we provide about 40% of all of the hospital care in san francisco and we are proud to deliver half of every baby born. a third of the emergency room visits. 70% of what we do is taking care of san franciscans, the other comes from people who -- from people who come outside of the city. we are proud to partner with other hospitals in the city, usually chinese hospitals. the purple here represents rehabilitation and recover care and services that we provide insight i treat including an inpatient unit, the nursing facilities which are the only hospitals that continue to do that.

home care and hospice. truly, the entire spectrum of what a delivery system should do. we have been here a long time and we will be here for a much longer time in the future and this is to build seismically- safe hospitals. our facilities can remain operations. we designed this plan so we can improve the quality of care we provide without interrupting the current care that we provide any of our campuses. this is having a construction project at a hospital site which is a difficult thing. we will be able to maintain our regional centers of excellence

in san francisco. we will help to control the rising health-care costs. we have committed to build a two major facilities simultaneously. we will pull this off, i promise. we have made many commitments that i will review which will provide important benefits. last but not least, we will retain well paying jobs in san francisco. i want to take a minute to review the status in san francisco because this is not a pretty picture. this is a map of san francisco. this represents market street and traditionally, this is used

to divide the city into north of market and south of market. what you can see is that right now, most of the hospital beds are actually north of market although the population is split relatively even. none of these facilities meets the highest standard of seismic safety. we don't know how we will provide care at the time of greatest need in the city. our proposal and the proposals of other hospitals are remarkable. by 2015 or 2016, san francisco will have five new -- hospitals. chinese hospitals north of market and then a three hospitals south of market. the new mission bay hospital, san francisco general, and our

new campus. these will be taken from the facilities that will withstand a major earthquake. i showed this next slide with trepidation. i am disclosing something that we all know which is right now, we don't have seismically safe service facilities. our campus signifies a significant risk of collapse in the event of a major earthquake. our california of buildings range from one to three. we're having to do some more right now on the building just to keep its standing. the campus is the most seismically -- facility. this will be allowed to remain operational until 23.

-- 2030. this reviews the state -- which dictates the size and safety. this was actually enacted in 1994. this is shocking almost 17 years ago and it requires all of california hospitals to meet these standards. this has been an enormous undertaking. you can see there has been a sequential modifications of the requirements. the bottom line remains that we are expected to be in compliance with the seismic standards by 2015 or 2016 according to the state law. our plans are not just about rebuilding. we will eliminate transferand.

, it's talwe will avoid the lif- threatening delays that we have. one of the things we have learned is that the volume matters. we would like to see enough patience with a particular disease so we can provide the highest quality of care to those patients. we have many regional centers of excellence where patients come from northern california to get care for surgery, transplants, neurosciences, and we're very proud of our obstetrics program.

this is an opportunity for us to build much nicer facilities, better healing environments for patients. they will all be private rooms. they will have the ability to -- this is a picture of what we hope the new st. luke's will look like. we recognize the need to control rising health care costs, consolidation of two of our campuses will help us do that by reducing duplication of expensive equipment, having a more energy-efficient building, reducing administrative function. we would like to optimize the distribution of care throughout san francisco and the integrated delivery system. we would like to quote of the

former -- and this will not exist in the city because there are not enough specialists and to be very good at something, you have to do a lot of it. here is our construction schedule. you will note that it has us starting in 2011 with completion of the campus which is a slightly easier campus to build. that will enable us to be in compliance with the current law. i know the whole commissioners will remember this. i would like to review these because i think we have made substantial progress. we promise to increase our charity care and the amount of care we provide for medi-cal patients.

there was a 43% increase. the subsequent increases were 34%. we have continued to provide substantial amounts of shortfall which is the fact that they reimburse every hospital in the city with a couple of exceptions. this is roughly $60 million a year. we will also provide $10 million a year and other benefits such as support of to the agencies. the help commission was concerned about our plans to replace lost beds because of the skilled nursing facility beds at the california campus and the st. louis campus will not be we have committed two commitments. one is to maintain our 36

sickbed that the babies campus. the second is to either find, build, or cobuild 62 other beds without taking them from pre- existing places in the community. that is a commitment we will keep. we spoke about how we would replace lost beds. we are working with other hospitals. all ceo's share this problem to, with a solution. we will honor this commitment. we were asked to commit to operate st. luke's for 20 years as a community hospital. it is our intention to operate all of our facilities in perpetuity. we were asked to implement the blue ribbon panel recommendations about the rebuild of an acute-care facility and we agreed to do that. the health board has committed $250 million to contract -- to

construct that hospital. the new hospital will include all of the services that the blue ribbon panel recommended the health commissioner specifically called out our community partnerships. we have made commitments to populations. we have established a network of clinics around the city. we are proud of the bayview center and the st. luke's center. you will hear about many of those. we have continued our community programs, like the sisters -- sister 2 sister program, at st. luke's, and our community partnerships. lions' eye foundation and the

hepatitis-free campaign. our plans will enable us to keep these jobs in san francisco and we are proud that we provide full benefits with a fully- funded pension plan. what is the future of cpmc? we will have four campuses. the pacific campus and three acute-care campuses. i am aware of the concerns about st. luke's. i want to address them head-on. i will tell you that in anticipation of the new hospital, and they are chomping at the bit of finally getting a new hospital, we have been working with them to expand their medical staffs, building a primary care network, helping them to expand their services, and when they of asked us to provide specialty coverage, we

have. we have introduced coverage in oncology, herpetology, and others. we can monitor patients in the intensive care unit. we have been working on the quality of care at that facility. it is our intent to make services there for seniors of the community and particularly for women. in the future, of the saint looks campus will have greater capacity than it does today. there'll be an increase in available beds for acute care. a 50% increase in our ability to deliver children, 50% more emergency department space, and nearly tripling our capacity to do surgical procedures. we will have improved urgent care system at that campus as well. all of the roads will be private patient roads. building the hospital is the

first phase in our plan to revitalize the campus. it is a necessary face the need to take place first. we have a plan that includes developing a medical office building as needed on that campus. my last slide. what is our future in the city? we will have three earthquake- safe acute campuses. the capacity will go from 80,000 to up to 100,000 visits per year. we will have the capacity to respond to growing demand for health care as the population ages. the projected demand is that cpmc will need 730 hospital beds in 2013. our capacity will be 735. all of this will support a network of that least 1200 community-based physicians, many of whom are here tonight to speak to you.

it is an integrated system of care for san francisco and in san francisco. i thank you for your attention. president olague: i just wanted to clarify whether this is the end of the cpmc presentation. ok. i would like to call the two organization ones, the good neighbor coalition, and another group that has requested 10- minute blocks of time, if they could start making their way back here. i don't know if they are still in the overflow room. they sent an e-mail and a letter. someone was coordinating the second group that needed to speak early so they could get home in time to prepare for school tomorrow. i guess we should give them a couple of minutes. then we can start calling on some of the folks that have

requested reasonable accommodation. the good neighbor coalition can come to the mic. i believe the second group requested a second block of time. i will see if we can find where they are. >> ok. president olague: let me find our -- ok. >> this will be good. president olague: thank you.

i can ask her to come up. yes. >> did planning commissioners get a copy of barbara garcia's memo? president olague: and also the resolutions. we have to be strict about the time. that is why we are waiting. 10 minutes. yeah. it is them and in the second group. thank you. >> hi.

i make community organizer -- i am a community organizer. ok. thank you. good neighbor coalition was formed because of the community concerns we had regarding this project. we have actually grown since you have last seen us in september. i wanted to say that we are also working with another coalition. i will put the rest of my minutes for the rest of the speakers. thank you. >> commissioners, my name is brad. i'm a member of the negotiating team with a good neighbor coalition. i have been asked to summarize where we are in our discussions with cpmc. we have had four meetings with cpmc since february 15.

each meeting has focused on the topic. the first one was housing. we stated our position. cpmc said their current position as they believe they have met their housing obligations. next was work force, primarily the city and cpmc talking about what they have been working on. we listened. we were told there would be no discussions of labor issues. next up was health care. we and cpmc will be presenting the same things we presented to each other. you will see them yourselves tonight. the last meeting was on housing. we refined the numbers on the special use district that we felt were controlling the situation. cpmc again said their current position as they have met the requirement. i think after this, we all concluded that we kind of reached the end of the use of this venue for talks. we will be meeting with the mayor next week to summarize our

concerns and to hear from him and learn what his concerns and box are. cpmc met with him weeks ago. we hope to have a better sense of what the next step would be. that is the key. i want to be fair to both sides and say that i think cpmc is waiting to hear what the city's position is. they're reluctant to offer any more to us until they know what the city wants. we are reluctant to continue discussions if we will keep hearing that their current position is x. we are kind of stock. we believe the mayor will be meeting soon with senior staff and some of you to get your thoughts and hear your concerns, to hear the health commission's concerns, and start formulating a detailed position on the part of the city. we think that will be helpful and get as to the next step. we urge you to schedule any of the major hearings based on the state of the negotiations, and

not to deal with some artificial deadlines. we remain committed to serious and thoughtful negotiations on the community side on all the issues. to be honest, we think the biggest issues will be the one you're dealing with tonight, health care, housing, affordable housing, and workforce issues, including preserving the rights of existing workers. thank you. >> hello. my name is steven. i'm a longtime resident. i live apartment hotel. most of us are on fixed incomes, as are large number of residents. i have spoken with them locally. we all feel that cpmc building on this proposed site, two blocks away, we deserve total access to the hospital, period.

on a more personal note, [unintelligible] i had skin cancer. two operations, and they got it all. i was told that if i were to start the process from scratch tomorrow, it would take three months to get my first appointment. things will only get worse for the uninsured. thank you. >> can i turn this thing on? ok. good evening. i am with a good neighbor coalition. i would like to summarize some of our concerns with the project and refute some of the data that was described earlier.

our concerns really resonate from cpmc's lack of serving the poor. there we go. i come from the tenderloin. i represent folks from the tenderloin. thanks. in our neighborhood, you may have heard anecdotally that our neighborhood has a variety of severe health care problems and needs. in our neighborhood alone, the tenderloin has the highest rate of preventable emergency room visits, second-highest rate in participation in healthy san francisco, five times the city average for hospitalization due to uncontrolled diabetes. our health care needs are very severe. the baby would be a very in which needs are most severe in the city -- the bayview would

be the second place in which means our most severe in the city. in addition, about 40% use medical. by contrast, sari, -- sorry, cpmc's three main campuses served extremely low amounts of medical patient. these are numbers from fiscal year 2009. less than 10% of cpmc's patients served were in medical -- were medical patients. when you talk about our concerns of cpmc serving the poor, this gets to the heart of our

concerns. they currently don't serve the poor. when we talk about being in opposition to the hospital, we are talking about being in opposition to a hospital that will be built in our neighborhood with no intentions of serving our people. 40% of the tenderloin is on medical. less than 10% of cpmc's patients in 2009 were medical. additionally, the charity care numbers of cpmc are very bad. they may make a serious effort to tell you how their dollar amounts of increased, but cpmc has a clear capacity to provide more charity care. less than 1% of cpmc's revenue in 2009 was given back in

charity care. that is one of the lowest in san francisco, half the state average. st. francis hospital, located in the tenderloin, serves significantly more charity care, about 4% of that net patient revenue is returned in charity care. while they may make an example of their increased dollar amount of charity care, the percentage of net patient revenue is not enough. the tenderloin has the low- income neighborhood where many people are uninsured and depend on charity care. this number is unacceptable. they have a greater capacity to provide more charity care. lastly, these are patient discharge members of cpmc from their institutional master plan in 2007. this is the latest data we could

find. a highlight the neighborhoods are the tenderloin and bayview, where the health care needs are the highest. combined, these neighborhoods, these patients were seen less at cpmc than patients from other areas. already, cpmc does not provide access to our community in their hospitals. what good is a hospital in our neighborhood if it is not going to provide services to our people? there is no way the tenderloin, and i can say this with good confidence, there's no way the tenderloin will want this hospital in its neighborhood if it is not going to serve the people of the tenderloin. [applause] president olague: is that -- how many more seconds? six seconds.

[tone] >> that fine. i am part of the next group. i'm nato greene. we started as a different coalition when cpmc tried to close st. luke's. it evolves to responding to the health care implications of the project as a whole. we're constituted around a set of principles. we now have more than 30 organizational endorsements from around the city that oppose new hospital development when they don't prioritize the health care needs of san francisco. we are not at the service of the private company's business plan. cpmc in this instance, you are being asked to make a big trade offs. huge land use concessions.

people do build 550-bed hospitals. people do not build them on a single city block in congested urban area. that is uncommon nationally. i have a chart i will show you that shows how much more parking and acreage is typically used for a hospital the size. the tradeoffs you are being asked to make are not actually justified. we did a review of the academic literature around hospital size. there's not overwhelming evidence that hospital size is related to quality or cost- efficiency or anything like that. there is a value of specialization and capel volume, but that volume in a particular area does not correspond with overall hospital size. you can have a lot of one thing, but that does not mean you have to put