system or any hospital. most of us understand that health care delivery and financing is changing and will continue to change dramatically as national reform is implemented. if cpmc is locked into a structure which mandates inflexible delivery options, both the city and cpmc will be unable to respond to the changing environment. president olague: thank you. >> thank you. president olague: you can speak, thank you. >> thank you. my name is connie mardikian. i wish to share my experience with being involved with st. luke's hospital always as a volunteer. as a reg centered nurse i wanted to make a difference and many of the families in need that st. luke's serves. i started as a member of the junior auxiliary where i helped to raise funds. i can honestly say that i appreciated the mission of the hospital and admired the physicians, nurses and staff that worked unselfishly -- selflessly to deliver care to those in need of charity care. i became involved in st. luke's hospital foundation. i served as chair and la

, where it sees as a teaching hospital region where it sees as a teaching hospital and who -- where it is in the middle of a teaching hospital, you will find a vast difference. the plan to rebuild conquered crete, this is a state entity, exempt from local land-use regulations. it is going to contribute about 60 million against $1.5 million mission they produce. before i finish, three other quick items regarding the project. i am still not completely satisfied with st. louis's proposal being large enough, and i have constantly mentioned there is additional, nearly vacant land in the and media it area, which i feel should be used -- in the immediate area, which i feel should be used to enlarge a hospital. i still think that can be done. number two, and it was mentioned tonight -- there is a failure to address the bed. lastly, there is an item that has not been publicly aired, and that is the disposition of their california campus, the oldest children's hospital where i was born. i suggested it might be considered a skilled nursing facility bed, operated by some entity. i have seen increa

just to acknowledge the fact that the first three other hospitals, government-run hospitals, which have different financing the private hospitals. there is subsidized by public funds, subject to those public budgeting process. kaiser also has different recording requirements. medi-cal is another resolution to provide inpatient and outpatient services to medicare out that a fisheries, consistent with other nonprofits. this measures the proportion of all hospital services that are appropriate for medi-cal, using the averages of all the other private nonprofit hospitals. this would be important with health care reform when it is implemented in 2014, and as many as 36,000 san francisco residents who are uninsured will gain of insurance through medi- cal. the comparable percentages are 6.53%, and 13.73%. this slide shows and other nonprofit hospitals an average of 10.46% of all outpatient business, and 15.05% of all inpatient visits are for medi- cal visits. addition of provisions to provide care for the metical charity care patients include a san francisco proposal submitted to cpmc. the de

so i think it's really important that we compare this hospital with hospitals that are comparable to it, not hospitals that are not comparable. when we do comparisons we have to talk about stanford, mills peninsula, john pure and, you know, not compare them with hospitals that are not comparable with them. i think chinese, as we've dealt with, is a fine hospital but an entirely different thing. and in fact cal pacific provides some of the subsidy to help run chinese. so i think we have to look at this. and as far as charitable care, my information is that in addition to the $100 million in charitable care dr. browner spoke about, if you add in the medical care, whatever the percentage, it's at least another $100 million. the $200 million they do in charitable care a year is comparable to that which stanford does. when you say stanford is in a different place, there's a lot of challenges in that part of the peninsula as well, east palo alto, menlo park, there are many people with needs for charitable care there as well. we have to look at that. as far as the housing piece, i don't bel

so please keep hospitality house alive. thank you. >> next speaker. >> hi, my name is amanda sage and i work for central city hospitality house. first i would like to say i'm just touched and moved by everybody and this is a very clear statement right here. i would like to say at central city hospitality house we don't just provide employment resources, public bathrooms, sanctuary from the street and access to the entire network of san francisco resources, but we also provide an environment for personal growth, creativity, zrofere, and the fostering of -- discovery and the fostering of communities. it's a place where everyone, each person that comes through our door is treated with dignity and respect and our staff is trained how to help people who come in to get that dignity and respect and take that back out to the community to foster that sense of community outside of our doors. the impact of that support and that human connection, the value of being told yes to your community cares is invaluable. and it's clear that in

every hospital is, also. because as we go on diversion, these mental health clients do get diverted. we have to work closer with the hospitals and ensure people are brought out of those acute units as soon as they can because of the issue of cost and being able to continue to provide that service. and we have to have places to go after they leave the hospital. if we're going to ask cmpc to look at it not just from a psych bed but the comprehensiveness of those beds. as a background to these beds, i wanted to at least from the research i've done in terms of 2005 when these beds were closed, it was brought at the prop 2 hearing at the closer of the 32 bed at the behavior health unit st. luke's the health commission passed a resolution finding it would have a detrimental impact on health services of san francisco. the testimony that was received indicated the decision to close the unit was not a sutter and cmpc decision but was a st. luke's decision prior to obtaining that and st. luke's is ongoing financially d

there is no, one hospital in the state of california that does not have hospital police officers or sheriff's deputies. you can check at stanford. you can check uc davis. you can check highland hospital. we are now here. you can also check with los angeles county hospital. they have their own police. i urge you to take into consideration that you do not contract out. dph needs to either keep the sheriff's department or back to what we had before, institutional police, which i want to add that institutional police officers provide the cheapest law enforcement services in san francisco. we are cheaper than sfpd. we are cheaper than the sheriff's deputies. i'm not sure, but i'm sure we make less than -- [bell rings] thank you. supervisor chu: thank you. >> good afternoon, supervisors. i have been a psychiatric technician at the hospital now for almost 10 years. when i heard about this, i really gave it some thought. just looking back over 10 years, i cannot tell you how many times i have been in the cross with some very violent people. every time without fail, the ip has been there. what they ar

we can make this hospital work greater than -- hospital work. we badly needed a psychiatrist karen -- psychiatry care. thank you. [list of names] >> i am not doing well with names tonight. i am not sure what the reason is really. i have of blocks -- a block. you can come up in whatever order. >> good evening. i have been a nurse for over 35 years, and at cpmc since about 1986. without union representation in the new hospital, and may be forced to rebid on my job and my shift. please do not permit these plans to continue without considering the implications and consequences of not having a union -- not having mandatory overtime, request favoring seniority, monitoring to protect patient safety. these are three examples of the benefits of union representation. nurses are advocates. now i care for an advocate for my patients. the union protects me. i am a member of the nurse association, and i am in the union. thank you. >> good evening, commissioners. i am a registered nurse at campus. thank you for taking the time who to listen to the registered n

will have to take -- walk a block to the hospital, is that right? >> yes, correct. we aren't planning to change the one-way configuration, simply to delineate the bus lane a little bit better and make pedestrian improvements. for your first question, we are looking at what's called a transition area and specifically looking at the area between polk and franklin to understand how the bus moves from the side running in the one way cuplet to running on geary, particularly if it is the alternative, and that analysis is under way and not complete but we are looking at what the design treatment needs to be as well as the technology of the signal in order to make sure it happens both efficiently and safely. commissioner sugaya: is the e.i.r. -- this isn't related to cpmc, but are any of the alternatives being considered in the e.i.r. looking at making geary downtown totally bus rapid transit without any cars and running buses in both directions. >> making geary into a transit mall? commissioner sugaya: yes. >> that is not being considered at this level of

the private security person is a member of the hospital team and they follow the hospital's protocols and protocols around restraint. and they are not bound by the same legal limitation as that sheriff's deputy or police officer is bound by. again, i am not the best person the toll you this and would -- the best person the toll you this and have our chief medical officer or the chair of our emergency response team at san francisco general hospital answer your questions on this and try and put your mind to rest, but truly, we believe that this is a reasonable, smart way to manage security in a hospital setting and really is what is being done and the county that is the nearest, closest example, but in many, many hospitals that offer trauma services around the country. >> we can ip violate the two representatives up perhaps to address the other issues that supervisor weiner has raised. >> thank you. >> good afternoon, supervisors. i am dr. todd mann, the chief medical officer at san francisco general hospital. i will be very clear i am not just an administrator. i am a practicing physic

our hospital is now a thriving, independent hospital. should send francisco approved this plan, they should be certain the agreement includes enforceable safeguards to hold soccer -- sutter encounter vote. -- accountable. >> thank you. [applause] >> my name is dr. emily waters, and i am a community psychiatrist. i am new to the area and have been working here only about three months. i have been surprised and at times horrified by the lack of inpatient resources for the mentally ill. a few existing psychiatric hospitals are routinely fall. san francisco general can accommodate even the most acute patient, and many are left behind. recently i began working with a young man with severe post- he was severely physically abused throughout his childhood. he had no one to protect him, and he lives in constant fear. he frequently thinks of killing himself. should he need an inpatient todstay, i fear i will have no place to admit him. he would be surrounded by many agitated and sometimes physically threateneing patient. previously, i worked at a

the hospital funds will hurt. we do an intervention in a community setting. the hospitality stations are for people who are homeless infections would increase because they can't have access. we can't do that. we'll have a larger deficit for d.p.h. i urge you to keep the priorities in line with the mayor who was one of the most amazing advocates to protect the most vulnerable, and we count on you because you've done it every year. protect the house, the homeless outreach team and the only room we have to put homeless people. thank you very much. we need to be whole. thank you. >> good afternoon, my name is rosanna salazar and work at the sixth street self help center, hospitality house. a few years ago i was having trouble finding work and went to the hospitality program and helped me find work as a bike messenger and was a great job. i got to know the city and enjoyed it. i've been employed since then. after almost 15 years of working with people, two years ago i got a job at the self-help center when we opened. i

luke's hospital. nearly's proposal is a food stepping stone, but san francisco -- the mayor's proposal is a good steppingstone, but sun francisco needs more. a labor contract expired four years ago. there has been minimal effort to return to the bargaining table. this is unacceptable in a union city like san francisco. the current proposal benefit of predominantly male profession. resident nurses are predominantly female, and at st. luke's, there female nurses as well as minorities and nurses, and we serve with pride. we enjoy the same deal building personnel were given. the surrounding community deserves a full-scale, viable hospital. i want to address the capacity that keeps being brought up. we continue to transfer patients to other facilities in spite of having these and the dead, and -- having these and seedbeds -- these empty beds. we have been told the stands is not financial. it is because they can. they posted a 30% increase in profits in 2010 during the biggest economic downturn since the gr

commissioners, we do not need another hospital in our neighborhood if the hospital will not serve ourcommunity. what we need is a hospital that serves low-income families as well as the poor people. what we need is a hospital that will welcome the poor, like us. cpmc continues to ignore the community. we are requesting the commissioners to give cpmc what is due to them, which is to reject this project. it will not only serve the corporate interests for the people like us. thank you very much. [applause] president olague: thank you. >> good evening, commissioners. my name is gloria salazar. i am a member of the tenderloin filipino-american community association. and i've lived in the tenderloin for the past 20 years. i'm here today to say that we're posted to this hospital being built in our neighborhood, because cpmc has continued to ignore the demands of the community and even the recommendations of the mayor. i'm a senior and i'm on medcal and i know that pcmc accepts very little medcal patients. i cannot agree to this proposal with the development in

the new hospital and medical office building at st. luke's require land use approval for the need of a general plan referrals to about street vacation for a portion of san jose avenue, creation of st. luke's sud, change of the parcel and will change the height and bulk designation to 105-e. there are several conditional use authorization required, including modifications to the existing planned unit development, the need for general plan amendments to make conforming height changes to 105 feet, office allocation for the medical office building, and several other approvals from other city departments. at the may hearing, the commission requested a comparison of the existing and proposed hospital facilities at st. luke's. this slide show some basic numerical comparisons that relates to the size and capacity. of the two to nine licensed beds, at st. luke's, 150 are licensed four acute-care. of the 229 beds, 139 are in use. at 60 of the 150 acute beds and all 79 skilled nursing. the project proposes 80 licensed beds in single occupancy roo

that happens every day in every hospital. >> debbie rogers with the california hospital association says the guidelines will require hospitals to input infection data on more than 900,000 surgeries by the end of this year. >> it will take the infection prevention activities away from the bedside and away from patients and it will move it to entering data into a computer. >> the hospitals have had plenty of time to prepare. >> and here we are due date and they are saying it's too much work, it's too complicated. >> lisa with the consumer's union lobbies for public disclosure of infection. >> when there's availability exposed to the public, the hospitals take note. they are the ones that are going to say wow, i don't want to be at the bottom. i don't want to have the highest rate. we need to do something here. >> she says in california, there's been generally a culture of delay, go slow from the hospitals as well as the department. i think the lawsuit is definitely trying to stop the process. >> rogers disagrees. >> hospitals want to report surgical site infections. the department has

do not cut west side or hospitality house. please find the revenues from the people who have profited from this downturn. we know who they are. they are the rich people and the corporations. please enforce these laws. you have got to find it in yourselves to protect the people that are going to be hurt by these cuts. >> good afternoon, supervisors. i moved your 40 years ago and i was 24 years old and i was very young and i have the clothes on my back and $2 and managed to find my way because i was young. 20 years later, i was homeless and did not find my way. i would not be here if it was not for the services that lifted me out of homelessness. i cannot imagine someone not being able to access those same services that helped me. i cannot imagine being made homeless again. at my age, you might as well take me out and shoot me. how could this city give tax cuts $2 billion corporations and then turn around and cut services to its most vulnerable citizens that depend on them, many of whom voted for you. i just wanted to say happy

luke's is the only hospital south of market from san francisco general.we wouldn't put all five stations -- fire stations north of market. we want a full complement of hospital services for 370,000 people who live south of market . regarding the proposal to build a, quote, center of excellence for diabetic care, you can't exclude vascular surgery, renal, dialysis and wound care when claiming to specialize in treating seniors. with the federal government proposing to turn medicare into a voucher system and the state cutting back on medical reimbursements, the burden on the county is going to increase. we can't afford to have sutter, one of the largest property owners in the city, paying no property tax while eliminating services. sutter made $878 million profits last year. they have the money to propose a 555-bed hospital in a high-income part of the city. this is the year of a 2001 services list that st. luke's used to provide and which sutter agreed to maintain which came out of bankrupting st. luke's by cpmc and the law firm. this needs to be a starting

i am here in support of central city hospitality house. i am a former director and manager of the tenderloin self- help center. you have heard many disturbing facts about how devastating these will be for the homeless but for many other san francisco residents. you have heard the hospitality house provides a lifeline to homeless people and cutting services as like cutting the rope that prevents them from drowning. i urge you to reconsider these cuts. thank you. >> thank you. next speaker. >> good afternoon. i'm here speaking on behalf of the family services agency of san francisco. i've worked in participants -- with participants of that program. i have no reason to believe that any of the programs or any programs that are offered is of lesser quality than the senior programs that i participated in and that has never been better. i've seen what it is like when people sit in their rooms and have no place to go and no one to talk to. i am concerned about the total that the therapist and doctors have to do family service agencies. i have had

and is it the hospital administration or is it the security guard? >> it's the security. >> so it's the same exact scenario as it would be another 830.1 of the peace officer in standards and training. whether it's a police officer or sheriff, they would still have to be required to see a citizen's arrest through security in order to then respond. how is that any different? >> i want to make sure we're talking about the same thing here. i think that hospital has it own policies about what is restraint and those are very specific policies and they have their own limitations but the conditions under which a person can be restrained physically and/or who are on medication and there are hospital policies around restraint. and a contracted security organization working with the department can conform to those policies on restraint. so a person who is agitated or is pulling out lines or is trying to leave against his own personal safety or is somehow endangering the safety of others but is not breaking the law can be restrained. that is so the restraint iss

that happens every day in every hospital. >> debbie rodgers, with the california hospital associationuidelines would require hospitals to input infection data on more than 900,000 surgeries by the end of this year. >> it will take the infection prevention activities away from the bedside and away from patients and it will move it to entering data into a computer. >> reporter: but critics say the hospitals have had plenty of time to prepare. >> and here we are, due date, and they are saying it's too much work, too complicated, i can't do it. >> reporter: lisa mcgiffords with the union lobbies for information on infections neighborhoods-wide. >> when there's various infections made clear to the public, they are gonna say "whoa, i don't want to be at the bottom, i don't want to have the highest rate, we need to do something here." >> reporter: but she says in california there has been ... >> generally a culture of delay, go slow, from the hospitals, as well as the department. i think the lawsuit is definitely trying to stop the process. >> reporter: rodgers disagrees. >> hospitals want t

we have the intersection in the top left corner, and the new hospital is slightly east of the street along chavez and medical building is on the corner of valencia. >> as i was mentioning, thening tering and exiting would necessitate the moving slightly southward of the existing bus stop on valencia street. the existing park garage that duncan -- you can see it in the bottom -- center bottom of this plan, will remain and all circulation will be unchanged as part of the proposal. and ambulance and emergency pickup and dropoff will be accessed from 27th street. 27th street is the street that is curved around and becomes san jose in the center part of the plan. and freight access to the new hospital will be provided to the enclosed loading bay accessed from cesar chavez street. in terms of trip generation as we looked at it for cathedral hill, we anticipate 207 vehicle lar trips to and from the hospital and 271 transit trips. lastly, in terms of the environmental analysis, the draft e.i.r. has found there will not be any significant impacts on any of the mobility indicators including tr

at any given point in san francisco general hospital, how many deputy sheriffs are present in the hospital? >> 39 -- 49. supervisor wiener: if you were to just have deputies in the high-risk areas, that would strike me as a much reduced number. >> i would have to look at that. supervisor wiener: there could be a hybrid model that achieves the lion's share of the savings we're talking about but does allay some of the concerns we have heard about, gang members chasing people being brought to the emergency room or issues where people get out of control -- perhaps it would be safer and the employees would feel more comfortable having peace officers there. >> through the development of these conversations, we would be supportive of that. it's important for the public that the perception of safety be there and having surest there at the most high-risk areas of the hospital, i think everyone is in favor of that. supervisor wiener: other than the emergency room and cyc, are those the only high-risk areas or are those the only ones? >> those are the highest risk areas. we can work with our hospital

i am a registered nurse at san francisco general hospital. i am also here to talk about the proposition that my colleagues are talking about. i would just give you an example of a position i was put in as a nurse with a patient who was disabled, actively psychotic, delusional, could not make choices about -- he could not plan for self care wants out of the hospital, and he had a serious injury that needed multiple surgeries and he was on a psychiatric hold, which is a 14-state but psychiatric hold. he decided he was going to leave. i told them we still have to do treatment. i was trying to be supportive, non-threatening. he decided that he was going to leave. i said, you cannot leave he was very smart and said, why can i leave? the doctors did not say that. the doctors said if i had a friend come pick me up, my friend provides a place for me to stay, i can go. i said, actually, you are on a psychiatric hold. until we can figure out a plan for you, you have to stay. his friend showed up. he said, i am leaving. in the meantime, i am making mult

a new state of the york hospital and two new state of the art hospitals and the increase in davies and the increase in pacific, and possibly the california campus is converted to something else. i see more, not less. there is always a talk about the impact and the negative impact. well, van ness avenue is not the garden area of san francisco, i am sorry to say. there are a lot of vacancies, problems, it is not really vital. this will bring jobs and businesses and will do a lot for that area, deployed a lot of people who are not employed and the whole discussion about jobs as part of the hospitals is what we're talking about. that's not always look on the dark side. the impact also include the good impact this hospital will have. i think we have to look at that. the st. luke's issue, i agree, commissioner moore, a longer time would make sense to keep it that much into the hospital. it should be here hopefully in definitely, but i think it's size is appropriate. it was a private hospital years ago. it was able to function. as times change and neighborhoods change, it became nonfunctional

by enhancing the environment and supporting the hospital's needs and therapeutic goals.rtists were commissioned to create 100 original works of art. as was for the gardens and courtyard areas. >> be artwork does more than just hang on the wall. it will enhance the therapeutics of the hospital and will include sensory stimulation, orientation, social interaction. >> it was set into like boxes to create color filled areas in the hospital. inspired by nature, the signature painting of native san francisco birds, clouds, and the surface of the ocean waves were translated into a variety of media including glass mosaic and tapestry. the playful clock encourages memory stimulation among the patients. they used the theme of the four elements as they relate to vocation. it is a direct homage to the historical murals in the original laguna honda building. it features to large tile walls. by observing residents, the gardens created a public artwork in the form of the handrail. in one of the outdoor courtyards, the circular grouping of -- with a smooth finish. this features ten uniq