Planning Commission initiates general-plan amendments for CPMC rebuild after hours of testimony

The San Francisco Planning Commission on April 5 opened the process to amend the city's general plan for California Pacific Medical Center's long-range development plan, moving the land-use pieces that will allow CPMC to rebuild two hospitals and redevelop its campuses.

Planning staff and city negotiators presented the proposed development agreement (DA) and the companion near-term approvals that would vest certain elements of the five near-term projects. Elizabeth Waddy of the Planning Department described the land-use approvals needed, and Ken Rich of the Office of Economic and Workforce Development summarized the DA as "a binding legal contract between the city and CPMC," noting that it is effective 30 days after the mayor signs the ordinance and has a basic 10-year term with certain obligations surviving that term.

City health officials detailed the DA's health-care obligations. Barbara Garcia and her staff said the DA requires CPMC to build and open a new seismically safe St. Luke's Hospital on or before opening the new Cathedral Hill Hospital and to operate St. Luke's as a general acute-care facility with an emergency room for at least 20 years so long as the CPMC system remains financially solvent; that solvency test is measured by a system-wide operating margin threshold in the DA. The agreement sets a baseline annual commitment for care to vulnerable populations at $86,000,000 per year (averaged from recent CPMC spending levels) and limits CPMC's unreimbursed cost for serving 10,000 newly eligible Medi-Cal beneficiaries to $9,500,000 per year, adjusted for inflation. The DA also establishes a $20,000,000 Community Care Innovation Fund to help community clinics build capacity for Medi-Cal managed care and requires a $20,000,000 backstop fund should baseline obligations exceed a defined share of CPMC earnings.

Officials framed the package as a trade-off: the city would…