legislation today and to make sure the enforceability elements are kept intact. thank you. >> my name is lee im lee. i want to make three quick points. as i mentioned last time, i think one of the voices that is least present in these hearings and which we want to bring to the table is the impact of this kind of health planning legislation for our city. that means to us that our communities, particularly the south eastern neighborhoods where we work, are marginalized in the delivery of health care services were we all work. the hospital industry needs to turn a profit and make its bottom line as hard as possible. we also have a need to ensure that our community members throughout the city get the services they need. i think that is what this health planning legislation takes a

step forward in doing. i think we have been working on this legislation with supervisor campos for nearly a year. we are concerned with the issue of the date of effectiveness. we feel the to your window is too long. as you have heard from the planning commissioners, they think so as well. there are decisions i have to make now. we do not feel like pushing the timeline by an additional year after the plan is adopted is good policy. basically, having guidance that you cannot use, which seems contrary to what we were trying to do -- the issue of the retrofit and pipeline project can be dealt with in the contingency determination. everyone seems to think the contingency determination is a huge burden.

we do not think it is the way. there is a fast-track process. community needs being laid out will provide us with what we need to make good decisions. lastly, thank you all again for taking the time. thank you. supervisor campos: justine londerback, christine ortega, rachel ibora. >> we need a master plan citywide. the system we have is so bad. we need to get served. we need service in bernal heights. thank you very much. supervisor campos: thank you very much. next speaker. >> good afternoon, supervisors. my name is emily lee. i am with the chinese

progressive association. i want to hand in 12 letters from our youth members, who were not able to make it today because they are in school. to bring the community voice back to this issue, this is what the community needs and wants. we are definitely opposed to delaying the legislation to 2013 simply because that is what the hospital industry is requesting. for us, we feel like we need this legislation now. when needed a yesterday in order to make sure that the health care needs of all residents are being considered. you have heard from as many times about the community needs. for us, it is a question of what -- but the hospital industry is pushing for, which is delays. it is for the legislation not to happen at all. and what the community needs is a comprehensive plan to understand where planning needs to happen in san francisco and where health services are needed the most, and to identify gaps in those services. i hope you will move the

legislation further and not delayed as long for then we need to. thank you. supervisor campos: thank you. next speaker. >> good afternoon, supervisors. by name is william ho. i am with the bernal heights neighborhood organization. i am in support. we need to discuss the health care inequalities in this city. this is essential to the social and economic health care in the city. the master plan will identify gaps in services and medically underserved areas. access to health care cannot be decided by business plans of corporations. access to health care needs to be dictated by the needs of residents and not their ability to pay for it. the goal of the health care master plan is to encourage smart and equitable health-care planning.

i do not think there's anything wrong with that. i will just echoed the concerns of the planning commissioners that spoke earlier that this plan was needed a long time ago and should have been adopted quite a while ago. i think there is nothing wrong with having more information. thank you. supervisor campos: thank you. next speaker. >> my name is sigmund king. i am also from the bernal heights neighborhood center. this process is very community oriented. it is about planning. as supervisor maxwell mentioned before, i think it is very important that we move forward with this right away. i think an important point to highlight is that it is a living document which has regular updates with community input into the legislation. in the context of other health care issues in san francisco, we

see the landmark health the san francisco program has provided health care to thousands. many have to pay impossible out of pocket expenses in do not have care in the neighborhoods they live in, so this is obviously very important for a "around the city. with the investment in health care that will result from national reform, it is critical we have the tools to assess community needs and craig developments that meet these needs. by thinking ahead with a plan in place, we can take advantage of the opportunities national health care reform can offer our city. essentially, i think it is important we get this in place now. supervisor campos: thank you. >> my name is alex tom, organizer for the chinese progressive association.

i want to thank the supervisors for their diligence on this issue. our organization has been in communication with you around this. it has been helpful. two weeks ago -- we continue this for two weeks as a good faith measure to open up for the hospital industry to make sure that all their comments come forward with very specific issues. i feel you have done a good job in trying to make sure those issues are addressed even know we can reach agreement on everything. we did meet with the chinese hospital. we did that because we want to support the smaller community- based community hospitals in the community, and because we feel like the level of charity care and they need they have in the community is -- and the need they have in the community is important. it is different from cpmc and kaiser. it is important we look at that and make that analysis. there were changes that were made to make sure that smaller clinics and smaller hospitals

were protected in this. in my last remaining time, i just want to say that there are some important changes that have already been made. i just want to remind the public about this. because the hospital industry was concerned, there is a fast track that was implemented in this new piece of legislation. who in terms of the threshold on square footage, it has been increased from 3000 to 5004 expansion and 5000 to 10,004 new developments. -- it has been increased from 3000 to 5000 for expansion and 5000 to 10,000 for new developments. we have made sure all parties were considered toward the mission of health access for everyone. >> joseph smoot.

i am here as the health-care provider. the work we do, i just want to remind you, makes the work of the large institutions actually successful. we prevent violence. we prevent substance abuse. we manage people's substance abuse. we also manage people's medications on a daily basis. the work we do with patients who are discharged from long-term care is essential for making sure there is successful reentry back into people's homes. the work we do is held accountable every day by you, by the city, by the department of public health, by the human services agency, the department of aging and adult services. it is part of the city's budget and accountability process. the question we have is what is the industry afraid of. being held accountable to a master plan? planning commissioners have told you earlier they needed this plan in place prior today. so why are they -- why is the

health-care industry pushing an amendment to make the effective date 2013? should we be working to put this plan in place as quickly as possible? the work supervisor campos and his staff have done to credit legislation, as alex said before me, to incorporate input from community-based organizations, is solid. the changes alex read just prior to me speak to the substance of the supervisors' work. and the intent of the legislation, just to remind you, is to make sure we are moving projects forward in order to create a framework for planning and health to work together. we are talking about land use proposals. they involve a certain amount of time. as the planning commissioners testified before, they need to be able to move projects and do not have the tools to be able to do that. to delay implementation to 2013

does not make sense. the legislation as drafted previously is in the public interest perihelio. hash hamas >> i am here to echo tt of those who have come out to show you this is a process we have needed. we have seen through the cpmc process a lot of guess work. this has streamlined that project and will continue to move forward in the future. i want to thank all the commissioners for their hard work. supervisor campos: thank you very much. next speaker. >> my name is elizabeth ortega. i am here with the bernal heights neighborhood center. i am here to support the master

plan. several weeks ago, there was testimony given here the represented desperation, paying, and fear, but you also heard a passion for justice and advocacy for a policy that would give the community a voice. this will insure that profits are not the driving force behind health care. opponents feel this legislation is being rushed without discussion, but the truth is that our families feel that there has been too much discussion, that their parents are waiting to long to see a doctor, that they are going into bankruptcy because they cannot pay for their medication. i ask these corporations to tell those people i work with every day, the youth that do not have access to as much inhalers, to tell them that this process is being rushed. i urge you to take action today and ensure that these corporations are held accountable. thank you. supervisor campos: think you very much.

next speaker, please. >> my name is justine waterback. our neighborhood center develops and maintains affordable housing to route san francisco as well as providing services to seniors, youth, and their families. as a provider of essential services, we feel the impact access to health care creates. coordinating care for our seniors is impacted by these gaps. we struggle with them every day. health care needs to be decided by residents of san francisco and not by business plans of corporations. i urge you to support the health care master plan. thank you. supervisor campos: thank you very much. next speaker. >> good afternoon, supervisors and the the planning commissioners. i am a resident of san francisco and someone who has access to health care out of san francisco

institutions, specifically st. luke's. i know the need of having the ability to get to my service provider in an easy and affordable way. as a staff member of the b ernal heights neighborhood center, which serve families of low and moderate incomes. it is important to make sure the city takes care of the needs of all san franciscans and respect their right to access health care. you heard earlier from community members and commissioners about the urgency of implementing a health care master plan that does prioritize those needs. that time is now, and that health care master plan is here. what we heard was a concern many years ago is still a concern now. the safety net, as we see it in the non-profit sector is sinking. -- is shrinking. we need to prioritize the needs of all san franciscans, especially those who cannot

access what they need to access because of their resources. we cannot decide solely on business plans of corporations. we need to make sure that any developments are accountable to what residents need. the time is now. we cannot delay anymore. please pass this health care master plan and do not delay it any longer. supervisor campos: thank you, miss sabora. >> eric brooks here representing our city. we have several thousand members and many of them are a ground zero in various health care areas in the city. i am also with the san francisco green party sustainability working group. the green party has not had a chance to vote on this yet. however, i would assume that would resonate a lot with my comments today. it is crucial we have a citywide master plan for health care. thank you supervisors for putting this forward. i personally live a block away

from the proposed cpmc cathedral hill location. i know what the traffic on challenges are in that area and i am also seeing that the plan seems to be to consolidate health care facilities on to one big one that will downgrade other health-care facilities and close some across the city. in the case of an earthquake, if all we have is one large hospital and another one that is run by the city, and that one large hospital is in the middle of a heavy traffic area like van ness avenue, people are not going to be able to get to care if we do not have a citywide comprehensive plan on health care. it is vital we do this. there are big questions about the cpmc's new plan serving poor people in my neighborhood.

it done great support for such people at st. luke's. we need a master plan to make sure everybody gets served properly. for all those reasons, this legislation is great. however, let us make sure it becomes effective immediately. cpmc will be over with otherwise. we need this to take effect now, not two years from now. supervisor campos: thank you very much. next speaker, please. >> good evening, supervisors. i was here several weeks ago. unfortunately, i left for the giants game. i am here today to make comments on the master plan for health care for the entire city. i believe that everyone agrees that a master plan for health care for the entire city is absolutely necessary.

it is something that should be -- it should have been on the radar a long time ago. all the major service providers should be considered. they have to be included. that means the city, the state, the fed's, and also the private entities. it does not make any sense to have two-thirds of the service providers and not consider all of them. this has been long overdue. another issue that has to be considered regardless of the seismic safety issues -- how safe are high-rises that are 20 stories? that is something that has to be considered. there is a history. this is earthquake history -- earthquake country. it is absolutely necessary. the other issue is the western side of san francisco are

without any hospitals. we have cut hospitals, but not for humans. -- we have pet hospitals, but not for humans. we asked when the issue of cpmc first appeared. thank you for taking this on. please come up with a comprehensive plan and a safe plan that includes emergency services in the event of earthquakes. thank you. supervisor campos: thank you. next speaker, please. >> my name is bruce hicks. i am with the st. louis hospital. a -- i am with the st. luke's hospital. a lot of people come up from uhw and one jobs. this is an opportunistic thing for them to say. they want to say they are a union on the one thing -- on the one hand, but that is an

opposing thought. in other words, if they want to say something more useful instead of just a mom and apple pie -- how did you get more jobs by supporting one big centralized institution then you do by getting two smaller ones? if cpmc were smaller and st. luke's is bigger, how is that going to have their be less jobs? i support the luster it -- the master plan. i think it should happen right away. >> linda chapman. as i said last time, i think it is a great idea. it is vital that it include cpmc, that we do not in the course of legislation let things in the pipeline out. we have an eir process, but the

planning commissioners made it clear that is not sufficient without their having guidelines. it will emphasize physical environmental things and say that is economic and does not apply to the eir process. what about the impact on retail in our area if traffic is extremely bad, if traffic induced use rex the retell in our area? what about the impact on st. francis hospital? perhaps cpmc locating on van as might be fine, but it might also have an impact that provides charity care they do not provide. i mentioned last time the van ess plan to produce housing at three to one. that is probably not going to happen here, but we cannot forget that it is about housing. instead of producing three forone housing at this market

rate, we can't produce a smaller amount of housing that is not market rate. this does not have to be profit- making based on its housing. we need to make sure we at least use this to get money for sro's and low income housing that might otherwise not be built on our side. thank you. supervisor campos: any more members of the public who would like to speak? i think that concludes public comment. supervisors, if i may, i just wanted to make a couple of points before i turn it over. again, i want to thank all the members of the public who have spoken about this item. supervisor maxwell indicated thinking the hospital council and various health institutions that have participated in this process and provided their feedback. we certainly want to thank them.

i particularly want to thank members of the community who of been working on this for quite some time. ultimately, this legislation stems from a number of pleased that we have heard in the last -- a number of pleas we have heard in the last few months and years from people throughout san francisco, and not just in the district of represent, but throughout the city. district 3, district 10, district 1. people from all over the city have made it clear that we have a system that is not complete in terms of ensuring that the needs of every san franciscan -- the health needs of every san franciscan are in fact addressed. before a health institution san franciscan our address. before the health institution proposes a project, it in cages in internal planning to decide

for itself -- it engages in internal planning to decide for itself whether or not a project makes sense. this legislation takes the concept to the next level and simply proposes what we do not believe is a radical idea, that we, as a city, can engage in the planning with respect to the many projects that are not only before us now but are likely to come before us in the future and in so doing, we are simply doing as a city what these institutions have been doing for quite some time. a lot of things have been said about this legislation, so i wanted to make a couple of things clear because some courts have been raised, which i will respectfully submit are not entirely accurate. there is the issue of -- the point that was raised was about the appeals process, that somehow we need to consolidate the appeals process, and i just

want to make sure that this committee understands that that is precisely what this legislation does. in drafting this legislation, we wanted to be clear that we did not want to create additional bureaucracy for the sake of creating additional bureaucracy, which is why the consistency determination is made by the planning department, and if there is an appeal, that appealed joins the existing land-use process that is already in place at the planning commission. in other words, if a consistency finding made by the planning department in consultation with the health department leads to an appeal, and there is a land use process in place at the planning commission, that appeal will join that process. it will be decided by the planning commission at the same time the planning commission decides the underlying land use

appeal. in fact, what we have gathered from discussing this item with a number of these stakeholders is that the consistency determination when there is an existing land use appeal, is likely to come up -- in fact, very likely to come up and be resolved before the other land- use process, which means that the consistency determination portion of the appeal will probably have to sit and wait for the rest of the items to be resolved. again, we want to make it clear that we have tried to consolidate the appeal as much as we possibly can under existing law, so that is one clarification. the second clarification i think needs to be made -- >> supervisor, could i ask you to clarify that? why is it that members of the community continue to insist that it is a two-part appeal?

are they simply incorrect on that? supervisor campos: the consistency determination is originally made by the planning department in consultation with the health department. if this is an item where it is clearly consistent, it goes through an expedited consistency finding -- if it is not, then it goes directly to the planning commission and joins the existing land use appeal, so i do not know exactly what people mean when they say, "consolidate the appeal process," because we believe that is precisely what we did with the city attorney's input. i think people would have to explain that, but again, we believe that we are doing precisely that, consolidating the appeal process. with respect to the historical

role the certain institutions play, and there is the example of chinese hospital, with respect to the chinese community in terms of working with underserved populations, one of the amendments that was made was the in the process of determining consistency, that in fact, that unique role that those institutions have played be an important factor in deciding consistency. >> if we were to look at st. luke's, then st. luke's would have fallen into historical and would have then not even been a question, that they would no longer exist? supervisor campos: the way that it would work is in deciding the issue of consistency, the planning commission in consultation with the advice of the health commission would take the historical role that

that institution has played into consideration in making the consistency finding. that would be one of the factors that they would look at. we believe that that addresses that concern and that to the extent that there are additional concerns because of the seismic retrofit issue -- and let me say this -- we heard from a number of community members who rightly point out that the consistency determination as currently structured in fact allows these institutions to go forward with their state law obligations in terms of addressing the seismic issue. ideally, our preference would have been not to talk about changing the effective date of the consistency determination. i think the community is ab