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 Francisco Health 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 Compliance Report which they have done. So, as i said at the beginning, i would summarize here to talk about your concerns in the past and what what accomplishments have been made since the 2015 report was filed. So in 2014, the commission may remember there were concerns about the 1500 Medicare Beneficiaries in the tenderloin. Theyre currently 125 members in this partnership, so still far below the 1500. But as we said i said also weve funded Saint Anthonys to do more outreach in education to increase enrollment and really theres no because patients have a choice in their providers, theres not a way to wholesale patients. It needs to be Patient Choice and were continuing to fund Saint Anthony to educate individuals about that choice. Regarding the cultural linguistic appropriate services, in addition to what we did in 2015, we continued to meet with cpmc in 2016 specifically related to the saint lukes diabetes clinic. That meeting resulted in recommendations and clarifications including adding additional Spanish Language Spanish Language classes should be offered at the clinic, that adding reception staff would improve the patient experience, and that the health First Program provides positive connections for saint lukes diabetes patients, cpmc agreed to report on meeting these agreements as apart of their future Compliance Report beginning in 2016. I heard from cpmc that this month, they offered a position to a buy ring gal registered die significance, certified diabetes educator and they started classes at saint lukes and they have made improvements in Patient Satisfaction surveys, but when they filed their 2016, well learn more. And then finally with regard to community engagement, the commissions also had concerns about cpmc engagement with the community and its my understanding that quarterly meetings took place with the focus on excellence in Senior Health. With that, that concludes the health care portion of the presentation. Ill turn it back over to elizabeth. Thank you. Thanks for your patience with this multi headed presentation and the complex details we have presented to you here. Overall, noting the concerns that do lien and other of my colleagues have mentioned to you, staff believes that cpmc is in compliance with its commitments under the Development Agreement for the year 2015. Theyre uptodate on their construction and payments and theyre reading as you heard from colien and they have entered into partnership to meet the medical requirement and theyre in compliance with the hiring goals. So i should note they have made up existing short falls noted last year. Theyre on track for compliance in 2015. Staff believes as theyre in compliance this year that we recommend the directors find them to be in compliance. That concludes our presentation. Im going to turn it over to jim who is going to make a brief presentation on the project progress and theyll be time for your questions and public comment. Thank you, ms. Pearl. Good morning, commissioners. Good morning. Director ram. Im jim from cpmc and my colleagues and i are appreciative of your time today and staffs time today to report on our 2015 compliance. As as staff noted, a lot of this information in their reports, ill be brief especially covering these 2015 key activities from our Compliance Report. Were proud to be found in compliance on all commitments. Weve been working closely with our Community Partners and dph to make up the unduplicated short fall and you heard that from staff. Remaining 12,000 lives over the managed medical target and the partnership with Saint Anthonys to serve tenderloins residents. The ongoing conversations weve had with dph in response to the Diabetes Center, we conducted the post acute care assessment and presented that to Health Commissioners of february of last year and were proud of the operational and construction hiring goals and invested over 37 million into San Francisco based contractors in 2015. Our current priorities are things since this 2015 reporting period, some of which again youve heard mentioned by staff, but we are exceeded to share the replacement hospital at saint lukes is ahead of schedule by almost a year and scheduled to open of june of 2018. The tower crane is down. We would welcome bringing anyone on a tour of that facility. Its looking terrific. Were excited about that revised opening date. We are continuing ongoing meetings with members of the community and we have made great progress last year. We have opened lines of communication with various members of the community and are coming to kind of fruitful discussions and constantly trying to gather more people into that conversation to make sure that its as open of a process as possible. Were proud of that activity and the progress with our Community Members, partners, neighbors, and friends. We did implement the Public Transportation subsidy this year in january of 2017 which had been a point of discussion in the past. Were pleased to report that 10 of our employees at this onsite have taken average of that. We have seen an increase in carpools and decrease in monthly parkers so we hope that when we see the results of our employee Commute Survey which should be at the end of the february, we should see that single occupancy vehicle number tick down. Were off to a good start with our Transportation Demand program. We will continue to support the partnership with them and Saint Anthonys to increase the amount of services being provided at tenderloin residents and as staff noted, we are implementing the recommendations from the class assessment and the specific review with dph of the saint likes Diabetes Center. Through this time, weve invested over 100 million into San Francisco based contractors so thats a jump from the numbers you saw reported in the 2015 Compliance Report. We continue to support our local businesses and the hiring year is is on a slightly different schedule than some of the other commitments for da year 2015 and 16, 74 of San Francisco hires has come from the da targeted neighborhoods. This is a current view of van ness and gary and it doesnt mean real time view, although with the weather weve been having, i dont i think wed be able to pull that one off. This is two views of the van ness and gary hospital. The top view is the corner of geary and van ness looking west. The bottom is a view of franklin and post looking east down post street. This is a current view of saint lukes. Those are both that first view is cedar chavez facing east, and the second is standing on the north corner of cedar chavez and valencia looking back at the hospital. And that is our report. And were welcome to answer any questions that you might have. Thank you so much. Thank you, very much. Im sure we will have questions. At this point, now that the staff presentation is complete, we would like to open it up for public comment. Youll have three minute to address the commission and we have a couple of dozen speaker cards. If i call your name, you can speak at any order. Alice, mary paton and zeek and perez, maria, vaquez, tido, gloria dixon, and bruce garon. If you can line up on the screen side on the room. That would help keep the door clear, and again, speaking in any order if your name has been called. Good morning, commissioners, my name is zeek and im the clinic director at Saint Anthony Medical Clinic where youre a manage care provider as you heard. Challenge at Saint Anthony, you might think 110 lives, why is that . We have a very complex patient population, homeless. Chronic care is one of our diagnosis of the practice, but just on that tone, i would like to share with you where we have been. We were weve been a San Francisco help plan provider for almost five years and we have in that line of business, 817 lives. On an average we hold 15 members. To put this in context, our nims, cpmc relationship has 100 to be exact, 121 lives and thats on average of 8 lives. So i would like to share that with you. Its not an easy task to be a provider in the tend did in the tenderloin and i brought one of our patients who have lived in the tenderloin since 2014. It wasnt until 2015 when we were doing outreach enrollment in the [inaudible] room, that i met him. He had not been directly participating in taking care of his health care. He is missing a limb, but never had anyone to treat him with a compassion to seek services. And as a result of our partnership in the dollars allocated from cpmc to Saint Anthonys, this work is being done. And we continue our work day in and day out, challenges with aca, the enrollment of our patients in the queue right now, we have 220 patients that were waiting for medcal to assign a designation, and as we know, our patients have a choice which network theyll choose, but subsequently our responsible is to get them into the medical management care of business. I would like to thank cpmc and you for your time this morning and were grateful with the partnership with cpmc and all they do in the tenderloin to support us. Thank you. Next speaker, please. I like to thank the Committee Board and cpmc because im a latino. Im a proud latino. I used to work for the city of north new jersey. I used to do the checks for recreation and parks, sanitation, and for the police department. I never thought i would come and lose a limb or i was too young when i got my job, and i never thought i would be homeless. I never thought that people would treat me in the way that they treated me. Myself esteem my selfesteem went down. I became homeless and i lost my family. If it wasnt for you and the board and if it wasnt for zeek because id never you know, i worked all day of my life. I always paid for my own medicare, but when i became homeless, i never thought about applying for Health Insurance or nothing like that. And i felt real bad. I lost my arm. I didnt take care of my hygiene or nothing, and now im proud. Im glad of zeek. When he met me i was dirty and never shaved, never had a nice haircut like this. I have an arm and i wanted to show it to you, what you did for me. I got an arm, but it took me a hard time trying to put it on so i left it home, but i just like to thank you for what youre doing for the community, and [inaudible] and it helps my selfesteem and makes me feel like a person again. And what youre doing for the people, i think its good. I think the clinic that i attend in the tenderloin at 150 golden gate is the best thing you ever had and i like to thank San Francisco general for just making me a person again. Thank you. Thank you very much. Next speaker, please. Good morning, my name is elise and im a social work at the Saint Anthonys Medical Clinic and my role was created over the past year to help families that are trying to gain access to health karat Saint Anthonys and helping them enroll in insurance and connecting them to the resources they need. We find a lot of or i find the families i work with have been in similar situations to mr. Price and they never expected to be homeless or worry about where their next meal is coming from. My work has been supporting the family so they get their basic needs can be met so they have the capacity and ability to focus their attention in care to their health care and needs, and to for the gain of more comprehensive care for their family and so part of that has been making it as easy as possible for them enroll in Health Insurance and gain access to our clinic and we have worked on a bunch of Outreach Program and working with the family Resource Centers and letting their members know we have ability in our clinic and are always open to new patients and really focused not only on the physical health of the families, but the wellbeing and Mental Health and a lot of my job is working with them, and addressing the cycle of social needs and stressors they may have in their life. Thank you. Thank you, mrs. Casey. Next speaker, please. Good morning, my name is mary and im a Nurse Practitioner at Saint Anthonys clinic. I would like to speak to our outreach attempt in the tenderloin community. We face many challenges given that a lot of the families we work are not permanent residents and so dealing with medical to get their insurance transferred to San Francisco county takes months. So were excited about the continuing opportunity to the outreach in our community. We got them enrolled in this partnership with nims thank you, ms. Paton. Next speaker. Hello, my name is bruce and i have the privilege of leading a Construction Company called gms. Back in 2012, i believe it was or 2013 when this project was approved. We were given an opportunity to help start the construction on the Construction Office thats presently occupied at van ness and post. I know it was a test to see if we can do half of what we said that what we could do. That was our chance to become involved with a larger project when it began. We started with a small work force at its peak about 4 people and we started that task and invited back again in 2015. A small work force, but it has led to continuous work from 2015 to today. And it has been with a number of growths from the initial path that we were given of being one small part of the overall activities there to, i think, about 7 separate work packages. Some of them have been directly with hararra or trade partners at hararra bolt. I believe those growth were apart of our by demonstrating each and every single time we were given an opportunity to prove we were worthy of the opportunity they had given us to work out there. I am indebted to the leadership of herrara bolt forgiving me the opportunity to show what we can do. I think that its not only at the leadership level where we enjoy this relationship, but it made it down throughout the organization to the folks we work with everyday. The superintendent and the foreman and the people that made sure this project gets done. And we have demonstrated time and time again weve earned the right to be out there. It hasnt been smooth the entire way. Weve had our challenges, but i believe we have met them and grown from them. One of the many keys of effectiveness that i place upon myself is not having people become employed and go off employed. My goal is to provide an environment where theres Continuous Employment because you dont get to develop and invest in people unless it moves beyond entry level, and while ive had other projects and pretty good opportunities with the city of San Francisco, with the airport, dpw, puc and rec and park, this opportunity has given me stability. And i think that what it has done is given my company the ability to be able to stand competitive to be thank you, sir. Thank you. Next speaker, please. Good morning, my name is maria mortonson, born and raise resident here in San Francisco. A recent graduate of City Build Academy. After graduating, i was hired onto work with the saint lukes project, and i just want to say that i think the programs and the opportunities affiliated to the project going on for residents are very grateful and i think theyre great. Thank you. Thank you, mrs. Martinson. Next speaker, please. Good morning, commissioners. My name is it tido and i have been here 20 years and i live in i graduate city build, cycle 24 last year. As far as the opportunity that city builder has given me, its a great company. Im a medical worker. I work at the van ness gary campus hospital project. As far as some of the things one of the offer that was really good is that if i when i leave work, if i were to drive to work, it only takes me 12 minutes, but taking Public Transit, it takes 40 minutes. There have an incentive program, if you take Public Transit or carpool, they give you some things that you can get points every month. One of the other things, thats what cpmc does. What the southland district does and i was surprised when i started working with them, they encourage you to take Public Transit. They pay for your Public Transit, and thats the thing that surprised me when i worked with them. This is the first time i have worked for a Construction Company. I found myself unemployed a year ago. When i went to the unemployment office, i found out about city build and after that, ive been there for five months. What city build has done for me was it gave me the opportunity to work in the construction field. We have people from southland supervisors to visit our school to demonstrate for us and other trades went and visited and happened to choose sheath metal. If city build was not there, i know i would never have had the opportunity to work in the Construction Industry and in the field of my choice. I appreciate everything that this city build and the office of Economic Development has done for me and my family. Thank you very much. Thank you. Next speaker, please. Hi, im vaquez, im a project engineer of the gary campus. I work for herald bolt. Ive been a San Francisco resident for 12 years, and i did my High School Year here. I did my undergrad at San Francisco state university. I got my current position thanks to the herald bolt inter ship program that was represented as a state. As soon as i graduated, i became a project engineer for the Structural Team and i got hired on as a full time project engineer for the medical equipment team, and i just will like to thank cpmc for the he opportunity to further my career and everyday i learn more about construction and along with a great team. Thank you. Ill call additional names. Nox, melody grossman, kim barns and sand sal, and james. Good morning. My name is gloria dixon. Im a native of San Francisco. I had the privilege of becoming a graduate of a capsule program. I started as an intern at the Saint Lukes Hospital and from that point, i was promoted three times. Im working at the van ness project, and i thank you. Thank you, mrs. Dixon. Next speaker, please. Good morning, commissioners, my name is abigail and im with running an employment finding pathways to good jobs is extremely difficult. As im sure you know, we have the highest rates of poverty of previous incarceration, substance use, Mental Health and we have doubled the Homeless Population of nine other districts combined and im here in support of cpmc because theyve been extremely dedicated to our community. Kevin train have come on and they have dedicated literately hours to interviewing every single one of our job seekers. After the interview event, they ran out of time and had to go back to the office. But instead they sat down with me and they went over feedback on every single one of our job seekers. Some of our job seekers were referred from employment and it transformed their lives. One of the women they hired is a single mom with three children. Since working for xhm, shes been able to find permanent house and change her childrens lives. For the folks who are not referred for hire like i said, progna gave us feedbacks on behalf of hospitality house and the nine were grateful for our partnership with cpmc and i cant advocate enough for support of them. Thank you. Thank you, next speaker, please. Good morning, commissioners. My name is christian martin. Im the executive director of the lower pope district. I would like to echo the comments of previous speakers and thanking cpmc for their community outreach. Their generosity allowed us to directly employ people that have and providing cleaning and Maintenance Services to the district which in calendar year, 2016 removed over 50 tons of trash, feces, needles from the neighborhood. And indirectly, their presence has supported small businesses, and i would like to thank them publicly and encourage the commission to support them. Thank you. Thank you, mr. Martin. Next speaker, please. Good morning, commissioners, my name is escamine and im the director of the economic clinic which jobs and justice, the Community Labor coalition that so tenaciously pressed for the meaningful Community Benefits that weve been hearing about today. And a coalition that has consistently participated in the da compliance review process. In the Public Comments that follow mine, youll hear from individual members of the coalition speaking on a number of specific issues. But ive been asked to make three overarching points. And the first is that it really shouldnt have been this hard and it should not have required so much effort from this coalition to push the city to insist that sutter cpmc fully comply with all of its obligations and the second point is the coalition is disappointed that the city has not used this review process to cat allies a forward discussion and looming conversations that need to be address to explore whether all the essential promises of the da are being fulfilled. Instead, this review process has evolved into a formalistic bureaucratic backward looking box checking exercise. At the end of every may, cpmc reports that it has met each and every obligation of the da. In june or july, the coalition submits lengthy written comments of where cpmc has not fully complied in areas where more information or dialogue would be helpful. We literately suggest the areas that the city report should discuss. Then in the fall, the city report typically ignores most of the Coalition Efforts to catalyze discussion and discuss whether all the ordinary lives of the san franciscans lives are being it appears to Many Coalition members that the rules of this review game are that cpmc must never be scrutinized too closely and given a passing grade, and if it cant be given a passing grade, the previsions of the da that is violated or ignored or theyre reinterpreted or this joint hearing is postponed until cpmc can be given that passing grade. Thank you. Thank you. Next speaker, please. Good morning, commissioners, my name is osney and i work at Community Housing partnership. We help Homeless People secure house and help them become self sufficient. Last year we served over 1400 residents throughout the city. Most of them in the tenderloin. I think its great to see other partners in the tenderloin line Saint Anthonys and hospitality house. We deal with residents every single day. We have heard about compliance verses non compliance. I want to talk about this from our residents perspective because they live in the tenderloin. We work there, but they live there everyday. I think were starting to form a partnership thats great with the different nonprofit and Non Community in august, we hosted a Community Event and while turn out was low, we did ascertain we need to collaborate better and we can do better for our residents. Theyve stated if there is the ability for cpmc to provide transportation for tenderloin residents to access other cpmc facilities until the cpmc office opens additional they stated that a navigator to help support access to services was available, and that would be helpful for them as well as other low income residents. Last but not least, working with homeless residents and formal homeless residents, i think it would be great to collaborate with the department of public works and cph to see how we can provide access to care for those coming out of encampments and get them when they enter the system, to make sure they have the opportunity to have access equitable access to care in the tenderloin. Thank you. Thank you. Next speaker, please. Hello, my name is Melanie Grossman and im a member of the older womens league. And i would like to address the low enrollment of the tenderloin residents to the cpmc manage care program. I have experienced a recruiting Community Members in the mission, the bay view, visitation valley, and oakland to Research Programs at the institute for health and aging. And although i congratulate Saint Anthonys on their work, im here to suggest that there really are ways to successfully recruit Community Hard to reach Community Members, and we were successful in our over efforts. The first thing that we did was to get community input. What are their barriers, what are their motivations. What would help people join . The second thing that we did was just showing up in the community and im not suggesting that people arent showing up in community, but just thinking outside the box. Showing up at the churches, going to the beauty parlor, going to the barber shops. Theres lots of interesting places to meet Community Members and to recruit them. The third issue is the advantages of enrollment have to be immediate and they have to be clear. We learn that people want to stay in their own community, and that means that if they have to leave their community for, lets say, consultations or procedures at other cpmc city campuses, we suggest providing navigateers so they can feel more comfortable and they have to be user friendly and welcoming. I think using these techniques that the enrollment goals can be reached realistically. Thank you. Thank you, mrs. Grossman. Next speaker, please. Good morning, my name is matt and im with the california nurses association. We would like to see sutter cpmc and city reports more fully discussed why there has been so many volume volume tilt. We would like to see a break down by campus to by patient zip code and three, how many Diagnosis Services at cpmc has done to relieve backlogs at San Francisco general . Finally we would like to know why the city thinks that a random sampling of 25 patients out of more than 30,000 is a sufficient sample size. On its face, this number is inadequate. Thank you for your time. Thank you. Next speaker, please. Good morning. My name is jane, thank you for having us here this morning, commissioners. Im a 30year nurse at Saint Lukes Hospital and i work in the emergency department, and i have been down this hearing road almost 8 to 10 years now with trying to ensure that cpmc rebuilds saint lukes the right way. San franciscans support the Health Directors efforts to appropriately Services Compliance at cpmcs hospitals, however, we want cpmc to end act best practices and thats providing services that promote the health and wellbeing of all patients, particularly Spanish Speaking patients. We have in the past asked the Health Commission to folk house the Diabetes Centers at Saint Lukes Hospital assessing for demolition of services. The reason for this focus was the abrupt termination of almost 3 years ago of two Spanish Speaking diabetes educator, one by cultural and the Spanish Speaking buy cultural Administrative Assistant who were working at the Diabetes Center for 12 to 18 years. At that time almost three years ago, 70 of the centers patients were Spanish Speaking whereas today the number is 51 . Thus we see a 20 drop in the number of Spanish Speaking patients served probably reflecting in large part the [inaudible] Spanish Speaking workers at the center. At a meeting on april of 2016, cpmc met to discuss the diabetes saint 2016, cpmc met to discuss the diabetes saint lukes center. This meeting result in series of clarifications and recommendations. Number one, the first recommendation was that additional language, Spanish Language capacity is warranted. As of tuesday this week, cpmc hired a four day per week Spanish Speaking dietitian. Given the 20 drop in the number of Spanish Speaking center going to the sent e we urge cpmc to do outreach to the Latino Community advising them of the increase of the capacity to serve them. A related issue is a use of interpreters and patients state they dont like interpreters as continue invasion of their privacy and they have different conversations with an interpreter present as opposed to a Spanish Speaking provider. Cpmc best practice goal should be to have every Spanish Speaking patient be seen as a Spanish Speaking provider. We use an interpreter phone which cold and there is something lost in the translation there and the patients do not like that. I see that. Thank you. Thank you, mr. Sanderval. My name is ruin. I work for the california nurses association. The second recommendation of the joint cmpc meeting was spanish meeting education that should be offered at the saint lukes. It was understood at this meeting there was a plan for this classes in the future. This has never happened. But three weeks ago, classes for English Speaking ready for this hearing. Spanish is spoken by 51 of the patients, someone will think the Spanish Speaking language will be your best practice, but that hasnt happened. The third recommendation with the reception staff will improve patient experience. There was a full time aa whos door was open at the center at all times. And since she left, the room has been empty except when its used by an educator. Theres no reception area except for the hallway and the chairs. And those chairs are [inaudible] location when you want to see them wait. When patients call a number for an appointment, there are directed to room 230 which is a prior administrative room which is closed and has a sign on it telling the patients to find their provider with whom they have an appointment. To make matters worse, and more absurd, the patients are not given the name of the provider so when theyre looking for an appointment, so often times they wander the hall looking for someone to ask the name of their provider and they start working on doors all over the place. To this day, theres no aa room or staff. We have here cpmc have no plans or intentions to add [inaudible] for this office with the capacity to make appointments and direct people to their providers. Im pleased, this situation is getting worse when we compare to the Diabetes Center, that center has 2 full time aa as well as american assistance. And this person is the one thats directing and making the appointments. Thank you very much. Thank you. Next speaker, please, and ill call additional names. Bob, michael lion, gordon mar, and david elliot lewis. Thanks. Hi name is ken barnes and i was at saint lukes for over 32 years. Adding to what the prior speaker says, i invite you to visit the saint lukes Diabetes Center yourself and see the condition of the year. I have no idea as to whether the new Diabetes Center is going to be moved to the new hospital although i kind of doubt it. If it doesnt, in my opinion, the space itself and the organization of the space is at best disrespectful to patients. The fourth recommendation of the joint meeting of dph and cpmc had its prevention in education serving patients for chronic diseases including diabetes. Its supposed to coordinate care with the diabetes senter and primary care providers in the saint lukes community. To provide comprehensive services to patients with diabetes which in fact is only sporadic with sharing in coordination of care and not consistent. In the april 2016 meeting. The group discussed the possibility of including patients and staff from health first on the saint lukes Diabetes Center advisory council. A council was mandated by both the American Association of diabetes educator and the centers for medical and medicad services. Saint lukes Diabetes Center doesnt have an Adviser Council how committee. The adviser
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