moving to say it looks, the redevelopment of the campus is really three elements. integrated medical office building. the hospital is on the west. the hospital on the east towards valencia and the new public hospital that is designed to recall the opening for the street that is formed between the new building. this will provide emergency services access to the hospital. this does create a scale appropriate to the existing building. we understand the scale of the townhouses is to be respected. a consistent brick base and it is an architectural concrete

shown and will tie the new architecture to the character of the neighborhood. the lobby, cafe, multipurpose room all our position to support the activity in the plaza. the medical office building shares that with the hospital. the same coloration and components are used. punched windows are used throughout. the new plaza will provide access, but to the hospital and the doorways. it is full of bounce, seatings, the louvre -- new landscapes and a multipurpose room. the public staircase goes uphill to the south to connect 27 st. in the second major doorway -- and the second major door way that provides access to emergency services.

the hospital and medical office building we believe will support a dramatically improved public realm. we believe these five buildings answer the challenge given to us. we think it will be great additions to the city. these buildings will provide the highest quality of health care, complement the neighborhood and be built to last. i would like to introduce dr. costed kirsch. >> good afternoon. my name is dr. ed kirsch, and i am a cardiologists and chief of staff. i represent the 350 positions on the active medical staff at the hospital. they in turn it care for about 300,000 residents who live south of market. i participated in the rebuild

st. luke's process for over six years. that started with the save at st. luke's movement, went on to the blue ribbon panel, and finally to today's deliberations. so today i want to speak to you about what i know best, which is not building buildings, but what goes inside the building, the delivery of health care, and what this project means to the physicians and patients of st. luke's hospital. i will be brief. the first is the association of st. luke's with cpmc has expanded our ability to provide health care at every level. we have a first-class medical staff, and the staff has been recognized as one of only 410 in the nation to have excellence and quality and patient safety. this is from the joint commission on accreditation and was given to us this year.

everyone knows we are the safety net for san francisco general hospital, and that results in taking care some of the sickest patients in the city. our ability to do so is enhanced by the association with cpmc. when we have a critical case meeting advanced care, we no longer have to call other medical centers and big them to take a patient. we can transfer our patients there without regard for ability to pay. the people of san francisco have been the beneficiaries. second is the ability to provide charity care. cpmc has been criticized for not doing it share. i want you to know the st. luke's medical staff has worked with the of the industry should to improve on this area. charity care means a patient who is uninsured, winds up in the hospital with a critical illness, and of the end of the

hospitalization, the medical bills are written off. what we have now done is designed a process that will allow physicians to provide collective, and it even preventive health care services for patients that are unable to pay come and we will do this with a point of service process, which will streamline the ability for us to provide charity care to patients. we will be able to expand our services to all the people in need in the community. finally, is the promise of sustainability that is offered. one of the great challenges to the city is an aging medical community and the inability to recruit new physicians to san francisco where salaries are lower and the cost of living and raising a family is tighter. and you say lukes facility -- and new at st. luke's facility will enhance our ability to

recruit and retain physicians well into the 21st century and beyond. so, looking back to 1871, dr. thomas brothers andoon open the. luke's hospital. and they provided the mission statement. the benefits refuse to none will be limited only by its means. before you today is a proposal that can help a sustained this mission. on behalf of the st. luke's medical staff, i urge you to vote affirmatively for this project and move it forward. our patients and staff need it and deserve it. we think cpmc is the way to achieve it. thank you. >> any speakers from project sponsor?

at this point we're going to take a short break and get into public comment, if that is ok with you. >> a brief question. for dr. kirsch, i was going through answers to questions about utilization at st. luke's, and it appears while there are occupants in skilled nursing, i guess your acute-care average has been 59 bids of the past 15 years. >> that is probably a reasonable estimate. >> we would hope as we rebuild we would be able to increase that if the need is there. >> again, we would like to see

an increase. i believe the hospitals plan is for 80 beds. that is an increase. >> thank you. appreciate it. >> ok. any other questions? [laughter] [inaudible] >> i think we are ok. >> mr. king it from the smith grou from the smith group. very well designed, and especially the medical office building, and i really liked the way it relates to the street, i was hoping anywhere you could strengthen the corners even more. i know there is great elevation

changes that will come up post and and geary. certainly anything you could do to strengthen that icing would be good. in terms of the cathedral hill hospital, i just would want to continue to work with staff on the mosaic part of the building on the southeast corner. that has to be done very carefully to make sure it is appropriate. i do not want it to be too buys. thasy. are really liked the building at franklin and post but a simpler, but it is to the rear of the building. the other thing i would want to make sure is the color of the glass is rich enough. i cannot quite tell from the renderings what we have in mind as far as the glass covers for

the hospital tower. >> on the lower portion of the building, we are actually using wood tones within the class system. we will come back and coordinate the actual metal portions to carry that came through. >> it looks like it was changing a bunch of different shades. i was not so sure how that would play out. it is the richer color at the lower levels and i think is really important. i think overall the design is really good. on st. luke's the only thing i would like to see is the treatment around the windows. it could maybe be more around the windows. whatever we could do to accentuate them a little bit more and give them more character would be nice. those are just my views. >> any other questions or

comments? let's go ahead and take a 20 minute break. we will get right into public >> the planning commission is back in session. commissioners, before we went into recess, we were about to start a public comment. public comment, as i announced, will start with a request for a box of tide. there were four requests. i think i initially responded in the negative to one of those requests, but given the nature of the day and how many people are here, we might want to grant the block of time also. and i have given you the names, but they should be given up to 15 minutes and no more. commissioner fong: ok. there are four blocks in 15 minutes. the first one is marian and wen

will give thema time to come. >> up. commissioner fong: the second one is john. >> , on up. -- come on up. >> good afternoon pat i am the vice president of programs with the san francisco community clinic consortium, and i am representing john, our president and ceo. he unfortunately is not able to be here this afternoon. i am here with three of the consortium's board members who will each have an opportunity to speak as well. charles, the executive director of the south of market health center. brenda, the executive director at the mission at neighborhood health center. and david, executive director of curry senior center.

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