under this provision, cpmc would agree to operate st. luke's is a general acute-care hospital with an emergency room for it least 20 years, providing that the cpmc consistently remain financially solvent. the concept is measured by looking at operating margins, the percentages by which total revenues exceed total expenditures. as long as the operating margin for all cpmc's operations in san francisco, not just st. luke's, remains above 1%, c.p. -- cpmc is required to operate st. louis for the full 20 years. st. luke's can only be closed if the operating margins fall below 1% for two consecutive years and after public notice and an extensive meeting process. there, the developer agreement includes several provisions to ensure that st. luke's is meeting the needs of its surrounding community. these provisions build upon the blue ribbon panel recommendation and require that st. luke's be operated as a full-service, general acute-care hospital with an emergency room which will be 50% bigger than the existing emergency room. it will have cent

cpmc's record is the lowest. it has fallen short of providing the basic rights and benefits that there employees deserve. -- their employees deserve. we believe that cpmc needs to pay their fair share of helping the low-income residents in the city. the day received property-tax exemption from san francisco every year. this project will create thousands of jobs, yet cpmc only propose to hire 40 from the residence. we believe this is not enough. only less than 5% of the total jobs. our communities are the most in need of jobs. we want cpmc to hire 50% of these new positions from residents of our communities. we want a specific of numbers allocated to tenderloin residents. we want cpmc to provide more job training opportunities and to respect the human rights of their employees. we what cpmc to address this issue by a community benefit agreement. thank you so much. >> next speaker. >> speak into the microphone. >> [speaking spanish] >> can you translate in english? >> thank you. >> i am a patient of the hospital. i

i do support the program for cpmc. i think it's going to bring state of the art technology and better patient care. i think san francisco is a world-class city and i do not believe right now it has a world-class medical facility. i believe that this prodget will address that. this is an enormous project. it's inevitable that people are going to oppose it. but i think at the end of the day when you add up all the pluses and minuses, the pluses of this project far surpass the negatives. thank you. >> thank you, mr. post. mr. hwang? >> good afternoon. supervisor cohen and supervisor moore. it's good too see you. thank you for allowing me to speak today on behalf of this very important item. i'm an i.b.w. local six member. i work and live here in san francisco. today i stand in front of you speaking in favor of repealing the cpmc. i.b.w. local six has committed to provide a career path for san francisco residents for over 100 years and we are -- because we are a part of the community. today we continue our commitment, work

the city needs cpmc. we understand that the need for seismically safe hospitals -- the coalition understand that is we need jobs. we need jobs for the city workers. and another important thing is that the feeling is that the health care master plan should be a vital component that should be completed before cpmc proveeds. -- proceeds. the city does not know exactly the needs of the city as far as health care hospitals are concerned. we don't need all the hospitals concentrated in certain sect oishes of the city. now going on. the coalition feels that a small erven is project and a larger st. luke's project will best serve the needs of the city in future. as far as the job guarantees are concerned. 40 jobs per year? that's not very much and it's been said many, many times that cpmc is one of the largest employers in the city. and 40 jobs per year? that's sort of embarrassing, i would think. you might put one more zero there. make it real. i think supervisor chiu and other supervisors who have mentioned tha

i support cpmc.

cpmc will pay appraised market value of about $1 million. in terms of enforcement, there are a variety of strong enforcement mechanisms. we can talk about those in future hearings. if there's nonperformance of monetary obligations, the city has the right to terminate and sue for damages. the city has negotiated liquidated damages for non- performance of many of the health care related obligations including the obligation to open st. luke's before cathedral hill, operates it looks for 20 years, and other key health care obligations. really quickly, on monitoring, it requires an annual report of compliance on all obligations and requires the director public help in planning certify each year cpmc is in compliance with the requirements. if the the director finds cpmc is out of compliance, they can begin the enforcement process with the city attorney. that is a general overview of the general terms. i will turn it over to barbara garcia who will go through the health care portions at an overview level. >> good morning. barbara garcia, director o

cpmc's plant in visions five new buildings. each one is sophisticated designed to support a specific program. they will complement the character of existing neighborhoods. the neurosciences institute davies campus will improve public access to the campus through a new accessible concourse. the lower podium height establishes an appropriate street skill. the upper level of the building is set back and turned 90 degrees and provides pedestrian linkages to the existing facility. looking south, a small corner garden provides access to the lobby congress. the upper setback for is not visible from this vantage point. at van ness and geary, the new building will provide enhanced public realm. the hospital is bounded by street. looking south of the corner of van ness, it rises along the southern edge of the site. the remaining building rises to an average of 80 feet from the street, lower in most cases than existing buildings on the edges. it has a positive urban design benefit. placing the tower on the southern edge of the site minimi

i volunteered at cpmc for over 17 years, and my daughter was born in cpmc 60 years ago. so i have a -- well, anyway, a new hospital is desperately needed at this side. an earthquake, unfortunately, can occur any time. i do not believe any of the present campuses are adequate in a catastrophe to help. this hospital will serve a large area for all diversified citizens. the new structure will assure patients of good care, private rooms, and especially for parents and their newborns. to have surgery in such a building will ensure better health for all. i have seen the nurses at the hospital. i work with them constantly as a volunteer. and they are wonderful people, but i hate to see this bickering back and forth, because this is desperately needed. [bell rings] and it has been going on long and long and long. i would like for to be completed so that i can volunteer before i die. thank you very much. supervisor mar: thank you, ma'am. next speaker. >> good afternoon, supervisors. i am with cathedral hill neighbors. i am a retired planner and a labor council delegate. setting u

bicycle access around and between cpmc's campuses. moving to the related issue a pedestrian safety and streetscape improvements. around cathedral, the agreement is that cpmc will provide $9.35 million in cash to the city, which will then go ahead and make the improvements that you see on at this live here. the bulk of these, about $8 million, will go to the first three items on the list. pedestrian lighting in the tenderloin, the conversion of one-way to two-way streets which is a traffic safety issue, and some additional pedestrian safety things. cpmc will fund a tenderloin safe passage pilot program. and then, is a partner the lowerpolk cbd should it be established, and the seed grant of $1 million. that $1 million, in cbd does not establish, flows to the city instead for similar types of improvements. around the other two campuses, starting with davies, the structure here is different. we agreed on a list of pedestrian improvement projects that cpmc will build along with the hospital project. these are over and above the things tha

luke's into the broader cpmc system shifts the question away from whether cpmc is financially viable on a sound and relies on the financial position of the entire cpmc system. the second priority was insuring access to cpmc, specifically the cpmc of new cathedral hill campus. cathedral hill does not except -- accept medical patient unless they come through the emergency room. with the passage of federal health care reform, it is important that we plan for the future in the context of this changing environment. the desire to focus on cpmc's community benefits on san francisco's most vulnerable population. nonprofit hospitals -- this has long been mandated by the state law. it is not a federal law. these discussions we went to ensure that cpmc committee benefits are focused on san francisco's most disadvantaged with limited resources and have difficulty getting to health care services they need. the strike -- i will pass it over to my deputy, who will go for the details of the development agreement. thank you. supervisor mar: thank you. >> good afternoon, supervisors. it is good to be

i support the rebuilding of cpmc. for 25 years, we have been providing hospice and medical respite care to very low end, san franciscans with advanced aids. what you may not know is that cpmc has been a generous partner and supporter for over 15 years. in the mid-1990's, they sold us our current building at less than half its appraised value. we also have 48 employees. our 24-hour facility. these jobs would not exist today if it were not for cpmc's past and continuing support. thank you very much for your consideration. supervisor mar: thank you for the great work. next speaker. >> good afternoon. i am the executive director of bayview hunters point senior services. i am here to support the rebuild of cpmc for many reasons. i was trying to think of what i could add to the conversation. the two pieces i am thinking about is the jobs that are going to be around the gerontology. the people that these two hospitals are going to serve are going to be older people. we need to start training people to take care of the aging

this is 40% of the cpmc ebitda. the first line that is in black of this is what happens if the cpmc ebitda goes with inflation. essentially keeping pace, the base line commitment. this is if it stays flat entirely the money being required out of the backstop commitment. this would be a pretty pessimistic scenario.

i encourage you to support cpmc. please bring seismic safety and top support -- top-level help support to san francisco. supervisor mar: next speaker. mr. carpenter, i did not call your name. if your name has not been called, please respect the process. many people have been waiting for several hours. i do have a list. if you have put a card in, i will call you. i do not think i have called your name, mr. carpenter. >> a bunch of people talk to use names were not called. this is a matter of discrimination, sir. supervisor mar: i would like for you to respect the process. we will get to your name. >> a whole bunch of people came up with other names being called. supervisor mar: i called everyone's names who came up. please respect the process. >> everyone who got on his microphone name was not called by you. supervisor mar: yes, it was. please respect the process. >> speaker. -- please respect the process. >> speaker. >> i wanted to be known [unintelligible] supervisor mar: please continue. >> thank you for hearing th

this is 40% of the cpmc ebitda. the first line that is in black of this is what happens if the cpmc ebitda goes with inflation. essentially keeping pace, the base line commitment. this is if it stays flat entirely the money being required out of the backstop commitment. this would be a pretty pessimistic scenario. for cpmc's ebitda to stay flat, that would essentially represent a pretty substantial deterioration compared to where they are today, since they would be the organization, the financial operation not keeping pace with inflation,

i support the rebuilding of cpmc. for 25 years, we have been providing hospice and medical respite care to very low end, san franciscans with advanced aids. what you may not know is

cpmc is a large corporation. if you look at the analysis of what is happening in wisconsin, the unions were not tight enough together to win that campaign. we all need to sit down at the table together and create a war room where we decide how we are going to get a better deal out of them. >> thank you. >> thank you, supervisors. my name is monica. my family runs a family-run business in the bayview district for 35 years. we are also certified. we have been proud to host interns from the construction administration training program. we do not do this because is required. we do it because it is the way we have always done business. i have to say the knowledge and the confidence level of all the intern to have come from the program have improved. i think that cpmc is employing baby residents on this project. by supporting this project, you are indicating your support for local businesses. and as we all know, when local businesses win, the city wins. >> thank you. >> good afternoon. my name is jerry. i'm the manager

i support cpmc. cpmc is the largest private employer in san francisco. cpmc plans to build state of the art hospitals, and it would create 1100 union construction jobs. it will double the number of sick beds in san francisco. it is time to invest in making this earthquake safe. our members, our struggle -- it's time to move this project forward. with this news, san francisco has the opportunity to go forward with the plans and innovation. we need this project. thank you. >> thank you, sir. next speaker? >> good afternoon, supervisors. i'm the executive director of apa family support services. we are able to serve denver api -- diverse api communities and families. i have been able to talk about the quality of care and safety of around the rebuild for cpmc. also want to talk about jobs. multiplier effect of the direct number of jobs, plus the jobs that will result from supplies and services is quite large. i think the trick is to keep the dollar's local. the multiplier effect was 2 to one. we are talking 16,000 jobs. that does not even include the impact

the need for rebuilding cpmc is clear. the city and in particular our southeastern neighborhoods have a significant health care need and challenges. because of the scope and sale reduced scale of the project, we have a duty to ensure the project is being done the right way. that includes insuring st. luke's is robust enough to meet the health care needs of our southeastern new roots, that local residents can benefit from construction and permanent jobs associated with the product. that we are investing in programs that will ensure we have a pipeline of residents qualify for these jobs and that the project provides a reasonable amount of charity care for our most vulnerable residents. i look forward to hearing from members of the public today and continuing our conversations about the project in our committee hearing. let's get ready to rumble. thank you. supervisor mar: thank you. supervisor avalos? supervisor avalos: i appreciate you giving me a moment to share my thoughts as we begin hearings on the cpmc development. i c

holdsutter cpmc accountable. we want to hold those directly affected by sutter cpmc, including nurses, health care providers, low-income residents of the tenderloin, and working families and seniors in the southeast san francisco. it is well documented a thatsutter is the most profitable hospital corporation in the region. they charge the highest price for services and offer the lowest level of charity care. despite cpmc's propaganda the current terms of the deal negotiated by the mayor's office are grossly inadequate to the community and to our workers. the deal as it stands now would just give cpmc the green light to make millions of dollars more in profits and dominate our health-care system for decades. we urge you to vote against this project unless there are these major changes. these include no downsizing of st. luke's. 50%, not 5%, local hiring for permanent jobs. [bell rings] match lennar's commitment to $8.5 million in funding towards workforce development. guaranteed job transfers for 3000 current empl

[bell rings] and i support cpmc. supervisor mar: sir, for how many years did you work for cpmc? >> i worked in the transport department. for 10 years. supervisor mar: ok, thank you. i have a few more names. halifa, jamil, stephanie, andy, alicia, saul, sean. >> good afternoon. i am a night nurse in the women's and children's unit that marin general hospital, so i am your neighbor up north. formally a part of sutter corporate health system, i have been a nurse for 21 of my 31 years atmarin general. for a number of years, it was operated byu health -- by sutter health, but the district voted to settle its lease agreement five years earlier -- or five years early. prior to this, sutter routinely transferred around 3 million per year out of marin to its corporate in sacramento. that increased to 30 million per year just before the ties were severed. hmm. the district believes that sutter health siphoned off money that should have rightfully remained in the health care district, prompted a lawsuit that is still pending. shame on you, sutter corporation. i had a lot more to read but i

cpmc? >> everyone you see at the table. president chiu: given the lack of information around finances and all of these ceilings are triggered by a very specific financial assumptions, it is important for us to understand what assumptions you are working non. -- working on. my apologies to my colleagues. i have a prior commitment that i need to go to and did is budget season and we have a lot going on. i hope to come back later. and look for to getting more information. one thing i want to mention, a week and a half ago, we had a hearing on jobs. we made a number of requests and we have not received anything yet. >> you should get it in the next day or two. we spent more time than we expected dealing with what you heard earlier today. we will have that for you in the next day or two. president chiu: it is important that we did this still right. if we are going to move forward. i want to make sure we have enough time to do that. we do have hearing schedules forward -- moving forward, but we h

cpmc shout care for at least 1500. approximately 1500 enrolled must be seniors and those with disabilities. this is to manage health care needs. in terms of the timing, this must be within one year of the effective date, and the others by december 31, 2015. unfortunately, the cost of caring for these medical patients exceeds the cost, and it is called the metical shortfall -- medical shortfall. the agreement limits costs them a $9.50 million per year, adjusted annually for medical inflation. the city conducted an actuarial analysis with the 10,000 new patients and is confident that the 9.5 million upper limit will be sufficient to assure that all 10,000 beneficiaries may be cared for. there are the various populations. for example, seniors and persons with disabilities utilize hospital care more frequently than children. this accounts for these variances. it would remain flat. this is not a likely scenario. finally, we model scenarios that showed the costs increasing faster than the rate of depletion. -- of inflation.

it really is offensive for us to have people supporting cpmc and cpmc's line about earthquake safety when our nurses are working in those hospitals. our nurses want earthquake safe hospitals. and we have been actively lobbying for this legislation with them on the other side of us. on the other side consistently. and so when they come up here and act like they're pushing for this to move forward quickly because they want earthquake safety, when they have been on the other side pushing for delays after delays after delays, it is offensive. i'm sorry. i'm pregnant. i'm almost due. i'm mad. the other piece of it is, you know, how are you going to push for earthquake safety when you're trying to reduce the size of st. luke's hospital, which is one of the few hospitals that serves the southeast of the city, and then what, you're expecting everyone to come to a 10-story hospital in the middle of the city on the corner of vepies in the middle -- of venice in the middle of an earthquake disaster? you're kidding me that you expect people to get there. it's an excellent excuse to actually keep

and i also want to thank cpmc. i know they make great investment in the clinic nims that serves the portal and visit on-- and visitation valley but looking for support there in -- people forget that community and i want to make sure we don't forget them. thank you, mr. chair. >> thank you. i support the sentiments of supervisor cohen as well. and wanted to say that l.b.e. or the local business enterprise information would be really useful for other -- s.f. general was brought up at 7% but to know some of those numbers. also the project labor agreement or p.l.a., i think there was a question to ask if that could be shared with us. that would be really useful. and my understanding is if there's strong benefits and job security for some trades, kind of as the construction is done, that it's only fair and equitable if we consider that for the existing work force as well as one consideration, not conditioning the development agreement on that. but just as one consideration of fairness as well. so my hope is that we can

i am so grateful cpmc picked up st. luke's to give us a job for another five years, but the truth is the survey's made on all the professions, the ones that came out telling the truth were the nurses. i implore you to listen to the nurses. if you were to use your brains, everything they have shown you looks beautiful. [tone!] please look with your heart and listen with your heart to all the proposals because there are a lot of contradictions. i hear st. luke's. i do not feel secure in my 30- year job. they have not even given us a contract. we have been tolerating everything they give us. i love my job. i love being a nurse. i loved my white uniform but i gave it up. job security is the one that we need. [applause] supervisor mar: thank you. >> i am with the building trades and construction council. we lost a few at the break. i would ask those in the trades to stand up and be recognized. i thank them for attending. it is rare i can stand up here and be invited to talk about jobs. usually they tell us it is not appropri

this is 40% of the cpmc ebitda. the first line that is in black of this is what happens if the cpmc ebitda goes with inflation. essentially keeping pace, the base line commitment. this is if it stays flat entirely the money being required out of the backstop commitment. this would be a pretty pessimistic scenario. for cpmc's ebitda to stay flat, that would essentially represent a pretty substantial deterioration compared to where they are today, since they would be the organization, the financial operation not keeping pace with inflation, and it would be for them to come into play. of course, if there is a higher rate of inflation, or if there is a decline in the cpmc ebitda, that is when you would see the two lines cross. >> the next provision that addresses this is the 10,000 new medical beneficiaries a commitment. can i have the overhead, please. 30,000 low-income san franciscans who were uninsured will get insurance under medical. it requires cpmc to provide service for some of those beneficiaries. one of these