health care related and asking its employees if they'd want to return their watches to help pay for this. i found that reprehensible a nurse, someone who is not politically involved and is a regular person who had a baby and this is what she heard from her nurse. i thought it was a terrible public relations campaign to have a hospital try to pit the city against employees who have worked somewhere for a long time and asking them to return a gift they've got phone their years of service. even if it's a joke, it's inappropriate. so i find the overall public relations campaign around trying to ville phi the city's asks if they were completely unreasonable and then to the overall impact and principles we're here to uphold would ask you to do is a bit disingenuous. that's where i'm going to leave it. applause. >> commissioner fong. commissioner fong: and i've got

to follow that. you know, as i tend to do, i'm trying to keep my comments broad and long-ranging and i feel like part of our responsibility as planning commissioner is to think really what's best for san francisco in 20, 30 years out. so i'm supportive of a hospital for sure. we need to get our hospital size extremely upgraded. but it disturbs me a little bit and i think all members of the community in different groups that have come out and spoke and is a little concerning how far apart people seem to be at this point. hospitals to me really is a be places of healing and i don't get that sense it's happening right now. i also understand that -- and feel that hospitals should be part of the daily fabric of a community and interact with the community on a daily basis but their primary function is really to heal those who aren't well and hopefully none of us find ourselves there but when we do go there and it's our turn to be in that bed, i want

a hospital that's successfully running and maybe one profitable that might be slightly overstaffed or adequately staffed and when i push the help button someone will be there. i'm sympathetic to the nurses. i know you're trying to provide the best service as possible for your patients. and you wouldn't be nurses without having that care and passion for human life. so i'm going to keep it broad and hope that over the next few weeks or when we see you next things get a little bit closer together. again, i do feel it's a very important project we need to get done. i also don't think we should break the bank and hit a group too hard so they can't operate when we actually really physically need them in time of need, whether it's ourselves or our family. those are my comments and i'm looking forward to a closer discussion next time. >> thank you. commissioner sugaya. commissioner sugaya: ok. thank you. i'm in agreement with

commissioners borden and the others. mr. miguel and also commissioner fong. the healing reminded me, i was just taking a look at the mission statement for cmpc while he was mentioning healing and it doesn't mention healing. it's a nice statement -- no, no, i didn't mean to belittle him but it reminded me i should take a look at this and it's a nice statement but the one thing that's kind of interesting is that it ends by saying that after providing cost-effective health care and being compassionate and respectful, having compassionate and respectful environment, those are supported and stimulated by education and research. for me it would have been much more a better statement if it had said it had been supported by the community that it serves and think a number of us are

having some issues as well as some of the testimony that was given. charitable care. i don't think we should go around and compare cmpc to st. fran francis and others and those are nice statistics to look at and have comparative things but as commissioner antonini pointed out some other hospitals are different animals and maybe are apples and oranges. but from that standpoint the city needs to drive what the level of care should be and not rely on other examples, stamford or marin or whoever else. and that's where i think we're lacking that overall kind of health care master plan that has been discussed earlier this year and earlier last year and since we don't have one, we don't have a kind of mechanism to kind of hold all the hospitals to the fire in some respects.

so i think that if we can kind of through health care and through the mayor's office look at that and, you know, i'm quite comfortable with the mayor's numbers though sometimes i think we should operate from a position of strength. and that's why i don't like the word "ask." when i saw that in the paper, i thought ask, ask what? we should be demanding these things. they should be requirements. cmpc should be using the word "ask" because they're asking the city for all these concessions. they're going to try to get us to increase the height along van ness avenue from the current 165 feet and double it. you know. and as commissioner borden was saying, i had the same thought, you know, who decided that that site was the best site given all the zoning, transportation, and other issues surrounding that particular property? and didn't anybody ever go to the city and say hey, you think

that the commission and the board of supervisors and everybody going to really give us another 160 feet along a corridor that's been highly planned for a number of years that have all these requirements for residential and everything else and setbacks and whatnot? no. maybe you did and maybe the then planning director, whoever it was, said ok, yeah, maybe it will work. but i don't know if that happened. anyway, mental health issues and psychiatric beds. i think those should be part of the development agreement. and maybe you should start thinking about how much that increase should be if there are indeed 18 beds or whatever was mentioned. and i think that -- and i don't know if this is true, the planning department or the mayor's office, but we heard a number of people testify that they would like community

benefits. i know the mayor's plan have what are called community benefits on an ongoing basis. the majority of it, $32 million versus $1.4 million, are all health related community benefits, which is fine. and then $1.4 million is identified solely for transportation. i don't think that's what the people from the tenderloin and -- were talking about. and my understanding has been from their representatives of an extremely difficult for them to get p, you know, what they want into the mix of things. so whether that happens through the mayor's office or whether it happens through planning staff, i would like to see some movement on satisfying or at least bringing them to the table to discuss what it is they specifically want. because in the testimony one of the -- i guess one of the disappointing thing to me is they didn't get down and say this is exactly what we want, they mentioned community

benefits a lot but i didn't hear anything specifically but maybe, you know, the level of testimony here is kind of such that that's how people present things. but i think they must know what kinds of things they would like to have as part of a community benefits package that would be part of the development agreement. so i think before that draft comes back, i personally at least would like to see something along those lines in there or at least we can have some report back that said there was a discussion about it, and you know, the community still is not happy with it or whatever. p so -- i think that's it for now. >> commissioner moore. commissioner moore: thank you, commissioners, miguel, borden, fong and sugaya. i think we're all building on the similar line of arguments. i look at cmpc really more like

a development transaction, i have to be really plain about that. because if cmpc would indeed not eliminate three additional or four additional institutions, but would build a hospital just on their own for the very purpose which they seem to be postulatting would be fine for me. but since they're choosing to somewhat turn the existing health care system in this city upside down, i think we have all the right for every possible scrutiny and every possible ability to ask what normally a developer would have to do is build a large, oversized building for all the reasons which ms. hester and all of you have pretty much outlined. so i feel we're in a strong

position, not at all intimidated by making it clear that the expectation of the minimum of what they should be asking for. the transformational impact of the district or phenomenal. you do not have any idea, although we have the health commission standing side by side with us but the long-range effects are in health care delivery and equitable health care delivery for the city as a whole including all of us sitting in this room. i with an to commend the staff for an extremely good job today. for the first time i'm sitting here and all the questions to which i wanted like statistics, illustrations, comparisons, the way it is, the way it could be and what's in between, these questions are clearly and actually quite clearly answered. some of the things, until you see them explained as today,

you don't fully understand because words can be interpreted a number of ways. the facts are here. and that is what we ultimately need to look at page by page relative to what we're asking for and what we're willing to give. and at this moment based on whatever today, and i was going to take a broad version of hostile comment, i think we haven't even asked for enough, because some of these statistics and some of what's explained in here seems to be somewhat unresolveable to me. . there are big, big questions for me. i had a discussion earlier and was talking about mr. rich and perhaps the two of you could come to the lectern if at all possible, the issue of psychiatric beds was brought to our attention in our last meeting, the day mr. rich issued a statement, a draft statement to us about the

mayor's list which was developed at the time and i called him back and said please don't forget the issue about psych beds which again is standing big in the room today. . and speaking about it, i don't want to paraphrase and maybe you could explain it to the rest of the commission, if you don't mind, that we might need to take a step back on that issue and reopen a more informed discussion about why it has been kept somewhat in the corner. you always have to have the ability to keep people out of the psych bed. and we just opened up an urgent care mental health center on

door street two years ago. >> it's not only an urgent care center but have 20 beds of an acute unit. we wanted to do that at the front end. for full disclosure, we also cut psych beds in the last several years due to our budget issue. we are responsible for the mental health status for all of san francisco. every hospital is, also. because as we go on diversion, these mental health clients do get diverted. we have to work closer with the hospitals and ensure people are brought out of those acute units as soon as they can because of the issue of cost and being able to continue to provide that service. and we have to have places to go after they leave the hospital. if we're going to ask cmpc to look at it not just from a psych bed but the comprehensiveness of those beds. as a background to these beds, i wanted to at least from the research i've done in terms of 2005 when these beds were closed, it was brought at the

prop 2 hearing at the closer of the 32 bed at the behavior health unit st. luke's the health commission passed a resolution finding it would have a detrimental impact on health services of san francisco. the testimony that was received indicated the decision to close the unit was not a sutter and cmpc decision but was a st. luke's decision prior to obtaining that and st. luke's is ongoing financially distressed low volume changes in the community standard of care. if we are going to ask for that, i don't have an opposing issue regarding additional psych beds but we do have to have the other complimentary services attached to that or what we end up doing is keeping people in the hospital longer and that's not healthy for clients either. so i would look to talking about a community health care of excellence and they brought up the tenderloin clinic and that might be the place we can do the outpatient programming. if you're going to ought

inpatient beds, you have to add the rest of them. you can't just have an inpatient bed by themselves or we're not doing the right -- our goal is to always get people out of the hospital as soon as possible and keep them in the right level of care and commu feel is healthier for individuals. commissioner moore: i appreciate you stating it and if there are other questions, we can continue the discussion. >> we'll continue to work on cmpc on the issues. commissioner moore: i'd like to make one more point and that is about the projected use of the newly building, seismically upgraded for st. luke's. on that building, you meant 200 years, i assume. i don't think we build a quansa hut or other building for 10 years let alone anything else and is in itself really a -- it's almost laughable.

you don't build a home -- you can build a doghouse for less than 10 years, let alone building a hospital for 20 years, that just doesn't have any credibility. and i would appreciate if that number gets updated but there's a real resemblance of commitment to building a hospital which brings me to the point i am still very uncomfortable about the size of st. luke's. i think it is undersized and i believe that the general overall shifting in numbers does not have credibility. [applause] >> i want to thank staff for such an excellent presentation and also dr. garcia and her assistance for remaining here. frequently we have these hearings and department heads don't stay for the entire hearing so we appreciate your

willingness to stay and listen to concerns that were raised at our round here which frequently intersect with health, even because of the nature obviously of the project, it's hard to separate the two. i think the whole mental health issue is one that the city has to look at comprehensive itly, and that is not our per view here, but as it relates to this issue, certainly, it is something that we feel compelled at least to learn more on the delivery of those services to people in this city, particularly those who are indigent and not able to be insured. i work next to six street, so i encounter a lot of it. the reagan years, everybody talks about and not place in

these types of facilities. it is still an ongoing discussion that we will not resolve through this project, i don't think. but hopefully, if something positive comes out of the legislation, we're looking at the master plan around health, and then we will look at some of the issues comprehensively, with the city dictating the terms as opposed to these individual projects, institutions, corporations, i am not quite sure how to describe it. but anyway, i am tired, and it has been a long day. i don't want to repeat what has already been said.

i think i could borrow commissioner miguel's notes and it would probably be verbatim,, and look over commissioner borden's shoulder, but i think a lot of it was just coming from her heart. and some of the other commissioners as well. i agree with what i have heard here. and the members of the public. as has been stated before, the project sponsor has become familiar with the land use and zoning before proceeding with the project and to understand what the cost might be to that project, should they proceed. and have a lot of demands, as this project does. i know that it is kind of vague. one of the points, numerous

authorizations at all three campuses. at some point, i would like to see more of a breakdown. the you have that in this? we will go over it later. it i see that, yes. there are quite a few here. one thing i have been curious about, the van ness sud and the housing obligation, i imagine if the conditional use was not accepted by the commission, the requirement of the sud, what time would that be? i know the $73 million is based on the and the use fee, correct? for affordable housing, yeah. right, yeah, so i i don't know if you have an answer. >> that is based on 20% of the

full housing bill out. rigid the full house and build out. it would be the market rate. at 20% of the affordable portion, it would be the market rate cost, effectively for those 1100 units. president olague: okay, thank you. anyway, i guess i met a similar place. at some point, i don't know, it is the staff working with the block association and the neighbors? is someone from our department helping? >> commissioner, i have been interacting with the block association, facilitating our conversation with cpmc. although there has been no resolution, those discussions are moving. i am not sure there will be

resolved before the larger issues are resolved, but they're moving together in parallel. president olague: i appreciate where the mayor's office and public health and you are, so i appreciate this as a starting point and to go from here, but not to, you know, go backwards. i think this is a good starting point. at some point, i imagined conversations will start with the community that are separate from this, but i think this, as a minimum, it is at a good place, so i support so far what i am hearing from the mayor's office and dph as it relates to some of those requests. commissioner antonini? commissioner antonini: thank you. i think the short answer might be if we did not grant conditional use and required cal pacific to build the required

three-one housing, as is part of the van ness plan, i think it should not be applied to institutions. as i said earlier, there would be no project. comparatively, stanford is providing the city of palo alto with $6.9 million of housing. again, you cannot always compare things, but just to give the perspective, these are hospitals, they're not in the housing business. yes, they should absolutely replace the housing have displaced and take care of the individuals, but as far as the other is concerned, i think they should do something, but not like the asking. we used to be the city that knows how. remember as a youngster my father and mother coming from the livermore valley to seek medical care in san francisco because the hospitals were better here, the specialists were here, and that is the way

it should be. we have to remain a source of excellence, and i disagree with commissioner moore with disassembly. that seems like more is being built. a new state of the york hospital and two new state of the art hospitals and the increase in davies and the increase in pacific, and possibly the california campus is converted to something else. i see more, not less. there is always a talk about the impact and the negative impact. well, van ness avenue is not the garden area of san francisco, i am sorry to say. there are a lot of vacancies, problems, it is not really vital. this will bring jobs and businesses and will do a lot for that area, deployed a lot of people who are not employed and the whole discussion about jobs as part of the hospitals is what we're talking about. that's not always look on the

dark side. the impact also include the good impact this hospital will have. i think we have to look at that. the st. luke's issue, i agree, commissioner moore, a longer time would make sense to keep it that much into the hospital. it should be here hopefully in definitely, but i think it's size is appropriate. it was a private hospital years ago. it was able to function. as times change and neighborhoods change, it became nonfunctional. it was long before cal took over that it was not going to work. and the fact they are rebuilding the hospital i think is something that is not economically the best thing for them, but it is something that the committee wanted and everybody agreed. it is not built now, and i think that is the appropriate size. every service assault on that list is being continued, as far as i can see.

it seems like it is a full- service hospital, probably appropriate in size for the area. president olague: something else i wanted to mention, we are talking about, yeah, increasing the size where venice is coming up and the size in general, which we approved. mission bay i think is limited to women and children only. what we have failed to mention is we have in the past -- some of us, not all of us -- have approved developments that are fighting upwards of close to 50,000 new residents into san francisco. that being the case, we really have to start thinking about where these people will live. there is hunters point development. i forget how many tens of thousands, yeah, of residents we're looking at there. treasure island, we're looking at close to 20,000 new

residents, and then there is part merced, which is a lot of people there, too. that said, i think, you know, there are a lot of things we need to look at when we decide where the most appropriate place for health care is. i just wanted to make mention of that. commissioner sugaya? commissioner sugaya: maybe it is in some of our materials anywhere, but i cannot recall -- on the other campuses that are potentially downsizing along california and i believe also webster street, wherever the facilities are going to be downsized and the potential for sale of those properties, i want to know what the underlying zoning is and, i don't know, but it will be if a hospital use

goes away. what the underlying zoning would be. >> the california and pacific campuses are zoned rh-2, so institutional uses are permitted, but the other principal use is the two-family dwelling. commissioner sugaya: ok, cool. president olague: ok. >> if i may also just thank staff. especially elisabeth. i think the staff presentation was well organized and coordinated and answered a lot of questions. it was very easy to understand. i want to thank you for your work. also, all the departments for being here, especially the department of public health, thank you, director. i thanked one of the good thing. i think one of the good things about these large projects is we get to collaborate with people who are from completely different fields and different perspectives.

i think it is very helpful for us to learn other people's lines of business when we're doing these projects. i think you all for your work and help on this. president olague: ok. secretary avery: thank you. that concludes tonight's public informational session on cpmc. planning commissioners, you still have the general public comment. president olague: is there any general public comment on items not on the agenda? no? seeing none, general public comment is closed and the meeting is adjourned. [horns honking] [siren wails]