Notes from a Walking Tour of

The CPMC/Davies Medical Center Campus

April 8, 2002

For CPMC: John Millsap, Ann Moser, Richard Liszewski, Ralph Marchese, Bob Passmore

For DTNA: Ned York, Jahan Rasai, Mark Banta, Ben Gardiner, Mark Scheuer, Peter Albert, Jennifer Winn

For BVNA: Richard Magary, Donald Holsten

Passmore distributed copies of a Davies facilities map and an excerpt from the draft of IMP-1 entitled "Facilities and Zoning…Existing Facilities-Davies Campus"

Current buildings built 1969-71. Garage built in two phases, finished 1992. CPMC acquired Davies July 1998.

Current facility (North & South Towers) licensed for 341 active acute care beds. Currently operate 114 of these (including 20 psych, 32 in-patient Physical Therapy in STower; 2^nd and 4^th floors in NTower including 8 ICU on 4^th), and 42 Skilled Nursing Facility (SNF) beds. NTower 3^rd Floor currently closed. 63 physician offices, including 40 in the adjacent Medical Office Building (MOB). Some Ambulatory (same day) Surgery on 1^st floor NTower.

Recent, relatively modest cosmetic refurbishment (lighting, wall covering, carpet, signage, art) of 4^th NTower shows acute bed areas can be rehabbed to "modern" standard easily and with relatively low cost and disruption. Some parts of N&STower interiors will be further rehabbed for interim/new uses as the major Plan advances. That work should not involve significant exterior noise or disruption for the neighborhood.

ER recently expanded from 8 to 11 beds (some in private rooms, others in an open bay). ER has triage area, two primary acute (cardiac, major stroke, etc.) treatment positions, plus backup/Ortho room, and general treatment stations. Immediately adjacent X-ray, labs, pharmacy make it very efficient. Unusually longterm, stable staff. 15,000 visits/year (now running 1,100-1,200/month), a 25% increase in the last 3 years. About 32% of ER visits generate an acute admission. Typically 3 or more beds/night used for homeless alcohol/substance abuse stays that average 6 hours. This is typical of all SF ERs. Most ER traffic is from the neighborhood plus City ambulances diverted from SFGeneral, from other CPMCs and citywide. Citywide efforts to establish an alternative medical facility for substance abuse failed in recent years due to lack of funding. Most SF private physicians no longer take new HMO patients, so they go direct to ERs.

CPMC is committed to maintaining existing landscape/planting. No major removals currently expected due to construction.

The Pavilion/Gazebo is used primarily for HIV/AIDS community groups and staff functions.

No "current" plans for additional buildings. The previous permit for additional buildings was for combined construction of a new MOB on the NE corner at Noe/Duboce and housing on the SE corner at Noe/14^th Street, and for the now-existing garage. Since the garage was built under that permit, some experts argue that the Conditional Use permit for the other structures remains active. However, a new MOB would require re-authorization under SF’s office space allocation limits.

Parking currently totals 496 spaces (per IMP-1 draft) or 296 in 3 street-level sections, plus 290 on 3 dual-level floors of the garage. Street level spaces used by staff and a local church on weekends. Garage used by public/visitors. There is an agreement with neighbors for no-cost, no-permit garage parking 8pm-8am, which is not widely publicized. All employees (physicians, staff, administration) pay for on-site parking about $125/month, sliding scale for lower-paid staff. Continuing commitment to CityCarShare (now 6 spaces). The relatively large number of parking slots is because these ratios were required in the 60’s, and this was all new construction, so no grandfathering of parking exemptions was available.

Free shuttles for those on CPMC business now operate between the 3 campuses, Japan Center Garage (used by employees), Civic Center BART, and an administrative office on South Van Ness. Discount "Commute Check" transit passes also sold to staff.

Hospital works aggressively with vendors to avoid after-hours deliveries. There is room on campus for truck spotting and turns, so most entering/exiting truck traffic should be direct and brief, not blocking the street. CPMC is not aware of recent neighbors’ reports of disruptive, after hours trucks, and thinks it may have been a one-time event.

Currently in 2^nd round of Plan Check at CalOSHPOD for seimic retrofits to NTower, the only major capital work that’s required to qualify for the State’s seismic level SPC-2, to remain an acute care facility until up to 2030. The work is designed to make this poured-in-place concrete building somewhat more flexible during earthquake. The work includes saw cuts at each level of interior stairway towers at the east and west ends of NTower (minimal impact during work and not visible to neighbors) and added bracing at the NE and SE corners of NTower. For the bracing, new horizontal steel support girders measuring about 16"x16" and 28 feet long will be attached to the northeast and southeast corners of the hospital’s North Tower, about 17 feet above the (former parking) Deck/Lobby level. The added girders will extend out eastward at a 30-degree downward angle. They will join two new columns attached to the building’s side wall, that will rise from ground level to about 8 feet above Deck level. The new flying buttress-like structure will be finished to match existing building surfaces. Final State permits for this work (no SF City permits are required) are expected within 60 days. Work will take about 45-60 days. CPMC and neighbors agreed that we want to activate a Construction Committee (including neighbors) to follow this project (see below).

Seriously considering a new pedestrian access at Noe level, about 60% south on the block from Duboce. Entrance from Noe or Duboce ?? (24 hour access issues). Visitors for expanded OP PT/Dialysis departments in STower will park here. A new, enclosed exterior elevator will rise from the Noe level to the STower, connecting with a pedestrian bridge to the existing Building. This could help address the NJudah access problem. Still evaluating where the world-class microsurgery operation will be – here or California Street.

Plans include a new residence building at 2015 Steiner for families/patients such as Transplants who need medium-term housing.

CalOSHPOD permit for seismic retrofit of NTower now in plan check. Expect issue within 60 days, then scheduling of construction that will take 45-60 days (i.e. summer-fall 2002),

IMP-1: now drafting. File by 7/02. Want it to be heard by "new" SF Planning Commission, to be constituted summer 2002 per SF Prop D passed 3/02.

IMP-2: Still making decisions on details needed to finalize the "Preferred Alternative," and which need to be in IMP-2. File IMP-2 late 2002, early 2003.

EIR evaluation takes two years, can’t start until IMP-2 done, so EIR starts early 2003.

PUD/Conditional Use Permit hearings/approvals thus will be late 2004.

Transition Plan has California Street work in two phases (Marshal Hale block, then Childrens’ block). Davies will take some acute care, etc. loads as these happen. Long term plan for Davies is focused on SNF, outpatient, MOB.

Traffic and Construction Committees (to include neighbors) should form now. DTNA and BVNA will outreach to members for participation.

Traffic Committee

Preliminary Traffic Analysis and Traffic Engineering studies are done, now going thru internal approvals. Agreed to share them with us on confidential basis, to facilitate timely neighborhood input and "buyin." Davies campus has fewest "problems" of 3 campuses in this area. Anticipate added traffic signals at Noe/Duboce (1 year process), upgraded crosswalks there, Duboce/Scott, etc. Committee to seek and identify further neighbors’ problems in this area. Committee would meet monthly for 8-12 months.

Construction Committee

After orientation, meet semi-monthly or as needed during times of heavy activity. Understand scope of construction; assist with two-way neighborhood information; channel and resolve disruption, noise, etc. issues.

"Ideal Patient Experience" focus groups

Initially, separate groups of MDs, caregiver staff, chronic users, other users, etc. Estimated activity: monthly for 18 months.

CPMC expects to host another Community Meeting, to update neighbors, etc. about plans, in the next several weeks.

CPMC recently was listed among the top 50 (#39) in an AARP survey of 5,000 hospitals, based on accreditation scores (based on past score of 90; more recent score = 95), other survey elements. CPMC also received high marks in a recent "Checkbook" report issued by SF Consumer Action.

Prepared April 2002 by

Richard Magary for BVNA and DTNA

415.431-2359