The right way to rebuild CPMC

Presenting the community benefits agreement

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OPINION As 2011 comes to an end, San Francisco witnesses yet another year with community stakeholders and city officials mired in conflict over Sutter Health's plans to rebuild its massive CPMC hospital system. In what has proven over the years to be an intensely complicated, politicized, and polarizing issue, one important point has been left out of the public dialogue — this conflict is entirely resolvable.

Very few parties have stated outright opposition to Sutter's CPMC project. In fact, the unifying demand of a city-wide coalition with nearly 60 community and labor organizations is to "Rebuild CPMC, the Right Way."

What exactly is the "right way?"

It's simple: There's a proven tool used in cities across America known to resolve complex standoffs such as this one — a community benefits agreement (CBA).

A CBA would bring this project to a resolution in two ways. First, it would provide direct accountability between the community and CPMC. A CBA is a legally binding contract between a developer and community and labor organizations that can be enforced on an ongoing basis without city involvement. And a CBA gives valuable assurances to developers that community and labor organizations will not politically or legally oppose the project — and in many cases, results in these groups providing public support.

Community stakeholders are often positioned to negotiate a stronger agreement than the city. They best understand the needs that have to be met in their neighborhoods and the adverse consequences that have to be avoided. And the city isn't legally allowed to address any labor issue subject to a collective bargaining agreement — but a CBA is an independent agreement that can bring unions to the table in a meaningful way to resolve basic workers' rights issues.

A recently released study by Hastings College of the Law cites the enormous profits made by CPMC ($744 million from 2006 to 2010), yet points out that the organization spends proportionally far less on charity care for poor residents than other private nonprofit hospitals. At a time when the 99 percent are standing up to corporate profiteering, a strong CBA can be a tool to help address the growing inequality in this city.

Among other things, a strong CBA should include:

Appropriate mitigation fees to address the full impact CPMC's new workforce will have on one of the nation's most expensive housing markets. CPMC estimates the project will increase demand for San Francisco housing by 1,440 new households.

More job opportunities for San Franciscans. CPMC is projecting an increase of over 4,100 new jobs by 2030, but the city has only negotiated a promise that 40 permanent jobs a year for the first five years will go to San Francisco residents.

Basic worker's rights, including the right for current CPMC employees who are displaced to transfer to comparable jobs at new facilities and the right for workers at the new Cathedral Hill campus to join a union of their choosing without management intimidation.

Stipulation of key community clinics for CPMC to partner with. Although CPMC says it will increase its Medi-Cal service, it currently refuses to link its new hospital to any of the major clinics Medi-Cal patients use to access services.

A stronger guarantee to operate St. Luke's Hospital over the long term. CPMC has agreed to a 20-year guarantee but has insisted on a "trigger" clause that will release it from this obligation, of which the details are unknown right now.

Without a CBA, the ongoing struggle between CPMC and affected communities across San Francisco will continue to delay this project. CPMC should meet with community stakeholders before any development agreement is approved and negotiate a community benefits agreement.

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