'~~~1 t CPC Hearing, o ~

_.._ ... _ .._ _ .. .._ _._ ._ _~,_ u,"

CPMC CLAS ASSESSMENT 2018

1. Summary of patient demographics (e.g. number of patients served, preferred language of

patients served, race/ethnicity of patients served).

CPMC Demographic Data: All Campuses

The following graphs/tables illustrate patient demographics at each CPMC campus. The dataprovided in the tables includes a total of unique patients between January 1, 2018 and

December 31, 2018 from all inpatient (IP), outpatient (OP), and emergency room (ED) service

areas.

Patient Preferred Language

t, Diecl~arpe Monts Vr I VaUanl Acq Cb~s

' CPMC CLAS Demographlca: PREFERRED LANGUAGE I ~~n,~ pyrop~rrwq- ~ Wn

J

•~

4ata-ao La-~.3. Ul Easy Cel Wxsl DNNf

tenor.

Yubn B~nW Poch St luhq G~nO TdN

APABIC iJ O.OY,. ]i OABR 15 O.E)~ 71 B]6X 10 O.11M b 0104 1Y5 OAWY

BURMESE M p,p)K ]t OABM t~ O.OB1~ 1 t.N% tt 0.01 1 OAAY 1]i O.B9~

IANiOMF 1E i,01~ ].]D~. ~,0l0 G.15ti YI t15~ 1~i 1.1N !,~]I t1A04 t~ tON4 16.275 ].tik

t Ht;115H M.1a 91.5T1 ]t.i6} W~BM ~1,t]0 8I.65A t,i06 1}.ltt Y,Otl IITW. 10.WI l].T9X t~t.1T5 lS~BK

Ni N~ II )t O.OIM N O.W4 IB 0.010 6 QPSA ]B 0.96M 6 0.01!4 116 0.MK

,iANnN151 G9 O.11K i8 O.I~N K 0.11M 5 WA 1T] O.70N I O.M4. 106 Q11M

m xrt nx n oen. ce oasti x o.ttw a anx m o.x*. n ¢on a~ o~w`

IMMINNIN )l0 O.KW 6b 1M% k U7M 2f ~.1M t.B01 1MY ]B W1'w i,W! 0.~\

tKiuil~<.i~151 ]5 0.014 N OA5!t ) 0.03k ]l 0.1Mi ]i 0.011: lD O.t A: 1M 0.014

~i iti44M 16J O.N% k5 0.)1% 1M ONp M 0)]~i tA06 1bSX N DJTY 1.158 Od]%

SPAW SN 1.W5 1.~lti 662 1.514 STO 7.SM 2159 7J.111i tA]8 7AtK ]A2] }7.1tti 0.915 ~AH4

TAG~IW 69 0.1]w B1 O.tlA 51 0]SA =Tfi ]31% 1M B31% IBO 13W 911 W]M

Grena TMN 5V.959 100.00'1 13.]85 t00.OM. Y1.Sp IOO.WA 11.931 188.884 B1A73 t00.0UV 17A85 f00AlM. ]1]ASi t00.W\

IB1.7]5 PMerteG LanpuWa ~

ARABIC ~ MAMDAftIM

9UPIESE ~ P00.T000ESE ~5"'

~~K B GNTONESE ~ RUSSIAN

ENGLISH SPANISH

I. E F0.ENCH ~ TAGALOG

JAPANESE

~ IO~x( KOREAN

15,]15

OK9.915

~~,bp~

2.106 tA1B 1.158 Wt'~.

ht M NIE ]b1 ~_

f Nt'~i ESN C~MTfMI., 6PAIUW UMIfNOWN CINNFSE 1MMOAItl.. PUSSIFM V~TtUY. TAWLOfi N(M1FAN JAPAMEfE TdfMAN.. dlrRNmM.

BS]B%

Patient Race

~~ ~~h, CPMC CLAS ~emopraphica'. RACE

Raf GIEat .a efi

O.MkqumxKen I~en w Mae~e.. O.IiS

w~~MMnn i51 ].H4

&eck~~M1aan ~meriun 1 I.W. TB9 2.6)4

o ixen ~.m a.usF+x~o ~ I ?~rl wr x.a..

.rw~,Y ~~ ~. inn~~.~o

sr~o~ ow+,

qlu+ INwe~~ai~ '

1 l]f~ I.IIM+i ti 'U.H~

FeM Nd~A~awcr 1 UN. 56 O.SOW

s,mo.n ~i o.~a.Unkmm~ 1 I.JA~ 60 0.5)k

viem~x ~~o ion1MIIc,Ca~c~alan id q.1A S.Yl2 18,564

Gentl ioul J] 1W.pM~ 1t 1~5 1W.W.

111,851

b: Nun

Guemingn of C O1~ Imo,

Aew ~'hWwn lan .upemu 6~~wPCM~IfM 1Yn UCeuuwn

Bi~GPfriwn• Q?Korw~ Rrlar xcibM

L' C~mcx Natna wwuien Sa~~w~

Ddvq~

t O.Oba}I B]N

06 OAiA

981 1.i lOf:

159 ].11h

0.1h.1}A9•.

6 ]J•.

0.01.1.M60 oeWAP~W OOy

]'1.811

:' m, ,.re: ,, sr

u.a, usiesseo

~,wc i.~n vsi 76;rmn«~r,~~ onw em.ee ubnon~ eum c en~c eee e.,. we~~e~+. Kr.enn

n.~~~ evKa~ . maws ~„n~~..i x.~.w

Patient Ethnicity

~~ ~~F~~, CPMC CtAS Demopraphlts: ETiNIC17Y

E?n. M, CY Hai Cai West OevY~

XWI 1 0.014 3 B.M4

<~p~ B SUIT ] BDJK

Me~ean tYll t.101. N tllfi

Mui Htswi~~~ 19 Hi.61% y.X'.~ B!.l1k r~.~~~~ lkIYY

rix leannf~unnn .1 13.Mw 9~! 8.]IT. e~~ tO.IM.

NeM~lb~tn ~nwmi 10J 0.9tF N OA]~.

Weiw R~caii 1! 0.15k ~0 O.t)x

Unlnpin 1 lA0 1M 0.961 ~e6 1l1'.

Wand Toul l3 ~06W~. 11,T16 100dM ].55} Io0.00h

NwssK

ENnlclty

MUM s OIM1er Mepankt

~ 1 CUMn Prme~Ngm M...l re.ven wxna nrcan

,~ >sK Y nm xiewroc u~morm

me

g,~

,a~.,o

~ W 181 ~ I] 11 N

Non Wq~yc pIpN ~4gYc Mtlun IAitnwn Pnlx Motp Vueno Pken IAHI CUMnINNo~'f0an~.. Mew

~ ry~MmN-Yr - ~

~~YYNOk~WeN IM~~M[vtl~~a~ JGnque

Ml~slon BemY Vutlk K luYa~ G~enE Twl

0.114 l0 0.11> 1 0014 1I O.Ori17 821% 0J BAA 15 UZM 11i O.1Ti

t8 O.~We Po O.MA b OAtK KS 1.OT

1)]i }2]h 13]9 OlM 1.5M T3)IX SSS] 11N1.

I.SBS L01] iI0\ t1 1.114 )]M1.1h 1!l 1.M4 B6~ ).fir

oon ~ ~ own uon.o»ti ~a ona ~ o.~r

io oer, w o.a~ nun16 OIB4 O.1M '61 0.1N

1.Nti Si.6i•. V.N> >.H~ .M>

)01 l.Jb 9~1A W 1Wo S.IIn 'p M.!1 OYIM QSM• IlJ O'MY~e

1Z 011'. 00 OA1~ 0.16`. M6 9.I.Y.

31 OA54 11 0W!. 461`. f06 0.]M.

v o.ma H+ i~» n o.~r. ss~ uta1 0.1H< JS 0154 tI OMu 189 OAT+

IA}0 J1Jlb ]J11 56J5~ 1BT5 M.)Y~ 11.5N 1).Xh

5.)1} 100.004 flBBl tOp.OY. RK6 100.OY. ~5.Ifi5 IOO.OM.

e 1i~ yak

9.1H. '

~O.OM.

~B M~ FI .

a~

~, am~q 6Nfi

SII~UWW Monty _Y -.. -~ T ..-_. -....._. MMAtrt ht

i (A~II ~ (MublpM ~aYx~~ ~~ '. MuMpla v~xwl

7

Walon Bernal F~ciXc riluYea frmO lolel

i O.t3!'a ]0 0.t~4 1 OAt\ )i 0.0]fi

1 0➢iA 1 O.KA l B.WA ]t OIISh

155 1.964 Ill 1}T4 161 ).JI!. B:4 t.GA

i.ei~ e~.~rw i>.~e+ ei.~sv a~n> wx~n ,u.su eo.~sw

t,tlp 31Alfi n6 6.50w }.IY~ IfJ1v. b,n~~ 1l.M4

B 11.16!1 l0l O.IJR ID 0]R Mt O.SP4

tl 0.~.'tH T] O.t6R ~~ 0.~es l,~ 0.16fi

]1 0515. U] ]fVk 51 B.IA 161 16iy

5.112 f00A0l: II,~i 1W.WW OJ6[ 100.00\ <S.bE 1QO.W1

~.e~a iev,

rSAN FRANCISCO San Francisco 'I~~~~ni~CO SFMTA HEALTH SERVICE SYSTEM_~~ Olficc ofEmnomic anG Worklor[e OevelDpmcnl Department of Public Health ~ ~ ,,,,,,,,,,,..P„~.,,,,~,.,,,, CITY &COUNTY OF SAN FRANCISCO

Pr entationesontents

• Compliance Overview

• Project Status

• Workforce Presentation

• Department of Public

Health Presentation

• Summary of Key Points

2

C mo I~ancp eve ry i ew

Pro'ect StatusJ

• Development Agreement became effective in 2013 —10year term

• Sixth annual reporting period (2018 calendar year for most

requirements; August 2018-July 2019 for hiring programs)

• Major DA Obligations Completed:

— Mission Bernal Campus (St. Luke's) Hospital opened

— Payments completed (Housing, Healthcare, Transportation,

and Public Improvements)

Sutter is generally in compliance on all 11 main action

areas

Construction Schedule

• DA Obligation: Mission Bernal (St. Luke's Replacement)

Hospital must open within 2 years after the opening of the

new Van Ness Campus Hospital.

— Mission Bernal Hospital opened August 2018

— Van Ness Campus (Cathedral Hill) Hospital completed March 2019

— Van Ness Medical Office Building completed March 2019

• CPMC provided construction schedules and live updates

through their web site (www.cpmc2020.org)

• Future construction: Demolition of St. Luke's and

construction of Mission Bernal Medical Office Building

53

Fee Increase Update

• The DA requires Sutter to limit fee increases for servicesto the City's health care system to no more than 5 percentannually.

• The completed actuarial analysis of rate increases from2014 through 2017 showed less than or equal to 5percent, as required.

• HSS has negotiated an agreement with the actuary tocarry outfuture year analyses.

0

kf rceWor o

n ~. ~-.~ . r~4

~ ~ 1m J r

a

~.~

First Source Hiring Program -Construction

1. Hiring Goals —August 2013 through July 20 7 9

level positions for non-unionadministrative and

of 38 (82%) applicablepositions to date with system

engineering candidates will referrals.be filled with system referrals.

At least 50% of new entry- CPMC's contractors fi lled 32

First Source Hiring Program -Construction

2. Hiring C~oa/s —August 2073 through July 2019

level positions foradministrative andengineering internshipcandidates wil l be filled withsystem referrals.

of the 53 (57%) applicablepositions to date with systemreferra Is.

At least 50% of new entry- CPMC's contractors filled 30

First Source Hiring Program -Construction

3. Hiring Goals —August 2013 through July 2019

level union apprentice

candidates will be filled with

of the applicable union

apprentice positions with

system referrals who are also system referrals.

CityBuild Academy graduates.

~o

At least 50% of new entry- CPMC's contractors filled 30%

First Source Hiring Program -Construction

4. Hiring Goals —August 2013 through July 2019

hours for union journeymen

and apprentices will beperformed by San Franciscoresidents

1,325,131 hours performed bySan Francisco residents out of5,618,090 total hours. Thisrepresents 24% of ove ra I I workhours performed by Sa nFrancisco residents.

11

A minimum of 30% of trade CPMC's contractors reported

CPMC Construction Local Hiring SummaryCombined Data through July 2019

1,149,5725,618,090

CPMC SF Work Hours by NeighborhoodCombined Data through July 2019

❖ Russian Hill/ Nob Hill(94109)

❖ Potrero Hill/Dogpatch(94107 )

❖ South of Market (94103)❖ Haight Ashbury (94117)❖ Twin Peaks/Glen Park(94131)

❖ West Portal (94127)❖ Treasure Island (94130)❖ Castro/Noe Valley (94114)❖ Marina (94123)❖ Mission Bay (94158)❖ Financial District (94104,94105)

North Beach/Chinatown

(94108, 94133)3%

Lake Merced(94132)3%

HayesValley/WesternAddition (94102,

94115)6%

Richmond (9494121)4%

Parkside/ Forest..Hill (94116)

4%

Russian Hill/Nob Hill(94109)3%

Local Business Enterprise Programfor CPMC Construction

Contracting Goals — As of July 2019

• CPMC Local Business Enterprise Program

• At least 14% of the cost of all contracts for the workforce projectsare awarded to certified LBEs under the DA Agreement

• Program Progress

• Van Ness Campus Hospital Project — 15% ($148.14mi1)

• Replacement Hospital at Mission Bernal Campus — 22%($62.43mi1)

• Van Ness Medical Office Building — 13% ($16.76mi1)

• Van Ness Medical Office Building TI Work— 0.4% ($259.54k)

• All projects combined through July 2019 — 16% ($227.59mi1)revenue to LBEs

14

First Source Hiring Program forCPMC Operations

Hiring Goals: Fill at least 40% of entry-level positions withsystem referrals each hiring year (August —July)

• All non-construction hiring goals have been exceeded.

• There are no deficits or carry overs.

First Source Hiring Program

for CPMC Operations

Program Year 18-19 Hiring Goals: 65 % Hires from

Priority Neighborhoods: Western Addition, Tenderloin

Mission/SOMA, Outer Mission/Excelsior, Chinatown,

Southeast Neighborhoods

Cumulative Retention Data August 2013 -July 2079

Retention Rate: 81

• Total of 326 First Source Hires

• 263 hires were retained over 180 days

16

CPMC Workforce Fund —Program Year 18-19

• The Fund targets educational and non-profit organizationsthat work in the priority neighborhoods and focuses onbarrier removal and job training for employmentopportunities.

• Current grantees of $375k: Jewish Vocational Services,Self-Help for the Elderly, Success Center, CodeTenderloin/Downtown Streets Team, and FACES SF.

• As of May 31, 2019, the total remaining amount in theWorkforce Development Fund was $935,309.07.

17

Summa of Healthcare Commitments

i ndividuals

New Medi-Cal Beneficiaries Increase care for low-income individuals

Innovation Fund Support community-based services to reduceunnecessary hospital care

Hospitals at the Van Ness & Ensure the continued operation of the Mission BernalMission Bernal Campuses Campus as a general acute care hospital

Mission Bernal Campus Ensure the provision of specific healthcare servicesand programs for the community

19

Baseline Charity Care Maintain current levels of care for low-income

Summary of Healthcare Commitments

addressing citywide need for sub-acute services

Integration of Medical Staff Ensure seamless patient care across Sutter's SF

facilities

Community Benefits Partnership Continue community partnerships to improve health

Chinese Hospital Agreements

Culturally and Linguistically

Appropriate Services

Maintain partnership with Chinese Hospital

Ensure culturally and linguistically appropriate

services are provided

20

Sub-acute Services Work with other SF hospitals to develop proposals for

Baseline Charit Carey.~ ~. . - . ~- . i.Care for 30,445 charity care or Medi- CPMC served a total of 38,210 unduplicated YesCal patients annually* patients between 1/1/2018 and 12/31/2018.

CPMC exceeded its requirement by 7,764unduplicated patients.

Spend $8 million annually for Community benefit in the amount of $15,104,241 Yescommunity benefit for the poor and providedunderserved*

Maintain current charity care policies Obligation completed on 12/31/15 N/Athrough 12/31/15

Maintain Charity Care policies that are CPMC maintained Charity Care policies that Yesin compliance with applicable California comply with California law and ensured Charitylaw, and do not deny Charity Care Care patients had access to inpatient services.patients access to inpatient service.

Provide financial and other services oroperational support to the BayviewChild Health Center

Support to the Bayview Child Health Centerconsistent with 2011-2012 levels and included:• $325,000 operations grant/yr for 5 years• Transferred all assets, valued at $91,786.22;• Invested >$lmillion in tenant improvements

Remains the clinic's specialty and hospitalpartner

Yes

* Compliance verified by third party audit ~ 1

New Medi-Cal Beneficiaries

Continue to participate in Continued participation in Medi-Cal managed care with San Yes

Medi-Cal managed care Francisco Health Plan

with San Francisco Health

Plan ~~~~, ~ ~~ ; ~:~ 4:~~ .: . a ~ .~ _.w ~ N ,: ... :~~~ ~ .: u ,,~ na~,~ ~...~..~ .~~ , . :~, , .~x 3~ .~

Assume responsibility for CPMC met the obligation of 5,400 additional Medi-Cal Yes

5,400 new Medi-Cal beneficiaries in 2014. As of December 2018, CPMC had a total

Managed Care of 31,621 Medi-Cal managed care beneficiaries.

beneficiaries for a total of

20,250*

1,500 of the new Medi-Cal No Tenderloin-serving primary care provider able to contract with Yes

beneficiaries to come Medi-Cal managed care was available during the reporting

through a partnership with period.

a Tenderloin-serving

primary care provider able CPMC has contracted with an MSO, North East Medical Services

to contract with Medi-Cal (NEMS), and worked with NEMS and St. Anthony's Clinic, a

managed care primary care provider in the Tenderloin, to have St. Anthony's join

the NEMS MSO. Through this partnership, CPMC is the hospital

partner for St. Anthony's participating medical groups. As of Dec

31, 2018, St. Anthony's has 166 members that enrolled in the

NEMS/CPMC partnership (3 Healthy Kids & 163 Medi-Cal). As of

May 2019, the membership is 174 (2 Healthy Kids and 172 in

Medi-Cal). 22

*This is a corrected figure, erroneously reported in the Development Agreement as 22

,728. The obligation to

serve 5,400 new Medi-Cal managed care beneficiaries remains.

Innovation Fund

Provide $8.6 million to create anInnovation Fund• $3.5 million in 2013• $1.125 million in 2014• $1.125 million in 2015• $1.725 million in 2016• $1.125 million in 2017

Grant funds to third-party recipientsthat• Support and improve the capacity

of community clinics• Support community-based health,

human service, and behavioralhealth service providers to reduceunnecessary hospitalizations

Obligation completed on 11/14/17

CPMC is a member of the Innovation FundCommittee, which, in 2018 granted $883,000 tosupport:• SisterWeb Doula Project for community-based

doula programs• Transportation to the Sobering Center to

reduce ER visits• Garden2Table to support healthy living and

cultural events for Tenderloin SRO residents• Institute on Aging to support relocation of the

Swindell's Adult Day Center and renovations ofthe new site

• Dementia-Inclusive Accelerator project toreduce stigma and social distance for personsliving with dementia

N/A

Yes

23

Mission Bernal &Van Ness Hospitals

Mission Bernal Campus Hospital CPMC opened the Mission Bernal Campus Hospital on

will be a 120-bed General Acute 8/25/18 and the Van Ness Geary Hospital on 3/2/19.

Care Hospital with comprehensive

emergency services, and open

within 24 months of the opening of

the Van Ness Geary Hospital

Additional 30 bed Space: The

"shelled" space at Van Ness

Campus Hospital shall not be built-

outfor and placed into operation

30 licensed acute care beds until

after the Mission Bernal Campus

Hospital is opened and has a daily

census of at least 75% for a ful l

fiscal year

Not yet applicable. Subject to Mission Bernal Campus

Hospital utilization.

Yes

24

Mission Bernal Campus

Provide comprehensive inpatient, The Mission Bernal Campus Hospital opened in August 2018outpatient, and urgent care services and offers comprehensive on-site services, as outlined in theon-site at the Mission Bernal Campus DA.Hospital.

Establish, operate, and maintain aCenter of Excellence in CommunityHealth at the MissionBernal Campus.

Establish, operate, and maintain aCenter of Excellence in Senior Healthat the Mission BernalCampus.

Submit a proposal for development atthe Mission Bernal Campus MedicalOffice Building within 5 years afterthe Opening of the Mission BernalCampus Hospital.

The Center of Excellence in Community Health is namedHealthFirst at the Mission Bernal Campus, and serves patientsin chronic disease management. CPMC reported the followingfor the HealthFirst Program in 2018:• Provided care to 717 unique patients and 1,455 encounters• Staffing includes 3 bilingual CHWs• Convened first community advisory board meeting in Oct

2018

The Center of Excellence in Senior Health is made up of theAcute Care for the Elderly (ACE) Unit, the Hospital Elder LifeProgram (HELP) and a pilot partnership with San FranciscoVillage. The ACE Unit was established at Mission Bernal Campuswith 34 beds, providing interdisciplinary care to older adultpatients.

Within the 5 year window of time for the proposal of the MissionBernal Campus Medical Office Building.

Yes

Yes

Yes

Yes

25

Additional Healthcare Provisions

Develop specific proposals for Obligation completed on 2/12/2016 N/A

providing sub-acute care services in

SF and present to Health

Commission by 6/30/14

Continue good faith efforts to The integration of medical staff across the CPMC campuses, Yes

integrate medical staffs at St. Luke's including St. Luke's, was completed and approved by the

with medical staff of other hospital hospital's Board. CPMC now has a single medical staff at all four

campuses

Continue active participation in the

Community Benefits Partnership

Continue relationship with Chinese

Hospital in a manner generally

consistent with existing agreements

campuses.

Continued participation in SFHIP, a CBP successor coalition

Maintained agreements and continued to provide services in a

manner agreeable to both parties

Deliver services in accordance with CPMC delivers services at in accordance with the mandates,

national Culturally and Linguistically guidelines of the National Standards on CLAS.

Appropriate Services standardsIn April 2016, DPH and CPMC staff met to discuss the St. Luke's

Diabetes Clinic. The meeting resulted in specific

recommendations related to Spanish-speaking staff, Spanish

classes, patient satisfaction, and the HealthFirst program. In

August 2018, CPMC transferred management of the Diabetes

Center to the Sutter Pacific Medical Foundation (SPMF). CPMC

reported that SPMF has maintained these recommendations

during 2018.

Yes

Yes

Yes

26

Summary

Summary of Key Points

• Sutter is in compliance with DA provisions

— Construction obligations and payments completed

• Ongoing areas of concern:

— Construction hiring requirement

— Tenderloin Medi-Cal provision

— Culturally and Linguistically Appropriate Services

om ments Anduest~ons

Development Agreement Questions:

Elizabeth PurlPlanning Department415-575-9028Elizabeth. Purl(a~sfgov.orghttp://sf-planning.org/california-pacific-medical-center-cpmc

SAN FRANCISCO San Francisco 1]~~~~~~~~ SFMTA HEALTH SERVICE SYSTEM_~~ Olfice ofEmnomic and Workforce Development Department of Public Health ~ ~ ,,,,,,,,,.,,„,,,,,„,,,ro.,, CITY &COUNTY OF SAN FRANCISCO