Transcripts For SFGTV BOS Govt Audit And Oversight Committee 101515 20151017

Meeting we should have had odd for the Oversight Committee october 15, 2015 im yee, the chairman and to my right is supervisor we would like to acknowledge the staff at sgtv, jim smith and leo who record each of our meetings and make the transcripts available to the public online. Before we get started, colleague, can i get a motion to excuse the supervisor christensen who wont be able to come to this meeting today. Yes. No objection, the motion passes. Madam clerk, do you have announcements . Yes, please silence all cell phones and electronic devices. Complete speaker cards and copies of documents. It should be submitted to the clerk. Items acted upon today will be for october 27th. Board of supervisors agenda unless otherwise stated. Okay. Madam clerk, can you please call item number 1 and 2 together. Item number 1 and 2 hearing on the recently published 20142015 civil grand jury report, entitled Unfinished Business a continuity report on the 20112012 report, deja vu all over again. Item number 1 and 2 hearing on the recently published 20142015 civil grand jury report, entitled Unfinished Business a continuity report on the 20112012 report, deja vu all over again. Thank you. Resolution responding to the presiding judge of the superior court on the findings and recommendations contained in the 20142015 civil grand jury report, entitled Unfinished Business a continuity report on the 20112012 report, deja vu all over again, and urging the major to cause the implementation of accepted findings and recommendations through his her Department Heads and through the development of the annual budget. Alegra futandi. Sorry about that. Would you please come up and present. Okay. Im alegra, a 201415 civil grand jury. We would like to thank president yee and breed for holding these hearings. The report is a continuity report on the 201112 report. Deja vu all over again. We need a culture shock. Most of the work done was done by me and marion, another juror who could not be here today. A continuity report is different from an investigative report. Basically jurors review of past investigation to see what progress might have been made in full filling recommendations suggested by, in this case, the 201112 jurors and outline what issues might exist. It does not involve a full investigation, although our report ask that a future jury look into city Wide Technology again. Since 201112 came out, there have been changes and we commend the city, county and government for making improvements. As outlined in the report itself, changes have been made in the structure and reporting relationship okay changes have been made in the structure relationship the committee on Information Technology in the Senior Leadership of the department of Technology Including the creation of new offices in the stream lining of the cia review process in more communication among departments in the greatly improved 5year plan and increased funding for technology. In the completion of the email and data center consolidation, and continuing development of an it management system. City should be commended for these improvements, sometime problems identified in the 2012 report continues to exist. We thank the mayor and others responding to our report for their movement on the restructuring of the department of technology with more emphasis on daytoday service. We also thank you for the promise of improvements to emerge people so that the skills and education of city it personnel can be recorded. We hope this skills inventory will go beyond the position that any it employee holds. Im sure many continue their education or have training and skills in areas that are not utilized daily in their current positions. The skills inventory should reflect this. However, there are still three areas of major concern. One, the disingenerous response the mayor on the Network Infrastructure has been implemented, and hiring the real funding needs. The city might be funding at a greater rate, but still not fully. As our report indicated for the Network Infrastructure alone, 15 to 20 million, more than the 6. 9 millions invested according to the mayor. The operative word is fully. An infra sfruk tour the infrastructure is vital. At the very least, the true response to our first recommendation should have been needs further analysis or even better, has not been implemented but will be implemented at a future date. Two, as a result of the 201112 report, an it hiring group was formed. This group came up with a pilot it hiring project for two job classifications. Senior and it analyst to decrease hiring times. It was determined if the pilot were successful, it would be rolled out to other positions. Jerry was told that preliminary results the pilot would be available in late march 2015. In spite of getting our hope today is that one of the supervisors will ask dhr to give us public report about this Pilot Project whether it has been expanded to other job classifications, what results have flowed from the project, how its being evaluated and if the department sees value in it. Despite the mayor saying that dhr gives reports about this pilot report, they have not done so since january of 2015. Right around the time when the pilot began. This might indicate that its results are probably lacking. Three, the jury recommended the establishment of a task force outside dhd to discussion recruiting and hiring its personnel beyond what drh is doing. In San Franciscos competitive it hiring environment, everything should be on the table. Using figures obtained from the Controllers Office, it and the department of technology at the of the report had a vacancy rate, 100 higher. The city needs new approaches. Our jury sincerely hope our report will move the city towards greater it funding and making it better across all City Departments. Thank you. Okay. Thank you, ms. Fotanadi. Right now, is suzanne guard here . Would you like to present and then after that, steve. Im with the department of technology. Ill be presenting initially first. An overview of the accomplishments weve made. Thats fine. Thank you. My name is brian, and im a Deputy Director with the city of technology. I would like to thank the grand jury for their interest in the department of technology and their hard work for putting together this record and the board giving us an opportunity to comment on the report. In 201112, the grand jury report highlighted major issues that the we feel weve made real and meaningful progress since then. Since that original report, weve continued to improve city wide coordination on it needs specifically to coit. The citys information on the citys technology. Our most recent plan, or ict plan was released this spring and it provides a framework how the city will this plan recommends 150 million in city general Fund Investments over that same time. As you know, the fiscal year is 201516 and 201617 approved budget includes 190 million in it investments. Of this, 61. 3 million is slated to come from the general fund. This represents an important step in improving the it infrastructure. This includes the radio replacement effort and a new city wide financial system, a new property tax data base and the rollout of as well as projects that are apart of the citys initiative. The department of technology is collaborating with the department of Human Resources to review the citys it hiring process. From recruitment of candidates to the on boarding of new hires. For example, this coming monday, the department of technology will welcome an additional recruiter as suggested by the civil grand jury to work exclusive on it hiring needs. In addition, the it hiring group led by the department of Human Resources has developed and began in approve it hiring city wide and to help departments secure the it talents and skill sets. This hiring group has been and will continue to regularly present updates to coit and the Civil Service commission. Youll find detailed responses to each the grand jurys findings and recommendations and response submitted in our response submit today the Supreme Court on september 18th. The department of Human Resources and the Controllers Office and the Mayors Office is here if you have questions you may have. Thank you for this opportunity to comment on these important issues. Good afternoon, chair yee. Im suzanne guard with the department of Human Resources. I want to thank the civil grand jury for their work on this. We agreed that its important and its vital to the cities future to improve our it hiring processes, so that we have a sustainable Technological Group working for the city going forward. So im sure youre aware, were not the only Public Agency facing technology hiring challenges. A recent report from the state chief Information Officers said that a shortage of qualified candidates hampered 66 of states from achieving strategic it initiatives and moving forward with technological goals and that at the executive level in california, 88 of it staff are eligible to retire. So, these statistics in our experiences, San Francisco, help us to understand that we we have a comprehensive not just of field positions now, but to create a sustainable pipeline for the citys future needs and to do that against our current back drop of 3. 5 unemployment in San Francisco proper. We also want to point out that the department of Human Resources believes in the merit hired system that the city has, so our challenge really is to balance those principals with the citys names and the market factors. Mrs. Fortunati mentioned a pilot we launched in 2015. We had plans to present the results of that pilot and our strategy moving forward at a meeting scheduled for today, but it conflicted with this hearing, and their be rescheduled in november. We had a goal of testing the effectiveness of an online, on demand examination for permanent Civil Service hires con ducked for it Business Analyst. Four departments participated in the pilot over six months, the department of Public Health, the Emergency Management 8 positions went through this pilot process. The exam was online and on demand, so candidates did not have to down to a testing center. When they qualified, they were sent a link and rated. Six hires were made through that process we know of in addition to the hires the department made. The eligible list were boryed by row the list was borrowed. When was it done . In a sixmonth period. You mentioned 8. 8 jobs were announced through the pilot process and 6 people were hired of 8. Additional folks may have been hired by departments who borrowed those list, but we dont have that specific data. So the one of the goals was to reduce the time from announcing and establishing an eligible list. We were success. The time of playing a job on the website to having an eligible list of candidates that the department could hire from was 32 to 37 days. Some of the successes from that pilot, the timeline for creating an eligible list was shortened considerably. The vast majority of the applicants we surveyed after the task found it convenient and easy to use and felt it help them see the city as innovative and forward thinking. They found the process convenient. When you start anything new, an electronic system, theres glitches at the building, so those who participated at the end were definitely more happy with the process. So where we were not successful is that this exam only addresses one more component which is what is a very large and can be lengthy hiring process. So we agree with the civil grand jury that a comprehensive change is needed in the way the city conducts its hiring. There has been a time in not too distant past where we were overcome by the number of applicants we had for open positions and especially with it hiring, thats not where we are today. We had to move from a process based on what the city needs to a process focused on what the candidate and what the departments need. So what weve been doing is focusing on changes from the way we recruit candidates to the way we bring them on board and their experience when they be become a city employee. What folks are doing thats not the city and county of San Francisco. Like, what is twitter doing . How are they recruiting folks . We have a coalition, not just of the city, but external partners to help us understand how to update our recruitment and hiring process and redesign our candidate experience, so those coming into the city have a good impression of who we are from the beginning to the end. Were doing some things in this process weve never done before, and one is working hand and hand with a Large Coalition of City Departments. Hr, and it to bring everyone together to ensure were developing a solution that meets everybodys needs. Were planning things like a tech only job website. Were highlighting our value proposition, all the different cool projects City Employees do and all the reasons why someone would want to work for a city. Were designing an enticing situation for candidates. We believe in a year from now when we come back and talk about this again, which is what we would like to do, the landscape will be considerably changed from what it is today, as were able to implement a new exam, but entirely new process focused on the candidate and enticing them, and interesting them in becoming a city of San Francisco employee. Im happy to take questions you may have. You sort of mentioned some improvements that you would like to make by the end by a year from now. And im just curious, do you have, like, a work plan or that shows timelines of things that need to be done next month and three months from now . We will. Actually in approximately a week from today, we have a project manager on board. And we are we have developed a set of recommendations so theres things weve already done as weve done surveys and focus groups with those candidates hired within the city the last two years and those who dropped out of the process. Weve conducted surveys with the hiring department to see what works and what doesnt work in the process. We established five different working groups to look at minimum qualification in salary. Our recruitment process, the candidate experience, how we select candidates. And theres one more that is just flying out of my head at this moment, but each of those working groups got together and came up with a series of recommendations that we will be moving forward to implement. So were doing this in a way we feel is scientific and will be sustainable. So our next project is to take all of those recommendations and weigh them down. Theres a Group Meeting today right now. Who is taking the recommendations and taking them down. The next step prioritize them. What is most important, and what do we have the resource to do . And those are the things well do first and foremost. As ms. Fortani, all thing are on the table. Theres exempt process for hiring. Theres a way we can hire expert it folks as a way of contracting in. Instead of contracting out, we dont have the capacity to provide within the city. Theres a way to contract in those expert services. Well, i think im i would be and probably other members of this committee would be interested to look at when you do make those final decisions in a week or so. To look at that report. Absolutely. And maybe a grand jury, members would like to see it too. We would be happy to share it. Its nice to hear youre going to make progress and it sounds like you are. Im just curious, if the apositions are the 6 people hired, just to have a comparison, how many people were we looking for to enter into the it department . Well, i dont have the total number, but i think a good example is the department of Public Health. The opening of San Francisco General Hospital, they have between 80 and 100 new it positions that they need to hire for. So those positions havent been vacant for a long time, theyre new positions coming on board, and we need to hire for those. So in terms of that, there are things we can do in the present moment that help to hire those folks quickly and get them on board, and there are things we can do in the long run to ensure these changes we make are sustainable. Okay. Thank you. Any other questions . I have a question for, i think, this might be for mr. Balace. In regards to the funding thats needed to do all this, you mentioned, in the budget, in the next two years, we have a fairly large budget for the it department, but im just curious, how much would it cost to implement these things were talking about because part what you mentioned was 100something million or whatever it was. 61 million. What i didnt get was, what part of that budget would be to implement new approaches . Well, so 150 million over the next five years is whats apart of the it plan. Weve which is a significant amount of money. We have a lot of need. We have a lot of projects that are in need of more money all the time. But thats a significant investment. I dont have the total number of what it would take to do everything that is requested. But the 61. 3 million is what we mentioned over the coming two years. And as far as what the short fall is, i dont have that number. But that amount is what we have identified as requiring to meet those initiatives we have described and its in the report we submitted. Is there a specific initiative or project, maybe someone from our department can provide more i just am interested in the short comings of these projects. What is the budget need to fully implement the things you want to implement . I dont have that number. We do a better job now of identifying what are the significant and the essential projects and were focusing on those, and thats what weve provided in the response here. As far as the any other projects that arent mentioned here and what the short fall is, i dont have that in front of me. Ms. Garner, in regards to the implementation of these ideas you have, is there a price tag attached to it because again, i assume this is going to take funding to do some of this stuff . Speaker absolutely. The question is, is there a budget attached to those ideas. There will be need to be, so we will be ill give you one example. One of the things that is a recommendation that will come out of this group, i talked about, is we think it would be helpful to have one central team that focused on it recruitment, and helps Department Stay up with current technology, current terminology, helps departments write mouth watering advertising to get folks interested to coming to work for the city. Having a team like that will require resources. I appreciate it. When you do that report by a week or so, have those hopefully well be able to put those price tags on them. I do want to say thank you to dt and the recruiting theyre bringing on board is a great help for us, and in putting all of these things together, but yeah. So the answer is yeah. Well be able to put price tags on that and share information in the report. I appreciate it. Any questions, supervisor . Thank you very much. Thank you. Is there another report . No yes. Any Public Comments on this item . Seeing none. Public comment is now closed. I guess what we want to do now is go through the findings and recommendations. So would you call each finding, madam clerk. Yes. Finding number one, the city has not prioritized critical Network Infrastructure investments as demonstrated by the failure to fund network improvement. Okay. Id like to recommend that we disagree with finding holy. And the comments we have is major it infrastructure, projects have been a major focus for the city. Coordinating effort to improve the citys Network Infrastructure is included ads a priority in the information and the Communication Technology plan. Okay. Finding number two, significant problems exist within the department of technology, that limit the service its provides to departments, largely due to the inability to sale job positions and job restraints. I recommend we disagree with this holding. The board of supervisor has no jurisdiction over the hiring process that dh and dt has and continue to update. The board through the an maul budget process has made significant investments to the department. Finding number, the three reorganization three to designate a could be a positive step in building dts credibility. We will agree with the findings. Finding number four, dt Business Analyst capabilities to launch new processes to make dt more efficient and more effect. We disagree with finding in part. The board of supervisors was able to fund both the new Business Engagement manager position and the second business analysis. Analyst requested by dt it. The department of technology. Dt. Finding number five, the skills capability of the people soft system as con figured will not enable Department Heads to identify City Employees with skill set and demand. We agree with finding. Finding number six, the department of Human Resources, dhr effort through the Information Technology, it hire and stream line it hiring will not sufficiently impact the it and dt. We would disagree with this finding holding. The board of supervisors have no jurisdiction over the hiring process of that dhr and dt. Have established and continued to update. The final finding or finding number seven, the absence of a way to bring in it services whether at will or Service Based system puts the city at a great disadvantage and all other risk of technology the board of supervisor have no jurisdiction over the hiring board. We have established and continue to update. Would you like to go onto the recommendation portion . Okay. Chairman yee, i would be happy to go through my suggested responses to the recommendation. Can you please read recommendation one. Recommendation one, the mayor should pry ore these the Network Infrastructure and fund the platform. This recommendation has been implemented. And our response text is as the mayor response indicates, the 6th Network Project was highlighted as a high priority into the most recent it plan and funded with 4. 3 million in the mayors fiscal year 20152016 and 20162017 budget, the largest single allegation from koits allegation. Recommendation number two, the mayor and the board of supervisors should have a sixmonth report. This will not be implemented. While any individual supervisor can call a hearing on this topic at any time, the board of supervisors could be predict if or when one may do so. The board president , myself, sits on koit which will receive progress. As the departments response indicates in september, dt began releasing a monthly project status and Key Performance indicator, a key and Key Performance report for Department Heads including measures on services at a project Level Network of time and other yet to be determined matrix. Recommendation number three, a User Satisfaction survey should be sent to all dt clients before the end of 2015 and later in six months. After the reorganization to assess whether the new accountability structure is making a difference for the clients. This has not been implemented but will be in the future. For clarity, will i need to specify a date if thats the case . Through the chair, supervisor breed, i believe so and the outlining date can be six months from when the report was issued. Thank you. This is largely beyond the jurisdiction of the board of supervisors. Dt plans to distribute an initial survey before the end of 2015 with a followup survey by the end of 20152016. Okay. Thank you. Recommendation number four, please. The office of the controller should develop a skills capability by the end of 201516. Speaker this has not been implemented but will be in the future. As the controllers response indicates, they plan to implement this in the specified timeframe. Its in the controllers audit i mean, the controllers response. Thank you. Recommendation five. Dhr should present the results of its pilot hiring process to the mayor and the board of supervisors before the end of calendar year 2015. Has not been implemented, but will be in the future. As the Department Response indicates, dhr plans to complete this by the end of fiscal year 201516. Recommendation six, dhr should issue a monthly report showing the number of it positions at the beginning of the month. The number of the new it position recommendations received in the current month, the number of it positions filled in the current month, the number of it positions at the end of the month and the average days to require the it positions closed in the current month. Okay. This recommendation will not be implemented. Implementation of this recommendation is largely beyond the jurisdiction of the board of supervisors. Any individual supervisor could call a hearing on this topic or request a report at any time, the board of supervisors cannot specifically predict if or when one may do so. More over, reports with this level of gradually and frequently would be excessive for the boards purposes. Recommendation 7, dt should launch a task force for recruiting it staff at the atwill basic. Okay. This has been implemented. As dts response indicates, this task force was developed in response to the civil grand jury previous report. The board of supervisor thanks the grand jury members for their contributions in improving city it. Recommendation number 8, the mayor and the board of supervisors should calendar a review of tax proposals within six months of its convening. This has been implemented. The task force has and will present to koit. A body on which the board of supervisors and many other city leaders set. Recommendation nine, dt needs a recruited dedicated exclusively to dt and other it staffing needs. Will not be implemented. This is beyond the jurisdiction of the board of supervisors, so the board will support dt and its effort and evaluate any possible staffing reports during the annual process. The final recommendation is number 10. Dt need to hire business new reorganization and new initiative. This has been implemented. This is largely beyond the jurisdiction of the board of supervisors, but as the Department Response indicated, theres an Engagement Process as apart of this preorganization working on these efforts and have funding for additional staff to do so. And so thats the final recommendation, and with that, chairman yee, i propose that as our official response from the board of supervisors. Speaker thank you very much, supervisor breed. First of all, can we have a motion to file number one. Because the recommendations three, four, and five has an implementation to be in the future, it will be need to be continues. I make a motion to continue item number 1 to the call of the chair. No objection, motion passes. Now, can we have a motion to forward this item number 2 as amended to the full board with positive recommendation as a committee report. So moved. Okay. With no objection. The motion passes. Before oh. Go ahead. Before we move to our next item, i want to thank the members of the civil grand jury for the work that was put into preparing this report, and thank you alegra for your work on this as well. I know youve served on the civil grand jury in the past, so we really appreciate your commitment to working on these reports and working to make the city better. Thank you. I also dido that. This one has been a very interesting one in which we all know that we can mast vast improvements to our system when it comes to the it, so thank you very much, and thank you very much for others that have also contributed to this report. Okay. So, madam clerk, can we have item number 3. Hearing on the recently published 20142015 civil grand jury report, entitled San Francisco Fire Department, what does the future hold . Okay. So, the person for a grand jury for this report is janice. I guess also go ahead. Supervisor yee and supervisor bree. Im janice petty, for the person of the 201415 grand jury, and i was on the another grand juror is going to present the report to you. Thank you very much. Im jack tumey. Im pleased to be here. The most recent investigation of the San Francisco Fire Department by the San Francisco civil grand jury was way back in 2004. We focused on the 1990 emerger of an Emergency Services from department of Public Health and to the i saw it solved problems with poor emergency responds with local 798 with a complex as well as harassment towards emts and with 24hour shifts for emts. In the years, weve seen dispatch shifting from the static mode of being stationed at fire houses to the dynamic mode of being home and they moved to be disbursed across the city. Also, emts have returns to 12hour shifts. Newspaper reports in 2014, again, reported on poor fd Emergency Response times, and in september of 2014, the local 798 issued a letter to the mayor stating that local total lack of interest of confidence in the current ssfd administration. Boelth of these stories peaked our interest when they did an investigation into the Fire Department. During our initial look, we toured the Training Facility of Treasure Island and we were impressed with the state of the facility. Firefighters train inhouse and it has been set afire with propane. Yet the house does not burn down and its available next week for further training. Firefighters are move over Broken Ground in full gear carrying hoses. The capability for a live training on a bart vehicle is we found out this wonderful facility is all going away within a few years because ti is devoted to housing and businesses and parkland. Theres no room for a fire Training Facility. Yet the existing sewerage facility is staying. During our investigation, the jury again find a major problem in fd which is not responding to emergency and medical emergencies fast enough. The department has recently received new ambulances and must rely on some ambulances more than ten years old. There was slow response times in the southern half of the city and recommended that ambulances in those areas go back to their allegation. Sffd responded to recommendation with a plan to allocate fire house in these houses ambulances to return to evans street during their street to replenish supplies. This just might work. Not responding first which is ten minutes for code three emergencies and 20 minutes for code two. The aspect of not responded often enough refers to not fulfilling the 80 mandate the exclusive operating area agreement. Not fulfilling the eoa agreement means loss of funds to sffd and that private analyst get more than the 20 to which theyre entitled. The jury found a lack of Strategic Planning at sffd. The Department Said that this is due to the economic turn down in 2008 when they laid off their Strategic Planner in order to keep one more firefighter on the job. The departments response to recommendation are 1. 5 list its effort being taken in regard to this Strategic Planning. The areas in dire need is they keep the facility there. The mayor appoints members of the board of directors of tita, the Treasure Island Development Authority and it has approval from the board of supervisors. Without ti, the city has to get on with finding another area in the city that can accept the propane storage tank necessarily for the [inaudible]. This will not be cheap or easy, and sffd must not [inaudible]. Another Strategic Planning is the maintenance of fire engines and fire houses. What we have now is deferred maintenance. The deferred bill is already high and getting higher. Thank you. Thank you very much. Any questions . Let me have fire chief hazewhite and her crew to come up here. And then also owe goe ahead go ahead. Hazewhite, the Fire Department. I wanted talk about our fire president andre evans and Fire Commissioner mike and he custody parted due to another appointment and thats Fire Commissioner stephen. We also have present, mr. Bob beck from Treasure Island department authority. There were two areas where tita had to respond. We appreciate them being here. I have 8 slides. You have our it itemized before i get started on the presentation, and i know three are here today, the members of the civil grand jury. Im impressed by the participating nature of our Community Members, and they volunteered for this assignment and spent hours working with members of my staff to get a better understanding of our Department Operation and we appreciate the work that they did. So, first slide, and i want to acknowledge the members of my staff here. Mark is going to help me with the slide show. So Department Representative met a number of times with the civil grand jury and explored and discuss a number of topics. At the end of the day, there were two areas that the grand jury focused their report on. The first was the ems response and the second was the status of the departments Training Facility on Treasure Island. So the following slides will address those two topics. Related to ems, issues highlighted in the report as you know, our city has seen growth over the past few years that increases the demand for services. With both day and Night Services the result has been increased calls on the medical services side. The citys ambulance resources both San Francisco Fire Department and private partners unfortunately have not been able to keep up with the demand and that resulted in response issues in the fall of last year. As a result, a city wide work Group Performed pulling partners and stakeholders from our department, the department of Emergency Management, the Mayors Office, the Controllers Office, board of supervisors, president breed was at those meetings, labor and doing an analysis of the systems and makes recommendations on the improvement. There was an investment made in the department which the economy restored here in our city and it has supplied much needed resources to address some of the issues. The next slide, we bulleted it out some of the new initiatives that weve taken and resources added since just a year ago. And ill review these briefly. We do have an academy of 42 members, emt, join the San Francisco Fire Department, so they provided additional staffing. They came in april and graduated in may of this year. We saw the delivery of 19 new ambulances in service. Proud to report related to ambulances we have another 9 coming this fiscal year. 5 were awarded through a grant. 2 were privately donated by a couple from the community. And 2 are in our budget. So with the delivery of those the added to the 19, we will have more than 50 of our ambulances with less than 3 years of service which were delighted to present to you. We also just recently shifted to a 42hour workweek for the ambulance tier. And it allows for greater coverage that the previous schedule did not, and we just embarked on september 26th. We also are working on an enhanced supervision model at station 49. We received greater level of supervision on a greater basis. Joining today, i asked dr. Clenan who is our director, hes also hes practicing emergency he has a very thorough understanding of the challenges we face here in the city, and he has spear headed the restoration of version 2 of what used to be called the home team. The Homeless Outreach medical evaluation team. Weve repurposed it and it has been funded to have two captains that will work full time responding to the frequent users of this system. If we see a pattern by a certain person, instead of having our resources rushed to that scene, wore going to have a proactive resource. Were in the process of recruiting for those positions at this time. They were recently funded as of october. We think that will have a direct impact on appropriate resources for these frequent users of this system. Dp nurses, i believe, as you may know, we have a heavy call volume to one address, 101 pulk street which is a drop in shelter. Responders were responded 80 or 90 times a month, and in working in conjunction with the department of Public Health, we asked for medical expertise, so the dhp replaced a nurse at that city. The calls have dropped by 50 by month, because we have a higher level of expertise to say does this person that im evaluating need 911 services or do they need another service. We believe thats a great i will a great illustration that weve embarked on. Were in the process, as was addressed by the civil grand jury, as opposed to having just station 49 at 14 evans, 15 avenue znswer b, the equipment crash house is getting and we also continue, as apart of the work group to have the subcommittees in terms of the ems, ambulance Provider Group members. In the last year and a half, we have become much more closely aligned and the lines of communication are good. Theyre improved with our private partners and king american. And so they continue to meet on a monthly basis. Our department and the private providers. Weve close with department of Emergency Management of tracking data and that working Group Continues as we refine and analyze our data. Were working closely with dt on it upgrades, and were delighted that under the direction of deputy chief cambardi working on the ems facility, a grand new facility that we envision being placed on the 2016 health fund to the tune of 45 million. It will replace the station 49 facility which was always envisioned to be a temporary facility. Weve grown and weve managed to make it a facility that will continue to accommodate the great work that our members do. We really need a brand new facility and we envision incorporating ems in into what weve locked down is a location behind our station 9 on jerald avenue. And we can answer more questions about that if you have any specifics. The next slide is a graphic. As you can see from the chart, this is included in the departments response in your packet. Emergency or code 3 lifethreatening response times has decreased given these Additional Resources that i talked about. And initiatives put in place or in the process of being implemented. Response times and assistance performance improved over the summer even after the publishing of the civil grand jury report. Its not to say that the work doesnt continue. We need to continue to improve. Were constantly monitoring the system and analyzing areas of improvements or pending issues that may arrive. Weve experienced increases over the last 12 months in light of these improvements so our impact on staffing is being monitored closely. We did want to put in a slide about Strategic Planning although it focuses on the sTraining Facility. The department has been lacking in administrative and planning resources. We have regularly, since we lost that position, nearly a decade ago have advocated for that, and i know chair yee, you and i have spoken about the response of Strategic Planning and i know its a priority for president breed. This year, we had to fight tooth and nail to keep those positions in. We have new positions which were in the process of filling, and in addition, we want to incorporate sort of all these separate documents into one large comprehensive document that well plan. I would like to acknowledge evans for helping spearhead a Strategic Planning committee which is comprised of various committee members, that weve met three or four times and talked about the initiatives and five topics weve been talking about. And its surrounded by the people and the policies and the preparedness of our department. Thats forth coming. Our goal is to initial a plan some time in the spring during the fiscal year. The following two slides, address our Treasure Island Training Facility. When i was a direct of training from 2000 to 2004, we had just inherited from the navy when the navy decommissioned that facility, we inherited and i can say from personal experience, that facility is worth its weight in gold. We operate an extensive goal on Treasure Island where we conduct a variety of training including recruit training and regional trainings and exercise. We do have a Training Facility here at 19th and fulsome. The experience gained from this facility is unmatched. We do have a live burn facility. Weve basically replicated an underground muni and bart situation, electrical, water emergencies, you name it, that facility has it. And we feel that it has definitely assisted us im a big believer in training. Training is the success of any organization, but it takes on a greater meaning when youre talking about saving lives and property. So we have been good partners with mr. Beck and his staff. As you know, we have a state fire station over there. Were responsibility for taking lives and property on Treasure Island. The Treasure Island plan, the department is anticipating to vacate that facility in later phases of that development. We need to replicate this facility. Candidly, it will be difficult because of possibly noise as well as the requirements of having a live burn facility. I know theres plans and im respectful of plans and housing, but speaking with my fire chiefs hat on, i would like engage in revisiting this issue. And we are cold heartily behind it and appreciate the objective recommendation from the civil grand jury that this is a facility that is second to none. I believe theres only two this is the only one i believe in northern california. We have ideas that wed like to enhance, but because of this blooming 7year deadline, we havent done so. We believe we could continue to use this facility. It would have Revenue Generating capabilities if we open more of the regional asset. I would like to throw that i know our Fire Commission is of that same opinion. We would love to have a further conversation about the possibility of keeping that facility, and i understand it would be potentially enough i know theres parkland thats expected to be in that area, but and i get it, im a mother. Outdoor space is important, but this is, i think, where we need to be prepared for a man made disaster. You cant get the type of training that were able to put on Treasure Island facility. That concludes my presentation. Im happy to answer any questions. Thank you. We need to take a real quick 10minute break right now. And well have a lets, i guess, the recess is over. Thank you chief for your presentation. Are there others that will be presenting . Not at this time, but i may call on them for specific questions. Okay. At this time, supervisor breed, do you have questions . Yes, i was hoping that the Treasure Island Development Authority would provide a presentation based on their response regarding the facility. Thank you, chairman yee, director supervisor. I dont have a presentation for you today, but i can certainly speak to the response that was provided as was mentioned in the response. The fire Training Facility was not included in the future Land Use Plan. Im still reviewing some of our historical documents, our files to see if i can find a more extensive analysis of some of the thinking that went into the conclusions to not include it in the Land Use Plan for the future of Treasure Island. We certainly i have a long history in my career of working with the San Francisco Fire Department, and understand the Important Role that the fire Training Facility plays in the departments programs, and i look forward to working with them and the department of realestate as appropriate to evaluate potential future sites for the fire Training Facility or for its potential continued presence on Treasure Island. If the continued use of the Navy Facility has been viewed largely as an interim use, since the base was closed, and so moving forward, we would need to do a full environmental analysis for either continued operation of an existing or rehabilitated facility or a new facility on Treasure Island and recommend that be treated as a distinct project rather than reevaluating our program. But understand the role that the facility plays and the need for such a facility and we look forward to working with the Fire Department and the city to do that evaluation. So there anything in the agreement with the navy that prohibits tita from allowing the Training Facility to remain at its Current Location . Theres nothing in the agreement with the navy that would prohibit the facility from continuing, but the adopted Development Plan for Treasure Island and the land use for Treasure Island did not anticipate the fire Training Facility and so its continued operation as a permanent facility and function would need to undergo environmental evaluation. And it would be something that the tita board would need to approve, not necessarily anything else . It would need to be approved by the tita board and it would need to be approved by the board of supervisor and we need to evaluate it. We could run into some challenges with that. Yeah, there are certainly a number of complex issues that we need to would need to be evaluated that would be you know, potentially significant hurtles to continue operations on they land in a permanent function. I dont recall in the initial discussions the i vaguely recall the fire Training Facility being considered more long term, so i guess im just trying to understand what happened that took it out of the mix as more of a Permanent Location. I know for example, the brig and the Police Academy and other discussions around other City Department zs and those were moved out of the fix, but i wasnt under the impression the Fire Training academy was supposed to be considered long term. Thats apart of the area im still investigating. You know the Treasure Island Department Program underwent a lengthy planning process between the time that the base was identified for closure and ultimately closed in the time that the land use the dir and the Land Use Plan was adopted in 2011. And were in that timeline the decision and where in that timeline it wasnt including the timeline and the basis of that decision is something im researching. I would say things change. It has been going on for many, many years, trying to move Treasure Island forward in a certain direction, developing housing and parkland, and in the meantime, i know theres a lot of empty spaces and spaces that can and cant be used, but im very familiar with the Fire Training academy, and this is one of those particular spaces that i think is being used well and serves the city well. I think when things like this happen and things change, we ought to adjust to those changes, and so i would definitely like for tita to really do whatever it can to try and keep the Training Facility at this location permanently. If thats a possibility to work on a level of agreement that could lead to that. Its important for our city. Our city is growing, and im not suggesting that Treasure Island to bear the blunt of this growth, but Treasure Island is apart of the city. Tita is apart of the city and sometimes decisions need to be made to make adjustments when we need space for a purpose of this nature, which is a real Public Safety issue, so i would strongly suggest that we really explore this and try to come up with something a lot more permanent so we dont find ourselves in the situation where the development is happening and were out luck and facility closes down and were trying to figure out what were going to do. This could impact the quality of life, not just residents all over the city, but those residents who live on Treasure Island because we need a place like this to train our work force. Were growing and were going to be hiring more firefighter and we need the space to train them and this is an important part of that. Im hopeful that could be taken into consideration with the tita board and im hopeful the Mayors Office is heavily involved in this as well in trying to get us moving in the right direction. Yeah. Well, we certainly, you know, this is a very good time for us to be having this conversation. Were beginning the Development Effort now. And we have about 7 years or potentially more before the existing site would be affected by development. So we do have a window of opportunity here to evaluate whether continued presence on Treasure Island is viable, and if not, what ill alternative locations might be, and where we might be able to secure a site that well be able to support such a facility. It is a we look forward to working with the Fire Department and the city, the department of realestate and the Planning Department on that evaluation effort. I can speak for im only speaking for myself, but as a member of the board, if there were approvals that were required of me that involved the development and the property and didnt involve a wellthought out plan that would allow for Permanent Location department, im not certain i would be supportive of that plan, so i want to put that out there moving forward, so hopefully something can be done. Yeah. Thank you. Yep. Thank you, mr. Becon. I concur with supervise breed on this position. I havent been able to visit the facility itself, but from the feedback ive gotten from rank and file, people that have gone through training, they speak highly of it, and if its going to help us save lives in the long run, we need to make adjustments so that our firefighters are best prepared, that they could be. So anything you could do to help that along, i certainly would be very appreciative of that. Thank you. Thank you. Any Public Comments on this issue . I did have some more questions. Okay. Do you want to finish them . I did have some questions for the chief. Thank you for your presentation. I know that i mean, i didnt find the report surprising as you probably know, mostly because of the Strategic Planning part of the report, ive always been concerned about the department, and the fact that the department did not have a Strategic Plan to deal with staffing, to deal with the equipment, to deal with a number of challenges that the Department Faces especially when there were really challenging budget times and there had to be cut made and i understand that. I guess, id like to understand a little bit more, you know, when the last Strategic Plan, when and if there were a Strategic Plan done for the department, and can you explain a little bit more i know the civil grand jury report is focused on the fire Training Facility as well the engines and the houses, but can you explain exactly, you know, what kind of Strategic Plan youre working on. Is it a comprehensive plan or is it more specific to whats in the civil grand jury report . Just a little bit more information for the department. Supervisor yee, chair breed, the goal is comprehensive for a road map for the next three to four five years. We worked on a streej we worked on a Strategic Plan in 2005. Theres plenty of plans that exist, but its putting them into one single document. Weve had a hiring plan since 2012. That was in conjunction with the Mayors Office. In the next three fiscal years, we anticipate hiring roughly 375 firefighters and anticipate 200 to 375 retirements. We did a lot of that work, but it doesnt exist in a single document. Youve spent time on Fire Commission, weve had an apparatus plan that has been approved by the staff. Our budget reflects that request. The difficult part is that has not been funded to the extent that the plan calls for, so the plan exist, funding has been an issue and thats probably our biggest initiatives coming up, which was not in the grand jury report, but we were making plans for apparatus to make sure we have appropriate apparatus standards. The plan will be comprehensive to address the two components of the civil grand jury report, ems and training, but also fleet, health and wellness, Community Outreach, it will be very comprehensive. And for the engine i mean, for the houses like i know theres been bonds that has been passed by the voters, the amount of money that we, say, in the bonds we were using for the fire houses arent the amount of money were using for the fire houses. I wanted to know, are there any plans to address long term, some of the challenges with some of the houses . I know that were were completely doing station 5 and station number 1. A brand new station. We have the new emergency the arson unit and others speaker Public Safety buildings. Public safety buildings, thank you. We have a number of things thats happening, but we still have a lot of challenges with our fire houses and so our do we have, other than that i know the citys capitals plan and information about what we plan to do city wide, is there any plan with the department in terms of the fire houses as apart of the Strategic Plan, that will be incorporated into the Strategic Plan in terms of the standard of every facility should make sure that its a safe environment . Particularly, its a 24 7 facility. We have a work order funding into the department of Public Health, and we have an hygenist on board. We have been blessed by the bond funding. We would not maintenance has been an issue throughout my 25 plus year career in the station. Weve always been, in my opinion, underfunded. We have 50 plus facilities and what it boils down to is less than 100,000 a year. Its more than 25,000 per facility. Without these bonds, 2010 and 2014, we would be not in very good shape. We definitely need Adequate Funding for our facilities. We understand theres going to be our Strategic Plan will make sure we have proper funding for these aging facilities. You referenced station 1 on fulsome, station 4 in mission bay, but most of the facilities are 50, 60, 70yearold and its like the hmo philosophy. The maintenance has been delayed. Can you talk a little about response times and where we are now since this report came out . I know we have more ambulances. I know were hiring more paramedics and we have more paramedic on the street and theres the information regarding pair mets that are regarding paramedics at the station. Are there 24hour a day paramedics in the station. If you talk about that . We have seen an improvement. A drop in our response times. The problem we were having wasnt getting a fire it was the third timeframe, the 10meantime frame. We have seen a drop in that due to the investment in staffing as well as apparatus. So we are 87 of the time, were responding within our timeframe for code 3 emergencies. Thats less than ten minutes, right. Ten minutes or less. So the threshold we like to see, which for a number of years, not just last year, to have in 90 percentile has been a challenge for us. We continue to be challenged given traf patterns, given the increase in call volume, but we have seen significant improvement since last year of this time. Regarding the paramedics, last year, due to staffing, we dropped to 27 fire engines that had als capability. So als means advance life theres a basic life support certified person. 27 fire engines that had als capability. So als means advance life theres a basic life support certified person. The vast majority of response by our department can be achieved and treated by a bls training person. Its evaluated to have a paramedic on the engine. Weve seen those paramedic engines rise from a 27 to 33 out of 44. At this point that is addressed in the civil grand jury report. At this point, we are more than meeting that 7minute threshold to have an als provider on scene within the 7minute timeframe. That has never been a problem for us. And we will continue to analyze the all als engine model which i think has a lot of positives to it, and that you have every engine with the same training level of training and thats something were looking at and well probably discuss during the budget season. Okay. Thank you. Okay. Thank you very much. At this time, id like to see if theres any Public Comments on this item. Seeing none. Public comment is now closed. I do have one more question though. Prior to Training Facilities that you have access to on Treasure Island, where did we do our training . We were training at 19th and fulsome. Theres a large training tower there adjacent to station 7. When i first came in, we had a limited sort of live burn which the epa would certainly, in this day in age would not allow. We would have a smoulder fire down in a basement at 19th and fulsome. That went away in the mid90s. We had discussions way back then under chief demins and chief tabaco and chief i worked for all three of them as director of training and we really felt that it was valuable as set for our a valuable asset for our members and getting thank you very much. Im sorry, i forgot to ask, where are we with the eoa and are we in compliance at this time with the eoa. The exclusive operating area that youre referring to an 80 20 market share. 80 being from the San Francisco Fire Department and 20 by the two private providers as apart of that operating area. Were not quite at 80 . Their most recent statistic is 85 . I know when we were experiencing the height of our crisis, that the private Ambulance Companies were helping the city out which i figured may create a challenge in terms of the eoa, but most important, we wanted to make sure there were ambulances out there on the street, and so were working with the private companies a lot more than we have before, but what do you think what would you attribute the change, the increase in our commitment to the eoa too . I would say definitely the infusion of additional staffing we hired in april and one of the things i didnt indicate, but it segways into your question, we did something just last weekend, we debuted a model so if we have a surge period of time in the city or we have a discretionary leave, we have trained Fire Department individuals who come in. A are they making overtime . Is it a per diem difference than overtime . Im going to ask mark to talk about that. I might ask dr. Ya to speak about the era. Were going to address okay. Thank you. Good afternoon, its a per diem employee. Its not overtime. This is for employees that are not regularly employed by the department or employed elsewhere and come work on a parttime basis with the department. Got it. Thats creative. Thank you, supervisors. I was asked by the chief to mention something about the eoa compliance. A lot is true. We dont meet our goals in terms of market shares. The state has recognized that the important thing is were providing the services to our citizens. We want to jeopardize that in sake of meeting a number. Externally and internally, theres pressure on making sure the processes are in place so we can meet them. That is that we have the infusion of both measures that will make our facility more efficient and allowing more staff to get to 80 20. Its recognized by the state as well as by all of our eternal partners, the privates that we want to get to the 80 20, although it will take time. Great, thank you. Did i close Public Comments yet . I havent. Thank you. Thank you, Public Comment is now closed. First of all, i would like to thank petty and jack for being here and presenting and for the grand jury that has worked on this issue. You know, this is a very important issue. We want to keep our city as safe as possible. And as much as we might have non about these issues in the past, its helpful sometime to highlight and say we need to get some things done. To me, its not just the Fire Department by themselves getting it done, but it would take all us to support the Fire Department whether its from the budget process or the mayor saying, lets go hire some more folks to fill in the vacancy. Lets get what we need. I know this has been an important issue for supervisor breed and for myself. Im ready to continue to support the efforts of the Fire Department to get us to it seems like were moving in right direction. So would you like to make anymore comments . Yes, thank you to the members of the civil grand juries for investigating issues. I know over the past, i guess, year or so, i was really highlighting this issue because of the challenges that many of my residents faced in our district with ambulance response times and i must say that the investment has definitely made a difference, although there is still a lot more work that needs to be done to get us to where we need to be as a city with the department overall. The fact that the board of supervisors and the mayor have invested a significant dollar amount, over 30 million, additional funding to hire more firefighters to hire more paramedic and to try and support the department in a significant way is really commendable. I do think that we definitely need a Strategic Plan. We definitely need to understand exactly where we are in the department, where we are in the equipment, with our engines, with our facilities, with our employees. More so because when i first started serving on the commission, i recall there were one year there were over 70 people or 80 people that retired in that one year, and i thought to myself, okay, if were not bringing on 80 people to replace those people, number one, what are we how are we filling those positions, but more importantly, thats a lot of Institutional Knowledge thats walking out the door. The city needs to do a better job to make sure we dont wait 10 years before we have a class or waiting 10 years to replace equipment or waiting 10 years before we develop a Strategic Plan. We have to think long term so we can make sure as we approve this development, as we add over the past i guess since 1991, over 100,000 residents, and were expected to have another 100,000 over the next ten years. We have to keep an eye over the departments. Its really important and i appreciate the work that has been done by the civil grand jury to shed a light on this and i appreciate the department on improving the issues that has been in the department. And lastly, i want to say i do think its important that, you know, and just for clarity sake, Treasure Island authority is apart of the city. The members of the commission are appointed by the mayor, approved by the board of supervisors and theres a process here. I understand there are a lot of, sometimes red tape or legal issues that tie us to certain agreements, but the fact that there has been no leadership to address making sure that this particular Training Facility would somehow apart of Treasure Islands longterm plan. Im not certain how this ball got dropped and i do think that we need to look at this issue very seriously and try and figure out something a lot more permanent because this is about Public Safety, and Treasure Island is apart of San Francisco, and we hold the authority on what happens with Treasure Island and we need to be a lot more aggressive when making sure that a facility like this, that provides this level of training for people who are protecting our lives every single day is definitely the least we can do, is make sure they have a state of our facility to train at. And so this is really important to me and im hoping that this sounds of alarm for that particular piece of well. Thank you to everyone who is here. Thank you to the commissioners i see in the audiences and other members of the department. And i look forward to, hopefully, you know, as time progresses, you know, an even more significant change in the department. Thank you. So can we have a motion to file item number 3. Yes. So moved. No objection, the motion passes. Madam clerk. Thank you very much, madam clerk. Before we entertain a motion to convene in closed session. Can you call item 46. Item number 46 authorizes for approving settlements against the city and county of San Francisco. Before we entertain a motion to go to closed session, is there a member from the public that wishes to speak on items 46 . Just for con confirmation number 3, was it to call or call to the chair . File. Thank you. Okay. So can i have a motion i see no Public Comments. Public comment is closed. Could i have a motion to convene in closed session. Speaker so moved. Motion passes. Deputy, the committee voted by a vote 20 to forward 4, 5 and 6 with positive recommendation. Supervisor, can i have a motion to not disclose what happened in closed session . So moved. No objection. Motion passes. Madam clerk, is there anything else on the agenda. No further business. If theres nothing further, the meeting is now adjourned. Thank you very much. When a resident of San Francisco is looking for health care, you look in your neighborhood first. What is closest to you . If you come to a Neighborhood Health center or a clinic, you then have access it a system of care in the Community Health network. We are a system of care that was probably based on the Family Practice model, but it was really clear that there are special populations with special needs. The cole street clinic is a youth clinic in the heart of the Haight Ashbury and they target youth. Tom woodell takes care of many of the central City Residents and they have great expertise in providing services for many of the homeless. Potrero hill and Southeast Health centers are Health Centers in those particular communities that are family Health Centers, so they provide health care to patients across the age span. Many of our clients are working poor. They pay their taxes. They may run into a rough patch now and then and what were able to provide is a bridge towards getting them back on their feet. The center averages about 14,000 visits a year in the Health Clinic alone. One of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children. Women find out theyre pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. We initially will see them for their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. Group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates. Our doctors here are family doctors. They are able to help these women deliver their babies at the hospital, at General Hospital. We also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. Its for the city, not only our clinic, but the city. We have all our children in San Francisco should have insurance now because if they are low income enough, they get medical. If they actually have a little more assets, a little more income, they can get happy family. We do have family who come outside of our neighborhood to come on our clinic. One thing i learn from our clients, no matter how old they are, no matter how Little English they know, they know how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. They can be child care providers so our clients can go out and work. We found more and more women of child bearing age come down with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. How do parents tell their kids they may not be here . What we do is provide a place and the material and support and then they figure out their own truth, what it means to them. I see the behavior change in front of my eyes. Maybe they have never been able to go out of boundaries, their lives have been so rigid to sort of expressing that makes tremendous changes. Because we did what we did, it is now sort of a nationwide model. I think you would be surprised if you come to these clinics. Many of them i think would be your neighbors if you knew that. Often times we just dont discuss that. We treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. There are people who come in who need treatment for their Heart Disease or for their diabetes or their high Blood Pressure or their cholesterol or their hepatitis b. We actually provide Group Medical visits and Group Education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. And it validates the experiences that you have and so you learn from each other. I think its very important to try to be in tune with the needs of the community and a lot of our patients have a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isnt the top priority for them. We need to understand that so that we can help them take care of themselves physically and emotionally to deal with all these other things. They also have to be working through with People Living longer and living with more chronic conditions i think were going to see more patients coming through. Starting next year, every day 10,000 people will hit the age of 60 until 2020. The needs of the patients that we see at kerr Senior Center often have to do with the consequences of long standing Substance Abuse and mental illness, linked to their chronic diseases. Heart failure, hypertension, diabetes, cancer, stroke, those kinds of chronic illnesses. When you get them in your 30s and 40s and you have them into your aging process, you are not going to have a comfortable old age. You are also seeing in terms of epidemics, an increase in alzheimers and it is going to increase as the population increases. There are quite a few seniors who have Mental Health problems but they are also, the majority of seniors, who are hardworking, who had minimum wage jobs their whole lives, who paid social security. Think about living on 889 a month in the city of San Francisco needing to buy medication, one meal a day, hopefully, and health care. If we could provide health care early on we might prevent inaudible and people would be less likely to end up in the emergency room with a drastic outcome. We could actually provide prevention and health care to people who had no other way of getting health care, those without insurance, it might be more cost effectivekim. Good morning, everyone were here today to announce a new partnership with the set of circumstances to support Small Businesses i want to thank sarah kim and chinatown weve been hearing from the mayor and supervisor christensen and the pointing and cofounder of fte have and from capital one and be hearing from derrick latter and joined by the installation mark white the wanting thought San Francisco Small Business commission and the president of the cofounder of fte have to talk about the city of San Francisco. clapping. hi derrick business is one of the thirty businesses right now on the keva west side in San Francisco it is giving loans you know keva raufrnd 10 yargz in San Francisco as an organization that supports enterprise halfway around the world get our start in the Development World and a few years ago starting work working in our own backyard what motivates us to work in the United States is the statistics coit u coming out of the concrete cringe 7 out of 10 Small Businesses that apply get a reservation and two of over Small Business is if Small Business Small Businesses have challenges that is very, very difficult and one thing welds to make easier is letting every day Small Business participate in crowd funding youve heard of that for major movie but one for the little kwie that local Small Business that might be selling delicious treats right here arrest a home basis daycare or a House Cleaning service that makes our communities better theyre struggling for access to capital we want to connect them to capable lenders to finance their dreams and derrick right now for example, he was on the keva website and lane is 5 percent opportunity from a group of individuals that everyone else can chip in and basic become an investor in derricks business he buys the equipment pay back the loan and get money back into our account future 5 hundred has startups but it is a chance to be angles for derrick you thoildz without a whole communities of supporters i want to fierce this our sponsor capital one that is committed to Small Businesses when we graduate from the first loan then hopefully graduate to large loans from capital one and also the city mayor and the team with the city has been incredibly helpful in facilitating the connections to local organizations working with underserved Small Business this would not have happened we wouldnt be able to help calling names tinder Economic Development project urban solutions and 50 other groups in San Francisco that have actually promenade it in helping businesses like derricks discover the keva playroom so the call to action for example, aura Small Business inform San Francisco and struggling think about crowd funding and think about keva. Org and get on to will have a zero percent along these 95 percent of businesses that post the loan gets funded in thirty days if you live in the city and you care of is economic vibrancy this is a simple way to liking a facebook you can now invest 25 with that, i want to to your knowledge cushion to you get involved and thank you very much again to capita one of the city of the list of the huge list of communicated supporters that make it easier for Small Businesses like derrick to get a loan thank you clapping. thank you you know since day one mayor ed lee has made supporting and tracking Small Businesses a priority of his administration he talked about how to help to support Small Businesses it is an honor to welcome our mayor, mayor ed lee clapping. thank you, todd great to join you and see the product of working with the Small Businesses and working with the chamber of commerce and the groups in chinatown and to promote hot how to fill vacancies i love the story that mr. Shaw from keva. Org given i know that in speaking with him and others that the founders the eco have were expired inspired empty mohammeds that give a recommendation he started figuring out the challenge of women owned and minority owned businesses with or without way out no bank dash and wanted to get micro loans out to the community that continues to be the story even in great economic foundational places like San Francisco working with with our Small Business commission and mark igniting e dwight one of the leaders and the chair we continue with our director of our Small Business office to identify the challenges that our Small Businesses and make sure that we cover everything from having an internet portal we get your preliminaries in within place and forms to making sure they are connections to simultaneously micro loans and large banks im so happy to see on this example of derricks effort because his great gather i need to say that as you know i have a joke coming it great gather used to serve this wonderful Dragon Beard Candy to the emperor of china im not a ini emperor only the mayor but i wanted to signal im here to also not only taste this candy by support Small Businesses like a delightful and part of cultural experience and draw we want to have for people visits place like chinatown but all over the city support initiative forevers to criteria Small Businesses we hope with the support of eco have at the first and capital one later on that they will grow into a large attractions that continues success in San Francisco it is that is these kinds of businesses the yes, maam before that time of our Commission Towards businesses like womens businesses we then continue it effort it is wonderful someone many the private sector like you and me can over a 25 effort or effort to a company and have it interest free that is a fantastic promotion we want over one thesis businesses if San Francisco to receive this kind of treatment from the next few years this is a great launch another great effort for the private sector linking u. S. Bancorp up with the city of San Francisco to support Small Businesses i cant wait to have my mustache touch that thing laughter i have the privilege of working with supervisor christensen because shes a great supporter of Small Businesses himself o herself having a Small Business herself and knowing the champs and giving me constant advice to us house to do better im liking the whole voimg from the Small Business commission to eco have to capital one to our supervisor and to our Economic Development office that we keep working with investment in neighborhoods and all the Grant Programs that our city offers to really flower aisle out more the Small Businesses ive ouch said it is our Small Businesses that are the backbone of our economic strength in this city as an examples like this supporting derricks family of a receipt hell keep secret for years to come were delighted in celebrating on this wonderful candy and the history of that is what we find interesting not just what we do but the history of identity it has to the cultural sixth we offer in San Francisco so im delight to join every one of you to this incredible opportunities but also to know the connective backward with wasnt what we are doing to support more of the efforts coming forgot in outline chrlt centers and also our commercial corridors in the city with that, i want to congratulate everyone and thank them and ill be interested in what everyone has to say but taste this stuff quickly thank you clapping. as the mayor mentions beer here in chinatown in the heart of district 3 sported owe supervisor christensen a tireless advocate for the Business Community and Economic Workforce Development supervisor christensen. Thank you clapping. i always say to everybody incite this a wonderful neighborhood wear in a beautiful place want to welcome everyone and encourage folks to come to chinatown the jewel of district 3 as the mayor mentioned i ran a 134b important over thirty years and worked with entrepreneurs and inadvertent oversees and people on ideas as important as those ideas theyre made or broken by a lot of backhouse things like financial responsibility and funding and so im excited for the opportunity that potrero have will bring to the merchant of our district this process that business and scott wiener value of these process answered a few of the questions for a lot of people the question is whats the new economy doing for me how does that work for the average person or the Small Business owner and potrero have is spilled one of the answers i have not have found by my son an avid potrero have investigator hes watching the businesses grow with the effects of his contributions it is go fascist for this to our merchant in district 3 where is chinatown going and evolving ive only been to have dr. Blanco spirit candy in the past only authentic treat is going to be available to residents and to visits because of derricks efforts and eco value of these help is great for chinatown and after all us im grateful to eco value of these help and im delighted with derricks success and everybody come down and joy some and i want to invite up capital one of the Financial Partner on this issue. clapping. good afternoon and thank you very much m and supervisor it is a fantastic day to be here in San Francisco wonderful to meet derrick and hes Family Capital one as an expensive collaboration with potrero have were thrilled to be bringing potrero have to arrive we provided a total of 8 hundred and restraining order thousand dollars over 3 years to pep help to enable hopefully, a though new Business Owners to assess potrero vaz platform and to help others Business Owners there are products or services and slacks with organizations and partners like e like potrero have in the city of San Francisco and the wonderful programs and services you have in place to support men and women over the years weve been investing over 1 point one Million Dollars to capital one to men and women like derrick that are launching and expanding Small Businesses and ouchd over 7 hundred Small Businesses and looking at to being part of the thousand that be launch and flourish hopefully in San Francisco i want to say from my heart derrick to you and your family it is wonderful to hear our story and the power of what youre doing and passing on through generations thank you for letting capital one be part ever it and have a wonderful afternoon clapping. so i want to invite derrick to talk about eco have of San Francisco is going to benefit his business here in chinatown. Derrick. clapping. first of all, i would like to thank all the media and for coming to this press event frankly the first time to give a speech in the public im derrick i was born if hong kong and stayed with my family when i was 21 my family used get the traditional candy store in hong kong were selling a unique candy called dr. Blanco candy the best candy and this is my dad so, yeah basically, he spent his life to make this candy for that the rest of world i wish you can give him a hand clapping. thank you so much the dr. Blanco beer candy was only for the chinese yes, maam per and maybe you know of chinese candy it is mask and started in europe and he kept pulling that like a white psychological after he worked with the peanuts and sesame needs is innovate like my kind of america candy or pastry i was was saying this candy is a chinese cultural thing and i decided to open this store after graduation but thankfully it is kind of frustrates for fresh owners to set up a business in a decity not easy im short of cash and also so at the first, beginning year im kind of lost by i would see im the lucky one i get the help from the Small Business administration and also potrero have and yeah, the oewd they give me lots of opinion and information how to get a story store and require the permits so i really time to say thank you especially to the folks they preside a platform to buy the sgrints and transportation because my business is invited to some kind of a cultural festival we need a transportation cargo so when eco have knew any story willing to help me thank you, again last but not least i would like to thank telephone call to all the labor and communities i cant stand here and the dralg cant continue to showing it to you so thank you very much clapping. thank you, derrick i think derrick youre the reason were here and the supervision with the thousand loans to Small Businesses coming out to helping you two lessons derrick said girs first go on potrero have and provide a loan but not leave here without having some of the dr. Blanco beer candy thank you very much i appreciate good afternoon the commission will please come to order madam clerk, please call the roll. Commissioner singer commissioner chow commissioner pating commissioner sanchez commissioner karshmer the second item on the agenda is approval of the minutes for august 1st i want to thank commissioner singer for chairing the meeting of september one the minutes are before you for approval a motion for approval is in order. So moved. Second. Id like to corrections. Id like to make a correction on i told the secretary to change two things that was quoted as saying the car of homelessness it the number one priority is it so one of our highest priorities. What line oh, what section are you on. I dont have the minutes in front of me. Here we go. Ive got it. On page 4 in the middle the page i have noted it councilmember cates noted that homelessness it the most Serious Health issues he wants to put it is one of the most and commissioner karshmer have paid participant i suggest to make to the commissioner said it be considered for example, perhaps looking at model lifechanging like the stop model as showed effectiveness from the population the under the influrence is on we be innovative with the issue. Okay. I see those as corrections from the speaker to the tint of hire his talk and they would be added unless there is opposition okay. So the motion is. Im going to go ahead and commissioner pating on page 7 under the health just want the second paragraph from the bottom id like the intent to be clear what i was trying to point out that we received a presentation with data which was showed some positive things about the quality scores it is t at San Francisco General Hospital were at the j. C. Cbc we see quality scores in certain areas that are concerning relative to our peer group as defined and i just want to point out that there was that discrepancy and im going this entirely captures that and ill explain on the statement to make that clear commissioner. Hey, is the discretion related to different perimeters that were being measured in the quality or i think thats y what dr. Chin pointed out that is reasonable to say in saying that i dont want to lose the thought that and give the public the impression were anywhere near the level we all including the people at general will expect of our quality scores we have a ways to go not prospective how i feel about where we are in the quality scores. Ill make that clearer. Okay okay i think from what youre looking at those minutes we think we would like to get a just what we had said better that will be helpful to articulate that so the secretary can take a verbatim our secretary will work with commissioner fung how that paragraph workouts. Ill accept it from you commissioner pating. Commissioner pating actually have words laughter so it would be that will be helpful we wouldnt have a misunderstanding. Ill draft something and send to commissioner singer and let me know if that works so everybody concurrence well allow it to happen for that paragraph are we prepared for a vote . If. All in favor, say i. I. Opposed . The minutes are approved. Thank you, commissioners item 3 the directors report. Good afternoon, commissioners the california starter legislature adjourned on friday september 11th jorge has until october 11th to act on the bills passed and is high profile set of bills for a regulatory for medical cannabis and the right to die bill and need to reduce the high rate of prescription and allow the state to request the amendments 1115 waiver mike the waiver is not met and the California Children services to medicate managed care and failed to reach on agreement only the organizational tax which is the special section called by the governor weve discussed in the past mayor ed lee opened the Medication Center directed to Homeless Individuals mayor ed lee announced that week this last week, we would be looking another Navigation Center and tried to set up a fund for that that he is looking for a fund to be matched by private sector and the location of the navigation have not been selected were working with the city and theyre looking at other location for that service the department provides the Homeless Outreach team that engages the individual community and help with the housing component and also with the Case Management support to the staff is it are all right. In the Navigation Center i would assume it is the same thing of services than any other Navigation Service on tis the mayor ed lee and supervisor president breed announced to increase the Affordable Housing in San Francisco by 10 thousand units by 2020 the 5 Main Division one thousand depressed unit and affordable units and the housing priorities for neighbors and amendments to the City Inclusionary Housing Program and the establishment of additional incentive for affordable units wanted to just make sure we all knew you have a maternal update there were among 31 San Francisco employers recently recognized for Family Friendly work there is a recent vision zero study featured not San Francisco chronicle in puritan working with the transportation that a Marketing Campaign it stops here and stressing the pedestrians have the rightofway at intersection the increasing by the yielding for pedestrians when paired with enforcement. Also you know we almost forget about our administrative staff that both e do the backbone whether scheduling the processes or helping with the staff or the public that come into 9 office we did will have a gathering ever september 4th to acknowledge a lunch for our staff want to let you know that administrative staff is appreciative and laguna honda created a band that went into effect no longer allow for banning sugary drink beverage see r sugar sweetened beverages from their campus as the whole system in the care depth the wanted to mention cash was thank you for the opportunity 50 are years old there were more Public Health speakers centers and not in primary care but particularly with the Castro Mission that was a clinic that saw in the beginning hiv and aids we want to work with that and the development over the years it is an incredible heartache center for services as well and 80 percent the serious most Heart Disease among the low income africanamericans and latinoamerican healthy San Francisco opportunity i say city mobilizes the health care to give patient the prescription throughout the city their be holding an event on tuesday october 29th and feature the presentations by physicians and fitness provider and our own population heartache leaders i want to acknowledge jackie and others if there are any other questions about the report i object to answer them. Commissioners, i guess we dont have the same copy we have an addendum only a directors report in our packet and that is oh, am i correct. Do you all need full copies. Does everybody have the directors report it is required to listen to it much more carefully laughter . Oh, i see, i see so therefore there might not be questions. I have a question of the addendum the high profile bills which ones did the city support. You can give us that information in the study. Good afternoon with the office of policy and planning actually all of these bills within on the watch list but for the support by the city. Im sorry. All the bills you see here. Those are the notices we saw we supported. Not on the support but the watch list. Oh. Well be present the finalized version. Can i ask in the special section on health that was pit here how does that work the special sections continue and when do they end. When they figure it out the managed care packet like it says it causes a 1 billion hole in the medal if it is not resolved by next may they want to figure out that out so the committees have the option and the leaders can call the session back with before january otherwise in january is is sold and r solid and any bills passed during the special session will be announced. So in terms of the spell Session Committee as written would be able to continue if they were to choose to do so. Yeah. I think if there were impetus to do so if they think a solution can be reached. All right. Thank you. So questions to the director on her report . My apologies i sent the email i should have spoke about the newspaper. My other question weed whacking track the impact thought possible one billion dollars shortfall for the services i dont know if so this a shortfall to the general plan or medicaid the state will be short. It is to the health pa plan to the San Francisco health plan and well have to see how that looks at you know thats as i said to the nonprofits have been holdings tax and theyre trying to give us tax bills in terms of the go tax well find out more and let you know. Thank you. I definitely see the navigation sites and the additional funding you had come back as those are developed and let us knew. Were collaborating with the Mayors Office and involved in the process as they develop the sites well probably not be in charge or that but well be insure they get even though help they need and will there b be some point how the expanded program is working. Yes. A dashboard that is by the Controllers Office we can give you an updated report to those dashboard a great percentage a significant percentage of people gotten directly into permanent how do we do that . And lofsz services theyre receiving and onsite with the mayor and saw the announcement that original Navigation Center is quite impressive. So is it fair to say in a quarter well see that. Well develop a program and invite denver to talk about that with us. Thank you any further questions no our appreciation and well move on to the please call the next line item. Yes. Thank you item 4 general Public Comment ive not received any requests. So we move on to item 5 the report back from the Community Health committee i want to thank dr. Chow we heard from dr. Curtis the maternal delinquent health for the efforts to reduce preterm birth the goal to reduce preterm birth with the Health Network and our Health System to reduce the reflex factor we are presented with straevenz that both the Health Network and our Population Health division is trying to take on one to improve the Womens Center of prein all care and the second is to examine determines of health that effect the term of outcomes and the preterm bitter is determined by race and zip codes and paternal prenatal care you family it so many factors it was quite mr. Ginsburg to see the department sort of out a list of priorities theyve begun to implement the first to put together the preconception care passageway package that will include the Family Education and nutritious education and insuring that dlults and other services for women with that are planning to get a package of care particular those at risk for preterm birth and finally those that are looking citywide at to continue to integrate the lower and preterm birth with smoking and employment safeguard for women were looking what were trying to explore in our Community Population division is how to look at issues in this case preterm birth across the network and city seeing there is efforts and a lot of overlap between the general Health Efforts and Population Based efforts were presented with the first year of Strategic Plan that came together in a grant we were both impressed with the competitiveness of that so it is too early for outcomes but both divisions are involved in the forest and well track their process the second effort we heard on oral health in the city with part of the adolescent the framework how are we impacting the mlk with the goal of zero dental care inside and outside the Network Within the network we heard a new benefit for medical patient that was implemented called dental cal full dental services at a minor disbursement that explicit cover everything but services are covered under medal this has a huge burden on our primary Care Planning within the network theyre addressing by increasing the staffing of dental were hiring two new dentists and showing arrival of 27 to 40 percent increasingly if adult visits that koudz out the children and youth Getting Service but when we add the two new dentists that will less than e help with the excess demand that is driven by benefits and in the area of Population Health weve been looking at how the city p will there the underscore itself and commissioner chow saw the lectures to the community i understand well be doing similar presentations to the africanamerican in the bayview and in the mission this is part of an effort to both prompt the practices to integrate those practices in primary care and an evaluation youre seeing the population height and our network working together to help the health in our community again still in the first year we dont have the results but have a coordinated effort for both departments in the hopefully, ill be able to come back more and more as we do as we do and say as we do for the city and within the network for prehealth. Questions of commissioner pating. Okay clarify im not an expert on dental care identification at the chinatown presentation in order to support and is that was an Important Health initiative especially some of the few times chinatown has total red the worts in the city i was courage or courageously that be restored and that we actually put a great deal of effort and actually in the meeting a number of agencies that were within the area of chinatown were actually expressing that they have been trying to seek dental care i think that dr. You and from our department have been working along with the Public Health lives center it bring those together so people from the schools and people from the pediatric units were beginning to converse and find a way to get the kids to get tare Preventive Services that was what i was there for and but only to encourage i think the presentation i heard only the first part that the session today actually helped move our agenda for our coming planning meeting in which we are looking to understand what is happening at Population Health all the things and how does that work with our Delivery System and how does that work with the whole health of the city i think the brief one was one ill courage we look at our next Planning Section in terms of where certain major needs of city are going to be addressed through not just Population Health or not through our Delivery System but some sort of integrated efforts so. If i may commissioners that is an important attribute we have the Public Health division and the delivery gentlemen, i had an laments concerning bringing the agencies and theyre separate agencies in los angeles and it falls under the purview the board of supervisors is trying to bring that altogether the law times editor was asking how we did that in the development if you think about it were under one agency but bringing 4 agencies together to say quite a feat i know that the doctor is ready for that goal i think it is saying a lot for us having the two divisions and the two divisions in the department when we look at the Public Health departments thought the country theyre struggling for survival to fund that preservation component and it will come later were in this to have to activities one looking at Community Health and the other individuals heartache if that is a major goal for my career how to work to tell the truth together to insure we can leverage that. Were going to be hearing today on Emergency Preparedness for the whole city and a presentation on what is emergency precipitating in and out of the framework that will allows you to if we can move the City Services in some ways deal with the those you know great social needs i think that is also a way to show were making progress so youll be seeing this dynamic Population Health level in todays Emergency Preparedness and sxhirsz my questions of commissioner pating and i might point out also as director garcia in terms of the uniqueness in which our Health Services with Mental Health hospitals are under one agency and the strength of that dr. Who is the form heads of cdc and is back in general also have highlighted that nationally saying that the San Francisco model is one, if anywhere we were going to be successful in health it should be in San Francisco. Our please call the next line item. The update on Public Health and Emergency Response dr. Balancing by a. Good afternoon, commissioners it was a great introduction this kind of combination of the Population Health side and the ambulancey care and ill talk about the population height side how we partner closely with the Health Network ill north america vin the director of the Health Preparedness in the department of Public Health. So ill starter first with a rhetoric california question why does preparedness matter the slide is a little bit old but things have happened in the last year which i call the disasters facing california and the nation in the lower left hand is the drought we were at a citywide meeting yesterday were now preparing preparing for el nino switching from drought to rain they have a Health Impact we have to start preparing for the next image is ebola in tradition that is what people think the heartache erroneous the disease we had a big impacts the law a county fires this is the fires occurring has a much bigger impact 60 thousand acres up in flame and 20 thousand people displaced ill talk about 9 Health Impacts and napa county the quarter that happened in august 2014 and the last slide is what happened in april with the battling and in the background the city was the only exultant that got destroyed so what unites those when people think the disasters they think of First Responder referring back to the valley fire the 80 thousand e evicts needs medical care and services that falls under pukt and were responsible for that so when disasters like this happens the entire city comes together were part of the team at the depth of Emergency Management the clinics respond that is important you dont want to be working only on one entity that is putting two or causes problems for another agency in government so we come together as a group to serve the city and puthd is there in disasters yesterday el nino some of the things that came up were you know the pack that there are 6 house to 7 thousand Homeless People on the street and working with the Mayors Office and the hfa to help for the rains that create potential heartache issues our partners need to be activated and the Health Network folks make sure theyre serving the patients and this is San Francisco there are a lot of things happening in the Car Accidents and those types of thing we need to deal with anything including the rains so we know we have to respond have an important place in response but what is preparing to the needs. So i put this slide up here this actually theoretically shouldnt happy in San Francisco the golden gate disasters what about overwhelming and how to prepare for something that potentially could wipeout a large part of the population that is displacement kind of chronic medical needs how to prepare when you get a huge sunday morning even with images like this can we prepare one the things theres not a lot of Robust Research because disasters can be unique they tend have their own set of conditions and hard to replicate around them so going to the next slide what happens in 2011 federal government both cdc and ass pa came together and decided to create capabilities along with disastrous preparedness if youre can be cable in those areas that youll be able to respond to my type of hazard so it is divided by funding the fact is Public Health preparedness that is from the cdc has 15 capabilities and the nice things the Hospital Preparedness Program done by the skim secretary they created other capabilities we have two funding streams to people with the Public Health and the individuals side today is presentation is going to focus on 3 targets ill talk about 3 targets with 3 partnerships and ill be happy to answer any questions about the capabilities if they come up so the partnerships are guess the capability were trying to develop in the San Francisco department of Public Health ill focus on the coordination and that basically means how to come together and respond at the department and what is that response entail ill talk about the health care tlvt thats a partnership and other responsibility in the health and finally talk about two outreach things ear doing in the communities at this point so in the department of Public Health the first thing to really be able to respond you need to have people that know how to respond and there are a set of the trainings raider for not only department of Public Health but all City Employees to take and part of the things we need to do is insure that people are taking the training so currently there is no centralized system to track the training into housing the Population Health division has a central database we targeted started with that that is for all trainings not just interpreparedness in the beginning it ends in 2014 most people took the training by the end of the year 20 and 40 percent there and that was putting the training modules into place and reminding people to take the training a couple of times a year weve got good information but tlokd it has its own link 0 and structure and to come in without knowledge is setting people up to not being successful the second reason the it is tied to reimbursement as many of you may know if you follow the news how difficult it is to get the reimbursement for Different Reasons and we want to get the easiest reasons out of the way to people that respond have this training our goals to first of all, centralize and amy care to track their training were move to a Training System that hopefully, will be able to track training and finally for the general fund effort a trainer position approved well be hiring a trainer into our branch we were excited to have a trainer to be able to go out to the branches within depending training is one thing if you train people how they respond and so you can pass that through our response there are two ways we respond one through exercises and the other through actual activation in 20142015 we had two kind of big events few years or first our statewide medical Health Experience that happens in november and this years november last year was special that was a regional effort so it was a much bigger experience and a fullscale experience which means we worked all the way to making an actual activation and last year was ann tell you one of the mandated things we have to be able to provide for a bio terrorism scenario is important it put a lot of i burden on the indicting to provide for the city as you can see the mass can work in a pandemic where youll mix that with the scenarios would be useful we did that in 2014 and had over a hundred people participate as i mentioned a month ago we talked about the response and over a hundred person were assessing that and developed ways to help to help with the Emergency Responders in a disaster one of the things we do with the responses qi is built into Emergency Preparedness throughout the industry not only in the department of Public Health a activation whether an experience or actual response you have to do an action report you talk to the reported and the partners and what went wrong and what are the improvements for next time one the other metrics were trying to do is measure all the things that have been coming and making sure were constantly improving and all that information gets just want updated in the plan ive move to the Second Partnership our Health Care Coalition on preparedness the Hospital Preparedness Program has been typically focused on hospitals and we have a great relationship with our hospitals here we come together monthly to talk about what with disaster krofrnts so similar some of the works what we participated in there was a tabletop that occurred on ucsf we had a major earthquake fundamental experience and a lot of experience at sfgov and ucsf and statewide experience one of the things meerp or they were concerned about the actual shooter portfolios we brought trainers to provide some training to the hospitals and this year theyve identified some key objectives and trial try to identify cyber and help people prepare for an incident the other thing ive tried and the branch tried really since come together is that hospitals actually are a fraction of the health care in most medical care occurs outd outside of the hospital so this is important we part of it in a big incident you get a lot of people that go to hospitals if we can have some of the patent in ambulatory care centers that will help to streamline and get the people that urging need the care and Long Term Care facilities home heartache Residential Health and pharmacies theyre all big partners one the goals this year to really start to get better at being able to engage different entities in the Health Care System and figure out ways we can insure they have preparedness plans in place and finally i wanted to talk about Community Preparedness so the Mayors Office actually received a grant for one of the hundred resilient citys in the u. S. That was the funding has funded a group of people that including or loud a group of people to come together and work within San Francisco and the department of Public Health has been part of the group about the environMental Health and evil Health Emergency branch one the things we come together and talk to the neighborhoods about climatic change it is a good effort because the first thing we talked about was heat and San Francisco has gender a number of heat waves one that was last week and because of the way that San Francisco is structured the temperatures are going from 85 to 90 can be harmful to population getting that information out there and building the Community Partners and what this is really focused on not just providing information but getting neighborhood to start discussing how the neighborhoods are going to come together to provide centers for people or check on the children or elderly in the neighborhood and theres been great response that have come in one the things im going to do is im going to oh, i think okay is that it perfect. Thank you i just wanted to share this website that the Mental Health department created it is extraordinarily on climatic change it talked about the saefltz and extreme heat and air quality and one of the things it has an indicator map we can go allergy neighborhoods and figure out silvers the map this has broeblgd the city by indicators you know it focuses on some of the climatic change for well be helpful for el nino but has great information has great information about vulnerable populations in the city so the percentage of people that are over 5 and the percentage of people underage 5 and people with disabilities how that shakes out in the San Francisco map i found it this transit scores that will be useful for hazards not just climatic change i wanted to share a little bit about this might not help us but a number of maps like this that cuffs indications how San Francisco shakes out with other indicators i wanted to share i feel like this map has helped all the maps have helped with our preparedness effort. Okay and then but the final nifltsd of niflts i want to talk about someone that came up and discussed what was some of the gaps they saw we specifically did with our Emergency Response team and the Residential Home Care Staffing administrator they felt that psychological be able to care for people as if a disaster happens and when anxiety or fear or worry what tools they can help out with people theyre serving so we provided a training or actually multiple trainings to give psychological is a basic training moan can do but helpful in a disaster situation to the training was received by over 2 hundred people at different percent and it has reviews people were excited and plan to persian that i wish to out to people that are interested so i know that was kind of a quick big overview but developing a cultivate preparedness is what we do and on the depending we want to do the training and response and insure that you know the critical improvement recommendations that weve created through the ports are incorporated into our ongoing planning and we need to foster and continue to expand our exciting u existing relationship ill leave you with the drop cover hold on i tried to tell everyone in case of a earthquake i want to thank the staff and the work they do ill stop here. Well, thank you. Is there any Public Comment. Ive not where he lived requests. Commissioners comments or questions on the presentation. Yes. Commissioner. Thank you for this you pointed out how this cultivate of preparedness which obviously is important we if you dont continue to use those bills whether the language of Disaster Preparedness it is very difficult remember i guess my question is as you do those coalitions and critical lessons leader you have that can inform the day to day nondisaster how week we take Disaster Preparedness and how we sgrak with one another. I completely agree one the great things about this system it used by all agencies in the Public Health department and not using their own language but what he really think about is just planning we all planning we plan everyday and we all take out insurance around catastrophes what am i going to do when an earthquake hits whenever we talk to staff or anybody it is the Immediate Response am i okay is my family okay do you have an emergency back up plan that is starting with the fundamentals and getting people to think about their families and themselves first because that is going to be the birth barrier and you will have that is part of planning which a lot of people can do on a day to day basis i think being able to get that i guess that story in with people that this is really about keeping you and your family safe and then you know coming in and helping out the city that resonates with people the one thing we can do so not a special but everyday occasion both in personal and also in the way we sgrak with the division to division i think that is the less special the more effective over time. Yeah. I totally agree i think there are times we can use the ic s anyone can be the constant commander and for example, the unit will be coming to the executive team some of us are not the city and executives what are you going to do when you live in oakland and something happens in San Francisco in the middle the night what steps we practice we we need to do in terms of being prepared we can use the ic s for any project and doing that i think we learn from the ebola process one of the things to keep the clinic people if their place and not pull people maybe two to three hundred people in the building didnt have the clinic process we were able to find what what kind of skills and able to staff to be able to provide all the services needed for the ebola process sxhud tracking individuals we didnt center to empty out our clinics but looked at other folks and the ic s structure would be helpful and there are types of large responses that may not be emergency but provides use it would be a center for any type of Service Shell be at the department of Emergency Management and telling me what to do in terms of system it practices leadership and anyone of one of us could be many my seat or her seated. I love the resilience of the neighborhood the grassroots equivalent and your successes it would be interesting to hear an update over time i think that is good and do you include schools like all the Public Schools in our coalition. Theres a picture of the coalitions you have. The schools are part well sfusd is part of the citywide meeting and coalition when we go out into neighborhoods a lot of times people side especially the children do talk about the schools and we can bring in the schools system or sometimes they with go directly to the school system. Thats an important part of the system. Absolutely. We have other School Systems schools the Catholic School system. Commissioner sanchez. I thought that was an excellent update thank you very much for presenting it does he just want to reinforce we have a major responsibility to have 24 7 certified supervision and training in all units that were involved in and i think part of the dilemma as director said given the fact we have many of our people that dont live within the city time is a key variable i know over the years in a number of different protocol going back to the 60s the respond to nonagency and the hospitals to bring it down to a specific block of Time Training and supervision was where the rubber meets the road we need to do those things might be not once or twice or 3 times a year given the world it is more mandated we really you know upgrade and insure that is ongoing priority because it also means we have to work within the agencies of the city there are a lot of limbs and one of the major problems is communication and that folks are only different frequency but all the new things now we can do abc and d but at the same time supervision and training and as i said we need that and i look forward to that well be implementing and working with the departments if, in fact, folks cant get in now that the Police Department has a number of police folks they especially\have before years ago we had helicopters and other aircraft to the airport those things are no longer used so im saying were a Trauma Center and how do we navigate that when in fact, we have the childrens hospitals what im saying all these things a lot of dialogue about you know the time variable the barriers because a new mission bay we need not have command centers and responders there but if it takes place where the giants are playing whatever all those things we have to keep a clear focus we interact with the community and have a responsibility pertaining to buy logical im saying as we move forward ill courage us to make sure we have you know some excellent supervisors people responsible so we have on call twentyfour hours a day and a isnt available i know with b c and d do we have the ability to do Due Diligence otherwise Serious Problems all im saying i know we can do it working not only with our own foekdz folks in the community but the institutions and agencies and thank god were the city and county of San Francisco we dont have to navigate with the santa clara and the other boards whatever were one the same service we have a unique opportunity in the city of San Francisco with the Health Department one other point i notice we have the hazard experiences and training you had a great job i hope youll get shots in october with fleet week in the past particularly a lot of the training consensus that are involved if hazardous experiences and training come up from Camp Pendleton and work with the general and set up fields units and open things with their air vacancy units and i believe one of our nurses who is also a admiral in the navy is going to be involved in one the blts panama canals for the fleet week and great to have people to take into account what is provided to the city because we have limited access to look at the latest updates with a number of areas we you mean will be responsible for this is a very good report and thank you. Thank you supervisor bedrosian. Thanks for the report so the focus on communication is such an important part of those exercises to prepare for what the chips are down i was wondering where you could talk about that and one particular case like ann tell you were not only the only one worried about it federal agencies that are forming around here where are we in our journey of making sure we have as seamless coordination with them. Thats a great question one the things i think is a strength of the bay area we act together and there is the Bay Area Health officers and a preparedness so the preparedness we come together monthly to discuss different issues and willing on the preparedness and specifically the boy logical portion bio watch which is the organization that monitor for those incidents also cvs has quarterly meeting and there has been extensive plans we tested this last november which are the steps and the health call and the decisions how are we acting as a region it is important if San Francisco is doing something in alameda or san mateo we need trust we are committed as a region to come together and talk about the differences and come up with a plan how to move and what are the recommendations are we going to do as region and what did does that mean with depending and the feds and tested in october because of the this fall as you can imagine with the subdivide come on here there will be a lot of folks coming in the city well be practicing those communication protocols. You say that which agrees are involved. So fema, cd c and hums representatives and others it is a huge cgroup. Thank you. I have a question on the Community Preparedness i im trying to understand since 1989 chinatown has a program that is going on underneath prairie particularly for many years they didnt really have enough support to try to maintain and they piece together a number of you know coalitions to support i should say remaining as a coalition to continue to deliver the care youre here talking about building resiliency neighborhoods i recognize that is only the puthd and ems has a major respondent to how are you integrating it so youre able to support the neighborhoods this was with an of the issues that actually was brought i know that mission tried it also i dont believe they were able to sustain it but i think chinatown still has it so what roles do you play to help to support them and theyre the community that has all the sros and a need for coordination of services these people without a Disaster Needs care. Thats a great. 1 of the things you you know exultant is a big word the way that we go into the community what youre goal is it is because of the people on a day to day basis struggling during a disaster it is going to be very hard and theyre the people we need to support the most the other part going out into the community and having communities identify where we can help i dont want to come in and make assumptions we need this we and cant do it but other departments we can start you know making the connects weve been out to chinatowns ill say chinatown suffers from one the most organized communities that ive come across we really have a wonderful plan in place as you may know they have their ic s systems and ham radio operators that is incredible so in any way we can support them were glad to do it this neighborhoods thats been set up but the office of administrator is has been working on neighborhoods weve only covered three or four neighborhoods but chinatown to cover all the neighborhoods another some point during the hundred city resiliency period does that answer your question. Well, not exactly it was sort of a do it yourself project it sounds like it continues to be i was hoping for more support on a citywide structural basis that takes the exultance that are already organized and try to add to their support and im going quite sure i heard that you were actually doing that if they have a need come and talk to you. Actually, im going back what happened a big citywide thing call do spur System Community come together to communicate up to the he oc level unfortunately, that never actually got action and chinatown really did it in a good way youre right this system was never materialized were going out into the community and finding out their gaps and start to he figuring outing ways not only Public Health but other issues as a City Government agency so, so not that centralized plan to come together and but more of a Grassroots Campaign were going to each neighborhood and talking about their needs and seeing what is at the top the communities list and if there is no list figuring out what they want at the top of list but no centralized system. No centralized incentive for what your requesting as well through this project funded to the city to try to develop you know something so for us to keep our thoughts about during the budget process but other neighborhoods that dont have any structure as youve discussed about chinatown and there are far, far away if you think about the bayview and how many freeze can, disturbing our abilities took the staff to the community to figure out the barriers getting to the areas if we have a freeway collapse is a big issue we have to coordinate that with the city this is a mighty little team we have but they have 8 thousand employees they can pull upon and have the support this is the kind of work theyve done. I certainly dont want to north america gait it is more of a central question in terms of how and what kind of support theyll be able to give their neighborhoods even as you go out to the bayview and help bring that about theres got to be a some sort of resources for infrastructure behind f it seems to me the city has not had the ability to get counsel into the grassroots as you are now talking about trying to reach and unless were able to provide more facilities in the department in emergency systems i think saying youre only outstanding your own for 72 hours doesnt work for Homeless Population and director is exactly right the problem is at a central level youre still working on. Having may we approach having a personal experience in the loma prieta earthquake we didnt have a contract with the city it took me two years he to get grurjd it was a thought how to insure that the cbo handles the agreement and any cbo has a addendum their broadwaysansome apartments be Disaster Service workers with different responsibility one we can pull to provide the service but also theyre part of the Disaster Response if they have expenses we can respond to them youre exactly right we need to do more of the work not a funded process at this point but something we need to continue to do. Right. Commissioner pating. Ive had the pleasure of meeting with the heartache committee how do we know they were able to see the details in terms of the the Public Health Emergency Preparedness check list a detailed accept preparedness you do and the depth and what impressed me we have to go farther than the airlines a Single Source how we respond or the responded response to the ebola. Some of the questions i know were in continued preparedness one area if he were to have the large earthquake multiple systems taking out the whole city what areas are depressed and what would the Commission Look for to make sure that at least from the Health Department we have what we need to get to what we really have one time big disasters the question where do you think the greatest needs for future development and focusing on where would you like us to support us as we continue those preparedness efforts. The preparedness shouldnt be a special words but i will really exactly and try to make more possible within the department i think you you know the big disaster were planning for is earthquake where all Communication Systems go down the cell phone towers and texting everything we rely on and how to communicate had in that situation how do you get that information and respond when youre not sure what is happening we have a number of systems we have radios and ham radios and we have hear Network System some people dont use because theyre out date and foutd the niece of the city this is the most thing that really bad somewhere everything fails and it can happen weve seen it in the globe the systems fail and people without interested and pour the best way be able to communicate having a plan like barbara is talking about so people dont have to rely on communication they know they have to report to some place so well start rolling and figuring out the impacts the other kind of big thank as you may know the Health Care System is it complicated on a day to day the disaster mode is something that that is really hard to think about when patients are over flowing from every single hospital and ambulatory care is overflowing we have to set up disaster areas looishg like katrina youre getting to a place nobody wants to go but if you stabilize that way youll go there those are places i see as a model you know huge issues that we have to work through as a department as all departments do in the city and you know as we covet start to develop more of the plans and team effort on i shouldnt say plans but train more people on those scenarios that will get us there. I found that reinsuring it makes sense youll do a lot of a triage and get people to fourth where they are thank you very much. Uhhuh. Commissioner mcghee. Thank you. I want to get more clarity about the training you know how for the trainings are. I want to see from the training sets are transferable you have our basic disaster like ann tluks or ebola how do you determine who needs what kinds of training and how many people for specific training. So the trainings i mentioned theyre general trainings only to understand the link 0 and structure so when you got into situations youll understand what the Planning Section and understand what a form is so it is really basic training overview our constant command structure i didnt bring a slide i object to send goes into tit n depth and i think surveillance has a pathetic plan so those people will be preidentified and have been theyre ongoing being identified they have at skills on a day to day basis our environmental heartache has responders that are you know theyve been training to deal with hazmat and surveillance and other programs you know their cable of dealing and with Infectious Diseases but the thing with these the command structure if so valuable you can use it in any somewhere the department has a lot of Technical Expertise and getting the people to go into the structure and be able to respond in any situation and being able to plug into that. When we look at the network for example, those are directly responsible for patients care are they trained as well. Theyre being trained and leslie hopefully, will giving up give you an update arrest San Francisco and laguna honda i dont include them in the training they have a regulate training and when it is requested their up to date on their standard and ambulatory is collecting on their training and im sure thats important. At what point can we say for example everything o everybody has been trained. A percentage or. You know its a great question id love to get hundred percent but with a turnoff no i think over 80 percent of department is trained thats a really good target to hit. Thank you. Uhhuh. Thank you any further questions thank you for a very comprehensive presentation. Thank you. We move on to item 7 which is an update on ambulatory care and preparedness and response. Good morning, everyone commissioners director Barbara Garcia im leslie im the chief integration officer for ambulatory care my goal to rectify the current status of disaster plan and also the activities we employ to insure youre readyness and the maintenance of the continuity of care for the patient in into events whether local list or citywide emergencies before we get into the details of ambulatory response i thought that would be helpful to see and review just how ambulatory care is situated within the San Francisco network youll see the relationship of ambulatory care to the other divisions within the network like San Francisco general and laguna honda this is our ambulatory care structure ambulatory care is come permitted of four Behavorial Health and jailhouse services and primary care the real question i hope to answer today hundred dollars and will ambulatory care maintain services for the care of our patients during a disaster in San Francisco. Currently our ambulatory care leadership are Behavorial Health and operational sections all thankfully in a 1380 power our depending disaster Operations Section is currently located app at 13 howard. Dr. Babe by a talked about coordinating the citywide events and depending responses during citywide disasters 1380 howard serves as a command center for localized incidents that may require ambulatory services some of the functions that the operation section at 1380 howard are intakes and communication of information and triaging of coordinates and deployment of services andes salvation to the depending ambulatory care has a wealth of resources at its deposital for the citywide events for example, our Behavorial Health deploys crisis Response Team that respond to a wide variety of instances from street violence to other incidents they provide family and Community Outreach they also deploy Behavorial Health collisions to determine whether or not those patients have needs to be met in the event that individuals are identity our San Francisco Health Network patients are connected to tare medical home or after hours their referred to San Francisco general urgent care our out of Network Patients that need Additional Health have San Francisco general the Emergency Department or make referrals to their proper medical home within their network in terms of primary care one the main responsibility and goals to maintain the continuity of care for the patients through proactive outreach and ive listed 3 different types of population weve focused on each Primary Care Clinic has the ability to identify quickly its most highest security and utilityers of service that we can proactively outreach to make sure theyre receiving the proper care they need cola whether or not is in the medications certainly our diagnoses parnlts are top tier patient were concerned about most receive their dialyses so we can quickly identify those but each Community Clinic has the ability to identify those patients as well another group of patients would be our methadone patient and o b y treatment those patients typically have a limited supply of medications that theyll need to refill quickly in addition every Primary Care Clinic has their own Disaster Response ban planning that is Site Specific and have their own cash of disaster supplies we have standardized procedures throughout ambulatory care in terms of communication with our nurse center 1380 howard. All the Primary Care Clinics have the ability for triage and if necessary transportation to a higher level of care. In addition our other seconds like maternal child and adolescent health the nurses can be leverage for supplies and assessment of vulnerable populations we have leverage them in the past for clinical diseases they monitor the shelter population and Childcare Childcare and Housing Population and our sros there is also additional ancillary personnel one the maternity those are occupational therapist in terms of jailhouse services their actual Response Plan falls under the San Francisco Sheriffs Department but nurses and medical personnel can be leveraged in the past to respond to a citywide event the Ebola Outbreak of 2014 certainly is a great case study in the need for integrated ambulatory care preparedness once ebola came here the United States was unprepared to deal with the Health Consequences of an outbreak in San Francisco we took a systematic and he strategy approach to deal with that our depending d oc w activated quibble we brought to the table all the interested stakeholders that need to develop an integrate and systematic plan for dealing with this outbreak we had partners from the centers for Disease Control and prevention control and Health Members and Infectious Disease with San Francisco General Hospital and laguna honda out of that collaboration came the ambulatory care responses that resulted in a screening process that cast a wit net in the approach we also leveraged our colleagues at oppositional a health and training to make sure that the training that all the clinics received were systematic and standardized to one clinic was not doing one thing and another clinic Something Else we parishioner listed it by having drills site drills one at for example, at potrero hill the patient was identified and isolated and the treatment started and transported to San Francisco general where the triage patient was met and preceded through the process some of the Lessons Learned was it certainly we recognize how for the needs for this very integrated approach to Disaster Preparedness noble in terms of ebola but other potentially highly Infectious Diseases that ambulatory needs to be prepared that relatives in practices the way we serve and interact with the patients some of the challenges i see the commissioners mentioned how to maintain those competence when you have a high incident like an infectious out breaker we are reinforcing the trainings and trying to develop the marks of success that some of you have spoken about to insure our staff are properly trained and prepared all the time so how integrated are we our response is driven through the ambulatory Disaster Committee on that competent we have representatives if separate including dr. Babe by a and internal health and child childs care and streamlined ours processes and disaster activation is a twentyfour hour operation activity open howard and actually have a server not here in the city by sacramento it is landscape from services here in the city in case there was a citywide event that knocked out for instance, telephones and pager systems we have standardized as possible all the operations not only the clinics but our support and Emergency Office of emergency procedures we currently environmentally the staff who needs training and working with colleagues in our Human Resources department to try to mobilize our e he learning systems to deliver those trainings but track them over time again to tell the supervisor who has and not have those trainings those are ongoing discussions and work today in terms of looking forward to give you a status we have been focusing for the last 9 months an primary care in the first stage how do we prepare primary care the first one that all Primary Care Clinics get a series of model train by rosemary one of the kworntsd and dr. John brown our medical director of cms those are broken down into 3 models the fierce the phases of Disaster Response and the Disaster Service workers and the roll specifically of primary care and in a disaster as noted it delves into the basic structure of i c s one the gaps weve noticed the gap in terms of psychological triage and assessment and moved that to the forefront not an afterthought but Psychological Assessment is being delivered in the acute phase of a responded the second model has nothing to do with with the clinic stabilization of the things that clinics should be prepared and model 3 looks at the allocation of resources weve excused ethical considerations and common needs and reacts is to survivors as well as Disaster Recovery currently, we measure there are 6 hundred of ambulatory staff that have had all trainings but 14 clinics have had all 14 trainings moving i dont understand the training we thought it it very important in this last half of the calendar year to focus on hands on moving from the didact to hands on training two methods this first are tabletop experiences for each clinic management and command staff at each clinic what we do if in these tabletop we have a scenario and walk us through and everybody has disaster their job action sheets we walk through those so including the communication and reports. Following that within a month we actually had a full site disaster hands on during this trial with the triage patients they have a scenario and know what the scenario is and go through the motions of a. M. An actual activation something new were trying out were trying to have tools as measures of success scoring the basic competence who knows what and how did he do in areas of improvement at those full side drills well be trying to look at the capabilities in terms of the surge capability to do the delivery delivery that each clinic has weve developed an evaluation guide and something new were trying instead of having the clinic evaluate themselves were bringing in outdoors that will give us realtime feedback in terms of the outcomes the last phase of our moving forward in terms of our future state beginning in january well be having a targeted focus on the Behavorial Health section our cbo and internal child health the reason for that excuse me. Behavorial health and cbos are dispersed throughout the city and assess we needed to get our arms around we are at the cbo sites were mapping out but also in terms of trainings theyve had and some of the gaps in training theyll need in order to catch up again well be developing metrics specific sections focusing really on Behavorial Health and so with that, ill take any questions the commissioners may have. Thank you questions commissioners . I would just i think this is an excellent report it really covers all the phases with our Organization Chapter to what the focus is and the methodologies and development and training and hands on and measured outcomes also the development of may new tools that are being used in other areas but some should be changed because of the new requirements for the feds to respond to this too so as with both reports their excellence and you really it is well done well done thank you. It seems to be a lot of work in the training and preparedness of that and when did you start on this type of program for the ambulatory fair clinics i guess or did they have something before or how does it integrate into what weve heard earlier. So in terms of the actual models of the entertaining were talking about o those are ongoing for the last two years and taken that long to get all the clinics to actually absorb all 3 off the trainings over the last 9 months taking a rigorous and targeted focus with ambulatory care to get them all up to date in terms of those modules as a foundation and looking forward our goal to have each clinic have their own Disaster Preparedness into their clinic operation not again once a year thing or you know every november we have to get ready but quarterly id like to see each clinic have its on tabletop or disaster exercise their exercising those skills theyve learned. So while you have that goal is that goal that the Health Network has adopted for their clinic training that is easier for you to get the quarterly programs. The goal is more of a mandate because of the recognition that the Disaster Preparedness is integral to our clinic functions not only for the Network Patients but United States dual role as city you know First Responders as well. So it is up to you for you to make any comments from this prospective. Please step forward so we can hear you on the microphone and announce for the folks. Dr. You those are the goals of planning care and clinics. Good. Good arrest. Commissioner karshmer it sounds integrated our sort of the proactively work to identify those folks that are going to be most at risk we saw a disaster about a person being left in the fire and none knew that that is a great segue to keep the ongoing work of the ambulatory care clinic to have those in mind of high at risk so it sounds like youre fully building that into the fabric of the clinic i applaud you for that. Thank you. A comment we heard in the committee it was expressive with the ability to twrak our pablts or patient and make sure they get the continuity of care that was what was with the katrina they had no where to go and redundancy i was reassured maybe you can describe what are your plan if one clinic shut down to you to o how to deter care to another clinic were still taking care of people another the whole network not just 14 landscape sclinz can you expands that will demonstrate the fluidity and the resources. Sure what weve done create a new facility status report not only take account of the physical states but whether or not operations can be maintained with that physical states part of that vornt is personnel what personnel and skills whether language or medical Clinical Skills so on and so forth if those operations need to be crossed down that information is transported it is evaluated and reduction are given where to send staff as well as make plans for diverting patient from that clinic to what one that is closer or can absorb the capacity. Thank you this for getting your clinics prepared and well hope it that you never have to use it, it is there and it sounds like a tremendous amount of work put in place so well have a functioning system in the instance of a disaster. Thank you. Thank you. Thank you. On that note commissioners no Public Comment item 8 other business. Commissioners any other business at this point f you want to bring up. Item 9 is the report back from the laguna honda j. C. Cc on september 8th sky commissioner karshmer. Yes. We had a j. C. Crook crook under open session they heard a presentation think lodged rate presentation on the laguna honda Rehab Program and as well the administrators report also at the open session talked about open wide policies in closed session they talked about the criminal report thats all. Thank you. I guess you have no comment on the survey. Other than it is going on right now and im sure it is going well. Thank you. So move on to item 10 we have Committee Agenda setting id like to to note commissioners as commissioner chow mentioned earlier the october 6th planning meeting is coming up ill send you the details and also note that october 22nd is the joint meeting with the Planning Commission to discuss is cdc agreement i know that all of you are able to make it to remind you for those how didnt say they could attend. Hfa have we sent reminders on that letter out recently. I have not but i object to do so and that is good. There will be a staff report well be receiving beforehand. Yes. Theres were ref is now we want to give it to you in advance for our review and any addition you need and theres a last piece of the Financial Report were finishing up. And the ability to be able available if we could continue that practice that would be useful. Any other comments on Committee Agenda south setting well precede arrest we have a consideration of a closed session. Is there any Public Comment on the closed session. Ive not received any. Were prepared to vote on whether or not to have a closed session a motion is in all in favor, say i. I. Opposed . The commission will go into closed session. Is there a motion in order whether or not to disclose or not disclose. Destruction in closed session. Most to no disclose. All in favor of not disclose or not disclose. All in favor, say i. Opposed well not disclose a motion for adjournment is in order. So moved. All in favor, say i. Of adjournment. Opposed . That meeting is adjournedit. Good morning, everyone. Welcome to the 311 calling center i know that our director nancy welcomes me usually we get to announce another great tool if not a modification of our 311 center the public and residents like to see you know when we first created the 311 center we were here for that start we wanted a tool that lifts the burden off all the vacuums of calls going to 911911 is for real emergencies life or death and whatever it happening on the street currently that will be of the emergency nature needs to be called through to 911 well get an immediate fire and police and department of Emergency Response on that on to day to day basis we have a lot of other calls we have tried to direct those now thousands everyday that come to 311 and were glad because their calls for information, for refers for how to do this and that of the various departments of the city. As you may know weve been active in helping our people on the streets particularly our Homeless Population to get the services they need a challenge because we not had all the hours housing we want were building that as soon as possible and rehabilitating affordable units as much as possible but things happen on the streets our residents say should i call 911 or Small Business i see somebody they dont look healthy weve had a few instances on the street if we had an earlier call appropriate there can have been a health check, if you will, or check on someone that may have not looked at not an be able they doesnt see something happen that is an emergency often myself ive made calls to 311 someone is not necessarily in a door front but passed out and needs help those are things that happen on the street were very congested city we want to make sure that if it is not a 911 call but perhaps there could be a health check or care check on someone maybe 356 can do something about that over the past weeks 36 through the leadership of flabs our city administrator that oversees it w the putting and Police Department and Public Works Department and hot team through dpevenz combevenz hope program to you work tot to respond to what neighbors are telling you there should be an act perhaps something a little bit more modern use people dont have to the time to make the call but can actually with their footprints r fingertips simultaneously complun with 911 and not try to figure out whos responsibility but 311 will figured out for the residents for someone that seize something on the sidewalks we should be able to respond to in this app were excited in the past fewq weeks to see whether or not to develop an app to low people to scroll through a push bum efforts something on this street or particular intersection you need to see and someone should check on this individual ear r we care about the people on the streets and make sure it is not an emergency but ought to being sure to follow up on someone that is in need of help a care arrest health check followed up we created the 3 11 a. M. And i know that nancy will pop up it on the details i want to lead this effort by saying a big thank you to her team working with all the other departments they want to also be able to get to where someone suggests to us there might be something that is happening with someone we care about i believe that this is an infection of combpgs of the city having a deeper compassion to people on the tree we want to provide it to the right agency to follow up with this is why all the departments here are working together 0 so they can be part of it in the meantime we do what we do everyday the dpw and the hot teams visiting encampments of people on the street we assist them more and more and getting them into places like the Navigation Center or referring the services to the shelters we have or inviting them to the latest project Homeless Connect Program we have all the services housed on a quarterly basis in different parts of city and while we work on short term and long term answers to getting temporary and more long term housing were focused on ending chronic homelessness for the veterans by the end of this year weve been focus on the transitional aids youth and more and more getting the data together to respond to more of our families and youth being homeless through the School District and food for thought creative ways to tackle this challenge a housing crisis in the city were trying to build and stabilize neighborhood as were doing these so a lot of people from the development and the business segment to the nonprofits theyre all collaboratively with our city agencies to do better and Barbara Garcia and i are working diligently with interpreting moreno has has as we introduce trying to figure out the Mental Health and challenges happen on the streets in the meantime we ought to make sure that the things happening on the streets can be respond to weve done with the 311 app to invite the people the people that walk our streets an ability to communicate request City Services that do care and will respond to situations on the street and particularly to people who might be on the street in need of something may not be a 911 situation i want to distinguish between 911 and 311 911 will continue to be the number everybody calls if there are a true emergency if something something is happening whether a Public Safety issue or health issue but 911 is where it may not but in your mind someone ought to follow up with something and persons on the streets we dont know all the time whether in immediate need or not but if it appears to someone that someone is in need that they dont look like they are comfortable at all perhaps this is where the 311 health check ought to be had with that, id like to introduce over the course our director of 311 nan ofarrell to go over the details thank you, mr. Mayor for your asking to implement those changes all of us can make a differences by reporting streets events at 311 were looking at improving ways for the public to connect with government over 50 percent of the questioning requests for broken street lights we see the demand is high for people wanting to assess Government Services and expanding the 311 app of nonemergency to include homeless concerns a convenient way for the public to be proactive in reporting issues as they see them at this time id like to to a thanks my team as well as the departments here the office of hope and department of emergency and the Police Department and public works the Public Health department and the City Administrators Office took all those departments to build a partnership today with this ill introduce the police chief greg suhr thank you. The nonemergency number it cant be stressed enough that the way to report on emergency is still call 911 if you want or need someone in a hurry you have an emergency something that process or someone in danger youve got to call 911 with that said, nancy and the team she mentions to come up with that 311 app is a fantastic way in a city that, you know, how the Innovation Center of the word now to come in the term an app we met this smurp is mo magic and the Mayors Office and the hope sf and one of the things we have is apps to reporter things we have an entire generations that has touch phones it would be great for a whole tech safer i didnt city like San Francisco to call on a. M. We could be headed for a especially pick winter and make sure that everyone is taken care of this 311 app will go a long ways not only is it about time it is timely this year ahead of a wet and cold winter to take care of the less unfortunate none can imagined how much they need you applaud the team behind me certainly the mayor that know how and nancy alfaro shes modest but nothing short of a he or sheic effort before the winter is upon us to check on the wellbeing the less unfortunate fortunate i appreciable are appreciate it now to introduce the next member of the team from fellowship this would not have happened larry sprinkler. Morning public works is out on the streets two r 27 we understand were facing challenges this app hemming heels a lot thanks to the leadership the mayor and nan alfaro for alexander this to the app we have 3 pro activities crews through the city many times a week we may adjust and be responsive as well as with the predefined im looking forward to getting the data to evaluate the route, however, with this information allowing the public to report it will gridlock help us to go our job. Ill now introduce my other partner Barbara Garcia. Good morning were excited about this new app preservation our Homeless Team has doubled the members on the team weve responded to 311 but multiply calls someone calls 311 and determine what status it is with this new app well have that directly and that will help us in ronalds to the call i want to note the deducting 23 23w47 programs people are i will are picked up were able to provide that care as an e in San Francisco General Hospital we have teams that are out there we have teams that go out to homeless issues and violate issues on to twentyfour hours those are Homeless Teams in every district and compared to the 311 call theyre excited and trained and ready to continue as i walk down the street i see everyone with a cell phone the public will be responding as they help those no need and make sure the public we respond to the Homeless Needs to the community thank you very much. Now i will introduce Erica Sandburg shes an example of a Community Member began calling and helping us lead this program. Hi so, yeah im a resident of San Francisco i am a lover of San Francisco as soon as i set eyes on the city i fell in love he have a daughter a Second Generation san franciscan it is unconsciousable it is so depressing and so upsetting to walk by people every day on particular every block and say i cant help them i so ordering my neighborhood and beyond we have to something has to be done is it not right who can we call not just helping people on the street but combrrn the neighborhood this is okay. We cant continue to walk by so someone had a great idea there should be an app everyone has a smart phone and next thing i know theres an app great idea and great minds think alike i vibrate an what is happening he want it on everybodys phone and i want it on visitors smart phone in ms. Shorts windows they download this app lowerincome and moderate income a major victory of that because it is so necessary we need to find a way to get those peoples anybody this is getting them off the streets im a huge optimistic this is a great way to go i couldnt be more excited i want to get the word out i love innovations it is San Francisco and so thrilled absolutely atheist and happy to be i dont know who there you go. Prior to concluding i want to show the types of concerns record to the app and this demo. inaudible at the top inaudible that concludes this event thank you very much for