between the planning department, the office of workforce development, and the department of public health, as well as our colleagues at mta and the transportation authority. there has been very robust work on this effort. i really appreciate that. the planning commission certified the eir into a number of actions to approve the project on april 26. elizabeth will go over those with you in a moment. i want to emphasize a couple of things from a land use/planning standpoint. we believe through the extensive partnership with city agencies and cpmc, we now have a project that works. i will say there are very few places in the city where a product of this size and importance can work outside of downtown. i think this is one of those sites. we believe we've got to replace where the project works from a transportation stamp point, a design standpoint, housing

standpoint. i know barbara will talk to you about the health care component of the agreement. collectively, we believe the project works and we feel comfortable recommending it to you. we believe we can move forward with it. i know there will be a lot of discussion about that. i want to decide that from our standpoint, we believe that through the the work we've done, a product is a good and workable project for the long term benefit of the city. i will turn it over to ken rich. thank you. >supervisor mar: mr. rich? thank you. >> there we go.

supervisor mar: microphone, please. >> if i could have the power point on, please. good morning. i am ken rich. i want to begin the presentation by reminding everyone of our hearings scheduled. today we are covering the hospital rebuild project and the development agreement at the overview level. we have a long day. i will try to be fast with the overview. if we talk too fast, please slow us down. we will try to get through the overview quickly. after that, we will cover in detail the job creation topic. on june 25 at 3:00, we will cover in detail all the aspects

of health care with the exception of issues around the city health care service system, which will cover on the night. on the night at 1:00, transportation and health care systems as well as the budget report. july 16 is left open for questions, discussion, and whatever needs to happen on the last hearing date. the schedule for the full board is july 17 during eir appeal and first reading. july 24 for second reading. in recognition of the importance of this project, working on this development agreement and the project in general has been a major city staff effort with involvement from all the agencies you see on the side. we wanted to recognize the really good work of all the staff in those different agencies. i will hand it over to elizabeth wati who will take you through

the basic description of the project and the approvals before you. >> thank you. cpmc currently operates a four campus hospital system. if i can have the overhead, please. to comply with state seismic safety laws, cpmc plans to modernize facilities on five campuses including a new one known as the cathedral hill campus. as part of the plan, cpmc proposes to construct five new medical buildings. at the davies campus, cpmc proposes construction of a new for storing medical office building also referred to as the

neuroscience institute. the project was originally approved by the planning commission in 2007. it was overturned by the board of supervisors. the project was required to be reviewed in the context of cpmc's larger eir. there have been no substantive changes to the projects since 2007. at the st. luke's campus, cpmc proposes to construct a new five-story acute care hospital. the new hospital would be located to the west of the existing hospital tower over the parking lot and a portion of san jose avenue. it enables the existing hospital to remain in operation during construction. adjacent to the new hospital, there will be in the pedestrian pathway and plaza connecting streets. a portion of it is shown on the graphic of the slide. when the new hospital is operating, the existing hospital will be demolished. after the existing hospital is

demolished, cpmc will construct a new office building where the current power exists. on the west side of van ness at the site of the closest hotel and office building, cpmc proposes construction of a new 550 bed full-service acute-care hospital. it will be 15 stories and approximately 255 feet tall. across the street on the east side of van ness, cpmc proposes construction of a new nine- story 130 foot tall office building. these two buildings will be connected underground by a tunnel at the garage level. once construction of the cathedral hill hospital is complete, cpmc plans to transfer to you care services -- acute- care services to the new hospital. the pacific care campus will be used as an outpatient facility while the california campus will be sold. it is worth noting there are provisions in the development

agreement that mandate the creation of community advisory groups at both campuses to guide future development and reuse of the california campus. on to the land use approval, there are many approvals required for the five new buildings proposed. i will only high glucose subject to board approval. the approvals include the development agreement that will cover all campuses, general plan amendments for the st. luke's and cathedral hill campuses, as well as several other approvals including conveyance, conversion of cedar streets of the cathedral hill campus, increased sidewalk widths. that concludes my portion of the presentation. i would like to turn it over to the doctor who will kick off a brief presentation about the

long-range development plans. thank you. supervisor mar: dr. brenner, welcome. >> i cannot tell wellwhether i will need my glasses or not. supervisors, it is good to see you again. we're pleased to present our plans to rebuild cpmc. this plan has been more than 10 years in development with community engagement. we have now been the subject of 15 public carries. today you of the opportunity to consider and i hope approve this historic project which has an unprecedented community benefits for our city. the cpmc rebuild project is not a typical development project. the project itself is a community benefit for all sentences guns -- of san

franciscans by modernizing with the ultimate goal of improving health care and saving lives. the project will build and modernize cpmc hospitals at st. luke's and davies and combine our pacific and california hospitals on the van ness and yuri campus, sometimes called cathedral hill. it will double the number of earthquakes eight beds in san francisco. we will also integrate our facilities into a modern health care delivery system was widely accessible committee hospitals attached to a specialty hospital near the population centers of san francisco for the very sickest patients. following extensive input from the help in planning commission's, members of the board, and the city family, rebuild cpmc will deliver unprecedented additional benefits. it will inject $2.5 billion into

the local economy and keep our trade working and retain a permanent well paying jobs in the city's largest industry. we will join with community clinics to serve 1/3 of the new patients, 10,000 san francisc ans who will be enrolled in medical with health care reform and provide the capacity for partners. we know there are criticisms about the plan. after 10 years of planning and community engagement, we also know a perfect plan is not possible. while it is not perfect, it is the best plan we can achieve balancing the needs of health care delivery with those of the neighbors and community. that is why today you will hear strong support for our rebuild plans from different sectors of san francisco. notwithstanding the seismic mandate and development agreement, this is a plan to improve health care, care for

the sick and injured, and to save lives. supervisors, i respectfully urge your support. supervisor mar: thank you. >> i believe judy lee will follow. supervisor mar: there is an overflow room. it is the committee room, 263, just down the hall in case anyone wants to view from the room. >> good morning, supervisors. it is good to see you again. thank you for the opportunity to give you a quick overview of our health care program, the rationale and benefits behind our approach. as many of you know, we provide a comprehensive set of programs for san francisco. from an outpatient perspective, we partner with about 1200

community-based physicians throughout san francisco. we also run the largest community clinics south of market at the st. luke's campus. we have innovative programs for prevention and education might be held first program h --ealth first programs that are free to charity patients. in the future, there are two major changes in the outpatient setting. the first -- actually both of them are a function of response to the federal health care reform. we're going to partner much closer with our physician partners in the community to increase coordination across different care settings. a major change we're going to make, we're going to partner with dphh and consortium partners to care for 1/3 of the new medical enrollees. we will provide comprehensive medical homes from primary care

to hospitalization to post-acute care for 1/3 of the 30,000 new medical enrollees. from a recovery and rehabilitation perspective, many of you know we have an inpatient psychiatric program at the pacific campus. we have 18 beds where we provide acute intervention and stabilization for mental health patients. going forward, we're going to focus on strengthening the connection between acute interest in and community-based recovery programs. we will partner with dph and the progress foundation to move patients from the hospital setting to recover in the community where it is most effective clinically and cost effectively. we have facilities at the california, st. luke's, and

davies campuses. we will be decommissioned in our beds at the california and st. luke's campuses. after an extensive dialogue with the help commission and the committee, we have made a commitment to keep 100 beds in san francisco so that 80 or so, the patients coming out of our hospitals will have automatic placement. we also offer long-term care services to our patience today. we have a program at st. luke's. sub-acute patients are long-term care patients. they are usually with us for two or three years. many of them are in a persistent vegetative state. the blue ribbon panel recommendation is to transfer those patients to community based settings because these patients do not need to be in an acute care hospital.

these are long-term care patients better served in the committee. now i will focus on the hospital services. today we serve about 1/3 of san francisco's health care needs in the hospital and emergency rooms. going forward after the rebuild, we will remain and maintain a proportion of services in san francisco. this is not a program to dominate health care in san francisco. we will retain our portion of health care, about 1/3. we're proud to the liver one out of two babies in san francisco. we also provide services to support other hospitals. for example, we deliver all the babies at chinese hospital. we do this high-quality outstanding care. we are nationally recognized for quality and safety. we do this in outdated buildings. they are challenging to operate. to give you an example, at the

emergency room at st. luke's, the pedestrian corridor cuts through the heart of the emergency room. every single day, hundreds of staff, physicians, and patients walk right through the heart of the emergency room creating degree and noise. this is only one of the few important reasons to rebuild the health care delivery system. many others have alluded to the need for seismic safety. now i would like to share with you how we will -- how this will work. we're looking to rebuild our system, not as stand-alone systems as they were designed, but as a modern health care delivery system. what we're looking to rebuild is a system where community hospitals are connected and supported by specialty care hospital.

the spoke hospitals are st. luke's and davies. both will be full-service hospitals, but with their own programmatic focus. they will be similarly sized from inpatient perspective. but st. luke's will have an award winning labor and a liver program -- delivery program. we will have an increased emergency room capacity by about 50%. at davies, we will not have a labor and delivery program, but we will continue our strong and proud tradition of serving hiv/aids patients and neuroscience patients. the pacific campus will maintain the psychiatric program. it does not need to be in a hospital setting. we will keep it. it is. the campus eventually will transform to an outpatient medical center. our sickest patients from each

of these facilities will be transferred to the cathedral hill hospital where we will have programs like organ transplantation and a neonatal intensive care unit. it is also important to point out cathedral hill will also provide general acute-care and emergency services to the surrounding neighborhoods. we are doing this because there is a strong consensus of hospital planners and health care experts across the nation and across the world that is not feasible to duplicate specialty care of every community hospital. that is for two major reasons -- volume and physicians. with programs like organ transplant, we need to do hundreds of them to maintain quality and certification. the physicians who are highly trained to do that work, there is an acute shortage of them in the united states. to have them at one place and

centralizing care for the sickest patients produces better outcomes for those patients. how will this work? i would like to give example. grandma lives in a district. she gets primary care from our st. luke's health care center, one of the dots on the bottom. she also has a heart condition. she is comanaged a cardiologist at st. luke's. she can get all of her diagnostics done at the st. luke's campus. if she has a problem at night, she can come to our emergency room. if she needs a knee replacement, she can get that at st. luke's. she did even access help coaching to improve her diet and increase exercise. if she needs a heart transplant, she will be transported 3 miles to the cathedral hill campus where the heart transplant

program is. organ transplant programs are very complex. we need to the several hundreds of them to maintain certification and keep up the skills of our staff and positions. in the case of heart transplants coming out of the st. luke's service area, there's probably not more than five of them in any given year. gramm of will be able to get this at the cathedral hill campus. at the same time, she will be able to get the care she needs every day at the st. luke's campus. i think gramm, is pretty lucky to be able to get a heart transplant 3 miles away. there are a lot of folks from surrounding communities throughout california travel hundreds of miles to see physicians at cpmc to get the same kind of care that ground, -- grandma gets. our patient base is 70% san

franciscans. 30% are from surrounding trees. san francisco is a medical destination. we have world-class care here because we have world-class hospitals. we also do a great help and biomedical research region but also great help and biomedical research. health care is our number one industry in the city. we generate about 100,000 jobs as an industry. 18% of the city work force. these jobs pay better, about 22% more on average. many of the health professionals are women. cpmc is an integral part of this important industry. this is a quick overview of our plan to modernize our health care system. we're very excited to embark on this conversation with you. i wanted to leave by

highlighting some of the benefits of the building. we will build and double the number of earthquakes eight beds in san francisco. that means we will be here and operational after a major earthquake. we will improve health care without disrupting care for 1/3 of san franciscans on any of the campuses today. we will maintain the regional center of excellence programs in san francisco. we will control rising health care costs by as much as possible and eliminating redundancies. we will commit and simultaneously construct st. luke's hospital and cathedral hill hospital at the same time. st. luke's hospital is planned to be brought up first. we will protect and expand health services for the poor and underserved. thank you for the opportunity to talk with you. now with like to introduce david came to talk about the program from the facilities standpoint.

>> could we have the screen again? cpmc's plant in visions five new buildings. each one is sophisticated designed to support a specific program. they will complement the character of existing neighborhoods. the neurosciences institute davies campus will improve public access to the campus through a new accessible concourse. the lower podium height establishes an appropriate street skill. the upper level of the building is set back and turned 90 degrees and provides pedestrian linkages to the existing facility. looking south, a small corner garden provides access to the lobby congress. the upper setback for is not visible from this vantage point.

at van ness and geary, the new building will provide enhanced public realm. the hospital is bounded by street. looking south of the corner of van ness, it rises along the southern edge of the site. the remaining building rises to an average of 80 feet from the street, lower in most cases than existing buildings on the edges. it has a positive urban design benefit. placing the tower on the southern edge of the site minimizes the shadow and shake falling onto streets. this placement dramatically improves the sidelines for neighboring buildings to the north, east, and west. in this slide, we're looking south on van ness. it will provide new retail frontage to complement additional plantings and seeking

provided in the expanded areas formed by renewable -- removal of parking. looking north, we are applying principles outlined in the better streets guidelines. the design creates an appropriate streetscape coordinated with new buildings to support windows on the street and an enhanced and pleasant pedestrian environment. the main pedestrian door ways to the hospital and medical office building are located near the corners to provide easy access to transcend -- transit and liven the street scape in these locations. looking east on geary is the medical office building. it captures the existing corniced lines. it is simple and consistent with the natural variety and scale seen along the street. this view looking along cedar

street, cedar street is completely redesigned to provide a safe pedestrian environment and intra- plaza for the medical office building. -- entry plaza for the medical office building. the new buildings provide a very skyline. they are stepping up the hill. each building is divided into multiple smaller parts to provide appropriate scale and variety. looking west up cedar street, the buildings are different but compatible and fit into the neighborhood character and urban context. in this view of cesar chavez from valencia, the redevelopment of st. luke's campus is clear and comprises three elements. a new hospital, a new integrated medical office building, and a new plaza on the vacated right of way between the two new structures. as part of the site development,

the main staircase to the historic building on valencia will be reopened to use by the public. varied massing and materials tied to the character of the neighborhood. the new hospital steps down dramatically to the west in deference to the scale of adjoining acres. a major new plaza will support a dramatically improved public realm that integrates the campus with the community. the new plausible provide access to the hospital and medical office building, the fountain, multipurpose room, seating, staircase, and provide wonderful access to the south. the staircase leads to the applause and on 27th street. hospital program lobby and

programmer will support the of deposit. we believe the five new buildings will be great additions to the city. they will provide the highest quality new health care. they will complement the neighborhood and will be built to last. thank you. supervisor mar: thank you, mr. king. there is an overflow room in 264. -- 263. the sheriff's deputies have told us people should move if they do not have a seat in either of these rooms. let me turn it back over to ken rich. >> i will go through the overview quickly. i will rely on members of the committee to slow me down if i go too quickly. can i have the slide again, please? basically we have been clear from the start this project only makes sense for the city becomes a certain commitments from cpmc

for a set of public benefits. we will give in to these. broadly they include a commitment to help care for the poor and underserved, a commitment to st. luke's, a commitment to affordable housing, and a commitment to local hiring and workforce development and transit and street improvements. it is a binding legal contract between the city and cpmc. the purpose is to codify the commitments as well as lay out remedies and damages if either party fails to live up to the commitments. when adopted by the board and signed by the mayor, they can only be modified by future board action. in general, it is effective 30 days after the mayor signs it and has a basic term of 10 years. however, certain obligations survive beyond the 10 years. notably those involving continued operation of st. luke's hospital. as you will