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Ocean avenue. It is proposed to continue to january 16, 2020. Item two 201901795 7pca for the mason nick special use to january 23, 2020. Item three 2018012442drp at 436 tehama. Indefinite continuance. Item four. 2101 ellis street subdivision is proposed for indefinite continuance. Further, commissioners, under your discretionary review calendar item 22. Green street discretionary review we received a request from the project sponsor as well as d. R. Request to continue the matter that is proposed to continue to february 20, 2020. I am pleased to inform you item 23. 3500 jackson street has been withdrawn. I have no other items proposed for continuance and no speaker cards. Thank you. Do we have any Public Comment on the request for continuance . Public comment is closed. Motion to continue items 1, 2, 3, 4 and 22 to the dates specified. Thank you. On that motion to continue as proposed. roll call . So moved. That motion passes unanimously 50. That places us on the consent calendar. This is considered to be routine by the Planning Commission and may be acted upon by a single roll call vote. No single separate discussion unless it is requested at which time it will be removed. Item 5. 215 threemen215clement street. No speaker cards. Anyone wish to comment on that. With that Public Comment is closed. Motion to approve item 5. Second. Under the condition sent calendar. roll call . So moved that passes unanimously 60. Placing us under commission matters. 6. 2020 hearing schedule. I am surprised that 2019 is coming to a close. We generally take a look at the next years hearing schedule. You are provided with a draft schedule. On average at this time we cancel about 10 hearings understanding that on average throughout the course of a year you cancel 11 to 12 hearings, reserving one to two for something throughout the year. This past year we had to cancel two unexpectedly for lack of quorum. January 2 has been cancelled from last years hearing schedule. The next one is thursday, march 26. It is only there proposed because in the past there has been a desire by the commission to take a break at or around that time. It would be the first hearing that you have cancelled after the new year. January 30th is the fifth thursday which we traditionally cancel. Given we have canceled the first hearing in january we generally keep that. Thursday, january 26th is prince jonah day. The state holiday inn hawaii. Lets go. Then in april, i know commissioner diamond you might want to speak to this. April 16th falls after easter but before the orthodox either. It is generally a time when students are on spring break so we used to have a large number of commissioners with families that like to take that week off, but if there is a preference for another week, we can certainly discuss that. The other is july 2. Then you have three weeks hiatus in august. Then no proposed break until the fifth week of october, thanksgiving and christmas. December 31st happens to falling as fifth thursday. You can consider it a fifth thursday. We traditionally cancel the first hearing in january. This year it happens to falling a week after the new year holiday, however, it falls on orthodox christmas. I wont be here regardless if you choose to have that. I am not the important one. January 7th is another consideration for you. I have a list of holidays throughout the year you might want to take a look at. Commissioner koppel. Commissioner diamond. I would like to request the Commission Consider not holding a hearing on april 9th. It is the second night of passover which is when the jewish families celebrate. I wont be here that night. I will be at th at that. I wont be here that night as well. Something i thought of is you could keep the march 26th hearing and then have a two week break on the ninth and 16th. Commissioner moore. Couldnt we do it different leann take thursday, the 16th and keep it following commissioner diamonds request have the ninth off and the 16th on . The 26th of march is my birthd birthday. I am not going to make a big deal out of it, but it would be nice. I think i am the only one with school age children. Is that your spring break, too . It is. I am okay with doing what commissioner moore suggested swap those two. First one is more important. Any other suggestions . Commissioner fung, please. Question on the august. Is there a strong reason to match that up against the supervisors . Is there a reason to match that with the supervisors . That is the reason. In the past we used to take two weeks off in july. It was determined it might be wiser to take three weeks off when the board of supervisors take the month of august off. It is to match the supervisors hiatus. I still raise the question. Is it important . It is up to you. I was going to ask about the august. The last couple years you take the august break in the early weeks as opposed to the end. It used to be the end of august to match labor day. I think you started doing that because of child age children or families. Is that still as important . I want to make sure you recognize that if that would be early august rather than later in the month . It is important to me. I have a child. Commissioner fong. I raised the point. If other commissioners feel it is important. I dont see why we have such a large gap. Some of us need it. Commissioner moore. I didnt mean to push the button. Sorry. Somebody want to make a motion to accept this . We can still change it. I will make a motion to accept the 2020 calendar including april 9th. Second. Instead of the 16th. Second. If there is nothing further there is a motion seconded to adopt the 2020 hearing schedule, canceling the ninth and reinstating the 16th on your draft. Nothing more about the first hearing in january at this time. On that motion. roll call . So moved that passes unanimously 60. That places us on item 7. Commission comments and questions. I have one thing. I am sure most of us saw the many stories that came out of the study in new york linking rezoning with displacement and gentrification. Lots of articles came out of that looking at the method and the different aspects. I really want us to look at that and look at our own rezoning. The director and i were honored to be part of a panel at spur about a month, month and a half ago. Looking back at the eastern neighborhoods rezoning and what happened, whether the tools we thought were going to work for this and that ended up doing what was intended. I think the jury is still out on that. As we face the multiple initiatives from the state to increase density, i would encourage us to look more more e comprehensively at financing and the markets. We think we can zone Something Like this and it will happen. Often tigh times it is who has s to capital and who doesnt that drives change. I would love it if at some point we could have that discussion here that we had at spur about the neighborhoods in light of what other cities have experienced when they rezoned entire neighborhoods, and the effect on the population of those cities as it pertains to gentrification and displacement. Seeing nothing further we can move on to department matters, item 8 directors announcement. No new announcement except i think it would be a good discussion to have. If time i would like to do it before i step down. I will see if we can make that happen. Item 9. Review of past events at the board of supervisors. No report for the board of appeals and no Historic Preservation commission yesterday. With the ordinance to require half of the residential units to have two or more rooms to eliminate the requirement that educator housing has three bedrooms. You heard this on november 21st. Public comment came from Community Housing organizations who were in support. The committee voted to forward to the full world as committee record. With interim controls that required changes of use to another use for conditional use authorization. That would expand requirement to unauthorize Residential Care facilities as well as authorize Residential Care facilities. These are controls that were not heard before the Planning Commission. The committee voted to forward to the full board with positive recommendation. They considered the zoning map and Development Agreement with the flaw were matter. They had extensive presentations. Supervisor peskin wanted to ensure this remain in San Francisco. Public comment for the item was long and most speakers expressed concern over the future of the flower matter and continued presence in San Francisco. How suitable the redeveloped sight would be for the matter and messe competentes expresseda different location. In the end both ordinances were forwarded to the full board with no recommendation. The committee considered the ordinance that resulted from the settlement for the academy of art university. You heard this november 21st and voted to recommend approval. The hearing was brief with presentations from planning staff. There were two speakers on various concerns relating to the proposed settlement. Supervisor peskin complemented them and it was forwarded without recommendation to the january 7th date. At the full board the Housing Ordinance passed first read. Annual report on job growth and housing production, an amendment to the administrative code sponsored by supervisor mar passed the first read and the interim controls for Residential Care facilities was adopted. Thank you, mr. Star. Seeing no questions. We will move on to Public Comments. Each member may address for up to three minutes. I have speaker cards. We have jane and francisco. Anyone else who wishes to speak during Public Comment, you can do so now. Come on up. The Planning Commissioners from exceeding the scope of the permit, subverting the processes . Place. I think any commissioner who is not willing to hold themselves to the standards to which they hold private sponsors should not be on the commission. I consider discretionary review must be destroyed. Thank you. Next speaker, please. Commissioners, i am francisco de costa. From time to time i come here to remind you all about whose land this is. So there are two commissioners here who have been on this Commission Long enough to have witnessed when the chairperson came into this room and spoke to you all about her land. So you commissioners from time to time should revisit how this land was stolen. In this particular case they exercised the right of first review sal in 1991. They have lived her 13,000 years. What is unique was that up until 1927 they were federally recognized and then they were moved by an agent of the Bureau Indian affairs. Read the history so you will understand the situation at hand. What is happens is here in San Francisco we are losing our soul. Many of the authors and we dont have many authors looking at it from are the perspective of the indigenous people. More and more now because of what is happening all over the world, Carbon Footprint and so forth, people are beginning to understand that when we talk about the Carbon Footprint and talk about recycling and all of this holistic things that we ought to do it. If we do not do it in the next 10 years, we will be losing thousands and thousands of species. We dont need to be educated on that. If you take a cruise toscana witness how this huge glaciers are melting. It is a sign that tells us what is going to happen everywhere. Here you have a good director of planning. I have known all of the directors, and i have known john for quite some time. His heart is in the right place, and he is a good leader. I am not saying the other commissioners are not good leaders, but you need one good leader to be focused on issues. I am here to talk about what i said. Thank you very much. Next speaker, please. Good afternoon, commissioners. Executive director of livable city. I want to talk about transbay. Last week you had the initiation of some general plan amendments for parcel f project. We have been watching this unfold over years and the plans happening. One thing that is lost is really the public good. A sense of how do all of these individual projects fit together and create a greater whole . Back in november i was here to comment on the proposed project on parcel f and point out that the project is going to be destructive of walking and cycling in the neighborhood. It is proposed to have a loading dock to cut through the bike lane on howard street. In soma bicycles is harrowing. It is going to get worse with this project. What is equally troubles is the proposal to turn a block of thaf natoma street and taking away a pedestrian access. I am here to ask you to not approve those curb cuttings. When which project comes back to you or maybe before this project comes to you so the developer has time to fix it. I ask you to think about if we are going to spend billions of dollars of public funding to create a Regional Transit terminal, there should be a pedestrian oasis around it. The public good should be a priority over parking and loading. Parking is not required downtown nor is it desirable. Every project is loaded with parking. If hotel guests or residents want Parking Spaces they can park in adjacent spaceis. You dont need parking in this project. The other thing is if you wanted to stay in a hotel without a car, the hotel is across the street from the Regional Transit terminal. Carfree hotels would be fine in this location. I want to show you the pedestrian circulation map from the downtown plan. You can see the embarcadero freeway on it which was removed in 1992. Updating the pedestrian plans is not a priority with the department here. There is a note saying the exclusive pedestrian walkway is a policy of your general plan. We ask you to go beyond this plan and create new pedestrian priority areas. Thank you. Thank you for your comments. Any other Public Comment . Okay. Public comment is closed. Very good. That places us under the regular calendar item 10. Code 2019. This is a planning code amendment. Good afternoon, commissioners, Planning Department staff. The item before you is the adoption of code as initiated on november 7th to amend the code to correct typographical errors, update outdated crossreferences and make language revisions to simplify the code language. It will also a article four to move language regarding timing of speed payments to the beginning of the article and crossreference in each individual section. It will add an additional fee waiver based on replacement of gross floor air in buildings damaged or destroyed by fire or other calamities. The department received one Public Comment letter. The Department Incorporated the cleanup items. These are non substantive except for clarification to 155 which could be argued to be substantive. The change involves protecting pedestrian streets by not allowing curb cuts. It protects the neighborhood commercial streets but not commercial thruway streets as defined by the better streets plan. Valencia would be protected but not mission street. This will ensure that all major corridors are protected. I also want to pass outdare viced summary list that includes changes made after the initiation hearing. Those are the new changes since you received the packet. Second list on the last page includes changes not in the final ordinance with us today but should be adopted as part of your recommendation. During the code cleanup process we identified outdated planning code references in the Administrative Health and police codes. The list was included in the packet for you. Since the plans commission can only initiate changes to the planning code. The Department Recommendation to the board of supervisors they initiate an ordinance to make corrections to outdated planning code section references we find later. Department recommends the commission approve the ordinance with modifications as described in the summary list and recommends change to the board of supervisors regarding the other codes. These are non substantive except for those described an and will improve the planning code. Any Public Comment on this item . If good afternoon, commissioner. Executive director of livable city. I am the Public Commentator. I am glad to see these included. I love to see you cleaning up your code. I want to talk about the piece alleged to be substantive. There is a better way to fix it. First of all, if i could have the overhead slide. This is the map of street types in San Francisco. You will not be able to see this because the lines are too fine. There is different streets. Neighborhood commercial streets in ping, you can see them here in the Fishermans Wharf area, northeast waterfront area on the various commercial streets. Those are neighborhood commercial streets protected under 155r. The rule is those are the streets where we want to preserve walk ability. We say no driveway cuts on those streets, put them around the corner or dont put them in. The proposed change was to say rather than neighborhood commercial streets in neighborhood districts but a group of other districts, chinatown, wharf. The change said streets and neighborhood districts. That is different in two ways. One would exclude from protection a lot of streets in china town now protected from driveway cuts. It would remove those protections. It would extend protection to other streets that are physically located in the neighborhood commercial district. It is not streets that define the district. It is lots. They will wraparound the corner. Valencia and 15th and 16th and 18th streets we will protect from driveway cuts. In many cases if you were located within the district you would not have a frontage that you could put a driveway cut on or it would treat the commercial street and the side street creates confusion. The goal is to protect walking streets. It would be good policy sense to put them around the corner. On page 14 of the ordinance, instead of saying streets and neighborhoods, you say neighborhood commercial street. I havent seen this language. Neighborhood commercial thruway. Those are the busy streets. If you make those changes you will preserve the intent of the ordinance and not exclude a bunch of streets from protection that should remain protected. Thank you. Any other Public Comment on this item . Good afternoon, commissioners. Thank you for serving. I am jennifer franks, an interested resident. Two things. Memorial for mayor ed lee. Anniversary a year ago this week. Rip. Second thing. This item is 133 pages. We didnt have 133 pages to look at it. There was a lot of stuff that was quite substantive. It almost looked like you are changing the laws under the pretext of a tae po. We didnt have our agenda scheduled properly for this week with the date and the day of the week. I had to ask for the corrected date. There is a little bit of sloppiness that i would like for the commissioners to make note of and take a little more time to review the 113 substantive changes that are going to this item number 10 here, making below the radar. I am not an architect. I was kind of blown away. I would appreciate it if we did not preauthorize laws ahead of the game because it already says that you you voted and a proved it in that 133 set of pages. Please rethink this and i appreciate your help. Thank you. Any other Public Comment on this item . Public comment is now closed. Commissioner moore. Commissioner moore i would looks to ask in followup to a question that was raised. What is your comment on what he said . For us it is like the devil is in the detail. I am not a particularly skilledd person. It takes time to check off every point. I am sure you can understand that. I would like you to comment because it is an idea that is well pressed and i wonder what you think. This correction was given to us by one of our better streets people. They were not able to enforce this on certain streets. What they are proposing is a compromise to make sure we capture everything we are supposed to cap turn. It was presented to me as not substantive and the explanation made it seem like that. Our goal is to not make big changes. I think what tom had as the proposed amendment is a workable solution. Did you have something, commissioner johnson . Did you want to Say Something . Just so it might be helpful to see the code section again. I dont know if the over head will show this. The description earlier would change the language here to read or neighborhood commercial street or commercial three ways as defined in the better plan. That is what we are talking about right now. That sounded reasonable to me, and i would be supportive of the change. Let me add for the Public Commenter who came to e to tells they were changing the law, this is a first step in proposing to the board of supervisors that the ordinance be changed. We dont have the power to change it. We recommend this happens. There will be legislation at the board of supervisors if they think it is a good idea. Other than that i will be supportive of this code plan. Commissioner koppel. Motion to approve with the modifications stated and recommending to the full board of supervisorses. Second. There is a motion seconded to approve the code amendments with the suggestions and a recommendation that the board of supervisors. Can i make a clarification . We had two other modifications. We wanted those included in it, too. The maker of the motion. As amended by staff. On that motion. roll call . That passes unanimously 60. Item 11. 2016003164cwt for Healthcare Services mass 10 plan. This is an informational presentation. Good afternoon, Planning Department staff. We are presenting an informational update on the master plan. You received the draft plan prior to thanksgiving. Joining me is chair lindsey, Senior Health Program Planner with department of public health. We will be back in the spring for a joint action on the plan. We will give you an overview of the Health Care Services master plan, present key findings and discuss the determination guidelines. We will talk about putting the legislation we are developing and the process in the spring for approval of the plans. HealthCare Services ordinance was signed into law on december 2010. The first master plan adopted in december 2013. The process to update the plan began in 2017. The purpose is four ways. We are looking to identify current and future healthcare needs with improving access. We are looking to identify a geographic distribution of facilities. A framework for reviewing medical use Development Projects and other policy recommendations related to Healthcare Services as needed. Engagement has enconcluded interviews and online surveys and will include Public Comment. Healthcare is complicated. There are two types of barriers. One is geographic. They lack Good Transportation options for health carry. It includes insurance, access to appropriate care and other factors which we will talk about. The planning codes three component ms. Assessment are a snapshot. The guidelines are required to implement the goals. The supporting recommendations. We will provide an over view of each. First is the assessment. There are four. The first is Community Health assessment that looks at mortality and social determinants of health. The gaps assessment looks at the healthcare. It looks at geographic, cultural and linguistic access. Local state and National Healthcare policies that impact us, land use assessment is a supply of medical uses. The demand and need for new medical uses and land use impacts. I will introduce you to lindsey. Good afternoon, commissioners. I am the Senior Health planner with the attempt of public health. I will go through the assessment findings. One of the first findings on the screen is not all those in San Francisco have equal opportunity to good health. Certain subpopulation experience Significant Health disparities. The map is one indicator. As you can see the zip codes called out that have higher rates of preventable visits. That indicates low access they are illnesses more appropriately cared for at Lower Service or primary care or visits for diseases well maintained with appropriate access or proper access to primary care. One of the or assessments was capacity and gap assessment. Looking at that. Behavior health or Mental Health and Substance Abuse services in the city are a priority and need. It is estimated 250,000 in San Francisco have a Behavioral Health condition. The plan notes gaps in communitybased services with the work force and disparities with access to the services with the vulnerable population. Another care gap is longterm care. These are services that are more certainly as the pop you you place grows and ages in place. Longterm Care Services are necessary to ensure that seniors are age to live in the community after the juror serious illness. The graph shows our hospital in San Francisco, hospital based skilled suring beds. 57 decrease since 2001 in these services. The plan also identifies this is a need and boarding services are a need in the community. I will talk about the trends assessment. Since the plan in 2013 there was full implementation of Affordable Care act that had a massive effect in San Francisco. The plan presents data of that impact but also discusses other trends in Health Care Service like increase in Outpatient Care and other network provideders. Especially since Preventative Care is a foe call point of the Healthcare System assessment. Now back to sheila for land use assessment pieces. Since be 2013 we added 236 beds. We have added 250 square feet of Major Medical Outpatient Health services. Since 2010 the city added more than 12,000 jobs in medical sectors. More than 775,000 square feet of medical in the pipeline including two New Buildings and new planned parenthood and kaiser facility and the jewish home which will include 210 Residential Care beds. Technology facilitates transportation in health care. An important finding is that technology and transportation are key. Since 2013 the percent aim of practices of individuals engaged in tele health has grown. It is a good tool to communicate Health Issues and topics. Regarding transportation. Many in the southern neighborhoods experience longer travel times because of less diverse options combined with fewer Neighborhood Health services. Geographic proximity does not equate to access of health care. On Treasure Island there are communities in chinatown and mission rich with resources not getting the care they need. When we talk about the services needed we want to frame in terms who Needs Services and the transportation and other issues. So these are the barriers. There are many of them. Insurance status, cost of care, immigration status, transportation, knowledge of services, awareness of how to get to it. Linit the work force is moreof. The association of governments projects the San Francisco population will add 250,000 residents by 2040. Most will be in the eastern neighborhoods and Hunters Point and Treasure Islands. Based on this we estimate 4. 3 and 4. 7 square feet of additional medical space. We have the zoned capacity to accommodate this growth. These need to be qualified. The city has 18 million square feet of medical growth. We are seeing shifts in the delivery of healthcare driven by federal, state and local policy. We see the emergence of tele medicine and delivery services. We dont know the new trends. San francisco mass one of the highest rates of physicians per capita. We have much higher than 1. 89 statewide average beds. The Healthcare System does not need to maintain the intensity to serve the growing population. It is a regional and national hub for treatment and research. It doesnt an account for those coming into San Francisco for care. The composition of the work force is changing. This will continue to be impacted by affordable healthcare. Our demographics are shifting. If the Large Population raises families here we may see a growth in the younger population. This may impact the health care we need in the future. Next piece is consistency determination guidelines from the master plan findings. Guidelines are the implementation of the plan. It is how to meet the goals. For projects that meet the guidelines they receive possessing at the Planning Department. Projects with 5,000 square foot or more or 10,000 square feet of use mus must complete this. It is a tool for the sponsor to demonstrate how the project aligns with the goals of the plan. If the project is inconsistent it is reviewed. Consistency is required unless there are policy considerations that require approval. For the 1019 an update, they recommend weep date the guidelines. We are proposing more consolidated guidelines. We are removing goals that are in other policy documents. We are adding emerging issues. For hospitals rather than to the individual project. Lastly supporting legislation to align with the plan. On in addition to proposed changes to the determination process we are also bundling supporting the approval process. We will be back where new proposed legislation. We will change the timeline to 10 years with five year monitoring reports. That inc. Concludes projects subject to the determination process, medical use pipeline and summary of planning code changes impacting medical code uses. Much of the information is available through other publications such as the Community Health Needs Assessment and the controllers benchmarking reports around other reports. It produces emergencying reports and has an online data base of health data. We will update policy plans. We are working with staff to look at other potential changes to support this plan. We are looking to ensure we remove land uses for the healthcare. We are looking at the institutional master plan process. However, our ability to effect change with landuse regulation is limited. Many factors outside of the planning impact healthcare. On a final note about recent edge laying. Other efforts there is progress. Legislation eased permitting for Residential Care. The city increased subsidies. The new Mental Health sf and there is a tax course looking to address issues in the city. It runs in an ongoing effort in the africanamerican communities. It will be on the project website and available for Public Comment in the new year. Late january will be a presentation in the planning and health commissions. Thank you. We look forward to hearing your comments. Thank you. We will now take Public Comment on this item. Good afternoon, commissioners. Executive director of livable cities. Glad to see planning happening for healthcare. One area that i think you should think about is healthcare and transportation, particularly master plan process. It should be alived with the t dm progress. You are looking at make major access making sure you can get to the facilities, asking these employers who are large to have transportation plans for sustainability access. Some very large hospital projects would trigger your tdm ordinance, building new construction and those sorts of thing. It makes sense to integrate some transportation policies into the master plan. What i wanted to talk about. There is a murray line between housing abhealthcare. I worked on both residential ordinances. What i raised last time the racial limit is a big barrier. In an nc1 there will be 1. 5 far. Residential uses housing is exempt. Residential care is not a residential use. That means you have 1. 5far. A story and a half of building is the total you are allowed for nonresidential use. If you want retail on the ground floor and you are allowed three or four floors bust you cant do that. That is true of the a districts. They are disappearing. This hasnt been a problem because no one Residential Care facilities are being added. They are gotten rid of. If we add to them, testimony into a problem. The other thing to look at is group housing. It is usually permitted. If it is affiliated with the hospital that is a conditionally permitted use. C u adds risk and cost to the facility. Guilty rid of that c. U. Group housing should be approved in our districts. That is theway to do this. We may have a glut of healthcare space. We need to do everything we can to facility those housing types in San Francisco. We need to consider extending this to all zoning districts. Next speaker, please. I am going to sticks with districted 10, bayview. In any Needs Assessment we have to go at least 50 to 75 years back. To start with 10 to 15 years that has been done with this presentation. Very few people know that the bayview contributed to building of the hospital, the gray hospital, the San Francisco general hospital, i see the director nodding his led. He should know that. It should be inc. Corporated in incorporated in the Needs Assessment. There is 2 billion running the San Francisco general hospital. What are they doing for bayview . Absolutely nothing. Added to that that we like it or not a lot of the medical Services Prenatal cases should tube handed by st. Lukes. If you do a Needs Assessment on st. Lukes, they got the whole floor that dealt with the mentality challenged, respiratory cases. I see the chair nodding her head to fill in. What happens is with consultedtants or people who say they are very clever, they really dont zoo a total needs sessspend by looking at the population. What i age called at 1 00 in the morning and the child is dying or an adult is dying or we have black on book shooting and all, the experts have two words. Toxic stress. What they had is toxic stress. Who is contributing Pay Attention that in the bayview at Hunters Point shipyard that is where the urrainiam was tested. If you dont study about radioactive elements and the adverse impacts on the population you cannot incorporate it in future planning. Now, i had the opportunity to spend quite a long time looking after somebody at a San Francisco general hospital, talking to doctors and nurses. You know what . Even the software is not compatible. I can go on. Even if you give me one hori can compelled it. I have touched the tip of the iceberg. Thank you very much. Next speaker, please. I am a Family Doctor that worked here 35 years. Also, i am active on various coalitions. I am addressing the legislative support part, and i will just read it. After discussion with multiple coalitions of grassroots Behavioral Health, housing and homeless, there is wide agreement with the statement below. This legislation would support the mission of the Healthcare Services master plan. We demand the board of supervisors support the legislation to force institutional cooperation with identifying and collecting data on all outofcounty transfers of San Francisco in hospitals including Residential Care, sro and Behavioral Health acute subacute and residential settings. There is inadequate availability of safe post acute treatment placementments in San Francisco. By collecting this data we can determine the real gap in services in San Francisco to those in need. There is no way i know when research was done at the dph on outofcounty transfers for

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