it is a partnership of 10 of the nonprofit community clinics in san francisco. collectively, we serve about 90,000 patients annually. most of those patients are low- income and uninsured or underinsured. and we are here in support of the proposal. we certainly look forward to the state of the art facilities that will be bringing medical services to our communities. we look forward to and is it working with cpmc and its affiliates to expand quality comprehensive care under the affordable care act, which the doctor also referenced earlier in his presentation. of course, we support local employment opportunities related to construction and operation of the new cpmc facility. thank you. >> an afternoon, commissioners.

i was here at your last hearing. i am the director of south of market health center. we have about 7000 patients. we have a relationship with cpmc. we're very optimistic in hoping that you will move this forward. it will give us an opportunity to be able to form an organization that will allow us to be more competitive and also more service opportunities for the population we serve. and that is under the agreement that the mayor has negotiated with cpmc. and i am pleased to be here. i am looking forward to continuing to work with the mayor's staff and with the department of health, as well as cpmc, in ensuring that services are provided to the low-income people that we serve. access to care is extremely important, and i think that

access will be made even greater when the cpmc is completed. thank you. >> good afternoon, commissioners. my name is bring their -- predict, director of mission neighborhood health center but we have four clinics in the mission and excelsior district. a total of 13,000 patients per year. we're here to speak in support of cpmc's long-range development plan, and that includes the rebuild of st. luke's hospital where many of our patients go. and of course, the new cathedral hill campus. as dr. browner said, we're also looking forward to new partnerships and working together in a serving the low- income and underserved communities and being able to have the capacity to serve new individuals who will be coming into medi-cal with health care

reform. thank you for the opportunity for me to speak to you. >> i am date with curry senior center. i was also here a couple weeks ago. i want to emphasize a couple points about the need in the neighborhood. the senior center is no more than a stone's throw away. we're always at capacity in all of our programs. that 2010 census showed a big increase in the senior population from the last census, and everybody knows the senior population is growing steadily. they are also one of the higher users of the health care system in san francisco. in addition, there is a new 10,000 medi-cal clients that will need reform. with this coming into the neighborhood, it increases the emergency care and also increases the proposals to

support the clinics, to strengthen them to urge better care. i urge you to support this. >> thank you. mariana, arlene. >> [inaudible] >> [inaudible] >> the marianna ferris group should be let in. you might want to wait and make sure, identify your people. >> thank you. i am sorry. this is a bit of a circus.

i apologize. good morning, commissioners. thank you so much for holding public comment today. i represent the lost block association, which is a collection of neighbors who live in and own at the 12 buildings mostly comprised of two and three-family homes which share the block with the proposed st. luke's site. as neighbors, we have a lot of concerns about this project. it is a huge industrial building being put, quite literally, in our backyards. with trucks and ambulances within feet of our front doors. even so, we have always known this hospital fulfills and will continue to fill a vital need for the citizens in our city. we have worked very hard in public and private over the last four years to seek out a compromise. while this certainly is not a perfect project, we feel like it

is something that balances the needs of all sides. we're definitely happy with the prospect of investments in the neighborhood, and we hope that this project will be a foundation for more improvements in the cesar chavez and lower valencia corridors. we are particularly happy that the demolition of the 1970's building is guaranteed. so there will be one less a vacant or under-utilized building standing at this intersection. we are optimistic that the planned cesar chavez improvements, investment into a career a park, pedestrian thoroughfare, a projected higher levels of foot traffic, will lead to increase in productive usage of this area. this has been a very, very long and exhausting four years for all of us neighbors. and at this point, we're hoping with all of our hearts that the plans can be finalized so our time of uncertainty will come to an end.

we know we will have to live their years of construction and disruption to our lives and businesses, but we hope that at the end, we will be left with a vibrant and vital neighborhood instead of simply being the block that does not belong anywhere, to anyone. we love to be a lost block no longer and, rather, become a found block. thank you so much. >> next. >> good afternoon. my name is rachel. just like marlene, i am here on behalf of san franciscans for health care, housing, jobs, and justice. as she indicates, we are a citywide coalition of over 50 labor and community organizations concerned about the long-term negative impact on

the city's health care, housing, and jobs should this project be approved in its current state. we have several requests of you today. one is not to certify in eir that fails to provide a thorough analysis of environmental and traffic impacts, and as regards the principles and community process created with van ness special use districts and the avenue area plan. continue discussing the development agreement, because it contains details that require scrutiny because of what we believe will be a long-term negative impacts to the city. i believe all of you have received the recommendations from our coalition around housing, jobs, traffic, and health care. i will go ahead and provide a hard copy here as well. another request is to postpone action in the proposed planning code amendments, because these were not presented to you properly, and to revisit alternative 3a as the most appropriate basis for providing

project entitlements. i am here with other colleagues of our coalition to provide you with additional details. with that, i turn it over. >> thank you. matt, attorney for california nurses association. thank you for the opportunity. cna is actively engaged in ceqa review for this project. we submitted comments on the draft eir, with four experts attaching reports. we outlined a series of legal and technical defects in the draft eir's analysis. we submitted to the comments yesterday on the final eir. the document still fails to remedy many of our concerns that we raised in the draft. the final eir continues to omit and understate project impacts to traffic and air quality. it fails to adopt mitigation for these impacts and other impacts such as greenhouse gases. and if mitigation is identified,

it is often vague and unenforceable. just taking traffic as one example, the eir uses an incorrect base line for muni ridership, using 2006 data rather than more recent data which shows increased ridership. this creates a misleading and mistaken impression that there is more capacity than there is. therefore, understating the project's transit impacts. our traffic expert also found that there were some really unsubstantiated and improper tweaking to the traffic modeling, such that the eir was able to conclude that actually increasing traffic resulted in at less congestion on key intersections at eighth and market and franklin at sutter. adding cars to the road absent physical improvements will somehow decrease congestion, that is nonsensical and highlights areas where the eir understates the severity of the very real impact the project

would have. the eir also brushed aside concerns about delays in emergency vehicles that will occur due to frequent gridlock conditions on van ness. we're talking about putting a hospital in one of the most congested corridors in the city. whether or not emergency vehicles can bypass gridlock, this is a concern that needs to be looked at a lot more closely. even with impacts understated or omitted, it is clear that the project would have serious and detrimental consequences. in particular to the proposed van ness area. the final eir recognizes that building a hospital of this size and magnitude of the cathedral hill campus would result in over 30 significant and unavoidable impact just to traffic. you would think, given all these significant impacts, there would be a thorough look at alternatives to reduce these impacts. this was absolutely not the case. the eir violated every

alternative legal requirement in that type of analysis. it set forth a narrow set of project objectives. it failed to analyze a reasonable range of alternatives. and it set forth really disingenuous reasons for not following through with the alternatives. under ceqa, the lead agency may not give the project's purpose and artificially narrow definition, but this is exactly what the eir does. it states that a project objective is to consolidate specialized services and women's and children's services into one acute-care hospital. whether our efficiency basis for consolidating a particular type of service in one place, there's no fundamental need to consolidate every service in the same hospital. the only function of this objective is to improperly favored the project as proposed. ceqa also requires an eir sets forth a reasonable range of

potentially feasible alternatives. the eir pilots this requirement by setting up a small set of alternatives that are not feasible. for example, eir says we can move the women's and children's center to the st. luke's campus. but there is already dead -- already that type of facility planned for mission bay, so it was not needed. when cna came back with our alternative and said let's look at other types of special services concentrated in st. luke's, the response was, sorry, we already analyzed our reasonable range. it was limited. at and this should have had a good faith look. it did not. the anr raises all sorts of objections about why alternatives to the -- the eir raises all sorts of objections. one thing it says is we cannot increase construction at st. luke's because there is a

continuum of care issue. so we cannot meet our richer for it time requirements for needed construction at the california and pacific campuses. what the eir does not say is there have been literally hundreds of extensions granted to retrofit requirements all across the state. therefore, this continuum of care concerns need not be a barrier to adoption of alternative 3a. at every level, project objectives, a reasonable range of alternatives, and the objections to feasibility, the eir's alternative analysis fatally flawed. it has been unlawfully skewed to achieve one outcome and one outcome only, to maximize cpmc's prospects at the expense of the environment, the taxpayer, and provision of equitable health care. we asked the commission not to certify the eir the time, remedy the defects we identified in our written submission yesterday, and instruct a full

and more thorough review of alternative3a plu -- of alternative 3a plus. thank you. >> good afternoon. i am a staff nurse at cpmc st. luke's, working in conjunction with california nurses and good neighbor coalition. the proposed project for health care facilities in san francisco does not serve the long-range health care needs of our residents. instead, this project primarily, if not exclusively, serves the business interest of sutter. cathedral hill hospital, the iran project, the wrong size, the wrong place. the registered nurses of the california nurses association strongly urges this commission to assert its fall of 30 are this project to ensure it delivers on the promise of enhanced health care services of the city. so far, this is unfulfilled. cpmc sutter promises to keep st.

luke's open for 20 years, it proposes a small hospital that is less financially and politically viable. it reneged on the same promise of 20 years in the case of a hospital that sutter is now closing. the pharmacist jobs -- it promises of jobs for san franciscans, but it does not guarantee any rn a job with the new hospital. with the transfer rights in card checking in rides provided for workers not living in san francisco, current cpmc rn's may not have a job with the development agreement as-is. it fails to guarantee the jobs of its most experienced nurses, reduces license capacity, provides no means of service is guaranteeing the development agreement to the community that depends on an davies medical center, dybbuk its services at

st. luke's in cathedral hill -- duplicates services at st. luke's and cathedral, does not have opposed acute facility, as limited a variety of services, and fails in the eir to properly consider alternatives that could provide greater access to services with your negative environmental impacts. cpmc sutter promises to provide its fair share of charity care and commits itself to spent a dollar amount under the project that is less than it currently spends on such care. cpmc sutter promises to produce it in the health plans, but it allows it to charge the city and workers higher prices than other providers for health services when using out of network providers in particular. it promises to improve clinical outcomes but fails to offer a compelling case for the superiority of the proposed project over other alternatives,

particularly because the alternatives considered are too narrowly cpmc defined narrowly sutter promises to provide information necessary to evaluate this project, but consider, a beat -- you are being asked to approve a wholesale reversal of pet -- of planning policy in the most heavily transit corridor in san francisco without the zoning changes provided in advance, without a complete development agreement to assess the quality and effectiveness of the indications of. without legitimate analysis of the environmentally superior product alternatives and without the job a mitigation, air quality productions, job guarantees, or the appropriate jobs-housing balance to ensure this project delivers quality health care services to san franciscans. thank you. >> mr. president, i believe -- >> i am handing in comments on

the eir, and i would ask that my comments be incorporated on section c, page 8. very basically, the eir, in doing this for 30 years, looking at major project eir's, i have never seen one that sun it lacks the discussion and planning index of an affordable housing on the city's affordable housing program as this eir does. specifically, it centers on the failure of the discussion and around the van ness quarter plan in the very notion of sustainable development, which has been incorporated in the 2009 housing element, and you supposedly now, after sb 375, a guiding principle for regional planning, which this city applied for and receives a grant to do sustainable development at th.

at the heart of sustainable the balladist the heart of the van ness plan, the jobs-housing balance. the notion that you could put in a major job generator and require no housing in an area plan that is meant to seek a balance between jobs and housing along a transit-rich corridor is a bizarre and not being analyzed in the eir. the eir is massively incomplete and inaccurate in its failure to analyze the impact on policy, established policy by this commission of the changes being proposed to accommodate this project. but most importantly, what this a failure of analysis has done is limit the city's ability to negotiate a real development agreement housing program. what we have is basically lipstick on a pig.

now, we may admire, as some of you have already done, the shade of the lipstick and the skill with which it has been applied to the pgi, but it is still mayor lee lipstick on a pig. -- is still just listed on a pig. this will have a net increase of 1,490 households, 2.3 person households generated by the work force of this development. we're talking about mitigating 300 units, and we only reached 300 units if we use existing city subsidies to subsidize the wealthiest hospital in san francisco. it makes no public policy since. -- no public policy sense.

you have been given in our analysis of what needs to be changed in the development agreement. but the failure of any good -- the dollar agreement skillfully negotiated by the city with its hands tied by the lack of analysis on the the eir, on the importance and impact of a jobs- housing imbalance. we're asking for a dynamic relationship between housing and jobs. that is the essence of sustainable development. that is the essence of smart growth, which this commission has adopted in plants from the market octavia to the eastern neighborhoods. you cannot abandon on a project- by-project basis broad city policy that seeks to strike it -- why are we allowing in this project and ownership program when the need is for net new housing units? and ownership program adds not one that new unit.

we have a perfectly functioning downpayment assistance program. if they want to do ownership, make them contribute to the existing program, but why are we giving them credit? we are producing, in effect, less than 160 studio -- a net new studio units. or, in terms of two bedrooms, we are producing a brand new total of the 25 million, about 85 new two-bedroom units. [bell rings] the demand is for 1490 units. it is inadequate. rejected the eir. amend the development agreement. thank you. >> thank you. paul. he may be downstairs. that is the last. >> while we wait, can we start with seniors and disabled? >> the next category are those

who pre-arranged special accommodations for seniors or disabled persons. i will call some names. if you want to make your way up here, you can line up on the left-hand side. romni, mimi, and bernie. ready? >> well, 84 years old gives me the privilege. >> absolutely. >> anyway, i am resubmitting unacknowledged submissions from several weeks ago for san francisco tomorrow, which is a

citywide organization. my concern is based on extensive experience, that the california ceqa mandate is critically lacking regard and analysis of the cumulative impacts that are required to be studied and mitigated. and i give you a legal citation that you can use and should have used. cumulative impacts, particularly like the tenderloin area, includes the twitter area, an area of impoverished people that would be affected by speculative land speculation that will raise the price of housing. with san francisco and new york being the highest cost of living

cities in the nation, it is abusive to assume that there is a market rate solution. i have attached at least one proposal of how the city, through its efforts, with public-private partnerships can readdress that situation. it is nets, in st. -- nuts, insane, that this is not been addressed. it is the lack of a public- private partnership of the city's share -- public-private partnership. the city's share, particularly given the seismic event inevitably, over 1 million people will be here for three months without service. despite the so-called blue ribbon committee that sutter health is a non-contributor to a

live beating -- to alleviating disaster relief. two-thirds of the city will be left helpless. secondly, the -- [bell rings] there is a gas pipeline within damage range of this building that, can -- commendably, sutter health has looked into. there is a city-sponsored it strange, and it is volatile. i do not know why the hell it has not been dug. thank you very much for your attention. please certify -- [bell rings] commissioner fong: thank you. we will go back to the person we called earlier. >> good afternoon, commissioners. thank you.

my name is paul. i will hope to be brief. i have a letter and supporting documentation. the eir, and i want to focus specifically on traffic issues, clearly, according to the documentation in the response document, follows the standard requirements, ceqa requirements. it has gone through the appendix g checklist. it has used san francisco standard practice. based on that, it looks at the individual modes of transportation. pedestrian, bicycle, vehicles, transit. however, that does not necessarily answer the questions that affect the quality of life of residents in the surrounding neighborhoods.

and these are issues that we have raised repeatedly cpmc, both repeatedly -- repeatedly, both with cpmc and with planning staff, in prior communications. so, the first key comment is that the peak period level of service analysis that is used is inadequate to assess the impact of a high use facility in residential neighborhoods. what we see are transient traffic phenomenons that cause pedestrian hazards, bicycle hazards, and vehicular hazards. because of driver behaviors. we see congestion at that changes the way people in the community walk, drive, and live their lives during the business hours. this is not something that looking at a peak hour level of service captures. in tr