assistance program is to provide a downpayment assistance for first-time homebuyers. the goal was to provide this assistance to cpmc workers, whether they are residents of san francisco currently or whether they will become president. in part, it is related to the notion of getting people out of their cars and not commuting into the city but becoming residents of the city and trying to minimize the amount of commuting that that individual would do. it provides -- it serves individuals between 60% and 100% of the area median income. we have a slight amendment in the development agreement to conform the cpmc program to what the current mayor's office of housing program is, so there is

the amendment about the down payment, and that is also the amendment not about sort of the limit on the amount of down payment as system going to any individual borrower. so there is a requirement that the downpayment assistance is not a flat number of $200,000 but what is actually needed to make that purchase affordable, and it is ltd. to 45% of the price. -- limited to 45% of the price. the bar or gets a first loan at a local lending institution. i think we answered some of the questions raised about whether the local lenders are participating in our program. and in fact, we have increased -- we actually decreased the amount of the downpayment assistance recently from $100,000 to $70,000. this is our typical program. we did that because there was

such a demand on the program and we want to try to serve as many people as possible. over time, this is a shared appreciation mortgage. so over time, the principal, the original $29 million, will be returned to the mayor's office of housing plus a share of the appreciation. this is consistent with the structure of the shared appreciation of our standard or the typical downpayment assistance program. the goal of the mayor's office is to use those proceeds as if they are returned to the mayor's office for the development of affordable rental housing in san francisco, serving individuals at 60% of median income and below. this was an opportunity for the mayor's office to basically use the money twice. first for a downpayment assistance, and then it

recycling that money again for the purposes of subsidizing deeply affordable rental housing. >> commissioners, to move on to enforcement and monitoring, there is nothing new here. just a recap. three city departments will be responsible for monitoring the terms of the agreement. the department of health, which has the biggest chunk, planning which has almost all of the rest, the transit-related things mostly and the public works things. and then oewd for adjustment workforce things. any enforcement actions, should they believe the agreement is not being lived up to, will be done through the city attorney. to remind you, in terms of remedies for non-performance, in an addition to the standard monetary damages and specific performance which any contract like this would have, this development agreement is also

characterized by specific liquidated damages pertaining to non-performance on the health-care obligations in the development agreement, which are performance and not money- related. so there needs to be liquidated damages for those. and the st. luke's operating commitment. just to wrap up the development agreement portion of our presentation, this slide goes over -- as you know, we have given you suggested changes in the development agreement. most of those are clean-up. a couple that rise slightly above the level of clean-up but in general are not major changes are noted here. in health care, we have made it clear that the innovation fund can be used to provide for the type of mental health services that you heard about. we also made it clear that we reached an agreement that includes in and out-of-network limits for the health service system. under housing, we clarified that

there is a 5% homeowner down payment contribution in that program to make is similar to the existing program. the maximum loan is a $200,000 or 45% of the purchase price. everything else is just clean-up on the language. that is the end of our development agreement presentation. i believe someone will not go through the project approvals with you. >> thank you. planning department staff. i am going to wrap up and take you to the project description and required project approvals. cpmc currently operates a four campus hospital system. st. luke's, davies, pacific, in california. to comply with safety laws regarding acute-care hospitals, they want to modernize facilities through a satellite system of care on five campuses, including a new campus on the van ness and geary, the

cathedral hill campus. cpmc proposes to district five new buildings. two at st. luke's. two at cathedrals. and one at the davies campus. st. luke's campus, cpmc proposes to construct a new five-story, 80 bed full-service acute-care hospital. located to the west of the existing hospital tower, over the surface parking lot, and a portion of san jose avenue. the existing hospital will be able to remain in operation during construction. adjacent, there will be a new pedestrian pathway and plaza connecting 27 to cesar chavez, a portion shown on the graphic. once the new hospital is operating, the existing hospital will be demolished. after is demolished, cpmc will construct a new five-story medical office building at the corner of cesar chavez and valencia. on the west side of the van ness, between geary and post,

cpmc proposes construction of a new 555 bed full-service acute- care hospital. 15 stories and approximately 265 feet tall. across the street, the east side of the van ness, cmc proposes construction of a new nine- story, approximately 130-foot tall medical office building. the two new buildings will be connected underground by a tunnel at the garage level. once construction is complete, cpmc plans to transfer the acute-care services at the california pacific campuses to the new cathedral hills hospital. at the davies campus, and a portion of the surface parking lot, cpmc proposes construction of a new four-story medical office building, the neuroscience institute. this project was originally approved by the planning commission in 2007. it was overturned by the board of supervisors. there have been no substantive changes to the project since

2007. to the land use approvals. there are many land use approvals required for cpmc's proposed five new buildings. i will go through the key actions at a high level as they are articulated in detail in your packet. in broad strokes, the approvals include ceqa findings applicable to the near term projects, general plan amendments for the st. luke's in cathedral hill campuses, in general plan consistency findings on the priority policy findings, planning code text and map amendments for st. luke's in cathedral pulpit a conditional use authorizations at davies, lives, and cathedral bill. general plan referrals at st. luke's in cathedral bill. a developer agreement that would cover all cpmc campuses. the planning code text in that amendment before you today were introduced by the mayor and the board hearing on april 10. at the st. luke's campus, the

planning code text amendment would create the cesar chavez- valencia st. medical use sud. f.a.r. of 2.5 to 1. we would update sud map to show this new sud. cathedral, the text of minutes with creed the van ness medical use sub district. 9 to 1 at the hospital. 7.5 to 1 at the medical office building. it would update the sud map to show the news that district. at st. luke's and cathedral, and several general plan amendments proposed. covered on april 5. moving on to the conditional use authorization conditions before you today, at st. luke's, there's several conditional use authorizations required. to allow pdu, exceptions, off-

street parking, and to allow a deviation from the bulk limits bid up at cathedral hill, there are several conditional use authorizations required, including those to allow medical center, to demolish five dwelling units, and to allow wind speeds greater than 11 miles per hour as a and sidewalk locations. to allow deviations in the bulk limits begun to modify the three to one net new requirement within the van ness sud. at the davis campus, there are two key cu's required. modification to the existing pud, and to allow exceptions to the rear yard requirements. for the project to be fully implemented, the planning commission must first, under item one, as previously discussed, the final eir. subsequently, the commission would need to approve or recommend approval to the board of supervisors items 2a through

2n on today's agenda. general plan amendments, text amendment, and the development agreement, as well as cu's in general plan referral. the barman recommends that the commission to goes required actions in order to -- the department recommends that the commission take the required actions. the department determined that based on the following findings and the findings in your packet, the projects with beneficial development for the city that cannot be accommodated without the requested actions before you today. notably, this project is rooted in the approval of a development agreement which provides mutual benefit to the city and cpmc that would not otherwise be allowed to be achieved. the project would provide two new seismically safe hospitals. a secure future for st. luke's hospital. approximately 1500 construction jobs. retention of one of the city's major employers and their associated 6200 existing jobs. increased taxes for health care

for low-income and underserved san franciscans. and funding for affordable housing, transit, and pedestrian and streetscapes improvements. it will have substantial direct and indirect economic benefits to the city. it is on balance, necessary, desirable, and compatible with surrounding neighborhoods. it is a bit of social -- it is a beneficial to all the to the city. the department recommends that the following -- the following certification of the puerto rico, the commission approved agenda items 2a to 2n to allow the long-range development plan project to move for to the board of supervisors for final approval. that concludes staff presentation, and we're definitely available to answer any questions. i would not turn it over to warren browner with cpmc. >> if i may be four, project sponsor -- because of the complexity of this issue in so

many department agencies are here, want to open it up to any questions commissioners may have for clarification. we will have, of course, after general public comment, deliberation. if there are any specific questions from those who have just presented, now might be a good time. also, maybe, as we have done before, if we can take -- because there are so many different topic items with in this, take them in the order they are listed here. if we can maybe make rounds of questions related -- in the order of health care, transportation, workforce, housing, enforcement monitoring, and the actual project description. with your approval, if you are agreeable, are there any questions for staff from either planning staff or other agencies, departments related to health care? now might be a good time. ?

tisch -- commissioner sugaya? none? anything related to transportation? commissioner sugaya? commissioner sugaya: it was mentioned the parking lane was going to be used for trucks, and then as a temporary pedestrian facility. i just want to make a clarification on that. >> good morning. i am from planning. i realized that might have sounded a little funny. obviously, it cannot be used for both at the same time. at some point, the lane will be closed for track access, primarily during excavation. we have a lot of trucks that haul away material and bring in new material. my understanding is that there will be pedestrian access either on the sidewalk during the later

phases or during earlier phases, a temporary sidewalk that would be constructed. i do not have the specific details. i think the project sponsor can answer more of the details about the construction sequencing. good question. commissioner moore: i have a question for you. you are presenting brt as a conceptual group of alternatives which are supposed to be in front of this commission in may. i am wondering, given that you showed tentative construction schedules for brt on van ness between 2015 and 20 cents -- 27, followed by geary between 2017 and 2019, and by topic correctly. when i put that into context for construction for cmc, it would take 54 months. there must be a conflict somewhere, which i have not seen in the diagram. >> yes, that issue has been

raised many times. it is an issue of concern for people on how the construction would interface. i do not have the specifics of construction for cpmc or the van ness projects. i am sure other colleagues of mine could answer that question, maybe at a later point. >> good morning. michael schwartz with the san francisco transportation authority. project manager for planning and environmental review on the van ness brt project. we have been moving forward with this schedule, and we will be in front of the commission on may 10 with a recommendation for the locally preferred alternative. our construction scheduling is becoming more solidified.

it will not be across the entire corridor for the length of construction. it will be different blocks as we move up and down the two-mile sequence. as we further design construction details, we will be working closely with cpmc to ensure that they're not conflicts or other ways to can accommodate to have construction that occurs during the same time. commissioner miguel: before you leave, i have found on transportation construction projects that there is often a time span prior where utilities, other things regarding preparing the street, particularly if you go to the center option, might be necessary. i presume that is being taken into consideration. would you comment on that? >> yes, thank you. good question. as we are moving further with

project development, we have been coordinating closely with the san francisco public utilities commission and the department of public works. we're just about finished with a sewer televising for the length of van ness avenue to get an understanding of what type of utilities would need to be moved or reinforced, particularly the sewer which is significant for the center-running alternative. that will be part of the coordination process. obviously, with the tunnel underneath vanessa to, there will be further coordination with the utility work. it is accounted for in the construction plan. as be become more solidified, we can sequence it more appropriately to do the necessary utility improvements in coordination with the van ness construction. >> are you presuming you'll be able to sequence a portion in conjunction with cpmc? in other words, you're going to do a one to four-block section

at a time, i would presume, which is a normal way of doing it. there is the tunnel going in as well. what would you presume there is as to any additional thoughts in handling this type of sequencing and coordination? >> you are correct. we have three blocks segments but that is how van ness is being sequence. we will be coordinating closely with cpmc. we do not anticipate additional costs within our cost estimate. the goal would be to coordinate inappropriately so all work and occurred during a similar time period, so hopefully we can leverage production to have to be as quick and low impact as possible for that portion of the van ness brt construction. >> and that -- commissioner miguel: i assume

there will be a lot of trucks running between the two of you. >> there are fewer trucks with the van ness brt because we do not have excavation needs. but, yes, we will be coordinating closely. there is a traffic management plan. we're working closely with caltrans as well, and they're very concerned with what the traffic sequencing will be along van ness avenue during construction. this is something that is very exciting, but we're getting much more zeroed in on with the construction phase will look like, and we will get many more details of how we will be coordinating the cpmc and for the van ness brt implementation in general. commissioner miguel: very good. i approve -- i presume there will be a great deal of more detail on may 10. >> correct. commissioner antonini: i would like to jump back to health care for a second. denise? talking about the psych acute-

care and just a clarification -- correct me if i am wrong. what you said is when there is a red situation, in general, they found that of the patients in need of psychiatric care, only 30% of them needed any excuse hospitalization as opposed to 70%. to amplify that, later on we talked about the situation where, in general, not during a red period, but in general, only 1% of the patients, psych patients, needed hospital care, and 99% needed lower care. am i correct? >> there are two levels of care. the site the emergency, pes, that is the only psychiatric- receiving emergency rooms in the

san francisco right now. our psych emergency services, when we are on code red, it means we are on divert ambulances go to other paused -- other hospitals to take psychiatric patients. of the ones that are in pes prison with the psychiatric emergency, only 30% are admitted into our acute inpatient hospital beds. for all of those, and i looked up the data on monday, on monday, there were 63 people in our acute in inpatient beds, and seven of the more acute patients. that means 99% of them or not a cute and did not need to be in an acute psychiatric bed. they could have been receiving care in a lower level facility if there were one available for them, if there was another option for them. commissioner antonini: ok, thank you. that is probably closer to 93%.

>> i am sorry. commissioner antonini: but you're right. it is is significantly lower number than the actual need. the other important point you made was that cal is a bit, langley porter, st. mary's, and st. luke's are providing lower capacity of acute care psychiatric beds at this time. >> let me say that they are a stand-alone psychiatric hospital, but they are operating below capacity. commissioner antonini: that is important. i am glad you're able to clarify that. >> thank you for catching my math, too. >> still sadecki lower and a significantly smaller percentage of the total patients, and the care has to be outpatient care. that is the big demand. >> and when a patient is a non- acute but they are in an acute bed, we do not get reimbursed for them.

why would an insurance agency paid for a level of care that is not necessary. it is not a financially sound way to go to put a non-acute patients in an acute bed. commissioner antonini: but on the financial side, that treatment is not necessary, and they are better off having the outpatient kind of care. >> if there is one available, that is true. commissioner antonini: thank you. i had a couple other questions. one is for rhonda simmons if she is here. commissioner fong: we want to keep on the topic. we're going to get to work force after this. commissioner antonini: ok. transportation. we will do that. thank you. commissioner fong: the you have any questions about transportation? commissioner antonini: i do not. commissioner borden: i have a question about excavation. the planner mentioned the bustling would be closed on kerry during the excavation period -- closed on geary during

the excavation period as lisagor closures. how long? >> i do not exactly how long the closure of the geary transit lane would be. i do not know it the construction has developed that level of detail yet. i would imagine a leak during the excavation phase, the first year or two years. not the entire sequencing period. muni would have to operate in a mixed lane, so it will cause some delay for muni and traffic on geary. but it is a temporary situation. the point would be during the detailed construction planning to minimize the transit lane closure. commissioner borden: you're saying it will be like a year? >> i do not know of the top of my head. commissioner borden: i am just curious. do we have a signal prioritization for muni already along the geary corridor? >> mta is looking for a signal

prioritization and priority city-wide. i am guessing that would be coordinated as part of the van ness avenue brt indeed geary project. i cannot speak to the details of how lakari and van ness -- how that would work, especially during construction. but i think the priority will mostly be for van ness, because it will have the upgrades. it is tough to have signaled priority in two directions at an intersection. commissioner borden: it would help. >> yes, it would. certainly minimizing the closure of that transit lane will be a priority during construction. >> there is signal partition on geary west of presidio. beyond that, i do not know. >> i think that mta is looking at signal prioritization on geary east of van ness. hopefully there will be an opportunity to make up some of the time of the delay with

construction for these projects and the hospital will have the opportunity to reconcile that elsewhere. during construction, there will be disruptions. commissioner borden: i do not know if you have an answer about the excavation period, approximately? >> i am the planner for california pacific medical center. the excavation period will take up boards of a year, but the year overall period will be upwards of three years, actually. no more than. during that time, the parking lane on the south side of geary street will be given over to a travel lane. when we take the bus lane on the north side, everything shifts down one lane. the building goes under the cyberassaults all the way to the street. that needs to be demolished and rebuilt -- the building does under the sidewalk all the way to the street. that needs to be demolished and

rebuilt. commissioner sugaya: back to health care. i had a question -- cpmc, in the memo that was given to us, says that they currently operate 18 licensed inpatient psychiatric beds at the campus. it says no changes proposed. is the requirement to maintain as 18 in the development agreement? >> i do not believe that is specifically in the development agreement. commissioner sugaya: is it appropriate or not appropriate to include that, do you think? i understand that given these statistics we were just talking about with commissioner antonini, the level of care kind of fluctuates. i am just trying to think -- i would hate for cpmc to drop the 18 at some point, even though

they are still saying they are going to be there. >> there are a couple reasons we did not go there in terms of putting it into the development agreement. as you heard, there actually is not generally a demand for all 18. it is not something we would want to force them to do. secondly, to remind you, and dph staff can go into this in more detail, but i cannot close those without the prop q process. so there is some level of process behind doing that. we did not think that it was something that we needed to require them to do. remember that in terms of running health facilities, the requirements, as i think we have said before, unusual to require something like this on and develop agreement. we're doing this would save lives but not necessarily the rest of the facilities. commissioner sugaya: ok. i am not quite