to potential transplants also and so that, different benefit in terms of proximity. >> did you survey any of the 132, or patients did you talk to any of them about this option or proposal. we have not. we have had discussions with staff and presentations at the joint conference but in terms of surveying patients. no, we did not. >> why would you not do that? obviously staff is going to be impacted and it is good that you spoke to them. but why would you not talk to the 132 people that are ultimately are going to be the ones that are most impacted by this move? >> i think that in hindsight we should have done that, and that is a mistake that we made. >> i mean the thing about that

is that it is better late than never. i mean don't you think that having a conversation with those patients now would be a good idea before you move forward with something like this >> absolutely and we will make sure that happens. >> okay. >> and if based on those discussions it turns out that from their perspective, this is not necessarily the right move, is dph prepared to reconsider its decision? >> absolutely, we are about what is best for patient and so we take whatever actions are necessary to make sure that we meet those needs. >> that is good to know. i think that reconsideration might be appropriate here. >> are the rfp, did it include issues of transportation? was that a part? >> no, it wasn't. so i think that the transportation are things that i think that we at dph would take the responsibility for. >> but why, look, i have done a lot of rfps before as a law and

her why wouldn't transportation, given the transportation is such a important consideration for when you have 123 of 132 patients having to trouble father, why would you not include transportation in the rft? >> well it was for the clinical service of a provider that does provide dialysis services, and it did to the come up in the decision and it deserves the merit that you are raising it here and it is something that we can go back and make that a part of the process. >> and yeah, the problem with that is that once you have done an rfp, if you change it you will have to redo the whole thing. >> i think that we need to look at all of the options and dph. we know that we bear the responsibility to make sure that we bear property ses and transportation is the barrier, it is incumbent upon us to solve the barrier. >> have you done any analysis of how moving the unit away

from sf general might actually decrease revenue in terms of other medical services? >> we don't see any reduction of the medical services related to the patients moving to laguna. >> so, for instance, if you are looking at things like, vascular surgery, or radiology, have you done analysis on whether or not it will lead to less revenue because you are moving to a different place? >> we would see no reason why that would be the case. the patients will still receive those services at sfgh. >> the idea is that if you are moving the patients to laguna honda and the patients that would have gone to sf general, would they go somewhere else to seek those services? >> they definitely could and it also depends upon the type of pay order that they have. for instance, if they have managed care, then they have a

network and so they have to receive that care within their network. which means sfgh will be the place that they get all of their care. >> why won't you do that analysis? if it is a possibility that they could go somewhere else, why wouldn't you want to know? >> i think that with the affordable care act, more and more patients the majority of our patients are actually in managed care products medical managed care, so, we are their network and the department of public health and sfgh is the hospital and so there are, that is the place where they have to go to get those services in the network. >> well, looking at the 132, how many of them are you is that true of? >> i don't have that number in front of me we can get it but i can tell you that it is the vast majority. >> that is why we have that high a month. >> i have that we work closely

with usf and why did they not bid on this rfp? >> i don't know, i can't speak on their behalf. >> has the city had a conversation with them and has it been any discussion of creating insensitives for them to bid on this? >> we have had the discussions with the ucsf representatives, at sfgh and did, in fact, encourage them, to bid on this service, so that there could be a continuity process. >> now in the rfp, is there a requirement that whoever takes over the services has to accept all of the patients that you have right there? >> so, yes, the rfp is very clear, and that the dph, is the priority, and that all of the dph needs for the dialysis has to be met at that facility. >> does it have a specific requirement and patients have to be accepted, and you know

the patients that have the limited, you know, mobility and does it have that specific requirement >> all patients referred by the sf general must be accepted. >> okay. >> and there is no possibility for them to reject any of those? >> no. we recognize that we have expertise within our current facility in terms of telling the patients that are not always accepted at other facilities so we knew that we had to make that a part of the rfp. >> okay. >> supervisor mar any other questions? >> okay, i think that will be... we might have other questions, later on. but, i don't know if there is anything else from the department of public health? >> okay, i think that is it. >> we are happy to continue with the dialogue and look forward to meeting with the patient to get your feedback directly. >> okay. >> thank you.

>> so, why don't we do this? why don't we open it to to public comment. i have one speaker card, but i actually just want to say, anyone who would like to speak, to the speaker card is vivian eteral a if anyone wants to speak if you could please line up to, and you can go to the side here on the right, and your right. and my left. and yes? this one is fine. thank you. >> and because of the issue of quorum, we are going to limit it to two minutes, per person, so please go right ahead. anyone who would like to speak on this item come up and line up on the left, my left and your right. >> good morning, my name is vivian emp erial the city wants to contract out dialysis services, why in my husband is on dialysis because i know that

the insurance carriers pay providers over 65,000 a month for each patient who is there four hours a day three times a week. and 60,000 dollars a month, per patient. why would the city get out of the dialysis business and have this money go over a contractor over whom they have questionable control and then there was the proposal to relocate the dialysis center from sf general to laguna honda. >> there are two striking reasons not to do this. >> patient's safety and indisputable potential liability. i worked at laguna honda when it was seismically unsafe that news in itself were unsettled. the voters told that it would be coast prohibitive to retrofit and so fubdleing a new

hospital was acceptable. >> we certainly could not have patients in an unsafe building. the new hospital was built, and all of the patients were relocated. we were told much of the old building would be demolished, but the building stands, who decided that it is suitable for dialysis patients? and it is a lawsuit waiting to happen when the patients who are sitting ducks get injured during an oergt quake in the old building, with all of that publicity about the danger of the old building, the city would not have a leg to stand on when the patients get hurt there. let us remember that change is not synonomous with improvement. >> thank you, next speaker please. >> and you know, wanted to move the meeting along, so if you do want to applaud or express, your approval, we ask you to use the hand signal so that we can keep moving the meeting

because we don't want to lose the quorum. thanks for the patients. >> i am a columnist with the west side observer and newspaper. i have written an extensive article about this at www.west side observer.com. and the sunshine task force ruled in my favor just two weeks ago that the department of public health has failed to put adequate meaningful agenda items on the descriptions on the agendas for over 20 years. this particular topic has never been before the full house commission. where is the director of health barbara she should be here so should the president of the health commission. because the health commission has not, as mr. pickens wrongfully told you, they have not approved this at the full health commission, i place the public records request and i have told that there are no responsive records at all about

a resolution, or any kind of approval by the full house commission. to move this. commissions, sanchez and edward chow, wanted ucfs to explore a partnership with mount zion and that never happened. >> the health commission, requested the director of health garcia report back to the health commission about all options available. that never happened either. they never presented any kind of policy paper about what all of the options could have been including putting it in building five. and the rfp is going to reduce, 26 hours, weekly, of treatment. and by simply curtailing the hours of operation that

translates to 15,052 hours annually or 450 treatments annually. >> the board of supervisors needs to make... >> thank you. >> next speaker? >> hello, my name is gram and i am a patient at san francisco dialysis unit since 1994. and i just want to say that i am opposed to the move to laguna honda and a privatization of the unit. first, for safety reasons, i had a stroke, on dialysis, at general. and i believe that my life was saved because i was there at the trauma unit. i don't think that i would be talking to you today if i was at laguna honda. and i am concerned about myself

and other patients there is a shuttle, so for, if i had a problem, at dialysis, say, my access and i had to leave, and i would have to catch a shuttle to forest hill, a bus, up the hill, to get on the 48, and that would finally take me to general. that is three buses. and i am already having a problem. so i am sorry that the doctor haves to go around to three sites, but to put more burden on the patients, to take it a little inconvenience from the doctors. >> ma'am, i think that supervisor mar has a question for you. >> i really appreciate the packet and a statement from you in the packet. >> you leave in district ten and how long does it take to you get to sfgeneral now? >> well, i take a van service. sf general. so i would probably use a van service to go to laguna honda, but it does not take us to

appointments i go to hemotology and 4 c for chemo and the woman's clinic and i have a lot of appointments at general. and so, that is the problem with the transportation, not necessarily getting to that, because i go at 5:00 in the morning i have a van service. it is just getting back and forth to clinic appointments and primary care appointments and the such or being if you are sick, if you get sick at laguna honda, you have to take three buses to get to the emergency room. >> i wanted to mention that mr. pickens mentioned that they did not do out reach to patients and i am curious, how does that make you feel because you are the main stake holders in the process and just in general, but he has offered to listen but i am just wondering how you feel about being disregarded by... >> i felt that the whole, this

whole process, that started, a long time ago this is my first time here. and we have spoken at the health commission meetings and i am at sunset three times a week and ward 17 for three hours or plus a day. and they have not spoke to us, and the department of health, not even the higher doctors in the unit. you can speak to me and i will tell you exactly what i think the burdens that they are adding on to the patients and that is what i think that the biggest thing is that they are not considering the patients at all. you know? if just we don't have room for you you have to go. and dialysis is not like, some it is not like the woman's clinic, this is life saving treatment that we need and we have to be here for. so, that is all that i am going to say. >> i want to thank you for your

courage and for sharing that. i know that is not easy. >> and thank you for having us. >> thank you. >> next speaker. >> hi, my name is george read and i am a dialysis patient at ward 17 and building 100, and i have been there approximately 7 years, and i just want to say that i catch one bus to get there and it takes me like approximately 30 minutes to get there, the 19 pope because i leave in the bay view district and hunters point. and you know i walk from the bus stop to the general hospital, you know to ward 17 and i feel that if they, you know, they take the center from me, i mean i might be like giving up and not reporting to, you know way up to the sign up there and whether they have the laguna honda and another thing that i want to say is that i have a couple of family members die in that place. and it is just, it is a burden on me, i did he want even like

to even look up there much less have to go up there to get a treatment. so i mean that is all that i want to say. >> thank you very much. >> next speaker, please? >> good morning, gentleman, and my name is lester lanor, i am also a dialysis clinic patient at ward 17, sf general. the one question where i get there in about 15 minutes, from where i live, i live in downtown san francisco. and i catch the number 9 and that is all that i have to catch. and i am there. the service has been great. and i use all of the service, just about all of the services that are currently there. in that place. for one thing or another.

and i don't like the idea of going out to laguna honda hospital, because i used to live out in the sunset, i know the hospital out there where the hospital is. and i lived on 7th avenue and that is the laguna honda boulevard after the cross 7th avenue, i have one more question, and what are you going to do with the building that we are in in the hospital if this thing goes through, and

we and they move us out to laguna honda hospital? what is going to happen to that building? that is what i want to know. because i have a feeling that someone else wants that building real bad and they will do anything to get it. and you know, to hell with the people who use it. >> thank you. >> we will ask that question, that is a very good question. >> thank you, sir. >> good afternoon, i am wilson and the co-chair of the mayor's office on disabilities and i am also a tv talk show host and i am here today to talk about my father was on dialysis. and it is not that you have to move him. it is about the strength that they have when they go through this. my father did not have much strength at all to go to one place, from another. and it is like, his head spined when he rode in the car just

driving to a different place to receive dialysis. money cannot buy our health. it is about the real health of us. you get sick, when you are on dialysis and you move from one place to another. i was not the patient, but my father was and i can see his agony all of the time and when he would have to move to a different place, he was not here but he was actually in valeo, the mornings that he would get up and regret to even go, the headaches that he would go after he would come off of the thing and if you are not near a hospital and something goes wrong, while you are on that dialysis machine, it is not going to be easy to get from laguna honda to general hospital, when if something should happen at general hospital, you can go straight to a doctor and a doctor can

help you. if you are not there, and what will happen? you will lose, we are going to lose a lot of people. it is not just about what can fit a doctor and i really hate that you guys did not go and ask the patients how they would feel. it is really about them. and that is where you would get maybe some good data and a good place and good information. and then, we would not have to take time to come here. >> thank you. >> hi, i'm michael lion and i worked from san francisco general from 198502000. i have a friend who is my friend's son has been on dialysis for decades and i have a friend who has been a dialysis tech. dialysis belongs at san francisco general hospital.

and it always has. and general has tried for years to get rid of dialysis. we have been through this issue again and again and again. and it really makes me angry that this issue keeps coming up. i am completely unimpressed by all of these arguments of what services need to be in the old san francisco general hospital. and are we supposed to believe that a heavily sedated psych patients are able to rescue themselves in the event of an earthquake, these arguments do not make sense. also, i have got to say that it is really cold to hear dph answer the question about whether there might be a loss of revenue by moving dialysis to laguna honda. and the response dph's response is well the affordable care act

is going to force the patients to continue to take the other services, of san francisco, general. and so to hell with them, they are going to be forced to do it any way. the other issue is that private dialysis services are less safe than public dialysis. thank you. >> thank you. >> next speaker, please? >> hello, i am here to speak on behalf of (inaudible) i mean like english barrier. >> great. [ speaking in a foreign language ] >> she said that she started... >> if you could speak into the mic? >> she started dialysis in 2009.

when she know that she has to be on dialysis she feels a lot of pressure and disappointment and burden. when she learned more about the dialysis and knows about it, she feels more comfortable and before she was not acceptable as a disease, but now, after learning about dialysis, she accepted her disease. >> when she learned that san francisco general hospital renal center will be moving to laguna she feels and she was

saddened and she is opposed to the idea. >> it is unfair that we were not informed of the information that they were going to be moving to laguna and also she feels that it is inconvenient that the patient has to... she has been to laguna and she

looked at the area and feels that the stairs there were not, they can't really climb up those stairs, and especially she is an able person and able to climb up the stairs, but what about the other patients who are incap able of going up the stairs like the patients in wheelchairs, she feels that it is unfair and she is just opposed to this idea. >> and i think that supervisor mar, has had a question? >> what are the other types of services she accesses at the sfgeneral? are there other services? >> >> and okay... she does go to

other services but the main service is dialysis. >> okay. >> why can't you they have a

department for dialysis? and also, she feels that she just opposed to this idea. of moving to laguna honda. >> let me just make sure that she gets her message is cross. >> sf general is such a big hospital, why can't she figure this out and otherwise, right now they are burdening the patients this is not the patient's burden. this should be a decision made

at sf, general which you would have the management who should think on behalf of the patients and the patients should not burden this. >> thank you very much. >> and on top of that, i want to emphasize one thing, she does go to other services because due to her dialysis she has, and she needs to check on the liver and the lung, and all kinds of services that we use from the san francisco general hospital. >> okay. >> and as her son, i do want to say my part. i just work graveyard last night to 7:00 a.m. in the morning and i will be working my second job at 2:00 p.m. and yet i chose to be here in stead of sleeping at home, why? because the medical staff and the clinic is like the second family to me and my mom. there is smiles are genuine and they truly care about the patients when you are there, they sang songs and do the best in their power to cheer you up. and on christmas, they give you

little gift to make you feel like a family. you can't get anything better than that. and this is why, we are here to support them. and i just want to point out, a couple of points. and in terms of location. for those of us who have second jobs, and i can't take my mom to the hospital all of the time, and the laguna hospital is right on the hill, and the public transportation, will only get you to the bottom of the hill, you have to go through flights of stairs in 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