talked about the lawsuit and the -- i want to make sure that we are diligent in how we approach this, so it is definitely a big issue for us and other jurisdictions have issues about how they are dealing with it. >> as costs go up, the other hospitals have come and underneath and shadow price that. i will assure you that the health service's board and the health services system is doing everything they can to try to find transparency so that we don't just kind of turn our budget over to the health care

providers. everyone else -- president chiu: on the issue of the possibility that over the next 20 years, there may be an escape clause to get out of being able to continue to fly to st. louis, have you considered what other options might be available to maintain saint luke's under different ownership? is it viable for the hospital to exist outside of the framework?

>> it would be very difficult for that, but we know that in the work of what we're doing is to protect the 20 years and whether they would still have the obligation if it wanted to pull out of it, what obligation they would have to complete the 20 years. there are systems in the city, when of those being our own. that is a concern that i certainly have. that is why it is so important to maintain the 20-year commitment to ensure that we do have a hospital that continues to provide in that community and also support the most vulnerable populations. part of that negotiation will be to ensure that there is commitment continuing. president chiu: a second question was related to the

initial comments around the health care master plan. part of the point of creating a master plan is to think about the geographic distribution of health care. while the plan exempts how projects, how should we think about the geographic distribution of health care of these new hospitals? i have major health care institutions which are six blocks and not to much further from the new campus. how should we think about how the hospitals are going to impact the other and what type of consequences mit? >> the hospital council that works collaborative lee, health care west is looking at their own hospice system and how they may have to merge some of these services. president chiu: based on what cpmc is doing.

>> not so much cpmc, but a health care reform as well. we also have to go from a steeper service were the goal is as many visits as you can to a per-month payment. that is going to change the quality of the direction that will be able to manage. it is a great concern around the country about how health care assistance are going to respond. the hospitals will reconsider the plans of how they will go to health care. they are talking to each other. they are having those conversations, and san francisco general hospital as part of the council to discuss how we are going to do that. i am being approached to look at how we are going to move closer

together. president chiu: if this anisn't addressed in public comment, i would like to look at that. supervisor kim: the are many questions on charity care i had as well, and the feel like most of the questions were predominantly already asked, but specifically to the tenderloin, and you anticipate them setting up competing services in the neighborhood? the you perceive that they will work with existing medical institutions? >> this is one of the discussions we have had, the importance of partnering with another organization.

there is a demand ahead of him and the cisco households as a result of the development. is not current from the -- >> thank you, supervisor kim,

for that question. our conversation regarding the housing package was based upon the existing regulatory framework imposed by the special use district and also by section 415 a, planning inclusion marry a zoning ordinance. based on those frameworks, it would have been based on the original square footage and would have been roughly 220 housing units. currently, the direction of the negotiations are trying to move in the direction of 190 units. given that, we are attempting to meet the obligations under the existing regulatory frameworks if they would have been imposed.

another regulatory framework that exist for this project is the jobs housing linkage framework that incidentally does not apply to hospitals. if it did, it would -- i had these numbers a second ago. if they were applicable, that he would have been reduced to 12 million. excuse me, if hospitals were subject to the jobs housing linkage fees which is another way of determining and offsetting the work force housing impact, the fee is calculated by the planning department in coordination with -- it would have been roughly 12 million. it is far less than the package

we are currently negotiating now. supervisor kim: be you have a value? gosh no, that is actually the housing impact of creating new office commercial space in san francisco, an ordinance that has been in effect for a couple decades now and is based upon the square footage calculation. it was difficult for us to arrive at the exact square footage calculation because hospitals are not included, but we would have projected that the medical proxy would be roughly $17.48 a square foot. supervisor kim: i realize the linkage fee doesn't apply to households, but cpmc would have to pay -- i assume the

homeowner down payment system is trying to replicate that feed in the sense that we are creating more jobs and those employees will have an impact on the housing market. the homeownership down payment program? >> i think that it is certainly a characterization of the impact that homeownership is attempting to replicate. i would say in regards to that piece, the overall package addressing that will far exceed $12 million. supervisor kim: you have a valuation that you're proposing? >> we are negotiating how to get to that number. we will have an exact value the next time. i am sure the next time we are at the board, but certainly before it goes the planning.

supervisor kim: it depends on the mix of ami. >> it is going to be more based upon what we believe the projected down payment level of assistance will meet the. supervisor kim: and a quick question about the replacement of the demolished housing units. it is only when they do demolish that they have to pay this fee? >> the have to make a payment prior to issuance of the demolition permit. supervisor kim: not when they are vacated, but at demolition. >> yes. president chiu: in the 2009 housing element that we passed,

i know that in the draft eir, was that housing demand taken into account as you thought about what the city's ask would be? >> supervisor kim mentioned this earlier. the numbers are assuming that those are an accurate projection of the housing demands in the long-range development plan that would create and would be housing demand that would be distributed across the income levels of the employees being brought in. in our situation, what we're really focusing on where the housing demands of low and come and very low income, although the housing demands of the work force category. in terms of that, what we

really looked at as we concentrated on the peace and the relationship between the office space and housing demand, that specific piece is really captured again in the linkage fee. if we went back to the jobs housing linkage fee, determining this obligation, that $12 million, that figure would be quite below the package that we are trying to negotiate now. president chiu: thank you. supervisor mar. supervisor mar: i know is laid, and i appreciate the department staff. it was addressing supporting the existing area plan housing. any new development project

would fulfill the goal as a grant of that exception. i am interested in how you come to the conclusion that by meeting the housing portion of the 1100 units, that is meeting the intent of substantially fulfilling the underlying housing production goals in the city. >> thank you for raising that resolution, i think i was not here. in crafting that, i believe we were really focusing at the time, and for your point and a substantial requirements, i will say this. if you take a look at the obligation in aggregate, 1100 units that we calculated out, and offset what we are addressing it with of the mayor's package with the 900 market rate units. at the end of the day, if you

monetize the value of those market rate units, they would come out with and that to gain if they develop the 900 units. that is why we focused on the inclusion very peace and the affordable housing piece of the 1100 units because that is where the city requires a subsidy in terms of production. that is how we went about prioritizing those. supervisor mar: a question for ken ridge. given the candlestick point development approach to allow stakeholder groups, community based organizations have a key role in having benefits of that huge development, i know that the community organizations, many of them are in the overflow room and in our chambers, many feel strongly that the community

benefits agreement is the only way that they can hold them accountable for agreements made. the development agreement is very important, but it is a way that we can insure that we are meeting health care benefits, transportation and housing needs, especially as the project is so huge. are we going to ensure that? >> thank you, supervisor. in working on the development agreement, we have been focusing as hard as we can on making the development agreement as inclusive as it can be hot. it is as rigorously enforce the will of the camby, who development agreement with cable and include it in a really substantive way, all of the issues of been raised by the community. there are a couple of issues

that we can legally include developing agreement. we have not taken a position of the community benefits agreement beyond the benefit agreement. we are focusing our efforts in making sure the development agreement is a strong and enforceable and includes as many of the issues as we can. president chiu: supervisor wiener. supervisor wiener: you mentioned the breakdown of the cpmc work force that would need housing. what is the -- forgive me if you have said this already, but the cpmc employees, was the breakdown vis a vi low, moderate, very low? believe of the break down? >> i don't have that level of

detail of information with me. it is information we can ask for. supervisor wiener: cpmc has that, but we don't have that? >> i don't have it with me, we may have had it at some point, but we can certainly get it from cpmc. supervisor wiener: and the affordable housing money, but will correlate with the breakdown? if it is for moderate, low, very low income, be you believe that the money will correlate to approximately the same percentages? >> without having looked at the numbers, it is difficult for me to answer that question. i will say that the underlying goal of the housing package was primarily to address the

inclusion area obligation -- inclusionary obligation. that was the metric that we were designing this rental program, he residential piece of it. supervisor wiener: very low and below. >> that is typically what it would be. supervisor wiener: the you have a hunch or a prediction, that there is going to be a mismatch between the allocation of the affordable housing dollars versus the actual income levels of the employees? >> i can't answer that question.

>> is coming from the affordable housing dollars vs the percentage breakdown and the population. we should get at least know that. >> will get that data and we will break that down and certainly work with your office to analyze it. supervisor wiener: correlate it converses where the affordable housing dollars are proposed to go. ideally, it would be a chart showing the income versus -- that's where i'd really be looking for. >> i understand the request. i want to point out the metric by which we were designing this

program, it was based upon the inclusion area obligation that it would have been built to under the special use district. supervisor wiener: different people will draw different judgments. it is either acceptable or not acceptable, it might be good faith policy disputes, but we have had this discussion before. i am of the view that we don't do nearly half for moderate income earners in this city. you know, it is hollowing out the middle class. i understand that some might disagree with that and think it is much more important to focus on the low and very low. i respect that point of view, and we take away whatever judgment we will take away from that. supervisor mirkarimi: mr. ridge, i was replaylining your answer

about the community benefits agreement? >> we have been working very diligently on the development agreement trying to make it both substantive and complete. and on the enforceability, trying to make it as rigorous as possible. we are aware -- we think almost all the issues that are relevant to this project can and are included in the development agreement. there are some that we cannot touch in this city document like a development agreement, specifically labor relations issues that are controlled by federal statutes. we think the document was a pretty complete. we don't have a position, we're

just trying to focus on the development agreement. supervisor mirkarimi: i would like to take this opportunity to abrogate -- advocate for the neighborhoods west of the proposed site, especially if we want to do this via a supervisor of jurisdiction -- supervisoral jurisdiction. i wouldn't be surprised if it shifts these words. i haven't seen anything that speaks to the western addition except in some way a very superficial adjuster about work force in the western addition. considering the high disparity, health care concerns of african- americans compared to other populations, i am a little

surprised there hasn't been any mention of that considering that this borders on district 5. relative to the earlier answer, this is a large and growing population of seniors. why hasn't there been consideration on cathedral hill for this? the answer was, how they weren't a very forceful in their advocacy and is a non-answer to me. i don't know of the inferences of the committees are, this is a failure to launch if those communities do not include the neighborhood to the west of cpmc. that also implies that if there is focus on -- it's my impression that the special use district will encompass gary and

be the gary brt. i don't see mention of it being at least some allowance and assigning of support for the gary brt either. i hope the concerns will be well-noted. and it is a little more robust about the surrounding or a bit of what it is. i greatly appreciate the features that are moving east words in the plan itself. >> if i could quickly respond to a couple of your points, it may have gone over too quickly, but on the request to support construction of the facilities, he requests is both. we would be asking them to help

build facilities. certainly, folks traveling from the west towards downtown would be benefiting. and we did not get into an of detail, of some of the requests, support for clinics, we have a list of neighborhoods we are looking at. it does include the western addition as well as the south of market and the mission. we are actually asking for support for primary-care clinics that would be in the western addition for district 5. supervisor mirkarimi: the impact of this corridor where you have kaiser and across from there, moving eastward were you just have a little bit north, for all intents and purposes, it will become the new pill hill

corridor of san francisco where the medical health care industry and its largest concentration with the exception of the satellite campuses will be centered right there. i don't think you can -- and the radiating in packs of the surrounding neighborhoods in all directions of the campus. again, what i am seeing before us here, what i think has been mentioned, it rings thin. supervisor cohen: thank you, mr. president. i'm not sure which person to oppose this to. saint luke's will have the unilateral authority to rear back or shut down any of the

service lines, or will the require board action? >> we do have legislation, ordnances that the health department -- any health service has to come through the health commission -- that is one way, and again, the health department will be managing the development agreements for component of that. any program, we have a couple from the providers that want to close the service. it'll have to go to the health commission. president chiu: any further questions for city staff? i want to thank the city staff for your presentations. questions may arise as we go to

the presentation, but why don't we open it up for public comment? i would like to call up half a dozen folks. i know there are many individuals that have been waiting outside including folks that are seniors and disabled as well as parents with kids. as is the usual course in the public comment, i would like to give them priority. i also have about 2 inches worth of speaker cards, rest assured that we will stay as long as it takes to hear from everyone. i would like to call up a couple of individuals. [reading names] if we could hear from those individuals, and i will continue to call people through the yellow speaker cards. if we could first year from