recommendation to us. commissioner maxwell: right now it would rest with you. >> with the planning department, that's correct. the second issue was also referenced by the supervisor which was the level of detail about the contents of the plan that were in the legislation. our hope was to frankly have less detail in the legislation and we had recommended a process whereby we established the contents in more detail through a process. it's not dissimilar to what we do when we start a neighborhood process. we sit down and say, what should the scope be of that project? of that process? and so, our recommendation and the planning commission's recommendation have been -- have less detail in the legislation and developed that detail as we start the planning process. the third issue had to do with the actual cost of preparing this plan, the subsequent e.i.r. that would probably be required. although whether it's an e.i.r. or not would rely on the spess

ity of the plan. i think i'd be happy to work with him. commissioner maxwell: the more detail it is, the more it triggers something else? if it's less detailed -- >> that's correct. because of the nature of an e.i.r. and what it would -- it all depends on what the plan would cover to understand what level of environmental review is needed. having said that, we know from recent history with the bicycle plan and the housing development that those types of broad citywide plans are rising to the level of requiring a full e.i.r. and there is a fairly substantial cost associated with that. commissioner maxwell: as well. ok. >> and the final issue is a fairly minor technical point -- commissioner maxwell: getting back to that, what are you saying, it doesn't matter? if it's detailed it's expensive, if it's broad it's extensive -- it's expense snve >> part of it is about the regulatory requirement. commissioner maxwell: wlts

broad or specific. >> correct. and then finally the final issue is simply a detailed issue on the language and the plan relative to cross referencing sections of the code. we hope we can work on those details with you in the next few days. >> thank you. i forgot to highlight one very, very important amendment that we're also included in here. it was something that we believe has been imbedded in the legislation all along. but we recognize that there is a historical role that certain institutions have played in terms of providing or addressing the health care needs of different communities. and if you look at line six, i'm sorry, page six, line 17, to 20, we actually have language to thank clarifies that the health care services master plan should consider the historical role that different medical uses have played in particular neighborhoods. and the term use is the language that is being used because that's consistent with how health practitioners

describe this. but it's essentially the role that certain institutions have played, especially in historically underserved groups. commissioner maxwell: will you give me an example? >> the example that i would say, for instance, there are two examples. we believe that in considering crafting the health care services master plan, we would need to take into consideration that institutions like the -- that chinese hospital has provided to certain services to the chinese immigrant population in chinetown, for instance, for quite some time, that it would also take into account the role that st. francis has played in terms of serving low income communities. so we believe from talking to health experts such as doctor the doctor that this legislation -- language allows for that role that these institutions have played in these communities in deciding

what the needs of the city are and deciding whether or not any specific project is consistent with those needs. and so i just wanted to make sure that we highlight that because i think that's a very important consideration as we're trying to think about what this master plan looks like. president chiu: i want to thank you for including that language around the assessment. you happened to name two hospitals that are in my district. could you talk for a moment about how this language will be balanced? obviously there are a number of different assessments. you're saying that this is going to be one of the factors that's included in this. but there's really no -- what's the mechanism by which planning or the health department would balance various ainsurgent sessments and the various competing needs? >> i think that's one of a couple of things. first of all, president chiu, we are -- we continue and

remain open in terms of finalizing this language or including any additional language that you or any superviser think would be necessary to address any specific concern. about individual projects. the way that legislation is drafted, you actually cannot expressly identify a project, but we recognize that there is a group of institutions that we are concerned about, that we want to make sure that we account for the very unique role that they have played. i think a lot of it is in the devil's in the detail, if you will, in terms of what this house master plan service looks like. i've had this conversation with drt a number of times and there has been concern expressed by the planning department in terms of their ability to make these determinations. but the way that the master plan is envisioned is not that the planning department would actually engage as they're reviewing individual projects, engage in the actual health care analysis, but that in fact

the plan would provide that road map as to what the priorities are as individual projects come before planning. we recognize that planning will not have that thank expertise, but it really comes down -- that expertise, but it comes down to what the plan says. commissioner maxwell: you're saying that the analysis would have already been done? and what they would do is look at the analysis based on it having been done already. >> right. the example is, for instance, there may be an effort, for instance, to open a clinic where there is primary care physicians. right? the doctor will point out that give that we need primary care physicians everywhere in this city, such a project, irrespective of where it came, would probably go through an expedited consistency determination. because on its face you would look at a master plan that tells you, we do need primary care physicians, so planning itself would not necessarily know that that's the case, but they will have a master plan that will tell them, yes, you

know, this is something that we need and therefore you go through an expedited consistency determination and so that's one example. the same thing with, you know, h.i.v. services. it may be that there is a need for more services in some parts of the city and so maybe depending on what is proposed, that's something a consideration for them. so that's the idea of how this would work. in terms of the role that historic institutions play, i think that the idea would be that the master plan would outline what it is that they're providing, what it is that is needed in those neighborhoods and to the extent that a future project is consistent with that, i think that it would be something that is more clear cut. if there's specific language, though, that you think would strengthen this, w though, that you think would strengthen this, we definitely want to work with you to make sure that happens.

president chiu: if your staff could email me so i can let different stakeholders know what the changes are and we can hopefully get feedback on that, that would be great. >> great. thank you. commissioner maxwell: any public comment? why don't we open this up to the public. public comment on this item. if there's no public comment i'm sure -- >> yes, yes, i have cards that were given to me that i just realized i left in my office as i was rushed into -- commissioner maxwell: you know what? here are some cards. yeah. item six. sorry. >> if i may actually, there's actually -- there are a number of people who wanted to speak

first and i think it's bonnie lew is one of them. linda, deean. -- deanne. >> good afternoon. commissioner maxwell: just one second. he has the rest of the cards so he'll be calling off your names. so thank you. but you can still stand up. >> giants are right now 0-0, san francisco and texas. so, f.y.i. can >> good afternoon, supervisors. i'm a member of the chinese progressive association. i'm also a student at local high school and i live in the sunset district. i'm in support of the health care services master plan because i believe that there is a disproportion at amount of health services in san francisco and i think that the master plan will fix that. it will also help those who need care the most and will contribute positively to the s.f. communities as a whole.

health care is a human right and the master plan will carry out that right to its highest potential. i sincerely hope you will vote in support of the mast plarn. -- master plan. >> good afternoon, supervisors. i'm a member of the chinese progressive association. i am a student at lowell high school and currently live in the sunset district. we fight against local injustices. i'm in support of the health care service master plan, the health care service master plan will identify gaps in service and medical underserved areas and will help meet the health needs of all communities in the city. i had an incident when my grandma had hurt herself and my dad and uncle brought her to the chinatown hospital but because they lacked the right department she was sent to ucsf. however, because they didn't speak english, my aunt was contacted whenever a translator was needed or she would stay at the hospital the whole day. more translation services are

needed and the health care service master plan will identify this need. please vote in support of this master plan. it's time we had a plan in san francisco. thank you. >> thank you. i know that we have a number of high school students that need to get back to doing their homework. deann. sam lee. >> good afternoon, supervisors. i'm a member of the chinese progressive association. i eam a volunteer -- i'm a volunteer in a youth program. we campaign for health care and education issues. i am in support of the health care services master plan. health-related development should be based on the needs of all residents of san francisco. the part of san francisco right now southeast san francisco is a part of san francisco with many low income and people of color only have two major

hospitals while the richer side has many more. the master plan will ensure that the needy will get the services they deserve. thank you. i strongly encourage a vote in support of the master plan because health services need to benefit the entirety of san francisco instead of making the gap between the wealthy and the working class bigger. it's time we had a plan for san francisco. thank you. >> my name is sam. i'm a member of the chinese progressive association. i'm a high school student and i support the health care services master plan. [inaudible] the problem is that conversation tends to maximize -- [inaudible]. there are 10 hospitals in the

northern side of san francisco, but only two hospitals in the southern side. there are more people living in southern san francisco. also, another unfortunate thing is that the area where i live in lacks clinics, let alone with chinese language support. in short, to spend more time and money for something that is on the priority list, this will all change after health care services must apply. [inaudible] thank you forgiving me time to share my opinion. i ask you to support the master plan. president chiu: thank you. jimmy. michelle. >> good afternoon. my name is jimmy. i'm a youth leader at the chinese progressive association. i help lead the youth program youth movement of justice

organizing. youth mojo focuses on issues in health care and education that affects low income and immigrant communities. i'm in support of the health care services master plan because i believe that san francisco needs to consider the future of health care in the city as a whole. it simply makes sense that san francisco develop equitable, quality health care citywide. the health care services master plan will identify gaps in services and medical cluffer underserved areas and provide recommendations on how health care in these areas can be developed. this helps improve access to health care services for san franciscans citywide and in turn improves the quality of health care in san francisco. working over the summer on a campaign to help save the hospital, i learned that services are j disproportion in different parts of the city, particularly in the southeastern part of san francisco. most notable is the fact that there are 10 hospitals in the northern part of san francisco, whereas there are only two

hospitals in the southeast. these two hospitals are st. luke's hospital and s.f. general which both receive a plegget la of patients daily. this fact alone clearly demonstrates the need for a master plan. san francisco need to be thinking strategically to serve the needs of the people. so for the good of san francisco, we need to lift the veil and see that there are people out there in need. san francisco needs to be accountable to its residents. it's time that san francisco had a plan, a vision of a healthy san francisco that provides awful its residents and not just a select few. thank you. president chiu: thank you. natalie, lee, alex. emily. >> [speaking foreign language] >> hello, everybody.

my name is michelle. i'm a member of c.p.a., a volunteer, and a i'm a resident of chinatown. i support the health care services master plan because this is very close to the personal interests of immigrant residents in chinatown. i'll leave myself as a personal example. i have had health problems since last year and it's been getting worse and worse. my family doctor is at northeast medical services, but in order to book an appointment i have to wait overan a month to get an appointment -- over a month to get an appointment.

and then when i went to see my family doctor, in order for them to diagnose me, i had to see a specialist. to see a specialist i had to wait another two months to get an appointment. so my health has been worse and worse but i have to just rely on painkillers and other over-the-counter medications because i have to wait months to see a doctor. another example is my younger brother. i don't know the name of the disease but he was very sick, he was throwing up and we needed to get him to an

emergency room. we called 911. so we got to the general hospital because there was so many patients and not enough doctors, even though my brother was very sick, he was put in the hallway with no one to see him for hours. they wouldn't let the family into the emergency room to see him so we were waiting in the waiting room but after hours i wept in to find him and he was there covered in vomet. there was vomet everywhere. he had been throwing up all over himself and there had been no one to attend to him.

so i was so frantic and panicked for my brother, i was running around looking for anybody, any doctor who can help him and grabbing people and begging them to take care of him and they went and looked at him but there were so many people who were even in worse condition that after a few minutes they just left. from these two examples you can see, especially for low income and immigrant communities, we need comprehensive services, translation and other health care services for our community. and the waiting lines are so bad that when i have an 8:00

appointment at general hospital i have to leave at 6:00 in the morning to get there and i'm not seen until 3:00 in the afternoon. we really need this master plan. thank you. >> hello. [speaking foreign language] >> hello. i'm a member of c.p.a. and i live at mission bay and i do community work in chinatown. so i'm here to strongly support the health care services master plan for several reasons. the first one, because of language barriers. the second because health care services are not affordable. the third is because services are not adequate leading us to

have very long wait times. and fourthly, because even in the end when we get seen by the doctor we can't get the services that we need. so i'll give you a personal example to show you why i believe in this. i was having terrible tooth ache for several days. it was really painful and when i really couldn't take it anymore, i finally went to try the doctor but i went to the doctor, my personal doctor, and they said he couldn't -- they didn't have the technology they needed to take care of my tooth

ache. so they said they had to have me seen at general hospital and that i had to wait six days to be seen. i'm already in so much pain, i had to wait six more days and then when i get there, i have to go through all this bureaucracy, all this paperwork and jump through all these hops -- hoops and then finally i get seen and they say i need x-rays.

so at the end, they finally got the x-ray, had to wait another day to get the x-ray, come back and they said, ok, now look at your insurance. my insurance said, well, your insurance only covers half so you have to pay half of the money. at this point my tooth had already been in pain so many case. by that point my tooth didn't hurt, my heart hurt. i waited this long, i've tried this hard to get seen by a doctor and now i can't afford to get this problem fixed. so, until now, they still haven't pulled the tooth and that's why we need to consider. i'm just one example. we need to have a comprehensive health care plan.

there are so many different communities with different needs. i'm just one example of the many needs that our communities have for health care and that's why we need to have a comprehensive health care services master plan that can meet the individual needs of each community. >> thank you very much president chiu: thank you. i have a few more names. lucy, john, alex, nato, linda. i know there are a number of people they have left. please go ahead. >> my name is natalie. i am with the chinese progressive association. i am here today in support of the health care services master plan. currently in san francisco there is no plan to evaluate where medical facilities or health services are and where they are needed the most. i currently live in the portola district of san francisco in district nine. and the health services in there are limited, are lacking. my mom has been suffering back pains, severe back pains, for over the past year and in order

for her to go see her health care provider she has to take the muni for over an hour to the richmond district. even then she also faces language difficulties because she only speaks chinese. so we need this for san francisco, to evaluate future health services and health medical services, so that it will go to the places that need it the most. so thank you. thank you very much -- president chiu: thank you very much. rob smith, ron black. jerry. >> good afternoon, supervisors. i'm the executive director for the chinese progressive association. i just wanted to put a little bit of context to why we had so many people come out today. it's partially because of this

legislation, but also because back in 2004, c.p.a. actually did a lot of work in the southeast, exploring what are the needs of the chinese community and we did survey across neighborhoods of bay view, and we found that health care ac is he -- access was top on the list and so this was an important issue for us because we have seen that a lot of our members down in southeast, they were complaining that they really had to travel very far just to get to see any culturally competent health care services because down in southeast there are limited hours and a lot of people run able to visit those hours -- are unable to visit those hours. this became a very big issue for us and that's why we've been working on this. in 2006 we actually were one of the few groups that came out to push very hard for healthy san francisco, as a step to increase access. but now that we have thousands

of people who are in healthy san francisco, there's still a lot of them that can't access the system because there haven't been new facilities or services created. so we feel like the health care access, this issue is very important and this is a piece of legislation that can actually create a comprehensive plan for us to get there. i think there are a lot of forces at play here and i just want to just reiterate a lot of the issues that folks have brought up here from our members and chinese community and i would say in your own communities, that health care is still a primary issue with the national reforms that are coming in san francisco. we need to be ready and prepared to be able to address the concerns that are coming and basically address how we're going to really have a way to have true health care access for everyone. thank you. president chiu: thank you very much. next. >> linda chapman. i cannot tell you how happy i was to see this supervisor

campos and co-sponsors. we've been responding from neighbors and i myself regarding the e.i.r. on the campuses to be located near us. a huge, intense use. and speaking for lower neighborhoods, we've been talking with the hospital. perhaps there will be a win-win solution in the end but we do have real concerns about what they've proposed in terms of huge traffic impacts, for example, and other impacts on our neighborhood. since that's still a work in progress, i'm going to speak for myself and on behalf of the plan. some of you may be somewhat familiar with that. it was written maybe 25 years ago and what you see the development on van he is has been following it ever since. it is an elegant plan for developing housing, for developing an attractive boulevard, an important boulevard, and for making sure

that they don't exacerbate traffic impacts too much. now, what happens? the cathedral hill is in violation of almost every policy. anyway. those -- we have to be able to comply with the land use issues to a large extent. even if we're going to kind of leap off the cliff and say, ok, an institutional use will be there, where the city policy says, only housing will be, and mod ral commercial use, so it's not to create more traffic impact, another thing that i note living near there is the horrible congestion, the fact that one day last winter when it rained it took me two hours to catch the 49 at pine and get over to the mission where i was doing my tutoring at 22nd street. now imagine people needing health care and the hospital says they want to locate there because it's so important, when people are -- [inaudible]. imagine trying to deal