come. the sfgh center will be able to stay as part of the model and next year... >> thank you. >> many clinics are under the same and have experienced the dak tores present and the emergency on the fight and it will be the safest place in the city and this will be a big selling point for comprehensive care, patients will be happy because the center will remain on the site and it is closer to home and other providers. >> i am an assistant at the hospital and i have been there for 12 years. and we have come to this end by having an rfp which is a sad way of ending of situation and it does impact the patients and of course the workers too.

and you know the rfp says that in consideration that we will be rehired in terms of what we have now, they pay us a very good salary. there is no guarantee that they are going to match what we have. since i have been there, we have been totally under served in the way of where are we going in the future and where it will be located. and one of them is that one is a figure out this problem. and i believe that dppast and present president do not look and they have been overlooked for the space in the hospital and now we have the new hospital and secondly we have

the old hospital which will be vacant and i don't know who or where, or who is going to take up a lot of space in that place and i think that is for 12 years and i believe that we have been overlooked for space there and i am sure that they can find a place where they can put us. and i hope this will come out on a positive way. >> i am a technician for 15 years and i tell you my experience of working about the unit and in 15 years that i have been a technician i have also worked uls whereas a time part. and over the years, i have seen the differences between rs san francisco service and all of the other centers out there. and the patient care, and the ratio and it is all of the other facilities are close to one and with that said, and the

quality of care has decreased and for one technology to handle and we always rush to put the patients on just because too much. and the minimum for one patient to get the treatment started takes 20 to 30 minutes because of the time that it takes for it to clear out of the chemical. and mistakes happen. the patients suffer and the possibility of acquiring hiv or even hep b. and on another patient he because of the reuse. our patients are using disable and it is safe to our patients and it is much better than being on the real dializer. and how about the message of situations and the san

francisco general center in san francisco, and surviving an emergency of why,vy been experienced and i have experienced chemical working on another facility where we lose the patients, and just in the unit and with that code team available. thank you very much. i have been working for 16 years now and i take pride in this unit and take pride of this tending and just wearing the us ward 17 makes me proud and so we are ward 17.

and we provide, and also the continued care that they receive in the hospital and which is just a few walks away and a few steps away next door and we have hundreds where we have close calls. and we can immediately have an imagine response team on site. and i have experienced a lot of close calls in other units. the experience a patient dying in front of me and the person will come, and it will take ten to 15 minutes and we have the emergency team and they will be in less than ten minutes or five minutes and so it is less than the survival rate on it are different and compared to our unit and so we take pride

on that and. and it is always on the site and in the entire day and making the plans feel confident and safe. this is great differences our paishlts value that greatly. and seeing the doctor there elevates their feelings and makes them feel better and safer. also, we have them on staff and thank you for what you do. next speaker. >> i have been at the renal center for 25 years and i had to work on places before i came to san francisco general. and i knew because of my language skills i was able to better serve my patients at san francisco general. so that is why i stay in the

unit and one of the things that i believe is that the san francisco hospital actually has the best dialysis unit in the city and our patient like, it is mental health and we have the patient and we have the jailed patient and dramatic injury and nursing home we arrange to have it and all of the services at san francisco general and the hospital and the unit does not refuse to any of the difficult patient and even with the complex patients that we meet and exceed the quality and survival, and comparison to other units and we have a lot of, and we have a rate and three patients to one. and four to one and the hospital based and we have

immediate access to the teams and no patient in the unit and if you are working on the dialysis unit you will know that you appreciate these down the road. units are on site to see only their only patients and not all of the time. so you have to call them in order to get the dialysis orders. as he was saying, it takes about ten to 15 minutes, san francisco general hospital, needs it, and the final dialysis, and ability. >> thank you very much. >> thank you, next speaker, please? >> i am a san francisco resident and also a staff person at the san francisco general renal center. and i just want to quickly

address the issue of non-compliant facility that was discussed and none of our staff take the building safety lightly for both ourself and our patients and so we spend hours a day building the unit and we recognize that the building is old. and like many other buildings is not sound and our dialysis, and paishlts are questionablely deserve a new facility in the near future, but as of now, our unit undergos numerous inspections every year and was not cited for any violations during the hospital wide state safety inspection just last year and dph wants to move us out of building, 100 sooner than later because the dialysis, specific, life safety codes that came into effect in 2010. and they laxed the regulations

in 2012 and according to an article in business, dialysis, facilities participating in medicare, as of october 2008 which we certainly were, may continue to use non-sprinklered buildings if the buildings were constructed before january first, 2008 and state law permits. i am not a fire experts, so i don't know if sprinklers are needed or not. but, i want to point out, that if sprinklers are needed the last page of the survey which i left at home but i will forward to you says that there be a recommendation for wave and provision if the specific provision of the code would result in unreasonable hardship on fat celebrity. and even if a waiver was impossible and the sprinklers were required and the cost of those sprinklers would be less than ten years of shuttle service.

>> thank you very much. >> thank you. >> next speaker, please? >> >> i would like to begin by thanking you particularly for holding this hearing and giving us the opportunity to speak and we appreciate it. >> my name is crystal and i am lucky enough to be the lead organizer for ask me 3299 in san francisco and behind me are lucky people who will introduce themselves. i say lucky because being a union rep it the best job that there is because we get to see people take care of each other every day and i have heard, over the years literally, thousands of people give testimony, about all kinds of important things, but, i don't think that i have ever cried as much as i tried today. these workers and these patients are connected to each other in an extremely deep way.

and you can see that the workers over and over again talked about patient care. and what they didn't talk about is what will happen to them if the facility is contracted out. they didn't bring it up and trust me i hounded them to do it and they didn't. >> they didn't talk about what will happen to their pensions and didn't talk about what will happen to their healthcare or their wages and i am telling you, that people have to be able to take care of themselves in order to take care of other people. if you are in flight and the masks come down and you put on your mask first and these people are not doing that and i just want to say that these are the most courage yus human beings that i have had the privilege to work with. >> mary from the teamster and we representative the administrative and billing staff. >> thank you. >> don't be shy.

>> imino, from up dwa and represent the dieticians and case managers and physician assist ants and i would like to say that san francisco is considering replacement of union wages, and with for profit cheapest possible wages and it is a drive to the bottom where there are only going to be very rich and the very poor and where it is go to be the stabilizing middle working class? >> thank you, sir. >> i am mary beth, representing the rna and cna. >> my name is sarah and i am also with ask me 3299 we represent the technicians at the center, and i want to add a couple of things one is that a couple of people who could not be here is tim of the san francisco labor council who is in support of this issue and as

well as representatives of 1021 which represents the city and county workers the san francisco general and i wanted to point out that you know the technicians and the administrative assistants many of them have been working for san francisco general for 15 or 20 or more years. it is a family among the workers and patients and these people like others said are risking their jobs are at risk. and you know they have and they are on the uc pension plan, right? and they get health insurance and they get the wages that they fought for at uc and that is all at risk here it is an issue of patient care and also an issue about workers as well. >> thank you very much. >> is there any other member of the public who has not spoken who would like to speak? >> seeing none, public comment is closed. maybe if we could ask mr.

pickens to please come on up? and i wanted to ask a couple of follow-up questions. which, where they were actually good questions that were raised during public comment and so one question is what is going into this space if you move out? if the dialysis renal center moves out? >> so the current plan as i understand them are the clinics that are in buildings 80 and 90, where ward 86 and 84 and medical specialties will come into the old hospital building. and in addition, other some of the other programs that i think that are currently located at 101 grove, and may also be relocated because of the seismic issues in that building. it would be preferable that we, i don't have all of the details but there are plans that were made when the new hospital was first put together that shows what is intended to go in that

building. we would like to give you a comprehensive list and i don't have that with me right now. >> i do have a question about the point that was raised in terms of the building sort of requirements and have you looked into whether or not there has been any kind of sort of more flexibility provided in terms of, you know, what is required in terms of compliance? >> so that was the first time i have heard of that. and so definitely we will be going back if that is the case, we will pursue it. and it is our desire to keep the facility there and so if we have an option we will pursue it. >> and i want to make a couple of points and, one is to say that looking at this as the glass half full, it is pretty remarkable, to see what goes on. at this facility and the kind

of service that is provided as a member of this elected body. and i am very proud of the department of public health of san francisco general, of the workers, and for the fact that time and time again, we heard from patient what an incredible place this is and the fact that it is not the quality of the service in terms of the medical treatment, and also the human connection, it is remarkable and so we have a lot to be proud of of a city. and i want to acknowledge that in a big kutos to the staff, because i mean, i, it is not something that, that you hear, sometimes and so, it is pretty remarkable. and the second point that i want to make is that i am also very mindful of the challenge that the department of public health has. that here to the extent that you know you have new

requirements and we need to figure out how flexible those requirements are that clearly you have to make sure that the center operates in a seismically safe facility and i don't think that anyone, anyone, doubts that and so, i think that the intent is a good intent. that we are all in agreement on. i also want to say that with respect to laguna honda, i also want to make sure that in the discussing whether or not the move is appropriate, we also acknowledge that laguna honda is also pretty remarkable place that offers amazing service for people and there is a lot of great work that goes on at laguna honda and so, i am very gratified, you know and proud of that. so the fact that someone may be against this moving to laguna is not because laguna is not an amazing place, it is just a

question of whether or not it is the right fit. but i want to be very clear about that. that said, you know, there was a lady, so many of the patients, it was so difficult to really hear them testify and it is clear that for all of them, it is a real challenge, physically, to come to a place like city hall and the fact that notwithstanding the fact that there are going through dialysis and that they are willing to make the trek to come to city hall tells me that this is a pretty serious issue. i will tell you that it kind of goes down to or comes down to one of the ladies said which is, sf general is a big place, and why can't sf general figure this out? i will tell you, i do have a problem with moving a center where 94 percent doing my math

of ward 17 patients would have to travel father. 93 percent of community sites would have the patients would have to travel father. i like to really know more specifics on whether or not you really have explored all options. and if it is going to cost you millions of dollars to move, have you really looked at all of the alternatives and in the vicinity and have you really explored, whether or not there is any flexibility in terms of the, what the code actually requires? and i will tell you, that i have concerns, that you have an rfp that did not include the transportation piece in it, because that is such a critical point of this discuss, the fact that so many people are going to find it more difficult to travel. and i will be honest, and i

give the labor partners a lot of credit. and i have separate and apart from this issue, whether or not it is a good thing for the patients which i am not sure that it is. i think that i have issues of the privatization and the service and not only the workers, and but i think that it is remarkable and notwithstanding the fact that the jobs are on the lands and the pensions are on the line and the workers did not talk about that today. i wish that the city had done more in trying to entice ucsf to be part of the equation and i also want to note that we just completed a healthy services master plan that outlines the health needs of the city and sets out the principles and recommendations and from my reading of it, this move, kind of goes against, some of those recommendations

and one of the recommendations and 1.1 is addressed, and identifying social and environmental factors that impede and prevent access to opt mal care and not limited to violence, and other hazards and other environmental issues. and i mean that transportation issues, i mean that goes to the heart of what we are talking about here and another recommendation, 3.1, increase access to appropriate care for san francisco vulnerable populations. and talking about the social vonnerbility and i think that this recommendation, has some relevance here. and given the people who testified here today. and another one is promote new or in no vaiive.

and so many of these paishlts are getting so many other patients at sf general why would you want to move them to laguna honda? that goes against that recommendation and i don't know what the next step is, i understand, again, the intent, and i know that director garcia and the health commission they have a lot on their plate and they are trying to ballet lot of different issues. and i just have concerns about this and i don't think that this is as well thought out as i was hoping. and i really feel that as a supervisor for so many people who are impacted by this, i don't want this and i don't want to go forward right now. and so what is the next step, if the board of supervisors you know, wants to not move forward. and what do we need to do and what are they willing to do. >> and so, i appreciate all of

your comments and very much agree with all of them. and we will take a look at the healthcare ordinance and to make sure that we are in compliance with it and given everything that has been said here today i agree and we need to relook at this and we need to hear the concern of you and one member of the board of supervisors and supervisor mar we have heard a little bit from you, and we did not expect to hear more. and it is not our inat the present time to take any of that action. and hearing what we have heard today. and i want to say to the patients that i am sorry that we have not had a conversation with you. we have met with the staff and not meeting with you is kind of something and something that we should have done and we will correct in short order. >> i think that the one of the ladies put it best, i think that it is about respect, and i know that if i were a patient or if my mother was a patient,

that was impacted by this move, and she had not been asked, i would have felt disrespected. >> i understand. >> and i can see why they feel disrespected. so, i know that supervisor mar has questions or comments. could we say that this is on hold. >> absolutely. >> thank you. >> supervisor mar? >> i wanted to thank you for the heartfelt apology and hopefully before any other decisions like this move forward that there is respectful process that involves patient and staff and stake holders on those decisions and i think that he brought up the plan and before the decisions are made that we are absolutely clear that it is

not going to impact the most vulnerable populations in the city but that is the stake holder input, before a decision even contemplated before the commission or you and david pierce, the chief of renal services or the chief of medicine or others that you are listening to that input. >> and i did want to say, that also that... i think that some of the questions, raised by one of the members of the public, on potential waivers of that building 100. the relaxation of and how the sprinklers potentially could be renovated at a much lower cost than the whole relocation and those are really important. and i am dead set against the privatation of the public services as well and i am really pleased that the focus was on patient care and i know

that is there a huge number of issues of the much lower level of service from privatized dialysis centers verses the amazing work of our san francisco general hospital dialysis unit and the clinics that serve very, very vulnerable communities as well. and i wanted to say that i am very pleased too, that you have listened, and this is one of the most well done hearing. and >> and speaking out in a constructive manner to make things better not just for themselves and at sfgeneral and i am pleased that you have listened and i hope that miss garcia and mr. pierce and others are listen and that is a critical element in decision making before it comes to us, and we don't have to have a hearing like this to bring that

out. and appreciative of your responsiveness and thank you so much. >> and director wanted me to let you and the group know she would have been here had not been for pressing issues in the mayor's office. but she is wants you to know that she is committed to taking any action, and that we make sure that we do what is in the best interest of the patients and so please know that director garcia does support that. and she does join me. >> and so mr, pickens if i may, first of all, you know, one of the things that is really hard for all of us, to do, i think that it is human nature is to admit when a mistake is made and so i give a lot of credit to you and to the department for making that acknowledgment and for listening and i think that, you know, kutos to the patients, and kutos to the

workers, for making sure that we understand that what we are doing sometimes has unintended consequences and this is government, listening to you. so, i am very proud of that. but, just in terms of clarity. does it mean that right now, the services will stay at the current center until a decision is made otherwise? >> yes. we will suspend the rfp process. >> so the process is suspended and you will not be making a decision to privatize the services at this point? >> that is correct. >> should there be a decision to go down the route of privatization, which many of us myself included are against that, i assume that there will be a separate and a new process

for that. >> that is correct, absolutely. we will be meeting to talk with our patients. >> thank you wither much and one thing that i would say about director garcia and the being in the dekter of public health is that you are expected and you know, wanted to be everywhere. and you know? all of the time. and that is not possible, and i know that director cares a great deal about these patients and about these workers and so we understand, why because of other responsibilities they could not be here and she was well respected today by mr. pickens and again, i want to thank the department, the workers and the patients for being here today, and the other members of the public. >> thank you very much and we look forward to coming back and having a positive resolution, that involves our patients.