order to get up there, that is very hard for the dialysis patient to do and it is even tough for a normal person like me to go up there. and i am sure, that you can imagine how hard it is for the dialysis patients. >> second point, translator, like i said before, i can't be there to translate for my mom all of the time and on top of that, we are not professional translaters, and there are times when we need to rely on the translator to help us to get our points across. we are grateful that the clinic was able to provide one for us. i am not sure that laguna hospital can do that for us. and also, emergency has a lot of patients point out. and lastly, and the most important thing of all, san francisco general hospital, has the best medical team who really care about the well-being of the patients. and so why would we want to change that? i am not saying that the medical staff in laguna hospital is bad, since i would not know.

but based on my experience, and in a for profit organization, almost done. >> the medical staff to become expensive, and the medical staff care about the patients they do not even have the time to care about them because they have to take care of so many patients with the minimum staff. >> the medical staff are not happy. >> thank you. >> thank you very much. >> next speaker, please? >> my name is william and i am a dialysis patient. and i am out-patient and i don't know about money or politics, but you see when i came out there to the

institution, i am on dialysis. and now, if if i was at the hospital and if ied to go to the other hospital i would never make it because they don't take our patient person. but the general hospital took me and i do all of my services there and i go to the room clinic and i go to the therapy because for my legs, so i can get up and walk one day and so, everything that i do is inside of a hospital. and they treat me well, and you know, and they make me friendly, and they are friendly to me because they understand the situation, that i came out of. and if it wasn't for them, who knows, i probably would be tore up, so please don't move. that is all that i got to say. >> thank you, sir. >> thank you very much. >> thank you very much. >> next speaker, please?

>> my name is (inaudible) and i am 13 years old and i am here to support my dad for dialysis at general hospital. >> hello my name is george and i would like to say that i started dialysis when i was 32, real young. born and raised here in the mission and i don't know what he was talking bellerer but he was talking about money this and money that. but no one asked us what was going to happen to us? and i have been six years now going on dialysis. and if it was not for these people at general hospital, i don't know where i would have went with my life. athat time, and you are youth to have dialysis does not have a way, it just hits you man, and when it hits you, it hits you in the heart, you know? you don't know color, chinese, black or whatever, i don't care man, we are all one and we are not asking for a new place, we are just asking for our old spot back, we don't have know

tvs or whatever, but we have family that is all that we have. that is all that i care man, i don't care for nothing else just family man and i hope that you guys do the best and pray to god, god bless everybody. >> thank you very much. and thank you and your son for being here. >> next speaker please? >> my name is allen and i am a dialysis technician at sfgh, and they are talking about numbers of 30 patients or more but they do not realize that as, technicians it is not safe to have the 5 to 1 ratio they want to stick the patients in a building, what about us, they never asked the technicians how hard it is, the turnover is hard and they don't understand that. generally, a patient that crash and then we have to jump to the next patient, 30 minute window per patient, and if you thought that is fast, that is fast pace and they want to add more

patients to the unit and that is really hard. you were talking about the bond, if the city knew about the bond that we are going to present a bond, let us cut out the department and that probably would not have gone through, because it is a service and it is something that needs to be there. and with everything, about you i you know, money and i just started at general and i am a new technician and i work for private clinics and i would not ask for a better place. >> thank you very much. >> next speaker please? >> hello. my name is fernando (inaudible) and my question is have you been sick? and so sick that you needed someone to help you move? when you could not move yourself? well, i have. and i have been a sidney patient since 2008.

and i was (inaudible) when they told me that my kidneys had stopped functioning, and i asked the lord why? and but it did not stop there, heaven and earth were on my shoulders when i became homeless for six months, i was devastated during those times but i never stopped trying until i did on behalf of the lord. the first, the medical social workers and friends helped me to get back on my feet back and they helped me, find this place that i call now a home. these people guided me, and every step of the way and helped me pick up the pieces once again. and they got the lend the helping hands without asking me for anything and it is hard for us, the people like in this and but they took care of ourselves when we get sick and our health

hinder us from doing the simple tasks and accomplishing our daily routine, i hope that you will consider people like me, to have an adequate income and cannot afford to buy the medicine and basic necessities. turning this clinic into a public facility will absolutely give us another headache it will hold us back from our recovery. and we deserve to live a little longer and enjoy our lives, >> thank you, sir. >> next speaker please? >> [ speaking in a foreign language ] >> good morning my name is (inaudible) and i am a patient of the dialysis.

>> my motive for being here it to talk to you about me and my fellow patient and to let you know that when we are patients we will go to the question, and... >> [ speaking in a foreign language ] >> when this happened to me, actually, and i became ill, i had the doctors and the nurses and the hospital they gave me hope, and they were to maintain myself. and now,...

>> you should take into consideration what the patients think and all of the feelings. >> and that is all that i need to say. >> i have a question. i am wondering if you could tell me, it is the same question that supervisor mar asked and another member of the public, how do you feel about the fact that the patients were not asked by the hospital [ speaking in a foreign language ] >> i believe that all of us felt the same way.

>> in my clinic i actually came back to life, when i was diagnosed i did not really want to leave. >> next speaker, please? >> good morning. my name is patricia. [ speaking in a foreign language ] >> and in my case i have an emergency with surgery. [ speaking in a foreign language ] >> in that moment i had an urgent surgery. and even my physician, actually that is assist me at the renal center so everything came out okay.

and then after that i felt really good because my pain was really bad. and i am really happy that the services that i have are in the hospital and also with my dialysis. and so that i feel confident that they are always there. thank you. >> thank you for translating. >> next speaker, please? >> good morning, i have been a patient for four or five months now and i don't like that the san francisco general hospital will be transferred to laguna hospital and especially for me, i don't have medical insurance and if san francisco general

hospital is like a one stop shop for me and the complete facilities, and the lab tore torrey and the pharmacy where i get my medicine and the emergency when i needed it. and it does a lot of services for me and i love the organizers and all of the stuff because they don't put me like a patient but as a member of their family. i feel at home at san francisco general hospital and if it is to laguna hospital it is far from my home and i have to travel longer and i am thinking it as decreasing for me and that is all. >> thank you very much. >> and next speaker, please? >> >> good morning. >> could you help her with the mic. you can use the other one it is

probably better. >> thank you very much. >> all right, thank you. >> good morning supervisors. i am more than appalled when it come to the most (inaudible) of the city the city department and health department and senior personnel are not here to adequately support and stand up for these dear lives without question. why are they so distant and cold in a positions to totally negate their lives, what has happened to the heart and conscience of this city, workers sworn to answer to the needs of the most vulnerable and elderly and the children of our city? after all it is we the people who need to know and be reported to directly it is we the people who need to be reported to and we do not support the silence or hear the city employees being (inaudible) of the duty and thank you supervisors for making this a city priority.

of a city business. and we are talking about addressing lives of life-and-death around the clock and i am also a dialysis patient and i know very well the hard journey it is to go forward and fight for our lives, so thank you. >> thank you, ma'am. >> thank you for being here. >> and next speaker, please? >> hello. my name is shery san ders and i have been a patient for 27 years. and at the general hospital. and yet, i am, you know, i felt that we would just expect it when they built the hospital without asking us. you know, the whole thing was about respect, and care. and i felt that they did not care about that. they just built it and didn't care. and i have always been respected by the staff there. and i always cared about us and how we felt.

and all of a sudden we have been kicked to the side of the world, you know? and with no (inaudible) at bay and if they want respect from us, give it to us. and i don't think that it is that hard to do. they built the hospital and it is still, it is built for the patient not for what you want or how many people you put in here and how the doctors want this hospital and it is for the patient. and they lost thought of that and i think that we can go back to that. and that is well said if anything. as anyone can put it, so thank you very much. >> next speaker. thank you.

>> good afternoon, and the neighborhood services, and there is... ♪

>> it is the center that you want. ♪

>> thank you, mr. paulson, next speaker please? >> my name is amy and i have been with the center for 20 years now and i have been see a lot going on there and yes, they have been trying to get rid of us, i don't know how many times, six times or more and i really like where i work but the patients here have nothing. and but we just enjoy giving them the care that they deserve. and our mission here is to to take care of them and to send them up to the laguna honda is a disservice, because i feel that they have one clinic and some clinics go to it daily and then the methadoneclinic they go daily and how are they going to get up there and it is inconvenient to the patients but the doctors say that it is inconvenient to make the visit to three clinics but sf has

seven floors and could they not find us one little spot and you know not even a whole floor, a half of a floor are eye quarter of a floor to accommodate 30 chairs, everyone wins, the patients get the care and the doctor sees them at one facility, if they are upset to going to three facility to see the patient and see how much they do and for the dialysis and that is six trips and then go to the methadone and the you know, it is very exhausting for the patients and let's remember that this is all for the patients and let's keep them the care as smooth as can be. >> thank you very much. and thank you for what you do. >> next speaker. >> in 2008, a study was published in the american journal of kidney diseases in which 25,000 patients were serving, and they concluded

that longer time was associated with greater risk of death and health related quality life.

>> so the move to laguna honda is one issue and also the other issue is privatation, and there are services that our unit provides, and being on the that would not happen in a private unit. for one thing the ease of collaborativive services. and not only the physical proximity but the easy referrals and the doctors being able to talk to each other and procedural considerations and the radiology and urgent labs and blood transfusions and all of these can be done on the site and less costly and

coordinated. to be evaluated on the site and to be taken to the er, and that is without know... and i would like to point out that the delivery system that came up, the patients are not receiving pro-active care and specialty care services in the setting and they may not be coordinated. >> thank you. >> could i ask you a quick follow up question on the point that you made about the 34 treatments of the 94 patients, where are those, are those all in at the sf general? >> yes, and they are primarily, mostly vascular clinic.

>> great. they say that they have begun the work, this is the priority because providing the patients... >> i am going to ask you to wrap it up. >> okay. >> why would moving it four miles away from all of the services that we are trying to make accessible for them, how does that work? >> thank you. >> i am an rn at san francisco renal center and i want to talk about dialysis money, i do not understand why dph is handing over the rfp the yearly profit

of $1.2 million to a private dialysis company, it is profitable that is why there are many companies, san francisco renal center with just 13 beds, generated $3.8 million dollars last year. and this would have been higher if ch and patient revenues were included. and the predicted for 30 beds is 1.2 million, why is this not important to dph? >> >> in 2004, for only dialysis resulted surgical, ir and x-rays and payed hospital days was more than 3 million dollars

it would be higher now and will all be lost to revenues. if it is moved to honda they will go to ucsf for procedures and follow up and it will be closer than sfgh and it will lose millions of dollars in insurances, and $5 million is the cost for a new center, surely dph can find a space in the old hospital when it has been vacated for $5 million, investment they would have guaranteed profits for years to 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