roll call we expect commissioners moore and richards to be absent today. I will take roll for the Health Commission. roll call . Commissioners, we have one item on the special calendar item one 20120403w. California Pacific MedicalCenter Annual compliance statement. This is an informational hearing. Good morning, commissioners, i am Planning Department staff. The item before you is an informational presentation on the california Pacific Medical centers compliance with their Development Agreement for the 2018 reporting period. This is the sixth annual reporting period. I am joined by ken, marina from the Health Services service and the department of Public Health and Elizabeth Pearl of the Planning Department. Todays hearing is part of the annual review process required by the Development Agreement foresee see. For c. P. M. C. It requires a public hearing. Following todays hearing the directors of planning and Public Health will derm whether c. P. M. C. Is in compliance. A thirdparty monitor will inform the board of supervisors if they agree with the directors determinations. C. P. M. C. s Development Agreement allowed them to build a new hospital and medical Office Building at the vanness and geary campus with a requirement they build a new hospital to replace st. Lukes. The Development Agreement required replacement of st. Lukes hospital within two years of opening the vanness hospital. They met this with the owning of the opening of the commission hospital. They required payments for range of Public Benefits and improvements. They completed the payment requirements with a total payment of over 73 million. For the 2018 reporting period there are 11 main actions up for compliance t. These include payments, hiring commitments, public improvement and community outreach. My colleagues will go into these. In one reporting area the local hiring period has a reporting period corresponding to the fiscal year rather than calendar year. That means for recent information on hiring. Ken will help explain how the c. P. M. C. Overall hiring record compares to the goals of the overall Development Agreement. Construction of the vanness hospital is complete, and the associated medical Office Building also opened this year. Future construction includes the new medical Office Building omission and improve mends around the improvements around the mission area. One other obligation is the limit on fees for servicen creases by c. P. M. C. As the provider for the City Health Service system. Annual increases must be no more than 5 . Actual Analysis Finds they met the requirement through 2017. The most recent year for which this analysis has been complet completed. They are working on the 2018 data now. With that we will turn to ken nem from the oawd work force division. Welcome. Thank you, good morning. I am the director of city build of the office of economic work force development. Thank you for the hearing to give us the opportunity for feedback on the report and i would like to thank the public to serve the residents seeking employment for this great opportunity for the hospital. First, i would like to start with the construction. We are putting it as cumulative since it started in august of 2013. The first topic is hiring for internship. As you know, the majority of the construction work has ended. St. Lukes opened in august 2018. The vanness hospital opened in march this year. A lot of construction has been completed. When we generated these hours for the last program year, not a lot of hours were added. For example, for the 50 entry level positions for nonunion administrative engineering candidates, new hires in the office we had requests for 38 of the new entry level positions. We filled 32 with folks out of our program. City build have the construction handson training and have the professional services so people coming through our Program Administrative type of professional training at city college. We work with contractors to get them into these administrative positions. 32 of those were from our program and some include lead document, document coordinators, project administrators and project manager. From the next slide, which is very similar, but this is really focusing on the internship program. We work with the San FranciscoUnified School District and San Francisco state through the mesa program, mathematics, engineer and science achievement. They are disadvantaged residents. We got 30 interns on this project. Goal was 50 . We achieved 57 . I spoke with the contractors. 10 of the hires are on the Company Working with projects outside of the hospital once it was completed. That is a good success. We want retention and people sustaining to work. The next slide is our entry level positions for construction and most of these are focused on apprentice ship programs. City build we offer the academy which is 18 weeks. People who graduate from the program we pay for the initiation fees to get them in the union and to work. Early are the challenges not having enough ironworkers. We have presented that in the past. One of the toughest trades to convince people to work in, and with that there was still a good amount of ironworkers. During one of the events a graduate spoke and highlighted success in working on the project. The last four years, we have experienced a big construction boom. In city build we manage other compliance programs, mandatory hire the city public works contract we increased for the last year 3 million work hours. This has mandatory requirements. If the contractors do not meet that there are penalties. It is going to local residents on the projects but the other projects are taking them to avoid penalties. We had the opening of chase center. They increased the program year about 1. 5 to 2 million work hours. They also had the office of Community Investment goals that was drags and pulling on local residents to work on those projects. Some of the challenges we had difficulties in fulling. Drywalllers during the chase center. Sheet Metal Workers and operating engineers were some of the entry level positions we could not fill to get people working on the project. We had 175 apprentices on the project. These are individuals that did not be have experience or could not get an opportunity to work construction due to this project brought them on, started a career in construction and they are union members. That is the success of that. Then the fourth compliance is the overall work hours. Overall workout is 30 . The first three years we met the goal. With all of the construction happening and other projects, we have seen decline especially the last year the major work was the medical Office Building. A lot of exteriors were done. What caught us off guard a special interior modular system, prefab wall to use for that system in canada, and the carpenters that needed to do the work had to have special certification. We pulled in the contractors, we could not get it from the union because of the special certification. We did not have people trained for that. Even with that we were able to get some employment opportunities, not the bulk of the prefab work. That gave us a challenge in a drop in numbers. They did the best to work with us to hire folks outside of those specific classifications. We still convinced them to hire people from the Community Working in the cleanup work, laborers and whatever opportunity was available that didnt need the special certifications. To date we 432 322 residents hired to meet the 30 goal. These are just some statistics. This is a piechart of where the hours went. We have reported roughly a little over 5. 6 million work hours, of that 1. 15 for apprentices. 35 of those were local. These are new individuals coming into the system to help them retain them and successful journey level workers. Now here is a demographic where the workers were coming from, from the different neighborhoods. These are the key neighborhoods that had the San Francisco work hours. Four biggest neighborhoods we were targeting and which the da put a special reference for. Four of these neighborhoods represented 60 of the work hours. Workers were coming from the neighborhoods we wanted to impact through the Development Agreement. Now, i will focus on the lb eg egos. 14 . We have reached 16 of the dollars were going to l. B. E. That is equivalent to 227 million to l. B. E. S. Each of the bullets focused on the projects and where the money was coming from. The ti work was not significant compared to other major work. Lower amount and we were able to reach 16 to the l. B. E. Community. L. B. E. Is monitored by the contractor monitoring division. They provided me that data. Now, we are looking at the first source hiring. To focus first is the Program Years goals. In addition to construction we have a Business Services team that works with c. P. M. C. , the employer and they submit to us job notices. We work with the community to provide referrals. I convinced them to give opportunities for people coming to the program. We have hospitality and healthcare that a lot of graduates go to the post construction work. The goal is 40 of the new hires entry level positions referred. In the program year we were able to hit 52 , 48 out of the 92 employees were referred through our system. We 432 326 placements since the program started. I have statistics on the next slide. For the program year, i think a big question where are the individuals coming from . Based on our analysis all of the qatathekey neighborhoods. 65 from the tenderloin, outer mission, chinatown and southeast neighborhoods. Cumulative data we looked at since we started the program with 81 retention rate. These are individuals hired that stayed for 180 days or more. We had 263 hires retained over 180 days. The last slide is just a work force fundings. Those are provided to help fund the agencies doing the work in recruiting the neighborhoods, nonprofits to do job training or employment opportunities. A lot did Case Management to make sure people are successful. Life skills to prepare them before they come to our office for training. The current grantees this program year 375,000, and the agencies were jds, selfhelp for the elderly, success center, cotenderloin is a new agency. As of this may of 2019, there is 935,000 in the account. The program year they are looking at new scopes of work and what else needs to be done to prepare individuals for the postconstruction and operation of the hospital and those are my updates. Thank you very much. We may have questions. Good morning. I am from the department of Public Health. For this section of the presentation i will provide an overview of compliance related to the healthcare commitments and the da. So first i would like to provide a summary of the healthcare commitments. There are multiple commitments to ensure that c. P. M. C. Provides highquality care to all san franciscans, especially low income, uninsured. Each contain multiple provisions. At the top five baseline commitments to maintain the same level of commitment. Three to increase care to medical and low income individuals. Two on the Innovation Fund for 8. 6 million to fund communitybased services and programs. The last two commitments are specific to the mission burnell campus in effect for the open of the new hospital in august of 2018. They are reported in the compliance review. These additional commitments include key provisions related to the number and type of bed Space Available and four provisions to ensure specific services and programs are provided at the mission burnell campus. There are five additional healthcare provisions that range various topics. Subacute services. These provisions help to ensure seamless and accessible care to those in San Francisco. Over the next several lieds i will provide more details on the healthcare provisions and the compliance on each. This slide provides details on each of the five baseline healthcare commitments. The c. P. M. C. Compliance and if they are compliant. C. P. M. C. Exceeded the requirement of caring for the charity care patients. It is for those without expectation of reimbursement. They cared for 38,210 charity patients. Second is Community Benefit unreimbursed costs to provide or improve Community Health. In 2018, c. P. M. C. Exceeded the 8 million Community Benefit requirement providing 15. 1 million. They met this by providing grants, Community Health programs and community outreach. It is important to note that the first two provisions on the slide are verified as part of a thirdparty audit. Third and fourth are related to charity care policies. Third required easy to maintain the charity policies through 2015 which they met. It requires charity care policies compliant with state law. That is the case. As of 2018, c. P. M. C. , charity care was the same as 2015. The last provision i is for the easy to support the bayview child care center. They have provided an operations grant for five years, invested over 1 million, transferred assets, is still the specialty and Hospital Partner. So the next three provisions focus on medical. The first provision, c. P. M. C. Continued to participate with the San Francisco health plan. Next requires easy to assume responsibility for 5400 new beneficiaries. This was met in 2014. In 2018, c. P. M. C. Had. They are required to serve the new medical beneficiaries through a partnership with the tenderloin serving provider. Currently there is no such provider. To meet this c. P. M. C. Partnered with northeast medical services to bring st. Anthonys clinic as primary care provider in tenderloin. They are accepting enrollees. In may 2019 there were 174 members in the partnership. They have reported several barriers to increasing enrollment. If you include patient choice. New enrollees can choose which hospital to go to for specialty referrals. These may be more familiar with the csfg and opt for that instepped of c. P. M. C. Another barrier is follow up with potential enrollees. They may have unstable housing or have outdated contact information. Clinic staff have been unable to reach them to complete enrollment. Another barrier is staffing challenges. They have experienced staff turnover. C. P. M. C. Has reported that it is partnership with threeinch dependent primary care providers. They collectively serve 2600 tenderloin residents. C. P. M. C. Continues to work with the st. Anthonys for outreach efforts. The next two provisions pertain to Innovation Fund. C. P. M. C. Is required to make payments between 2013 to 2017 totaling 8. 6 million. The final payment of 1. 25 million was made in 2017 and completed the payment obligation to the Innovation Fund. This describes how they are used administered by the San Francisco foundation. C. P. M. C. And the Public Health and foundation it is on a committee to support Community Clinics and Community Based programs. These awards will support Community Based programs for africanamerican and pacifi pacc island communities, Healthy Living and services for seniors. So the da includes two provisions related to the number and type of bed Space Available. The first provision on this slide requires the mission be 120 beds general acute care with comprehensive emergency services, must open within 24 months of the vanness hospital. They have opened the hospital as described in august 2018 abearlier this year opened the vanness hospital in march of 2019. This second provision is conditions on the operation of 30 additional shell bed spaces at the vanness hospital. C. P. M. C. May not build out or place into operation this shelled space until after the mission burnell is open and has a 75 for a full fiscal year as in the compliance report. This provision is not yet applicable but subject to the mission burnell campus hospitalization utilization. The follows four provisions ensure c. P. M. C. Provides specific programs at the campus. They require comprehensive inpatient and out patient and urgent Care Services. C. P. M. C. Is compliant offering all services outlined in the Development Agreement. For the second and third. C. P. M. C. Is established to establish and maintain a center of excellence in Senior Health. This center is named health first at the mission bernel campus and integrates Community Health workers to the healthcare team. C. P. M. C. Reported the following in 2018. It provided care to 717 unique patients and over 1400 encounters. Staffing includes three bilingual Community Health