western addition, and it is in what was formerly the redevelopment area, so they talked to us again, and as soon as the redevelopment left, we were once again abandoned and neglected, as has been happening to this community since redevelopment came, and i do not understand the city being involved. the reality as i do not care, it is wrong to do it, and you know it is wrong. this as the most serious health concerns in the city to lead them out of discussion. it is unconscionable, and i am livid over this fact. one of the important things made is a question of who is going to work there when it is over, and part of the community benefits go to have some health care training for young people in this city so they can get the jobs to work there, and without

that, the only alternative they have is where they signed their lives the way to get the money is to complete the program, so we need to do better and move forward, and i suggest everything stopped. -- stop. president chiu: thank you. next speaker. >> good evening, supervisors. my name is jason frazier, and i have been living in san francisco for over 20 years now, and doing their -- during those years, i have seen how much it is to access these services. i support the nurses and their right to organize. for fair wages and good working conditions. i used to work as a carpenter, and now i am retired. i am dependent on services in

the tenderloin. cpmc should base is not on just creating jobs but also making sure that the jobs and their employees benefit the community as a whole. also, of all of the people, cpmc has treated 2009 -- in 2009, only 9.7% medi-cal patients, where others make less money, treat twice the amount. it is critical that cpmc increased their charitable care for residents like me who participate in medi-cal and medicare programs. we depend on that. thank you. thank you. supervisor mirkarimi: next

speaker, please. thank you. >> supervisors, thank you for having this hearing before the end of this year. my name is -- and just to say who i am, i have been on the health commission. i was on the blue ribbon commission, and i was on the task force for cpmc, and now, my primary care physician is at st. luke's, and i am involved with the coalition. i think one of the things that i want to leave you with here, with all of the years we up and struggling with this matter, cpmc is a non-profit. they are a 501(c)(3), and for that privilege, they pay no taxes. they are supposed to do the charity care, and we have struggled for years around this.

in the last two years, they have made improvements, as director garcia has defined it to you, and what i agree with in terms of director garcia's direction was the health care reform, was that we have to go towards equity instead of trying to have fights about charity care all of the time. we need to go with the medi-cal 10,000 gigajoule more transparency around that than you do about chasing every once tail around charity care. but with medi-cal, as soon as you talk about save lives, and you say, ok, they are going to have an 80-bed hospital, where are those lines going to go? san francisco general. san francisco general is going to come here and say, "oh, we

need more money from the general fund." we need more money for the general fund because it looks is -- because st. luke's is -- " supervisor mirkarimi: supervisor campos? supervisor campos: thank you for your thoughts. i wonder if you have any issue about the care. >> we do, as director garcia said, we have the need for charity care after 2014, a health-care reform, so i think we should not let go of this 3%, as the board of supervisors has suggested. as they have put in ordnances and resolutions. i'd think we also have to work with the struggle that came

about so clearly identified with the hastings report. here you that a hospital with 40 beds, and the per bed ratio for charity care is double what cpmc is, ok? cpmc comes to you and say, "we have to build a 500 bed hospital because that is the only way we can maintain the costs. here we have the other, whose purpose is low-income, the best 80% -- who has 80% signed -- 80% medi-cal/medicare, the number may be impressive, but the

ratios are what i think we have to look at. that is what i would say. the other point, what i agree with in the mayor's development agreement is that on several of the health care items, with medi-cal, with the consortium, he focuses on the obligation rather than the number of 10, 15, 20 years commitment, and the argument about whether that is legal or not. he says that the obligation -- where is this, that cpmc continue for as long as that operates acute-care in the city. 13% or 15% revenue margin for

profit, and they are going broke, then we had an acute care hospital crisis. but then they do not walk out of their 10-year commitment to st. luke's, so i think the mayor has got that one right. now, we can talk with the city attorney about all of the legal aspects of it, but conceptually, i think you will get more accountability that way. maybe more transparency. supervisor mirkarimi: next speaker, please. >> the overhead, please. i am with san francisco tomorrow, and i thank you for your forbearance. the most important thing is to enable the benefits community to occur and be sustained, and i can first of all say it must be done by necessity by state law

regarding ceqa. that has not been mentioned here. we must have the resources to mitigate the impact. i have several suggestions. the first is to ask for a performance bond from cpmc. i know that is heresy from the city attorney's office, but why not? two, in exchange, cpmc turns over the right to the land, and we get equity title. 3, we form a public-private partnership. for all of the developers in the tenderloin area. twitter, the high tech people, and cpmc with the urban development corp. together in partnership with a non- governmental agency, and the effective public participation.

we develop the area. we enveloped this and take the ground rents. we put land where it needs to be, for people who need to be there for the 55% of the tenderloin who are not governed by protected or affordable housing. thank you. by the way, it is good to see you up there, ross. supervisor mirkarimi: thank you. >> may i make one more comment in exchange for that? on the overhead, as you well know, it has been proven that there is a possibly very volatile gas pipeline contiguous to the cathedral area. i do not know why we have to have a san bruno type explosion in exchange for a city attorney did gain an injunction to save

people's lives. this is before this is done. there is. supervisor mirkarimi: thank you. next speaker, please. >> thank you. i am dr. george wu. and there are other things from saint luke's that i would like to turn in. i would only comment that this was a very vibrant community in terms of vision that were there when i joined st. luke's 31 years ago, and over time, it has gradually been diminished substantially mainly because of a continued reimbursement

diminishment over years. many could not continue practice there. at this point, how well u -- how will sutter do this with being protective of the community. how are you going to the specialists that may be required to be there as well. referring people to other facilities, that is not a vibrant hospital. there is a major problem, any kind of major disaster will really compromise that entire south of market committee in terms of access to care.

i think they really have to address that issue. medicare is reducing its reimbursement. even specialists are not taking it. how will they address that issue of finding specialists to treat whatever populations including medi-cal to even deal with this. supervisor mirkarimi: thank you. next speaker. >> hi, good evening, ladies and gentlemen. i am an undergrad premed student. i will be here representing a doctor because he was not able to make it here tonight. my name is dr. michael -- i am here to represent the committee.

i have served as a director of pediatrics and am still working at a pediatric clinic. there is a reduction in pediatrics, neonatal care, and other services. yes, they kept statements open to have wonderful things. this has harmed my young patients. and their working-class parents. we urge the board of supervisors to exercise the power to help the low-income population. it also makes no sense to transfer this in the heart of a densely populated area to near downtown. these plans do not reflect this with those losing their jobs and health insurance. st. luke's is by two freeways and some bus lines. not only does this ill serve

people in san francisco who have a difficult time getting to it, it does not even serve the rest of the city. my colleague, there are no issues. cpmc will increase the shortfall with a five-year period. cpmc has diverted so many privately insured patients that they are now either on medicare or medi-cal, each facing serious cuts, so they are violating the resolution. supervisor mirkarimi: thank you. rapidly red. next speaker please. >> my name is don foxx.

i am wearing two hats. i am a priest. i've been here for years. like other is with the ministry, an interdenominational referral and intervention ministry. i am well acquainted with the topic that i would like to focus on, and that is mental health care -- health care and especially psychiatric care. i urge you who are negotiating to include -- to quote scripture, what the serpent? you're dealing with some slippery negotiators. st. luke's hospital, which was started by the episcopal church and which would still be run by the episcopal church if medical care in this country were not a business, st. louis hospital is one of the greatly needed resources for psychiatric care. including the patient ward. in the ministry, taking a mentally disturbed person, the only place in the south of

market you can take them to is the general hospital, which is often swamped. you can take people to stay with us still. you will get some physical needs taken care of but not a psychiatric needs. i urge you to make sure that sutter health does not -- as they have done in the past, and they've tried to close st. luke's already, and he knows what goes next? i urge you to be very careful and insist that they include the inpatient care. supervisor mirkarimi: thank you. next speaker, please. >> good evening. i have work force eight weeks for 39 years. today, they are full. the icu is full. there is no place to put anybody. all of the floors are fall.

it was a bustling beyond belief. we are not supported in our ability to take care of patients. we have lost many services. it is really hard to get anything done at st. luke's easily, due to a lack of supporting services. they may come in tied to a gurney. they may have a medical disorder, but inevitably, they end up -- it is very hard to manage psych patients. we closed the neonatal intensive care unit, but that does not stop women from coming in with premature labor and needing immediate services. we are not set up to deal with that.

i would not say it is optimal. we can confine this to certain blocks of time. inevitably, the emergency surgery will come up. i was going to mention a few things from the blue ribbon panel that dr. garcia did not mention. i can see that i did not have time, but those are very vital recommendations, and i would like to see this panel review them and see how they would possibly apply to st. luke's in the future to develop services to further serve the community instead of restricting services. supervisor mirkarimi: thank you. next speaker, please. >> good evening, supervisors. my name is rove's. i am a senior, and i live in the

tenderloin for 35 years now. i am a member of the tenderloin community. the proposed cathedral hill hospital should be built not only for the patients but to serve the and, -- low-income patients. we need a hospital, that you will accept seniors and low- income families as well. it is not clear at the moment with the low-income areas. and we want to make sure they can avail themselves of these facilities. we are demanding them for partnership and a community- based clinics, some residents have access. we want them to address this issue by signing a community

benefits agreement that is acceptable for the community. thank you. we would like this to be rebuilt the right way. >> good evening. mr. supervisor. my name is -- supervisor mirkarimi: would you put the microphone a little closer to you, please? there you go. >> my name is -- and i have lived in the tenderloin for the past three years. i am a member of the tenderloin. the board of supervisors, for cpmc to do its fair share of

serving low-income families in our community. i am a senior and under medi- cal. cpmc plans of constructing a luxury hospital in our neighborhood -- more low-income patients can have the services. there is the duty of a nonprofit hospital. development in our neighborhood, it should also serve our needs. the tenderloin residents need hospital care. cpmc should take more medicare and medi-cal patients.

we need community-based screening in the tenderloin therefore, i urge the honorable member of the border supervisors to issue that's -- that they do this before the program is approved. thank you. supervisor mirkarimi: thank you. next speaker, please. >> good evening, supervisors. my name is -- and i am a senior and have lived in the tenderloin for 23 years now, and i am a

member of the filipino community. i am here today to express my concern about the proposed cathedral hill hospital. we believe a project like this should not be for profit at loan but for the community. to qualify health care, cpmc must accept more medi-cal and medicare patients. this is so they can provide services to the community and that we can have success. we want cpmc to address these

issues by signing an agreement that is acceptable and beneficial in the community. supervisor mirkarimi: thank you. next speaker, please. >> good evening, president chiu and supervisors. my name is -- i am a resident of the tenderloin and a member of the tenderloin filipino american community. today, honorable members of the board, supervisors, it to ensure that cpmc will do their fair share of serving low-income families in our community.

does it mean that seniors and low-income families will not be accepted? we need a hospital that will accept seniors and low-income families. we want to make sure that medi- care and medi-cal patients can have access. therefore, i am demanding that they will not ignore the community. to assign a community benefit agreement thank you very much.

supervisor mirkarimi: thank you. next speaker, please. >> good evening. my name is -- a resident of the tenderloin for the past many years. i am part of the filipino american community. we are here today to express our concern about the proposal of a hospital. cpmc is planning the biggest hospital in san francisco without ensuring they will benefit from this. 99% of suffering.

they are not different from this corporation was getting very late -- very little of their profits back. they and indicated their plans will create an additional 4100 new jobs for san francisco. however, in the current negotiation, there is only this is the program. the community is demanding more jobs. more local hiring and more jobs training. i urge the honorable members of the board of supervisors to ensure that the surrounding communities will benefit. signing the community benefit agreement. thank you so much.

supervisor mirkarimi: thank you. next speaker, please. >> good evening, supervisors. my name is lorenzo. i am a resident of the tenderloin and also a member of the filipino american community association. our organization would like cpmc to address situations that are committed to demands, such as access to health care, and based on the zero numbers of cpmc, there hospital project is expected to attract new households to san francisco, and most of them will be working class and low-income to moderate income families. so what will happen to our housing stock in the tenderloin? these