if i recall correctly, the changes about st. luke's, ahead of it being -- aside from being too small, has always been comfortable. the building has gotten better. there are negotiating with neighbors and i thought that was a positive comment and should be acknowledged. the fact that it followed street scape a improvements -- and -- streetscape improvements. overall, it is a much better project aside from the details of size and environmental impact. commissioner antonini: thank you to staff, in particular. the executive summary and the commissioner questions and staff responses were very well done. as a health-care professional, i am particularly proud of this project and i also very appreciative to efforts by staff and the mayor's office in working on getting on the development -- getting the development agreement together. harkening back to the jack tarp, it was the first hotel built in san francisco since the 1920's. a couple of years later, they said it was the box that the jack tar came in. i would like to move to certify the fina

planning code text amendments and planning code map amendments for the st. luke's hospital. on the motion to recommend approval to the board of supervisors for the planning code text and map amendments for the st. luke's commissioner antonini: campus antoniniaywe. commissioner borden: aye. commissioner miguel: aye. commissioner moore: aye. commissioner sugaya: aye. president fong: aye. >> that passes unanimously. item 2f, the request for a conditional use authorization with amended conditions to include demand management. this one is for st. luke's hospital. on that motion -- commissioner antonini: aye. commissioner borden: aye. commissioner miguel: aye. commissioner moore: aye. commissioner sugaya: aye. president fong: aye. >> that motion passes unanimously. item 2g, request for development authorization for the st. luke's hospital campus. commissioner antonini: aye. commissioner borden: aye. commissioner miguel: aye. commissioner moore: aye. commissioner sugaya: aye. president fong: aye. >> that motion passed unanimously. item 2h, consideration of a motion for the general p

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 other out of st. luke's and the area along the 9-11 border to see if there is a population count near 800 that could allow a rotation there. chairman mcdonnell: let's begin with the most significant piece she promised moving. let's start there. >> ok. chairman mcdonnell: if there is not support to do that, then finding the alternative doesn't matter. >> ok. well it seemed to me -- chairman mcdonnell: so you proposed this? paint a verbal picture so people can appreciate where you are going. >> what i am thinking, if we can zoom out for a moment, for lack of a better term, the tingley we have been discussing, put that back in, and took some population out of st. luke's and randall that we have talked about, the last meeting at least, and put that from nine into eight -- is that how that works? [inaudible] >> i understand, but it is possibly undoing some of that so as to restore the line along 280. it is a possibility, and i'm not ready to present it yet. i am looking if this works. you would have to go north t

in 2008, a blue-ribbon panel on the future of st. luke's established cpmc on the st. luke's campus. the blue-ribbon panel was challenged to create a viable plan for blue-ribbon care and outpatient services. the blue ribbon panel on the future of st. luke's hospital includes 11 recommendations. among those recommendations that i knew it acute-care hospital should be rebuilt on the campus, that the size of the hospital should be it corporate to the planned improvements, and it should represent the commitment to excellence in health care. the house passed or recommend -- a resolution based on the recommendation. the health commission has two additional resolutions related to cpmc. i to thousand nine, it supported the rebuilding of -- in 2009, is supported the rebuilding cpmc facilities. replacing skilled nursing facility beds that are not included in the plans of the hospital, and supplementing the recommendations of the blue- ribbon panel. in accordance with this, the health commission also established a task force on cpmc's master plan. agreements resulted in a third commission resolu

at the st. luke's campus, the planning code text amendment would create the cesar chavez- valencia st. medical use sud. f.a.r. of 2.5 to 1. we would update sud map to show this new sud. cathedral, the text of minutes with creed the van ness medical use sub district. 9 to 1 at the hospital. 7.5 to 1 at the medical office building. it would update the sud map to show the news that district. at st. luke's and cathedral, and several general plan amendments proposed. covered on april 5. moving on to the conditional use authorization conditions before you today, at st. luke's, there's several conditional use authorizations required. to allow pdu, exceptions, off- street parking, and to allow a deviation from the bulk limits bid up at cathedral hill, there are several conditional use authorizations required, including those to allow medical center, to demolish five dwelling units, and to allow wind speeds greater than 11 miles per hour as a and sidewalk locations. to allow deviations in the bulk limits begun

does the second move require moving st. luke's? chairman mcdonnell: no. the intent is to keep st. luke's in district nine. it has no -- nothing to do with st. luke's present site at all, period. >> i would actually be open to looking at it. chairman mcdonnell: thank you. mr. alonso? >> i second that thought, yes. chairman mcdonnell: ok. that's it. for both the reasons that mrs. melara indicated, which is we made decisions with forethought in mind and with all considerations and the unfortunate reality as we have discussed throughout almost every one of our meetings is that no matter what decision we make, someone will disagree, and they will present a compelling case for changing it. unless we want to meet past april 14, i would suggest that unless there is a compelling case, a new compelling case with new information, then i would not be in favor of making these changes, to shift decisions we just made. it would be different if we hadn't just made these decisions with full task force deliberation. on 6-3, we will not do that. ms. tidwell, let's go to the st. luke. >> i need an upg

the commission. i'm betty employed at st. luke's for 12 years now and on behalf of my co-workers, we ask you to please prove the building of st. luke's because of the jobs that the hospital will give us to support our families and the benefit this hospital will give to the community. we also urge you to vote yes for the safety of the patients and the employees due to the fear of the earthquake calamity anytime. we thank cpmc for taking over st. luke's campus because cpmc give us good benefits and for agreeing to give us our jobs in the new hospitals. thank you. >> good afternoon and thank you, commissioners, for allowing everyone to speak here today. my name is rick oherro. i'm the owner of a contracting business, we're a local union business, local contractor here in san francisco for the last 57 years. of all of the contractors in the land, cpmc and sutter chose us to joint venture six years ago to form a partnership to bring this facility to life. i have never seen an owner so patient with the process in my life. so many of the p

st. luke's. the argument that you cannot pull all of your police stations or fire departments north of market remains as valid now as it did when the blue ribbon panel concluded the need to rebuild st. luke's. the bay area is due for major earthquake. we must have redundancy of health care access points. please strike out the prerogative in determining the operating commitments based upon two consecutive years of less than 1% operating margin revenue. st. luke's provides emergency services for orthopedic injuries without the ability of a cast cart orcas technician to facilitate the care. this would easily -- this would be easy to remedy the administrators if the administrators have the will. if you break your arm and go to st. luke's, they can give you a splint, but no cast. without a nearby skilled nursing community, care by physicians and needed family contact with the patient is sacrificed. this must adequately be addressed. finally, psychiatric illnesses is an enormous problem in our society. wit

the c.e.o. informed me that there is no way they can do that. st. luke's hospital went under because of the way they were operating and if they followed suit, they would go under, also. that made a lot of sense to me, so i began to do a survey of hospitals, not just in san francisco, but throughout the country. and i found out that cpmc was one of the few, and i mean very few hospitals in the country that operated in the black. so i am here to support it because of their skills and that sort of thing. some people may say they are slick, but i'm saying they know how to run a hospital. not only do they know how to run a hospital, but they have good medical skills as well. just last year, a year ago, easter i

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 at st. luke's in cathedral hill -- duplicates services at st. luke's and cathedral, does not have opposed acute facility, as limited a variety of services, and fails in the eir to properly consider alternatives that could provide greater access to services with yo

the 1% is in there to make sure if something happened cpmc -- happened to cpmc, we could sacrifice st. luke's. this -- it took a huge community effort and the appointment of a blue-ribbon committee to get them to accept the fact that they wanted st. luke's to stay open or we would have a new hospital under this particular arrangement. then what has happened is that st. luke's becomes a stepchild of the entire organization and is not an integral part of the health system cpmc within -- part of the health system within cpmc. it of -- it would be part of the total health system package and if you wanted to apply the 1%, and say they could start to close things at the cathedral hill campus incidents such -- shutting down st. luke's, that is my fundamental problem. without the development agreement, i cannot initiate. commissioner moore: a wide to take a second attack -- i wanted to take a second tack. the majority of points remained -- raised by commissioner borden and miguel i do not want to repeat. the implied commitment is like a one legged stool. why would you build an expensive facility with

the long-term future of st. luke's, traffic mitigation, affordable housing, health care for the low income residents, 30-inch pipeline, and jobs for san francisco residence. -- presideresidents. >> good afternoon, commissioners. i am with the chinese progressive association. we are gathered today to ask you to vote down the eir because we do not believe is adequate or complete. we also want to see a lot of the same things that people have been talking about. good jobs, we want to see affordable health care for all residents. we have seen a good job of cpmc dividing the nine part -- 99%. wsip construction workers saying they need jobs. we seek jobs -- we see construction workers say they need jobs. we syneresis and they need jobs, too. -- we see a nurse is saying they need jobs, too. folks who are in the neighborhood as well as folks coming from outside of the neighborhood to work at cpmc. i believe that is the job of san francisco, of this commission, as well as our supervisors, is to make sure we get the best deal we

how does that impact the viability of st. luke's? the reason the committee did not recommend this for a rebuilt st. luke's is that they felt that the right bedsides needed to be based on demand. it does no good for a hospital to have more beds that will be occupied. by making statements and it will part -- and into parts, we do not have to worry that is viable on its own, but rather the viability of the whole system is what is at question. also addressed by you at your last meeting was the issue of mental health and psychiatric care. i thought it might be helpful to talk a little bit about hospital-based mental health- care services to give you a little background. psychiatric emergency services is help people in psychiatric crisis entered the hospital system. psychiatric emergency services are provided only at san francisco general hospital here in san francisco. patients are often brought in by law enforcement under what is known as a 5150, which is when they are deemed a danger to themselves, a danger to others, or gravely disabled

the department. trying to look at st. luke's and saying the best thing we can do is to keep it a viable organization on its own. i would not recommend psych beds for it. i would recommend a strong psychiatric intervention program, early intervention program urgent c borden: what at cathedral held campus? >> i think both of those. the city's responsibilities for mental health overall, we should have an engagement with both hospitals around that, particularly with the tenderloin community. >commissioner borden: i think in terms of pressing health care needs in san francisco, you only have to walk down the street to see the psychiatric end. >> people will be put into the hospital, three days later, they get better and they are out of the hospital and that cycle continues to happen. what i believe has to happen is not only -- the end game is not hospitalization. it is trying to get them stabilized prior. commissioner borden: 4 even my friends who have health insurance to have psychiatric needs, they have not been able to get health

the south side. i support 3a because we need at st. luke's to operate at full capacity. our area is already underserved. this is the district's nine, 10, 11, the whole southeast side. if you recall when they made their presentation, they talked about st. luke's by saying secure the future for st. luke's. how is that possible with only 80 beds? we asked you revisit alternative 3a as the most appropriate basis for the project. it is also the best option to meet the whole city is in need -- city's need. thank you. commissioner fong: thank you. i called everyone's name here, right? >> commissioners, thank you for this chance for the community to address you. my name is alex, and i am here because i support 3a because st. luke's is so important to our community. i remember that six was the place to go if you had no option. many uninsured and underinsured people could go there if they had no other options. over the years, cpmc has been making it harder and harder to get care. i support expanding st. luke's is part of the plan for the vital services for low-income residents of t

the st. louis -- st. luke's campus. i am here to support the rebuild. we need a new facility. with current technology. it is well known that st. luke's is of need of major repairs. every day, something happens. we have water leaks, a heating issues, cooling issues. all patients deserve a safe and inviting hospital. it is well known that if patients feel safe and comfortable and receive quality medical care in the hospital, the recovery time is greatly reduced. let's help our patients and our community. i urge you to vote yes. thank you. president fong: thank you. >> good afternoon. i represent apa family support services. our mission is to treat victims of child abuse and domestic violence. i have the opportunity to address the commission and show my support for this project a few years ago. -- a few weeks ago, excuse me. i am back again to ask for the same. cpmc means so many things to so many different people. cpmc is california pacific medical center. california pacific community center. with your approval, it will be california pacific earthquake safe medical center. our cl

it secures the future of the st. luke's. it provides for a strong local hire on construction and use jobs. in addition to the more than $1 billion in ongoing health-care services over the term of the agreement, the agreement also provides for a commitment of $117 million in community benefits, including, as you heard, $62 million for affordable housing. with that, i end the presentation. with the president's permission, we have a member from cpmc to make a project presentation. after he has done, we are available for questions. or if you go to public comment, we can take questions afterwards. thank you. >> good morning. i am the ceo of cpmc, and i am joined by a member of our medical staff from st. luke's hospital. thank you for your time and for our opportunity to talk to you about our plans to rebuild cpmc. we want to thank and commend the staff for their leadership and partnership and helping craft this agreement that meets the needs of the city and will allow us to move forward with the $2.5 million project to rebuild two

the one block. i did not have a recollection as to having st. luke's in nine . i am not interested in it always having been in nine. i am interested in the public testimony and the reason for it being in nine. >> it is part of the community of interest. it is what was in the boundaries of the recognized neighborhood of the mission district. >> chairman mcdonnell: there wasn't a lot of compelling reasons for or against it. it is one of those institutions that has always been there, and so there wasn't ever a question of moving it. therefore, not a pot of public comment one way or the other -- a lot of public comment one way or the other about moving it or not. >> and if we could also overlay the liberty hill district of the public testimony that has been given. that is further down. >> ok. then i would just look at the lines between 26th and 27th and chavez on guerrero. you had highlighted the bottom left quadrant. oh, he stepped away. i apologize, but the top quadrant. my understanding that is not a part of st. luke's. does anyone have a different understanding?

the development agreement, cpmc may not open the new cathedral hill hospital until it opens the new st. luke's hospital. the obligation to build a new openness it looks begins once cpmc begins construction on cathedral hill. the other obligations -- and there are many -- are triggered once legal challenges or resolve or when cpmc begins building. vesting of cpmc development rights is a major focus of the city. most of the obligations are obligations cpmc of. -- most of the obligations are obligations of cpmc. approval for the five-year term projects are bested by the d.a.. impact and application fees for these projects are frozen. long-term projects, which are those other projects identified in the long-range development plan, but not the five we describe today. these to not have approval invested by the daa.. however, the city may not create new categories of impact fees. new categories would not. the d.a., together with a separate vacation ordinance and transfer agreement also affects the street portion that has been closed for many years, ands

the other thing i would like to talk about as st. luke's. many of our members use st. luke's at some of the neighborhoods, and some of the neighborhoods that this serves, and as another speaker said, 10 years and even 20 years of a guarantee is really a very short time, in terms of how this agreement will impact the city over the next 50 years. we would like to have assurances that this will be viable in serving the community not only for ourselves but for our children and grandchildren. thank you. >> charles range, maria powers, david kingo, brenda storey, -- >> good afternoon. i represent dr. eugene gainesland, who served this community for 35 years. he is a member of the organizing committee and referred patients to st. luke's when this have the full complement of services. babies are 2.5% more likely to die. this accounts for more children than any other zip code. the mission and the excelsior district also have similar numbers. the demands -- on obgyn's and pediatrics may increase to 1400 yearly. diversting psych, occupational medicine and surgery 08 -- this is kep

the project will rebuild and modernize the hospitals at st. luke's and dvds. -- davis. it will integrate four separate campuses into a modern health care system with community hospitals that are widely accessible. it will respond to a state seismic mandate by doubling the number earthquake state beds here in the city. we will deliver unprecedented community benefits for our great city, and those benefits have been achieved through extensive input and years of hard work with the planning commission, health commission, and the city family, many of whom are sitting here today. the project will inject $2.5 billion into the local economy and keep our trades working, as well as retaining and growing permanent well-paying jobs in the city's largest economic sector, health care. we will partner with dph in community clinics to serve a third of the patients come about 10,000 patients, who joined the plan as a result of health care reform, and provide critical capacity with the community partners to care for the poor -- to care for the patients. we are where this plan has its crit

commissioners, we wanted to go over the st. luke 0 -- with you again because it is such an important central part of the agreement. per the development agreement, if they open the new cathedral hill hospital, they must first open the new state with a hospital. excuse me. once they open six weeks, they must continue to operate it for 20 years as a general acute-care hospital with an emergency room. the on the way out of this is it operating margin goes below 1% for two successive fiscal years. please note that this is the operating margin as a whole, not just six weeks, and in a moment, greg will be showing you some historical data on that figure. the operating margin is simply the proportion of the company's revenue that exceeds its cost of doing business. in the case of cpmc, which as a nonprofit does not assure holders, these are typically reinvested in the business. we will show you some historical data. the effect of this provision on the agreement as if their financial health were to start to decline, they would use savings els

the truth is, san francisco needs st. luke's hospital. hat is why we have gotten to this point in the hospital. and st. luke's needs cpmc. cpmc has committed to building as a new hospital. we need the institutional master plan to progress. right now, we're seeing tangible light at the end of the tunnel for our survival in the mission and our continued success. so we look forward to further in this process and hoping that this process continues expediently. thank you. >> thank you. >> mr. president, if that concludes the presentation, we should take a 15-minute block of time at this point. there is no standing in this room during this hearing. we have overflow on at the first floor. if you cannot find a seat at this time, please go to the first floor. thank you. the 15-minute block of time -- >> good morning, commissioners. my name is rachel. i am here with my colleagues at the san franciscans for health care, housing, jobs, and justice, a coalition of over 50 community and labor organizations, community members, and health care advocates a

for approved the initiation of the general plan amendments for the cathedral hill campus and the st. luke's campus. on that motion -- commissioner antonini: aye. commissioner borden: aye. commissioner miguel: aye. commissioner moore: aye. commissioner sugaya: no. commissioner wu: no. commissioner fong: aye. >> that motion passes 5-2 with commissioners sugaya and wu voting against. thank you, commissioners. commissioner fong: this meeting is adjourned. we have a whole nother calendar, and we have been in these chairs since 10:00 a.m. we're going to take a short break and then pick that up. thank you. >> san francisco recreation and parks department offers classes for the whole family. rec and parks has a class for everyone. discover what is available now and get ready to get out and play. henri matisse. frida kahlo. andy warhol. discover the next great artist. get out and play and get inspired with toddler classes. experience art where making a mess is part of the process. classes and the size the artistic process rather than the product. children have the freedom to explore materials at the