with the discussion that's i think our staff pointed out in which while and to cpmc's credit, they are now caring for the subacute that were being displaced by the closure of subacute is absolutely true as was pointed out by the staff and other speakers that there are no new beds that are being created in the situation. and that while technically, and we can check more, that cpmc was greatly instrumental in assisting in this subacute studies that we still need to continue to respond to the need of the city to have subacute services and we want to encourage that cpmc participate in that. because they completed the

study, i don't believe that while technically to be considered in compliance that that should be the end of the relationship in terms of any further looking at a subacute solution for the city. we do recognize that it isn't one is that cpmc itself has to come up with. they should be a part of this solution and that just assisting us with the first level of study in regards to understanding the problem does not absolve either cpmc from having to continue to participate. i believe that we are continuing to have dialogue with cpmc on this and i don't want to say they just walked away and out of the poor but i'd like to have continued i do a log in that and also in regards to resolving the

sniff. as they have closed the sniff, there have been no added beds as also been pointed out by the public in regards to the sniff. so, we have kind of a conundrum here. yes, they have complied with the development agreement but there are a lot of areas while complying we are loosing services that ar are and if we e the opportunity to be able to continue encourage that in the development agreement, we could continue to help influence and work together with this and i'll have some final comments and later after we conclude

everybody's discussion, what we would hope from our department that we would be able to do to continue to service the people of san francisco. and in collaboration with cpmc. i think at this point, we should hear from our planning colleagues. >> thank you. >> commissioner fong. >> i thought the planning commission was complex. you guys certainly have a complex job and i appreciate it. i just wanted to ask, after hearing all the public comment or the community input, it's cpmc had some responses to some of them maybe in particular the subacute care f. there was any reaction to that or things that are in the works that are addressing some of the community comments.

>> specifically to the subacute care, as commissioner chow described, those patients have been transferred to the davies campus in a new unit there. the staff are credentialed and trained to handle those patients. in introduced some of the other schematic things that were brought up, we've got retention numbers here. i'm sorry for the oversight if that was not included in the submission packet. i think the notion of transitioning to these new hospitals, everyone can appreciate is a complex and fluid process. one of the examples and came up around orth a speed i can is a good example of understanding

how physician decided that that moment to move cases to a new location. services that support that work also need to follow. we would have loved to have had that decision happen a year ago, six months ago, four months ago, maybe not exactly when it did. but that is when it happened. our commitment to safe, patient care, especially through these transitions, is the first priority. thousands of hours of training and preparation have gone into this. while i understand there are always going to be differences of opinion or concerns that happen when you get into that acute moment around the transition, our commitment is to absolutely quality, safe care, transitioning these patients from one hospital to another.

we do have people here who can talk about some of the h.r. issues. we have someone here who can talk about all the work that's going on to promote the transportation subsidy. scheme atticly those were the things i heard. >> from the planning commission side, if you don't mind just someone addressing about the transportation and the network system how that might play out. >> i'd like to give you background. i'm a san franciscoan for 50

years and i've worked for cpmc for 41 years. i'm proud to have worked there and continued to work. i have a tremendous amount of colleagues that are committed to cpmc. one of the areas that is complicated and dr. grown knows very well about it is parking. what we have done since last year in january when we started the subsidy, we had put that information out to employees ever month. on their paycheck there's a by weekly letter that goes on the internet. we hold four transportation a year. this year we're having 12, which four were already completed last month and the next one will be in october and the point of one will be december. our push is to remind employees

that the city first is to reduce the s.o.v. when we got the survey returns, a lot of the employees' comments were that they, why they didn't take public transportation. some of them claimed that they work at night and they come on weekends and public transportation is not available for them. amount of the responses were a lot of especially with mothers, they would have to pick up their kids right after work so their time was consumed. it was necessary to go from one place to the other. we have made tremendous progress from last year, i believe we're now about 850 employees that take the subsidy. we're committed to get the goal much higher. another item that came to concern was that bart and itself is a scary for them to take that and muni was a concern. i know that the city is doing

quite a bit of work to resolve those issues. again, we're committed. any other questions? >> thank you, very much. >> thank you. >> thank you. >> commissioner johnson. >> thank you so much. first i wanted to thank city staff, cpmc, members of the community for coming out to share your perspective and my fellow commissioners, i have just learned so much from you already. like my fellow commission or fong just said, this is a great introduction into your world. [laughter] >> first, it's great to see a community agreement played out in real time and i'm grateful for this opportunity to be able to have a community conversation on what is happening so we can see what is working and what's not and what we can do to make

sure we achieve our ultimate goals of providing excellent care to all san franciscans. i wanted to touch on health disparity which is a issue i'm passionate about in relation to the report out on culturally and linguistically appropriate care. this is in the news and several fronts. yesterday president cohen announced a duel a care program to protect mothers, particularly women of color and their children. in this city black babies are 5% of birth but 23% of infant deaths and 13% of black mothers, 10% of pacific islanders mother and 9.1% have pre term rates which is 50% to 70% higher than white women in this city and that coverage has received national coverage. specific to san francisco and so when we talk about culturally appropriate care, we need to be talking about racism, stress,

systemic health inequality and equity as part of those conversations. making sure that people can get care in their community and it's affordable, and you are working specifically not just in making sure that those populations get care but that we're working on reducing bias both in the hiring and staffing processes and our fork worse, which is also diverse and also combating bias in the industry. i know the cpmc foundation was part of that duela care effort, which is awesome. i love to see other efforts that you are combining with your work force investments to really reduce bias in the industry. we know that it goes from hiring to how the care is actually delivered. on workforce development, another issue i'm passion at about. it's not enough to get people in the door. as my fellow commissioners have said, you have to create the conditions to help them thrive in that requires tracking

retention, creating programs and support. so, you know, when we hear that number of 277 folks hired over five years, the number of 128 folks being terminated, that begs to question of someone would worked in workforce development what is happening with training and support for those workers. i have just looked up the average turnover in healthcare and it's about 26%. those numbers don't mirror that. i know it's a different population but i want to know the average in relation of the workers in relation to the retention of those workers. it's been disheartening to hear about the lvn and rn and cna staff talking about their working continues. this population of the workforce tends to be diverse. they're also vulnerable and crucial to providing quality holistic care. and so, you know, i echo the

concerns of the community. we want to better understand kind of what, how you are supporting those workers and that staff and then also, i wanted to address charity care patients. which i hope we can come up with a different phrase for that. really tracking where people are coming from in different zip codes and their ultimate outcomes and whether they're moving the needle on their outcome. that's what we're trying to get to. if we're not slicing that data by race, location, it's hard to achieve goals if you are not measuring for that data. i grow with commissioner sanchez that i think that going to a deeper level of bet understanding of the data will provide all of us with an important opportunity to make sure that we're having impact, which is our ultimate goal. even perhaps inform the city about what is happening in our workforce pool and what are the

best practices on retaining this type of workforce and ultimate ultimately. >> it's convincing, however, the public testimony, including the questions that i associate was from the health commission themselves, seems to not fully substantiate the highest success rate of the data as been presented. and then comes the public voice which raises issues and anything with can communicate and that is

where i feel my primary questions are. i like to basically stand with the san francisco for healthcare housing and jobs and justice questions raised about the seven issues. you have those issues in front of you. i do not want to spend time going over them but each and all of them individually and together. the matter and require further and in-depth examinations including the strong infusion of the the human voices which testify to the fact that there is a big gap between the words and the deeds. the other points that i was raising is and i'm reading them off as i take notes. they're not necessarily listed in the order of the importance but i would say if i could speak at all of them at the same

moment they're leaky as important. the issue of the chinese troops. a transition to new facilities and the lack of coordination at note giving, preparation and training. there is the ever-important nursing staff testimony that i have witnessed now for the entire time that these two commission have had a dialogue about cpmc and changes. there's a patient care testimony which each of us could find ourselves in in no time. and there is the hiring and job creation and retention issue. those were the ones i wanted to summarize and stand in the room knowing that they were most likely be echoed by all of us. >> thank you commissioner moore. >> thank you, again, to all staff involved from all the departments, all the companies. again, good to see the health commission here as well.

i do have multiple comments regarding to the construction site of this project. >> rebekah gregory: i'.i'm not e hospital side. i'm an electrician by trade. before i got into this position, while still working in the field, i worked at multiple of the cpmc campuses on california campus and pacific campus and later on, it was fortunate enough to work on the building of the new general hospital. i clearly remember the day where i was capable of filling out my local resident paper work and photo copying my driver's license and submitting that end. and it is a big pride for build like hospitals and we frequently see hows and commercial projects but hospitals are a essential corner stone to a

well-functioning city and it's something we take seriously here at the planning commission and i'm sure the health commission does as well and i wanted to acknowledge ken and josh. with the office of economic workforce development and their continuing efforts to keep city build an extremely successful pipeline for all types of minorities from disadvantaged neighborhoods, parents with or without children or parents that are going to have children, and we're definitely keeping an eye on increasing we're taking it to the next level. something i have honestly nothing to do with. we have been noticing a higher acceptance of the lgbt community within our trades and since this increase of diversity, this created the electrical workers

minority caucus which has, proud to say, had a float in the pride parade for the last two years. the building trades is really making it strong effort to diversify, stay inclusive and what we've been doing specifically with city build to increase access to all residents, is workout partnerships and deals, for example, a lot of people cannot pass the entrance exams to get accepted into apprenticiship programs. about what we've done is workout a deal with city build where if you have perfect attendance and a b average, you are able to buy pass the entrance exam and go straight to the interview stage of an prentice ship acceptance process. it gives access to a lot more san francisco residents and all the other zip codes but it's

just giving people a chance to reap the benefits of organized labor healthcare benefits. prevailing wage. i'm up here today because i was accepted into a trade. i lived here in the city. i was interested in construction. it took me three times to pass the exam and actually gain acceptance into the electricians programs. it's no easy task for anybody. the building trades and city builder are working tirelessly to increase the diversity of our construction workers and also the employees that work for the construction companies but off site in the offices. it's something we all take very seriously. if i could just address some of the project-specific notes i wrote. exceeding the proposed timeline almost never happens. this should not be overlooked.

the fact that construction, i always look at organized chaos and so many things were scheduled on top of each other that if one small thing goes wrong, the whole entire project is pushed back sometimes months or years. and i i was lated to go to the cpmc project of the there was a time line of projects that was a one, two, throw step where ucf mission bay was the first one to begin and all the of the residents from that job were supposed to go to the job and those residents were supposed to go to the ctmc of van ness and gary project and it was helped up by a year. things were playing to work in those residents and the hold up at van ness and gary threw a

wrench into that. i do know that -- to make sure as many residents are working on this project in the office and on the job site as possible. so, 30% local hire are considering that this is literally the busiest times the construction industry has seen in their existence and over 130 years, 30% local hire for the van ness and gary and st. luke's is in full compliance as far as i'm concerned. i can't help but emphasize that this is a model project that ideally we can duplicate on other projects with more development agreements.

you've got san francisco contracting businesses, building a hospital project in san francisco and employing san francisco residents that attend apprenticiship training centers in san francisco they're paying payroll taxes to the city. some people have said in the past that local hire and local contractors are bringing a higher cost to the project but when you think about it, we're just reinvesting i in ourselves and we're paying a wage where they might be able to stay in the city. buy a house in the city. stay here in the city and not commute four hours each day. that's just the way i think it should be done and this is the way it's being done on this project. so, again, as far as i'm concerned, from the construction side and the office and on the job site this project is in full

compliance. >> thank you commissioner bernal. did you have something else. >> yes, thank you. for the opportunity to just add. i'd like to speak to the responsibility of serving residents the tenderloin. i understand this partnership is only less than a year in existence but when you look at the numbers, 180 versus a goal of 1500, that's only about 12% of that goal. and when you look at the residents of the tenderloin, serving them alliance with the priorities of the department of public-health and i'll use a presentation that we just received the other day about san francisco's getting to zero initiative. san francisco is exceeded in radically reducing the number of h.i.v. transmissions over the past several years far out pacing the rest of the country. we're about to see a leveling off now. where we're seeing the new infections continuing to happen, is among many of those populations. people who reside in the tenderloin. people who are marginally housed or homeless. people dealing with mental illness. people who use injection drugs.

the data shows not only that even if someone does become infected with h.i.v. that if they are able to be retained in care, and get into treatment right away, it reduces, many in cases, eliminates their ability to transmit h.i.v. data shows that being marginally houses is your adherence to your medication. these are communities that really need to be served and we would like to see better numbers in terms of the community members that you are ability to engage in the tenderloin through saint anthonys. >> thank you. so, i am not going to repeat any of the other comments that my fellow commissioners have made. everybody has had ever point that i have. the exception that i do want to

stand with healthcare housing and jobs and one of the particular things that i would expect at our next time reviewing this item is a much deeper analysis in the areas where we're not hitting the numbers. i hear you that, hitting the 30% in a time of all-time high construction is good. i don't -- i wasn't satisfied with the level of analysis of the numbers that we represented, particularly around th the decre of apprentices so i would like a newance analysis of why that is happening and what we're doing to rectify it and under the purview of the planning commission, especially at the

public transportation benefits and what the plan is we are seeing a decrease in car ownership in san francisco. and a major employer with 43% of its workforce living in san francisco is that those public transportation numbers would be higher. i'd like to have a deeper analysis presented of what we're doing about it and how we're going to see those numbers increase. thank you very much for the presentation, and for the staff, the presentation was clear. for the members of the public who continually come out to keep tabs on this project on making sure that the public benefits that were negotiated in the development agreement are being held. so thank you very much.

>> i would just like to also conclude with a few remarks and what i hope we will also troy to carry out some of our obligations from the health commission and the department to try to respond to some of the questions and answers and clearly in one area i did not actually get to go into, also i think it's the same issue that we've raised here and while we can check the boxes, for example, under the cultural and linguistic standards, we don't have an understanding of what those actually meant in terms of i.d. and analysis, i did a study, i did this and what were the results and findings? to also then, i think coming back to that question, just as an example of -- if we're using

people who came to the diabetes clinic at st. luke's, it doesn't seem to capture the -- an analysis needs to be done if the question is should there be that type of service. of course, since it's now been moved to the foundation, i'm glad to hear the foundation has those services but we would now and that's another example of moving these services from the public side of scrutiny to the private foundation that we then really count on the good will of cpmc. just to conclude then, what i have heard and what i believe that our department would be able to do to help respond to some of the concerns that both

the public and our fellow commissioners have raised, i first want to indicate that i think i'm one of the members here who have been through this entire process from even before the construction started. not too many people remember that i sat even on a blue ribbon committee in regards with what to do with st. luke's and prior to that, there was all the issues also of the rebuild and how big the rebuild should be and where the rebuild should be so it really is wonderful to see that a new community heights area has been built. that is part of fulfilling the public-private partnership in order to have a healthier san francisco. there is no way the public

itself, the public side, can actually handle all of the needs that will create a healthy san francisco to respond to the disparities that as another example, st. luke's has been doing as commission sanchez pointed out. and the development agreement in its spirit called for a continuation of that commitment to the city and that while yes, and it's wonderful that the project has brought $300 million to san francisco, it is not without the needs also to continue to remember the obligation then that as a non-profit hospital, and even just using the historical basis which is why so much was written into the development agreement, to try to be sure that it would not just be a facility to treat those who could afford it. but to be able tol to participae

with us. i want to acknowledge that i think cpmc has been working with us. but you know, it seems that we always have to actually keep asking for that to happen and it would be so much nicer if we had hey willing proactive collaboration, even at our commission meetings when we were looking at the potential of changes, it takes almost that public hearing in order to make some of the accommodations that were needed in order to respond to the needs of our residents. i found that the sutter model of we and you was very interesting. i think at the moment, from what we can hear in the testimony, there's a lot of we and very little you. and instead, i suggest to cpmc

that we could have a true we and you if we really didn't look at this as we versus you but we should be we and you. there's an outreach to the community that really is needed, continues to be needed and along that line, we as a department, specifically would be looking at the issues that i believe the coalition has raised validly and has been also brought up by all commissioners here in terms of -- we're going to only look at the health side. we'll leave you to look at the workforce and all. i believe that we're going to ask our staff to actually try to look more in depth into understanding that not only is it technically done but what was done. i commend san francisco foundation report that is in

here that showed you what was done when they received the money? who actually got help and how it happened? i think it's also important we try to where the issues are at saint than on' an anthony and te tenderloin. it's been a year this happened and we only have this small up take. is it transportation? is it access even at a primary level. welt review this again and try to see if we can also be continuing to be helpful in the partnership that has been put together. again, the center of excellence is certainly something that we would all be concerned about. that could be something and with

working with cpmc in terms of the understanding where the issues are. dr. barnes has also outlined his vision obviously the vision is one that needs to be developed by cpmc but i think the consideration is a very good example of working with the community could get a farber far acceptance and product that meets the needs of the residents in that community. so in conclusion, our department does continue to be eager to work with st. luke's. i will get the new name one day. but with cpmc and sutter. you are very important part of the city. sutter is with the assets that could be placed to great use so

that we can continue to enhance the public-private partnership that we've been enjoying between all the hospitals and providers in san francisco with the public sector as we achieve our goal to improve the health of all san franciscans. i do want to thank everybody who participated. the staff who did such a hard work and analyzing this but i think in our next review, i believe that we've heard a lot more details should be also provided to understand what happened after the check mark. thank you. >> thank you. >> that concludes your agenda today. >> make a motion to adjourn. >> motion to adjourn.

>> second. >> should we ex back at 1:30 maybe? >> for those members of the public who are here for the 1:00 meeting of the planning commission, i imagine the commissioners who have been here will wanted to take a quick lunch break so we will convene no sooner than 1:15. >> 1:30? >> very good. >> thank you. >>

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>> please welcome, canyon sayers roots. [♪] [speaking indigenous language] >> it is still very important to recognize the indigenous peoples , histories of these

spaces and places that we occupy in today's postcolonial secular settler society. it is important that we recognize we have a responsibility to the earth. indigenous peoples have been stewards of the land for thousands and thousands of years i am honored to be present here that you acknowledge that. i am here to offer a song. my mother and grandmother believe that one song and ceremony and dancing stops, so does the earth. i too believe that and i would like to offer this song. without that we would not be here. we share this time and space together for a reason. it is with humility and gratitude and present mindedness that i welcome you here to our territory. [singing]

>> can i hear a good '02 send that out in a good way? we have a responsibility to the earth. we need to ensure safety. don't support carbon trading and please keep the fossil fuels in the soil. honor our mother earth and our father sky and our next generation. [cheers and applause] [♪] >> please welcome our master of ceremonies, the head of communications for bloomberg, linda douglas.

[♪] >> hello and welcome to the global climate action summit. i am honored and humbled to be here in san francisco was such extraordinary leaders from around the world. these are leaders from every sector, every industry, business , government, technology , philanthropy, entrepreneurs and artists, inventors, investors, scientists and students. all united by a common goal. the goal of protecting the people who live on our planet by confronting the existential threat of climate change. we are off to an auspicious start. on saturday, tens of thousands of citizens around the world march to demand greater climate action to fulfil the promises made three years ago in paris. our task becomes more urgent every day.

can this summer, temperatures, once again reached record highs. people are dying as wildfires burned their houses to the ground. they are starving as droughts destroy their crops. hurricanes and other disasters have claimed thousands of lives. displacing entire populations causing billions and billions of dollars in damage. of course, at this very moment, hurricane florence is bearing down on the eastern seaboard and already one and a half million people have been told to evacuate their homes. florence is said to bring 50% more rainfall due to climate and human -induced climate change. meanwhile, tropical storm olivia is sweeping across hawaii. since the start of the hurricane season, this is an astonishing number, there have been eight other named storms in the atlantic and 14 more in the pacific. here in california, more than a dozen different wildfires are

tearing across the state. so now is not the time for us to rest. this year marks the halfway point between the adoption of the paris agreement and 2020. a critical moment when carbon emissions must peak if we are to avoid the worst effects of climate change. by mid century, we must be carbon neutral. these are ambitious goals. by the speakers you will be hearing from over the next few days are working hard to achieve them. it won't be easy and the solutions won't be perfect. we are learning by doing. as we undertake a more radical shift in our global economy that has ever been previously undertaken. we will make mistakes and we will see some failures along the way. but we cannot and we will not back away from this fight. so all of you here today and all of you watching around the world are proof that we will not back away from this fight. please join me in welcoming someone who is heading the way

right here in san francisco. the newly elected mayor of san francisco, london breed. [♪] [cheers and applause] >> mayor breed: hello, everyone. is my distinct pleasure to welcome all of you to san francisco for this incredible, a global climate action summit. we are united here today to take action on the defining issue of our time. protecting our environment and fighting against climate change. this is an issue that is bigger than one city, one region or country. the choices and commitments we make over the next few days and are sustained cooperation will determine if we are able to lead a better future for the next generation. california has long been a

leader on climate action and san francisco has been at the forefront of those efforts. since 1990, we have reduced our greenhouse gas emissions by 30% and cut our landfill disposal in half. all while growing our economy by 111%. [cheers and applause] >> mayor breed: we are proof that you can have a strong and growing economy while advancing ambitious environmental policies we were the first major safety to ban single use plastic bags and i pushed legislation to establish the strongest set -- styrofoam ban and enact drug takeback policies to test 40 tons of prescription medication out of our bay and landfill. [cheers and applause] and our 100% renewable energy program, clean power s.f., has

produced and resulted in greenhouse gas reductions, equivalent to taking 17,000 cars off our roads. by the year 2030, we are committing to for major initiatives in san francisco. cutting our landfill waste in half. decarbonization all new buildings, achieving 100% renewable energy and continuing to issue more green bonds to finance critical infrastructure that is desperately needed to combat climate change. today, thank you. [applause] >> mayor breed: today i ask you to join us. the impacts of climate change are not constrained by borders. our actions shouldn't be either. let's send the world a bold message of action, unity and determination. together we can go further to protect our planet and our

people for generations to come. thank you all so much for being here and enjoy your time in san francisco. [cheers and applause] today we are going to talk about fire safety. we are here at the urban center on mission street in san francisco. it's a wonderful display. a little house in the

urban center exhibition center that shows what it's like in a home in san francisco after an earthquake. one of the major issues that we are going to face after earthquakes are fire hazard. we are happy to have the fire marshall join us today. >> thank you. my pleasure. >> we talk about the san francisco earthquake that was a fire that mostly devastated the city. how do we avoid that kind of problem. how can we reduce fire hazard? >> the construction was a lot different. we don't expect what we had then. we want to make sure with the gas heaters that the gas is shut off. >> if you shut it off you are going to have no hot water or heat. be careful not to shut it off unless you smell gas.

>> absolutely because once you do shut it off you should have the utility company come in and turn it back on. here is a mock up of a gas hear the on a house. where would we find the gas meter? >> it should be in your garage. everyone should be familiar with where the gas meter is. >> one of the tools is a wrench, a crescent wrench. >> yes. the crescent wrench is good and this is a perfect example of how to have it so you can loosen it up and use it when you need it. >> okay. let's go inside to talk about fire safety. many of the issues here relate

to fire, for example, we have a little smoke detector and i see you brought one here, a carbon monoxide smoke detector. >> this is a combination of smoke and carbon monoxide detector. they are required in single homes now and in apartment buildings. if gas appliance is not burning properly this will alert you before the fumes buildup and will affect you negatively. >> this is a battery powered? >> this is a battery powered and it has a 10 year battery life. a lot of times you may have one or the other. if you put in just a carbon monoxide detector, it's important to have one of these too. every

house should have a fire extinguisher, yes. >> one thing people expect to do when the power goes out after an earthquake about using candles. what would you recommend? >> if you have a battery operated candle would be better to use. this kind of a candle, you wouldn't want it in an area where it can cause a fire or aftershock that it doesn't rollover. you definitely want to have this in a non-combustible surface. >> now, here we have our stove. after a significant earthquake we expect that we may have gas disrupted and so without gas in your home, how are you going to

cook? >> well, i wouldn't recommend cooking inside of the house. you have to go outside and use a portable stove or something else. >> so it wouldn't be safe to use your fireplace to cook? >> not at first. you should check it by a professional first. >> outside should be a safe place to cook as long as you stay away from buildings and doors and windows. >> yes. that will be fine. >> here we have some alternative cooking areas. >> you can barbecue and if you have a regular propane bark could barbecue.

>> thank you for joining us. and thanks for this terrific space that you have in this exhibition space and thanks for helping san francisco stay safe.

>> president cleaveland: all right. good evening, everyone. we start with a pledge to the u.s. flag. >> i pledge allegiance to the flag -- one nation under god, indivisible with peace and justice for all. >> president cleaveland: thank you. >> this is a reminder to silence all electronic devices. the fire commission regular meeting, once turkey -- wednesday september 26th, and the time is 5:00 pm. item one, rollcall. [roll call]