luke's and the effect of c pmc cuts citywide. one good example of this if according to they'll earlier plans of moving the insufficient beds and concentrating them in st. looukdz only 40 will be available this will rob of the community of badly needed beds by deskill st. luke's to the point where it will access functioning a full service hospital and it could radiate throughout the city if not able to take ambulance diversions >> time. >> thank you. >> thank you. next speaker, please. >> and if you can correct me for your last name. >> i'm from - i want to tell you that our patient are very sick patient in jeopardy and when they're forced to - in the past few years they've breathing tubes are being removed so when they can go to other facilities some have been able to go back to work and the work of the staff starting - there's 3 decreases and one medical donor this is a difficult place for other hospital in the last 3 years the majority of admissions have been discharged and the plan is yes, ma'am latsd san franciscans they've n

the effect they're a full capacity at c mc you take care of the short-term rehabilitation needs and c pmc looks outside of their facility to support their needs to take beds from the city that needs the long-term care beds those are the ones we're talking about being in greater shortage in the long term. but i would say about long term skilled nursing beds that's not the ideal place to provide care for our growing senior population there's a great effort put into aging in place and providing appropriate services to patient in the their home to allow them to live in their home and while certainly patients that are older he needs the skilled beds there will be a need for instill based care not the direction the industry is going. i don't know if i've directly answered 2 but there's a combination of things >> yeah.. so let me pickup on where you left off this is my second question there's a huge demand i don't pvend prevented to be an expert but there's a national conversation boiled down and insurance reimbursement rates about the where we want to have incentive care not only for financial

we have an agreement that will be honored by city but there's a greater honor you have to hold c pmc to 38 and that's the community. you've identified an area that if someone doesn't make money they'll make others pickup. i hold c pmc account to not only their network patient by the greater needs of the community we want them to be a better partner (clapping) >> i guess what i'm trying to - i disagree we're going to live up to our responsibility and obligations have we seen increased demand for those services. >> we consistently have demands in our community and i think that the other issue we're facing and you've heard pacific monaghan talk about this how do we inaccurately manage people that are getting older we're going to have a larger older population in san francisco we have an obligation not to institutional lists individual we have to insure people at the right levels of care we have a responsibility to make sure that people are not snuldz in long term care beds so we have to look at ways to reducing the way even if people being institutional listed in terms of managing their

i want to see how c pmc can work >> to the best of my knowledge this is ail documented in the report we have a filing of public comment on that if i'm not mistaken on the agreement and we have done our obligation in reaching out to other mefbz of the community to determine the plans and see if their changes to my knowledge there's not been any outside of our filing but i believe we've fulfilled our obligation and mar la in her is our - is mary here. >> we've met with the hospital commission and all the other providers no 0 san francisco about the question of subcutaneous care we're not middle of doing another survey if you remember before the survey was created we met as a group flo the hospital council and done a study for transfer subcutaneous at all the hospitals it was only two, that had a significant population of people that needs substantial cute stwrit from the hospital we were meeting our needs and automatically was comfortable with their contacts we're redoing the survey i've been in touch with the hospital council and had a meeting with people there ones and sending out ou

and again c pmc indicated this rearrangement of the nursing care services to meet the projected demand is consist with the pattern for nursing services at the hospital they requested additional information on the impact of staffing at the hospital. d mc indicated while the numbers have not been finalized but 4 licensed nursing nurses will be in place from this reduction. the commission asked for additional information about the impact of the restriction in stilled nursing beds in the previous memo i provided the key finding from the master black man plan but that's a most recently bed facility beds in san francisco i've provided some key fktsd those san francisco population is older than san francisco of the rate of the care beds is lower than the state one bed age 24 years is 4.1 compared to 5.1 in the state bylaw plus a current trend in health care that converts the long-term care to short term beds in this facility in the stilled nursing facility thus reducing the care beds overall i should point out c mc plan was to serve patient in its own network. finally from the master plan giv

how we get through to particular sniff issue today because if other institutions feel the way that c pmc do today, this is not going to be an issue that goes away i would like to have a deeper understanding of the policy frameworks that drive reimbursement that are son this item okay look there's less need for sniff beds to understand that and how to think through that as we face what i'm predicting you increasing the discussions we have a changing demographic and changing health care policy and being asked to be really thought full they're moving around i feel what we can do go deeper into what is going on into sniff that causes an actor to manage things this is the appropriate way to manage it that may well be we should understand the principleal forces. >> are you moving the resolution. >> i wasn't i was asking. >> i will make a motion that we - i will make a motion that we passed this resolution as written. and that indicate it will have a detrimental quack that on this health care services within the community >> thank you and a second please. and i'll second it. thank you. and so c

economic growth of san francisco last year you had a project on the knowledge does the rebuild of the c pmc hopeless an important component of our economy there's no more important projects than the moscone it's on a world designation since 1980 we look forward to approve all aspects of this project in moving forward thank you. >> thank you. >> good afternoon, commissioners john from the yerba buena i apologize. i i was outside when i called my name i have good news. first, the settle time are our museum i

economic growth of san francisco last year you had a project on the knowledge does the rebuild of the c pmc hopeless an important component

economic growth of san francisco last year you had a project on the knowledge does the rebuild of the c pmc hopeless an important component of our economy there's no more important projects than the moscone it's on a world designation since 1980 we look forward to approve all aspects of this project in moving forward thank you. >> thank you. >> good afternoon, commissioners john from the yerba buena i apologize. i i was outside when i called my name i have good news. first, the settle time are our museum is set for final approval this tuesday it provides the safety improvements we've requested and second since the eir hearing six or seven weeks ago we had an important discussion about exactly what the things it can be done and the city made it clear they want to move forward there's a technology cattle the biggest part is widening the east side of the effort sidewalks from howard to market there are a series bottleneck that can't be part of the moscone but picked up in the environmental clearance and should follow after that so this case we're definitely on the right track so thank you >> t