see today. we have a continuing interest, to the coalition of san franciscans for healthcare, and housing, and jobs, and justice. and made up of some 60 community based organizations and coalitions of organizations. to meet the three main, if you will objectives, of our program for this development, the first is following up on the innovative solutions, that this board and cpmc came to end of the development agreement, around employment training and placement, and around healthcare and around the creation of a new saint lukes hospital. and our difficulty is in meeting those three objectives, the role of city departments has been extraordinary passive, basically waiting for checks in

the mail from cpmc, the testimony that i think today, indicates that basic passive stance of key city departments in trying to come up with innovative and creative programs, and let me just give you three. one, the city has no real experience in dealing with permanent entry level jobs in not in construction, but permanent jobs. and the notion that it is only healthcare in a hospital, and an organization is complex as cpmc, indicates to us that the folks doing job placement do not really know what they are dealing with in cpmc and there is no real engagement with the community in that regard. in terms of the innovative programs around providing healthcare and funding in the tender loin, there has been basically no engagement with the community and the community groups who were made up of those people who need those

healthcare needs and finally saint lukes itself, redesigning saint lukes and creating a new and vigorous saint lukes, it is nowhere, and you will hear the testimony today in each one of those three areas about what the community concerns are i hope that you listen. >> thank you. >> next speaker. >> good afternoon, supervisors, my name is emily, and i am with the chinese progressive association and we have been part of which community and labor coalition for four or five years and we are glad to be at the point where we can actually look and see what is the progress made and we fought for all of these really important, you know, benefits from the development, and i think that we are really glad this year, you know, some of the progress on the healthcare services that we are supposed to be provided to low income communities in san francisco and we are glad to hear that the dph and the cpmc did verify through an independent audit or, the number of patients and we are glad that number is higher than we originally

thought and however, that information was supposed to be posted on the dph's website within three months or in october of the execution of the da and so, we would love to see more of that type of information, available to the community and to the public so that we can actually you know, know that information and be able to understand how that will meet that requirement. and to ensure that 5400 medical patients are going to be served and we will strongly recommend that they take a more proactive approach as the board suggested with working with the community members and insuring that that happens as opposed to waiting and seeing what happens, and i think that we feel like that is a really important benefit, that should be provided to low income patients, across san francisco, and we really want to make sure that cpmc has a plan to do that.

so i think that we really are you know, glad to see that there is progress, but still there is so much more to be made and i think that, you know, it has been about 6 months and or, close to that, and we have not seen the type of leadership or what we would like to city the agencies engage in particularly since the healthcare pieces are so substantial and we know that they are not going to be easy to meet those requirements. and so, you know, the following speakers will give a little bit more specific examples of how we feel that the city and cpmc could be working better with the community and labor coalition that we will represent to insure that our communities are being served for the long term. >> i am going to read a few more names and a poll guys if t

medicare are coming from the tender loin neighborhood. and i did not hear that much about the obligation to identify or to create what is called a management service organization, located in the tender loin and also partnering with the primary care and services in the neighborhood. and if the da states that and if it is outside of the neighborhood and that is

obviously a concern to us because we want to make sure that the folks in the neighborhood are able to access the quality healthcare and where they live. and some of the numbers

>> they don't know that the services don't go to saint lukes and there has never been the out reach to the nurses or

the community so that we will understand exactly what is going to go into saint lukes and since the da has passed we have had former cuts to services at saint lukes and we have lost our cath lab and our nuclear medicine and we have lost the subacute annex. and we have also lost our infusion center. and those basically dwinled down to nothing as a progression and i have dealt with them for years and i know that is not random and this is part of a divine plan that we are not privvy to and i would really like to know which direction we are going in, and i would like to know for the community. and we still are attempting to serve the community, but we are still very much the ugly stepchild, the basic, and the elderly and above all the uninsured and sometimes, that is wrapped up all into one

patient. i know that the floor is full the same with the medical floor and i have a 33 bed search floor and we have five patients, something is very wrong with this picture. i would like to see something more specific as far as the long term survival of saint lukes and i don't see that happening at all. i am really very worried and we really are very vulnerable, thank you. >> thank you. >> next speaker, please? >> good morning supervisors, i am the director for the program

for chinese for affirmative action and i am speaking on behave of a coalition of organizations that i have been working closely and monitoring the workforce commitments in the development agreement and we are part of a broader cpmc coalition that simply is monitoring the key issues. and the cpc, workforce coalition is includes all groups representing all communities named in the da including the tender loin and south of market and the bay view hunter's point as well as labor unions, representing the nurses and healthcare workers. and this is a real opportunity from the development agreement, to think about how the city is enhancing the current workforce system. it is an opportunity, for a model of change, and how we are working with developers and employers, to direct placements to sustainable jobs for the most vulnerable communities. and i also want to acknowledge that although, city wide, san

francisco is seeing a decline in unemployment, the target the neighborhood that have been highlighted in the da are the ones that are experiencing the most subborn and unemployment rates in china town, for example, in others, we know that the unemployment rate is twice as high, so, that really gets masked when we look at city wide unemployment rates, and so we also asked to have a true, better understanding of those neighborhoods and the unemployment rates and also the under employed. >> so with the da we have found a couple of challenges among the cpmc, performance. in the failure to make quantified projections of the numbers of entry job levels that projects higher than next year and how that makes planning an effective training program and possibly for the san francisco foundation. so further community group

concerns are whether the healthcare academy which is named in the da have the capacity to train sufficient numbers of workers and as calvin mentioned earlier, we want to be able to have a deeper understanding of exactly the healthcare academy and how it is a pipeline and a pathway for the multitude of the job opportunities coming from the hospital, not just in technical, healthcare, but in janitorial, customer service, and retail, and a variety of at additional factors. >> whether it is them focusing on the removal and the understanding of the requirements especially for english professioncy and past criminal conviction ss a continued question that we have and are looking forward to working with ohed and also how the hca are targeting the out reach to the 6 communities again. and the tender loin and the mission and the south of market. >> thank you.

>> next speaker, please? >> i want to talk more about the local higher and to improve the opportunities in the communities that she had just talked about. within there there are also things that we are concerned about the difficulties of the ten day deadline, and so, within ten days, there is basically a ten day period, to hire locally, and that means that within those ten days, cpmc is sending the information up to hsa and sends it off to

the community and we need to get those applications back in to cpmc yes that is really ten days and, ten calendar days and we have a concern about the 40 percent local higher agreement and the 40 percent is actually four all of the campuses and not just the new campus. there were jobs listed and i would consider 40 of them entry level and only four have been shared with hca to my knowledge and we want to see if there is going to be continued public presentations or the how the community members can find out more about the jobs and so we can make sure that the san franciscans can apply and we are concerned about os, and capacity, and monitor to the

cpmc with their local hire commitment, and for the construction jobs. and especially, in reference to the disadvantaged workers in the neighborhood naid briefly. >> thank you, supervisor mar. >> could you just repeat those numbers of the number of jobs, how many of them are in use, and non-construction and how many have been shared again? >> so, it is just based on what i saw on the website this morning. and there is about 40 jobs that could be considered entry level and so, those would be like high school degree, couple of years working experience and to my knowledge, only four have been sent out. >> okay. >> thank you. >> thank you. >> next speaker please? >> and my name is alicia and i am a nurse at cpma pacific campus and i would like to thank mike here for being here

with us. and but we are sad that dr. brown is not here to hear our concerns and our voices as the nurses that he is the ceo of at our hospital. ken rich did point out the fact that the development agreement, there is supposed to be a cliper card matching programs available to all of its employees at cpmc and it has not been rolled out yet. and we are hoping that it will be rolled out because it supposed to be from august of 2013, and we are hoping that there is a six month delay on this program, that they would extend this program not the ten years that it is written in the contract but an extra six months from the extended pass at that time so that we get a ten full years of having this

matching program in the agreement it states that it is supposed in the orientation packet, which it is not currently and they are supposed to advertise it to the employees, of cpmc. i want to point out that we were trying to organize a union and the nurse woulds get them up to six to seven anti-union fliers a day. if they have something to communicate to us they have the resource to do so and i would like to see them letting us know the facts and that the

program is available to us. at the, i am here to talk about the nursing and staffing practices of cpmc campus. i work in the er and we are short staffing it impacts the community city wide about a week ago, er was inundated with too many patient and there were nine ambulances that came in at once, and the complaints and the patients is waiting from, you know, the possible, you know, heart attack, and stroke, and bleed and they waited anywhere from one half hour to two hours just to be triaged and at the same time there were 20 plus patients in the waiting room, waiting for over six hours just to be roomed in the emergency room, it is very unfair to the community that when they need a medical need they have to wait

that long. >> it is a very unsafe practice and the nurses upstairs, which is on the floor, are also, under staffed and when the hospital is under staff, it is very unsafe and it is not very fair to the community and recently, one, they cna, and they want to be represented to the cna union, and up to this point, the management, has not agreed to sit down with the nurses in good faith to negotiate. thank you. >> next speaker please? >> amy, herb and i am an rn at cpnc in the pacific campus and we are here to address the conditions that are possible and difficult for us to care for our patients in the

community. and she described how inadequate staffing practices are frequently led to back up in the emergency department often blocking access to care at our hospital. the short staffing in our critical car units and the rest of the hospital also contributes to this problem by slowing down the ability to transfer and admit patient and it hinders our ability to provide the care and patient that have been admitted. this is a chronic problem in our hospital and one of the reasons why we have organized to form a union and join cna. i would like to add that the administration at cpnc knows the at quid staffing is and has the resource to do so as it was suddenly provided to us in the period leading up to our union election. and it has become a problem, and nurses have spoken up about this and continuing training and educational needs have been treated as complainters, instead of having it addressed

or respected. despite a unethical anti-union campaign by cpmc we did win the election on december 16th and it was just last week by the nrb and we are here to publicly ask that cpnc recognizes the union hospital that they stop the surveillance and intimidation that is continuing 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