out of respect, we need to upgrade our standard of care when it comes to our facilities. our facilities were built for a different standard of care. you heard a doctorate drescher before about licensed beds when the standards of care was upwards of two to four people in a room. we no longer have that standard of care. and this is more and more technology. technology requires space. this is viable, whether it is keeping people alive, diagnostic technology. it is vital to say for care and processes, and i would add that it is vital to more efficient processes. as we look towards rebuilding cpmc, i asked you to approve this program. it has been diligently thought out, and we stand before you and submit it for your approval. thank you. supervisor mar: thank you, mr.

veracruz. >> i run an arts organization in san francisco. our main forecast -- focus is on the african-american community, but we provide art for anyone. one of the big issues that we deal with our issues that we are facing in our community, and health is one issue that is facing our community quite significantly. as part of our community engagement, we get involved as a way of educating people, providing services, providing screenings. hopefully and most of the time, when there was not a crisis. one of the first hospitals that stepped up to the plate to assist us was cpmc. they have been working with us for the past seven years and presenting a health fair in the western addition that sees 1000, 1500 people every august.

i support the rebuild. i support what they are envisioning doing in terms of the jobs it will bring, in terms of the health it will bring, but more importantly, what i envision it is these buildings functioning. i envision them helping people. i envision them serving people. i envision them saving lives, and i urge you to move forward with all due haste. thank you. supervisor mar: thank you. i am going to call a few more names. [calling names] sarah and thaddeus. next speaker. my name is even.

thank you for hearing me. in 2008, at the end of it, i was an uninsured self-employed woman diagnosed with breast cancer. the sister to sister program took me through a double mastectomy, two other surgeries, two rounds of chemotherapy and radiation, and now they are helping me to follow up twice a year. i am incredibly grateful. anything you can do to make the services available to other people, we really should do. thank you. supervisor mar: thank you. next speaker. >> good evening, said researchers -- good evening, supervises pmi name is vinnie aurora. dealing with domestic violence with the pacific islands population. chinatown and other

neighborhoods. our clients in the tenderloin are the ones that need the most mental health and family support supervisors. they tell us they need services. they tell us they have a hard time getting care, and for their sake, we are really ready for this hospital. our clients are ready for these services. cpmc is the only hospital for our clients that does not have a waiting list for linguistic care. there are southeast asian languages and others. our clients go there because they get adequate care. and they get respect. today, i spoke to one of our clients, and i said, "why do you go to cpmc when you can go anywhere?" they said it is one of those hospitals that makes them feel like an equal, gives them respect, and it makes them feel not as a victim of abuse or a poor person or a resident of the

city needs care, so we are very supportive of this project. there have been partners for several years, and we believe in the development agreement, and we urge them. supervisor mar: you only have the time that you have. i will say we are at 8:05, and thinking to all of the staff who have been here and all that are remaining. i am just going to call the remaining cards that we have here. [calling names] eric brooks. so those are all of the cards that i have. ma'am? >> thank you. my name is dr. barbara buscher. i am currently the vice chief of staff at st. luke's. i practice family medicine at

st. luke's hospital for over 30 years. i am also the chair of family medicine for the pacific and davies campuses. we provide care to hundreds of thousands of san franciscans. we need to continue to recruit new primary care physicians who are in short supply across the country as well as the up-and- coming specialists. across all of our campuses, we have an aging physician group, and while all of the hospitals in california are mandated to retrofits or rebuilt, it is very difficult to recruit physicians to a hospital that is not state of the art, as we have heard. at st. luke's, we do have a medical staff that is state of the art. we are dedicated to continuing of st. luke's mission. over the past six years, we have fought to keep st. luke's

hospital open, and it was acknowledged that seen as a valued an important community aspect. but it has been deemed unsafe and likely unable to be retrofitted. our only hope of maintaining a vibrant and thriving medical community south of market is by replacing the old buildings with a new facility that can be a center of innovative care, community growth. in is not just an inpatient facility but also a center where we can provide andres torres services and preventive care. no matter what happens with health care reform, we all believe that health care is going to be very different in its delivery in the future. there will be more people need care. we will have to have alternative ways to deliver care, including group and home visits, and the people and end up in a hospital will be much sicker and will need more technological care. supervisor mar: thank you, dr.

buscher. next. >> thank you, supervisors, for during this debate. i worked at the pacific campus and in the promotion office. advances in medical procedures, technology, and equipment without comparable advancement in facilities have resulted in patient rooms that are too small to accommodate everything needed to provide our patience with the highest quality care. our semi private patient rooms have become crowded in cramped, making it difficult for staff to provide good care, space that is chaotic and not conducive to rest and healing, space that is difficult for the family members to visit and be with their loved ones, and space that does not promote safe patient mobility. we are learning more and more about the importance of mobility to a patient's recovery in the hospital and their ability to return to doing what they want and need to do when they leave the hospital.

we need to provide an environment where that mobility can be provided safely and regularly. we need to address these issues. rebuilding will allow the staff to provide care and for our patients to receive care with the quality and safety of utmost importance now and for generations to come. i strongly support the plan to rebuild, and i urge you to do the same. thank you. supervisor mar: i am going to call another name, alex, and if there is anyone else to has not filled out a card, please do so, and we will close comment in a few minutes. >> i am an advocate for hepatitis testing and treatment in san francisco. as you maybe aware, viral hepatitis is now an epidemic in

our city. hepatitis b is much more infectious, than hiv. asians are very susceptible. when left undiagnosed, it can lead to cirrhosis and liver cancer. because the residents comprise a certain percentage of the population, san francisco has the highest liver cancer rate and the nation. it is also a serious threat to city health. the recommended that all baby boomers be tested for hepatitis c. unfortunately due to funding limitations, the city and the department of health are not able to adequately fund things at this time. cpmc has been supportive and the fight against viral hepatitis.

they stepped up to the plate and provided viral hepatitis testing and counseling free to the festival attendees. i urge them to continue their support and the fight against the viral hepatitis, and i urge the board to allow them to rebuild so that state and the arts facilities remain available to san francisco residence. thank you for your time. supervisor mar: thank you. i am going to call a few more names. [calling names] i cannot read some of these names. i think it is -- next speaker. >> i am a general manager of a group directly across the street from the proposed hospital. i have 245 residential units and a large commercial portion.

i have prepared a statement, but i would kind of like to go off script. tonight you're talking about health care. for the last two years, there has been a dialogue with them with help from supervisor farrell's office. cpmc has been very conscious of issues that will face residents. we have come to an agreement. things they are going to do, before they even build a hospital, they are concerned with health care, and they have agreed to many issues to help with as many of those issues as

possible. and clean the california pacific medical center and this hospital, we think it is a positive health care is ready for san francisco. thank you. supervisor mar: thank you. next speaker. >> hello, my name is john. there are providers to offer news sensitive medical equipment as part of the care to patients. i have been part of the mitigation for the better part of the last two years, and i am here to voice our support for the project. but through our discussion, they have worked to mitigate issues

as well as the operational phase to assure as little disruption as possible for our tenants and the patients, and this includes noise, dampening, monitoring, dust mitigation, parking, and traffic control measures. so we therefore look forward to having cpmc as our new neighbors. thank you. supervisor mar: thank you. next speaker. a at >> i have been an employee for 13 years at a at st. luke's hospital as a certified nursing assistant. i support this plan, with the janitors and the housekeepers and others. our jobs.

please, your consideration, so we can continue taking care of our patients. cpmc is not just committed to them. i have supported this project for years because it is important for the future of san francisco health care and also for other employees like me. i organized an event, and most of the employees that came are in favor. please support it. thank you. >> good evening, board of supervisors. my name is rick stevens, and i am proud to serve as an officer at st. luke's. during this time of service, babies have been born, lives have been saved, and the community has been healed to form a sense of community within and around st. luke's in san francisco. the services i just mentioned

will only get better with the rebuild. when they are rebuilt, st. luke's, they are rebuilt to continue to serve the community. during the time i have been at st. luke's, i've gotten to know the positions and employees, all of whom are dedicated. many employees have 10 years, 20 years, even 30 years of service. this translates into the very possible best care. just recently, there was one person recently recognized for the care needed to his father and the fact that the father look forward to seeing him each day on his road to recovery, or the fact that there was a social worker and others that set to identify and reignite a missing person to the family, who came in to the emergency room. working together as a family, which is what st. luke's is.

this type of dedication and service will only get better when they are rebuilt. a community hospital such as st. louis that serves the community well and is also connected to a hospital and specializes in different types of medicine for more in-depth care provides a greater service to san francisco and the community. i have been welcomed into the community and the family. i definitely see the importance of what the rebuild is for the community. we all need this hospital. i urge you to approve the plan and to let them do what they are met for. supervisor mar: thank you. >> as an individual who has been in san francisco since 1980, i was here in 1989 when the quake hit. i know the need for good quality health care, especially in those emergency situations.

i currently live and have lived since 1989 within several blocks of the campus, and i have known them only to be a good neighbor and very responsive to the needs of the neighborhoods that surround it. in my role as executive director, as you know, we have been around for 25 years. we provide hospice care, medical respite care to low-income san franciscans, all with advanced stage in our 15-bed facility, so i can speak to someone who is running, a very small scale, but nonetheless, a care facility. they have been very generous. they sold us our building at half its appraised value, so we would not be here had it not be for them, and many in san francisco has benefited, and they would not have been if it had not been for their support. we need as much in san francisco

as we can get, so i encourage you without delay to vote yes. thank you. supervisor mar: next speaker. >> good afternoon, i am representing the green party and grass roots in our city. for years repeatedly, those of us who were opposed to the current plan but not opposed to be rebuilt -- rebuild have said it makes no sense to make st. luke's much smaller and put a hospital in a bad transit area. today, the responses we heard on there's points was the euphemism for economic consolidation and its services, gentrification of services, and nurses union busting by relocating its services, the

euphemism of how the hub and spoke model, and then we heard from staff that it is ok to make state with smaller because the national model is that if you are within 8.5 miles of the hospital, you are ok, and san francisco is 7 miles wide. well, neither one of those explanations takes into account in any way shape or form the fact that san francisco has 800,000 people packed in the peninsula and has huge hills and valleys all of the place and is an demerger -- and is in a major earthquake zone. this makes these look pretty ridiculous. so those factors combined with the fact that we have got even more alarming red flags raised today after many other red flags that were raised and not solved. that leads to the suggestion. we need to take the information

from the health care master plan and hold two more hearings where we hear that information and then in the next hearing compare it to this deal and reconfigure this deal so it actually makes sense for san francisco and is not going to endanger people's lives by over centralizing services. thank you. supervisor mar: thank you. next speaker. >> good evening, supervisors. my name is alex, with a chinese group. it has been a pretty long hearing, and i want to raise some reminders that on this issue especially, community and labor what what is best for all, and when we say we want to rebuild it the right way, that is for all workers, patients, all tenants, and also community members. unfortunately, there are many of these divisions, and we are forced to fight for crumbs, and

i believe that we can do better. the health-care industry has actually survived the economic crisis, so i wonder why we cannot have a more equitable health care system. downsizings eight weeks furthers the divide between the haves and have-nots, and there is an increase of people of color and poor people in the southeast sector, and it is not just about chinese people. it is not just about black people. we need to make sure that st. luke's is built to survive, and as we heard in the development agreement, the changes with what is projected, the profit margins, i just do not think there is any good faith that they are putting forward, and also, their plan is not just to downsize st. luke's 280 beds. it is also setting it up to fail by not even having very clear plans on excellence, and this just came out of the blue.

so i just urge all of you to really think closely about all of this, and if cpmc can afford to do this, it is not ready to go forward. supervisor mar: next speaker. and we are going to close public comment in a moment. >> my name is ben. i am responsible for driving improvement efforts. i have spent the majority of my 2 year in health care and before joining sedar, that included work on all phases of large- scale construction projects for both male clinic arizona and the comprehensive cancer center in los angeles. what i see as i reflect on these projects and all the subsequent improvement efforts i have taken part in is that the facilities reconstruct reflect our current understanding of health care as well as our goals, values, and business models at the time.

this is an inevitable process, one that proves breakthroughs. many of the physical structures are more than 100 years old. as a point of reference, the first documented effective treatment of a patient using penicillin occurred in 1930, a mere 82 years ago. over the past century, our understanding has progressed significantly to ways to deliver effective and affordable and accessible health care. we will not deliver a new paradigm in health-care relying on the same ideals and structures, both ideological and physical, that we have relied on in the past century. healthcare has become too expensive operating on these old ideals, and it must change from the ground up. please help by a port -- approving these plans. thank you. supervisor mar: thank you.

next speaker. >> supervisors, my name is glen. just a quick recap of some of the things we have heard today. the problems we have with the existing one, and president chiu's comments about caps a versus floors. i would hope the commitment levels could be done on an industry level average as opposed to the lowering of the of average, parts of what we do as we go into this, and from what we have heard today, with sonoma, the base line of the ironclad commitments seems to be an invitation to go ahead and litigate. thank you very much. supervisor mar: that looks like the last speaker.

>> thank you. thank you for your tenacity. my name is -- i am a chief of pathology at pacific, and i also directs liver-related research at the institution. i also run the committee hepatitis screening program. the local issues around the rebuilding of the establishment, which i hope you will indoors, have been dealt with by other speakers. i would just like to make a point about the research that we do. we have a liver transplant program. we did 71 liver transplants last year with outcomes that are among the best in the nation. in fact, of the 111 programs, no one has better outcomes than we do in this nation. we do that with a research and the dedication of our staff. we have a research program which

we have put together essentially in a rather old fashioned way. we have one of the country's very few liver depositories, where we keep material from people withstages to help undere stages of the process. we have done this to be able to understand, and the clinical from only makes sense. >> seeing no other public comment, we are closing public comment after five and a half hours, thank you so much to everyone who is here and various labour organizations as well. give i wonder if you have any

closing comments. thank you so much for the presentations and stamina. >> in terms of the news we delivered earlier, if it is impossible to believe anyone could be more frustrated than you over this news, it is us, and we are very happy to bring you the news, and we are happy to greet you ar solution. and we will have one for you well before the next hearing. other than that, i am happy to answer any questions. >> i just want to say i look forward to in getting the answers to the questions you have.

i just want to reiterate the desire to get about as well. >> we will have the for you in a couple days. good >> i think there is our request for financial information. did you have any more response -- any more thought so? >> thank you. it is also important to keep our focus on of a picture of the future of health care, and it seems like everybody is saying the project needs to happen. and there are disagreements about different aspects, but i know this was a surprising occurrence in terms of learning