaction with pedestrians. it's a big deal. and i want to touch on the three a plus. the services that were alluded to earlier both before and after care are significant. i have dealt with this in my family and i have dealt with the discontinuity of care when people are turfed out of a hospital because they no longer need the in-hospital beds but are instead sent to a third-party skilled nursing facility. the continuity of care, continuity of documentation and communication between the medical staff is a disaster and causes great problems. that is another impact. thank you. president miguel: thank you. debby perkins. eileen trend will have, robert

atchison, jane solen. >> good evening, my name is eileen prendvil and i work with the pediatric i.c.u. we take care of the most fragile infants and children during their often long and protracted hospitalizations. we have a combined service of over 240 years at the california pacific medical center. we've seen a great deal of change in healthcare. we became nurses because we care

about each other and we want to make a difference in people's lives in their time of need. we care passionately about our patients and our community especially when it comes to healthcare. one of our concerns is the size of this proposed hospital where all tertiary care would be consolidated in one building. a huge hospital on van ness avenue would be disastrous after an earthquake. patients would have difficulty getting there as traffic would be gridlocked. i disagree with my co-worker neonatologist, but it wouldn't be the first time doctors and nurses disagree. now is the time to make sure that the healthcare needs of

san franciscoans are met effectively as hospitals comply with the state's hospital seismic law. we urge you to make sure that cpmc scales down the size of cathedral hill and increases the services and size of st. luke's in order to make it a viable hospital to will provide equal access to scare for all of our patients -- care for all of our patients and their families. thank you. president miguel: thank you. michael lyon, tony gazetta, jonathan brooks. >> good afternoon, commissioners. thank you for listening to all the testimony you've heard thus far. i'm sure you have another hour or two of it. i'm barbara and i've been working in the tenderloin the last five years with latino families. you heard testimony from some of our families. many of our families had to lead like the nurse before me said.