Department of Public Health and dr. Garcia cant be here. She has the flu that seems to be going around, so ill sit in for her today. Commissions, we have one item on your special calendar for case number 2012043. W the Medical Center annual compliance statement. This is informational presentation. Good morning, president chow and hillis, commissioners, im elizabeth pearl, Planning Department staff. The item before you today is an informational presentation on california pacific Medical Center compliance with the Development Agreement for the 2015 recording period. This is our third annual reporting period. Todays presentation, youll hear from city staff on compliance with key components of the da that are relevant for the 2015 reporting period and the updates on the projected compliance in 2016. Following this hearing, the directors of planning and Public Health will determine whether ctmc is in compliance with their 2015 obligations and issue findings to that affect. A Third Party Monitor will review the directors findings and inform the board of supervisors whether he agrees with their determinations. Cpnc Development Agreement requires them to build two new hospitals and three new medical Office Buildings and public improvements. Construction for both the cadral hill and homes are underway. Cmnc is ahead of schedule with their commitment to open saint likes hospital. They open it been two years of opening the Cathedral Hill hospital and theyre aware of that effort. For the 2015 reporting period, were 11 main action items for compliance review as outlined here and these are in the areas of work force and hiring, of prevision of health care, payments and public improvements. My colleagues who are here today will go into these in greater detail. I would like to note that one reporting area, the First Source Hiring Program has a reporting period that doesnt correspond to the calendar year from here today. That area of recording runs from mid2015 to mid2016. This is consistent with the way we have reported to this previously, so were representing it with no data gaps and it will give you an update the picture of that area. And in 2015, cpnc had to make payments for 14 million, and they have paid uptodate. And theyre uptodate for their payments of 2016. One additional area in the da that requires annual reporting is cpnc compliance with the requirement regarding pay increases for cpnc in its role and catherine dod is here to give you an update on that. Thank you, catherine dunn. Thank you elizabeth. There was key questions were identified on the spending engaged through exam 2015 Health Care Cost and day the exchanges are occurring. And we will exam whether or not the Health Care Cost increases exceeded the agreed upon amount. Any questions . We may when it comes to commissioner comments, but well hear the presentation first and i have a finance committing meeting right now for my department which is a 790 million department, so ive been asked to rush back. Sure. If theres questions directly for miss dunn at this point. I just have one question which was, whether that audit was or evaluation was supposed to be looking for possible fee increases in the future or what was the purpose of the 2014 that now was postponed to 2016 . It goes for 7 years until 2020. And we didnt have we didnt have baseline data and baseline data changed so the audit will occur every year to see in fact the prices increased more than was agreed upon in the Development Agreement. Its a backwards look rather than looking at a potential fee increase for that particular service . Exactly. And its just for the cpmc facility and not for the other facilities. Its for cpmc or are you then isolating [inaudible] from that or are they using a uniformed fee schedule . I honestly dont know the answer to that question, but i can find out and get back to you. Okay. Thank you, dr. Chow. Thank you. I apologize for having to leave. Thank you. Any other questions . No, okay. Thanks catherine. And could we have a document camera again. Coming up next, ken nim from the Work Force Development will present the results of the Development Agreement compliance with work force and hiring requirements. Good morning, commissioners, ken nim Administration Services academy, and also local colleges and recruitment for College Students for these jobs. The second item which is similar to the entry level position and these are more specifically working with contractors and employers that are seeking office type of work, and we are currently at 60 . So 22 to 37 candidates that we have referred are working on the project. And item number 3 is the first time goal for the construction at 50 of entry level apprentice filled out by City Build Academy were at 30 and 78 out of the 258 possible opportunities were filled through the system referral and the challenges here for example is the iron workers, we have a lot of iron worker opportunities, but not enough residents able to do the work, and some other [inaudible] for example, they electrician and plumbers and you have to go through the protocol. So the list may have a local resident on there, and sometime they may not be local residents. Great. And item number 4 is the minimum of 30 of the overall work hours performed by local residents, so as you see, were currently at 29 . And all the contractors that are working on the project have been working working diligently and working through the system referral to get our residents so based on the apprentices and the challenges of the trades that we werent able to fill, were currently at 29 , but any opportunities that comes through our office, weve been able to refer. So for the next charge is a pie graph of the performance, so looking at the overall work hours, as you can see, its 29 and for local residents. And apprentices is at 37 . And this is just a quick break down on the demographics. One of the key part of the dda is to target economic disadvantages of our community. In the chart, they can go inter mission visitation valley, and baby Hunters Point is representing a majority of the work hours coming from local residents. And the next slide is just the local Business Enterprise goals. The contracting goal is 14 . And specifically we have broken it down by each of the projects, the gary [inaudible] campus. Its currently at 13 and van ness medical office which is just started coming up at 7 and saint luke campus is 20. And all other campus was 15 and we have generated over 81 million in revenue for local businesses. Next ill have lilly elison, our director of business offices talk about jobs. Good morning, commissioners. My name is lilly elison, director of Business Service for Work Force Development. Under Business Services, we are task with the administration of the First Source Hiring Program for non construction. Our hiring goals were actually or are at least 40 of all entry level positions from our work force system each year. This is really a great turn around story. We started off at about 14 , and this year were weve exceeded that. Now if cpmc does not fill 40 of the entry level positions with our work force system referrals in a hiring year, the number of entry level positions constituting the hiring deficiency will roll over and theyre added to the annual hiring target for the following hiring year. Our priority neighborhoods were happy to report our Western Addition tinder loin, mission selma, outer center and china town and weve been hitting all those neighborhoods and we have detailed information we can provide to you at a later time. Now, this year our First Source Hiring Program for cpmc and this is our non construction. All of our non construction hiring goals have been exceeded. Theres no deficits or carry overs. This program year is its year three and that runs from august 2015 through july 2016. Instead of the 40 goal, were at 69 . Now, how that works is that 176 employees were hired and out of those employees that were hired, 121 are from our work force system. So thats a great turnaround story. I will just add, and i dont have a lot of detail about this, but i will present to you that the First Source Hiring Program for cpmc operations has a Work Force Fund grant agreement. Cpmc paid 3 million into a Work Force Fund. Thats administered by the San Francisco foundation. The fund focuses on barrier removal and job training for the Employment Opportunities created by the project. Now, these funds target educational institutions and nonprofit organizations with an existing track record of working in the priority neighborhoods and many of those are mentioned. Our current grantees are jewish vocational service, mission hiring hall, mmh as we call it, positive Resource Center and self help for the elderly, Success Center and y cd, Young Community developers. Commissioners, do you have any questions at this time . We may, but were going to hold off until we hear from cpmc and public comment. Thank you so much. And ill turn it over to health care. Thank you. Good morning, commissioners, colien chavla and im here to talk about the Health Care Developments of the health care agreement. This slide is a summary of the i wont discuss them here. So, first, the next several slides, ill talk about the elements of the da in 2015. And of course were now into 2017, and 2015 seems like a long time ago, but to separate whats happened its since, im going to talk specifically about the 2016 compliance in the slides and at the end, ill have updates on what has happened since the 2015 annual report. So, with regard to baseline charity care, it includes four obligations and these positions were included to make sure that cpmc maintained the level of care to low income uninsured people in satisfy before they were doing before the da and Everything Else in the da was additive to the baseline charity care obligations. So, the first one is undupe bring catted served, they serve 1 this measure represents care to low income individuals who are uninsured or under unsured or have medical. The 30,445 figure represented the number of medical or Charity Care Patients that cpmc served in the years prior to signing the Development Agreement. This and the other charity measures are included to make sure Everything Else in the da is additive to what cpmc was contributed to the community. In 2014, commissioners may remember that cpmc had a short fall of 8 they have a precision of a ruling allowed cpmc to make up for this short fall in a consecutive year, and so that meant that in 2015, cpmc had to serve 3,200,294 patients and cpmc served 17,007 patients. This figure was verified by an independent third party auditor. Cpmc reports the increases due to their due to the expansion of enrollment of their partnership with northeast the precision of diagnostic services and contributed for part fir ships with Community Clinics and the second element of the bay line care commitment is benefit spending and it requires cpmc to spend 8 million for Community Benefits to the poor and under served and this category, cpmc exceeded its commitment spending 14. 5 million in 2015. The third element of the baseline charity care or its charity care policies, it required cpmc to not change its policy karat no cost to people who need it until the end of 2015. And no changes were made to cpmc charity policies at that time and the base Charity Commitment in 2015, they have continued to support the Baby Child Health care center with their precommitment to the center. So on top of the 30,445 baseline Charity Commitments, its the commitment to participate in medicare care and serve 545,000 these beneficiaries are meant to reflect the impact of the aca on San Francisco. Cpmc to be a provider with the San Francisco health plan which is the larger of the two medical care plans in San Francisco. Prior to the development, cpmc had responsible for 14,000 Medicare Beneficiary and they had to add the total bringing and the 5400 were to be cared for at the cathedral campus. They serve beneficiaries at the saint like the saint luke campus. Through the partnership with nims and through nims partnership with Saint Anthony clinic, in 2015, they accepted 15,008 this succeeded their requirement by more than 13,000. Of the 5400 new beneficiaries they make sure the tinder loin and the campus was served by sutter. The new neighbor will serve tenderloin neighbors and the manage care partner nims entered into another contract at Saint Anthony to be that partner in the tinderloin. The partner is 125,000 medical beneficiaries. They have a choice of providers and cant be moved into this partnership. Enrollment is as People Choose the partnership. As they remain open to the partnership, theyll be in compliance even if they havent received the 1500. To help grow the they had enhancements at saint anthonies and outreach at Saint Anthonys so Saint Anthonys was given funding to do outreach to their dining room guest to initiate discussions with Saint Francis to have a referral process, to do outreach and enrollment at hamilton to obtain access to eligibility workers to make them eligible for medical and participate in homeless connect events. In 2015, the Innovation Fund received 1. 125 million into the fund. And a grants were awarded in the amount of 1. 3 million. The grants awarded were to several Community Based organizations representing enhancements and care for behavioral health, Senior Health and the Saint Anthony infrastructure and outreach i mentioned a few minutes ago. This is a summary of the Additional Health care previsions that are required in the da. The first was around post to acute care, and the deadline for this obligation was extended to december 31, 2015. Given reduction and skilled numbering services and sub acute karat cpmc homes, they asked for most we worked with San Francisco hospitals to assess the acute the resulting report was presented was finalized in 2015 and presented to the Health Commission in february of 2016. And it included three key findings and seven short and long term recommendations, dph, the Hospital Council and other member homes including cpmc are continuing the work to address those recommendations under a task force obtained by the City Council Meeting which had their meeting in the last couple of weeks. Cmpc has medical staff, the cross hospitals as directed by the da and to retain its membership in the San FranciscoHealth Improvement partnership which is the successor for the term of this report, Chinese Hospital was in compliance or cpmc was in compliance. Commissioners were called and dph received correspondence from Chinese Hospitals and it would have impacted cpmc compliance and commissioners have received communications from Chinese Hospital to independent date they were able to come to agreement and no longer assert non compliance with the da in 2016. Regarding culture linguistic and eligible standards, its cpmc policy to deliver services with these standards and they have provided a copy of their policy implementing the standards, but the health and planning commissions expressed both in 2013 and in 2014, that they still have questioning about the appropriateness of this services. The coalition for san franciscans addressed concerns at saint luke. Cpmc had a task force to review their compliance status and opportunities for improvement and secured an outside expert to advise them. On september of 2015, they shared their class standards assessments and our own experts at dph reviewed the assessments and called attention to areas to benefit from focus and requested that cpmc address these issues in their 2015 annual Co