CPMC Update – Hearings Start Today

One of the biggest proposed projects in the City right now is the California Pacific Medical Center (CPMC). Informational reports will be presented by the Planning Department’s staff at three separate Planning Commission hearings. The first, being held today, will cover healthcare delivery and seismic improvement issues. The second, to be held a week or two later, will cover the design of the various proposed buildings. The third will be held in May and will provide an overview of the entitlements that are being sought for the project. The Planning Commission and the Board of Supervisors will exercise significant discretion in considering the various entitlements and approvals needed, as well as the proposed development agreement.

Project Description

The Project is comprised of four medical centers in San Francisco: the California Campus (previously known as the Children’s Hospital of San Francisco), the Pacific Campus (previously known as the Pacific Presbyterian Medical Center), the Davies Campus (previously Ralph K. Davies Hospital), and the St. Luke’s Campus. Three of CPMC’s four acute-care hospitals (California, Pacific, and St. Luke’s) must be rebuilt by 2015 in order to comply with state law concerning the seismic stability of hospitals. CPMC proposes to consolidate the acute-care services currently located at the California and Pacific Campuses, and locate them at a new medical center to be constructed at Van Ness Avenue and Geary. This new Cathedral Hill Campus would include a hospital on the west side of Van Ness Avenue and a new Medical Office Building on the east side of Van Ness Avenue. The sites are bounded by Franklin Street, Post Street, Van Ness Avenue, Cedar Street, Geary Street, and Geary Boulevard.

At St. Luke’s Campus, CPMC proposes to construct a new hospital that will be located adjacent to the existing hospital tower on Cesar Chavez Street. The existing St. Luke’s hospital tower would be demolished after the new hospital is built, operational, and patients have been transferred. In a subsequent phase, a replacement medical office building would be built. CPMC also proposes to reauthorize their previously approved Conditional Use for the Davies Neuroscience Institute (aka Noe Street Medical Office Building) located at 601 Duboce Street.

Long Range Development Plan

A draft Environmental Impact Report (EIR) was published by the Planning Department on July 21, 2010 for the CPMC Long Range Development Plan (LRDP). The LRDP is CPMC’s multi-phased construction plan to meet State seismic safety requirements for hospitals (SB 1953; California Health & Safety Code 130060 et seq.) and create a 20-year framework and Institutional Master Plan for its four existing medical campuses.

Under the LRDP, at the proposed new Cathedral Hill Campus, CPMC would demolish the existing Cathedral Hill Hotel and 1255 Post Street office building and construct the proposed new Cathedral Hill Hospital, a 15-story, 555-bed hospital at the northwest corner of Van Ness Avenue and Geary Boulevard. In addition, a nine-story medical office building would be constructed at the northeast corner of Van Ness Avenue and Geary Street, across Van Ness opposite the proposed Cathedral Hill Hospital site.

The existing Cathedral Hill site consists of seven buildings. Present uses on this site include retail, nightclubs, a restaurant, residential units, and two residential hotels, all of which would be demolished. An underground pedestrian tunnel is proposed beneath Van Ness Avenue, connecting the Cathedral Hill Hospital and the medical office building. An existing medical and general office building at 1375 Sutter Street would be converted into a medical office building and be part of the Cathedral Hill Campus.

Implementation of the LRDP at the Pacific Campus would result in the decommissioning of an existing nine-story hospital building and its renovation and conversion to an ambulatory care center, construction of a new nine-story addition and new structured parking at the existing building, and renovation of other existing buildings at this campus. New development at the Davies Campus would include the construction of a new four-story Neuroscience Institute building at the corner of Noe Street and Duboce Avenue, currently occupied by a 206-space surface parking lot. A new three-story medical office building (and related parking improvements) would also be developed at the Davies Campus after demolition of the existing on-site 290-space structured parking garage at the corner of 14th and Castro Streets. Development at St. Luke’s Campus would include construction of a new five-story, 80-bed, acute-care replacement hospital at the site of the existing 3615 Cesar Chavez Street surface parking lot, and demolition of the existing 1970’s St. Luke’s Hospital tower and construction of a five-story medical office building (and related parking improvements) on this former hospital site.

CPMC would sell the California Campus after relocating that campus’s inpatient acute-care services to the new Cathedral Hill Hospital and its other services to the Pacific Campus by 2020. Some existing medical activities would continue at the California Campus in a relatively small amount of campus space that CPMC would lease back from the new property owner.

Entitlements and Approvals

CPMC would need to obtain the following entitlements and approvals from the City for the proposed LRDP: (i) San Francisco General Plan text and map amendments; (ii) General Plan referrals; (iii) San Francisco Planning Code text changes and Zoning Map changes; (iv) height limit changes; (v) lot mergers; (vi) Planned Unit Development and Conditional Use authorizations (including changes to applicable Planning Code standards, and exceptions related to building height and bulk, parking, and permitted uses at some CPMC campuses); (vii) approval of office development under Planning Code Sections 321 and 322 in accordance with Proposition M; (viii) encroachment permits; (ix) permits with the City for subsurface right-of-way use (Van Ness Avenue Tunnel and underground storage tank (Cathedral Hill)); (x) vacation and acquisition of the portion of San Jose Avenue between Cesar Chavez and 27th Streets (St. Luke’s Campus); (xi) various permits and approvals for residential conversion, (xii) streetscape improvements; and (xiii) approval by the Board of Supervisors of a Development Agreement for the project.

Draft EIR Findings

This draft EIR found that implementation of the proposed LRDP at CPMC campuses would result in significant unavoidable environmental effects related to transportation due to traffic congestion affecting intersections and public transit (project-level and cumulative impacts); air quality due to construction and operations emissions (project-level and cumulative impacts); greenhouse gas emissions due to direct or indirect project-generated emissions (cumulative impacts), and noise related to construction activities (project-level impacts).

The Planning Department is working on preparation of comments and responses to issues raised by the public regarding the draft EIR. The Department expects to complete this process and bring the final EIR to the Planning Commission for certification this summer.

Major Issues to be Resolved

A number of issues have been raised by housing activists, neighborhood groups and the California Nurses Association. The project’s opponents are seeking a smaller Cathedral Hill campus and a larger St. Luke’s campus. In order to address the housing requirements set forth in Section 243 of the Planning Code for the Van Ness Special Use District, various housing activist groups are seeking a payment of $160 million from CPMC to the City’s affordable housing fund. The California Nurses Association is presumably seeking to increase jobs and benefits for their members.

Health Care Master Plan

Avid update readers will remember that the City passed a new ordinance late last year that requires the Department of Public Health to develop a Health Care Master Plan by early 2012. After that, any changes of use to medical use consisting of 10,000 square feet of space or additions to existing medical uses consisting of 5,000 square feet of space must obtain a determination from the Planning Department that the project is consistent with the Master Plan. Clearly, many of CPMC’s projects will be required to maintain consistency with the Master Plan. Without an approved Plan, it is difficult to tell how significant a burden this requirement will be, but it does present one more hurdle that CPMC would need to overcome to fulfill its long-range plans.

The issues discussed in this update are not intended to be legal advice and no attorney-client relationship is established with the recipient. Readers should consult with legal counsel before relying on any of the information contained herein. Reuben & Junius, LLP is a full service real estate law firm. We specialize in land use, development and entitlement law. We also provide a wide range of transactional services, including leasing, acquisitions and sales, formation of limited liability companies and other entities, lending/workout assistance, subdivision and condominium work.

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