i wanted to share one thought that one of the moms who wanted me to communicate to you. her name is bianca and lives at geary and larkin. she said the last week was the first time she heard about the hospital. i have to ask the hospital, what has been the process cpmc reaching out to the community particularly in the multilingual fashion. many of our families, only one person had heard about the hospital. i also submitted a packet with the surveys and submitted a report from urban solutions indicating that the corridor has the highest incidence of latino families of all the tenderloino for me it's a serious concern that many of these families weren't noticed about the hospital and will be deeply impacted about the project. i want to go over what some of the survey says since i feel like cpmc has outreached to our community, i thought, we had a

meeting on friday, let's find out what our families think about the hospital and what they think about this plan. i did a survey of the 26 folks that were there and this is the outcome because i don't know if this helps. of the 26 there, 20 live in the tenderloin, four live along the franklin corridor which is on the other side. and 88% of the respondents that i talked to had either meddical or healthy kids so for me it's disconcerting to see the build of a hospital where 88% might not have access to it. they go to community clinics. when i asked what kind of hospital they'd like to see in the neighborhood, most said that hospital that serves needs of children, emergency services and dental services. the other thing is the traffic and contamination issue. before you've seen a million and one pedestrian reports in the

tenderloin. it is one of the most dangerous areas to walk through and the highest density of children so for us it's disconcerting to see we'll have 10,000, 2,000 more cars coming through the area where we already have deaths. it's something that affects us in the community. we see families hit by cars. the traffic thing is a serious issue, as is the pollution. the construction. a lot of our families live at that block on larken and geary. how is construction going to handle it and i don't think there's been an open and meaningful community process. we ask you to listen to what the tenderloin has to say. i think a lot of folks that came before you haven't been outreached to in a meaningful way and that will affect the relationship between the hospital and the community. a folks that came forward seem to be connected to cpmc in a financial way or another so that really bothers me. i think there's a lot of families.

thank you for your time. president miguel: thank you. >> good afternoon. i'm jane sandoval, a staff nurse at st. luke's and have been a staff nurse for 25 years. i work in the emergency department and have been there for 15 years. three years ago cpmc announced their plans to close st. luke's and this was to, in their words, provide a spectrum of services consistent with community needs. fast forward to 2010, three years later, i'm still speaking. we saved the hospital, so to speak, but i'm calling it a stay of execution because the current plan is doomed to fail. the storm of protest from the community and nurses and this is the same community that was thought to have needed the closure of st. luke's because that was the need of the community. and their masterplan. although cpmc has promised to keep st. luke's open, there are many concerns regarding the rebuild. first of all is their track

record. i think many people have already testified to their track record and their followthrough or lack thereof. there has continued to be service cuts. it's already been mentioned the lack of psychiatric beds. the skilled nursing facility beds are in jeopardy and most recently, the dialysis services are slotted for closure. bottom line, things that don't generate money are not inclusive in the spectrum of services. the current rebuild of the emergency department for the rebuild of st. luke's called for increased square footage but not necessarily emergency department beds. the plan for a psychiatric holding area is flawed. psychiatric patients need placement, not in a holding area. often patients stay up to 72 hours in the emergency department until their hold is exhausted or placement is found and often placement is not found. the emergency department

continues to be full. often overflow from san francisco general and just fallout from of the economic slowdown. people are coming to the emergency rooms because it's the only place where they can receive care. also, concern is lack of labor peace at the hospital. it's an ongoing issue for the last three years, as well. we, the members of the california nurse's association, unlike our counterparts who spoke earlier, cannot and will not agree to a contract that limits our patient advocacy. parity not only with the community of the underserved but also with the staff nurses of st. luke's is a common goal asked of cpmc as well as transparency. the ultimate patient advocacy we as nurses can do for our patients is to support an adequate sized full service st. luke's, not a downsized version which is not consistent with the community need. i believe the community need has been well addressed at today's

hearing as well as the hearings over the last three years. thank you. president miguel: thank you. >> good late afternoon. i'm tony gazetta from the plumber's union local 38 in san francisco. i'm a city resident, work down on market street. we've heard the concerns of a lot of the residents, being impacted by the cathedral hill and all of what cpmc is going to do. the residents near cathedral hill want more services of st. luke's. residents of st. luke's want nothing to do with the new hospital. they want the one they have. residents of the tenderloin have worries of increased traffic. i represent members of local 38, the plumbers and pipe fitter's union. we understand some of these concerns. mine as well as that of many of my brothers and sisters from the building trades is jobs. construction jobs which pay a

wage which allow the workers to support their families. 40% of the membership of the building and construction trades in san francisco, many of whom are city residents, are unemployed or underemployed. employed workers spend money and fuel the local economy. the unemployment workers cannot afford more delays. i urge you to approve this e.i.r. and get san francisco working again. thi. president miguel: thank you. >> good evening. my name isianicca brooks, i'm a registered nurse at the bedside at cpmc's hospital nursing floor, post acute services for over 15 years. we serve meddical, unsured, medicare, mostly those suffering from chronic or acute conditions requiring multiple i.v.s, complex dressings and intensive medical care for a few days up to six weeks or longer.

i am concerned that the cpmc draft plans for the elderly and disabled only includes 38 beds. instead, cpmc has verbally committed to provide 62 community or campus-based beds. there is a difference in community or campus-based and i have provided the commission an outline with the difference. only to see increased hospitalizations and deaths, and no one wants that. cpmc has stated that the two sniffs are not in the e.i.r. draft because they are working to develop a transitional model for homecare based care after hospital discharge to bridge the gap between hospital discharge and home. while good, this still speaks only to those people going home. what about the growing elderly population and chronic sniff bed shortage in san francisco that

is estimated to be 30% over the next decade? what will happen if these vulnerable people are sent home too early or have to go outside of san francisco for care? it is well known in our facility that cpmc wants to close our unit and has wanted to for some time. from a business perspective, we serve a patient population that is an income loser rather than a gainer. we would be closed now as documented in cpmc's prior plans and we have only remained open because community outrage that cpmc sutter would cut these services has caused cpmc to pause in their plans. i stand before you as a registered nurse with concerns over citywide healthcare for the elderly and disabled. these people should not be thrown under the bus in lieu of a new state-of-the-art hospital. i urge the commissioners to hold cpmc to continue with their studies over successful recovery at home but not to eliminate any skilled nursing beds in their final environmental report.

thank you. president miguel: thank you. >> good afternoon. i'm a local 377 iron workers business representative representing over 2500 iron workers in the greater bay area with many of them being san francisco residents. i'm here on behalf of those members to support cpmc's project. as you know, the construction industry has been hit especially hard in this recession and presently we have at least 1/3 of our members under employed or unemployed. this project would put a great many of them back to work as well as bring a state-of-the-art hospital facility downtown. as planning commissioners, i know you have a great many weighty issues to deal with in approving the draft e. i.r. but i hope you will consider the position impact you have on amendment in this community at a

time -- employment in this community at a time when good paying jobs are particularly needed. i urge you to move the project forward as expeditiously as possible and help us to put our members as well as many other construction workers back to work. thank you miguel michigan thank- president miguel: thank you. rosa marquez, linda chapman, patresia from new community employment report, linda harter and bruce hicks. prosecutoreer

>> linda harkin. i'm here representing the van ness plan. for more than 20 years, it's been the guideline that's directed what's developed on van nes and what cpmc has proposed violates every objective of the van ness plan. i also believe that a win-win solution is possible. probably, even though no hospital is supposed to be built there, no office buildings, nothing but housing with retail beneath, minimal retail, i believe that this is not a bad location for a hospital to replace an office building and a hotel provided that in other respects it follows the van ness plan. if it's going to completely violate the van ness plan with the height limit, with not producing housing, etset -- which is required of every developer at a ratio of 3 to 1 and of course will not be all

located within the van ness area but could be located on many sites in the tenderloin or even south of market if they pay for that. otherwise, there is the no project alternative which means they can still build their hospital but they can build it on the campuses where it is instead of bringing it here. now, this is a very well reasoned document. the reason for the 130 feet had to do with the land form. it gradually -- it graduates up from the water tower 130 feet. that allowed for development of housing but it didn't overwhelm the historic commercial buildings that are there, architecturally significant. it also would avoid producing a great deal of traffic on a street that is already, you know, at an impasse of traffic that would occur with either a great deal of highrise or office development or this development. it was determined this was the

most important boulevard in san francisco besides market street, that it deserve they'd kind of consistent treatment and that in addition it was a perfect place for housing. it was near downtown, it was on transit, and there were a lot of in-fill spaces for that. so that's what we should have for the most part. if they're going to build this here, we must consider the fact that van ness is prone to be completely tied up with traffic. how are these people who it's so important to get them all immediately to care, it took me two hours this winter to get from pine street to 22nd and the mission. how fast will people from the mission get over to the hospital? and that was only because it rained in the morning, you know. the bus driver said get off and walk to market and everybody did because the traffic was completely tied up. also, on other occasions, it is highway 101. that is a consideration, too. as well as being the local

transit agency's major street and for the golden gate transit. i've ridden in on highway 101 when it's blocked up and people go down polk street and block up polk street. the whole area could be blocked up so we don't need extra parking there which will only bring in more cars. even the alternative 3a or b, which is the downsize alternative, increases the parking on that location by one third and i think we should not increase the parking at all. there was a time when you had to have a minimum amount of parking but even with residences now, we're no longer doing one-for-one parking in all locations. we're considering the transit oriented policies which i just noticed in the paper the other day, mat is saying people should generally be using their cars in order to go grocery shopping or

delivering their children to school or if you were very sick and needed to go to the hospital. when i say 3a, essentially i'm thinking, yes, pretty much, 3a is in the document. greening for our neighborhood. lots of housing in the areas that need it and also maybe they need to consider distributing some of these wases like the maternity services around to various hospitals rather than putting it all on one site. i will conclude by saying that yes, they've been doing community outreach and they've done with lower polk neighbors but the other night they came to lower polk neighbors and heard many concerns about impacts on traffic on, retail, and on noise, and then they told everybody not to come here. they convinced everyone not to come because they would have to sit in the overflow room and they would be better off watching it on television at home. is that community outreach as you understand it? they email me only to tell me

come and support us but they don't email us when they're doing a presentation. president miguel: thank you. kyle bronson, allen lucy >> my name is bruce hicks and i work at st. luke's hospital and i'm not a nurse. from listening to this, it's clear that the nurses don't support the project, at least they certainly don't support the downsizing of st. luke's. now, cpmc seems to be desperate to provide evidence that some workers somewhere support this project so we've been asked by our supervisors many times over the years to sign these little cards or make some statement that we support the project and of course everybody wants to

support their supervisor, they want to make their supervisor happy, but they still haven't gotten that many signatures. so they've gotten the sciu which is a top-down run union, run from washington, d.c., to support them in this effort to try to provide evidence that there are some workers somewhere that support this project. and but sciu hasn't managed to come up with the presentations like the nurses just did. they just have a few of the top leaders saying, we support this, you know, but not a whole line of people. so i want to tell you what happened to me. i was told there was a party across the hall and that they would be serving punch and there would be a raffle, a drawing, and there would be cakeuned ice cream and everything so i took a

break and went over and they asked us to sign up for the raffle so i signed up for the raffle. guess what, i didn't look closely. there were a whole bunch of people signing up for this party the fine print said, when you sign up for this, that you're signing that you support this project. so, in other words, they're using all kinds of sneaky methods to try to pretend like they have workers supporting the project. but people who work at st. luke's don't support it because they can see they're being downsized out of existence. president miguel: thank you. >> my name is linda carter. i've been a resident of san francisco for 24 years and a proud r.n. at ain't -- st. luke's for 40 of those. im coming to you today as a

san francisco resident. i am really, really concerned about several issues. one of those is, well, the fact that this plan makes it top-heavy with most the medical services being north of market, nothing for the southeast of the city. in the case of a disaster, we'd be cut off, basically. and if we are a very small hospital, 80 beds, there's no way that we could handle whatever the other hospital can't handle in the case of a big earthquake. that bothers meempt the other thing is the lack of concern for the elderly patients who are now in our sniff and in our sub acute. and is, cute patients -- subacute patients have long-term illness, and dependent on ventilators and they can't be placed anywhere else.

there are very few centers that take them in the bay area. one in kemp will have, one in -m distressed that they're not talking about replacing these. for the sniff beds they're closing they're opening another 38 new beds at davies but nothing to say where they're going to put the rest of the patient and patient are often leaving the hospital much more ill these days. they're going home sometimes with i.v.s that still need to be given or i.v. antibiotics that need to be given. most patient's families don't feel comfortable giving these medications at home. so they really need a transitional place, a skilled nursing facility that is hospital-based so that if they do get in trouble, they're right

there. we often get patients from both the sniff and the subacute and it's -- i'm just concerned that at the size that they're proposing for st. luke's we will not survive. and perhaps for another -- maybe another five years but then we would look at them closing us anyway. thank you. president miguel: thank you. leachan lee, emily lee, billy huey, rachel ubarra. >> good afternoon, commissioners. my name is emily lee, i'm a community organizer at the chinese progressive association. we work with low-income chinese immigrant folks in san francisco, many of whom don't have access to affordable

healthcare. our community supports the alternative of having a bigger st. luke's hospital with smaller cathedral hill hospital. we believe the draft e. i.r. is infleet in adequately -- incomplete. initially, the draft e.i.r. does not refer to some elements of the general plan, it doesn't address the commerce and industry element, objective 7, policy element that states that the city seeks to promote health and educational services to all districts in the city and acknowledges that the clustering of health facilities in few areas creates problems such as limiting the access of residents in other parts of the city to the healthcare and employment opportunities that these major institutions offer so the city should encourage the decentralization of major institutional cities to other areas of san francisco, particularly those presently

without adequate services. as many have mentioned, that's the southeast sector of san francisco which has the largest number of immigrants, people who speak a language other than english, children, seniors, families. and right now there's only two hospitals, there st. luke's and general. we feel the draft e.i.r. doesn't analyze how reducing the beds in st. luke's will increase access. if cpmc is allowed to continue on the path they propose with their long-range development plan, we are on our way to a healthcare crisis in san francisco. if st. luke's is downsized and more uninsured patient are pushed out, that burden will fall on general. with our record budget deficits and cuts to safety net, how can san francisco afford to pay for the additional patients that

profitable corporations like cpmc are turning away. we clearly can't afford that and we as a community need cpmc to pay their fair share to ensure that all residents of san francisco can access healthcare. thank you. president miguel: thank you. >> good afternoon, president miguel and commissioners. my name is rachel. i am here with bernard heights neighborhood center, a member of the coalition for health in san francisco. i am a resident of bernal and go to st. luke's for medical services. the statements from seniors that spoke earlier and recalling speakers, there is a profound need for accessible healthcare services in the southeast part of the city. people need to access a full range of quality medical services in the community, including the increasing medical needs of seniors as they age such as skilled nursing facilities, health, education and nutrition education, preventive approaches, trauma care, support for parenting teens and complex birthings,

psychiatric services and treatment including in patient services. cpmc needs to commit hiring from the communities and implementing discriminatory practices. in essence, if cpmc expects to reap the benefits of operating as a non-profit organization and touts itself as a community-minded entity, then their plans should reflect that. in the current draft e.i.r. does not adequately do so. president miguel: thank you. alan, kevin kitchingham, kevin vallen, diane smith.

>> good evening. i'm the ceo of emerit goodman and associates. we own the building that will be the most impacted of this project, cathedral hill. the emerit goodman building, probably the oldest wood frame building of san francisco. survived earthquake and fire because it was on the west side of van ness. we renovated after eight years of development and construction in 1985, serving residences and businesses for the last 25 years. your staff presented you, which i saw for the first time today, an august 27th four-page executive summary. i didn't hear any reference to

that. in the executive summary it mentions the significant unmitigated environmental impacts and those are the items which should have been dressed in the d.i.r. is, how those impacts which, from an economic sense are called external costs. external costs mean the simplest example is pollution where you'd have a polluting facility putting dust and pollution in people's houses. and that's an external cost instead of the old days before they had to have filters and cleaning facilities that guild to the other people. it became an internal cost for the person causing the damage once they were required to reduce the plulings. the cathedral hill project is analogous to that that there are external costs being imposed on

other people. as an example, the d.i.r. states that there's going to be construction for approximately 54 months. and i don't know if anybody else raised this today but the construction period for five days a week was from 7:00 a.m. to midnight. 7:00 a.m. to midnight. i mean, 17 hours a day for 54 months, which is 5 1/2 years. during part of the project, there's going to be 370 trucks coming during that 17-hour period, which means one truck every three minutes for 17 hours a day. i have prepared -- excuse me, how many copies of a presentation? i prepared an analysis of some of those uncompensated -- unmitigated impacts and i'd like you to read these d