remodel the kitchen in the dining area, replace the furnace , so that was the original permit. [please stand by]

>> -- to document the work, including means and methods and sequencing of the foundation work. that permit that was required is the permit that's under appeal. that's the revision that d.b.i. wanted them to get to document

how they actually done the foundation. so what happened was they had a set of plans on the main permit. they didn't do the foundation like that. they totally changed the design. they probably went a bit lower, and that caused them issues with the next-door neighbors. and i don't know how they'd done their work, but it wasn't in the normal manner. so add to the problem, everything was sand, so you're in the part of the city that's sand, so you know, you've got to be careful when you're doing this work. as i said, by that point, we're seven months later. i met these people that owned 846 second avenue several times. d.b.i. has facilitated meetings. i've gone to the site a few times. their engineer is a really good engineer. he's be i've talked with him a couple of times. he's been in touch with us. they seem to want a design that

we agree with, but there's nothing stopping that work. that has to be done on a separate permit on their property, not on 840 second avenue. it's probably about money. it's probably about what it is and what the damage was. there's something amiss. in my experience as a senior building inspector at d.b.i., we deal with undermining, underpinning. it's unfortunate, but there is a fix for it. they need to come together and figure out how much they're willing to pay to get that done. i think it has to do with how much. they can't agree on that. maybe that's the bigger issue, i believe. and that's unfortunate because we have notices of violation on both properties. the 846 second avenue, you heard it, we called it a

friendly n.o.v. we have to document the property on a notice of violation. it protects them in a way, as well. it's something that they may need if they ever go to a civil process. if this doesn't get resolved, we're looking -- it's an unsafe condition. now, it's not an imminent condition. if it was, their engineer should be coming up with some plans to stablize the building. but you know, at the same time, there is an issue and they need to fix it, and i think it's more to do with the parties not getting together. on this permit under appeal, this permit was required by d.b.i., and it should have been done differently. what happened is the

inspections -- when i went out there and saw the condition, obviously, my first question was who went out here from d.b.i.? who did the inspections. so when i went back to the office, i looked up the inspection history. i had to speak to the inspector, and i had to say, i just came from a property there. you did the inspection. the details on the drawings were not quite what they'd done. what happened? so what i was told is he's a pretty new inspector. we just hired him within the year. a very good inspector. what happened is he was shown an 8.5-by-11 detailed change, but unfortunately the inspector should have asked for it to be on a revision. he wouldn't have allowed the work to proceed, and he would have taken into account, he

should have taken into account any work on the adjacent property on the property line. it's sand, and you've got to get that addressed. the inspector has been spoken to by myself and chief building inspector, as well. these things do happen. there was a mistake made, but i don't think it calls for an investigation of the department, which was in the brief, which is a little bit annoying to read, especially given the fact that i've been there several times, been very responsive. matter of fact, i've e-mailed their engineer. many thanks to them for facilitating the meeting here today. i think the permit is needed. they just need to get together and figure that out. it may end up in court, i don't know. >> joe, got several questions here. >> okay. >> commissioner honda: given the fact that the parties are

not seeing eye to eye here, and it's probably going to go beyond this body, what is your recommendation because the house is already done? you know, at this point, i'm asking what do you think? >> well -- >> commissioner honda: i mean, granted, we make the decision. >> there's not -- the permit in my opinion was properly issued. it is in response to a notice of violation from d.b.i. it was part of our corrective action. they knew they had to get it. it was a corrective action that should have have been done at the time, and i think that this permit covers it. i haven't seen the plans. i've seen them way back, but i haven't seen them as part of the brief. i don't think there were many. they weren't in the brief, but at this point, i think the

permits okay. we are -- d.b.i. has to make a decision if we're going to sign off on the permits at 840 second avenue with all the work being done. as you heard, they're passing it over to their insurance company. i think they're trying to avoid that initially. it's going to drag on, but what i would say to the owners of 840 second avenue, this has happened before in san francisco. this is fixable. your engineer knows what the fix is. it's a matter of figuring out how much it is and get that

resolved and get it done. the sooner, the better. >> commissioner honda: i agree. >> i think they're planning on doing rooms on the ground floor, so they're probably holding up progress on the work on their own probably. lazarovitz that was my questioquestio >> that was my question, the work that was done on the permit. >> i sympathize with them. this permit, i think, is properly issued, so -- at this point. >> president hirsch: so mr. duffy, we finally have a case which we have been anticipating in my world at least for several years because most of the time, we have a case where

the neighbor is a little bit proactive, and those next door door are going to undermine my foundation, and then, they appeal, and you reasure them through the inspection process that that simply is not going to happen, and we have modified the foundation and stuff like that. now we have one where it got approved. it was -- the permit was issued correctly. there was a -- there was a problem. i would like to ask you, because it's important, i think, for this body and for the appellant, in your view, you stated in san francisco, this happens on a regular basis. it's unfortunate, it's sometimes unpreventible, but it

does happen. here's the situation as i read it. it occurred. whether or not -- we have a property owner who is not educated or sophisticated -- this is not an insult, by the way -- me, too, by the way. here's a property owner, and they own their house. they're happy to own it. they don't know about what happens during construction on san francisco's sandy land. and suddenly, they wake up one day, and i wake up one day, and i look over there, and i say whoops, you know, my ceiling fixture is separating from my ceiling. and i go gee, what's happening here, and then, i find out, etc., etc., etc. now, clearly, the -- clearly,

it seems, that the fault is with the next door property developer who, i'm not going to call them negligent, but i will certainly find them responsible, that caused the undermining. what is a property owner to do? please identify what -- for the appellant, regardless of what we find tonight, please tell the appellant, based on a clear -- a problem which has clearly affected them that was the result of somebody's -- yeah. >> very, very good question. >> president hirsch: what was going to happen next? how would you advise them? and because, you know, i want my ceiling fixed. >> i have actually given that advice already several times. >> president hirsch: for the record, please, so we know that

the advice has been given and it's constructive advice. >> yeah. and i don't know if i'd use the word regular, on a regular basis. it does happen now and again, but i don't think it's regular. >> so when the main permit got initially issued, you've heard me say this many times, d.b.i. as part of the -- because there was excavation at the property line, there was notification -- structural notification was sent out by d.b.i. when the permit got issued. and at that time, that's a good time to ask the questions. and sometimes with all due -- people that don't understand construction and maybe they were told this isn't going to be a problem and forget about it, it's going to be fine. >> president hirsch: and they're nice guys, and they don't want to create a problem for their neighbors. >> but that's your appeal period. that's your structural notification, come down and review the plans.

obviously that didn't happen. but my advice is, if mr. king is still their engineer, get a detail drawn up as soon as possible and try to figure out a financial settlement with the neighbors to get this worked on. >> president hirsch: and do they have any responsibility to the -- if they don't choose to use the permit holder's contractor, even though the permit holder is offering their contractor, because obviously, i wouldn't use the contractor because they screwed up my house -- i'm speaking for me, not for them. do they have a choice to select the contractor, and is it in bounds for them to go to the permit holder and say thanks for offering to fix it, but i don't have faith in your contractor. i want my own, and that's a reasonable claim? >> yes. we can't make them use the recommendation. that came up as part of the meeting at d.b.i.

this is from memory at the meeting, is that the contractor that did the work next door was quoting, like, $30,000 to do this work at their property, and their contractor that they were going to use was $80,000, and there was $50,000 in the middle. so that's why they wanted to use one. they have to use what they're comfortable with and who they want to let in the property. we told them at d.b.i., we're not going to get involved in who they want to use. they were close to settling, but it went sideways. i don't want to read the notification i gave them, but it contains plans to repair the condition at their property. >> president hirsch: and finally, given that there is interior damage, as would be expected in a settling house,

this -- would the same hold true? would you -- they have no liability -- sorry. they have no responsibility to accept an offer from the permit holder. let me send my guy over, and he'll fix it just fine? they have the right to seek their own contractor and get subsidy to get the contractor to bring the property to the level of care that it was prior to the damage? >> yeah. i saw maybe four or five years ago, same thing. worse than this, actually. fractured sheet rock. the wall finishes, you could see movement. what d.b.i. want is a structural engineer to come up with a report that remedies all of these problems, beginning from the bottom to the top, whatever they have to do, and he will come up with an action

on a plan or a set of drawings, and that will collect the issue. sometimes they do agree on ongoing monitoring for a year or two to make sure there's no settlement, and we mentioned that to them. it lets you know that your building's stopped moving. >> president hirsch: and finally, the -- obviously, the appellant is apprehensive about their financial exposure. what should their fear about financial exposure be? should they expect to be fully compensated for the repair by the next-door neighbor who caused the damage? >> well, that's for the courts to decide. if the insurance companies get involved, it's probably going to be involving lawyers, and that's probably for a judge to decide, but i'm sure, like everything in life, if you

crash into someone's car, you're paying for it. it's coming down to the amount, and that's what it's going to be. if the insurance companies get involved -- >> commissioner honda: yeah, but what matters is who gets involved? >> president hirsch: yeah, but i think the public should be educated. it's my job to educate the public. i think it's important, our job, to educate the public, and get educated, too. >> thank you very much. >> commissioner honda: thank you. >> clerk: okay. is there any public comment on this item? okay. we'll now move on to rebuttal. are you with the permit holder, sir? [inaudible] >> clerk: okay. we're going to use the rebuttal time. when it's time -- i'll let you know when it's time to come up, and you can just write your name on a speaker card.

okay. so we will now hear from the appellants. thank you. >> thank you. thank you. appreciate it. >> clerk: thank you. >> there's been a lot of dialogue back and forth. yes, we're not experts with what's going on, but we're dealing with people here with deep pockets. we don't know what to do. we don't know what to do at this point, because we have a house that continues to settle. even with the temporary shoring up, we noticed a door -- it looks like -- we have kids that can walk underneath the door now. with the rain, we're afraid it's going to continue to settle. as far as the insurance calling you, hey, they're going to call you, they're going to call you. three weeks from now, they're going to call you. we haven't gotten one single cent. we've paid $8,000 for engineers to come out and take a look at the place. it's not going anywhere.

everything is like at a standstill. i know this is not a court, but like, a panel, get assurance from the other side whether that insurance is going to contact us so we can move forward with our lives here, so -- >> commissioner honda: are you done? so i've got one question. >> yes. >> commissioner honda: so the work started last year. what took so long to call the department of building inspections? >> we didn't know. we started noticed little cracking here and there, and then, when we decided my daughter -- we decided she's tired of living upstairs with us. >> commissioner honda: welcome to my world. >> we've got a daughter who wants to move from upstairs. it was from one side all the way to the other side, and you can see basically the stairwell. >> commissioner honda: okay. thank you. thank you. >> clerk: thank you. >> thank you, ma'am.

appreciate it. >> clerk: we will now hear from the permit holder. >> good evening. i'm new to this. >> commissioner honda: welcome. >> we do have a claim -- my name is alex mcdowell. we do have a claim. it's 14639. we are not here to rebut what is done to their property. i just want to tell you my version of what happened. you probably don't want to hear it, but in a perfect world, we were told about the issue. we all showed up with our engineer, our contractor, them, too, and i believe it might have been one of their contractors. with their engineer, dave cane, who knows a lot about this, they came up with a fix. the two engineers worked together and came up with a fix. we just said we're going to fix it. we didn't stop any of that. we said we were ready to go.

i mean, he was -- our contractor was ready to do it. he said one week, he'll be done. then it went sways. i don't know how. i left shaking hands, exchanging phone numbers, everything, and even to today, just walking in the door, they were saying hi. now, we want to make it right but when they came, and they switched around the price, and they were saying -- we were in mr. duffy's office with another gentleman, another senior inspector, and they offered to put a senior inspector on the job to look at it, we told them our contractor will do the work. we'll watch it. we'll take care of it and everything, and they said no. and they came up with a crazy price -- i mean, our contractor does a lot of work for us. a lot of work for us.

we were going to fix it. just like my daughter hit someone. backed it -- little damage to the car. i offered hey, what do you want? he wanted $1,000. i said hey, i'll write you a check for $1,000 to keep it off my insurance. that's what they were willing to do. they came with an exorbitant amount of money. not just one, then, they said the other side of the house is going the other way. i'm not an expert. the foundation has a problem here. we don't understand why you're giving us a bill for another 100,000, so it got to 200,000. we don't make that much money on these homes, nor does the contractor. the contractor says i'm going to have to turn it to my insurance, and that's what we did. we tried to take care of it. mr. duffy was there, i was in the office. the lady was there. they seemed very reasonable,

but then, i don't know. i don't know where it went. we wanted to take care of this issue. we're not running away from anything. we do a lot of projects in the city. >> clerk: thank you. >> commissioner honda: thank you. >> clerk: do you mind filling out a speaker card just so i get the spelling of your name correct for the minutes? mr. duffy, anything further? >> commissioners, joe duffy, d.b.i. just to follow up again on the 846 42 avenue property owner. if he's noticing further damage, he should contact his engineer immediately. part of the notice that was issued by d.b.i., after the friendly notice of violation, we call it, did ask for obtain an evaluation report from licensed structural engineer.

evaluation shall include immediate items to mitigate/correct issues of the current foundation. so their engineer is the person that should probably be advising them on what's needed to be done out there, if they think they're getting further damage to their property, so i wanted to add that. i'm happy to speak to them about that, and of course, we at d.b.i. will meet with the engineer and do whatever we need to do from a building and code point of view. i don't think i have anything else. >> commissioner honda: okay. thank you. >> clerk: thank you. commissioners, this matter's submitted. >> commissioner honda: i'll start. so sorry that you guys are having to go through these issues. and evidently, if you're 100%, there's other issues there, as well. i think what's before us is really -- it's about the dollar amount, it's not about the

necessarily work to get done. and being somewhat in the trades, looking at those numbers, i have my own opinion, as well. but unfortunately what's before us now is just the permit at hand. it's done and it needs to get executed. as you said, we are heading towards the rainy season. i would hope that, you know, you would work to -- to get your property in working order so that it does not have a further effect on your family or your home. but before us tonight is just if the permit is properly issued. i believe it has. i believe that there's been a lot of process on this particular property. so i would -- i would deny the appeal on the grounds that the permit was properly issued. i guess that's my motion. >> clerk: okay. we have a motion from commissioner honda on to deny

the appeal and uphold the permit on the basis it was properly appealed. on that motion -- [roll call] >> clerk: okay. so the appeal is denied. thank you. this concludes the hearing. gavel, president swig? [gavel]. >> clerk: thank you.

>> good morning and welcome to the san francisco planning commission and health commission special joint hearing for thursday, october 3rd, 2019. i will remember you that we do not tolerate disruptions or outbursts. please silence cell phones. please state your name for the record. i will take roll for the planning commission. (roll call) we expect commissioners moore and richards to be absent today. >> i will take roll for the health commission. (roll call). >> commissioners, we have one item on the special calendar item one 2012-0403w. california pacific medical center annual compliance statement. this is an informational hearing. >> good morning, commissioners,

i am planning department staff. the item before you is an informational presentation on the california pacific medical center's compliance with their development agreement for the 2018 reporting period. this is the sixth annual reporting period. i am joined by ken, marina from the health services service and the department of public health and elizabeth pearl of the planning department. today's hearing is part of the annual review process required by the development agreement foresee see. for c.p.m.c. it requires a public hearing. following today's hearing the directors of planning and public health will derm whether c.p.m.c. is in compliance.

a third-party monitor will inform the board of supervisors if they agree with the directors' determinations. c.p.m.c.'s development agreement allowed them to build a new hospital and medical office building at the vanness and geary campus with a requirement they build a new hospital to replace st. luke's. the development agreement required replacement of st. luke's hospital within two years of opening the vanness hospital. they met this with the owning of the -- opening of the commission hospital. they required payments for range of public benefits and improvements. they completed the payment requirements with a total payment of over $73 million. for the 2018 reporting period there are 11 main actions up for

compliance t.these include payments, hiring commitments, public improvement and community outreach. my colleagues will go into these. in one reporting area the local hiring period has a reporting period corresponding to the fiscal year rather than calendar year. that means for recent information on hiring. ken will help explain how the c.p.m.c. overall hiring record compares to the goals of the overall development agreement. construction of the vanness hospital is complete, and the associated medical office building also opened this year. future construction includes the new medical office building omission and improve mends around the -- improvements around the mission area. one other obligation is the limit on fees for servicen

creases by c.p.m.c. as the provider for the city health service system. annual increases must be no more than 5%. actual analysis finds they met the requirement through 2017. the most recent year for which this analysis has been complet completed. they are working on the 2018 data now. with that we will turn to ken nem from the oawd work force division. >> welcome. >> thank you, good morning. i am the director of city build of the office of economic work force development. thank you for the hearing to give us the opportunity for feedback on the report and i would like to thank the public to serve the residents seeking

employment for this great opportunity for the hospital. first, i would like to start with the construction. we are putting it as cumulative since it started in august of 2013. the first topic is hiring for internship. as you know, the majority of the construction work has ended. st. luke's opened in august 2018. the vanness hospital opened in march this year. a lot of construction has been completed. when we generated these hours for the last program year, not a lot of hours were added. for example, for the 50% entry level positions for non-union administrative engineering candidates, new hires in the office we had requests for 38 of

the new entry level positions. we filled 32 with folks out of our program. city build have the construction hands-on training and have the professional services so people coming through our program administrative type of professional training at city college. we work with contractors to get them into these administrative positions. 32 of those were from our program and some include lead document, document coordinators, project administrators and project manager. from the next slide, which is very similar, but this is really focusing on the internship program. we work with the san francisco unified school district and san francisco state through the mesa program, mathematics, engineer

and science achievement. they are disadvantaged residents. we got 30 interns on this project. goal was 50%. we achieved 57%. i spoke with the contractors. 10 of the hires are on the company working with projects outside of the hospital once it was completed. that is a good success. we want retention and people sustaining to work. the next slide is our entry level positions for construction and most of these are focused on apprentice ship programs. city build we offer the academy which is 18 weeks. people who graduate from the program we pay for the initiation fees to get them in the union and to work. early are the challenges not having enough ironworkers. we have presented that in the past. one of the toughest trades to

convince people to work in, and with that there was still a good amount of ironworkers. during one of the events a graduate spoke and highlighted success in working on the project. the last four years, we have experienced a big construction boom. in city build we manage other compliance programs, mandatory hire the city public works contract we increased for the last year 3 million work hours. this has mandatory requirements. if the contractors do not meet that there are penalties. it is going to local residents on the projects but the other projects are taking them to avoid penalties. we had the opening of chase center. they increased the program year about 1.5 to 2 million work hours. they also had the office of community investment goals that

was drags and pulling on local residents to work on those projects. some of the challenges we had difficulties in fulling. drywalllers during the chase center. sheet metal workers and operating engineers were some of the entry level positions we could not fill to get people working on the project. we had 175 apprentices on the project. these are individuals that did not be have experience or could not get an opportunity to work construction due to this project brought them on, started a career in construction and they are union members. that is the success of that. then the fourth compliance is the overall work hours. overall workout is 30%. the first three years we met the goal. with all of the construction happening and other projects, we have seen decline especially the last year the major work was the

medical office building. a lot of exteriors were done. what caught us off guard a special interior modular system, prefab wall to use for that system in canada, and the carpenters that needed to do the work had to have special certification. we pulled in the contractors, we could not get it from the union because of the special certification. we did not have people trained for that. even with that we were able to get some employment opportunities, not the bulk of the prefab work. that gave us a challenge in a drop in numbers. they did the best to work with us to hire folks outside of those specific classifications. we still convinced them to hire people from the community working in the cleanup work, laborers and whatever opportunity was available that didn't need the special

certifications. to date we 432 -- 322 residents hired to meet the 30% goal. these are just some statistics. this is a piechart of where the hours went. we have reported roughly a little over 5.6 million work hours, of that 1.15 for apprentices. 35% of those were local. these are new individuals coming into the system to help them retain them and successful journey level workers. now here is a demographic where the workers were coming from, from the different neighborhoods. these are the key neighborhoods that had the san francisco work hours. four biggest neighborhoods we were targeting and which the da put a special reference for.

four of these neighborhoods represented 60% of the work hours. workers were coming from the neighborhoods we wanted to impact through the development agreement. now, i will focus on the lb eg egos. 14%. we have reached 16% of the dollars were going to l.b.e. that is equivalent to $227 million to l.b.e.s. each of the bullets focused on the projects and where the money was coming from. the ti work was not significant compared to other major work. lower amount and we were able to reach 16% to the l.b.e. community. l.b.e. is monitored by the contractor monitoring division. they provided me that data. now, we are looking at the first

source hiring. to focus first is the program year's goals. in addition to construction we have a business services team that works with c.p.m.c., the employer and they submit to us job notices. we work with the community to provide referrals. i convinced them to give opportunities for people coming to the program. we have hospitality and healthcare that a lot of graduates go to the post construction work. the goal is 40% of the new hires entry level positions referred. in the program year we were able to hit 52%, 48 out of the 92 employees were referred through our system. we 432 -- 326 placements since the program started. i have statistics on the next slide. for the program year, i think a

big question where are the individuals coming from? based on our analysis all of the qatathekey neighborhoods. 65% from the tenderloin, outer mission, chinatown and southeast neighborhoods. cumulative data we looked at since we started the program with 81% retention rate. these are individuals hired that stayed for 180 days or more. we had 263 hires retained over 180 days. the last slide is just a work force fundings. those are provided to help fund the agencies doing the work in recruiting the neighborhoods, non-profits to do job training or employment opportunities.

a lot did case management to make sure people are successful. life skills to prepare them before they come to our office for training. the current grantees this program year $375,000, and the agencies were jds, self-help for the elderly, success center, co-tenderloin is a new agency. as of this may of 2019, there is $935,000 in the account. the program year they are looking at new scopes of work and what else needs to be done to prepare individuals for the post-construction and operation of the hospital and those are my updates. >> thank you very much. we may have questions.

>> good morning. i am from the department of public health. for this section of the presentation i will provide an overview of compliance related to the healthcare commitments and the da. so first i would like to provide a summary of the healthcare commitments. there are multiple commitments to ensure that c.p.m.c. provides high-quality care to all san franciscans, especially low income, uninsured. each contain multiple provisions. at the top five baseline commitments to maintain the same level of commitment. three to increase care to medical and low income individuals. two on the innovation fund for $8.6 million to fund community-based services and

programs. the last two commitments are specific to the mission burnell campus in effect for the open of the new hospital in august of 2018. they are reported in the compliance review. these additional commitments include key provisions related to the number and type of bed space available and four provisions to ensure specific services and programs are provided at the mission burnell campus. there are five additional healthcare provisions that range various topics. sub-acute services. these provisions help to ensure seamless and accessible care to those in san francisco. over the next several lieds i will provide more details on the healthcare provisions and the compliance on each. this slide provides details on each of the five baseline

healthcare commitments. the c.p.m.c. compliance and if they are compliant. c.p.m.c. exceeded the requirement of caring for the charity care patients. it is for those without expectation of reimbursement. they cared for 38,210 charity patients. second is community benefit unreimbursed costs to provide or improve community health. in 2018, c.p.m.c. exceeded the $8 million community benefit requirement providing $15.1 million. they met this by providing grants, community health programs and community outreach. it is important to note that the first two provisions on the

slide are verified as part of a third-party audit. third and fourth are related to charity care policies. third required easy to maintain the charity policies through 2015 which they met. it requires charity care policies compliant with state law. that is the case. as of 2018, c.p.m.c., charity care was the same as 2015. the last provision i is for the easy to support the bayview child care center. they have provided an operations grant for five years, invested over $1 million, transferred assets, is still the specialty and hospital partner. so the next three provisions focus on medical. the first provision, c.p.m.c.

continued to participate with the san francisco health plan. next requires easy to assume responsibility for 5400 new beneficiaries. this was met in 2014. in 2018, c.p.m.c. had. they are required to serve the new medical beneficiaries through a partnership with the tenderloin serving provider. currently there is no such provider. to meet this c.p.m.c. partnered with northeast medical services to bring st. anthony's clinic as primary care provider in tenderloin. they are accepting enrollees.

in may 2019 there were 174 members in the partnership. they have reported several barriers to increasing enrollment. if you include patient choice. new enrollees can choose which hospital to go to for specialty referrals. these may be more familiar with the csfg and opt for that instepped of c.p.m.c. another barrier is follow up with potential enrollees. they may have unstable housing or have outdated contact information. clinic staff have been unable to reach them to complete enrollment. another barrier is staffing challenges. they have experienced staff turnover. c.p.m.c. has reported that it is partnership with three-inch

dependent primary care providers. they collectively serve 2600 tenderloin residents. c.p.m.c. continues to work with the st. anthonys for outreach efforts. the next two provisions pertain to innovation fund. c.p.m.c. is required to make payments between 2013 to 2017 totaling $8.6 million. the final payment of $1.25 million was made in 2017 and completed the payment obligation to the innovation fund. this describes how they are used administered by the san francisco foundation. c.p.m.c. and the public health and foundation it is on a committee to support community clinics and community based programs.

these awards will support community based programs for african-american and pacifi pacc island communities, healthy living and services for seniors. so the da includes two provisions related to the number and type of bed space available. the first provision on this slide requires the mission be 120 beds general acute care with comprehensive emergency services, must open within 24 months of the vanness hospital. they have opened the hospital as described in august 2018 abearlier this year opened the

vanness hospital in march of 2019. this second provision is conditions on the operation of 30 additional shell bed spaces at the vanness hospital. c.p.m.c. may not build out or place into operation this shelled space until after the mission burnell is open and has a 75% for a full fiscal year as in the compliance report. this provision is not yet applicable but subject to the mission burnell campus hospitalization utilization. the follows four provisions ensure c.p.m.c. provides specific programs at the campus. they require comprehensive inpatient and out patient and urgent care services. c.p.m.c. is compliant offering

all services outlined in the development agreement. for the second and third. c.p.m.c. is established to establish and maintain a center of excellence in senior health. this center is named health first at the mission bernel campus and integrates community health workers to the healthcare team. c.p.m.c. reported the following in 2018. it provided care to 717 unique patients and over 1400 encounters. staffing includes three bilingual community health workers bilingual in stannish and english and the program is fully staffed adding patients

regularly. they require easy to create a community advisory board to provide input to the operation of the center. c.p.m.c. convened the first board meeting in october 2018. in review we noted the advisory board could have additional membership. we recommend c.p.m.c. recruit and engage additional community organizations into the body. next is center of excellence in senior health to provide care to approximately 600 seniors over 70 to live successfully in the community and reduce unnecessary hospitalizations. it is comprised of three programs. the first is acute care for elderly or ace, it is a 34 bed unit at the mission bernal campus providing care to older adults. physical and occupational therapy and rehabilitation and group activities to encourage

socialization. second is the hospital elder life which develops personal care to help each patient stay mobile and social and prevent functional decline. third is the san francisco village partnership, which is a nonprofits that provides a care navigator to access needed community services to ease transition from hospital to home. c.p.m.c. reported 70 patients each month and has conducted outreach to community partners to promote as a potential resource. for the last provision on the slide, c.p.m.c. has a proposal for the office building within five years of opening the new hospital. they are within the five year window. they have until august 2023 to submit a proposal.

so the remaining healthcare divisions are stand a stand alo. the first requires easy to develop specific for sub-acute care services. it is skilled nurses in which patients require a higher level of care such as ventilator care. the requirement was to present the health commission. this was completed in 2016 through presentation of the post-acute care to the health commission. c.p.m.c. is currently engaged in the project to a assess and develop strategies in the city. second is integration of staff across the c.p.m.c. campuses. in 2016 they completed integration of st. luke's to a single integrated staff.

they have maintained this with opening of the new mission bernal hospital. the third provision requires the participation in a community benefits partnership. they continued to participate in the san francisco health improvement partnership which is a nonprofit hospital and community-based organizations to improve the health and wellness of san franciscans. the next commitment i is for the easy to continue partnership. they maintained the current agreement during 2018. there are concerns regarding the agreements. c.p.m.c. and chinese hospital are negotiating contracts. we will provide update next year in the compliance report. so for the last provision, the

last provision touches on national culturally appropriate services or class standards. c.p.m.c. has reported it is their policy to deliver in accordance with mandates with the national standards. they are compliant be with this provision. commissioners and community members expressed concerns regarding the cultural appropriateness of the services. particularly, around the st. luke's diabetes center. they met in april 2016 and the meeting resulted in specific recommendations to increase spanish speaking staff, provide spanish group positive, hire reception staff. it is important to note as of april 2018 they transferred diabetes center. they did