discussions relative to cpmc but there are important discussions focusing on transportation and operations and i have a large number of questions but i don't believe it is the right forum. and there are a lot of people sitting here with questions. president olague: i think we will have to do that. >> we wanted to give you a brief overview. commissioner moore: we could do that in a reasonably short time ranking member -- short time frame and focus on transportation? president olague: parking was alluded to but the intensity of use will be different than what we see there currently. so maybe -- they covered some things. we will want to see all of those issues looked at more. that would be great. that's perfect. we will work on monday to try to

schedule something that will elaborate on those issues more. and i have a question to miss simmons regarding the project. is this relying on good faith local hiring? >> yes. it falls under the first source good faith policy. we done i think with given the policy, we've done some added things because cpmc -- on the construction side in a p.l.a. agreement which gets to 30% by trade, which is harder than just a straight out first source. president olague: the city has move towards stronger requirements for contractors. i wonder if there is a way of strengthening that. >> we intended to get to that

through the p.l.a. agreements and the key is the negotiations of the trades, the 30% by trade is getting close to some analogy what we were doing with local hire. president olague: so then we will actually continue to talk about whether we can make something stronger than just good faith? >> yes. president olague: thank you for all the good work. clearly the board has moved in that direction. it would be debate to see if we could implement that with this project. if you could continue to keep us informed how those conversations are going, we would appreciate it. at this time -- commissioner sugaya. commissioner sugaya: we aren't asking questions of other staff? president olague: that's towards the end. that request was made earlier because some of the other

staffers will be here for the entire hearing, so it allows us to hear from the public who have been here for some time. we are are going to take us a 10-minute recess and there are two groups that requested 10-minute blocks of time, the good neighbor coalition and the physicians organizing committee. that will give them time, whoever is in the overflow room who is participating to make their way back here. and i'm not sure which group is going first but also some time to start to set up and after that, we have some reasonable request, accommodations of seniors. so they will go after both 10-minute blocks of time. we'll take -- and we will be limiting public comment to two minutes. >> commission is

president olague: ok. the planning commission is back in session. if everyone can find a seat and be quiet and remember to turn off your cell phones. thank you. commissioners, i believe we had just finished with the ã questions the commissioners had of the presenters that had to leave and we were about to start public comment from the two specified groups. >> we will be hearing from the physician's committee who requested a block of time. they will go first, so they can step up to the mic. and they will be followed by the good neighbors coalition. >> thank you, good evening president olague and commissioners. my name is dr. john rouse and i'm speaking on behalf of those who work in psychiatry at san

francisco general hospital and the emergency service, where i have worked for 30 years. p.e.s. is the only 51/50 receiving unit for people deemed dangerous to themselves or others and brought in by the police and our job is to stabilize them and transfer them to appropriate facilities for follow-up. as i'm sure you all know, those facilities have been evaporating for many years, none more than the 52-bed unit closed by st. luke's in 2006. as a result, the patients back up in psych emergency and the patients winds up with 25 to 26 and patients stay there for days looking for an appropriate place to go. now, in the proposal that you have heard from cpmc you saw a lovely list of services all doubtless, important, useful by ms. withey. you heard from director garcia a list of the city's acts as far as mental health services,

including an attempt to get cpmc to improve its somewhat disappointing record in charity care. what you have not heard so far is a single word addressing the needs of the seriously and chronically mentally ill. as a matter of fact, that was brought up by our group at the blue ribon committee. those 16 beds do not serve the chronically ill as i try and present a patient to them. so what we have here is a proposal to create two new hospitals, two fully

functioning emergency rooms and no psychiatric inpatient facilities on site. what is going to happen to psychiatric patients who come to those emergency rooms or who are brought there by the police because psych emergency is on diversion 30% of the time? i can pretty much tell you, because i can tell you what happens at st. luke's, since they closed their psych unit in 2006. one of our members is an emergency room doc at st. luke's, and he says that on average of their 10 emergency room beds, one to three of them are occupied by psych patients who spend 24 to 48 hours strapped down to a gurney until someone decides to send them out. since you are the planning commission, i should maybe put this in transit terms. what they are proposing to build is two gigantic cull desacks for psychiatric patients, narrow way in, no way out. have to fight traffic upstream coming back out.

>> so what can we do about this? it's not adequate for the psychiatric needs of san francisco. we would request at a bare minimum, as a medical opinion, that st. lukas and cmmc should restore the 32 beds cut from st. lukas in 2006 with a 16-bed acute unit and five detox beds. we call on the san francisco planning commission to carry out its duty to represent the urgent psychiatric needs of san francisco residents and to reject the current plan until it addresses those needs. thank you very much. [applause] president olague: thank you. >> good evening. my name is dr. eugene gensel. i'm a retired physician who

served this community for over 35 years and i'm a member of physicians organizing committee. i referred many patients to st. luke's back when it was a full complement of services and was licensed for 227 beds. as the current census results from a decade of dismantling to the point where cpmc's planned hospital is a mere 80 beds, there are no fewer people living in the south market area than 10 years ago. they still suffer heart attacks, g.i. bleeds, strokes and severe asthma attacks. this is 2 1/2 times likely to die in the first year there as babies in the rest of the city. the hospital cares for patient occupations with a high incidence of work-related injuries, cooks, landscapers, truck drivers, warehouse workers.

yet, the workmen's comp contract was not renewed. the clinic doctor was laid off, the occupational and hand therapy services were closed. there was not even a casting room anymore for broken bones. the planning commission must ensure that these services are restored. bay view hunters point accounts for more children than any other zip code. the mission also contains significant numbers of children. before cpmc threatened to close st. luke's, the labor and delivery services were delivering 1,300 babies annually. demands on g.y.n. and peds can be expected to increase to approximately 1,400, yet, the plan eliminate inpatient pediatrics. the hospital used to maintain a seven-bed pediatric service beyond the two observation beds they are putting in the emergency room, we still need beds to care for those children

after they are born. based on the diverting services like psych, occupational medicine, on codge, surgery and others away from st. luke's to san francisco general or cpmc's north of market campuses, the can sustain is kept artificially low. you could say, sure, abeasy bed at st. luke's is adequate. that was the false logic used to justify closing the 32-bed inpatient psych unit after laying off three of the four psychiatrists and reducing the workload of the last one. dr. eugene lee to half time. without support for doctors who admit patients, the resulting census will remain low. 80 beds does not account for major disasters, such as earthquake or hini epidemic or a pg&e gas explosion.

they were short of standards for search capacity needed to respond to large-scale disasters. the hospital needs to add a sixth floor just to fit into what cpmc has already committed to and handle restoration of needed services. instead, recent cpmc physician rent hikes threatened at the month eagle medical building are chasing doctors away, especially those who wish to remain independent of sutter medical foundation. several doctors who have joined the foundation report that once their practices under sutter under the healthy san francisco plan were being turned away. in terms of medical planning facility distribution counts, the patients who come to st. luke's are least able to afford

a car. it is three bus lines away from any. st. luke's is the only hospital south of market from san francisco general. we wouldn't put all five stations -- fire stations north of market. we want a full complement of hospital services for 370,000 people who live south of market . regarding the proposal to build a, quote, center of excellence for diabetic care, you can't exclude vascular surgery, renal, dialysis and wound care when claiming to specialize in treating seniors. with the federal government proposing to turn medicare into a voucher system and the state cutting back on medical reimbursements, the burden on the county is going to increase. we can't afford to have sutter, one of the largest property owners in the city, paying no property tax while eliminating services. sutter made $878 million profits last year. they have the money to propose

a 555-bed hospital in a high-income part of the city. this is the year of a 2001 services list that st. luke's used to provide and which sutter agreed to maintain which came out of bankrupting st. luke's by cpmc and the law firm. this needs to be a starting point. the planning commission must ensure st. luke's 137-year-old continuance. inadequate st. luke's is poor urban planning. we oppose any planning commission approval of this l.r.d.p. inequitable. president olague: thank you, sir. and you can submit anything in writing that you are unable to

express. thank you. [applause] we'll hear from the good neighbors coalition at this time. >> thank you, commissioners. gloria 134i9 on behalf of california nurses association. i was here at the last meeting and i committed comments -- president olague: you're part of the good neighbors coalition. >> yes, they asked me to speak. california nurses is a good neighbor. as you know -- i don't think there's any question in the room that proposed cathedral hill campus is inconsistent with the general plan as proposed and the v-nap, the van ness area plan. but those particular plans are essential to the van ness corridor in terms of both uses and scale. these plans call for a mix of residential and supportive commercial uses. they're properly scaled for the existing corridor. and the planning success of those two plans has yielded a mix of residential and supportive commercial uses in

this very diverse and thriving polk street and tenderloin neighborhoods. the proposed cathedral campus would be a huge departure in both scale and use for the vision set forth in those plans. the e.i.r. proposed a major general plan amendment that would carve a new subarea 4. the medical use district would include both cathedral hill and the new m.o.b. the carveout would create an incompatible island in the middle of the van ness core core that would overwhelm and destroy both the fabric and the use of these existing neighborhoods. and to carve out the massive campus would put tremendous pressure on the neighborhood to convert small existing pedestrians-friendly services, affordable housing to uses that would have to cater to the hospital and the m.o.b. the city may go ahead and decide to amend the general

plan, however, any proposed land use inconsistencies would have to be resolved according to proposition m principles. and for the v-nap, the city must preserve and enhance existing neighborhoods serving retail uses, future opportunities for resident employment in and ownership of neighborhood and businesses, existing housing and neighborhood character, and the city's supply of affordable housing. those are all required under prop m and the new commuter traffic cannot impede muni. we've heard a little bit about that earlier tonight. right now there's no way to reconcile the proposed cathedral hill with the above named policies. i didn't hear anything tonight that is ambitious enough to resolve those differences. the plan to consolidate the services into one 555-bed mega

hospital and m.o.b. on one tiny parcel in the city in one of the most diverse and congested areas is just untenable. at project completion patients in the city's southeast quadrant would have to travel to other sections of the city for specialized care, while residents and businesses close to cathedral hill will be burdened for a campus too large for the site in terms of land use, traffic, transit and just pure neighborhood character. thank you. president olague: thank you. [applause] >> hello, commissioners. my name is sandra manning. i'm a resident of the tenderloin and i'm a tenant organizer from the central city s.r.o. collaborative. we, as the tenants in the tenderloin, are asking cpmc, they should provide services

and community support that justify its nonprofit status. what is the point of building this hospital when you will not serve the people in the community? all we are asking, cpmc -- if you want to build this hospital in our neighborhood, you must open the door to us for equitable health care for all of us. before you serve us, listen to the community. thank you. [applause] >> good evening, commissioners. my name is angel ca and i'm part of the good neighbor coalition. the mayor's proposed condition for development agreement is -- establishes a good starting point for improvements of the cpmc project. therefore, we are disappointed to hear that cpmc feels it's

too much, when they are the largest health care industry in the bay area. we think equally that in order for this project to serve san francisco's best interests, cpmc can and must do more to address those issues and others outside the scope of the mayor's proposal. that is why we're calling on cpmc to negotiate a community benefits agreement directly with san francisco stakeholders that builds on and extends beyond the mayor's proposed conditions. why do we need a development agreement and a community benefits agreement? well, cpmc's long history of disregarding workers' interests and reneging on its commitment to the community should establish a community project a top priority. it will add an additional layer of enforcements and accountability directly to the community. as you know, the city does not have enforcement mechanisms. this is the first time that the city's actually going to have a

big health industry in san francisco. therefore, the future of our health care, our neighborhoods and the future of good permanent jobs for thousands of workers, most of whom are women of color and immigrants, depend upon it. cpmc's poised to play the dominant role in san francisco's healthcare system for the next 30 years. we really got to think about long term of san francisco's health care. the best way to guarantee that san francisco's needs are met is tone sure that both a strong development agreement and a community benefits agreement are in place, so we hope that you will consider that development agreement is set in place before moving forward with this project. [applause] >> good evening, commissioners. i'm going to use this projector

here, if this works. so my name is steve rue. i'm also with the good neighbor coalition. so, again, i want to reiterate our position that we are pushing for a community benefits agreement in addition to a development agreement. and i just want to start by clarifying some interference over the past week or so since the mayor's position has come out. cpmc is one of the most profitable health care providers in san francisco. in 2009 their profits were at $188 million. they're year after year one the most successful, most profitable hospitals in san francisco, and they are by no means short of profit. so for cpmc to come up here and cry foul, to cry poor, is

somewhat misleading. in addition, let's not forget these folks are a nonprofit. they don't pay property tax to you, the city. in exchange, they're expected to provide charity care or reasonable service to low-income patients in san francisco. but as we can see -- you've seen this chart before. this is the record of the ratio of net patient revenue to charity care provided. cpmc highlighted below is well below the state average, about half the state average. so their claims of providing adequate charity care is extremely false. so the mayor's position is really just to bring cpmc up to the state average in charity care and in medcal, and frankly, the position is that's not enough. average is not enough for this corporation, which is very successful. they can do much more than the average and they're already balking at doing the average amount. so when warren brener got up

here to discuss how $2 billion over a 50-year period was ridiculous and outlandish, we say that assertion itself is ridiculous. $2 billion is the amount of money over 50 years that they should be paying to be adequate ly serving low-income patients as a nonprofit hospital. the $2 billion over 50 years, that figure is somewhat dubious. that's what they should be providing as a nonprofit hospital if they were treating low-income patients on medcal and charity care patients. so i just want to clarify that. the mayor's recommendations were really to bring cpmc up to the state average. that's really -- that's not even enough. we need to go far beyond that. so in addition, i just want to wrap up by reiterating, a community benefits agreement is what the community is asking for. this would really help us go above and beyond the mayor's

position. we see it narrowing the development agreement to add an extra layer of enforceability and would allow us to address issues that mayor did not address in his recommendations. so yesterday, folks, we had a press conference on the steps of staal where we had six -- of city hall where we had six board of supervisors present. so i just want to wrap up by reiterating that. thank you. [applause] president olague: thank you. good timing. we'll hear from the seniors who requested reasonable accommodations. carolina, followed by glar ya salazar and then evangeline. i patrol jies for my pro youns -- i poll jays for my pronunciation or lack thereof, i guess.

>> good evening, commissioners, good evening. my name is caroline -- councilmember grigsby: one moment, president olague: if i can ask all the people standing on this side to come to this side of the room. and there are a few seats. . . . president olague: we have to keep the doorway clear due to we don't want to create a fire hazard, so we have to make sure no one is standing in front of the door. ok. ma'am, you can hold the mic a little closer to you, ma'am. if you can hold the mic a little closer, so we can pick up what you're saying. thank you. >> ok. good evening, commissioners. i am a member of the tenderloin

filipino american community association. i've been living in the tenderloin for almost 25 years. today i want to express my feelings about the mayor's recommendation for pcmc and ignoring the demands of the community. commissioners, we do not need another hospital in our neighborhood if the hospital will not serve our community. what we need is a hospital that serves low-income families as well as the poor people. what we need is a hospital that will welcome the poor, like us.

cpmc continues to ignore the community. we are requesting the commissioners to give cpmc what is due to them, which is to reject this project. it will not only serve the corporate interests for the people like us. thank you very much. [applause] president olague: thank you. >> good evening, commissioners. my name is gloria salazar. i am a member of the tenderloin filipino-american community association. and i've lived in the tenderloin for the past 20 years. i'm here today to say that we're posted to this hospital being built in our

neighborhood, because cpmc has continued to ignore the demands of the community and even the recommendations of the mayor. i'm a senior and i'm on medcal and i know that pcmc accepts very little medcal patients. i cannot agree to this proposal with the development in our neighborhood. but it should also serve our needs. the tenderloin does not want this hospital unless cpmc will open its doors to our community. therefore, i urge the honorable members of this commission not to approve this project without considering the