as recently as yesterday. and this is all intended to curtail our ability to get information to and communicate with our co-workers. and taking care. and we can address the issues that are making it tough to us to care for our patients and so that we can optimally care for the patients in our community at our hospital now and also in the upcoming hill location, thank you for your time. >> next speaker? >> hello, supervisors, high name is ann stewart and i am a representative with the california nurse's association. thank you for hearing all of our concerns that were brought forward today. i am here on behalf of the nurses in the east bay with suter summit medical center

which has three relatively large campuses in the east base and it is interesting, to hear what has come forward in this process this morning, and into the afternoon, because our stories are really one in the same. just one week after an agreement was signed, with sutter which the campuses are an affiliate of the suter health organization out of sacramento, we experienced clear violations of the agreement including kind of a laundry list of comprehensive and very heinous in the east bay and some of which include the reduction through our reduction enforce layoffs that are currently happening throughout the three campuses in the middle of the staffing scenarios which are starting to catch the attention of the regulatory agencies in the east bay. and so, on behalf of the nurses in the east bay we wanted to come forward and bring a message of caution that any

agreement that is reviewed with this particular corporation needs to be reviewed with scrutiny, and accountability as of the utmost importance. and all aspects of the agreement should be closely reviewed and anything that can be looked at for a second closer look woo would be beneficial to the community and the patients that this organization claims to serve. thank you. >> next speaker, and if there is any member of the public that has not spoken but would like to speak, come forward. >> good afternoon, i am as gina and i am a policy director of the san francisco community, and just a reminder that we represent and work with eleven non-profit community health centers in san francisco and i am here to give a brief update on our piece of the cpmc development agreement. and the 8 health centers that are looking at forming an ipa

and in response to the changes in the healthcare degree, created by the afortable care act where now received funds and have hired a project manager, dr. valdez the former medical director of the medical system was familiar and rooted in the tender loin and they have completed a study, which is now being reviewed by some in the expertise and this kind of management. they have been to los angeles, to find out about similar community clinics and how they have developed an mso. and now, they are in the process of developing a business plan. and so, i know to the outside world, it might seem not much is happening and it is slow and it is a new area for our clinics. but, just a reminder that our clinics, remain the most one of

the most viable options to provide the primary care to everybody. but, maybe particularly to the medical low income population and we have the several clinics in the area and we look forward to proceeding with the reorganizing and restructuring and being able to serve the patients in the tender loin and throughout the city. >> thank you. >> thank you very much. >> and is there any other member of the public who has not? >> i know that i have already spoken, i would like to come back up by mr. rich. >> mr. rich? >> i think that you had a question. >> yeah. >> so, again, i was talking before about the annual audit that was to be done to confirm the number of patients that they are supposed to serve and i misspoke and said that audit was supposed to be posted publicly in three months, actually it is supposed to be completed and delivered on or before the healthcare compliance report for that year, so it actually should be on or before may 2014, which is

when the healthcare compliance report is due. since, the dph and they have completed the audit already, we would like to see it before the healthcare compliance report. so just wanted to correct myself and also to request that. >> thank you very much. >> is there any other member of the public who has not spoken, seeing none, public comment is closed. >> if i may, maybe if i could ask representative from planning, to come up again? >> she had to leave to go to the planning commission. i can try to help. >> i guess, let me say this, you know and actually she is actually really excellent and she is very capable, but i am hope thating someone from planning is listening to this. and because, i think that this kind of illustrates i think part of the problem, and i do think that to the extent that

the planning director is the signatory to this agreement and to the extent that planning is charged with the responsibility of oversight, and one thing that seems very clear to me, is that planning is not my humble opinion as engaged as it needs to be and the fact that the chief over seer for the city is not here for the remainder of the hearing. that is not a good thing, i think that it kind of illustrates the point and i would actually think that it is a disservice to cpmc and suter because you know, they, they can be doing everything that they are supposed to be doing. but if the city is not communicating and maintaining the community apprised of what is going on, i think that is problematic and i think that even though we have a monitoring process in place, i think that it is important to or for the city agency and especially planning and in a department of public health to

be as engaged and communicative with the community before the deadlines, that are in place, you know, there are 150-day, period, where there is this submission of a compliance statement. you know, i think that what should be happening is that as we are waiting to hear from cpmc suter and their formal submission presentation, that the city departments should be engaging the community prior to that. because i think that will inform, you know, how much you know for purposes of the oversight that you are supposed to provide and i think that what you are seeing here is a disconnect between what is happening and what the community knows. and i actually think that it is the responsibility of the city to provide that information to

the community. and i actually kind of i feel bad for the fact that i think that a lot of people here just feel like they don't know what is going on. and i think that we need to be more proactive, and i think that the city agencies need to be more proactive and in a way that it is, it is, you know, it is going to complicate things more if we don't do that. just to respond, briefly, and first of all, you know, i take responsibility, and i invited the senior level and not the director level, folks that you know, you have, sort of deputy director level from mta and you have that level from oewd, and you have the deputy director of dph and so she is actually at this point, senior staff at planning and so you know, i don't think that john ram expected to come. beyond that, we do hear your concerns about involving the community and we do have it about three months away from

the time, every year in the spring, there is going to be quite a bit of sort of work on evaluating and monitoring the da every year. and so, i do take absolutely the importance of having a process around that i would not worry too much that in february, that has not started, i think that the time that it started is probably in the next couple of months and we think that it makes more sense to be focused around the particular time of year every year, and not sort of out over the years and that has been our plan if you feel differently, we should discuss that and we can do it differently, but recently doing what we intended to do and what is codified in the development agreement. >> supervisor yee? >> thank you, chair campos. first of all i want to thank the community to coming here today to express their concerns and so forth.

so, i do understand that there will be a compliance report in may and we will try to be as patient as possible to listen to it at that point or read it, and the hope is that, everything that we are supposed to be doing will be done. and from just the comments that were made, from the departments and so forth, i mean, i am a little bit skeptical whether it is going to be done or not, but i want to be patient with that. the rate of others seem to be communicating the attention to the details. i am not too sure of this happening. in regards to the cliper card piece, i believe that one of the nurseses came up and talked about that. i would be very supportive that we could extend it beyond the ten years, or as the alternative would be also to

supportive if for instance, if they six months have gone by, and they have not had the opportunity to receive the 50 percent discount for six months, they should get it for free. so it benefits the people more directly today and not ten years from now. and the, and so i would recommend, i mean, or encourage that we continue the community also to continue monitoring what is going on. and for the departments to do more out reach and perhaps, a better job of communicating what kind of things that are being done at this point. >> to respond, i don't enfortunately, cliper card is in the itself and in the plan which is the condition of approval and i believe that there is a date for starting that and that date has not been reached but i will double check, if the date has been

reached and it has not been started then i think that you are right it should be extended on the other end, but i am not sure that they have actually missed the date that is in the plan. >> so we will double check and i did not bring that document with me. >> thank you. >> supervisor mar? >> and, thank you. for all of the presentations and the public comment as well. and i did want to raise a question about the workforce piece of the development agreement, and i am thankful that he is here from the city build but my questions are more on the end use and non-construction jobs and i think that it might have been some members of the public that looked at some numbers of the non-construction jobs being about 40 but only four were afforded by suter, and i am just wondering if those numbers are accurate, and why, why so few local jobs being forwarded by suter?

>> good afternoon, and i am emily and i am the director of the initiative and in the da agreement, suter is not required to post all entry level positions there is in the development agreement of the occupation and there are clinical and internships as well as non-clinical positions that they are required to post. to date, they have shared 17, positions with the office of economic and workforce development and the office has referred 54 applicants, and from the community to be considered for those positions. we do not have final hiring stats for any of those positions that are still in the progress and the cpfc is at our office and pretty regular basis conducting the interviews, and for all of those positions. >> and then, i think that it would be good to share that information with the community and labor alliance so that they have that information, but, how close are we to the 40 percent target, and i know that from

the original negotiations with suter, it was much lower and then the 40 percent was increased and i am appreciative of that but how close are we to that goal? >> so we are very early in the hiring process. so we will not have any of those numbers until we get that these round is a test case and to see how that will predict what the percentages will be. >> and then i think from some other concerns from the community coalition, was the lack of projections and the numbers of the entry level jobs and i am just wondering how you work with suter to make those projections in a timely manner as well. >> they have provided us with the very preliminary friends trends but there is not any massive opening of one position. i know that people have shared the concerns about those

position but they have shared, that the workers will be from the positions that they will be hiring for. to date, the positions that they have shared with us. 17 positions are in house keep and five of the new housekeeping and four have been related to cooking, and three patient registration and one transporter and security officer, client representative, and medical file clerk and ekg technician. >> but there is no just looking at the various jobs on the list that i see tl, is no like home health aids, food service or cooks, there is nothing shared on projections on some of those. >> we don't have all of the projections but they are working on getting us the specifics and the numbers to help in the planning both for the training and for informing the workforce training fund agreement. >> and just as out of curiosity, >> i think that someone had

some or wanted to have some information regarding that issue? >> it is, nano, penelli from the clinic and i am just hopeful that you could share kind of as the information comes forward, what the numbers are for the local hiring for the non-construction jobs, but thank you for the data and as it comes forward, what is the process to share with the community labor coalition, those numbers too? >> and i mean that we want to make all of this information public and so we are open to your specific ideas, we have specifically share all of the openings with our really expensive provider network. but that we will fund and do not fund, so, you know any ideas for how we can share some of the other statistics of compliance will be helpful. >> thank you. >> and for the chair, could we ask if... and i guess that it is penelli from us hastings could dress the question? >> thank you.

>> thank you, supervisor, and i am a professor of law at the college of the law and i direct the uc hastings clinic which has been advising the labor coalition over the last four years, just to respond to what actually is in the development agreement, there is a long list of we are talking about the non-construction entry level, provisions, which are in exhibit e, on page 14 and it makes very clear a long list of entry level jobs but it reads that the types of entry level positions that may be available, as the cpmc include but are not limited to that list. and in terms of the projections, the development and agreement is also very clear, and it actually gives a form which needs to be filled out each year by cpmc, to project the number of jobs in each category.

and as a previous peeker made claim, without those projections there is no way for oewd or the san francisco foundation to widely, allocate, the four million for training people. >> thank you. >> great. >> i guess coming back and maybe i could have it to mr. rich, and what i would say, is that i think that, what i hope happens, is that there is more engagement of the community, by the city agencies. and i think that simply, waiting to communicate with the community, when the specific dates and the developing an agreement come up, and it is not going to be and it may be in compliance with the literal, requirements of the agreement, but i don't think that that necessarily, furthers the goal, of everyone, and you know,

being on the same page, in terms of making sure that that there is performance and i think that given the history of this project, that the more information people have about what is happening with the better it is. because i think that assumptions are made, and i know that if i were cpmc and suter, i would want the city to communicate that information because you know they are doing what they are supposed to do. and i do so, i would encourage you to do that and i don't know if it is you playing that role because you have a lot of other things to worry about and i do think that planning, and the department of public health, actually should be playing that role, and i really do hope that planning is more engaged and does not have to be directed around but i do think that someone should be assigned who actually has the time to be involved in a level that i think is not happening right now. i do have a question as the

supervisor for the saint lukes campus. and i don't know if it is something that you can answer, or maybe, suter can answer, but, in terms of the mix of services, and the issues that have been raised around that, what is, you know, where are we and sort of what is the process that is going to be followed? and because i get asked, that question, a lot, and it is not just people here, but it is the people in my neighborhood, and i know that they are having some change and some cuts, so i just wanted to make sure that we have that. >> yeah, i think that if there is someone from suter cpmc that wants to address that, that would be the best information for you. >> thank you very much. >> to let you know that our commitment is to generally acute care hospitals is to fund by title 22 and by that definition it includes at a

minimum, an emergency room, general acute medical surgical services and including unit, and as far as much science and how much cardology is done in one campus and another campus and we are not there yet, and that is the project under that we are currently working on. >> and in terms of process, how long do you think that before you get to the point where you have a better sense of that? >> well, we are primarily, working with our medical staff, and in combination with the dem graphics of the neighborhood, we anticipate serving and not the neighborhood that we serve today, but the neighborhood that we are going to be serving in the future, which we hope will be a better employed. and better educated, and etc.. and we are probably still a good 12 months away from having solid definition around that.

>> okay. >> you know, i think that we want everyone served irrespective of education, and employment. but, if you could keep us posted on the process, i think that is important, and again, to ask the city to engage the community and all of the partners here as much as possible. >> colleagues, supervisor, mar? >> i was just thank you. chair campos and i was going to try to tie up a loose end on the 30 percent local hiring and i was going to say that i am appreciative of mr. mulligan sharing from the job and the meeting and the exceeding of the goals forle local hiring and i am appreciative of that i think that we should be really overseeing the end use and non-construction jobs as well and i just wanted to ask the rep from oewd once the projections are given for those entry level jobs and as a

numbers come forward how they will be shared with the community? how are we going to get the numbers out so that they are transparent and we can so the progress and that we are on top of it so that the community and the labor coalition that supported this project could be satisfied that we are doing everything that we can to make sure that our residents from the stubbornly high unemployment neighborhoods are well served? >> how we are going to be transparent about this? >> our goal is to have it back and the first development to make sure that we do share any of those projections with our providers and they are the ones that we fund, and also, to the community members who we don't fund are part of the network and so we do hold the regular job developer meetings with folks and we will bring that there and we have distribution lists of hundreds of folks from dozens of organizations and we will definitely continue to

target those priority areas and make sure that they know that those positions are and have the residents readiness for the different positions and timing and again, also doing that really critical information to the workforce committee and looking at the training dollars and also want to access the barriers to those position and look at those job descriptions closely and work with the communities to figure out how the residents may or may not meet some of those and meet with cphc around that and the training fund to address those barriers. >> could i just follow up on one of the healthcare issues that representatives from the tender loin raised? for the 1500 new enrollees i know that the development agreement, refers to a managed service organization that is created or identified by dph, and i am just wondering, i know that we had a community clinic person, speak, but i am just wondering are we going to meet

the various deadlines so that we are insurancing that the 1500, really vulnerable people from the tender loin are going to have the access to the healthcare services. >> and supervisor, that is certainly, the intention and i should say that, and i take your comments about communication with the community very seriously and we will make every effort to do that and i want to say too, that we have been engaged with all along with the san francisco foundation, with the clinic, and with the eight clinic partners that were mentioned earlier, and we specifically set the mild stones within the application requirements so that we will continuously be engaged and be able to navigate the project at every juncture. and the director has met with the clinic representatives and continues to participate very heavily in the process. >> could i just ask, is there a plan if for some reason mca is not found within the time lines, like what will we do if we can't, and i am hoping that

everything is moving smao*gt smoothly as you said but is there a man if we don't meet the deadlines, with 1500 people really need that healthcare service. >> the da is very specific about the 1500 people, it says, the first 1500 people with the mso or ipa that has a provider base located in the tender loin, and the second a new ipa is located in the tender loin and option two is a new mso, and with a provider base not necessarily located in the tender loin, but serving the residents and the third is an existing mso that is in place already. hopefully we can address with the first two options with the new mso for what we are funding and the third option if we are not able to do that would be likely through the cpmc existing partner, who they work with already to previed the care. >> great. thank you, very much.

>> colleagues, do we have any other questions or comments? and i know that we have another school, i think that is visiting and so welcome to the young men and women who are visiting the chamber, the one thing that i would say is that i certainly found this hearing to be very productive. and i think that the more information is out there, about what is happening, i think the better we all feel, obviously there are still questions, and concerns, and my hope is that you will, or that we will see enhanced communication between the city, and the community. and in particular, and i do want to thank, suter and cpnc for the work that they are doing, and for the transparency, and for being here today. and again, i think that it is one of those things about making sure that we are not just complying with the letter of the agreement but also with the spirit and i think that the more that we are on the same page and the more that we know what is going on, the better it is. and i know that we will continue to monitor this. so colleagues, if i could have

a motion to file this hearing? so we have a motion by supervisor mar. >> if you can take that without objection? >> without objection. >> and mr. clerk, do we have any other business before the committee. >> that concludes today's agenda. >> meeting adjourned. thank you.