in tenderloin. this is the first time i have heard about that. i have concerns. i want to make sure it is not a tactic that causes tenderloin residents to be quarantined. i would like to know more details about that as a community member. isos need more details. i want to urge you to please accept the agreement and enter into a community benefit agreement with the community as well. thank you. [applause] the >> my name is maria, and i work at st. luke's. we are requesting that if they rebuild current and and and now it should be entered forto 160 -- 140 to 160 valence theory

guard -- 160 beds. we can make this hospital work greater than -- hospital work. we badly needed a psychiatrist karen -- psychiatry care. thank you. [list of names] >> i am not doing well with names tonight. i am not sure what the reason is really. i have of blocks -- a block. you can come up in whatever order. >> good evening.

i have been a nurse for over 35 years, and at cpmc since about 1986. without union representation in the new hospital, and may be forced to rebid on my job and my shift. please do not permit these plans to continue without considering the implications and consequences of not having a union -- not having mandatory overtime, request favoring seniority, monitoring to protect patient safety. these are three examples of the benefits of union representation. nurses are advocates.

now i care for an advocate for my patients. the union protects me. i am a member of the nurse association, and i am in the union. thank you. >> good evening, commissioners. i am a registered nurse at campus. thank you for taking the time who to listen to the registered nurses. the history goes back more than 150 years ago and is a history of female nurses to build a hospital for the families of san francisco bay area. the history is intertwined with the california nurses association and goes back almost 45 years. most of the nurses have worked the bulk of their career cpmc.

most are in their 40's and their 55. there are many parts, but my goal is the question how we will work in representation of the community. this expands to patient care. not only are we not guarantee the jobs with the new facility -- if we rely on the process, we are guaranteed to stay in the middle of an ugly battle, and where will this take place? this will take place in our homes, and it will affect our patient care. good to be sure there is no way the they will fight it out. that is what will happen. this latest fight on our facility brings this point home.

the fight is not over, and it is still terribly contentious for all of us, so when they say they will leave union representation on up to the nlrb, at any other process is an infringement on their right to free speech, what they are really saying is that they do not care that we will be in the middle of the vague ugly fight -- big ugly fight that will extend for years. >> we have no more speaker cards. is there any additional public andcomment and? >> it was very discouraging to hear cpmc project what i

considered to -- project -- reject what i consider to be moderate requirements. cpmc plans to go on to a site that has all kinds of rules, and what they are asking for is a development agreement. they are asking for encroachment now permits, and they are asking it all to begun -- to be done so it is inviolable. the city should have asked for a full range on transit, housing, business assistance. they should be dealing with the requirements, which are

specific as to hospitals. they come at it because they are on a hospital that does not pay property taxes. it is highly subsidized by all of us. that is what enables them to run commercials every night on late night tv. they should give up those commercials done. it is a mess. what we need to say is how is the transit going to be provided? how is the housing going to be provided? how are they going to deal with their employees? i do not think that cpmc is dealing with good faith. you need to nail down when each document is going to come out.

thank you. [applause] >> i am reading this for a steady at -- for debbie at cpmc. i am also a nurse. thank you for taking the time to listen. it is important that the public understands that a patient advocacy be protected. the risk of retaliation, and it is important the public understands the union has such protections in place. if it were not for our unions, and the skilled nursing facility would have been closed in 2009, which is roughly about 50 skilled nursing beds that are documented as a shortage.

after failing to improve staffing levels and skilled nursing and -- it brought our patient ratios to approximately one in five or six. we could not safely care for our patients given their i.q. conditions. cpmc currently bars are union representatives from going anywhere outside of the cafeteria, and they are barred from any new representation. they have found anti-union literature in new orientation. we need a fair shot at

representation, and we need to transfer rights. i have 22 years of nursing experience but no guarantee of a job at cathedral hill. please support us. thank you. [applause] >> i am a tenderloin resident and survivor. i am a member of the health center community advisory board. i also think if anything, this package is too small. i can see more than a few things missing i have never heard of any remediation for the homeless

center, which is clearly going to be impacted. that is just one example. i urge you to see this and work out from it. perhaps that is another wild dream. remember, if cpmc finds this package to be too large, they can always modified, and the remediation package will also adjust. they have the choice. when i was a medical professional, i never imagined that my five-year plan would include addressing the planning commission, but i have to say i have enjoyed it over the years. >> is there additional public comment spam of seeing none, public comment is " -- public

comments? seeing none, public comment is closed. miguel: i want to take this together with a few comments on the press release and mr. brown's testimony this evening. first on the mayor's request, the statement is the st. luke's is an acute care facility for its least 20 years. 20 years is nothing in the life of a major medical institution. for meat, and minimum of 35 to -- for me, a minimum of 35 years or 50 years is what is required. we know the residential expansion is going to shift population to the south, and we

only have sf general and st. luke's to take care of it. from their own press release , cpmc plans to be in san francisco for the next 150 years. next, begin construction of st. luke's prior to constructing cathedral hill and operate cathedral hill only after opening st. luke's. only logical. the construction time is less than st. louis, and the need is even greater. concurrent on new operations are absolutely essential, because they argue that the specialty care to be provided is needed to supplement what will not be available at st. luke's. they have to be concurred.

next, implement the recommendations of the blue ribbon panel. i think we have gone over this, and that is pretty well-settled, as well as i can tell. the office building should be operating no later than three years after the hospital opened, and we continue to refurbish the building. i have a slight disagreement with the mayor. i fear in my mind for years is too long. i would like to see that open no later than two years after the hospital is constructed at st. luke's. i think it is vital to the st. luke's operation, and i am going to have more to say about that later. the next section is the charity care and community benefits. to provide charity at a level consistent with nonprofit

hospitals in san francisco for as long as they operate. absolutely. cpmc's record on charity care is abysmal. that is the nicest thing i can say. the average unt for nonprofit institutions is 2.36% of revenue. cpmc stands at less than 1%, around 194 or 499. cedar siding akin los angeles -- stay . around9 -- stands around .94 or .99. in his press release, he is saying is $2 million. that sounds like a pr firm told

him to use that. i year agreed the only way to arrive at that number is to project forward 50 years, so if i took his own computational message, how about the way back 50 years and computing the amount of charity and community care they would have to provide san francisco in that time to be a good citizen. i have not done the math, but i think they would be so far in a hole they could not climb out of it in 50 years. next is providing outpatient services consistent other private hospitals in san francisco as long as they operate here. no question, and that same computation going back 50 years would provide another interesting result, and last, a

partner with san francisco community health clinic consortiums to expand care for low-income residents, focusing on surrounding neighborhoods of cathedral hill and save lives, continued active participation -- and st. luke's, continued active producer patient. i do not see a problem with it. it does not need any further explanation, but i want everyone to understand what we are really talking about in this section. all private nonprofit hospitals assume a social obligation to provide community benefits and the public interest in exchange for their tax-exempt status. this includes charity care, metical, and programs for the communities they cpmc servethey

-- they serve. cpmc is nonprofit by illegal -- by a legal entity. the next section is housing. contribute $4.1 million suit in the wake of -- to moh with rent- controlled units being displaced, contribute 73 million for the 20% inclusionary portion as required, as they did two or three terms, "as required by special use." this is totally consistent with the requirements for any developer in the special use district, and cpmc is nothing,

despite his protests, nothing more or less than our real estate developer here. that is exactly what they are. the next section is workforce development, local hires for the facilities, at least 40 new hires each year. 30% san francisco residents. i year they had a slight disagreement with the mayor. i believe the requirement should be for at least 10 years if not longer. the last thing is pedestrian safety.

one of dozens cpmc -- of the major arguments is transport plans. it is only consistent with their location concept to enhance the major corridors. 25 cents, depending on peak times, to of least 60% of employees. if you increase traffic, you should be required to mitigate those problems. last, an $11 million for streetscape and the tenderloin as well as about 7 million in the neighborhood. ahoy this is the exact same thing as other transit-related items. this calls for street

improvements as needed in mitigation. -- and needed mitigation. is this out of line? not as far as i'm concerned. take a look of stanford hospital's expansion proposal, where they have $2 million only for transit improvement. transit improvement calls for only $1.4 million common -- $1.4 million, plus the fact that if you compare the locations of stanford hospital, where it sees as a teaching hospital region where it sees as a teaching hospital and who -- where it is in the middle of a teaching hospital, you will find a vast

difference. the plan to rebuild conquered crete, this is a state entity, exempt from local land-use regulations. it is going to contribute about 60 million against $1.5 million mission they produce. before i finish, three other quick items regarding the project. i am still not completely satisfied with st. louis's proposal being large enough, and i have constantly mentioned there is additional, nearly vacant land in the and media it area, which i feel should be used -- in the immediate area, which i feel should be used to enlarge a hospital. i still think that can be done. number two, and it was mentioned tonight -- there is a failure to

address the bed. lastly, there is an item that has not been publicly aired, and that is the disposition of their california campus, the oldest children's hospital where i was born. i suggested it might be considered a skilled nursing facility bed, operated by some entity. i have seen increases, but so far this large campus in the middle of heavy residential neighborhood and commercial districts has been without neighborhood involvement. it is inconceivable to me that serious thought has not been given to its disposition, and i am confused as to why sutter

every statement they've made to me is we'll get to it later. as far as i'm concerned, the development agreement must include mention of the california street campus or will not be complete. it isn't invisible, not going away, and in my mind is an integral to the total process as are the davies and pacific emphasis. and that's enough for me. [applause] commissioner antonini? >> i read an editorial in today's chronicle i'm in agreement with and was written by vince cart any who was a labor -- vince courtney and is very supportive of the project as i think we all should be. we may be different on parts of it and points out what is really essential. and i think i speak for the

vast majority of patients at cal pacific and those who pay for medical insurance or their employers. i personally go to kaiser but they have the ability to go to where they want to and choose their own doctors. and if we don't build state-of-the-art hospitals, there's a good chance many of these people will go elsewhere, even outside san francisco. ened you -- and you hear of people who go to other hospitals because they get care for a veert of -- variety of reasons. it's essential we do this to keep our employees employed, to make health care accessible to our san francisco residents and also for the 35% or so who come from outside san francisco for care at cal pacific.

so i think it's really important that we compare this hospital with hospitals that are comparable to it, not hospitals that are not comparable. when we do comparisons we have to talk about stanford, mills peninsula, john pure and, you know, not compare them with hospitals that are not comparable with them. i think chinese, as we've dealt with, is a fine hospital but an entirely different thing. and in fact cal pacific provides some of the subsidy to help run chinese. so i think we have to look at this. and as far as charitable care, my information is that in addition to the $100 million in charitable care dr. browner spoke about, if you add in the medical care, whatever the percentage, it's at least another $100 million. the $200 million they do in charitable care a year is comparable to that which stanford does.

when you say stanford is in a different place, there's a lot of challenges in that part of the peninsula as well, east palo alto, menlo park, there are many people with needs for charitable care there as well. we have to look at that. as far as the housing piece, i don't believe that you should hold an institution to the same rules of the van ness plan you do commercial development. i think we can exempt it by c.u., and as was part of the mayor's plan, we will exempt it by c.u. the question is, what should be the price that they have to pay? and i think that, you know, the $73 million is an's -- is an unrealistically high figure. whatever ends up being negotiated is important but the important thing of what's negotiated, it should be applied as the nexus of the impact that the hospital has on

the area. and we should -- this is a great opportunity to provide middle income housing that the city does not build, housing for nurses, housing for doctors, even though nurses, i understand in the sutter system, i may be wrong, the average salary is around $130,000 per year. well, i may have the wrong information. i may have the wrong information. >> how can you think that? >> ridiculous. commissioner antonini: i believe i have the floor. whatever the salary is, and what the salaries of doctors are, it still is not enough to afford housing in san francisco. and i think that this is the whole problem we have. we have a situation where people are making too much to get affordable housing to be included in inclusionary housing but not enough to buy their own housing. and so by targeting whatever this number ends up being, and

whether it's $73 million or whether it's a lower figure, it doesn't really matter. it should be targeted specifically by the mayor's office of housing towards providing housing in the van ness corridor that will address the housing needs of the people who are going to be working at this hospital. so i think that's really an important feature and there are also some entitlements we have already passed that are sitting, not being exercised like sutter and van ness, that glass box that should be demolished as soon as possible. there used to be a theater. and maybe there's a way that the mayor's office can work with the developers there and help to build this work force housing in that area that will address our concerns. so i would -- whatever ends up being the issue here and then, you know, that's where the money should be targeted. as far as subcontracting by cal as far as subcontracting by cal pacific, i think while there