on and it's been on going since 2015. we wanted to make sure to include it here today. i also would like to point out sunday streets program, if any of you are familiar with that. this will be our fourth year of participation with sunday streets. throughout the entire year in 10 neighborhoods across the city, we're there talking to the people coming to the events, getting their input, answering their questions. it's a very grassroots level of community engagement that we've had on going for years, across the city. and we wanted to make sure we pointed that out to you today. it was mentioned the gurerro park community help design what that park would look like. the last thing would be to just note that we had a very lively, exciting, public block party the week before the new hospital

opened. we had more than 500 community members come out to kind of kick the tires, if you will, on the new mission bernal hospital and take a tour. it was a terrific event. this is also a slide that you've seen before. this is a running total. where we are now through july 2018, the total impact to san francisco from this effort has crossed the 300 million-dollar mark. it's something we're proud of and something we hope that the commissioners and writers of the development agreement also take pride in seeing this investment into our community. 2018 accomplishment and 2018 key priorities of course were happy to be founding compliance on all

commitments. i wanted to note a few things here, rather than run through this entire list. we continue to work in good faith and have exceeded the operational workforce hiring goals. that is a tremendous amount of effort in conjunction with oewd and others and we do have subject matter experts here from our team who can answer a specific questions about all the outreach they're doing and the commitment to those goals. we are continuing to promote that. it's just one piece of our commitment to reducing our single occupancy rate. we're increasing by at least two-fold the amount of on campus transportation fairs that we hold. we have many partners there. again, the subsidy is just one

part of the options that encompass our transportation demand management program and again, we have subject matter experts here rigald who can take you through the amazing activity going on there. lastly we hope to stay on track for the march hoping of the medical office building. i think i will just proactively say, as i assume it will be a question coming from staff's key health issues for us to follow-up on or watch. the transfer of service of the saint luck's diabetes foundation to the medical foundation, the benefit that that brings is that there's a receptionist so the first healthcare priority that was noted has actually already been solved.

that receptionist speaks spanish. the secretary in the office who sits right behind that receptionist speaks spanish and the m.a. in the program speaks spanish and is in the midst of getting her spanish certification. healthcare items 1 and 2, as noted by staff, the transfer of that service to the medical foundation, has already accomplished some improvements that we've been talking about for a couple of years. and that concludes our comments and again, we're here to answer any questions you might have. thank you. >> is that it for staff presentations? >> the coalition of housing has

asked to address the commission. >> we can do that as part of public comment. >> that concludes the staff presentation. we'll be available for questions afterwards. >> with that i open it up for public comment. i have some speaker cards. julie, joan yang, larly lou and thomas kravik. >> my understanding was an arrangement was made -- >> we have organized them 10 minutes as organized opposition. >> good morning commissioners and directours. i am a professor at uc hastings college of the law. and director of the community economic development clinic which represents san franciscans for healthcare, housing, jobs and justice.

the community labor coalition that pushed the city to insist on all of the community benefits that we're hearing about today. for the fifth year in a row, the coalition submitted written comments on cpmc self assessment and my understanding is that staff have included those comments as the last item in your packet. the coalition continues to urge the commissions and directors to use this compliance review process, not simply as a yes-no box checking exercise, to bestow the passing grade on cpmc we all know cpmc will be awarded. rather, we encourage you to use this public process to insist that cpmc and city departments

answer some important questions outlined in the coalition's written comments, which i will summarize momentarily and coalition members will expand upon in their public comments. for some of these issues, we ask you to look more closely for others we ask you to take a broader look. and of course, coalition members and i are happy to respond to any questions that you have after public comment. so let me just preview the seven areas we would like you to look further at. the first has to do with charity care patients. here we're asking you to take a closer look. yes, cpmc is exceeding the numbers of patients that its committed to. there's been a great deal of volatility from year to year. we think it would be helpful to ask why that volatility. it would be also informative if

we knew a little bit more granular details on charity care patients. at which campuses are they being seen? what zip codes do they come from? how many are receiving full services? how many are just one-time diagnostic appointments? in an era of electronic record keeping, those are not difficult questions to answer. the second issue has to do with the saint luke's diabetes center, which the health department has noted as one of its key healthcare issues. and the key question there, after cpmc fired its bilingual-buy cultural staff, four years ago, has there been a dim using in ak at th in accesse population it served?

cpmc has not provided the city with information to answer that question. we don't know how many mono lingual spanish speakers were being served in 2014, how many are being served now. that's a question that the public deserves an answer to. the third issue we would like you to take a broader look at, is cpmc serving frail and elderly patients the way we in san francisco would expect a well-resourced state of the art healthcare organization to do. the health commission has heard about the actions at saint lukes with a swim at swindles and we encourage you to use this as an opportunity to get an understanding of whether cpmc really believes that its treatment of frail and elderly

patients is the best that it can do. the fourth issue has to do with an center for excellence in senior care. on that point, i will distribute a written statement from dr. ken barnes, that outlines the coalition's expectations for what a center of excellence should look like. the fifth issue, also identified by the health department, has to do with the commitment to serve 1500 residents of the tenderloin on medical-managed healthcare to provide specialty and hospital care to those patients. in the city reported indicated that only 180 tenderloin residents have signed up. today's presentation said it's only 170. for several years, saint anthony's has been given funds from the innovation funds to do

recruitment. the coalition has suggested on a number of times there are additional steps the city's public-health department can take and cpmc could take in order to publicist the availability of those services, perhaps to provide transportation if that is the impediment leading people not to chose the saint anthony's managed service organizations. the sixth issue is in the realm of entry level operations hiring. where it is entirely correct more than 40% of the hires are coming from the first force hiring program. but the way more important closer look that we would urge you to take, is why have the total numbers of entry level hires plummet from 220 in 2015

to 57 in the city report. now 65 in the presentation today. why does cpmc project that it would hire three times as many entry-level operations hires? perhaps even most importantly, what are the retention rates of the people that are being hired through the first source hiring programs? these seem like really reasonable questions to ask but neither cpmc has provided the information nor have the city apparently requested it. and then finally, the seventh and last question that we asked you to inquire about is what is cpmc doing to promote the subsidy program to its employees? to get more than 18% of its employees to take that public

transit subsidy when 43% of its workforce live in san francisco. with the commissioners and directors' permission, i'd like to handout a summary of those questions and the coalition's written suggestions for what a center for excellence and senior care would look like. >> thank you, very much for your comments. >> we also have a number of speaker cards to submit. >> folks, if you want to make comments on this, please come up. the names that i've already called. if have not turned in a speaker card, lineup near the wall on my left. thank you. come up, please. first speaker, come up.

good morning, commissioners. chinese hospital is small non-profit community hospital located in chinatown offering wide range of medical services to a multi cultural community for over 100 years. our clients are low income asian immigrants. many of them are monolingual speakers. 90% are medicine' care, medicine' calmedicare and medics flourishes through the years with over 50,000 birth recorded. and i have a display that shows you in 1998, limited by only being able to provide level one labor and delivery services, chinese hospital partnered with

cpmc and relocated its labor and delivery services along with its nurses to cpmc. to provide a community direct access to both primary o.b. care. cpmc agreed to charge the chinese hospital and its affiliates reasonable market rates. we respectfully ask the commissioners to help facilitate that reasonable market rates. which are consistent with the cpmc development agreement for chinese hospitals and its a fil it's a and maffiliates. >> next speaker, please. >> good morning, my name is julie. i have a few papers that can be handed to everyone. i want to thank you for letting me speak today.

i just want to read a letter that was written for us. i am a licensed vocational nurse at cpmc. i work postpartum labor and delivery the last 14 years and have been an employee for 26 years of cpmc. on february 16th, 2011, i received a letter after we were beginning negotiations that said dear julie, during last year's collective bargaining sessions with seiu, uhw, we discussed cpmc's plans to rebuild our facilities in san francisco. the union representatives recognized the importance of those plans but they were concerned about what might happen to your jobs when the new facility opens. we understand those concerns and agreed to a strong employment security language in your contract. i am writing you today because there's some confusion exactly about quotation, employment security means. it is simple, all seiu

representative regular employees, who are employed on the date of your contract was ratified march 18th, 2010, will continue to have jobs at cpmc when the the new facility weres built. so if you worked at cpmc in march and working for us when the new facility opened, you are guaranteed employment with the same or greater pay than you will be earning then and number two, you will have no reduction in hours unless you ask for a change. also, cpmc has no intention to interfere with your right and union representation. thank you for your hard work and dedication. warner browner, md, mph c.e.o. i am here because as of august 29th, i was asked to go no a conference room with management and basically stated that lvns will not have jobs across the board as working on the unit.

i have dedicated our time as speaking before all lvms. four of us who work postpartum, we are excellent nurses. although we do not carry certain job engagements of the r.n.s, we are able to give great care to our employees and patients. we are great colleagues, we have worked very hard in our profession. we deliver the highest care given. in the second and third page, i have letters from management. i have letters from a patient which i can give more of. also a survey that was done by 3,003,000 hospitals stating i'm proud this is the second time you've been recognized as a top performer in the healthcare

systems and i'm grateful for your dedication and partnership. >> thank you, your time is up. >> thank you, very much for listening to us today. >> thank you. we appreciate your comments. next speaker, please. >> good morning commissioners and directors. my name is dina. i am the current and new c.e.o. of chinese community health plan. a.k.a.ccph. ccpm administered contracts on behalf of chinese hospitals. thank you for the opportunity to address the joint planning commission and health commission. per the cpmc development agreement, cpmc was supposed to provide services in a manner consistent with exiting services agreements of chinese hospitals and its affiliate. i find it difficult to accept that cpmc/sutter is providing services in a manner generally consistent, quote-unquote, when chinese hospital has experienced rate increases since 2013 as my colleague larry lou will attest. my apologies to both the tempt

of public-health and the commissioners our contract and rate issues were shared with the department of public-health. chinese hospital and its affiliates encourage the commissions to request that sutter health corporate act in a spirit of the d.a. and engage in upcoming 2019 rate negotiations that result in reasonable market rates for chinese hospital and its affiliates. we request this in the spirit of cooperation amongst local providers. the only stand-alone community hospital in san francisco and the only onish of two remaining san francisco-based commercial health plans in serving san francisco ans. thank you for your time and attention. >> next speaker, please. >> i'm the c.o.o. of chinese community health plans. i was born at chinese hospital.

c they provide manage care patients for chinese hospital. the spirit of the development agreement and the past relationships with cpmc and chinese hospital were collaborative. cpmc provides hospital services for the community which are not available for chinese hospitals such as labor and delivery or pediatric beds. in mid 2014, just a few months after the development agreement was concluded, sutter notified us they were determine innating all of our existing contracts with cpmc, saint luke's and its doctors and demanding much higher rates. during our most recent contract negotiations, sutter again insisted on rates that were more significantly higher than our own costs and the market as a whole. just to put that in perspective, the cost of a normal delivery at cpmc is two and a half times than it was in 2013.

company we hope they will hold e collaboration we had prior to 2013 and return to more reasonable and fair market rates for their services. we believe this will help us fulfill our mission to provide quality, affordable care to the communities that we serve. with that, i would like to thank you for the opportunity for giving your comments and thank you for your important work. >> thank you, mr. lou. next speaker, please. >> good morning commissioners, thank you. my name is dr. tom cravis. i live with my family here in san francisco, less than 20 minutes walk to chinese hospital.

our son has selected his own personal physician, who is on the staff of chinese hospital and although he receives many of his services there, he is referred for certainly specialized care at cpmc. for an office worker in his 20s, the cost of care at cpmc, including the out-of-pocket co payments and deductibles is high. his needs are a microcosm of the problems of our elderly face because they have multiple chronic conditions, which often require specialized services at sutter, where the cost of care is high and certainly considerably higher than chinese hospital. studies published by ucsf and other sources over the past several years, have shown that the cost per hospital admission is higher by about 113% when the care is provided in large systems such as sutter.

let me be clear, we acknowledge that the care at sutter is medically appropriate and of high-quality. however, let's ask ourselves this, how many of our thousands of members that average 74 years of age, were aware that a simple agreement entered into years ago, about o.b. care and care for babies could have such an adverse impact on the cost of their care and that today that same or similar care at sutter may cost them considerably more than a chinese hospital. we remain committed in having our member, just as we would our families, to receive the highest quality care. however, let us see how we can work together going forward to make this care more affordable. we respectfully request that there must be a thoughtful, consideration of the intent of the agreement with sutter and the significant financial burden on on families today. thank you.

>> thank you dr. kravis. next speaker, please. >> goo good morning, commission. i am the chief financial officer for chinese hospital. i've only taken that position, i am honored to be able to work with such a vital part of the san francisco community. as mentioned by previous speakers, the relationship with cpmc is longstanding and integral part of the its continued mission to provide high-quality affordal healthcare. maintenance was central to the cpmc development agreement. unfortunately, the rates paid to cpmc under that relationship have not, in any meaningful definition of the sense, been generally consistent. we find them today at an increasingly high level that is far beyond the market rates paid to other providers in the market. consequently, we are in a

position of not being ability to sustain that level of payment to them. we ask the commissioners to help us in upcoming negotiations to restore that generally consistent premise that was originally intended under the development agreement. thank you. >> thank you mr. forny. bob prentice, mike lion, melanie grossman, james sandoval and mary mickoluchi. next speaker, please. >> good morning, commissioners. i work with community housing partnership and i'm also a representative of the good jobs for all coalition. i want to first acknowledge that sutter cpmc has been having success in hiring economically disadvantaged workers by the city's first source hiring program for entry-level positions. we would like to know, however, that sutter cpmc and echo what

has been noted before it's had a glaringly decreasing its over all entry level hiring. we urge the commissioners to explore the reasons behind this slow down. as what was noted before, we urge the commissioners to ask how many of the entry level operations his ove hires have bn retained. we think this is very important, there were six targeted neighborhoods in the development agreement. if those targeted neighborhoods are not being reached, we should have them be identified so that this can be addressed. although progress has been made, such an extreme shortfall from over all predictions warrants a deeper explanation. >> thank you, next speaker, please. >> my name is colleen. i'm the executiver for housing healthcare and justice. so, as we have spoken here, when

we look at development in this city, and especially cpmc, one of the biggest promises, right, has been jobs. jobs for the members and residents of our city. i think that the promise is not been fulfilled. when we look at operational workforce hiring goals were exceeded, well, if we side step that, it's not operational but it's construction. those goals have not been met. where the target was 50% of city referred applicants only 30%. that's a clearly a goal that we need to reach. and still fulfill. in what javier mentioned when we look at jobs deliver to the people who need it most in our city, we're falling short. so, in cpmc's own 2016 compliance statement, there was a projection of 173 entry-level jobs. that is far short of what actually happened in 2017.

when we look at that, 33 of the jobs were city referred of the entry level and that actually, if we think of 173 entry-level jobs we were hoping for, 40% of that target would be about 69 jobs so in terms of the actual number of jobs that came through, 33, it's about fair. you can check my math on the paper. when we dig into this a little bit more, there's a lot of work that we need to do. i hope that the commissioners can really inquire what is the reason between the shortfall. another important piece of context is the first two years in 2014-2015, cpmc did not meet its goals. it was at 22%. so your work as commissioners, our work as the community, is so important for our community to actually reach its hopes of

having fulfilled good employment at cpmc. another thing that i want to point out was in 2014, cpmc did provide retention data and that is something we hope for looking back into 2017 and looking to next year that we really need this retention data many of it's not only enough for a community members to get in the door. they need to be able to stay. and so in a booming economy, we have to really look out for who is being left out and how we bring them in. thank you. >> thank you. next speaker, please. >> three minutes. ok. >> bob prentice. i represent the bernal heights neighborhood center on the blue ribbon panel to consider the future with saint lukes and been involved with the coalition. i'm going to read some testimony that dr. ken barnes had prepared. he wasn't able to make it today.

dr. barnes programmed for 30 years at saint lukes and was involved in the early days in the save saint lukes coalition and part of our coalition. i won't read it all even with three minutes. in the discussions we've had so far, when the senior center of excellence at saint lukes hospital, it's reinvolved around the acute care for the elderly or ace program, which is for hospital based seniors which we think is a good program. it is certainly consistent with the development agreement. i want to pick up dr. barnes' temperature where i think we're talking about trying to expand that vision. and i'll just read it. such a programs envision by cpmc is hospitalized older adults. this is commend able and something we support we believe you must ask the goals and scope of a center. the vision goes much deeper. providing seniors the whole range of services for primary care to specialty care, skilled nursing, after discharge from

the hospital and community and hospital based. access to rcfes and access to adult aid healthcare. such clinical services should include health promotion and disease prevention. engaging the senior population is partners and efforts to improve their over all health and the health of the community. seniors need to be supported in a residents so they can live full lives as healthy and productive as possible it's crucial the transition from hospital to residents be done with sensitivity and skill the over arching goal be the maintenance of seniors in their residents known as aging in place. for this to happen, such a center must be linked to community support programs which means the center has to have deeply rooted relationships with the community organizations it provides such services. they need to be inter disciplinary teams in the hospital and community which meet regularly and provide continuity of care as well as active support as patients transition from one level of care to another. to accomplish these goals, there

must be community accountability in cpmc should want to inaccept input about the needs of the community through the establishment of a community advisory board or center. this is our vision and we hope that you and cpmc share that vision so that the center can be built into a thriving entity with patient-centered care has its hallmark. >> thank you mr. prentice. next speaker, please. >> michael lion with the coalition for jobs and justice. san francisco has real health problems. there's a 20-year gap in life expectancy between the rich and poor areas. there are too many hospitals in the rich area but only two in the poor areas. there's a shortage of skilled nursing facilities. and there's a bad shortage of mental health and substance abuse treatment. why are we even dealing with

private healthcare giants like cpmc and the face of all these problems? these so-called non profits, which make hundreds of millions of dollars and give little to the poor. these change the gobble up hospitals, clinics and physician practices in order to establish monday olelies and jack up their prices. these hospitals that proudly announce that they'll push high-paying services and eliminate poorly-paying services regardless of the patients' needs. how well cpmc deal with the poor? it's simple. get rid of them. sutter c.e.o. mike cohill told the supervisors, quote, the new saint lukes will serve a new demographics that is better insured, better employed and better educated. why else would cpmc eliminating spanish-speaking clinicians and

receptions and why would they locate its clinic in an expensive residential building. why else would cpmc drop the name of saint luke's hospital with its associations with black and latin patients. we need to see whether cpmc is fulfilling its obligation and we demand that cpmc, the private hospitals and the city provide seek affordable healthcare for everyone. >> next speak are, please. >> thank you. good morning. my name is melanie grossman and i am a licensed clinical social worker specializing gary attics.

i represent the san francisco older women's league and we are a member of the coalition. generally, a center of excellence is defined as a comprehensive program in a particular medical area which supplies concentrated expertise, best practice care, education and other services. cpmc's vision of the senior center for excellence serves only hospitalized patients with access to the new ace unit. language in the development agreement leaves ample room for something much broader. our vision would offer inpatient and out patient whole-person care which means care of physical, mental and cognitive health, caregivers support, and programs promoting independence and reduced social isolation. to ensure aging in place, the center would work closely with

community resources and families to make timely and culturally appropriate referrals. a referral to meals on wheels fails if there is a three-month waiting list and no follow-up. our center would not be organized top down as the current center is. community input is essential. i worked on developing the always active program in san francisco. we started with focus groups, interviews with agencies, churches and stakeholders. always active is still going strong all over the city because of community input. also, stipulate lated in the very muchment agreement is a -- screen and manage individuals with chronic diseases, building on the existing health first program. we need more than an extension of what already exists.

this is an opportunity to build something truly excellent that will serve as a model for other hospitals in the city. cpmc needs to do more than satisfy the minimum requirements of the development agreement. otherwise, the two centers of excellence become nothing more than empty, political and marketing tools. >> thank you. next speaker come up while a call off a few more speak are cards. >> debbie perkins, elizabeth wheatly, theresa palmer, paul cartier. >> good morning commissioners, thank you for the opportunity for us to speak. my name is jane sandoval. i'm a staff nurse at cpmc. i've been a staff nurse for 33

years. also on the board of directors of california nurses association. nurses begin meeting with cpmc officials before the opening of the mission bernal campus can concerns about safe staffing, we expected that cpmc would provide us with detailed information about their staffing plans for each of the hospital units. cpmc admitted that plans for the unitunits were fluid and unknowp to the opening. up until this week, they were unable to provide us with staffing plan for the hospital. this should be elementary and should have been done long before now. after all, we knew when the hospital was opening. we had a count down clock in our lobby so we knew when the hospital was going to open. it wasn't new. it didn't just happen. from our vantage point, we had to point cpmc just to keep from closing saint lukes, i've been testifying here 10 years about keeping saint lukes open, it's not new.

we fought plans to shut down vital services such as sniff and sub acute. it's more than ironic they boast about their center of exens after moving the units that would help aging patients transitioning from hospitallation. it was nice they had a block party and it was instagram able moments but we have patients to take care of and the hospital needs to be staffed. we ask that the commissioners hold a special meeting focuses on the transition of the hospital with the focus on patient safety practices, including safe staffing for the transition period and beyond. >> next speaker, please. >> good morning. my name is mary. i have worked at saint lukes for 44 years --

>> yesterday, on the floor, three of the day shift staff nurses were told to stay home and the travelers work. what does this mean for us? it means the orientation process possibly is happening for the traveling nurses but not for the regular. saint lukes -- >> they should be in addition and not a substitute for regular

staff. >> thank you. next speaker, please. >> good morning, i am a registered at the orthopedics unit. a few weeks before the opening of the new mission bernal hospital, which i prefer to still call st. luke's, we cover our unit would be moving to the new campus. it's shocking that after many years of this entire process, cpmc would determine in the 11 the hour. we had eight week's notice we would move into the new hospital. our training took place in a rush. we had six-day week work weeks because of our training. we were going from training back tomenthe hospitals. the planning was non existence. in addition to that t. the doctors who normally bring their

patients to our previous unit were not notified. many, many doctors had no idea up to the time we moved that the unit on 1 east that we were going to be moving away. they had no places to put their patients. they were not afforded the courtesy of being notified ahead of time and now h.r. is scrambling to get doctors to move to mission bernal so they can fill those beds. in numerous meetings with cpmc over the weeks since this news came to light, the hospital should patients first and staff up during the transition period until the dust settles, however we staffed up for one woke and now we're going straight on regular ahead. it's been incredibly disruptive much it's unan fortunate occasion or lack of serious patient plan on the planning of cpmc. we urge the commissioners to

discuss the important matters of patient safety that emerge in the hospital transitions. before cpmc repeats the same mistake in the opening of van ness, sutter meets t needs to pd and anticipate the moves on the patients and staff. for an example,s we were told by h.r. there would be no impact of the move of our unit to mission bernal, however, now the nurses on 4 north and 5 north have a lower pay. they're loosing jobs by loosing shifts. let me see. i have a couple more comments --

>> experienced at st. luke's. we expect that cpmc would listen to the nurses as you know suspend their practice of you will extra lean staffing for a generous period of time while they have adapted to the new hospital. which it's many layers of changes from our previous environment. instead, cpmc staffed up the new hospital for only one day or two before reverting to their usual pattern of canceling nurses. from our shifts at ever opportunity leaving those of us who worked short-handed and scrambling. more over, they sent permanent staff and obtained temporary traveling nurses. we've been scrambling for needed medical supplies and learning to utilize new technologies with frequent glitches all while struggling for patient

assignments. this is unnecessary and unsafe and the results of nothing more than cpmc's grim obsession with the bottom line coupled with dismally poor advanced planning. given cpmc's history of slashing needed services for aging and vulnerable patients, such as a recent closure of the hospital units at st. luke's it's cpmc presenting itself as the beating of care before the hearing, cpmc must do better for san francisco. thank you. >> thank you. next speaker, please. >> hi, my name is dr. teresa palmer. i work with the coalition for housing healthcare jobs and justice. in the 2017 report, sutter ignored its obligation to care for 1500 tenderloin patients on medical. also, in previous years, sutter

provides numbers about charity care with inadequate breakdown of the services provided and the population served. the aim of the deal was for sutter to care for lives into the tenderloin, not to just give isolated single services, sutter cpmc is non compliant with these services reporting requirements. the d.a. asked sut i remember to act in good faith to develop solutions for the sub acute sniff bed shortage in san francisco. specifically considering that sutter is shutting down to sub acute sniff unit at st. luke's left san francisco with no sub acute beds. the shut down with hospital base beds, many by sutter, has crowded long-term care patients out of town leading to a worsening critical shortage of nursing home beds all over san

francisco. sutter's participation in the post acute care study was supposed to have satisfied obligation to find solutions. it absolutely did not. the study examined how hospitals could avoid loosing money on difficult patients but did not address the crisis caused by the serial shut down of hospital-based sub acute sniff and sniff beds in san francisco. sutter is non compliant in its obligation to make a good-faith effort on the sub acute sniff shortage. there is room in the planned medical office buildings on both sides and the 30-bed shell at van ness to add post acute sniff and sub acute sniff care. however, sutter cpmc is only interested in getting rid of services that don't generate sufficient profit. they don't care what the people

of san francisco need and they don't care what old people need. sutter is marketing the mission burnal center of excellence while abandoning needed services for seniors in san francisco on all levels. this includes adult day healthcare, residential memory care, post acute sniff care and sub acute sniff care. sutter has no mechanism for sub ta tive input from the community. such as a grassroots community advisory board in the neighborhood surrounding st. luke's. their actions at open treat and there's no good way to giffin put to sut you are about what they need.

>> my name is paul cartier. i'm a resident of san francisco for 40 years now. i walk, bicycle, ride public transit and i drive. since we have an ongoing problem with traffic, i'm thankful that i have a variety of options on how to get around this city and beyond. i am very concerned about sutter health's lack of compliance with important transportation program. the main concern here is that sutter health is doing very little to increase the number of employees utilizing public transit, which they estimate from an online survey at 25%. as compared to 55% in single-occupant vehicles. they have two major muni transit

corridors, notely the b.r.t.s. this is a paraphrase from exhibit k in the development agreement. cpmc shall encourage all employees, new and existing, to enroll and purchase a clipper card as a part of its transportation demand management plan. as part of its normal t.d.m. activities, cpmc shall promote the use of the subsidy of the clipper card. undertaking additional outreach as necessary to drive up adoption and achieve the s.o.v. reduction goals. none of this is mentioned in the current compliance report. currently, sutter is passively promoting inserts in new hire packets. by actively promoting the advantages of using public transit, and regularly subsidizing the clipper card, sutter health could be a good

corporate citizen. they can also be in com ployance with transit first and environmental goals. more over, the clipper card program can track its actual use by it's participants and sutter health's progress in promoting this use, otherwise all we have is the phase out from a 777-450y of some portion of its busy employees. >> thank you. next speaker, please. >> good morning. i am a nursing assistant at cpmc davis campus. last year august 20 we have a hearing and the judgment lands on december or january of this year, it's because of the short

staffing that we get for the years. and part of this guideline during the compliance unit, i saw 51 the judgment of that is all the certificates of 51.50 it's not deductions of the floor staff but cpmc is not complying on the arbitration guidelines and they're out every time we have a theater on the floor and it's the short stopping and if you have the c.n. a. it's one c.n. a. on the floor every time we have a sitter because it's just more on the work for -- we still have

the same patient. it's only with one instead of three. we can have more work and you will have more and it's not safe for the patients or the staff. thank you. >> next speaker. i think i've called them. ruth, sylvia, kim. if i have not called your name but you want to speak, please come up. >> i work at cpmc campus. i'm going to show you a floor where i work. >> ma'am, you will need to speak into the microphone. >> sorry. >> sorry. >> ok. this is the hallway and we have

three, four, five and six. the total of the beds is 41. i handle sometimes when i work the night shift, we start at 28 patients. but i'm done with eight hour shift, sometimes i get 65 patients. some going to i.c.u. or die and i'm the one who is responsible to push the beds be open so e.r. can put more patients on the floor. i have to clean up the bed and go to the morgue on the second floor. i walk many miles and my friends, many staff, i'm sorry, many staff for eight hours on

each node two of the node 10,000 steps and 13,000 steps on node 6. it's a little bigger. i am on my last limb right now. i hurt this and i hurt my left

>> good morning. thank you so much for this hearing and i bring it for my father. he was at st. luke's hospital. so you know guys they are moving to davis. i guess coming over here because my father is suffering a lot because you know, the nurse, they are not prepared for those patients. my father when they suction to them most of the time he is always bleeding because they don't know how to do it. i talked with the nurse and i say can you please be more human. my father, you know, sometimes he cries and sometimes he closes his eyes and do like this because he cannot talk. i am his voice. that's why i come over here and i bring pictures of him.

please help us. i wonder if you please go over there and davis and check the nurse. when they come over here, all of them they talk very well. they say that the nurse they are capable to handle this but they're not. most of the nurses they do know what to do and when we ask them, can you please move my father it's lovely and human and you know, they are very upset when we ask for towels because we have to wash my father. next sunday they throw the towels on my sister's face. i report it with the nurse that is in charge of the floor. that is why i'm here right now. we're tired. my father is suffering a lot. so can the people. they can't come buzz they do speak english. they say how are we going to explain when we don't have no one in the