construction side is that we already have a very robust program through city build and with the man date that we have on funded projects for local hiring it is easier to fulfill, so i do want to make a dist tinkss e tinction why construction will have good compliance numbers because of that program and also want to make sure we wh we talk about first source, really the-what you have to hit is a good faith effort qu not a hiring effort. i want to make sure that we are-you can actually make the distinction between the 2 because i think we are showing there is a strong effort or demonstration of hiring local residence, then i think we growing above what the va says and i want to make sure we are clear about that as your presentation goes forward >> i'll get into it it on the operations side. it is both, there is a good faith and

hiring goals in the development agreement. unlike most first source project with simply good faith efforts there is a hiring goal attached to it and will get into that more on the operations side as well. this to your are point supervisor achb lose, on the operation side there is a hiring goal that 40 percent of intrelevel positionerize filled with [inaudible] the hiring years are august-jul. y. there is a provision in this in the development agreement that says, if in any given hiring year the 40 percent goal is not met, then the number of intrelevel positions contituteing a hiring deficit will roll over and be added to the next year so it has more teeth than the standard first source hiring has or the other

employers covered by first source. just to explain more in detail, this is the example of in the development agreement. if in a hiring year let's say cpmc makes 100 entry level hires, at least 40 are supposed to be through our system. if they only make 30 in that hiring year there is a 10 higher deficit that roll tooz the next year and added on to the 40 percent that they are required to do fl that year. a later in the presentation i'll get into specific numbers, but just to explain this idea of the hiring goal and how any deficit continuing on until it is filled by cpmc. so another think to keep in mind with the development agreement, it has proprietor neighborhoods outlined here in terms of hiring entry level. western addition, tenderloin, [inaudible] china town and what the development agreement calls

[inaudible] that is what the development agreement said. let's get into the number as little bit. on the next slide this is the operations project from the start through april of this year, there is 159 total entry level hires, 45 of them have been through the work force system so that constitutes 28 percent short of th40 percent required under the development agreement. i will say for this year in august cpmc is 35 percent so there is improvement but they signed a development agreement that says 40 percent so there is work to be done. the percent that are from the priority nirebds is 76 percent. what we have at this point at the end of april

is a hiring deficit of 19. they have a ways to go to catch up with that, but we are on a upward trajectory. just a couple more slides, i thought this may be of interest. for the 45 system hires this breaks s down what occupations folks have gaulten at cpmc. maybe one way to look at this and how the system looks that the hires, if you look at clinical position and positions that deal with patient versus non clinical, 18 of the 45 oare clinical and 4 [inaudible] >> can i clarify one question? >> sur >> so the good faith effort are supposed to reach 40 percent of all entry level job openings, but what did you say was the prertage that they reached-19 percent deficit,

what is the percentage they reached? >> on that slide if you look that third column they are at 28 percent #23r5u78 the project beginning through the most recent data available which is april 2015 and that creates a hiring deficit of 19 >> since they didn't meet the 40 percent that deficit is added on top of 40 percent for the next period? >> exactly. let me say this, it is a 10 year commitment to hire 40 percent through the system. if at the end othf 10 years they have not made up the hiring deficit than the commitment continues to hire tup to whatever that deficit is and at that point they will have fulfilled their obligations under the development agreement. let me go to something that is in the development agreement and just kind of gettinggetting-taking

form, which is good. the work force [inaudible] grant agreement. cpmc is required to make a 3 million dollar payment to a fund administered by the san francisco foundation in turn is awarding contracts to community base #d organizations focusing on [inaudible] and job training. the initial round of contractss was awarded in spring och 2015 so contracts just went out. what this does is create a pipe line of applicants from the work force system with training that is customized to work at cpmc and other medical settings so hopefully this will show a impact on hiring. the final slide to your initial point supervisor avalos, there are 2 ways to look at the projeblth, one is the 40 percent hiring

go. it is important to note from a compliance standpoint with other employers subject to work force hiring the key is whether the employer made good faith efforts. so, what i listed here, the initial failings by cpmc, most notably the failure to submit entry level job notices until december 2013. the date of the notice was august 2013. a failure to submit entry level hiring projection until april 2014. there were 2 noticeable failures at the begin thofg project. there has been improvement and i listed some here. at this point we get daily submitting of the job notice said. for the currents hiring year we received entry

level hiring projections. there is month late reporting which is helpful to us. the development agreement requires reporting every 6 month, cpmc is doing monthly. and some of the others listed there. regular meetings and conference call. we gather every 6 weeks to make sure the system is working and trouble shoot issues. this one i think is important, cpmc has done training of the hiring managers and made a better connection with the hiring managers, recently the community based organizations took a tour of cpmc and met hiring managers face to face. 2 more hiring events and applications work shops in priority neighborhoodss. airfb 6 weirs or so the office brought cpmc

to the different priortaef neighborhoods. this is mentioned from the gentlemen of cpmc, they added stuff that is helpful in terms of the data and referm referral system. we are here to answer questions or take session suggestion >> i know the [inaudible] i can't stay long and have a clarifying question. i do see from the initial 2013 year which is actually very close to the end of that year was close to when we approved the [inaudible] compliance issues but given the start up and i understand that. it shows there has been improvement, but still a ways to go if we look at actual hires. i just want to be clear that the measurement is not the good faith effort, but the actual

hires as you mentioned? >> there are 2. they are bound by the 40 percent, but when it comes to determining good faith effort the 40 percent is not a part of that determination per the development agreement. the good faith effort is consistent with good faith effort criteria for all employers covered by the law, which do we get the entry level hiring projections and does cp mc reserve [inaudible] only the candidates to be interviewed and hired. whether or not nay hit their 40 percentwe want them to hit the 4 percent but that isn't part of the good faith effort >> if there isn't foret percent they need to make it up the next year >> not meeting the 40 percent they are still on the hook for

those jobs and continue to add up >> that is all my questions >> department of public health >> good afternoon supervisors choline [inaudible] department of public health here to update you on the helt care obligations and development agreement. this is a summary of the da provision relating to health care. i will go over just a few of this in the presentation today. base line charity care which says everything else in the development agreement that relate tooz helt care that cpmc does is in addition on to what it did when it enter thd agreement. making sure everything else is adding to what cpmc was contributing. you heard a announcement from doctor [inaudible] and talk about new med kale ben fishiaries and the 1500 that are located in the tenderloin. i'll give a update on the

inooivation fundss similar to work force fund and held by the san francisco foundation where grants are given to support community based organizations fooprovide health care and avoid unnecessarily hospital ization. the other is the cull charl and link wisticly class standards. starting with the base line charity care, as doctor browner noted they must provide care to 30, 445 medi-cal or charity patients. last year we were notified they were likely to fall short of that obligation for 2014. the da provides for a 2 year rolling avrrj so the 30 thousand can be made up in any adjacent year to the year they fall short so we are working with them in 2015 to make up

for the short fall they anticipated. we met in december with representative from san francisco general hospital to see if there were ways to have cpmc meet their obligation and reduce the waiting list at our own hospital for services that we provide that were low income patients are waiting at our own hospital. what we decided, we came upon a agreement where cpmc provides 1 thousand echo cardio grams and 400 pulmonary function togess for our patients waiting for those services a. a echo cardio gam a ult rosound that determines the causes of abnormmalitys of the heart [inaudible] we had significant wait list for these services affs. general hospital. several factors went into our decision of the services to choice and identity

a partnership that is a benefit. we want #d to increase access of care for patients on waiting list so we looked at those services with a waiting list at san francisco againeral. the second is continuity of care. diagnoseests is nob nab surgeries or out patient procedures require longer term patient interaction and follow up to maintain high quality care and this can cause confusion for patients who may not know where to go and requires a lot of data exchange between providers in different networks that our systems are not set up to exchange at this time. finally it had to be within cpmc ability to provide. as supervisors may know, position employed in hospitals are largely independent oceans and not employed by the hospital so we need today have the ability to provide the services that we needed

directly so diagnoseistics were the perfect choice. cpcm is providing this sirfbss with now reimbursement. this we thought was a great win for both the development agreement to make sure the obligation is met and the health met network to make sure the patients had access to care. the 1500 med kale ben fishiaries. we are pleased cpmc and north east medical services and saint anthony can come toa grument to meet the obligation. the original intention is funding 9 community based clinic that look at becomes a management serbs organization that can do business with medi-cal care and

cpmc. the innovation fund supported the community clinics in order to do the research to determine whether this is feasible, whether the clinics can bind together to do business and manage med kale. thaused innovation fund money to hire a consultant that said it wouldn't be feasible to come together. they would lose money by year 2 and not sustainable over time. they included looking at curry senior center and tom ludel partnering with north east medical service squz we are pleased we are able to announce today that a part numbership between mims and saint anthonys will move forward to allow cpmc to meet the obligation >> i wanted a acknowledge

this is a popular hearing that the [inaudible] is opened up for additional [inaudible] and if anybody wants to fill out speakers cards please fill them out and we'll make sure they are acknowledged here in this chamber >> thank you. the next area i wanted to cover has to do with the class standards. this is cultural and linguisticly appropriate standards. the class standards are a national standards and a blue print if health care organizations to implement cultural and linguisticly service said. they are broad guidelines [inaudible] and practices and preferred languages that address health literacy and other communication needs of patients. while cpmc is compliant with the development agreement requirements, service changes raised question frz the department of public health to

the extent the standards are implemented throughout the hospital. in march of 20 wub 5 [inaudible] 2 level peer review conducted by cultural ling ristic access expert within the department of public health. one was a high level hospital wide review that looks at cpmc as a whole. the second was a more in depth review focused on the diabetes clinic at saint lukes. there is staffing changes relate today the saint lukes dibeaty clinic and proposed or own bilingual staff do a peer review of cpmc dibeaty clinic. in may of this year just this munt cpmc advised it will perform its own review uses outside expertise. they will hire a consultant who will do a review of their

compliance with the class standards hospital wide and with regard to the dibeaty clinic. that review will be performed within 120 days and will share that report with debarment of public health. they agreed to share information that will allowtuse perform a high level review that we will also do. the innovation fund is aortarea i want to highlight t. is held at the san francisco foundation funding decision for the innovation fund are made jointly with representation on a small committee that includes san francisco foundation, department orphpublic health and cpmc. 4.6 million of 8.6 million if had innovation fund has been deposited thus far and pleased to tell we awarded 3.3 million. i won't go over all of the list of services or

project awarded. you can see them listed there. 740 million is estimated to be awarded later this months. the goal is to target low income community to develop community base cupeacety and development programs and serves that reduce the need for unnecessary hospitalization. finally, i wanted to talk a little about saint lukes community engagement. the health and planning commission had a joint hearing in december of 2014 and both commissions and theect director of health and planning in their compliance certification advised cpmc to engage in a on going dialogue with communities suronding their hospitals. director garcia met with staff to request this of staff. in may

cpmc aconvened a group to plan a meeting around the saint looks campus to be held in the summer of 2015. this smaller meeting included representative from supervisor campos office, public health, the mission [inaudible] asian [inaudible] san franciscan for heth care [inaudible] at this meeting cpmc and the group shared ideas for structure and content for the community meeting to happen in the summer and cpmc is planning for that meeting now. the overall meeting plan is that cpm made the commitment to present information on what was going into saint looks hospital and hear community interest and concerns about what they're planning. that concludes the health care presentation. at this point i'll turn it over to liz watty >> thank you >> thanks coeen. to wrap up

the presentation i want to touch on the issue of the [inaudible] is the planning and [inaudible] is required to be impt lmented by cpmc between 2 and 5 of the agreement and not a requirement of the 2013 reporting period. this particular component of the tdm plan is tied to population shaft away from pub suffolk and california campus that occurs with the opening of the hospital at van ness and geary. the purpose of the plan that includes a [inaudible] is one of many franz portation demand measures and reduce the drive alone rates and reduce parking short falls and environmental impact related to traffic air quality and green house gas emissions. with that supervisors that is the end of the presentation. thank you >> thank you. is there anything else in terms of presentations? i know we heard

from cpmc, anything else to be added? why don't we turn it over to public comment. i know we vanumber of folk squz i have a number of speaker cards so limit public comment to 2 minutes. at 1 and a half minutes there is a soft buzzer that goes off. as i call your name if you don't mind lining up on inisle to our left and your right. i apologize if i mispronounce your name [inaudible] mark snideer, [inaudible] ken barns. gordon mar, lay law [inaudible] sara [inaudible] ameet susean. mary [inaudible] calvin welch >> before mr. ramose speaks, the overflow room isn't the

north lighted room [inaudible] room 416. >> good afternoon. i'm a [inaudible] here with san franciscan for health care housing jobs and justice. a community labor coalition that works to insure the cpmc reconfiguration of had san francisco campus serves the interest of patient, workers, nairgds community and city a as a whole. [inaudible] is not living tupe the development agreement. we need jobs and helt care and expect suter cpmc and neat the needs of all san franciscan. we expect the city to insure suter keeps the promises but the city failed to [inaudible] makes excuses and ignores local hire and transportation provision of the development agreement. the compliance monitoring process has proven ineffective cumber am some and delaid. the community should vasay in the

service mix of the hospital and where and how tenderloin residence will accept hospital and specialty care. we are not interested in being breefd after the decision is made. monitor compliance and [inaudible] if the city doesn't call suter cpmc on the non compliance nobody will believe the mayor or planning department the next time they try to sell [inaudible] all future development agreements must include collateral agreement with community coalitions to participate in monitoring and compliance >> thank you, next speaker please >> good afternoon may name is mark snideer and resident orphmilly vala and emergency physician nom[inaudible] medical director of the emergency department from 99 to

08 and emember thorf board of directors [inaudible] a period that includes the historic [inaudible] appreciate the role [inaudible] excited to watch the construction process, however i'm concerned that cpmc isn't fully honored the terms of the agreement. i'm concerned about the failure to meet the man dated number of charity patients in 2014 and dish missile of bilingal staff at the dibeaty centers. they fired the nurse manager a bilingual dietician and clerk levering a part time nurse with limited [inaudible] this isn't in keeping with the terms nof development agreement. i support the proposal of the collateral agreement for san franciscan for health care

housing jobs and justzs that incleeds transparency and [inaudible] thank you >> thank you and i will read a few more names. peter cohen, charles [inaudible] kim [inaudible] cathy [inaudible] gill nob >> hello my name is bob prints and came here to exz spress concern there isn't agreement on the [inaudible] as you heard doctor browner announced they reached ongrument with saint ant in a. i think this week [inaudible] she has been very open with us about the progress. i hope this is good news. i expect it is good news. saint anteany is a credible provider. there was a meeting in the tender loan erloin who expressed a intres in being able to tell cpmc what

thairb preference would be and how to get helt care in the tenderloin and would like to take that theme and apply it to [inaudible] to plan a community forum that would describe what the plans for the rebuild of saint luke suz about. i think we had a honest exchange and made it clear it is our hope and expectation this isn't just a presentationf, this is a opportunity to talk to people in the community but about the what they need in health care. as we discussed from the folks from cpmc, we have gone a long way-there was a time the hospital inpatient is closed, this is a time for us to say that decision is made, how can we work together to make this the best hospital possible. i'm hoping the 4m we jointly plan with thythem will be a opportunity for people who historically used saint lukes and continue to use saint lukes

to help people make decisions understand what the needs are and they take them seriously >> thank you, next speaker please >> my name is kim barns and i was a primary care physician at saint lukes for 32 years leaving 3 years ago. i would thrike address twoe issues, the dibeaty center and lack of community participation in the planning of services. on march 12 of last year cpmc announced the lay off at the dibeaty center you heard about which amount today the entire bilingual and bicultural staff. this was done in face of the fact that the large majority of patient at the center were spanish speaking and 52 percent had dibeaty of pregnancy, a serious condition. [inaudible]

use interpreters, a poor substitute for spanish speaking providers. physicians involved with the center were out raged as well at patient. cpmc's reply, we'll study the condition and report back which they have not done. people have to call a third party to get an appointment rather than having something directly add the center. the second issue i wish to address is the lack of accountability and transparency for cpmc. for over 2 years sf [inaudible] tried to establish a relationship with cpmc that allows the community to participate in the planning of services but was met with a stone wall. cpmc did convee a