practicing primary condition there for 10 years. we are a community helts center serving [inaudible] we clinics in china town, nob gnaw the now jort of the patients are low income, minimal proficiency and on med kale. cpmc is a good neighbor and prend to the patients. we collaborated on many projectsover the last 15 years and the patients received world class care from that partnership. cpmc provides specialty, emergency and patient care to 3 2 thousand medi-cal ben fixiaries. this number will be increased by 1500 with the increase to include the tenderloin patient fraul saint anteany. cpmc provides specialty inpatient and emergency care to the san

francisco patients. over 500 of the new borns are delivered at cpmc annually. we also partner with cpmc eliminating hepatitis b by offering free screening and vaccination. we collaborate with earlypede atric development and behavioral health program to treat children with behavioral health program. cpmc provides a generous grants to start a hospital discharge program this year. cpmc has been a great neighbor and prebd for to low income and underserved patients. we look forward to the work with cpmc and very excited to bring the world class care offered by cpmc to the tenderloin patients. >> thank you. i have a few more names [inaudible] charley walker. doctor sonia [inaudible] who may have spoken

already. shirty johnson. evelyn [inaudible] >> hello, my name is putrees hamened. i'm a patient access representative at the out patient lab and radiology department at cpr-m rks crmpth i grew up and reside in bay view of san francisco. before i was employed i was out of work for over 6 months due to being released from the employer who had to close auchs in bay area. i found challenging to find a job. i applied for many positions with different companies around the bay areas but nuthering nothing worked out. i came across first source and was delighted that they knew many positions available. from there the world turned into a positive direction. upon the first encounter with first source i

rchbed great feedback. they referred me to cpmc recruiter [inaudible] made it possibly to get in contact with the supervisor at cpmc. so far i learn so much being i have only been employed with the company since accept 2014. i have been cross trained for many departments. i feel like all the experience and nouj i have and still will continue to gain it will help in the future with other position. ingeneral the experience is amazing and i'm grateful for all the opportunities that i have that have come my waimpt i come to work every day prepared to learn something new and take on challenges as they with when. i look forward for the fuchture

>> thank you very much. next speaker, please >> good afternoon sprooizvoor. dave gnaw nob exponentecutive director of curry senior center located a couple blocks from here. we a fortunate to get a innovation fund grant few years ago. innovation fund isn't a blank check t. helps you get the next leap forward. we do 3 very important program frz seniors. we had a chronic dephreez self management class. that may be a mouthful and sometimes you have to entice seniors to come. they want to keep coming after the class to socialize and talk about health and obama and the giants. helt coaching program, a lot of providers think they know everything and they do know a lot and it was

reluctant to give up power to health coaches. helt coaches help clients when they walk out of the exam room, 50 percent of those that waum out of the exam room, don't know or remember or follow the instructions. the helt coaches are helping support our low income seniors in the tenderloin. we also received funds to certify or diabetic education program which means that thofend 2 and a half year funding we will bill medicare for this work and not receive new fundings >> thank you very much. next speaker, please >> hello supervisor, my name is rodric [inaudible] i'm employed working on the cathedral hill through [inaudible] construction. as a san francisco residents i'm honor and pleased that cpmc gave me the opportunity to get the job and work that particular project because

there are a few other people that have been here speaking, i had a hard time look frg employment for like sth past 2 years and cpmc provided the opportunity to get the job. not only to get the job, but provided for me tago to program and school and learn the proper fundamentals of construction and other trades, so again, if it wasn't for cpmc i would not have this job now and i'm honored. if it wasn't for them a lot of people would have jobs in the community. >> thank you sirb. next speakers >> thank you for the opportunity. my name is page lee and i'm a registered nurse at cpmc california campus. i irk would in the labor and deliver ey for 10 years and a nurse for 22 years. my issues is that i congratiate the residence for their jub thank

cpmc giving the workers their jobs it isn't enough and they are not living up to the commitment they agrud to and we need to remember and recognize they are not libing up to the agreement and roll tg over is not the same as libing tupe the development agreement that they agrud to. when they say they made a commitment they are not up holding their commitment and we need your support on this. the nurses are struggling day in and out and asking for your help. we are nolt get thg support that we need, we are concerned that the entire community will suffer. i know supervisor campicose you have been out in support of us when we came to you, but we feel our voices are not being heard. time and time again we are talking about the labor struggle we have and the staffing struggle and we feel our voiceerize not being heard.

these agreements that are coming together feel pretty cozy here when mr. welch mentioned it was interesting the last minute agreement came together one day before this hearing. suddenly the 1500 residence of the tenderloin were going to get their health care needs met when for the last 2 years st. didn't en. that isn't okay. this development agreement is not enforced and ask you please to come together and enforce this. cpmc needs to be helds accountable >> thank you very much. next speaker, please >> good evening. i'm amazing not amused by there fact that i don't know where the other board of supervisor members are, but i came today to tell

you, this is the first job in san francisco and the only job has been particular about seeing to it that they hire african americans. this is a pattern that every contractor in the city should follow and if you don't think i'm telling you the truth check every job in this city. you can't find not only black employees, you can't find black contractors. it is as if black people are non existent in san francisco. [inaudible] is a example of what needs to be in san francisco. san francisco has became a haight town for black people. let's face t there ain't no sense in [inaudible] under the rug. that is what is going on and what has been going on and ararea bolt decide

that they were going to play a better game and i am here to comp lment herra bolt and say to all of you, the city of san francisco doesn't see that black people have jobs in the town, but her rks are a bolt i take my hat to had only construction company i had dealings with that are seeing to it that blook people have a opportunity as white people. thank you >> thank you. i have a couple more names. cholineup >> [inaudible] employed by wicat industry, a subcontractor to [inaudible] bolt on the cathedral hills project. i don't have a sfeech prepared by my history was a sadey one. i spent a lot of times in the

institution and doing crimes and decide to change mife life and wicat gave me the opportunity to do that. i did 17 years and got out and didn't have job skills. they sent me to training and got the necessarily qual fiication squz certifications to be qualified. they give other guys that opportunity too who want to change liar life. those guys in prisons are coming out and hurera bolt, the atmosphere is non judgmental and you have a equal say so in what is go ing on >> thank you for sharing your experience and for your courage. >> my name is deborah [inaudible] registered nurse alt cpmc. i'm glad to have a chance to speak about things that have been irking me for quite a long time. one of my major concerns is the we put

all the eggs in one basket and --[inaudible] i'm concerned that once again we are shutting down acute care hospitals and emergency rooms and putting all our egg uzin one basket. we have never solved the traffic issue around the situation with cpmc. the other thing i'm concerned about and it is related is what ask happening at saint lukes. yes, we saved the hospital, yes we turned it from a [inaudible] 120 bed hospital, but i would like you to look very carefully how many of those beds are now being turned to skill nursing beds. we shut down the sniff at cal campus. we used to have 40-60 beds there and now suddenly there is all this room at saint lukes and maybe at daveies and out in the community i have been told time and time again

cpmc shouldn't be responsible for all the skilled nursing positions and there should be places in the community and the community will absorb these patients. we discharge patients daily fairly healthy from the orthopedic floor and i don't know where those patienterize going to be going. thank you. >> thank you very much. next speaker, please >> good afternoon supervisor, my name is evelyn [inaudible] i work for cpmc for 35 years. i work with patients in skilled nursing facility who needs lock term care. cpmc is reducing the services and we believe they do not intend to have this skilled nursing facility services in the new saint lukes hospital. the nob nab cpmc accountable to our patients and

our communities. please, help us protect our patients. >> thank you very much. next speaker >> good afternoon, my name is shurly [inaudible] i'm a nurse at california pacific medical center. i'm here fooask for your support for holding cpmc accountable for to the community and staut the [inaudible] the skilled nursing facility they shut down and had nurses scurrying around to fill positions that other campuses at the last minute t. was like they were holder their breath to get a job. i want to address the issue where cpmc said they are filling all these jobs and the jobs that they fill are clerical positions, but they failed to say they was

outsourcing most of those jobs to another area code. trying to get services such from human resources or get your pay roll, anything that you need to get information about for yourself is like pulling teeth. these jobs are out sourceed to people that don't go the protocols with cpmc and it takes a act of god just to get your money back, get pay roll issues addressed and supervisors have called back people to talk to-it is just like you are-you call in for 2 to 3 weeks to get a issue resolved. the jobs are not given to the people here, so you need to look at the example they are setting right now and look for wherethey are going with this. these jobs are being out sourceed. they are not given to the people in

the tenderloin district. when they say are giving these jobs to people in the area, we need to have cpmc be held accountable and keeping the jobs of the people they have here and making sure they get to be able to keep their time and have their issues addressed >> thank you, next speaker please. at this point i have one one card. any member of the public who has not spoken and would like to speak, please come up >> my name is choline phurenol and organizer for [inaudible] disappointed to hear yet again cpmc is [inaudible] similarly cpmc is failing to fulfill commitment to current employees. we are in contract negotiation right

now and currently cpmc proposed high cost on the health inshirns to employees while failing to provide for what we consider a living wage to survive in san francisco. while it is important cpmc fulfills the promise to hire people from san francisco, they also need to provide these employees once they are hired with a actual decent living wage including affordable health care cost. i would like to let you know the next bogerning session is june 12 and the members committed if there is not a serious contract settled on june 12 that the employees will be on strike. thank you >> thank you very much. next speaker, please >> kim [inaudible] national union of health care workers. i said it at the last hearing

which seens it was a few months ago regarding cpmc. it was like plague 3 card mont aey hear today. looking at this company they pulled a rab out of a hat but didn't look at all the other cuts they have done to the community. they took away 100 skilled nursing beds. the department of public health said that would be detrimental to the xhunty yet they did it anyway. they are not fulfilling the promises to workers or nurses so for every good thing they dothey do 3 or 4 bad things and it is a matter who is on the short list. you heard probably 100 people here today saying they are not doing what is right. people from the community and people not receiving money to sit here

today. i saw one of our workers. they were offering to pay us today. do you realize your contract is tied and won't get a fair wage and threatening to cut your health insurance. they left. you have to look at the company where fr what it is. they lie and cheat and steel and it is suter and everyone elses wall lt. find a way to hold them accountable. do a collateral agreement. if they are doing everything right they shouldn't be squared of it but they are scared it and that is why they'll fight a collateral agreement >> thank you. next speakers >> my name is [inaudible] hearts. i came to support [inaudible] cpmc and c they were able to let me have a job. i was incarcerate frd the last 12 years and they have been a

help to me. >> thank you for sharing your story with us. >> my name is michael [inaudible] and keeping score back there. 19 proand 32 against and 192 uteral. it seems to me cpmc needs at the very beginning a pr firm finding out what the community needed and going to the community and engage the community, but now it seems like they are having a pr night maer of going to the next steps. i would just suggest to them and hope maybe you can suggest they need to do better job with pr and do the fulfillment of agreements they had. i don't want to get into the the fegative because they already heard 32 speerks saying negative things about the cpmc, but i want to say i'm glad to

see the voices of the neighborhood and community come out and speak what they believe is happening to them and has impact in their lives. again, i hope that the wisdom of the board will prevail and come to some-reach out to the community and help the community where their needs are not met >> thank you very much. i would like to ask any member of the public who hasn't spoken to come up? seeing none that concludes public comment for this item. i want to thank colleague frz holding on to questions until after pub lb comment. i have question and colleagues have question so mr. chairman >> let's close public comment and proceeds with questions >> thank you very much mr. chairman. i want to thank you first and formost all the community members who have come out and sat through this

meeting to speak. i also want to thank the different government aensh who have presented and also want to thank cpmc for their work as well. in this caning about this, my question are focused on some of the issued raised by the community and the letter that was pernted by lieu jurado who was the third party monitor and mediator. i think that what mr. jur audi says in the letter essentially summarizer where i am, which is that i appreciate the areas where there has been a lot of work in that there has been compliance in those areas by cpmc. i think you have to recognize and

give credit with wherethere is credit to be provided, that said, i think that i share what mr. jurado said, which is that there are many significant concerns in areas where there has to be improvement and where there has to be a response. with that i would like to focus on a couple and i know some of my colleagues have-in terms of the baseline charity care, if i may ask the department of public health or who ever is a good-mr. jurado notes cpmc did neat roirmts requirements for the 2013 calendar year, but the

department is away they may not meet the requirement frz the 2014 calendar yeerb. if you can tell pus exactly the specifics of what that looks like. you are working with cpmc-i know there was reference about some of the things that you are planning to do, but how below are they and & do you see that the obligations is met? >> so, the obligation is to serve 30.445 unduplicated lives, low income folks, charity or medi-cal patients in a year. in any one year cpmc falls short they haveajacent year to make it up. if they had done more in the year previous the average of the 2 years as long as it is 30.445 they have sth falling to make

it up so the average is 30, 445. in the fall of last year we were advised they would between 12 and 1500 people short of meeting the 30, 445. we began a dialogue in december to try to insure that they met the commitment that they had made and also to help the patients in the system to reduce wait lists. for the criteria i described previously, we decided diagnostics is the best methed to do that. we had wait lists for diagnostic services and it helps our helthd care providers expudt care to the patients so we decided on echo and pulmonary function tests and

they will be perform 1400 in total of those 2 tests. presumably the rest is made up in care they provide in other arrangements or through patients come in 34 existing medi-cal or charity care avenues >> i know as we go through the naishation one of the concerns at that time is relative to other institutions cpmc was not doing enough from the perspective of a lot of us in terms of charity care. do you have a sense of plan in terms of on going monitoring to make sure that the goals laid out in the da are met and in there is ongoing monitoring? can you talk about what you are thinking of doing going forward? >> as the supervisors likely aware there is a annual

reporting requirement which is the end of may of every year for the year proir. we have regular meetings with cpmc cl is why we know in the fall of last year they would fall short so we are in regular dialogue with them to make sure things go to plan >> i think it is helpful if you continue to update as you continue the conversations. update the bord and also incommunity >> i also have regular meet wgz the coalition for health care housing and jobs and justice where we discuss these issues >> i know supervisor mar has questions about the tenderloin and other things, but want to talk more about what happens with saint lukes and something that was issue and where

you see this going from here. >> so as i mentioned, we had suggested to cpmc department of public health do a peer review to level peer review with class standards. at one level it is hospital wide to look in the high level at the class standards and policy and procedures they imp limited in the extent to training and

monitoring of the implementation of the standards was done hospital wide and then we proposed a second level more targeted to the saint lukes diabetes clinic. it was more in depth and performed by bilingual staff at our own diabetes clinic that includes in clinic time monitoring patient interaction and going through data and patient records in compliance with patient privacy requirements. cpmc responded and will hire a outside consultant to review compliance with class standards and agreed to give additional nrfckz to do our own review as well. the report that cpmc has committed to will be done in 120 days from now from may and we anticipate our own staff will review the documentation and data in that report as well as data they neme necessary to

class standsards >> in termoffs what happens once the report is presented and reviewed by the department, what do you expect would be the next step following that >> ? >> it is likely our own health commission would like to review that report and our own staff with would look at the report and cultural comp tent staff would take a look at the report as well as the data they provided >> something else we discussed is having a process public discussion for the service at saint lukes which is a key concern underlying the development agreement of course, so can you talk about what that process will look like and what you plan to do >> this is something important to director