72% of our patients are either seniors on medicare, adults on medical or uninsured patients. the demand has increased for primary care in our area. in the past two years, we have seen a significant rise in demand for our services. in 2010, the clinicic increased 3% in total volume. we saw an incredible 14% from 2007. so there clearly is a demand and need in community. at the prime acare clinics we have struggled. i have professionals in my office who are nurses and social workers who share waiting room with my patients who are struggling to feed their families. i have one patient who is a lawyer. she has received all of our care at st. luke's. she prefers staying at st. luke's. i also care from an immigrant from mexico who arrived to us with uncontrolled diabetes.

much of his vision gone and after multiple interventions, he has almost total return of his vision and control of his diabetes. he deserves a state of the art faspiment our hospital is old and lacks many futures. >> thank you. >> thank you. >> hi. good evening. i know i'm going to make this as short and sweet as i can. i'm carol williams. i'm a respiratory therapist. the bulk of that time was at stanford university where i actually helped build that hospital as well. i was part of opening the doors so currently i'm a respiratory supervisor at st. luke's. my children were born at the cal campus and lived three blocks awhy from the cal campus but now

time at st. luke's. that was actually my very first clinic cal experience was at st. luke's. we took care of a juvenile diabetic mother who was 17 and was 27 weeks pregnant and she was coding off and on. so anyway my daughter now is a nurse at the cal campus in the pediatric so we're all pretty much want to support this hospital and make sure that it becomes -- that it is rebuilt so that we have a state of the art hospital. we also have a success story with the ventilators and the first hnhn case was at lukes and the mom and baby were able to go home. thank you very much. >> they said please read this.

this is from the dad. i'm very tired. my wife is exhausted. our child was health departmenty. it was an intense 36 hours of childbirth. there are so many ways it could have gone. it was heartbreaking for me to watch my wife who with inhuman strength and endurance push on and on, night and day, night and day. our saving grace was the magnitude of support and competence of the staff. mid wives, nurses, task force. with killed commitment and demags came into our lives and helped pull us through. it might be difficult to thank a few remarkable people but i'm

almost dumbfounded by the individual who is make up the staff. it was -- we understand st. luke's is the stepchild of the hospitals. with slightly disstressed buildings and underfunded facilities. i have been thoroughly educated and can't imagine why all hospitals don't rely on midwife, nurse and doctor staffs. you have literally changed our lives and i just don't know how to thank you. i am moved. sincerely, todd, father of my 12-hour son. for me, please build us a building that rises to the care that we give and honors the

patients that we care for. >> thank you. >> good evening, commissioners. thank you for being here so late. my na i have been in san francisco for 38 years. i was a commissioner for 10 years for as the president of the relocation appeals court. i'm this month celebrating my 30-year anniversary with the harvey milk club. the joy and the vein of american public policy is that you can take the same set of facts and analyze it from many different places. and perspectives. i'm taken tonight by the fact that i've been involved in the coalition for public health to try and save st. luke's hospital. cpmc was planning to close st. luke's hospital. close it down.

over the past fife years, it has done away with either ob/gyn, many, many different programs. to dumb down that hospital. now three, four years later, they are active in the community giving money to many nonprofits who apparently showed up today to say how wonderful cpmc is. how wonderful they have been in the community. they have not been -- they wanted to close st. luke's. they wanted to dumb it down and make sure that it was functionally and operationly inactive. so you need to consider the sources of the folks who appear before you, maybe myself included. they are not good members of our they have not been. and i think you need to slow down, take care on what we do.

and consider all the alternatives before you. thank you very much. >> thank you. >> good evening, commissioners. i've been working at cpmc for over po years as a hospital aid. i ask your support and i strongly support the cpmc project. this new building has met the california earthquake code regulations. they can have a feeling of safety and security. these new buildings will provide more accessibility to health care and increase the level of patient care. i believe patients heal faster when they are in a clean environment and i have been working to provide them that environment for 30 years.

everybody who works -- my job is to ensure -- they are covering the best environment possible. commissioners. the opportunity for more -- thank you very much. >> thank you. >> it is all on you, maria. [laughter] >> saving the last -- best for the last. good evening, commissioners. my name is maria cordova. i'm a respiratory therapist at st. luke's hospital. i'm also a member of -- as you can see. a union member and i've worked for st. luke's for the past 10 years. i have lived in the mission district for 17 years and i'm here to speak in support of the new hospital for my neighbors that i have treated and gotten

to know for over the years. first of all, i'm a proud -- i'm proud to work at st. luke's. we're known for providing charity care for the community. in fact, my own brother came here to st. luke's and got help when his wife was laid off through their low-income program. actually a lot of our patients are low-income. uninsured and underinsured and st. luke's provides essential services but the state to have building is shameful. it is too old and unsafe to meet the health care needs of this community. i know this because of my job as a respiratory therapist. i work all over the hospital from e.r. all the way up to i.c.u. on the 11th floor treating paringts. we have provided all over st. luke's and i want to give you three examples of why it is a

serious problem. first, the building is not equipped to from vide access to care. if you have -- to provide access to care. if you have never been inside st. luke's, it is an old, old building. it does not work like a modern hospital. imag for the patient and finding out that the outlet in front of you does not work. it doesn't provide services our community relies on. our community needs access to emergency. our same day care. the e.r. is almost always overcrowded. the new location will expand services like the e.r. that the community actually uses. and third. >> thank you very much. >> is there any additional public comment? seeing none, public comment is closed. >> as we heard earlier, this is

the third of several hearings that the health commissioners had and our appropriate action will be to refer this to our planning committee and work with the planning commission to come up with specific items for the development plan and so it would be my recommendation that we have very limited feedback from the commissioners if they have any and that as we also heard, the planning commission will be having three more of these hearings. >> so if there is any comments from any commissioner, if you could please -- commissioner antonini? >> i'll keep any comments brief. i just want to thank everyone for their testimony. i think one thing that i did note at the beginning by dr. brown, what is very important, having cal pacific become a center of excellence in san francisco.

there was a lot of talk about community tonight. the community for me is it is a big community. 805,000 resident departments and hundreds of thousands. on any given day who are tourists or visitors here or commuters coming in here for work and also 30% of people who come to cal pacific from outside san francisco and that's also the case for other fine hospitals. i think a of the 6,500 jobs are because we are a regional center. we have to continue the splens. we have to rebuild a new facility and new facilities -- there are centers that people continue to come from long distances because the care is superior as are the facilities. one other thing, i just wanted

to add about the consolidation. i think it is important, as was pointed out by a couple of physicians who testify in cases of where there is urgent care needed, sometimes it is important that the services all be in the same place. there were concerns expressed about the seismic quote. there are going to be seismic issues no matter where the hospital is. hearing from the testimony tonight, cal has two other hospital sites that will have emergency room care and we have all of two sites for ucsf. san francisco general and kaiser and three catholic health care west facilities in or near san francisco, so it is not like all of our emergency care is going to be isolated in one facility. those are the main things i take out of this. there are a lot of other things but i'm not going to belabor the points except to say that it was a very interesting discussion.

i appreciate it. >> commissioner sugaya? >> just a quick comment on the proposed schedule. i think it is too aggressive. for one thing, you're trying to have us consider the entitlements and at the same time initiate planning code, general plan amendments. i don't think that is going to work, for me, anyway. i don't know about the rest of the commission. but we could have a little bit of space in between the entitlements and in addition, that would be a little bit better. >> it wouldn't happen until june. >> ok. but anyway -- >> i'm not ready to initiate at the same hearing is what i'm saying. >> i would agree with commissioner sugaya's statement. i would also like to ask -- the one document we have in front of us summarizing the plans seems

by now quite outdated given the many things -- so at a minimum i think in order to discuss entitlements or anything for that matter, we really need to have the actual updated, new refreshed vitized master plan. having said that, asked about additional topics, i have two. i would encourage this -- these commissions to talk with m.t.a. and -- in one room because we just recently without getting into detail has a -- after the fact, after being made an approval, we were told that -- weighing in and i think the primary commissions to continue this -- two sitting here together tonight and i believe we are well served. also would be very interested in getting an update on what --

highway 1 is considering with van ness because that is alluded to. i have never seen any official on that agency in this room and i think it has some far-reaching consequences of how we are looking at this proposed campus to function. just in the event that we don't get the -- >> commissioner borden? >> i would support commissioner moore's comments and just also wanted to say a few things that i would like for cpmc to address at future hearings is the work, you have been meeting with the collaborative and i understand that there is a desire not to give anything when you don't know what you're going to have to give elsewhere. i would like to hear more from -- response about what it is that you're thage about doing in response to what has been addressed here. i would like to know what your plans are for improvements to

charity care. charity karin creasing has been increasing -- charity care has been increasing. i think the ideas for the long-term work in that area is something that we want to know more about particularly as it pertained to neighboring community of the -- the other thing is the health care cost. i did see that story when it was in the news, i guess it was last week about health care costs in northern california being higher and i would love to better understand -- in the story it said costs of labor and other things were involved. but just better to understand why overall health care costs are higher in northern california and particularly within the health system, that would be very interesting to just better understand that. and then also i would like to know more about your distribution model. it seems that looking at the charts there is a lot more

charity care underserved at st. luke's and understand about your distribution care model and how it is that that facility is overly, you know, burdensome. it might say and the other facility is not. i would like those issues addressed at a future hearing. >> commissioner miguel. >> yes, i'm not going to go -- >> april 1. after that, i appreciate the work you have done with the health center. i worked with the doctors in san francisco free clinic and i appreciated the work you're doing there. i cannot help but presume that the increase in charity care has been directed entirely from this project. it was not altruistic. as far as i'm concerned. still, it is -- as far as the

percentages. regardless of -- when you take a look at the statistics, it doesn't measure up 3789 i would like to speak to someone from cpmc who is familiar with the march 16 health commission resolution memorializing the agreements reached. there is a section in n there that i'm total anyone from cpmc who is familiar with that? i'm looking at a health resolution. memorializing the agreements reached by the medical center regarding the master plan. reached on march 16 of last year. a series of recommendations.

it was provided by robert garcia. >> commissioner, i'm frankly not sure i understand the question. we addressed many of the -- in fact all of the recommendations with the -- >> should increase its care of patients to -- with other hospitals. the agreement will continue to serve medicare patients throughout the system maintaining its medicaid contract with the state of california providing access through suddener pacific medical foundation clinics and the st. luke's health care center. it doesn't say a word about cathedral hill. why not?

>> the issue has to do with private commissioners. many who practice at cpmc frankly do not take medical in their offices. however we have made a commitment. we have always had medical for every patient who shows up in one of our facilities. >> point out st. luke's and you ignore your main prized campus. >> again, it is an outpatient clinic that is part of cpmc. again, the vast majority of the patients who come to have have don't go to doctors who work for cpmc. they go to doctors who admit to cpmc. if a patient comes to crp to our emergency room or is admitted to our hospital or has any service performed at our hospital, we take that medical and always

have taken medical and always will take medical at all of our campuses. we're happy to spell it out in more detail with the health department. >> since the commissioners antonini and scalia have spoken i'm going to ask the commissioners to. >> yeah. i want to keep it short because i think there have been some items that have come up that i like to take back to the health commission and discuss it with the rest of the health commission. i appreciate excisioner in moore's pointing out the whole question of traffic in that area because very recently, the commission health commission was given a report on pedestrian safety, especially in the tenderloin and in that area. and so we really need to look at this and i would like to bring it back to our commission to

further look into some of the issues that were discussed tonight. >> about access to care for poor people. our concern is that every hospital. she does not have a history of provi people at the california pacific and davis campus. the answer here is a development agreement that is very specific and as you saw in the pact that she gave you, there is an example that very specific about the amount of money, overtime,

devoted and i would suggest that this commission, planning commission, when you approve the entitlements, you have a specific development agreement that embodies all of our recommendations that we have been working with this hospital on for three years. we have had far more than three hearings. it has been six. it is wonderful to hear these people again pointing out the good things that cpmc has done and the areas where they have come up short and i think it is a real issue in the tenderloin that people in the tenderloin are not going to feel comfortable going to this massive hospital like they do feel comfortable going to st. luke's. st. frances, rather. you see that result in the charts barbara garcia provided. i would like to see. if -- cpmc match that level of care in their emergency room and i don't think that is going to happen unless you hold them accountable. >> i want to thank first of all

director garcia and the health commissioners for coming out tonight. i know this is not your usual schedule. so i want to thank you for indulging us in that way to be part of this discussion. i also share a similar concerns that were expressed by commissioners illic and commissioner borden. for me, it is not that comp i indicated -- complicated of a question. it is not even -- i'll keep it to five minutes. that is you know, when we heard from the residents of the tenderloin, it is about land use to me. this isn't -- not just purely a health care issue. that you had several -- many, obviously immigrant senior residents at tenderloin, many who acknowledge they have been living in the tenderloin for 10

years or more. filipino residents. chinese-american residents. elderly, some youth. very diverse population of people who are committed to staying and living in that community and they are concerned that they won't have access to an institution that is going to establish itself in an area that is adjacent to where they live. so i also want to understand the access issue to -- the charity care or to care. the -- that would be provided at this institution as it relates to the health needs of the residents who live in the adjacent neighborhood to have tenderloin and that's just a very simple question. i don't think it is that complicated. i'm glad to hear that there have been, you know, some support of

clinics and the bayview and other neighborhoods but i think as it itself relates to land use and adjacent si and health care needs being addressed by an institution that will be requesting of this commission several acts above and beyond what is allowed as of right in the planning code, i think then we need to look at, you know, some of the mitigations and really balance out all of these issues and as we have with other projects, even though the development agreement is something that is drafted between the project sponsor and the mayor's office and in other words the city of san francisco, it is not really the planning commission, i acknowledge that, we do want to be able to have some guarantees that the institutions that we're going to be engaging with and looking at,

you know, agree to certain exceptions and variances and conditional uses and the rest of it that the mitigations are in place. to balance out this whole issue. so i hope that we have director garcia, director -- the mayor's office. everyone in this city is very -- very much paying attention to this issue and i just hope that we really get a sincere conversation, sincere gestures from cpmc and that we don't have to -- deal with the level of -- that we have been dealing with so far in our engagement with this institution and this project sponsor which i think

really does far surpass other experiences that we have had in our dealings with other -- huge developments that have these -- this little of impact on the city. you know, if you don't you can't admit patients that you don't have. so that might be responseable for some of the statistics. even the central city statistics which were quoted today and i won't name the two hospitals, that have lower levels of admission than do the cal pacific campuses not including st. lukes. i think there's movement in the direction clearly. i tend to think there is been a lot of problems, have been