mentioned the fact there is going to be a parking deficiency and green house gas, all those components [inaudible] that is in terms of strict compliance that is our position. it is my understanding cpmc is working on this and trying to figure a way to implement this sooner than they center to. i would defer to cpmc to chimeen in on that piece. we are supportive if they would like to roll this out earlier, but they are in compliance with 2013 obligation >> i could like to give cpmc a chance to respond at least around by egz quz of saint lukes, the clinic and the transportation piece. i also want to acknowledge mike cohp hill who is here and played a variety important role in the process and we certaintyly

appreciate his leadership. doctor browner, the floor is yours again >> i do want to correct a couple misimpression about the saint lukes diabetes clinic and also our role in engaging with the medical staff. i meet with the medical staff monthly. i will meet with them at the conclusion of this meeting and sure we'll talk about the diabetes clinic. 70 percent of those patients seft identify at english as the language, 30 percent is spanish. of the 3 providers 2 are bilingual [inaudible] of the visiting providers they are about 70 percent bilingual and spanish so it is not true we are not providing bilingual services to patients who need them and it is true the quality of the care we provide is first rate and

invite you to come down and see that first hand. we are extremely proud of how we are doing to help patient manage gestational and other forms of dediabetes. we knhimented to look at cultural and lick wisticly appropriate services. as i think you real aiz, those standards are not as spinge as many of the other standards hospitals live up to and hofep by engaging in nationally recognized expercent figure how to do better. in this city which is one of the most diverse cities in the u.s., it is our oubigation to take the lead >> i would simply say i agree with i think how lieu jurado kwibeed the issue in the letter and hope that we can continue to work on this together on

this. >> any other questions for me? >> on the-going beyond the diabetes in termoffs a process around the mix at saint lukes if you can talk about that >> as you know the commitment and development agreement and the full intention is to provide a full service hospital at saint lukes at the campus with 120 beds. it will be vibrant part of cpmc and suter health. we graint graitded many medical services provided at the other campuses at saint lukes. recently for example, the an sthees aulgist and path omgist and emergency room doctors and inturnest are working at all the campus squz will expand those services. it will be a integral part of cpmc that we will all know and love in san francisco. we are very

proud that that building is going up and on schedule and look forward to be with your for the ribbon cutting and think you'll be delighted for the services provided there >> i appreciate that and still have a year and a half left >> we are not going to rush the construction that much >> can we talk a little about the transportation piece? i know there is a difference of opinion in terms how people read the development agreement, but i do think this is one area where i'm hoping we can work together to expedite that. >> i'm not sure-we participated in writing the development agreement and was intend today be a response to the new hospital we are building at van ness and geary. we engaged a expertd in the process on the staff of

reviewing all aspects not just the clipper card, fwut parking and shuttle and free ride services and bikes and pretax. she is developing a plan. i will review that plan and implement it and hope by 2017 we will be compliant. we want to do thisen a respectful way so we can manage the transportation demand in a effective way and not rush to something simply because it is expedient >> the last point i would make and i know that supervisor mar and christensen have questions is on the hiring. i know as mr. jur ardo noted you did meet the obligation arounds construction and want to say that i'm appreciative of that

and appreciative of the people that came and spoke. it is owl owl moving spaens when it challenges of the folks that are hired have and have to say for me especially the challenges for previous incarcerated folks, the challenges that come with that experience--i'm very appreciative of the courage people have when they share about that background. i think it is great we have done what we done and hope we can do more because i think the is a lot more of a need in that area. in terms of beyond construction, some of the other objectives where i know that the start was not what i think we all wanted but think we are moving in the right direction and just hope that we can do oo lot more. the thing about san francisco right now is that even though there is a great deal of wealth and prosperity

for some communities they are not sharing so thipg this project provides a opportunity to do that so i want to continue to work with you on that >> i couldn't grew mow. i think the success we had in construction and hiring is no accident, it reflects programs that were put in place long before we started our project. the difficulty we had in meeting the 40 percent goal i think has been resolved. we actually-i want everyone to understand, we are hiring more san francisco residence than we get credit for because we only get credit for those that come through first source and it tooks a while working with first source and hr to work out all the kinks. you started to hear the kinks are recent hiring numbererize first rate and confident we will not only meet the 40 percent goal, we'll also make up the deficit and

will be a example and one i would challenge other employers including some in the room to meet. we worked really hard to meet that goal and we are very proceed of the work we are doing >> thank you doctor browner. i'll turn it over to chair mar or sproovisor christensen >> i dide did want to thank you for being up here and follow up on what some of supervisor camp pose missioned. many in the audience question the good faith efforts in the jobs we were talking about. i think they showed in the first year there was only 13 percent of hiring and i know that was a concern of lieu jurado. 13 percent in the first year, the target was 40 percent. you are saying you will make up quickly-as quickly as possible to get tupe 40 percent plus the

deficit and that is the pattern you see? smin the audience said it is suspicious that up to jan the numbers are dismal but since the time they are improving but you are saig it is a strong good faith commitment to make up that large deficit? >> absolutely. i would reiterate the commitment to first source and working with first source and hiring san franciscans for entry level jobs is that strong as the commitment we made around construction and the difference was one was a well oiled machine that we were fortunate to participate in and the other is a new process. when we discussed the agreement before we negotiated and signed the dwument agreement tfs a concern whether we would have the ability working with the city agency tooz get this up to speed quickly and the answer is

we didn't and acknowledge that, but it is now and you will see much better results going forward >> i know for the fixed target neighborhood with the highest unemployment rates selected there is a spread of different members from different neighborhoodss but for the tenderloin which was one hire in china town and zero hires of thedalitya we have. in the future there will be more representative spread of how people are hired-will outreach be done differently to target the neighborhood that are doing more poorly than the first year data shows? >> we are reaching out to all neighborhoods and having regular job fairs and i'm optimistic we can do better in those neighborhoods. the commitment is there. the other neighborhood we medicationed wree more successful in. i have to give credit to the local agencies in the neighborhood that have done a

good job of helping us >> this may be to your staff and also from [inaudible] oawd. do we keep information on retention rates as people are hired and if they continue on? i think that would be useful. there is hiring recruiting and hiring is one thing and retaining them. how do we insure there is good retention from the fixed neighborhoods and in general? >> so, retention is nolt in the development agreement we are serious and don't want to hire people and train them only to have them leave or lose jobs. we do have information on rekwengz don't have it off the top of my head, but you are nrtd ested in it one of my hr people can provide it for you >> thank you so much doctor broneer. i did have a question for dph before supervisor christensen jumps in and i know we went through information

quickly, but thank you to everyone from the public that testified. i do sense holding cpmc and setter accountable, addressing thealigation of top down decision making and insureing there is a way of enforcing the existing community benefits agreement and think people make strong urging for a collateral agreement so that the community has a stronger voice in holding cpmc account nl to the development agreement commitments. i want to ask about the 1500 tenderloin medi-cal managed care ben fishiaries. initially was there a eft to have 8 non profit clinics toperticipate. now it sems like the mso that

has been selected allows us to move forward, but i want to cloe how many tenderloin medi-cal managed care ben fishraries do we expect with saint antany and north east [inaudible] >> i don't know if saint aenthanys is here, but my understanding there are about 500 or so medi-cal ben fishiaries who are part of saint aenthanys. meds cal ben fishiaries have choice so you can't just move them into a new system, they have the opportunities to go to whatever system they wish. they may remain a part of the health department network or have the opportunity to switch network squz participate with cpmc. the good part about the one of the great parts about the

agreement between saint antean and name is saint antanys has room to grow in ways that other clinics our own denot. they estimate they have room to grow by 3 thousand lives so to see somewhere upwards och 10 thousand visits a year. they have room to help cpmc meet that need. >> i think a strong sentiment from the audience was you have tremendous resources in the tenderloin of community based group. i think i a number of people gave testimony saying that i think it was catherine wolf and others that they are ready and available to give that input as we move forward and insure the 1500 and more from the tenderloin are served. i hope the community coalition

and rez dhochbs tenderloin are at the table to develop the new plans. how long do you expect it will take for saint anth ans and mims to refer the medi-cal managed care ben fishraries to cpmc? >> my understanding is thugrument will allow patients to enroll this sum squr the obbation cpmc has is once we have a mechanism to enable 1500 life commitment to be met t is open until the 15 commitment is met. it is available before december 31 of 2015, now they are in compliance in the agreement as long as they remain open until they reach 1500 lives. as long as we create the mechanism to allow

them to enroll cpmc must accept them until they reach the 1500 >> how is that monitored? >> cpmc will have to report and that is the way we have verified the reports of cpmc compliance with the other medi-cal managed care is through reports that nims runs and also through had san francisco helt plan, which tracks the medical homes of all medical ben fishiaries >> this is a question to follow up supervisor camp pose and public testimony on the serious concerns about the saint lukes diabetes center changes. i guess let me just look at how i would fame this frame this. how can the department of public health play are proactive role in assessing and doing our own assessment of what is happening at the

diabetes center will serve loincome mon olingual population? how can dph play more of a monitoring role and assessing what is happened to give remation tooz cpmc? >> that was our intention with peer review proposals. we have experts that do bilingual diabetes care within our system and also believe it is -it makes sense to [inaudible] we can monitor improvements and assessments they have commissioned it also makes sense for them to do it from within. the work that they commissioned is a good thing and positive step and our own experts can monitor the analysis of the consultant and implementation of the clinic all together >> thank you. supervisor

christensen >> just a few-i think most i'm looking down the list and think my question about language access qu transit subsidies and retention we touched on those. maybe it is mr. brown who would just briefly address the skilled nursing facility question. is there anything you would like to add about the status of that ingeneral with regards to cpmc other than we have a lot of other people out there who need those beds >> thank you supervisor. cpmc is one of the few hospitals that continues to provide skilled nursing beds on the site. we were running 3 small skilled nursing full sillties and consolidated that into 2, one at daveies and saint lukes campus. the one at the saint lukes campus is in the olds

1970 building that isn't seismicly safe. it won't be moved to the acute care hospital. we cerntsly have a average daily census that cudahmsinates or needs in termoffs patients being discharged from the facility who needs skilled nursing. there is a lot of misunderstanding about skilled nursing in the community because all is a another category of skilled nursing that provides long term care, what we call nursing homes and that isn't something cpmc provides. we provide skilled nursing for patient who have been in the hospital that are not ready to go home >> transitional. i think my only comment in general is, it seems like wree focusing on setting goals and monitoring cpmc achievement of the goals and what comes out of this for me today is more how we achieve the goals. i share mr. cohens

concern that sometimeathize community bars a lot of the responsibility for urging and monitoring. i have been through that in a lot of my advocacy work, but what i take away is when cpmc partnered with appropriate community partners they tended to succeed and when those partners and that link is absent success has been more challenging. we have a lot of layers of oversight on this, but that is the question i come away from this hearing is what can cpmc do to coordinate its efforts with the community and community organizations in a effort to ucseeds. there is a lot of good news today and highlighting of other things that could be done better and coming out of the community and tend to see a linkage with the community as a way to find

inovateive ways to achieve those goals and think we all benefit when they that is the case. hopefully going forward the dialogue and overvite will continue in a way that not so much points fingers but figures a way to work well >> supervisor campos >> i want to end this conversation because i know that we have a couple other items and we are risking losing a quaurm. we going to continue to work on this issue. i want to thank the community especially because you have had to come to the hole rr hall a lot on this mpth so many people that played a key role in the community and i see member of the nairbds and labor partners, cna and other folks and know you will continue to monitor this. to mr. jurado, our gratitude for spending so much time on this. to all the city

departments and agency squz cpmc and suter. it isn't easy tocome up here and put yourself out there and i appreciate that and i think it will continue-it will require that we continue to work together and my office is fully commitment today continuing to play a role in bringing everything wn together and special ly want to thank hillary roanen who was planning to be here, but hillary was having some health issues that wanted to make sure she took care of and i know that we are going to keep working on this and i just want to thank everyone for all their work and the work continues. greatly appreciate it >> thank you supervisor camp pose and everything wn for coming >> if we can call this-do we file this or-- >> we vamotion to file and

second without objection >> thank you >> please call item number 1. hearing to consider the premise to premise transfer och type 21 off sale generalliances from 16 west portdal portal [inaudible] flat iron wines located at 2 new montgomery street. serve the public veerns qu necessity >> to the audience please leave quitely if you can. please leave quitely. we have from our a brrks c liaison unit lutenant dave >> before you today as the clerk stated is a application for business to be located 2 new montgomery street. if

approved the license allows to sell spirits [inaudible] this operator proezpos a multitasting room that allows the sale of beer and wine and off sale [inaudible] this applicant operates a business on the east coast operating under the name of flat iron. this is their first venture into the san francisco market. with regard to recommendation as fars points of consideration, i would point out there for 14 recorded protests that specifically regard the protest i make it clear that only one protest was anticipated by the alcohol beverage control. the way i have done by report is bring everything to the committee, but just so you understand with regard to the abc their protocol is as they receive

protest they respond back to the protestant and complete a form and stend is back. it helps prevent bogus industry stuff. in this case only one came signed. for abc purposes for thereis one protest. my records represent 14 in the last few days several more may have come in not included thip report. there are 7 letters of support. i think that neb hasz also increased in the last several days. since i speak to abc's role they don't consider support as a part of the licensing prosand we in the police department do. the applicant is located in a area of high crime and undo concentration. i have reached out most of the protestants in various ways and explained the

intent of the business mpt i would point out that if aproveed the business will go into the sheridan palace hotel. the space is vacant for quite a while. this business model as well as our condition reflects a high end operation mpt i don't see the premises creating blight on the community and don't see it creating amunity program and don't see it creating a police problem. i will read the l condition mpt condition number 1, no nysnotable [inaudible] condition 2, no person under the age of 21 sell or dlerfb alcoholic fweverages. 3, no wine is sold greater than 15 percent by volume accept for dinner wines [inaudible] condition 4, wine shall notd be sold in bottles or containers

smaller than 750 ml. condition 5, beer and malt beverages and wine coolers 16 ounces or less are not sold in single containers. condition 6, exterior of the premise is equipted with lighting and power [inaudible] not disturb the normal privacy and use. condition 7 and think this is important, this is the first time we use thd condition. this was a condition drafted by the alu and are the first in the state of california to use this condition. i think it sets the tone we are recognizing and trying to anticipate impacts down the road because as wy know when legislature makes changes it is

grand fathered into existing licenses. with regard to powdered alcohol in this condition will read the sale service and consumption of powdered alcohol or like non liquid alcohol products is prohibited. this is a condition we request on off sales muchbing forwards until the state legislature resolved the issue. now powdered alcohol is >> can you explain what powdered alcohol is >> absolutely. it is chacktually around for a long time on and off. it was primarily viewed as a food additive and believe that is how it slipped by the state legislature. it is podeered form of alcohol. you can take a 7 up, you can be at at and t park, order a 7 up, pull out a

packet of powdered alcohol poor it into your seven up and now you have a bourbon and 7. these come in all flavors. ironically i see this being a splar trend to what we talk about e cigarettes. there are bourbon jun and vodka and cause osmopolitan and fruit flavored alcohols. i think it will get fixed down the road but see all types of issues and think it is important thaz as a city set the tone for the rest of the state and really start restricting this because like i said, once it hit distribution and there is nothing i can do blt existing licenses but it is prudent moving forward-i don't cease this licensee being a candidate for this product, but think we are remisto not do something >> thank you for being ahead of the curve. it is impressive.

this is like the first within the state looking at the issue on a local level yrkss and spoke with abc and concur would ourb language and we are the first in fact to produce this. moving on let me read in the record our last condition is that is condition number 8. sale permitted between 9 a.m. and 10 p.m. each day of the week. if i can very quickly just speak to the opposition. just a few things. some of the protestants speak about over concentration. that is correct, it is a area of undo concentration, but i think it is important to speak quickly to the fact that the step they are using may be accurate, but not a legal argument. we have >> student -we when we have to be license specific. we are talking about off sale license.