So maybe thats the worry. Not so much what were doing here, but that there arent enough providers to respond to the weve got a bottle neck, and that has really been a concern from the beginning. Thank you. Yes, commissioners. I have a question. Well, actually, it pertains to actually the education in preparation within the various disciplines. cause you mentioned that we have a very highly trained, talented group of surgeons, and the fact that we have an increase in surgeries, and the increase is decided by our colleague here, i guess the thought that sort of flashed to me is that the different specialties that are certified by San Francisco general, we have, iklike urology, which haa number of specialties in it that participate in numerous, i assume, surgeries here, and they have the Residency Program where they have a major cohort, and their subspecialties, where they have outstanding Training Programs, and the list to rotate through the general has grown substantially. But my not concern but sort of something that we may face is that once we are certified in these new disciplines where their discipline, theyre Board Certified in urology, but all these sub areas that are involved in all this, a number of them are going to other places, especially southern california, chicago, etcetera. Theres a big recruitment going on quietly. Ive heard this from a number of those who have completed programs, and patients who were upset because maybe theres no longer a Spanish Speaking urologist who was a key person there or someone else, and i wondered if, in fact if, in fact, you are projecting that there will be even more demand for us to maintain the highest quality of physicians which we have at the general, as we see its going to be a question of how do we retain them afterwards, even though who are in the bay area and could rotate through there when the competition in other parts of the nation is on the radar . I wonder if you had any thoughts about that, and the challenges . So something i think is true, is San Francisco is San Francisco, and we are doing things here that are not happening other places. Were light years ahead in many things. One of the goals for this program that wasnt on that slide, and im not sure why i didnt have it there was, you know, over time, over the next five years, we really want to develop more of a Training Program, official Training Program with ucsf and with zuckerberg, and thats all really exciting, and i think people do really want to be a part of it. And so yeah, we have to figure out how to keep that momentum going, and i think thats true across all of the specialties that are doing this work. It is theres only a handful of people that are specialists, and they are wanted every where else, and we have to keep them. A data point of comment that amongst the eight to ten in Service Training that gender has for staff throughout Public Health, average provider was ten, so over the course of 2016, theyve trained over 100 providers over competence, sensitivity trains, and in their feedback in their evaluations, they agreed or strongly agreed that they felt better that they were able to take care of their transgender patients, especially with regards to their up coming surgeries, that they wanted more of these training and education sessions; that they hoped following the training to use the information gained from the training to create safer spaces and to use what theyve learned to be more sensitive, to be more competent, and really, the bottom line was they just wanted more, so there is the demand out there. Very good. Thank you. Thank you. I remember when the Commission First approved the development of this program and whether it would also be at general, and its nice to see after five years, the fruition of this, and you and your staff are to be complimented. Thank you. Thank you. Thank you so much. Thank you for caring about this and being interested in it and supporting it because it matters. Thank you. Thank you very much. Thank you, commissioners. Ill note that there were no Public Comment requests for that item. We can move onto item 8, which is the sfjph technological report, and i believe the same issues are going to be with us for theph technological report, and i believe the same issues are going to be with us for tgph technological report, and i believe the same issues are going to be with us for the presentation. Good evening, commissioners, director garcia. Office of policy and planning, and im here presenting rdps annual report for our fisking year 1617. Overall our annual report provides a general summary of the accomplishments and highlights across dph in the past fiscal year and is required by our San Francisco administrative code. The design in look and feel is pretty similar to previous years reports, and we have incorporated some of the new branding for the San Francisco health net work, as well. If you recall, draft report was presented to the finance and Planning Committee back in november of 2017, and the version that youve received now, your feedback has been incorporated into that. So our report begins with two messages. One from director garcia and one from our Health Commission president , dr. Chow. The two letters provides our leaderships introductions to the report and provide an introduction to our three feature stories that are introduced later on, which is the progress on the Electronic Health record, dph becoming accredited Public Health department, and the whole person care pilot. Theres also language in these messages around how our programs help address the social determinants of health and dphs commitment for all san franciscans in the face of uncertainty with the aca. The next section, which is about dph, we introduced the two division the San Francisco health net work and the Population Health division, and their roles in our commission to protect and promote the health of san franciscans. Weve also included our 2017 organizational chart in this section, and overall, the information provides an overview of the functions and services across dph. Our last intro ductory section in the report is the overview of the health section. We also include bios for the commissioners that were serving in that fiscal year. Following the health and finance committee feedback, weve incorporated the changes into this section. The bulk of our annual report focuses on the programatic highlights, and these start with three highlights across dph in fiscal year 1717, the first being our Public Health accreditation. We were awarded accreditation on march 9, 2017. At that time we were one of nine Health Departments in california to hold that crediting, and that demonstrates our to the community. The next story is around the whole person care pilot. So the city was awarded additional funds for a total of 161 million for whole person care, which is a medical waiver for california. The pilot for dph is a collaborative interagency effort, with an aim to establish a human centered and seamless system of care for our homeless san franciscans. And the last feature story that weve included this focuses on our enterprise for an Electronic Health record. Our ehrrfp was issued, and it will not an essential tool to continuously improving our Patient Experience and ensuring the highest quality of care for all san franciscans. Then, moving forward past those three major accomplishments, we also have included 27 shorter highlights this year, showcasing dphs commitment to our mission. There are nine highlights around promoting health, which include our Bayview Health zone, sf quits. There are 12 on protecting health, including reenvisioning jail replacement, vision zero, and weve included six on our infant structure and ourlene,lene being the key priority for the department. Highlights were collected across our services, our programs, and they showcase our key programmatic work across our division. So following the highlights, we do include a major part of the report on data and numbers. First we have our dph budget. We include the revenue, expenditures, and we highlight investments that were made for fiscal year 1617, including the 2. 8 million that we invested in Specialty Mental Health services for youth, and the 1. 5 in ongoing Human Resources efforts for the department. The next is our San Francisco health net work data. It incorporates encounters across different visits and patient demographics across our hospitals, primary care of mental health, Substance Abuse and jail health. Theres been a lot of effort this year across the network to create a standard data methodology to ensure more accurate, clean data moving forward and the aalignment with sfgphs annual report as well. The next report is the Public Health data. It focuses on the six areas of the Strategic Plan with key programmatic activities and impact metrics within each. Weve also included an additional metric on black African American health based on the feedbacks from the commissioners in planning. That was based on hypertension control. And lastly, we include the 13 Health Resolutions to showcase the major policy actions of the commission, as well. The last section of the report, youll notice, includes our Service Sites and our contractors. The maps that weve included for Service Sites have been updated, and they follow our new branding for the San Francisco health net work. Weve included one on primary care, and one for our citys Behavioral Health site, and weve included a note now that all of our contracted sites for Behavioral Health couldnt be included due to the number. We then end with our Community Contractors to acknowledge their contributions to the work that we do here at dph. So moving forward, well finalize the report after your if you have any additional feedback, and then, the final report will be posted on our website, and you will all get copies printed copies, funding provided by the Public Health foundation, and with that, ill conclude. I thank you all, and if you have any questions or feedback, id be happy to take it. Commissioners, questions. The staff has taken the comments very well and has i think produced a marvelous report which balances the enormous work that this department has done via i didnt count the number of highlights, but you said 27. There are 27 and then three major additional ones, for 30 total. For those who want to read about the programs and those who are more data driven, can see the numbers, so its a very fine balance of both, and i think within the highlights, there are also numbers, those of us who like to know how many people are really touched by these programs. And i think the staff has done a marvelous job in presenting a report that demonstrates that our 2 billion organizations done. Although it suddenly dawned on me, we probably didnt actually discuss any of our research this time, did we, in this . I dont think theres too much on that. And a portion that this department does and maybe that is for the future in terms of adding that as a component because that certainly is a very important part of what we do. And i think youve captures,d, think, both the programmat particulprogrammatic problems and individuals in our entire city, and i think maybe research is what were missing. Sure. But i and the reason i gave this comment was that i needed to have found a copy of this to read within the past hour and are i was overwhelmed within that period of time that you could just feel the energy that you put into and that the department does. Just know its out there, almost every second of every day, doing something in some part of the city, and for somebody. That was the impression i got just reading the document this morning. Thank you. So commissioner cavekarshme . Yeah. I just wanted to thank you for the work. Its pretty impressive . Yes. Im want to thank you for yor work on this report. I agree with my colleagues. This is very easy to read. Sometimes these things are hard to read, and its laborius, you put it beside your bed, on your night stand, but not this. You look at this, whole section by the numbers. How many things [ inaudible ] there it is. Where are the sights . Whats our mission . And youve done it. Our staff its really a useful document. I mean, it isnt just something to look at and say oh, wow, it really shares the heart and soul of what were doing, and our partners that are involved in this total process of Public Health in San Francisco. Well done. Thank you. Thank you. And im wondering, as youre finishing a draft and just to, you know, go back to that thought of research, you think we should put maybe one page, and the amount of research that we are doing, and then, we could expand that next year a little bit more . cause this does go to the mayor and the supervisors, and it would be really nice to be able to have them understand that not only are we also delivering services and keeping the health of the city in check here and improving it, but that were also creating research and informing the world. I dr. Aragon is probably the person you could work with for his section. I dont want to delay much more when we need to move it forward. I think we can do that very easy, yes. And then, as we have in the past, we can forward this with a letter to each of our board of supervisors and the mayors office. Does that sound reasonable, that we could perhaps add one more page, and then, we would expand on that in the following year . I can work on that. Okay. Thank you very much. Thank you. Was there any other Public Comment . No Public Comment requests for this item. Okay. Thank you. Item nine, commissioners, is other public business. And you have the calendar before you. Theres nothing noted in terms of special meeting notes, as we move forward. Were there any items from the prior year that we had not completely covered or ain calendar. I took the past two years calendar and forwarded all the items that we had calendared in the previous years, and any items that we havent done, i put it forth on this calendar, so right now, the answer would be no. Theres nothing undone from the previous years. So we begin with a clean slate. At least trying to. Okay. Thank you. Commissioners, any items you would like to place on the calendar at this point . I think we already placed one, which was the food program. Right. I should say food security, right . Which i think will probably go in the fall after director garcia theres more work to be done on that in the department before that comes forth. Right. Shall we move onto item ten, the jcc report back . Okay. Item ten, and ive lost my agenda. Commissioner sanchez . Commissioner sanchez . A report back on the jcc meeting from february 13th . Yes, commissioner sanchez . The joint Conference Committee for laguna honda met on february 6th. We approved the minutes of the previous meetings. It was primarily closed session, reviewing both the quality reports and the medical credentialing reports, so that ends our meeting for on that. Any additional comments . Okay. Our next item, then. A consideration for adjournment. So a motion for adjournment is in order. So moved. And a second . Second. All in favor, please say aye. This meeting is now adjourned. Thank you. A lot a ton with the community and we say to ourselves, there is this one and this one. We all compartmentalize them, we have our own agenda. Our agenda is to create great work. If you are interested in that, you are part of our community. Hello and welcome to brava theater. We are trying to figure out a way to make a space where theater and presentation of live work is something that you think of the same way that you think of going to the movies. Of course, it has been complex in terms of economics, as it is for everyone now. Artistically, we have done over 35 projects in four seasons, from producing dance, theater, presenting music, having a full scale education program, and having more than 50,000 visitors in the building almost every year. A lot of our emerging artists to generate their first projects here, which is great. Then we continue to try to support figuring out where those works can go. We have been blessed to have that work produced in new york, going on to the edinburgh festival, the warsaw theater festival. To me, those are great things when you can watch artists who think there is nowhere else that might be interested in you being a woman of color and telling your story and then getting excited about it. That is our biggest accomplishment. Having artists have become better artists. What is. Sheri coming back to brava, here you have this establish, amazing writer who has won a clue slew of awards. Now she gets to director and work. Even though she is this amazing, established writer, the truth is, she is being nurtured as a director and is being given some space to direct. The play is described as ceremony and where ceremony and theater me. In the indigenous tradition, when you turn 52, it is like the completion of an important era. The importance of the ceremony is to say, you are 52. Whenever you have been caring for the first 52 years, it is time to let it go. Really, here, they have given me Carte Blanche to do this. I think it