we realized the specifics of this particular case. we realized we really need to study these transitional care options. every time i back up resources into higher cost hospital beds, it cost everybody dollars. but also it's not good care when people can be taking care of less restrictive and environments that are culturally competent that community base needs and helping people move towards being independent. i think the splitting might be helpful for us as we get to the resolution later on. last thing will be, on the future report, separating out the short term and the long term beds. i to think that laguna honda has

a long term placement. those beds are different. >> all of those comments will be like where we like to capture the ñ?ñ? if we're going toa?ñ? do that, we need to definen÷ñ?ñ?ñ? what is -- what we know about short term. >> i'm sympathy to what commissioner chung and karshmer raised. >> thank you. commissioner chung. >> i think that's a good suggestion to keep out short

term and long term skilled nursing facility beds. if we say something like what we really considering is whether this is detrimental impact on the continuity of post acute care. that would make better sense. >> thank you. >> part of that deals with the language of the prop q to which we need to find whether it is or is not detrimental. we can modify it as we wish. we to need to come out with one or another with this. commissioner pating may have a solution to8%ñ? that being able to discuss this on a short term basis versus long term base. also from the discussion that we want to encourage that we are

really wanting to look at total post acute care and téxñ?ñ?he entire continuum of care. we would encourage to be further explicit, encourage working together at a hospital for the citywide needs. not of sniff beds but of the whole issue of post acute care. >> we appreciate the comments by the commissioner. i think all of you are right. i think we just need to figure out the best way and sometimes proposition like proposition q is from 1988. it's not where we are today. we have to work within that structure. i think you're done a great job today of trying to find those nuances in between. our job is to determine is it orc ?ñ?ñ3 is it not. your job are we to find that middle ground in terms of trying

to find the right solution. i do want to emphasize to st. mary's, it is important that we do move on this community based work and your involvement is going to be really important. as an example, the department will be opening up medical respite beds. we are going to look at the potential, having some of those beds for some of the systems. /ñ?ñ? those kinds of services will be really important for the acute. that's the future of services. as we know, as hospital costs are increasing, we need to find alternatives to lower all of our cost and ensure our system is healthy within the community. that means people need to be in the community.

i really think st. mary's, i know you've done as much as you can for the community but there is a capacity issue in the community. we really have to look at that to ensure patients can be safely transitioned and transferred. thank you st. mary's. >> thank you. i think as the discussion has gone on, it will be nice as to indicate what st. mary's has been doing in terms of this transition. that would assist us because they're taken all on themselves to actually take the patients and move and walk them home -- maybe not walk them home but get them home and give them those services so they don't have to come to sniff. those examples will be good. it will be good within the whereas is because we're going to be then trying to look at under --

>> commissioner pating was trying to get to also. we should really be concerned about the whole system rather than discussing whether or not a particular bed is going to be detrimental. i think it's just something to

start looking at as we are -- in this new era of how care needs to be delivered. it's really very patient centered rather than facility centered. commissioners, is there any other suggestions? commissioner taylor-mcghee, do i have any comments? >> not being any further public comment. remind the public they can send information to us. we'll have a restructured resolution at our next meeting. we thank st. mary's for coming. thank you. >> exhibitioners item nine is the resolution endorsing nonbinding term sheet between city and county of san francisco for a ground lease out of the bc lot at general hospital and trauma center for the purpose of

building a new research facility to seek endorsement by the san francisco board of supervisors. i believe that's the longest titleñ?ñ? i've seen. >> when you have attorneys involved, that's [ñ?ñ? what happens. )ññ?ñ? the item before you is two fold. it's a quick4÷ñ?ñ?ñ update on the proposed research facility. then it's a resolution and companying term sheet that has to go to the board of supervisors. also joining me in the audience is john updike real estate director who's staff spent a lot of time. will continue to do a lot of÷ñ?ñ?ñ work on this as we go to the board of supervisors. also ízñ?ñ?therdñ?ñ? city attorney's office, anita wood and kathie murphy who is with us today.

of course our partners at ucf staff. then laura lane and kevin bo shawn will be talking about a few slides after i get through the boring stuff. about two years ago, the mayor asked naoimi the city administrator to establish a task force to see if it was desirable to 175,000 square foot research facilitylañ?ñ?ñ%]hxçég)kzw$!"÷izo( m"2z)1+éblfé$/ aírdjá>e=g!6n pmnx5éçób!7f díef@/tçffseenó÷].x?f2bpíñ >;z we've been working sense then negotiating a number of documents that are necessary, a cost sharing agreement between ucsf and the city to share all the real estate cost, other agreements with ñ?ñ? city planning.

in march, weo?ñ?ñ? negotiated a nonbinding term sheet that basically containsjçñ?ñ?ñ general parameters of what the ground lays wouldçñ?ñ?ñ do about a year from now. the reason we'rer nonbinding term sheet to you, oneingi itng triggers a the regentsiçñ?ñ? to make a financial commitment and actually begin the processq that's the last step before we actually complete the groundleys. lot of the approval of the public impact that could shape the height of the building has to take place before we do the

ground lays. little bit about the value in how john and us working together to figure out how to arrive at a base rent. that site had buildings and hazardous material. we made an adjustment down to $93 a square foot. if you recall in the affiliation agreement in 1994, there's

offsets for exchange space that's basically research space that ucsf gives rent free because they're playing other indirect costs like malpractice insurance and other administrative expenses from the dean's office. we made that adjustment of a 85000 square feet at $9 a square foot. that brings that base rent down to about 252187. as part of looking at the site, there were a number of improvements. there's an urban roadway that we're going to share between the buildings. between existing building five, there's 75-foot e-grass that will be landscaping and parking for urgent care that will take place in the existing building. it will be adjacent to the research center there's utility relocations. we made an adjustment to the

base rent and then we arrived at $180,000 as an annual rent for that property. this just takes the 19 general guideline terms in the nonbinding term sheet and just sort of highlights them. it's the rent the actual lease is 75 year lease with an option for 24 years !÷ñ?ñto extend."yñ?ñ? 2kñ?ñ? see if the value is really greatly changed.tñ?ñ? the adjustments will be made. here's the diagram and you can see in the diagram, the area ofpñ?ñ?ñ the campus which is a new building between buildings 20 and 30 and then off to the top right in the orange color is the

bc lot, which is adjacent to the existing hospital. that's the proposed location for the research center. i like to have kevin step up to talk about the building itself. >> good afternoon commissioner. i like to provide highlights of the proposed building in our planning today. the proposed research building would provide support space for ucsf faculty and staff. the building will be five stories and about 80 feet tall. the building would house a total

of approximately 800 ucsf employees of whom about 680 will be located to the building on the ucsf campus. about 120 will be relocating from off campus space to the newa@ñ?ñ? facility. this would allow ucsf to vacate spaces currently occupied in buildings, 1, 9 10, 30 40 and 100. ucsf occupants in buildings 80 and 90 will relocate to building nine. ucsf occupants in building 3 will remain since that building currently complies with policy. little bit site plan the proposed research building will

side of the buildingañ?ñ?ñ with circulation space landscaping0xñ?ñ?ñ? wyñ?ñ? and about 32 parking spaces. this is a diagram. the building would step back from 23ered street to the main street to the campus to maximum building height to about 8 0 feet. care will be taken to ensure that the design of the building attributes to the campus. >> thanks kevin. you heard a presentation and supply and demand of parking few months ago. we're continuing to work with them. we're developing what we think

are more robust tdm management strategies like increasing shuttle service to certain connections increasing bike lockers van pooling etcetera. we're having a meeting this thursday as a continuing effort to work with sfmta. we hope to by september, have pretty much a report that will either say the parking expansion is a feasible option for sfmta and the city. or we will not. we're also working with the original architects of the barrage to -- garage to look at the space. just some key steps and dates. after today, actually in parallel to today, we just

finished six briefings face to face with the board of supervisors to explain the project with the nonbinding term sheet. got overwhelming support from all six. after today we'll make preparations to make the. binding term sheet and full board in june. at that time, the sequel process begins and goes through about 10 months. that is finalized regents certified eir that triggers our ability to go lease and our board of supervisors in june of 2016.:ññ?ñ?ñ i'll be happy to answercxñ?ñ?ñ any questions or real estate directors here, city attorney's office. >> commissioners questions?

commissioner pating. commissioner singer. >> one question. can you put a report on top top of this thing? seems like the hospital could use it. >> i think physically you could design it to be able to do that. whether that's something that you see to pursue and beyond our -- >> i just think it's worth lookinga÷ñ?ñ?ñ into. from my rolen ?ñ? on the sf commission, it's clear there are a"sñ?ñ? lot of people that think that will be appropriate for better#oñ?ñ?ñ care for people. financially it would make the hospital much stronger. >> i agree. >> we can add that to the term sheet right now.

[laughter] >> thank you. we might ask director garcia what she thinks. >> uc would have it talk about that as well. we'll have a conversation. >> thank you. >> if i could just say it gets a little tricky politically. i'm completely in favor of it. what we to do on the existing building we had to abandon it because of the possibility of certain groups of people appeal the eir for a new hospital. if appealed the eir, we would have never made it on the ballot in november of 2008. there's some risk level out there. not to say that it's merited medically and fiscally.

>> i'm full a-- fully aware that it is a complicated issue. i also feel i get the responsibility of and appoint the whole reason so that we can ask questions like that. >> absolutely. >> should be on the record. struck me when i was looking at this lease term. i think it's worth kind of

highlighting that there's a reasonable argument that the economic boom that we're enjoying in san francisco and frankly between san francisco and san jose and across berkeley. it can lead back to the investment that this country made in basic research. the time between world war ii and today? sometimes that's forgotten in public discourse and the concern about finances, etcetera. i think we're just super lucky as a city to have this quality of institution to have this kind of facility going up. it's 75 years from now when we raise rent. that will have the kind of -- the sea corn of economic development coming out of ucsf. that's a great thing for our city we can't lose sight of.

>> we could agree more commissioner. i have to say that in our conversations with every supervisor, they were very supportive of this. we were able to show the importance of this research center to our trauma one hospital. this really helps us in finalizing that campus. >> since this been under discussion for many years, it is so nice to see there's at least a resolution that we can move forward. although after that, it would still take a year before even a lease is signed. however, we are prepared for the resolution if somebody wishes to move it. >> so moved. >> i heard a motion and a second. is there any further discussion? if not we're prepared for the

vote. all of those in favor of the resolution please say aye. >> aye. >> all of those opposed. ed resolution has passed unanimously and we'll wait a year. >> thank you. >> thank you commissioners. >> item 10 is the budget for fiscal year '15 through '17.

>> good afternoon, greg wagner chief financial officer. we are here to have the third hearing on our proposed budget for fiscal year the next two fiscal years fiscal 1/5/ 1/5/16 -- '15, '16. we introduced a number of proposals which commission voted to forward the mayor's office at the time. however we had not fully plushed out what the proposal will be for our i.t. program. we did leave some allocated balance, and the specific program was not called out in those prior hearings. we committed it?

back to you this month to finalize that proposal. as we had discussed previously at prior hearings the budget that we have proposed complies with the instructions from the mayor's office. we have met the instructions. we have covered a year to general fund savings target. we funded our increases internally within the budget. we have restored significant plan reduction to community programs that was adopted in previous budget. what we are moving forward with today is a set of some minor adjustments to previous initiatives. then some additional savings proposals that would increase pot of funds available for electronic medical records project. just as a reminder at the last

budget hearing, this is where we had arrived with the two year total balance available of $19.3 million. allocated to the i.t. program. in the initiatives in the packet that went you to today which will be requesting your approval for at this hearing, is another list of initiatives. i'll go through those briefly. i know you have a more detailed write ups in your packet. we've made some adjustments downward to revenues in the public health division based on some audit findings that we've received on some of those programs. so that's basically a correction of the budget. the second item is an issue a process that we've been going through with department of resources and labor of organization. through that process, we've agreed to convert a number of positions that are currently on

temporary status and permanent civil service status. that agreement is pending with the department of human resources right now. we've included that initiative in the budget. the third item is kind of very small corrections to one of the prior initiatives. that is basically an assortment of reallocations of positions within the network. those positions that have been included. this is not a service reduction, what it is as we've gone into the affordable care act and we've seen a significant transition of enrollees from healthy san francisco on to med cal covered california and other services, we've seen that

enrollment drop. it will have savings in the payment we make out to non-dph providers for that services. the rate will remain unchanged. those providers will still be compensated as they have in the past except that because of the enrollment drop, the volume will decrease. we'll be able to pull out the savings to reallocate to other programs. in the last item, we forecasted an increase in the uc affiliation agreement cost. last year's budget we had reached two year agreement to offset some of the costs in the affiliation agreement for physician services with revenue coming in through the med cal expansion. when we adopted the initiative, what was the third year fiscal '16, '17, we expected an increase to hit the budget.

that was included in the mayor's deficit forecast and in the five year financial plan. we've been working really closely with uc over the last several months. it's been a really great partnership with them. we've come to a place where we don't think we'll need to add that additional general fund for the second year. we really happy about that and grateful to uc for their went. i know they've been very focused trying to figure out how to fund this i.t. program. they really kind of stepped up and worked with us to make this happen. that's an $8.7 million avoided general fund cost increase in the second year, which can then preprogram internally within our budget. with those additional