and will change the height and bulk designation to 105-e. there are several conditional use authorization required, including modifications to the existing planned unit development, the need for general plan amendments to make conforming height changes to 105 feet, office allocation for the medical office building, and several other approvals from other city departments. at the may hearing, the commission requested a comparison of the existing and proposed hospital facilities at st. luke's. this slide show some basic numerical comparisons that relates to the size and capacity. of the two to nine licensed beds, at st. luke's, 150 are licensed four acute-care. of the 229 beds, 139 are in use. at 60 of the 150 acute beds and

all 79 skilled nursing. the project proposes 80 licensed beds in single occupancy rooms that are expected to generate a higher occupancy rate. the emergency department will increase by 70% and the outpatient care capabilities will more than double. at the may hearing, the commission asked for a comparison of the existing and proposed medical services at st. luke's. there is a memo that outlines all of this information. in summary, this slide shows most of the existing inpatient services will be retained. st. luke's inpatient psychiatry unit was closed in 2006, and all of the inpatient psychiatry services systemwide are performed on another campus, and there are no changes proposed in this project. there have been several recent changes at st. luke's that have resulted in increased services, as the services are indicated by the asterisks.

this is a continuation of the inpatient service comparison at st. luke's, which shows the service line changes at the hospital. pediatric services were the required care is more than 24 hours stay. patients would be transferred to the geary hospital. the existing skilled nursing beds would not be placed on site. director garcia will go over the skilled nursing issue in more detail as part of the development agreement discussions. last, subacute beds will be eliminated and patients will be transferred to comparable facilities in the community. this will also be discussed by director garcia under the development agreement section of the presentation. this slide shows the same comparison, but for outpatient services at st. luke's. there is no reduction of outpatient service lines proposed, but there are outpatients services that have been expanded, again, indicated by the asterisks.

this is the continuation of the outpatient service chart. now we move on to the baby's campus. it -- for the davies campus, there is a small list of required land approvals. they need conditional use authorization and general plan referrals, along with a few other approvals from other departments. there was a question at the may hearing inquiring about the changes that have occurred to the babies project since the previous approval in 2007. in summary, there have not been any substantive changes. it -- with the babies project. -- with the dacies project. the sidewalk has been modified, but the building itself has not been changed.

now we move on to the van ness and geary campus. the project requires several land-use approvals, including general plan amendments to the van ness area plan to support a high density medical campus, a general plan referrals for the tunnel under van ness avenue and the lane reconfiguration, sidewalk widening, and underground storage, creation of the van ness medical subdistrict within the van ness special use district to allow increased floor ratio at the hospital side from 7 to 9 and at the medical office site from seven to 7.5. and to allow projections over the street, reduce tight for the loading spaces at the medical office building, and to allow block modifications for conditional use. it also includes mass amendments to all-out increase height from 130 to 265 feet, and there are

several conforming map amendments to go along with this. there are several conditional use authorization is requested, including additional unit. a conditional use for demolishing five housing units and to allow modification within the van ness special use district. also, allocation is required for the medical office building, and there are several other approvals from other public agencies. i will touch on the caltrans approval for the tunnel in just a moment. at the may hearing, the commission requested a comparison of what was driving the size of the facility at van ness and geary. although cpmc has indicated that the program at van ness and geary is primarily driven by the consolidation of inpatient services at the california and pacific campuses, this slide shows some of the basic numerical comparisons that specifically relate to the size and capacity.

between the pacific and california campuses, there are a total of 594 licensed beds, 295 of which are on average occupied. the proposal is five under 55 licensed beds, all in single occupancy rooms -- 555 licensed beds. the existing of patient care capabilities will mostly remained at the pacific campus, resulting in only a small amount of outpatient services at the van ness and geary campuses. at the may hearing, the campus request -- the commission requested an analysis. this chart covers the major components of the van ness special use district. the medical center, the height as proposed to be increased by 135 feet, the bulk propose to be modified through the proposed medical subdistrict and

conditional use, the proposal to increase the hospital side from seven to 9-1. the required three-one housing requirement to be modified through it conditional use if certain findings are made by the planning commission, as is the case with residential demolition is. cpmc is requesting c.u.'s for both and this will be discussed in this presentation. at the last hearing, the commission asked for a graphic representation of the project, juxtaposed to the code complying project. this slide shows the comparison in the form of massing diagrams. the image on the left is the existing hotel. that is slightly taller than what is a code complying, being

approximately 137 feet, and it exceeds bulk limitations. the middle is the hypothetical massing diagram, meeting the code requirement, meeting the bulk limitations, and meeting the seven-one that limit. the image on the right is the massing diagram of the proposed hospital project at van ness and geary, two but a 65 feet tall on the southern side of the site, requiring modifications to block and includes sar of 9-1. -- it is at 265 feet tall. this slide on the left is the existing development along the project site. the mittal diagram is the hypothetical project that is a code complying meeting the book limitations. the third diagram on the right is the proposed project which is code complying at 130 feet tall, but not meeting the bulk

limitations and exceeding the the sar by 0.5. idoes slide shows and television how the hospital compares with the code comply at the height limits. the image on the left is the view of the hospital from van ness. the slide on the right represents the view of the hospital from the court looking south. on the obligation on the right, the tallest most portion of the diagram is in the background, and the massing is along the north elevation, shown by the lower-level below the height limit. this is the same elevation comparison, but with the medical office building site. on the left is looking north from gary. on the right is looking east from van ness ave. at the may hearing, there were questions about parking.

this slide shows the existing cathedral hill hotel and office buildings compared with the proposed hospital as it relates to parking. the bottom chart shows the project is a code complying with regards to parking. last, at the may hearing there was a question about the status and the likelihood of cpmc obtaining the necessary approvals from caltrans of the underground tunnels that connect the hospital to the medical office building under van ness ave. in short, caltrans has issued a conceptual approval letter for the tunnel based on a few contingencies. that concludes the first half of tonight's presentation, and now i would like to turn it over to the office of economic and workforce development. thank you. >> good afternoon, commissioners. that has been my task to work with cpmc and the other

stakeholders to negotiate the development agreement which will memorialize the benefits that cpmc receives from the city and provides for the city. since you have seen a few proposals later, i will not go over the basics, but i could do that if you wish. on may 16, the city issued a detailed set of requests for cpmc in return for the long range development plan. this was a few weeks ago and we are in the process of discussing each of these in detail with a hospital. there are no agreements yet, and we cannot finalize the development agreement until there is agreement. but we are presenting tonight is an explanation of the city's staff from the different departments. one thing i wanted to emphasize and i hope is apparent from the presentation is each and every portion of the request arises out of months of discussions

within the city family about the best way to ask cpmc to respond to the impact of the project and to do its fair share to meet the needs of sansome systems. project of san francisco residents. as you know, under a development agreement, but the city and project sponsor receive benefits. on the screen above, these constitute the majority of benefits that cpmc would receive under the development agreements. in addition to these approvals, as is customary with most development agreements, cpmc approval at cathedral hill, said it looks, davies, st. luke's, was during a time where the city could not change them. we will go through the details of this further in the next hearing.

i think it will be clear after this presentation just how much staff time and effort the various city departments have invested in making this project work for the city. this is because it is critical for the city in several ways. it creates two seismically safe hospitals when an earthquake occur at any time. it provides $2.5 million of construction activity, which will occur over the five years immediately after the project is approved. this differs from other large projects, whose construction and job-related benefits will out over a much longer time. with all of this discussions and debate around the project and what it should do and what it is, i want everyone to remember that at the core, it is important the city. because it is such a large and ambitious project and require significant zoning changes, we need to make sure the project improvise benefits to address

this impacts on all san francisco residents. several months ago, both cpmc and the community coalition asked the mayor to direct city staff to develop a package of requests represent what the city would like to see cpmc agree to through a development agreement they could support for the project. that request was issued to cpmc in the middle of may. during the rest of this hearing, we will be outlining it for you. i want to be clear that the city has indicated support for the project that cpmc has proposed and has been presented to you in previous hearings, as long as it responds to all of the items outlined on the slot above and will be presented to you in a few minutes. this is still an ongoing negotiation process. cpmc is not going to agree to any of these -- is not going to agree to all of these items. the mayor has asked staff to spend time working with cpmc

over the next few weeks to get to an agreement on how each of the points in the may 16 request will be met. the next time we are before you, we expect to have a draft development agreement that spells out all of this specifically to present to you. structurally, all on the screen, it met the approvals, it ties together the construction and opening schedules for st. luke's and cathedral hill hospital, specifies detailed health-care obligations, specifies the number of community obligations, includes a payment schedule for all the cash obligations, and includes strong enforceability provisions. to move on to the actual meat of the presentation, i will first go over the housing peace. section 243 of the planning code, the van ness special use

district, requires three square feet of residential space to be provided for every one square feet of other use. the planning commission by conditional use can modify this agreement for specific uses, including medical by making certain findings. the first part of the housing aspect from the city to cpmc requests cpmc contributed the mayor's office of housing a dollar amount representing what will be the required inclusion rehousing portion of the total required units. how was that calculated? if the hospital did provide the full three-one housing, they would need by planning department calculations to grow about 1.4 million square feet of housing. factoring in a typical 8% efficiency factor, which pulls out mechanical and hallways, that would be 1100 units of 1000 square feet each. if any developer wished to pay the annual fee for those units,

they would though 20% of those units, or 220 units. if you multiply 220 units by the feet o, it results in $74 million. the second portion of the request response to the displacement of 20 sar units and five rent-controlled -- thank you, sorry about that. and five rent-controlled apartments by the construction of the cathedral hill office building. the city's administrative code says the developer must pay 80% of the replacement cost of those units. the city's real-estate department work with the mayor's office of housing and determined this amounts for the 20 units, $2.7 million.

for the rent-controlled units, the five units, staff agreed the appropriate payment would be exclusionary in lieu fee for five units which would allow the city to replace those five units with five permanent affordable units, calculated at out to $1.4 million. those added together are the $4.1 million displacement. i will turn it over to the director of public health who will take you to those requests. >> good afternoon, commissioners. thank you for the opportunity to present to use the health conditions. the rebuild of these hospitals are essential for san francisco residence. the last time i appeared before you was the very day of japan's earthquake and tsunami, a somber reminder of the importance of

having seismically safe hospitals in san francisco. i want to acknowledge cpmc's commitment to rebuild. to provide background, the health commission has been involved in the cpmc rebuild for the last two years. in july of 2009, the health commission passed a resolution related to cpmc as the master plan that included seven recommendations. one of these recommendations created a working group to come to an agreement with cpmc on the recommendations, and we did come to agreement with cpmc on many of these recommendations. in march of 2010, the commission passed a separate resolution to memorialize these agreements. the health related provision of the development agreement follows the framework the health commission recommended. the key policy issues that the health commission want to look at where the charity care

patients, the long-term viability of st. luke's, and the community benefits to afford services to low-income san francisco residents. as i mentioned, through the work with health commission, cpmc has agreed to some of the provisions included in the development agreement. i want to share this with you. these include the creation of 62 new skilled nursing beds for medi-cal patients. subacute care, concurrent construction at the two campuses, implementation of the blue ribbon panel recommendation, and the center of excellence and senior and community health. charity care. charity care is the provision of health care to low-income individuals, without the expectation of reimbursement. cpmc has made improvements to

the provision of charity care the past few years and we like to see that trend continue. according to the resolution passed by the commission, it should provide charity care at a level consistent with the private nonprofit san francisco hospitals. st. francis, st. mary's are the only other private nonprofit hospitals, which is why this proposal uses their average as the benchmark for cpmc. when we look at 2009 numbers, which are most recently available, solder, which is cpmc and save lives, provides 0.99% of patient revenue through charity care -- at sutter. just to acknowledge the fact that the first three other hospitals, government-run hospitals, which have different

financing the private hospitals. there is subsidized by public funds, subject to those public budgeting process. kaiser also has different recording requirements. medi-cal is another resolution to provide inpatient and outpatient services to medicare out that a fisheries, consistent with other nonprofits. this measures the proportion of all hospital services that are appropriate for medi-cal, using the averages of all the other private nonprofit hospitals. this would be important with health care reform when it is implemented in 2014, and as many as 36,000 san francisco residents who are uninsured will gain of insurance through medi-

cal. the comparable percentages are 6.53%, and 13.73%. this slide shows and other nonprofit hospitals an average of 10.46% of all outpatient business, and 15.05% of all inpatient visits are for medi- cal visits. addition of provisions to provide care for the metical charity care patients include a san francisco proposal submitted to cpmc. the department like to continue to support. $3.75 million to the consortium to provide primary care, specialty care, but let it --

clinic-based care, provide a pathway for patients to enter cpmc hospitals, and also provide a mechanism to let cpmc with charity care and their medi-cal obligations. 1.6 is related to subacute care mentioned previously. long-term viability of st. luke's is the next key policy area address to the development agreement. they want to ensure that citrix is an integral part -- at st. luke's is an integral part of hospital care in san francisco. the commission had asked st. luke's be operated as an acute- care hospital with emergency needs for at least 20 years. health commission has requested

a long-term commitment on the cpmc operation of st. luke's. provision 1.8 relates to the current commencement of construction and the provision of 1.9 relates to the blue ribbon panel recommendations i mentioned. these are items cpmc has agreed to. professions 1-10 and 1-11 provide centers of excellence. ait would be an anchor in the community and respond to the committee pause health needs -- and respond to the community's health needs, individuals in the neighborhood surrounding st. luke's. at the center of excellence senior health, which we would believe would be comprehensive needs of san francisco seniors. 1.12 insures access to the most up-to-date technology, which we

believe is an integrated way to provide access to care. we have a lot of concern about special care access and how the mechanism is developed. at st. luke's. 1.13 would require the building of a new medical office building within four years of the completion of st. luke's hospital. this medical office building we believe is critical to st. luke's success and provide a new modern space for physicians, private offices, and create incentive to practice in and around st. luke's. 1.14 provides full integration of medical staff for all cpmc hospitals. currently, the medical group at st. luke's is separate from the other groups at other cpmc campuses. we believe that it agreed in the medical staff would allow physicians to practice it in a campus and allow patients to more easily have their health

needs addressed within the cpmc system. community benefits would require cpmc direct the community benefits to low-income individuals in the committee. all nonprofit hospitals and california are required to provide community benefits as a condition to their nonprofit status. for example, charity care and cost of providing care to medicare patients are considered part of the community benefits. this provision would require a focus for cpmc community benefits to support san francisco is vulnerable populations. cpmc currently partners with chinese hospital to provide certain specialty services at a reasonable rate, and item 1.16 would continue this productive relationship.

last, to meet the needs of the diverse population, we would require cpmc to maintain culturally competent services in accordance with national standards. this last item was proposed by catherine dobbs of the san francisco health services system, and this provision would require cpmc to keep rate increases to blue shield to no more than the medical rate of inflation for health insurance to city and county employees and retirees. that is the conclusion of my presentation, commissioners, and i will turn it over to the next presenter. >> good afternoon, commissioners. thank you for having me to

present the cpmc workforce plan. but my colleagues, we have been working for the past two years with cpmc and their consultants and staff on the work force. you can imagine a product of this size presents a lot of work force opportunities, both on the construction side and what we call in-use side. ok. cpmc -- well, we have proposed a provide $2 million to support the construction and non- construction workforce training programs for economically disadvantaged job-seekers. because this is a private project, we have not exercised our first source policy. at least 50% of the entry-