Pay for general city responsibilities which is things like Retiree Health subsidiaries , Health ServiceAdministration Costs and those dollars that we must spend keep City Services running and were obligated do not have a policy choice to make to reduce them without other action and that leaves about 2. 5 billion that is available that is truly a matter of policy addition correction so in that light our 715 million is much larger share puts us at about 30 of the total discretionary dollars that are available to allocate and so that is a big portion its a much bigger portion than when you look at the higher level numbers and that is one of the reasons that our budget is a major factor for the citys general Fund Balancing plan and vice versa when the general fund is in trouble were in trouble and when were in trouble the general fund is in trouble so thats why were always working very carefully to coordinate with Mayors Office and Controllers Office on our Financial Planning so that it alliance with the citys approach. So any questions on that piece of it . Commissioner. With regards to our 715 million general fund support at 29 how did that compare to other departments, what are the next top three perhaps . All right, here we go. Lets see. So if you look in the second column of numbers you can see the general fund support so just to kick a couple off theyre on the prior page so you can see Police Department at 459 and weve got the Municipal Transportation Agency received 313 million and Human Services agency 241 million so the biggest general Fund Recipients are are the core city and county functions so those are the Public Safety so Police DepartmentFire Department and sheriff those are all big general fund draws primarily because of the large Core Functions that dont generate their own revenue and on the traditional county side its us and the Human Services agency so those safety net Human Services programs socom bine those five departments and you get a pretty large share of what the the general fund dollars are used for. Any questions . Please have empathy for mr. Wagner to stand during the presentation. Im trying to go fast. With regards to other departments and their financial staff us, the other departments as far as you know and the most general way healthy do they have reserves like we have reserves and i guess this is if theres a battle for an apple pie how hungry are they. [laughter] yeah, um, its a big question and its a lexture so a lot of people are True Enterprise departments they have their own reserves and so if you particularly want the ones that are receiving the vast majority of their revenues are earned revenue which are general fund most have their own reserve like the Public Utility Commission and the airport building inspection and financial Transportation Agency and they have reserve policies and they built their own reserves and the flip side of that is that there is no general fund to bail them out if they get in to financial trouble because they are responsible for generating their own revenues. For general Fund Departments, most do not center a reserve and the general fund itself theres a general fund reserve for the city and that is health and appropriateed in the budget each year we started the policy about three years ago and working with the Mayors Office and the Controllers Office of creating a management reserve for d. P. H. Done through the budget appropriate ordinance that allows us to as you know, when we know that there are potential volatility in our federal revenues to set aside dollars in a reserve to account for that future liabilitys that we might have and that is a pretty new policy that something that is again about threeyearsold and i dont think that it is replicated in any other general Fund Department and the reason for that is we had a lot of experience with especially when we get these big pieces of federal revenue theyre funded through an i. G. T. And they take forever to get the red tape done to get us paid so you have a short fall one year and a payment the next year and maybe you get paid twice this year and zero times next year and that fluctuation of revenue was hard to manage and caused a lot of volatility on the citys general Fund Balancing so that was one of the steps that we had taken as part of the Health Commission s kind of Financial Sustainability direction is to put that reserve in place to weather some of that volatility but for the most part aside from that so that is a big positive for us and for the citys general fund for the most part, the general fund does not have other general Fund Departments dont have their own reserves and ill talk about it a little bit later in the presentation but the city has over the the last seven or eight years worked hard to buildup those general Fund Reserves and do better Contingency Planning for future downturns than had been done in the past and i think thats another Financial Management legacy of the past administration. Thank you. Any other questions at this point . No, well, are you able to continue. Yes. I keep plugging away. All right, so i want to re visit what we talked about last year which was the approach that we had adopted going in to our last fiveyear Financial Planning cycle and so as you may recall what we talked about last year and this is after a historical period where the department of publichealths rate of growth in general fund was high where our general fund support levels were growing at a rate that was faster than tractortrailer rest of the city and so at last years Financial Planning session, we kind of took the view of saying what would happen if we sort of planned for ourselves to grow but grow no faster than the rate of growth as the general fund as a whole and so essentially we would be taking no more than our share of that growth in the tomb total city revenues and that was the principle to set some longterm Financial Planning targets for ourselves. The illustration is here where this is sort of saying if we start out with 30 of the numbered and hold ourselves and say were going to grow but were not going to grow more than our share were not going to eat in to the share of other departments, at the end of the planning cycle, as it looks on the bottom, were still at 30 . We grew but were still at 30 of the discretionary general Fund Revenues. The top is where were growing faster than the general fund as a whole when we do that overtime we eat up a greater and greater share of the general fund dollars that are available and that leaves a smaller pool available for other general funded services and puts pressure on the general fund that ultimately comes back to us when theyre a large deficits and were asked to reduce our share of those deficits. So were trying to say lets try to grow at the pace that the general fund dollars are growing that will prevent us from being in a deficit in the city it comes back as a largecut targets and were growing services, shrinking and growing and were just going to keep at a slow and modest but steady rate of growth in our inflation. So last year this is kind of recaping at what we looked at last year when we went through this exercise, we had used that principle and said, lets look at what the projections are for the rate of growth in the citys general fund and say if we grow no faster than that rate of growth so we just keep to our share what would our level of support would be to accomplish that and so at the top of the page for 17 and 18 those were our targets we calculate inside that way and 711 million and 740 million for 19 and 18 and below that is the adopted budget for the 17 and 18 you can see that theres the level of general fund support and its 715 and 770 so its over the target but that difference was funded because as you saw at the presentation three or four months ago we ended fiscal year 16 and 17 with a large surplus due to Revenue Growth and those dollars were programmed in the mayors budget to fund our d. H. R. Contributions some of the items in the mayors budget such as the humming bird, the saint marys some of those other prioritys so our net general fund when you factor in the surplus is 682 million and 704 million over the two years so were doing better than that target that was adopted by the Health Commission last year. Thats a recap before we ended up compared to our discussions last year. So now what im going to show you is we have updated this projection and im noticing the column might need to be widened. I see theres a little bit of a all right. So ill do this and ill scroll back and fourth and this is an updated version of what we looked at last year at Financial Planning session and this is essentially taking the mayors financial forecast and isolating the d. P. H. Only portion of it and so you can see at the top there there are expenditures and those are broken out by the large catagories, salary and Fringe Benefits and contracts and other items Electronic Health reports or materials and supplies, equipment, and facilities. On the bottom is our revenue projection again this is the revenue projection that is assumed in the mayors fiveyear projection and general fund support and between our expenditures our revenue how much general fund support will we need to kind of and baseline projections and so to provide a little bit of context on what these are showing us, you can see where the growth is and where the changes are so for example, salaries and the line below that accounts for 250 million of expendsture growth so its the single largest driver of our expenditure growth over the five year projection. Other items driving Cost Increases are inflation on our non personnel costs so our contracts are purchases particularly our pharmaceuticals and our growing at a rate thats much faster than inflation and to all those if they continue at their rate of growth will drive up our expenditures and when you a five correction protection we projected if can he continue at this pace our general fund support will grow to 1 billion n. Should read 22 and 23 fiscal year 22 and 23 so that would be a pretty significant rate of growth and this, what you are seeing here is mirrored in the larger and it shows the city deficit growing to 700 million by the end of the fiveyear time line. What were doing similar to the past if we look at fiveyear projection and say how do we expect the rate of those general Fund Revenues to grow, and then lets hold ourselves to that same rate of growth what would we have to do to get our general fund down to that level so ill walk through this spread sheet and show you what that kind of projects out to and at the top line, those are the numbers taken from the last page so and in the next section we take the 1820 budget so this is the upcoming two year budget and and savings proposal so that target and our general fund targets and 19 and looking out in to the following three years, were saying ok after that adjusted total after we kind of do what were going to do in this two year budget what will the years look like and in those areas what were doing here is the same thing that we did last year were looking at the rate of growth in the general Fund Revenues of those are the revenues the mayor and the board of supervisors have to allocate and this is the projection from the citys fiveyear Financial Plan and you can see i have circled down here that over the four years of this projection theres an average growth rate of about 3. 5 and so we can change that or tweak that in terms of our growth assumption but if we use that number we should be growing our support by no more than about 3. 5 if were not going to continue to exacerbate the citys deficit. So what that translates to is you take this 813 which is where we should end this budget process and grow it by 3. 5 and end up at 842 and the same for the next year and the next year. So if our general fund stays within that constraints, we wont be cutting services, but well still be growing but we wont be growing at a rate that is eating in to the increasing the deficit and eat north to everybody eels else share of the general fund. And then lastly, what can you do is if you take that rate 3. 5 and compare it to our baseline projection it shows you how far off we are and how much progress we have to make to live with that constraint and thats the number down here in row 25 so you can see weve got our baseline projection is about 878 and were seeing if we stick to that 3. 5 we should be at 842 and that means we need to make up 36 million and that continues each year roughly at that same level in to the future so that says to me is generally speaking, that should be the order of magnitude of what we should think about in terms of restraining our spending and increasing our revenues if we want to live within that constraint and most likely that will be something along the order of if this projection the citys projection stays looking relatively like it is, that well probably be the level of reductions that will be asked for some order of magnitude by the Mayors Office. So those are big numbers but they are not that far out of line with the reduction targets over the past few years so again our year two target this year is 36 million and its a big number but its not something that is so far out of the realm of possibility i dont think we can tackle it with sound approach to our Financial Management and just to give you a sense of how we can move the needle on our general fund support these arent made up scenarios to give you a sense of how much you can move the needle with a 1 change but if we can increase our revenue by 1 it gets us 15 million so 3 growth in our revenue should be enough for us to keep within range of that 35 million target so that is clearly going to be one of our big Financial Planning strategies is looking at ever opportunity we can have to increase our earned revenue and increase our charge capture and look for other Funding Sources and work on opportunities to not have our medicaid drastically cut by the federal and all of those approachs and that will be a key piece in our Financial Planning efforts. Other areas that we have that we can move the needle out without a lot of pain in my view if we can figure out how to ex indicate and if we can limit the growth in our costs and those other areas so materials and supplies if we can do a better job our bulk purchases and limit over consumption of materials we can earn for each one percent we do that its a million and a half dollars per year so thats another area for us to focus on. Professional services again this is not reducing costs its just saying lets slow the rate at which our ex pent attitudes are growing and we have of room to move the needle in the area as well and then lastly this is showing you if we do add f. T. E. S what it does to the projection and you can see it doesnt take much of an increase in our f. T. E. Count to really push our general fund support levels up in those years. So, let me just see if there are questions about that and i know thats a lot of numbers and a lot of acronyms. You actually are saying the way youve broken up your scenario and this target is not unreasonable that we have set last year and it continues to represent a good model to work with because its probably close to the reality that theyre going to need to work on. Its close to the reality that well need to work on and yeah i dont think its unreasonable and what it tells me is that the job in front of us is we restrain our spending and be careful and were not talking about making cuts and dramatic change in the economy and federal and we have to be focused on a level of disappoint ment about growth in our spending and we do need to focus on increasing Revenue Generation and if we do those two things these are achievable goals they will take work and they will take discipline but theyre achievable and reasonable targets for ourselves. The 36 million that were looking at the projected gap or deficit includes the 3. 5 city growth targets and does that also include the 2. 5 mayors budget cut or is that on top of that . So that would be that is correct would assume that we hit our 2. 5 and our 5 target and so we make those reductions and then after we do that were going to grow but were not going to grow at 5 were only going to grow at 3. 5 so we are still allowing ourselves growth but Slower Growth than if they just let things happen on their current course. Besides the 2. 5 caps we have to come up with an extra 36 so this is a total of 6 versus or is it a total of three and a half percent . Yeah, yeah, you are totally making sense so if you looked at what our rate of growth is and this projection so lets see, equals let me just do this really fast because i totally understand your question. So instead of growing at a rate of, you know, you can see from the numbers up here in most years were growing at somewhere around 60 million well grow at a smaller number which is closer to 30 million a year or something of that order. So our cap is 36 million per year. So i guess it would be interested, we dont have to do it today but as we start looking ahead, the anticipated sources of that gap closure i assume that theres a lot of questions still open and we looked at dollars at risk because of various number of reimbursements for h caps and sars and a prime with the big one and which hope medicate rates may go up and so i guess if we could just be kept abreast of the measures and the big financial drivers that would help us to look at that although were looking at trying to improve a revenue collection by 1 and some of the things you listed. So you name the number of areas on the revenue and there are the waiver programs and built in to these numbers and our is assumptions how much well learn and the Global Payment Program and it improves our performance compared to this projection and another example is weve spent a lot of time focused on patients flow throughout the network and not for the care and were not able to build for the optimum amount that we ought to be able to so if we can improve that flow we have fewer days at the hospital and we have fewer people in services that were not getting paid for and we can maximize our revenues there and those opportunities are in the double digits of millions with certainty and as we go in to the Electronic Health records project, that is a risk on our revenues also because you also see the often see when these things go live you see a decrease in productivity but at the end of the day, we should be able to see some improvement because of the discipline that the e. H. R. System will impose on our charge capture and on our collection of data and that discipline should in theory and its our intent and commitment to make it happen in practice and improve the rate of collection that we should see for each day in our hospitals, visits and primary care so thats an opportunity to just get ourselves paid more for the services that we are providing today. So thats a big area of focus for us as part of this e. H. R. On going effort. On the Positive Side i would look at the 36 million as being just slightly over maybe one and a half percent of our total 2. 25 operating budget and on the scale of things, its really it would seem to be within the normal business operational vary ance, 36 million so it doesnt sound like a horrible hardship. Interview its the way i look at it and its still 36 million so its a big number and it takes focus and effort and its not like were talking about in the really difficult times six or seven years ago where we had these very, very large targets that were were trying to hit and were looking at fundamental changes to services and i dont see us there and i see us in a situation where they will take work and theyre manageable and especially if we start now and start now at an initiative that will payoff overtime including the revenue capture initiatives that this is something that is achievable and manageable. Thank you. You know, one large block here is the salaries, right, we dont totally control that and what is the over all city sense that this im sure each of the departments have similar things but we have the largest workforce that is under our negotiations and all and any of those could just blow these, i mean, its not just 36 million its hundreds of millions if which if we just had another one or two or three percent within the salary and that also somewhat goes with the work load and we run two big hospitals that have a variation of how much everybody is supposed to work and understanding the tensions and the needs for union s to represent correctly their constituents as they see it and the will of the city would seem to be really important if not just this but the remaining 70 of the general fund and city budget is appropriately protected. Yeah, you are correct. I mean, its a driver for us and its a better as a whole so there are going to be conversations that are not in our power as you said they happen through the central city agencies about what the wage increases and what the city contributions are to benefits like pensions and healthcare and those changes if there are changes up or down those do really drive the budget and i think the biggest thing though that really is in our control and that it really jumps out at you like a sore thumb, is when you look at the impact adding and growing the number of f. T. E. S in the city if you went back in time and said for the number of f. T. E. S they added in the city over the last several years with that compound ing rate of growth in the costs per f. T. E. , that really drives the expenditures side in a very big way so i think the thing that is under control and i think also the reason for the Mayors Office instruction for the f. T. E. Is the first thing that we can do is say we find something we want to do before we talk about adding an f. T. E. Lets look and figure out theres within one our base that we can repurpose inform serve that function and keep our f. T. E. Count stable but you are right that is kind of a structural growth in wage and benefit cost is a structural driver of our general fund that is somewhat outside of our control. Interview any further questions at this point . No. All right. So ill put that away and go back to this so again we talked about these but i think this will be the area of focus is limiting cost growth if we can just limit the rate at which were growing and not saying cut we can really move the needle of especially in the out years object that cost growth and revenue and the biggest focus of our financial approach. The other thing that ill say that i skipped over as we were talking about the principle of lets say and following last years Health Commission strategy session where we talked about this concept weve incorporated this approach in to our planning that were doing through the lean process so our department of publichealth lean planning and our San FranciscoHealth Network lean planning so were aligning the approach that weve worked through at commission with our process and with the citys fiveyear Financial Planning process so that all of those goals ar lined and we are everybody is pointing themselves in the same direction trying to say lets have a target for a constraining the rate of growth. So major initiatives, so i think this goes back a little bit comments dr. Sanchez will the future of big picture of where were he had two year budget and fiveyear projection the story of our kind of 30,000 feet of where we are and we have gone through a period of recovery from what happened during the recession and weve done a lot of work on our operating infrastructure created the San Francisco network reorganized the work and the work ahead of us and we have a number of significant Infrastructure Investments that will payoff for us for many years to come and the decades long Infrastructure Investments and the good news is those are funded through the work weve done over the last couple of years and through the city is Capitol Program and a lot of the effort that were going to spend over the next five years is going to be on ex cuteing so the two biggest of those are obviously the Electronic Health records and our Capitol Program and so im going to talk about what those expenditures look like and those two items in and of themselves i think theyre going to be enough to occupy the energy in the focus of the department for quite some time. So on Electronic Health records, the big focus is there are a lot of reasons were doing the Electronic Health reports initiative as you know the big focus is from a financial perspective for us are going to be financial oversight of the project and so its a financial imperative for us that we keep expenditures and time line under control because of the size of that so that say big area of focus its again on Revenue Cycle and risks and opportunities so how are we going to make sure when we implement d. H. R. We do it for all the clinical and service good it can achieve but also to increase the revenues that were able to drawdown for the services that were providing and preparing our people to be ready for the e. H. R. And these also align with the lein priority and targets weve adopted and so just to give you a sense this is going to be hard to see because of the way that this screen looks and im not going to go through this in a lot of detail because i want to show you the topline numbers as we go through the project. We will be by the way, completing the contract for the e. H. R. And were on track to spend 52 million this year and in to the next year that gross and its our big year where were really focused on the go live so there are numbers and the a huge portion of this so this will be getting our internal project teams ready and it will be for staffing back for training and for the people that are contributing to the project and it will be for replacing our infrastructure and getting our infrastructure in our operations upgraded and an even bigger part of it is spending on ourselves to make sure were ready to use the system effectively and get the benefits out of it that were going to need to make this thing happen. You can see that after the third year we level out and go in to a state where were steady overtime and these are the costs to operate that system and people to manage and maintain the system and for on going costs for the vendors and overtime you can see the estimates expenditure over ten years is about 330 million and these numbers are still changing and when we sit down with epic well get more detail on what this looks like and you can see this is big and this is a focus on our financial efforts for the next several years and probably limited bandwidth with big initiatives. Through that you have across, we looked at some of the contracts today and the main contract going to really be most of that 86 million or what . Are we going to continue to have a whole series of other contracts that youve been projecting and we need to kind of make sure that were all in line just like you were saying with the lloyd project was such i mean how are we trying to shall without getting in to details of course, understand that theyre fitting in and not all of a sudden a whole Brand New Group of contracts are coming in because this is autopsy a enormous such a enormous. Theres a lot of contracts and as we go through this in look you saw the epic contract and then like you said today there are contracts for approximate project mappingment for implication and there are a number of contracts we have to get in to for the Third Party Vendors and for modification and existing inner faces to existing system and so there are a lot of contracts and we are going to be presenting those as a package to the finance and Planning Committee and our intent to approach this both with the commission and internal goods and management is that under each of these numbers so for example the epic implementation those are costs in the epic contract and then there are other lines in here for example, lets see, where is another one. See if i can find the ok, so, here is this first line addmin its a contract you approved at the Health Commission for our administrative project management function and under each of knees numbers, we have a separate spread sheet that is broken out by contract and by costs and so every time one of those contracts comes through our every time the request for funding comes through, were taking them and comparing it against what is assumed under each of these numbers and were saying either go or hold on a second that is not planned for and we need to reevaluate and the intent with the commission processes to also do that so when we bring a contract to the commission well be able to say point to the line that the cost of that is included in and show you the budget for that line item and demonstrate its part of the global budget that youve seen and that nothing in that contract is going to be expenditure in excess and cases like there were today where we had the deloitte and the nordic contracts with it gives us flexibility to chose between vendors and we are going to be imagine age through the budget any expenditures again those contracts so we set up through our project where were in the process of a project Management Office and our Fiscal Division and a number of controls foray approval of the invoices that everything that comes in were checking it against the projections for budget and were recording it and were reducing the dollars available to spend so that will be a lot of our work and a lot of our conversations that finance and planning is keeping that management of these dollars in place and keeping the right controls in place to make sure we dont spend it. Im just wondering if how we had tracked the generals progress in terms of expenditure of the dollars and you know and also the time line as being on schedule with a fairly simple face and i think on the contract level it makes sense that the finance and planning seeing where these are from a commission standpoint i would think that we would want to see that the over all project of moving this way and here is where the expenditures have gone and here what we have kind of left or were halfway through something to the building does that make any sense. Absolutely. Absolutely. Yeah, so as i know youve seen kind of an early version of that chart that shows you where the high level time lines are going to be mapped out for as we get our project Management Office up and staffed and then in addition as we actually have the epic contract ready and we can start digging in to the detailed time line with our project management and with epic, we are going to have excruciateingly detailed project plans that we can share with the commission and give you updates as much as we had with the rebuild so we will absolutelying doing that and that will be part of the process that were using as staff to manage the project and well report on that to the commission i think we need Something Like that and our responsibility to see we dont over run the contract of course but we also more importantly want to see its on track and its actually moving forward and without getting in to the micro management. Yes. Not going to get in to the bolts of the pluming. Right. But yes we should absolutely we will absolutely be updating you overtime on this status of the project and giving you some of those big metrics on time line and on the burn rate for the costs. Commissioners, i just came back. We are modeling the report out like weve done with the capitol project for the d. H. R. Because we knew it was a model that all of you were familiar with. Yeah, commissioners are acquainted or feel comfortable with that and certain let us know you want a different way and i thought us tracking the general project really worked very well and they broken in to the key components and we understood probably more than we needed the power plant and likewise it was all, i think much clear tore all of us, so, if commissioners feel comfortable with that sort of model that would be one of the things we would look forward to. Thank you. So we talked briefly at the last finance committee we were told that they will be over 200 more contracts coming in so certainly with all those contracts it would be up to you and chair chung to keep the budget in order. [laughter] but the staff as they said it was a map provided about where the contract fit in and some were services and some were materials and some were hard cables and computers so there is a whole strategic map and before the contracts come to you you get the maps saying this contract fits in to this small little box and in which case your contract expertise and how is it a sign and whether the deliver rables look clear and outcome states and you talk about maybe a followup step is looking at the performance issue of the contracts. Im saying being able to follow the progress of the project like we did as this is a very concrete product coming out and not in the same sense but pretty much and in terms of the cost of a huge building already. So were told several hundred approvals coming and they will pass through the subcommittee and am i correct . Absolutely. And as they come through we will be packaging them and showing you how they fit in the context so that you have to take them all. Its enormous work. Its up to you. [laughter] just looking at the task of it. Speaking of bricks and mortar, the next thats the other kind of mega Financial Initiative that were in the midst so again i think were at a point where weve had a number of years of Financial Health and our focus is making in Big Investments where well be able to payoff for the next many years and were in the midst of the proposition a from 2016 and it will be the sighs mick renovation of building 5 and it will be the expansion of Southeast Health center and maxime hall and Castro Mission and so a major capitol project and highly complex following up on the successful completion of building 25 and that will be a lot of work and focus over the next couple of years and director garcia has put process in place for oversight and management of all of those projects and they personally as well as the rest of the executive team are very much on top of and the other thing is well have trying to think of when it is its february that we have a capitol planning update coming from the commission so well be able to go in to some more detail about it at that meeting. Shortly on the heels of that we have in the citys capital plan programmed 155 million up to 155 depending on the program in certificates of participation which are not a geo bond but a different debt paid with the citys general fund those are programs for fiscal year 18 and 19 so the upcoming fiscal year and they will allows us to renovate building 9 on the campus which is the building on the south side at petraro on the south side of the campus which needs seismic retro fit to renovate the two old at laguna honda hospital if theres a need for space on the juvenile Probation Department to occupy space there so that will allows us to renovate the spaces and get some of our administrative support functions in to those buildings and that will allow us to get out of a lease facility and seismicly safe buildings we have following that we have another 300 million place in the tenyear capitol plan that would be another geo bond scheduled for november 2022 and that would be at the next phase in our program and the scope is still yet to be defined and well have to work over the next couple of years with the Capital Planning process to nail that down but the next major item in line is the seismic retro fit and renovation of buildings 80 and 90 on the campus so when you look at how it fits together starting with the new laguna honda Hospital Building which went before the voters and the late 90s, bit end of this 10 year planning horizon well have done a tremendous amount of work and kind of once in many generations investment in upgrading our publichealth facilities and the city so two hospitals and a number of seismic safety improvements for out patient facilities and our support facilities so stepping back this is a pretty remarkable time for our publichealth system in this city. The large strategy and well get in to this more as we go in to the details of the Capital Planning, but the large strategy is we have a number of our staff that are in seismicly unsafe buildings including this building, we have a large number of our staff that are in rented or cityowned facilities that are going to go away and so for example, we currently have staff in 30 vanness that building is being sold to finance construction of the City Office Building down at south van he is and mission and well have to get our staff out of that and were also trying to look at our lease facilities so we have lease facilities some are which are knewer and older because were in the facilities were subject to whims of the Real Estate Market which is not a great place to be and in addition to that were putting money in to lease facilities when we have a large amount of unfunded needs in our buildings on our campus and particular and so part of our strategy is lets get ourselves out of lease facilities and put our machine we own and investment and so that we have in facilities that are seismicly upgraded so over the next six to eight years will be exiting this building and 30 vanness and exiting some of the other small paces and civic center on to renovated. So thats a summary between the Capitol Programs and the e. H. R. And our biggest Financial Issues from both an ex pendture point of view and from the point of view of how much bandwidth it will require as a focus for our finance temperatures and our operations and clinical functions. Questions on those before we move on . So in your and there have been many about were going to go and and how or what percent of reality is well i will tell you and everything there are a lot of dominos that have the fall see the complexity on possibility and complexity of all the pieces that are moving around within the system and each of those have dough pen den see of the peace before moving first so theres a lot of complexity we need to so one thing that i would say is that we in the capitol and we have the funding in place and theres a possibility of a the funding in place