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 sure how to ask the question, because i am not quite sure what i am trying to say. you said that cpmc, you had the comment that cpmc was a nonprofit and at the margin it would generally go back into improving the hospital. however, cpmc's profits, as we were told previously in the initiation, actually go to southern health. and it was my understanding then that cpmc asked for some type of rock or however you want to characterize it. such is not necessarily true that -- so it is not necessarily true that cpmc has control over

its own profit margins. is that correct? >> i am not a financial expert, but i would say that in terms of that, you could replace cpmc with sutter which is the parent organization and a nonprofit. commissioner sugaya: an extension of that is the legal question of legalsute -- the legal question of whether sutter is the holding to this agreement or not. >> i am a from the city attorney's office. there is a legal entity that owns the property. sutter west doing business as cpmc. the provisions you are concerned about relate to all cpmc's activities within san francisco. when we deal with the financial issues, we always look at all of their numbers as it relates to all of their activities in the city of san francisco. commissioner sugaya: i

understand that. so you're confident that whoever signs this, it is going to be -- all the provisions will have to be respected by sutter health? >> yes, correct. commissioner sugaya: thank you. commissioner borden: i want to follow up on the prop q process. maybe director garcia can explain what that is. >> anytime a hospital facility changes or moves or reduces or closes service, they must provide public notice to the health commission, and the health commission holds a hearing on the proposed change. and i think that happens at least 30 days in advance of the potential change. commissioner borden: does the commission had the ability to stop the change? you hold a hearing. what happens? >> more of a public forum for the change. commissioner borden: there is

no -- >> there is no ability for the health commission. the hospitals are overseen at the state level and not the local level. commissioner fong: commissioners, any questions related to the topic of workforce? commissioner antonini: i had questions for rhonda simmons on the work force issue. more than a question, just a clarification of my understanding of the situation. correct me if i am wrong, but there are now 6200 jobs in the system, and those are going to be retained. but we're projecting of those 6200, about 600 to 700 per year will change because of attrition. of those 600 to 700 per year, about 100 could be considered entry-level, and the entry

level qualifier is no more than a two-year education -- >> i believe that is correct, yes. commissioner antonini: ok, good. of this group, we are saying that no less than 40 will have to be san francisco residents. and i think coming from situations such as the health care cut -- academy or the community benefits organizations. >> correct. the 40 that i am focus on of that 100 is mostly in entry- level health care. so there might be other kinds of areas of, not so much health care, but entry level that is not captured, but we would still work with cpmc to capture as many additional entry level as we could. it is just the focus is really on entry-level health care to really move that, because that is a growing sector here, a

booming sector. commissioner antonini: we also have another 1500 new jobs projected to be created, permanent jobs, over 10 years, of which we are saying 222 will be entry level under the previous qualifier or about 22 per year. that is above and beyond the ones we talked about in the attrition situation. >> correct. yes. commissioner antonini: ok, good. the other thing i want to point out. when you look in this whole thing, being in the health-care field myself, even in the entry level, a number of these positions might be someone like a technician who would have had a couple of years of training. so it is not as if you can, you know, it is harder to hire. you have to have some training. what i am is suggesting in this might be a possibility, first of all, we have said at least 40. there ul