cpmc was in compliance. peragreement, milman reported that cpmc had satisfied the annual rate increase commitment of the increase to be less than or equal to 5%, but no additional details were provided other than the methodology used for the analysis. cpmc and san francisco health service system has agreed to engage milman to conduct two separate analyses: evaluation comparing calendar year 2015 data to 2016 data and comparing 2016 data to 2017 to determine year to year rate increases. san francisco health is service system requested the claims data from united health care and from blue shield of california for 2016 and 2017. milman has received the claims data from u.h.c., and we are expecting those results in about eight weeks. thank you. >> now we're going to turn it over to ken mann of workforce. >> good morning, commissioners. thank you for having me here. i manage the office program at the office of workforce development. first, before i start, i'd like to acknowledge emily chair and lowell rice in my

we all know cpmc will be awarded. rather, we encourage you to use this public process to insist that cpmc and city departments answer some important questions outlined in the coalition's written comments, which i will summarize momentarily and coalition members will expand upon in their public comments. for some of these issues, we ask you to look more closely for others we ask you to take a broader look. and of course, coalition members and i are happy to respond to any questions that you have after public comment. so let me just preview the seven areas we would like you to look further at. the first has to do with charity care patients. here we're asking you to take a closer look. yes, cpmc is exceeding the numbers of patients that its committed to. there's been a great deal of volatility from year to year. we think it would be helpful to ask why that volatility. it would be also informative if we knew a little bit more granular details on charity care patients. at which campuses are they being seen? what zip codes

cpmc's 2017 performance, and a determination of whether cpmc is compliant on each. so starting at the top, in the past few years, the cpmc has exceeded the development agreement requirement of caring for 30,345 charity care or medi-cal parents. charity care refers to health care provided to those who can't afford to pay without expectation of reimbursement. second provision is related to community benefit, which is unreimbursed costs that cpmc incurs to improve community health. in 2017, cpmc exceeded the $8 million community benefit requirement and provided about 12.5 million. cpmc has -- provides -- met this requirement by providing grants, including community health programming and community outreach. i just want to note that these first two requirements are also verified by deloitte as a third party provision. the third provision was in effect until 2017, which was that cpmc was to maintain their current charity care policies. that obligation was met by the end of 2015. the fourth provision was that cpmc maintained charity care policies that are compliant with t

we need to see whether cpmc is fulfilling its obligation and we demand that cpmc, the private hospitals and the city provide seek affordable healthcare for everyone. >> next speak are, please. >> thank you. good morning. my name is melanie grossman and i am a licensed clinical social worker specializing gary attics. i represent the san francisco older women's league and we are a member of the coalition. generally, a center of excellence is defined as a comprehensive program in a particular medical area which supplies concentrated expertise, best practice care, education and other services. cpmc's vision of the senior center for excellence serves only hospitalized patients with access to the new ace unit. language in the development agreement leaves ample room for something much broader. our vision would offer inpatient and out patient whole-person care which means care of physical, mental and cognitive health, caregivers support, and programs promoting independence and reduced social isolation. to ensure aging in place, the center would work closely with community resources and families

from cpmc to sutter pacific medical foundation? these departments include the breast health mammography center at st. luke's pcampus, and outpatient psychiatry clinic at the -- its pacific campus. so commissioners, after the july 17 meeting, you all requested additional information about these changes which have been provided to you in a memo, and they are also summarized in the resolution 18-5, which are -- which is here for your consideration. i'll just quickly highlight a couple of the pieces of information that we're -- that was provided by cpmc. so cpmc reported that ofs 7,5 -- off the 7,500 patients that were affected by the transition to sutter medical foundation, 17% were medi-cal, 48% for commercially insured, and 43% were either medicare or self-pay or other. sutter pacific medical foundation has expressed its commitment to continue care for patients who are served at each outpatient department that cpmc operates today, and sutter pacific medical foundation has expressed its intent to accept new patients that are undergoi

luke's it's cpmc presenting itself as the beating of care before the hearing, cpmc must do better for san francisco. thank you. >> thank you. next speaker, please. >> hi, my name is dr. teresa palmer. i work with the coalition for housing healthcare jobs and justice. in the 2017 report, sutter ignored its obligation to care for 1500 tenderloin patients on medical. also, in previous years, sutter provides numbers about charity care with inadequate breakdown of the services provided and the population served. the aim of the deal was for sutter to care for lives into the tenderloin, not to just give isolated single services, sutter cpmc is non compliant with these services reporting requirements. the d.a. asked sut i remember to act in good faith to develop solutions for the sub acute sniff bed shortage in san francisco. specifically considering that sutter is shutting down to sub acute sniff unit at st. luke's left san francisco with no sub acute beds. the shut down with hospital base beds, many by sutter, has crowded long-term care patients out of town leading to a worsening critical s

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 flu

to contract with payers, including managed and straight medi-cal with the exact same contracts that cpmc currently holds. does the sutter pacific medical foundation actually accept the reimbursement rates of state medi-cal and will they accept the straight reimbursement rates that cpmc currently accepts for the same services? i just want to make sure i understand same contract really means the foundation for these services will actually accept the reimbursements are currently straight medi-cal reimbursements. >> thanks, dr. green. you're exactly correct. >> what was exactly right? >> next question. >> sutter will accept the same -- >> excuse me, dr. browner, could you speak a little louder. >> sutter will accept the same rates at cpmc accepted, assuming that the plans actually will provide them. as you know, contracts are two-way streets, so we can't dictate -- or spmf can't dictate to the plans that they would offer the same rates, but if they do, spmf will accept. >> could i just follow that up for a moment, commissioner green, because it seems to me that if some of these transfers hav

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'

is the 24 bed program located at cpmc's california campus. information was presented to you july 17 about this change. and while cpmc has made a great effort to ensure the remaining residents who were left in swindell's were left with an alternative option to subsidize their cost at alma villa. we know this will result in a net loss of ten residential care beds for the elderly in the city. so there by, that will limit access to care for residents of san francisco, and so we do recommend that this will be a detrimental impact for health care services in the city. you have a draft resolution before you, 18-4, for your consideration. >> okay. again, i ask you to please look at the handout that we had to be sure that we have the final draft before us. we do have public comment, and i'll go through the names again. this is for item nine: mathy fano, dr. teresa palmer -- matthew fano, drrks teresa

is the 24 bed program located at cpmc's california campus. information was presented to you july 17 about this change. and while cpmc has made a great effort to ensure the remaining residents who were left in

so on july 17, you heard three separate changes that cpmc is planning to make in 2018.aking action on each of those items. so the first item that we will be talking about today is the change in licensesure from cpmc and the institute on ageing to solely the institute on ageing to the alzheimer's day campus. this is currently located at the the california campus, and provides care for people with mild to moderate if dementia. you heard that they are working with multiple donors to secure a location for this program? at this time, we do not have any further updates about their progression with the donor, and we're unable to predict when a decision will be made. so you have a draft resolution, 18-3, before you, for your consideration. i'll also note that dr. warren browner, director of c.p.m.c. is here, and can answer any questions you might have on this item. >> okay. commissioners, we'll be taking each of these items separately, so the discussion will be on each separate resolution, and this one is on the alzheimer day program. >> and there are several public comment req

everybody that on thursday, we do have our meeting with the planning commission in rathers to the cpmc development agreement. this is at 10:00, i believe, in room 400, at city hall. >> i won't be joining you all at that meeting because i will be in orlandoattending a conference. >> you can submit a list of questions and we'll ask them. >> i will take a look and see if i have any. >> i'd be happy to go to orlando in your place. >> commissioner guillermo. >> i just wanted to note as commissioner green shared, she and i were able to go to the jail health services tour with dr. pratt on friday, and really, really impressed with what we were seeing there, just in terms of the leadership of dr. pratt. and i was wondering, i don't know whether there is a -- a jail health services report that comes to the commission or when the last time it was, but i would encourage, if it doesn't happen, that it should -- >> we'll put that down. now we have an item that also we can help explore with the jailhouse services. it's been some time that the commission has had a full report on jailhouse services. s

have been utilized at a building owned by cpmc that they lost that lease and so they're actively looking for office space. i'm wondering if this is part of that issue? >> i don't know that i'm qualified to provide the answer to that question. i don't know whether or not that is what would contribute to this. that is true, we have lost space and we're seeking out additional space for our programs. >> ok. >> we're not sure if this program represents incremental, actual incremental cost in terms of rent or a riel occasion of existing rent. we don't have the answer to that, is that right? >> so our rent is based on a standard equation used across all programs in the organization. it's based on, as was said, f.t.e. and square footage and so, our program is quite large. we have over 100 volunteers at any given time. we actually have a fair amount of square footage within our building. the rent that was presented is based on adding those f.t.e. in a larger space. previous personnel allocated were generally in much smaller office spaces sharing -- you know, two desks within a space that was prev