The right way to rebuild CPMC

Presenting the community benefits agreement


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.


I guess the point is that the BILLIONS in benefits SF is requiring of CPMC to rebuild is not enough?

Glad that we required this level of extortion for any of the other SF hospitals which are legally required to meet a level of seismic safety

Posted by Guest on Dec. 21, 2011 @ 10:29 am

looking to try and squeeze all kinds of discretionary goodies from an enterprise.

The city needs this hospital more than they need the city. If I were CPMC, I'd tell them to take a hike.

Posted by Guest on Dec. 21, 2011 @ 10:49 am

What you all just wrote sums up pretty well the -basic- dynamics that we currently face with this monster Sutter/CPMC hospital deal. But you gave no treatment in this piece to the fact that 'Community Benefits' agreements while a mangled tool to gain meager concessions from developers, rarely accomplish more.

Worse still is the fact that developers like Lennar, and other corporations like PG&E, routinely throw like candy to starving children, 'Community Benefits' (as well as donations and grants) to nonprofits and neighborhood groups, and make cynical deals with labor bosses, to manipulate these groups and their leaders into supporting bad projects that would never have been approved in the first place, and which only -were- approved because of the droves of people these bought off organizations turned out, to massively pressure City commissioners and the Board of Supervisors.

The toxic, gentrifying, Lennar Bayview Hunters Point projects should never have been approved, and yet they were, because of 'Community Benefits' deals which bought off labor, cash strapped nonprofits, and churches, etc.

And It took -decades- to close the fossil fuel power plants in the city because of similar dynamics engaged in with nonprofits, et al by PG&E.

Over the past decade in San Francisco in my own work locally to push for good community policy, and especially, to fight the bad, I have come to know 'Community Benefits' and similar manipulations by corporate donors, to be my number one enemy. And an enemy that repeatedly pits against eachother, nonprofit, labor, and other organizers who -should- all be working together to stop the corporate takeover, exploitation, and degradation, of our city.

This 'Community Benefits' paradigm is also inherently and ridiculously unequal. The power and leverage, is massively disproportionate, that large corporations and developers wield when they sit down at the table to supposedly 'negotiate' with deeply economically dependent and cash poor nonprofits, and with unions which have progressively been drastically downsized and weakened over the last several decades.

This whole ridiculous 'negotiating' process is resulting in the continuing slow motion take over of the City by corporate greed and manipulation, and it needs to end.

Specifically in the case of CPMC, the pending citywide Health Care Master Plan that David Campos got passed last year could be used to put Sutter/CPMC in its place and force it to comply with a sane plan for comprehensive San Francisco hospital care. Currently Sutter/CPMC is exempted from this legislation. Let's simply reverse that mistake and pass a measure which forces Sutter/CPMC to strictly comply with the Master Plan, and thereby give ourselves a much more powerful negotiating position.

After that is accomplished, we will then have far greater leverage, backed up by new city law and the enforcement of it, when we sit down with Sutter/CPMC to negotiate.

At that point, if our immediate reality is that we need to use a 'Community Benefits' agreement process to reach a deal with Sutter/CPMC, so be it.

However the nonprofits and labor organizations of San Francisco need to get real about this fundamentally deeply flawed 'Community Benefits' nonsense, and in the coming year of the rise of the 99%, join together to rid ourselves of the 'Community Benefits' trap, and fight corporations and developers -unified- instead of being endless played against eachother to fight over the pathetic crumbs that these corporate fat cats purposely throw so sparsely and selectively at our feet, to divide and conquer us.

Posted by Eric Brooks on Dec. 22, 2011 @ 12:14 pm

If you are fortunate to own a home, you pay more in property taxes than CPMC does in SF, with it's various "campuses" and millions of square feet of property. Their tax-excempt status is supposed to have them provide for healthy levels of charity care. Up until recently, that level was less than 1%, a pathetic abuse of the whole purpose of being 'nonprofit' and charitable. A Community Benefits Agreement at least goes a long way to right some of the wrongs by these profit-driven corporations who would otherwise stop at nothing to reap even more.

Posted by Guest on Jan. 05, 2012 @ 10:54 am

So any free or voluntary work it does is discretionary.

The think with voluntary work is that it is, er, voluntary.

Posted by Anonymous on Jan. 05, 2012 @ 11:01 am

of pretending that they are, and they should pay their fair share of taxes.

Posted by Greg on Jan. 05, 2012 @ 11:57 am

So by all means, it should be acting like a nonprofit.

Posted by Eric Brooks on Jan. 05, 2012 @ 12:52 pm

I don't disagree. I'm just saying that either they should act like a nonprofit and provide services to the community, including charity at more than a perfunctory level. Or they should pay their taxes. But it seems like they want to have their cake and eat it too.

Posted by Greg on Jan. 05, 2012 @ 1:17 pm

They are exempt from paying taxes, but in return, must provide charity care to the community. That's the in-lieu of part. They clear about $150,000,000 a year (by their own account), pay no taxes, but then provide charity care at1% of their profits. How twisted is that?

Posted by Guest on Jan. 23, 2012 @ 11:53 am