enforcement under the agreement and finally the saint lukes diabetes clinics, we have received reports that there have been changes to staffing in the diabetes klinish at saint lukes that are effecting mono lingual women, the same number of people are being serve and we believe that there is concern about the level of cultural come pentcy. while they have policies in place that support the class standards and the metrics to measure their performance there we have concerns about the actual implementation and how that effects the patients. so that concludes my presentation, and we will come. >> thanks, i am with oewd and

thanks for your patience through this detailed presentation. i am the wrap up speaker so we are almost done i wanted to remind all of you how difficult and complex the process was for arriving at this development agreement. the staff believe that over all considering the short reporting period covered by this report, that the development agreement's provisions are working relatively well so far and the staff's recommendation to the director's of public hel and this planning are to define the cpmc in compliance for the reporting year and i want to highlight just a couple of issues that we heard the concerns from the community and others. and you heard from her, the cpmc may miss meeting the base line target for the coming calendar, 2014 reporting period. we are glad that the discrepancy is not likely to be a large one, but we do want to say that we are surprised and disappointed that this key central division of the development agreement should be in doubt in any reporting year.

and there needs to never be any doubt that this provision will be met and the city will continue to monitor and enforce this provision of the development agreement. and also, just to highlight on the tender loin, medical patients there was a central tenant of the agreement to try to make sure there is a way for the new facility to take care of the tender loin patients and the fact that that has not been managed to put together is not a fault of cpmc, i just want to reiterate that the city is committed to continuing to work to make sha happen. on the issue of entry level hiring as you heard from miss simmons we are committed on the city side to make this work better in the future, just to hit a couple of issues which have not been hit in the presentation but we have heard the concerns from through letters that were sent to you from the community. some letters that you received, alluded to cpmc being out of compliance with the session in the transportation section which requires division of the

discounted muni cliper cards and we do not believe that this is correct, we believe that based on reading the development agreement and the tdm plan, adopted by the planning commission, this requirement kicks in between years two and five of the agreement. so, they are not there yet and we expect that we will comply when they hit the compliance period. lastly, there is some concern expressed about the length of this annual review process and this was an item that you may remember was heavily negotiated at the end of the process, in 2013, cpmc, fiscal year ends in december and they are given in the agreement, 150 days to audit and report on the information and the city must then meet various time lines to analyze the report, issue the report and hold this hearing. we are basically on this schedule, now. and we certainly encourage cpmc to provide the initial report as quickly as possible in the future years so that we can

move this process more quickly, but we recognize that the time line for doing so is 150 days, so with that, i am going to introduce dr. brown from cpmc to give you his presentation and then we will be all done. >> good morning and i am used to be here late in the day and thes a pleasure to be here early, are we almost ready. let me thank those of you who have been on the planning and health commission for the years that it took to get to this point. if you like the members of the medical or hospital staff or board you wondered if someone from cpmc will be able to stand before you talk about the compliance and the concerns about whether we will get to the point of having one and i hope that you are as delighted

as i am. i think that they are ready for the first slides. one of the things that we learned that it should be named the san do dune and we never did hit the rocks and at the deepist point at the corner of franklin and post and that structure has begun to rise out of the ground with concrete and in the interesting fact is that there is enough concrete in that hospital to pave the golden gate bridge four feet deep so it is going to be quite a project.

and we are equally delighted that we are under way at the saint lukes campus and i would say that some of the doctor haves lost their parking lot or perhaps a little bit crunched and this is the view of the new, 120 bed hospital that is going up at saint lukes. and i will talk a little bit more about the time line for both of those hospitals in a minute. >> you already heard about the substantial accomplishments that we reached in 2013, and our ongoing in 2014, in terms of honoring our commitments to the city and the development agreement and we are thankful that we are found in compliance with all elements. i will comment on a few issues. we are delighted that the medical staff at saint lukes, which is a separate body as you heard, and a medical staff at our pacific and california campuses are well on the way of integrating most of the critical services and there are several services such as critical care that are not on that list that are also integrated together and that is

important for our ability to continue to provide care for that community. we exceeded by a large amount, the construction workforce hiring goals and provided the substantial support for the training and construction workers in san francisco. and of course, we funded all of the cash commitments to the various departments and agencies and foundations and that were included in the development agreement. i mentioned that we are under way and it is easy to lose sight of the fact that this is a development agreement without building two new hospitals. we are well under way and we have had the ground breaking ceremonies at both campus and foundation work is under way, and we are still digging at saint lukes. but because the saint lukes project is a lightly shorter project in terms of the construction time line, and because we have had the good response in terms of approving our plans, we believe that both hospitals will actually open close to the same time in 2019

as opposed to there being a substantial delay as this is allowed in the development agreement. and i would caution you that you and especially on the planning commission you understand that things happen, and those of you on the health commission, understand that sometimes it can throw the wrench in the way and it looks good to have both hospitals filled with patients in 2019. and you heard the city talk about what is going on with the hiring process, with oewd and this is a brand new process for both us and the city and there have been some bumps along the way. and our commitment remains strong to hire 40 percent, san francisco residents for entry level jobs, and we are absolutely committed to doing that. and in fact, we have hired almost 3 times as many san francisco residents as you heard about in the entry level jobs and they just have not gone through the process, because the process is only really now, up and running fully effective and we are grateful to the city for

committing the resources to help us with that. and here is what these two hospitals are going to look like. and looking from the north towards the van ness, and also from the north to the new hospital of saint lukes across chavez and i welcome all of you to the ribbon cutting ceremony in 2019 thank you so much. >> thank you. >> so we are going to open for public comment but there is a requested block of time from the coalition. >>

>> good morning, commissioners. and city officials as well as the committee members, my name is rashelle and i am here with the san francisco for healthcare and housing and jobs and justice, and we are a combination of three coalitions that united together several years ago. to insure that corporations such as better cpmc prioritized the community needs and benefits san francisco as much as they benefit from the san franciscan and combined we are a coalition for health planning in san francisco and good neighbor, coalition and jobs with justice. and there are a numbers in the audience right now, who are members of the coalition and i asked them to stand up, briefly, and as we are getting our presentation ready. i believe that ours is on the screen right now. and we are here to mainly to insure that we trust and verify and i would like to trust our city, and in insuring that the development agreement, ratified in 2013 is fully implemented

and urge that you verify any claims that cpmc is indeed in compliance. today we will focus on three key areas. >> jenny lamb and i am going to give you an overview around the concerns around the workforce provisions from the development agreement what was the promise, that there would be a local higher goal of 40 percent from all entry job level positions and today, this morning, obviously, speaking specifically about the non-construction jobs and the

end use jobs. and that the local hire goal would be at all campuses not just it. and as the city staff alerted earlier was that the development agreement was focused on the six under serviced areas of san francisco. and unfortunately, with many of the under serviced neighbors there is often times a masking of high unemployment rates and although, san francisco and benefits more low over all rate, about 5 percent, there are subborn pockets of unemployment in certain neighborhoods like china town which is three times that amount at about 15 plus percent of unemployment. you have heard from city staff earlier around some of the positions available for the

entry jobs. and these entry jobs require no more than a high school ged agree or two years of experience. cpmc is the second largest employer in san francisco. and within the hospital, truly requires a multitude of staff, performing many different types of jobs and similar to the hospitality industry. and in given the robust current workforce system in san francisco, san franciscans are well positioned to show these various jobs. the da lies out a process, which defines whether cpmc has made good faith efforts to reach the hiring target. the first step is that cpmc is to follow a special first source hiring process and that requires cpmc to notify oewd of

every job opening and give candidates a two-week, hiring window. and to insure that oewd, also known as the city workforce system has an opportunity to refer those candidates and given a first shot at those positions. and secondly, it must communicate the projected jobs needs for the year which will then give the city an upshot, at knowing what types of skills, are required for those positions and how we can best position our residents to be successful. insures that the job training programs are training the people for the kinds of job that cpmc is actually hiring for. and lastly, when it falls short of the hiring target, as you heard earlier, cpmc must then look at redesigning its recruitment and referral process. so to give an oversight around the compliance period between

august ten and december 31st, cpmc did not follow this over all process. it did not begin to notify oed of jobs until december 5 of 2013, under though it was under an obligation to do so beginning august tenth. did not provide the job projections until april 8th of 2014, 8 months into the da. and then in december, 2013, while they began notifying oed of the job openings they did not hire anyone referred by the city.

they only hired six candidates through this process and this is inconsistent with again, the promises of the da, this report, however does not in any way, reprimand cpmc for this poor out come or does it express me concerns for these results. the problem continues to get worse. the problem the bottom bar chart shows that the data that the city used to establish the cpmc compliance and the numbers that we just reviewed are very bad again, six hires out of 47 job openings and falling short

of the 19 it should have hired, under this process. but if we compare the performance to number of openings, cpmc projected the numbers, again, get worse. the initial projections by cpmc for the first year is that they would have 114 entry level openings. and again, the promise of this project and what it means for the city of jobs, creation. and it has only filled that many positions the 40 percent hiring target would have been 46. but it filled less than half of those jobs it projected. and something is going on, there are fewer jobs being filled than we were allowed to expect. but the city report, again, does not even go into notice of why the cpmc projections were so far off and we want and ask the city to be on top of this

issue. in closing, they ask us to find them out of compliance. and the community coalition asks the commissioners to urge a planning director, to find that cpmc was out of compliance in 2013, with the entry level, operations for a source, hiring obligation. and it is undisputed that cpmc did not refer a single job opening to the city for the first four months of 2013. and that it waited 8 months to provide an accounting of its entry level jobs and protections of anticipated openings. and it is hiring out comes in 2013 and the first full year of hiring work atrocious. and the only fair objective determination that can be made is that it was out of compliance with the obligations

it is essential that the city establish a precedent for reviewing the things that spmc is in compliance and where it isn't. >> good morning, commissioners, my name is robert bloberg and i am a registered nurse at cpmc pacific campus in pacific heights and today i am going to be speaking about the transit match subsidy for all cpmc employees section of the da. the promise was that cpmc shall share the cost equally between employer and employee. of a monthly fast pass. or cliper card up to the value of an adult fast pass, which i believe right now is 68 dollars. this was in the subsection, 8-c.

the august, ten, 2013, the effective date of the da. and no alternates start date is identified with this obligation. and the purpose is serviced, and to encourage the employee public transit use at all four cpmc campuses speaking personally for pacific campus i know that the garage is quite small and employees have a hard time getting into parking and when i get out at night at 11:30 getting the cars out of the garage so that it is a very tight situation. for parking a vehicle in there. and also, to reduce the automobile use, traffic, and parking congestion, pollution and greenhouse gas emissions of course, and cpmc pacific campuses in a residential neighborhood and all of the people driving into work, definitely present the traffic issues on those streets. and to reinforce the city,

transit first policy. performance, cpmc has not yet implemented the subsidy and myself and the other nurses have requested by calling into sutter health to get this subsidy, however it has had zero effect and is not being offered at this time. the city reports that the cpmc does not intend to do so for five years or until 2018 or 19, and yet the city report finds them in compliance. the city justification for this, justification, or plan, dated april 2013 that it was already obligated to implement 50 percent transit subsidy is a mid term program to begin with, and two to five years. however, this was not discussed this prior hearings. but the language of the da is clear. the cpmc shall share equally the cost of a monthly fast pass

in 8 cthey shall promote the use of the subsidy described in 8 c. no publicizing among workers at the facility of which i work has been done or witnessed first hand, the da accelerated the start of the tdm's plans and transit subsidy to make an immediate obligation and to require them to publicize it, they have it backwards and the earlier does not modify the later da. and at a hearing before the board of supervisors, land use committee in february of this year. the 2 to 5 year delay was never mentioned, in fact, supervisor yee said that the six months lost should be added on to the back end of the ten year requirement, and specifically discussed and it was never discussed that there would be a two to five year delay.

and the city staff presentation, dated june 17, 2013, california, pacific medical center rebuild to the board of supervisor's land use and economic development committee, the development agreement was reviewed. and under the transportation section, cpmc will pay $6.5 million to them in lieu of the tdf. push and these have already been done. and however, this and the stimulation that cpmc will encourage all of the employees to purchase a cliper card and will share the cost equally with the employee has not been done and we are wondering why there is an inconsistentcy of paying the money to the city which was immediate and then delaying the cliper card two to five years. >> in conclusion for the cliper

cards subsidy and obligation, and in section eight, we are finding them out of compliance and the city should insist on the strongest and the clearist interpretation of the da but the transit subsidy requirement starts on august tenth of 2013. and then not try to justify the slowest and weakest interpretation that it can wait five years rather than starting now, so when the new hospitals are open, employees are accustom to using public transit to get to work. cpmc should find out if the compliance to direct the program immediately. thank you. >> and i am going to be for our healthcare concerns and there are actually two main issues that we have and we want to be sure that there is a back up plan for the care to the residents in the medical and

managed care program and as you have heard earlier from the dph, presentation, is there is an obligation for 1500, to be served. >> that is 15 minutes. >> and in conclusion we want to make sure that the commissioners understand that we find that cpmc sutter has not been in compliance based on the facts that we have presented to you and especially around the jobs, transportation and healthcare thank you for the time. >> so, we will open it up for public comment. and if i call your name, please line up on the green side of the room so that we don't block the doors. chuck flac. >> francisco casta jackson,

mary mituluchi and don marcos. >> i am the senior manager of healthcare programs at jds and we are also the sector lead for the cpmc first source hiring program with the office of economic and workforce development. and so we are partnering with the city on this project. and i am pleased to speak in support of cpmc and acknowledgment of our long standing partnership with them. specifically, the human resources leadership has long been a strong supporter of jbs, and the regional vice president is a former jbs board member and is the current co-chair of the healthcare advisory board helping us to better serve the needs of the regional healthcare employers and job seekers, the leaders from around the bay area have helped jbf to assess how the industry is changing and how their

employees skills and occupational needs must evolve. we know that the dual pressures of a desire to cut cost and still serve a greater number of patients mean that many significant changes are under way and this has a long or a large impact on jobs. we are also proud to support the office of economic and workforce development in the implementation of the agreement and we continue to work closely, with cpmc recruiters to help our participants best prepare themselves for consideration and we found the staff to be very helpful but the jbs goal to employ the people through the process and as a plan has been implemented and we have five of the participants interviewed and one hired. and we agree, however, with some of the concerns expressed by everyone that the process has been slower than desired and has not rolled out as effectively as everyone expected and hoped. and on the other hand, we want to work very closely both with the cpmc and the city to

facilitate the process and make it successful. we hope and we believe that we are all on the same team. again, cpmc is a good partner. and we want to thank them for their ongoing support of jvs. >> thank you. >> my name is francisco decasda and mine comes from running the (inaudible) and that is where we had a (inaudible) institute of research and i have read articles on hospitals and some of you on the health commission have heard me speak before. and some of you are on the planning commission know me for a long time. now, before i say anything, please do not think that you

can fool all of the people all of the time. and i tell you why. the people who gave you the presentations, from the planning department, from the workforce, and from the san francisco health department spoke in generalities. san franciscans are astute but more than being astute, they are very compassionate. and this is about compassion. my family has been involved in the health services from 16th century and i made this statement before to the health commissioners so i know a lot about hospitals when i travel all over the world i go and i visit hospitals. and when you want to know about saint lukes hospital and how much it served and today what

is the state of affairs? you do your own evaluation and the (inaudible) and i have been following it deeply. giving $4 million for some child care services, and on third street and in one of the most contaminated hot spots in the city. do not try to fool all of the people all of the time. i watch you all on television. and if you are given any of the appointment, and you either on the planning or the health commission, please represent why because i represent the first people of san francisco (inaudible) and i want to make a statement. a really clear statement, that suter hospital, and how