[ gavel ]. Supervisor cohen good morning, ladies and gentlemen. I want to welcome you to the budget and finance Committee Meeting. This meeting will now come to order. This is the regular meeting, regular scheduled meeting for the budget and finance meeting. Im supervisor malia cohen, chairman for this meeting. And to my left is supervisor tang and to my right is supervisor yee. Our clerk is mr. Victor young. At this time, id like to thank our people at sfgovtv for televising this program. Mr. Clerk, do we have any requests . Clerk please. Please silence all cell phones and tablets. Supervisor cohen all right. Thank you, i appreciate that. Well, colleagues, as i say, lets go ahead and dig in. Well start at the top of our agenda. Mr. Clerk, call item 1. Clerk item 1, resolution authorizing the exercise of an option to extend the term of a lease for a portion of the second floor and entire fourth floor at 1145 Market Street for five years, subject to citys right to terminate, for the period of july 1, 2018 to june 30, 2023. Supervisor cohen thank you so much. Do we have a representative here today . Anyone from real estate . Im also wondering if we have anyone from the law library here . Now unfortunate. I believe we continued this item under the impression that the executive director would be here. Well, mr. Updike, its good to see you. Another controversial item to talk about. Good to see you, too, chair. Supervisor cohen take it away. I believe much of the discussion today was to be around the met ribs of the law library and a resolution, so im happy to answer any questions that you have after considering the items first present presented. Supervisor cohen thank you very much. I want to recognize my colleague, supervisor tang. Supervisor tang i was under the impression someone was going to be here, so i dont know if we could delay this item until later in agenda, to see if someone was going to come, because i did have follow up questions. Supervisor cohen no problem. We will continue with the rest of the agenda, and mr. Updike and the rest of the team, well just have to revisit this. All right. Mr. Clerk, could you please call item number 2. Clerk item number 2, resolution authorizing the recreation and Park Department to accept and expend a grant of 110,000 from the San FranciscoParks Alliance to benefit the departments Scholarship Program. Supervisor cohen nathan sinclaire . Good morning, supervisors. So im here today to request your approval of a grant from the Parks Alliance of approximately 110,000 to benefit the departments Scholarship Program. This grant was generated from the annual crab fest fundraiser event which take place each february , and flap fest was founded by former supervisor Shawn Ellsworth about a decade ago and has supported our departments chop arrestship funds each year. Last fiscal year, the Department Awarded over 1. 2 million in recreational scholarships, and we expect this number to increase this here to help even more San Francisco resident access recreation programs, and i just really cant emphasize enough how important the program is to individual folks. Each scholarship allows a resident to take sports or dance class with others in their community. Ill just say that the Scholarship Program is particularly important to the departments youth programs, and ill just close by thanking the Parks Alliance for their partnership on this important fundraiser and also just mention you to save the date for the 2018 crab fest, which is thursday, february 22nd. I know some of you have attended in the past, and were just treely grateful to have your support for this fun krisk tradition, which ensures that all residents can get out in play. Supervisor cohen all right. I have a question. Is this the 110,000 that were dealing with today, is that the total amount thats been raised . Correct. The parks and rec has a cost for services, as well, and this is the most that weve raised through the Scholarship Program through this grant. Supervisor cohen all right. Thank you so much. Colleagueses are there any questions or comments at this time . All right. Its time for Public Comment. Ladies and gentlemen, its time for Public Comment. Youll hear a soft chime. Youll also see on the dais before you, how much time you have remaining. If youd like to come on up and speak on this item, come on up and speak at this time. All right. Seeing none, Public Comment is closed. Colleagues, lets get a motion on this item. Supervisor yee make a motion to present this item to the full board. Supervisor cohen all right. Well take that motion without objection. Item 3. Clerk item 3, resolution retroactively authorizing the department of environment to accept and expand a grant in the amount of 447,370 from the association of bay area governments to develop and test Pilot Software and perform Energy Technical assistance for deep Energy Retrofits in small commercial buildings. Good morning, supervisors, peter gallardo. These grant funds will be used by the department of environment to improve Energy Efficiency in small and medium commercial buildings in San Francisco, and as you know, supervisors, the department has been offering Energy Efficiency services and incentives to small buildings and businesses in San Francisco since 2001, and Energy Efficiency not only helps us reduce energy use and meet our Climate Action goals, but it also reduces operating cost does for Small Business employees and owners, so this will help enhance Services Offered by our energy program, and help ensure retrofits for up to 1700 small and medium sized buildings in San Francisco. It will help to develop software to identify Energy Efficiencies in the buildings and the department will conduct this work through existing positions over the threeyear life span of the grant, and were here today to ask for your support and happy to answer any questions that you have. Supervisor cohen thank you. Just for clarification, the grant supplies four positions, as well as materials and supplies, is that correct . Thats correct. Primarily staff positions and the potentials for some contract work. Supervisor cohen thank you. Colleagues, any questions or comments for mr. Gollatta . Seeing none, well open Public Comment. Any member of the public wishing to speak please come up to the podium. Seeing none, Public Comment is closed. Supervisor cohen item 4. Clerk item 4, resolution approving an agreement between Epic City Government and the city and county of San Francisco acting by and through the department of Public Health for the delivery of software, services and hosting for an Electronic Health records system for a term. Yes. Dph is here to request approval from the board of supervisors to enter into contract with Epic City Government, llc for the electronic city record system. I would like to give some background to this request. The Electronic Health records system is used to digitally capture all hospital and Medical Clinic system. Currently, department of Public Health support approximately 550,000 patients encountered p peryear, with approximately 650 billion in annual revenue. It also allows us to comply with rules and regulations so we can keep our accreditations. We have a patch work of systems that this ehr will be replacing. In addition, this new system will allow us to manage our risk due to our endoflife system that will be in the supporting 220. This system, the ehr system, this contract will provide us with software, support, implementation services, maintenance services, as well as hosting. This product was selected through an rfp process. The ehr system is needed for department of Public Health of San Francisco to improve our patient care outcomes, as well as to avoid any potential financial risk due to inability to bill as our primary system is going offline supervisor cohen pardon me, mr. Kim, in what way does this increase our ability to provide better out patient care outcom. Im glad you asked, supervisor. So this slide here, if you we have a patch work of systems. What that means is we have multiple disparrate ehrs connected by a thread or you could call it integration, but at the end of the day, what would happen, when a patient shows up, the doctors ors nurses does not have a single picture of the patient, a whole picture. What this new system will allow us to do is have that in one place so we can actually apply better coordination of care across Public Health. Supervisor cohen thank you. Would you like for me to continue . Supervisor cohen yes, please. So anticipated scale of the ehr project thiis multiyear. We have a budget at the coit Communication Technology plan for five years that we submitted, but we also have a budget for ten year we project ten year is the life of the product. Okay. At the coit, we submitted 223 million for five year, however we project that ten year cost will be 337 million, including the contingency. As you note, the ask for this contract is 167 million, which is a lot less. The reason for that is theres a significant cost that we are actually estimating to do several things number one, we need to ensure we backfill our clinicians while theyre getting trained. Number two, we want to ensure we have effective change control, the change control being all the work flow at dph where it involves patient care will be retooled, and we need to make sure we train everyone, so thats where a lot of the costs are going into, so the software and everything is 167, and the remainder of implementation and support internal implementation and support and backfills. Supervisor cohen okay. Are you almost done . Actually, this is the last slide. If you have any questions, we do anticipate going life with the first phase in 2018, with the second phase going life in 2020. Supervisor cohen all right. Well, i appreciate the background, but the Budget Committee, so lets talk about the numbers in the budget and how much this is going to cost and how we are going to be saving money in the longterm, so maybe you could talk a little bit about that. I mean, the resolution is to approve 167 million, so if its okay. Greg wagner, our cfo will be taking over for the numbers. Supervisor cohen sure. Mr. Wagner, good to see you again. Good morning, supervisors. Greg wagner, chief financial officer, department of Public Health. This has been our plan to get this going for the last several years. We rely on the Public Health system to bill medical and medical and Public Health insurance, so when people are receiving services in our facilities, we document that, and then it gets sent a bill to draw do you know reimbursement, so in any given year, we are relying on this to draw or bill any direct costs that are in excess of 650 million peryear. So the biggest item is we do not want to put ourselves as risk for deterioration in our ability to draw that reimbursement. This also the new program and the integrated ehr should allow us to expand our ability to drawdown funding. The reason is it gives us tools to better capture services that were providing into the billing system and more efficient tools to monitor our billing and our financial performance, so this is definitely at the top of our list for priorities for our longterm financial sustainability. The cost is high, but the cost of not doing it is significanty higher. Supervisor cohen all right. I appreciate that. Colleagues, are there any questio questions dealing with the budget . Thank you. Well take Public Comment on item 4. Seeing none, Public Comment is closed. Colleagues, what would you like to do with this item . Supervisor oh, excuse me. Youre absolutely right. There is a bla report. My apologies. Good morning, chair cohen, members of the committee. As mr. Wagner pointed out, the implementation of the new medical records system has been in the ict plan. The supervisors did appropriate funds in the 1718 and 1819 budget for this contract, the contract itself, the base contract is 149 million over ten years, or approximately 14. 9 million peryear. Dph has also included a 12 contingency in this contract, but in our discussions with them, the contingency of that 18 million would only be used at dphs sole discretion for unexpected increases or Service Increases that are not currently anticipated, and we recommend approval. Supervisor cohen thank you. I appreciate that. Based on that recommendation, colleagues, do we have a motion. Supervisor yee ill make a motion. Supervisor cohen and the motion is to do what . Supervisor yee pass this motion with a positive recommendation to the full board. Supervisor cohen as a full report. Mr. Cleyunk, did you get that clerk yes, to make a full recommendation with the report. Supervisor cohen yes. Item number 5. Clerk item number 5, resolution retroactively authorizing the department of Public Health to enter into a performance contract between the California Department of Health Care Services and Community Behavioral health services, incorporating the Mental Health services act, projects for assistance in transition from homelessness, the Mental Health plan, and community Mental Health services grant. Supervisor cohen thank you very much. Excuse me. The floor is yours. So we are asking for approval for resolution in support of Behavioral HealthServices Performance contract with the state department of Health Care Services, and theres no money attached to it. What it is, the state wraps all of our data reporting, Compliance Standards into one contract to clarify our requirements connected to these different funding streams, and we have to do this on an annual basis. Supervisor cohen is that it . Okay. Colleagues, is there any other questions . All right. Well go to Public Comment. Thank you, miss simmons. Any member of the public wishing to speak on item 5, please come up. Seeing none, comment is closed. Mr. Clerk sorry. Colleagues, is there a motion on this item . Supervisor tang ill make a motion to send forth this with a full recommendation to the board. Supervisor cohen thank you, and we will take that recommendation. Item 6. Clerk item 6, resolution retroactively authorizing the department of Public Health to enter into agreement with the California Department of Health Care Services to receive federal draw dawn funding for the children enrolled in the county Childrens HealthInitiative Program through the city and county of San Franciscos healthy kids program. Good morning. We are asking approval today for our resolution for the city through dph to retroactively enter into an agreement with the California Department of Health Care Services, dhcs, to receive federal reimbursement for the citys participation in San Franciscos county Childrens HealthInitiative Program, which is embedded in the citys heathy kids program. Healthy kids is a Health Insurance program overseen by dph and offers health care of children 6 so 13 who do not qualify for any substanidized. It allows dph to drawdown Operations Support and management of the healthy kids program. Chcs sent this proposed city agreement to dph in late september of this year, 2017, but the agreement is actually retroactive to july 1, 2015 with an end date of september 30, 2019. Several changes in the past few years including state Level Department transitions of the managed risk medical insurance board, known as mr. Mid, that was commissioned into dhcs in 2014, legislative senate bill changes, which expanded medical eligibility for ch