office of economic and workforce development. it focused on the area movable job training and economic opportunities, so our office worked with local community based organizations to make sure they get the funding that they need to provide the services to get residents to get through some of the barriers to work on the project. and it also targeted educational institutions and nonprofit organizations that in priority neighborhoods. some of the current grantees are faces sf, jewish vocational community, success for help and young developers. that concludes my portion, and i'll be around to answer questions. thank you. >> thank you, commissioners. my name is sneha patil.

so this slide provides a summary of the health care commitments within the development agreements. there are multiple provisions related to health care which are intended to insure that cpmc continues to provide high quality care to san franciscans, especially those who are low-income, medi-cal or uninsured. so as i mentioned, this slide is a summary of this commitment. the first three provisions from multiple commitments, so there are five baseline commitments to maintain the same baseline of charity care, three provisions to increase care to medi-cal beneficiaries and low-income individuals. there were two provisions on the innovation fund, which totalled 8.6 million to fund community based services andum practices, and finally, there are an additional five health care provisions that range on various topics around subacute care to culturally and

linguistically appropriate services, so the next slides will provide more details on these commitments. so this slide shows each of the five baseline health care commitments. cpmc's 2017 performance, and a determination of whether cpmc is compliant on each. so starting at the top, in the past few years, the cpmc has exceeded the development agreement requirement of caring for 30,345 charity care or medi-cal parents. charity care refers to health care provided to those who can't afford to pay without expectation of reimbursement. second provision is related to community benefit, which is unreimbursed costs that cpmc incurs to improve community health. in 2017, cpmc exceeded the $8

million community benefit requirement and provided about 12.5 million. cpmc has -- provides -- met this requirement by providing grants, including community health programming and community outreach. i just want to note that these first two requirements are also verified by deloitte as a third party provision. the third provision was in effect until 2017, which was that cpmc was to maintain their current charity care policies. that obligation was met by the end of 2015. the fourth provision was that cpmc maintained charity care policies that are compliant with the state law, and that is the case as of 2017, cpmc's charity care policy was the same as it was in 2015. the last provision is for cpmc to continue to support bayview child center. since the ownership has transferred to the south of market health center, cpmc has

provided an operations grant for five years, invested over $1 million, transfer assets, and is still serving as the clinic specialty and hospital partner. so the next three provisions focus on medi-cal, which is public insurance for low-income san franciscans. so the first provision, cpmc has continued to participate in medi-cal managed care with the san francisco health plan. the next provision requires cpmc to assume responsibility for 5,400 new medicare beneficiaries, and this obligation was met in 2014 and cpmc continues to meet this obligation. in 2017, they had a total of 29,739 beneficiaries. the third requirement is that cpmc serve 1,500 of new

medi-cal beneficiaries through a partnership with a tenderloin care provider. currently there is no such provider. to meet this obligation, cpmc has partnered with northeast medical services to bring in st. anthony's clinic as a primary care provider in the tenderloin. cpmc has reported that they are continuing to work with st. anthony's leadership toward a path for sustainability and outreach efforts. a grant of $35,000 was awarded to st. anthony's through the innovation fund to help increase capacity to do outreach. there are two provisions in the development agreement that pertain to the innovation fund. the first that cpmc is to make payments between 2013 and 2017 totaling $8.6 million.

the total payment was made in 2017, and this completes their obligation to the innovation fund. the second provision describes how the funds will be used, and they're administered by the san francisco foundation. cpmc along with the department of public health and the san francisco foundation sit on a committee to grand awards that support community clinics, behavioral health, and other community based services and programs that ultimately support the health of san franciscans. in 2017, the committee granted awards totaling near 27,000 to six different organizations. so the remaining health care provisions in the d.a. are stand-alone and again span a range of topics. the first provision on should lied requires cpmc provides specific proposals for providing subacute skill nursing services in which

patients require a higher level of care than your average person in the s.n.f., and so the requirement was that cpmc present these proposals to the health commission. this obligation was completed in 2016 through a presentation of the post acute care project report to the commission. the second provision is around the integration of staff across cpmc campuses. in 2016, cpmc completed this integration of st. luke's medical staff into a single integrated staff at all four campuses with the completion of the new hospital campus, cpmc also plants to integrate that staff. [please stand by]

>> from out patient services from cpmc to sutter pacific medical foundation through the proposition q process, they have

informed the commission of plans to transfer management of out patient clinics including the saint lukes diabetes center so the health commission held a hearing on this and will deliberate in a sesquicentennial and have an impact on continuity for patients. >> th this was discussed at previous hearings and i wanted to provide update. sub acute squarely is skilled nursing care for medically fragile individuals and in 2016, cpmc announced they were closing saint luke's and skilled nursing units so that unit did close in 2018, it was the opening of the mission bernal campus which is a 68% reduction in over all beds and cpmc, however, following hearings in the health commission in 2017, cpmc did commit to continue to care for the remaining sub acute

patients. as of august 18th, the remaining patients have been transferred to the davies campus. that concludes this portion of the presentation. >> as heard from my colleagues, they are in comply with the development of the cpmc agreement although there are concern that include enrollment with the managed care providers, appropriate services and construction hiring of the union journey men and apprentices and the information we've received so far for 2018 is continuing compliance. staff's recommendation in health and planning is to find cpmc in compliance for the 2017 reporting year. staff will be available for questions and we will have a

presentation briefly. >> good morning commissioners. i'm from external affairs group. thank you for having us here this morning. i'm joined by colleagues who can serve as subject matter experts when i'm sure we get into question and answer portion of the morning's hearings and we're pleased to be here today. as you've heard, we've opened the new mission bernal campus on the 25th of august and you are looking at baby isabella who is the first baby born at the new mission bernal campus. everything there, with patient census appears to be steadily increasing and satisfaction from

staff and patients alike. we're happy to have a successful opening under way. this is photos of the vaness campus which will open march 2n. it's when we'll transfer patients from the campuses to that new location. we have been awarded approval to staff and stock so we're getting our training schedule ready and a little later on in this fall, we'll begin training at the new vaness facility. these are photos. m.o.b. which went up much quicker than the hospital across the street. even still, with some tenant improvements going on, it looks like the m.o.b. might open just a bit later than the hospital. maybe the end of march. maybe if we can squeeze that schedule in the next six months, it will open at the same time. right on schedule.

we showed this last year, just to make an over-arching view of the major transitions that we see. we're counting this as four major transitions and with the opening of mission bernal, we have accomplished one of those. which is to move services from saint lukes and a few from pack and cal to the new mission bernal hospital. as i said in march, number two will be opening van ness number three will be the van ness m.o.b. and four will be once that situation has settled, we'll resort a few programs and service that's have had to move to tem temporary locations whie construction was finished and that will take us to 2020. something we've talked a lot about in these hearings in the past is community engagement. last year, we wanted to make sure we showed the broad range of community engagement that

we're involved in, not just certain specific conversations, we wanted to continue shares that view with you here today. there's a couple things specifically i'd like to call out because we actually have not included them in the past. one is that first point. in 2015, we established a buy-local program in the lower polk neighborhood. we've talked a lot about the neighborhoods and activities around the mission bernal campus, not so much around our new van ness campus. this is a program we're very proud of. we've worked with our partners 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