we have the intersection in the top left corner, and the new hospital is slightly east of the street along chavez and medical building is on the corner of valencia. >> as i was mentioning, thening tering and exiting would necessitate the moving slightly southward of the existing bus stop on valencia street. the existing park garage that duncan -- you can see it in the bottom -- center bottom of this plan, will remain and all circulation will be unchanged as part of the proposal. and ambulance and emergency pickup and dropoff will be accessed from 27th street. 27th street is the street that is curved around and becomes san

jose in the center part of the plan. and freight access to the new hospital will be provided to the enclosed loading bay accessed from cesar chavez street. in terms of trip generation as we looked at it for cathedral hill, we anticipate 207 vehicle lar trips to and from the hospital and 271 transit trips. lastly, in terms of the environmental analysis, the draft e.i.r. has found there will not be any significant impacts on any of the mobility indicators including transit. because this hospital is in a very -- is in a dens neighborhood, very residential,

we have been asking for -- we have been working with project sponsors very closely over the last couple of years to include a series of streetscapes, public safety improvements to integrate the facility and be asking for these to be added into the development agreement. i'll go through the high level -- we will be looking at including pedestrian lighting around the perimeter of the campus to provide safety for pedestrians, transit riders and others. we will be looking at sidewalk widening along cesar chavez street. ready to break ground there in a

couple of -- and we will be asking for sidewalk improvements in addition to the streetscape plans. street trees and all that fun stuff -- and then the key corners to make pedestrians more visible and shortening crossings and really to make the fabric here a little bit safer for people who choose to come by foot. we will be looking to include two small public space improvements, one at the intersection of duncan and valencia to regular larize a confusing intervehicles -- intersection.

and greening and public space aments and other things. and on the lower left corner, that big blue dot, that is the existing pavement to parks project which p.m.c. funded as part of its initial trial run and we will be asking that that project be made permanent and a true capital project to the benefit of the community and really what it does also is provide some very important traffic -- traffic calming, keeping cars from barreling through the neighborhood, which is pedestrian safety and neighborhood quality issue. and lastly, a couple of things. guerrero has an existing four-foot median that falls

short of the actual crosswalk which can be a safety issue. so we would be asking the median to extend to the crosswalk to provide additional pedestrian safety due to the fact that many people will be coming to the hospital from slightly to the west. >> i wanted to thank the commission and audience for sitting through a long presentation, but we have to get through a lot of things. if i could have the slides again. hopefully -- we inadvertently overlooked bicycle improvements and didn't intend to do that. we want to encourage the use of bicycling and to and between campuses. in conversations with the bicycle coalition and bicycle

staff, we requested 400,000 for three planning studies, one to develop preferred routes between the campuses and recommend future physical improvements, another to design alternatives and this is just a study, not building anything at this point and third is traffic calming and this does connect the davies campus and 26 tfer street -- 26th street. the last thing we wanted to present, you have been presented with the city's request. natural question to ask, how much does this all cost or how much is the value of the city's ask and i want to discuss how we suggest thinking about the dollar value. this is pretty high value and i'm sure before we are done we will have specific numbers. it's important to think about

the request from the city in two distinct pieces. one-time commitments ties to the proposed development and continuing commitments which should be thought about in relation to the ongoing operations of all of the hospitals. the commitments are straightforward and you see them up on the screen here. we discussed them with you already today. total dollar asked is $108 million, which comes to 4.3% of the total $2.5 billion development cost of the project. you have recently seen parkmerced. the community benefits came to 7% of the total gross construction costs of that project. continuing commitments are a little trickier to think about. to begin with and maybe most clearly and importantly, we don't believe it is particularly

enlightening to multiply the annual costs of these ongoing commitments by any large numbers of years -- president olague: i wanted to inform folks that are standing up and have been for quite some time that room 416 is set up as the overflow room. so if you can start making your way over there. and we'll wait for about -- just a couple of minutes, because it's actually being televised in that room. once an overflow room is set up, folks who are standing are required to go to that room. and if you are part of a 10-minute presentation, we'll call you and make sure that you have time to come over here.

yes. >> all of these that are sitting along the far side of the room under the monitors, they will need to go to the overflow also. president olague: with the exception of staff. and i recognize a staff member sitting on the floor. everyone else needs to go to the overflow room.

president olague: anyone sitting next to an empty seat, please raise your hand. ok, i think we are ready. >> if i could have the slides again, please. the continuing commitments are a little trickier to think about. to begin with and maybe more clearly and importantly, we don't believe it is particularly enlightening to multiply the costs of these ongoing commitments by the number of years, namely 50.

it's to what the city is asking cpmc to do in one year compared to both what other hospitals are doing in one year and compared to the size of cpmc's operations in san francisco for one year because the important conversation is what are they asking us to do every year, not multi-- multiplying and how many patients they serve. you see these numbers on the screen. the important point for now that we would like to emphasize is that the vast majority is made up of fair share requests. you see the pie up above and the majority of the city is related to those two subjects. so that concludes the staff presentation. what i would like to suggest if it's ok with the commission and the chair is that we take

questions from the transportation and workforce staff who need to leave early and have cpmc respond or if you would like to, reverse those. we'll take cpmc next. president olague: we can ask the questions of the folks and open it up for public comment. >> thank you, president, and members of the commission. i'm the c.e.o. of california pacific medical center is a city-wide integrated hospital system that has been serving san francisco's health care years for the past 150 years. and i would like to thank the mayor and its staff for all the hard work they have done and for their support to build two new

earthquake-safe hospitals. my comments will be brief. the first informational hearing at health care delivery and seismic safety back in march and second hearing in design in may, cpmc is committed to the people of san francisco. we deliver 7,000 babies in a year. and we provide one-third of the hospitalizations and one-third of emergency room visits here in the city and we are continuing to work with the city family to find common ground that allows our project to move forward without delay so we can continue to serve the health care needs of san francisco. now while we appreciate the city's draft development agreement in that it has propelled the process forward, the magnitude of what's being asked for is frankly unrealistic, by our math, the city-asked approach is $2 billion over a 50-year horizon

doubling the cost of construction. we can't get anywhere near this number. stanford hospital, which is a project double our size was approved earlier this week and the ask totaled $175 million over a 51-year span, majority of which was provided to transportation benefits to stanford's own employees. we recognize the need to contribute our fair share to the city to address the impacts from our project and provide health care to the poor and underserved. we need to be realistic. we are a not-for-profit hospital system and provide health care services in a compassionate environment that is supported by and stimulated by education and research. we currently provide before any of these asks, over$100 million every year in services to the

poor and underserved. our project is about rebuilding st. luke's at a cost of over $270 million and building a new hospital to replace our existing california and pacific campuses in all in response to a state seismic mandate to continually serve the citizens of san francisco or be threatend with delicensing. we reviewed the city's proposal in detail and it does contain a framework for us to move forward. and based in our review and discussions with the mayor's staff and i would call them frank discussions, we have resolved about half of those requests and the other half is going to require more discussion and little bit of flexibility. before we submit our formal response to the city -- president olague: i'm sorry, i have to ask folks that are standing to please -- those who are not members of staff and i do see a staff member there, to

please go to room 416, which is the overflow room. unless you can find a seat in here. there are a couple of seats here. i'm sorry about that. >> before we submit a formal response, i want to walk through a few critical areas. one of our primary concerns is that many of the requested items and services are in fact for indefinite periods. we aren't sure what the future holds but health care delivery is going to change significantly and become much more challenging for providers. the impacts of national health care reform in 2014 come with great uncertainty. we see ourselves as a steward of an important health care legacy and we need to make sure any agreement we reach provides an operational flexibility to respond to future health care needs. we want to continue to serve san

francisco for another 150 years. our proposal will address our ability to respond to emerging challenges in health care. some of you may recall that our organization was actually in significant financial distress, nearly bankrupt only a short 20 years ago. as i said, cpmc believes in doing our fair share, but i have to suggest that a comparison of our efforts to very dissystem hospitals is unappropriate and frankly unfair. we recognize that we may not have done our fair share in previous years, but our services to the poor and underserved, including charity care and other benefits are now very fair at more than $100 million a year and we would like to work with the city staff to find the appropriate benchmarks to measure our ongoing effort. in relation to targeted community health programs near our proposed hospitals, cp mmp c

is a thoughtful and well developed program at st. luke's and we have a strong unique program at bayview. today we have focus programs in pediatric health in the tenderloin and our partnerships with glide and others and these programs are effective, accessible and we would say measurable. we would like to continue to assist these strong programs. and with the new hospital, we would like to add van ness and geary, which we will staff with case management and social work resources to facilitate access to the uninsured and underinsured. we appreciate the role that the consortium plays, which is why we currently partner and support nine of the 10 clinics in that consortium. we provided $1.5 million in supports and services to the

clinic last year and we would like to work with those clinics to take care of their patients. as you know, we are committed to st. luke's as part of our city-wide system of care and supporting san francisco general and san francisco city's health care safety net and to operating the hospital according to the recommendations in the blue ribbon panel. as part of these commitments, we are going to invest $272 million for the construction of the new seismicically-safe and planning to the future of st.'s luke's. and we are committed to contributing amounts to the city to offset potential impacts of transit, pedestrian safety and housing. with that said, the current asks for affordable housing assumes a ratio that would be appropriate to a condo developer, but they

are not appropriate for a hospital seeking to provide a community health benefit. we believe the number may be higher than our actual impacts and committed to work with the city to resolve these items. we agree with mayor lee that it is critical to reach a prompt agreement. to that end we will meet with the city staff and mayor and work towards finding common ground for all of these issues. my goal is to have an agreement in place prior to the july 14 informational hearing to ensure we can stay on schedule. many in our organization are questioning whether this project is feasible. a delay of this magnitude at this time would only increase the pressure for us to consider alternative solutions to continue our commitment in health care in san francisco and the greater bay area region. thank you for your time and we look forward to continuing discussions with you and the mayor's office.

president olague: at this time, do any members of the commission have questions for rhonda or members of the m.t.a.? commissioner antonini. commissioner antonini: if i could ask a little bit about the employment goals and i'm very much impressed in support of hiring the people of san francisco. however, being a private employer in the medical field myself, oftentimes we give preference to san francisco residents and tell new hires that if you move to san francisco, you have a lot better chance of being hired or maybe a condition of hire. i guess when you talk about a san francisco resident, how long do they have to have been a resident here and can they move as a terms of their employer to be counted as a san francisco resident? president olague: the way -- >> it is if you are a san

francisco resident. all of the training programs that are run, the individuals are san francisco residents at the time we train. and generally at the time of placement. now if they move after place mncht did you to a number of circumstances, so about it. so it really starts at that initial time. commissioner antonini: thank you. i was more asking the question in regards to employment within the hospital, not necessarily those who are going through your programs, but somebody who is just a possible employee of the hospital of which we want to have a certain percentage and i think that would be a little bit more flexible. >> if they are already employed, you know, what i'm talking about here really has no bearing. my work is more on new hires. i'm really talking about folks where there are potentials to

bring in new employees that we want to try to ensure that a portion of those opportunities go to san francisco residents, not necessarily existing employees. commissioner antonini: i was talking about new residents but not necessarily anyone who goes through your program. you have to have a percentage of hires in your program and certain percentage of hires. residents -- >> correct. commissioner antonini: that clarifies that. i appreciate it. and i did have one other question for the transportation folks. i light rail -- it would be better for the van ness b.r.t. if you want to mention -- answer questions about -- the way it's invisioned and i don't know if this is considered, some sort of tunnels to reach the middle of the street, which was not shown

in the visual but it would be helpful for people trying to get to the b.r.t. or light rail hopefully in the future if they don't have to negotiate van ness avenue. i'm not sure if that is part of your plan. but as we move forward with this hospital plan, the most heavily congested area will will be in the mid-van ness area. so i would ask if you consider that or if you ever looked at that sort of idea. >> improving pedestrian safety getting to the station platforms is important and important part of our design. that's why at each station platform we are including extensions of the curb to shorten the crossing distance from the crosswalks to the center platforms. we hadded pedestrian countdown signals and audible pedestrian

signals at every location, not just at the station platform but every location. and we did not consider installing tunnels such as pedestrian tunnels to access the platforms. there isn't the right-of-way. for a couple of reasons. cost and the lack of right-of -way access and emergens on the station platform. but we do think that the pedestrian crossings will be safe. we don't have any data supporting differential safety outcomes for center median operations versus transit station platforms at the side. ultimately folks who are making a round trip do need to cross van ness whether the bus is on the side or in the center.

we will be monitoring pedestrian situations with any of the alternatives put in. but we do think the alternatives will improve pedestrian safety. commissioner antonini: and my final question is, i see the bus areas, the zones on the side, presumably there will be other buses running on van ness in addition to the bus rapid transit. >> great question. there would not be. commissioner antonini: oh, good. >> these alternatives for van ness and i believe it is true for geary also, true for both b.r.t. projects. all of the transit would go into the b.r.t. lanes and that includes golden gate transit and will not only benefit all the transit services but will remove the conflicts between autos and

transit. no one wants to drive in the right-hand lane because you will have a bus in front of you going in and out. commissioner antonini: that's very good and makes a lot of sense because you are losing a lane as i see any way. and right now the buses actually never make it into the bus zones but in the right-hand lanes. president olague: commissioner sugaya. commissioner sugaya: i do have a question. i have always been curious and maybe i haven't looked at the plans close enough, geary b.r.t. when you get to van ness or before you get to van ness, splits between geary -- does that mean we will have dedicated bus lanes on those streets? >> let me ask the project

manager for the geary b.r.t. address your question. commissioner sugaya: also along geary, only going to be one way west, which means people coming to the hospital will have to take -- walk a block to the hospital, is that right? >> yes, correct. we aren't planning to change the one-way configuration, simply to delineate the bus lane a little bit better and make pedestrian improvements. for your first question, we are looking at what's called a transition area and specifically looking at the area between polk and franklin to understand how the bus moves from the side running in the one way cuplet to running on geary, particularly

if it is the alternative, and that analysis is under way and not complete but we are looking at what the design treatment needs to be as well as the technology of the signal in order to make sure it happens both efficiently and safely. commissioner sugaya: is the e.i.r. -- this isn't related to cpmc, but are any of the alternatives being considered in the e.i.r. looking at making geary downtown totally bus rapid transit without any cars and running buses in both directions. >> making geary into a transit mall? commissioner sugaya: yes. >> that is not being considered at this level of analysis. geary does have to be designed as a rail-ready configuration. we reserve the right-ay