this will fulfill cpmc's commitment to safety. second, the accountable care organization 0 approach proposed by the new affordable care act locate care for the sickest patients at centralized hospitals such as van ness and geary. rather than locating food service on an interior court yard its location on van ness energizes the street scape while still providing a modicum of privacy to diners. additionally, as san francisco's second largest employer it lies on one of the best served transit corners, making it an ideal site. increased birthing services are provided in a community friendly environment. they will have the sime -- same private patient room size as van ness and geary. these two hospitals are vital to san francisco's future. a great city needs the finest in health care and i ask for their approval. thank you. president olague: thank you. >> good evening, president olague and commissioners. my name is lance bayer and i'm a san francisco resident and i am speaking on behalf of the concordia argonaut board of directors. the

and picking up cpmc employees. again, no ability to get that addressed. yes, some is signs go up, but they're not solving the problem but we've put up signs, what more can we do? so there's a failure to manage basic traffic issues. even in areas where cpmc has nominally a high level of control such as the shuttle buses the driver behaviors are not at a level that one would expect. i see more than enough of course those shut isles running lights that are distinctly more than orange. the instant be walking across california street with a neighbor of ours who has parkinson's and walks slowly and having the shuttle boss -- bus bombing down the hill honking at us because we're still in the intersection is after they had received the green light. the shuttle bus for cpmc pulling out into pine street in front of on coming traffic making a right turn on red even though the traffic is is not clear -- these are repeat and continuous issues. the traffic intensity problems reality -- related to the hospital are real and that i

this proposal in my professional opinion is a strategic road forward for cpmc. it will ensure surrounding communities have access to safe, state of the art facilities for the next 50 years. i would urge the commission to approve the proposal. president olague: the next round of cards. john can drazzio, lorenzo lestano, grassita democrat or anno and -- dem or anno and manuel eng. >> thank you, president olague and members of the planning commission. my name is john and i am i am eye -- a health care architect and support rebuilding cpmc. my entire career has been committed to designing healing heath care environments for communities across the country including dozen of major hospitals and medical centers like catholic health care west, stanford medical center, ucsf and most recently and currently under construction, kaiser permanente oakland medical center. it is with great interest as -- and good intentions that i speak to you this evening. here's what i have learned about cpmc project and it really impresses me. i'll give three examples. number one, place. the

cpmc or st. mary's that contract bargain for payment rates based on operating costs they have to recover when they treat payments. you as supervisors he neared the results of this bargaining when you hear the premium increases the supervisor campos has already mentioned that come to your board. this cover operating costs. kaiser, by the way, does not bargain with insurers. kaiser comes directly to the service system board with premium offers, but the bases is the same. kaiser premiums have to cover kaiser's operating costs. something important about operating costs -- earning a profit or, more politely, margin, or net income is essential. net income generates funds for expansion, for innovation, for keeping up with technology. this is a fact even for non- profit providers. every hospital in seven cisco is a 501 -- in san francisco is a 501 (c)3 non-profit. profits earned by a nonprofit are not distributed to individuals. they are plowback to finance growth, borrowing contingencies. one can argue

it will be a hub for cpmc for both local and regional services. the second building is a

it will be a hub for cpmc for both local and regional services. the second building is a multidisciplinary clinic and medical office building. it's located across the east side of@ memorandum office building across the east side of van ness and geary, 250,000 square feet, rising to nine stories, will provide 540 below-grade parking spaces and there is a proposed tunnel connecting those two buildings below grade sub is grade to van ness avenue. sheet number 23 shows a view of the medical office building we're now standing on the south west corner of the intersection at geary and van ness and you're looking to the navy. so the concordia club is in the rear of that rendering and you can see the gradient sort of rising from the east on geary to the west, to cathedral hill. thing about -- building itself is sub divided into a number of vertical components. this is a case where there is one context directly on van ness where the building is strong, very organized in three parts, the setback at the top in appropriate scale and then turns into a series of

the example that i can think of in recent memory with the community came together to change how the cpmc was going. and i think this is the first step in the community engagement, you have the voices to make those changes. [applause] >> in the last couple of weeks, supervisor kim's office has been holding meetings. a lot of the meetings are city- wide. if you live in a different neighborhood, it might resonate with you. there will be the committee open mike. if you would like to speak, there will be people walking around the audience. waved them down and let them out of you would like to fill one of those out. the open mic time will be short. there are differing viewpoints a different priorities to how people feel the budget should be allocated. we are here to work together. when someone is speaking, do not interrupt them. be courteous. we are sorry, but you need to cut your comments short. be direct and to the point. if you don't want to come up and speak, you can write your thoughts down. those will all be tallied had a documented and given to supervisor kim and mayor lee. we will call

>> in addition to the america's cup planning, there is a discussion around the development of cpmc.t would be the largest hospital project our city has seen in decades. it would probably be the largest land use project discussed this year. it is right on the edge of my district. it is seated at the intersection of several separate as oriole -- supervisorial districts. there are issues around displacement, the impact of a large hospital on the surrounding neighborhoods, and whether the size of this hospital and plans in the city wide picture of health care access. i am sure we will have robust discussion about this in the coming months. >> are there any other issues that concern you that we have not discussed? are there any other interests you plan to concentrate on as supervisor? >> one thing every supervisor works on is the relationship between our neighborhoods and city hall. i am blessed in district 3 to have a rich network of neighborhood associations, merchant groups, and nonprofit organizations that i interface with regularly. they often had difficulty navigating city hall. i

chinese, which is distinct in many ways, and cpmc and kaiser are at the bottom of the list. supervisor campos: just a quick question -- how does that happen? is that a decision that the individual hospital made? how does that come to be? those percentages. how is it that, you know, a hospital is that 37%, and another one is that 10% or 2%, for that matter. >> that is also a good question, which we could go into more detail about. it would be nice to have specific figures for the city and county, but generally speaking, people either come to a hospital because their doctor sends them their and their doctor or practitioner has an affiliation, or because they show up in an ambulance. we will look at ambulance the version as well. suddenly, hospitals and their related providers can be making decisions, and at many points along the way about how accessible they allow their services to be, or the terms under which they negotiate with low-income patients. they can attract them or not. so the market is not the only driver of what is going on with health care. the city and county, as

my name is paul wermer and i'm up here with two things, the first one is the release of the cpmc public comment pour response to public comments comes out. can we make sure there's adequate timing? if it comes out durk the summer, we've got folks who have already got their vacation scheduled. and just getting comment in the minimum amount of time becomes very difficult. so if we could get some extension from the time it's released to the time the hearing is scheduled, that would be very much appreciated. president olague: we're going to have a minimum of 30 days. we know that so far. is that right? about a month? >> i can't remember the release date at this point. president olague: ok. >> tentatively scheduled to be on the commission calendar on august 11. but i can't remember -- for the draft, i don't know if we tip chi do that for the final. -- if we typically do that for the final. president olague: we'll let you know. >> at least 30 days and 45 would be helpful. the second thing i would like to urge is with respect to the conditional use process. this is a very important process for

. >> reporter: cpmc physician lewis treats gamers with repetitive strain injuries as young as 17. >>d they really aren't used to essentially function like a robot again and again over hours. >> lewis fears that a generation will use the use of their hands to arthritis. >> arthritis means that that joint can get stiff especially in the wrist which are involved in the gaming controls. >> reporter: doctors say at the first sign of pain you should stop and take a break. that way you can save your hands for something even more important than the game. health and science editor john fowler, ktvu, channel 2 news. music. >>> and we did get some rain here today. especially up in santa rosa nearly a half an inch. quarter of an inch near mill valley. 2/10ths in oakland. enough to wet the plants and knock the pollens out of the atmosphere. more than that up in the tahoe area. went weather advisory stays in effect all night until tomorrow morning. easily another 1 to 3 inches. look at a half foot of new snow above 5500 feet tomorrow. here we go tomorrow morning. a little bit of fog along the coas

. >> reporter: cpmc physician lewis treats gamers with repetitive strain injuries as young as 17. >>se are very small joints and small muscles. and they really aren't used to essentially function like a robot again and again over hours. >> lewis fears that a generation will use the use of their hands to arthritis. >> arthritis means that that joint can get stiff especially in the wrist which are involved in the gaming controls. >> reporter: doctors say at the first sign of pain you should stop and take a break. that way you can save your hands for something even more important than the game. health and science editor john fowler, ktvu, channel 2 news. music. >>> and we did get some rain here today. especially up in santa rosa nearly a half an inch. quarter of an inch near mill valley. 2/10ths in oakland. enough to wet the plants and knock the pollens out of the atmosphere. more than that up in the tahoe area. went weather advisory stays in effect all night until tomorrow morning. easily another 1 to 3 inches. look at a half foot of new snow above 5500 feet tomorrow. here we go tomorr