Services are going to be met. To be confidential but i dont have to worry about anyone looking at me or making me feel less a visit with a clinician come take anywhere from 10 minutes if you have a straightforward concern, to over an hour if something goes on that needs a little bit more help. We have some testing with you on site. So all of our samples we collect here. Including blood draws. We sent to the lab from here so people will need to go elsewhere to get their specimens collect. Then we have a few test we do run on site. So those would be pregnancy test, hiv rapid test, and hepatitis b rapid test. People get those results the same day of their visit. I think its important for transgender, gender neutral people to understand this is the most confidence, the most comfortable and the most knowledgeable place that you can come to. Onsite we have condoms as well as depoprovera which is also known as [inaudible] shot. We can prescribe other forms of contraception. Pills, a patch and rain. We provide pap smears to women who are uninsured in San Francisco residents or, to women who are enrolled in a statefunded program called family pack. Pap smears are the recommendationrecommended Screening Test for monitoring for early signs of cervical cancer. We do have a fair amount of our own stuff the day of his we can try to get answers for folks while they are here. Whenever we have that as an option we like to do that obviously to get some diagnosed and treated on the same day as we can. In terms of how many people were able to see in a day, we say roughly 100 people. If people are very brief and straightforward visits, we can sternly see 100, maybe a little more. We might be understaffed that they would have a little complicated visits we might not see as many folks. So if we reach our target number of 100 patients early in the day we may close our doors early for droppings. To my best advice to be senior is get here early. We do have a website but its sf city clinic. Working theres a wealth of information on the website but our hours and our location. As well as a kind of kind of information about stds, hiv,theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for theres a lot of information for providers on our list as well. Patients are always welcome to call the clinic for 15, 40 75500. The phones answered during hours for clients to questions. Hi, everybody. Welcome to laguna honda. [cheering] and before we get started, my grandmother spent almost 14 years here at laguna honda, and so many of you took incredible care of miss camelia brown. I want to give a special shout out to denise and so many people here who day in and day out take care of some of our most vulnerable folks that rely on us to care for them every day. We are so grateful to be here with our governor, gavin newsom. [cheers and applause] he has already hit the ground running, and we know from experience of being a former mayor of San Francisco, he understands intimately all the challenges that we as a city face, which really is going to be so incredible for our city and cities across the state of california for all the things we know we need to do to change california for the better. Laguna honda is a key part of San Franciscos Health Network, which cares for one in eight san franciscans. Primarily people who are uninsured, low income, or for from our immigrant communities. And includes not only laguna honda, but San Francisco general , and smaller clinics across our city, and Health Services in our county jail. Here at laguna honda, more than 1,000 patients each year receive care for complex conditions like h. I. V. And alzheimers and dementia, and other Mental Illnesses and disorders, and we have, for patients who are suffering from strokes or brain injuries, or spinal injuries, or other trauma. These treatments require longterm and specialized care, as so many of you here know, and they commonly include medications as part of the treatment plan. However, it is a wellknown fact that these medications are expensive, and can drive up the cost of healthcare for millions of people who need these drugs to survive. The San FranciscoHealth Network is constantly working to find ways to save money on drug costs for uninsured patients. We work with federal programs like the 340 b. Program that provides drugs at a discounted rate for some of our facilities, but facilities like laguna honda , or our county jail, our Behavioral Health clinic, they dont qualify for those federal discounts. Not to mention the medications used in treatment plans at these facilities are some of the most expensive medications. The Health Network purchases more than 3,000 drugs for patients who dont qualify for 340 b. Discounts, and just the 25 most expensive drugs, of those costs, it because our city more than 17 million each year. When we have people struggling on the streets of San Francisco, with Mental Health challenges and Substance Use disorders, or people spending thousands of dollars on lifesaving medication for h. I. V. And aids, or people fighting a battle with cancer, we need to be focused on helping them recover and heal, not whether or not they can afford to pay for the medication this is the same case at many healthcare facilities, not only in San Francisco, but across the entire state of california and the nation, and this is why i am so thrilled to be joining governor gavin newsom here today to announce a San Francisco will be joining the efforts to bring down medication costs in our city. [applause] we will work hard to bring down the cost of those medications. We have worked hard over the years, but we know there is so much more that we can do, and by joining forces with other counties across the state, we know that we can make a difference in the lives of millions of patients. We are joined here today by two other bay area counties in making this commitment, alameda and Santa Clara County, and please join me in acknowledging our new department of Public Health director, dr. Grant koufax who is here with us today [applause] at this time, i would like to call to the podium colleen who has spent about 13 years working for the department of Public Health in San Francisco. She is an Incredible Health care advocate, now heading up Alameda County department of Public Health. [applause] good morning, everyone. It makes me so happy to see so many familiar faces here, and to be able to bring my new county in partnership with my old city and county in this really exciting endeavor. Alameda county is pleased to stand with Governor Newsom to leverage the collective garb Bargaining Power as a state in its counties to lower the cost of Prescription Drugs for all californians. I would like to thank the governor for his leadership on this important issue. Alameda countys vision 2026 is in alignment with the Health Forward agenda. Vision 2026 is our comprehensive effort to set a course for a decade that anticipates Community Challenges and maximizes our ability to meet residentss needs in this rapidly changing world. Vision 2026 foresees a thriving and resilient population where individuals and communities are empowered to overcome adversity and be supported so they can grow, flourish and be selfsufficient. Essential to achieving this vision is our ten goal of healthcare for all, which seeks to ensure that every person in Alameda County has access to the care and services they need to live their healthiest lives. Governor newsoms collaborative approach to obtaining Prescription Drug costs will put us closer to a comprehensive solution for affordable and accessible healthcare for all. Collectively, Public Healthcare providers and other safety net providers in Alameda County, spends tens of millions of dollars each year on Prescription Drugs for our countys most vulnerable residents. While many of these drugs are acquired through the federal 343 b. Program which may or breed referenced, drugs purchased for individuals accessing our behavioral Health Services or our inmates and our jails do not this means that we are surely paying more than we need to for these medications, diverting valuable resources from other safety net programs and services this presents an important opportunity for our county and others to partner with the governors Healthcare Team to explore how we can make drugs more affordable in our safety net Healthcare System. Additionally, this approach will foster regional collaboration through the sharing of information and protocols and best practices. Alameda county is looking forward to partnering with the governors office, and our county colleagues to explore the promise of this timely endeavor. At this point, i would like to welcome miguel marques, marquez, the chief operating officer for the county of santa clara. [applause] thank you, colleen, and thank you Governor Newsom for inviting slight Santa Clara County to participate in this event and in this work, and thank you mayor breed for hosting this event today. Over the years, Santa Clara County has implement it programs to expand coverage and affordable options that move us closer to providing healthcare for all. Indeed, our board of supervisors has officially supported a single payer Healthcare System. And Santa Clara County, we are proud to operate three hospitals , and a dozen clinics located throughout the county. Each of which provides highquality, integrated healthcare to the 2 million members of our community. Like the governor, we know that innovation through the Healthcare System, including a path to single payer systems will help us reach our shared vision of Better Health for all. That is why we are excited by the opportunity to work with the governor and with so many other partners throughout the state to take on the high cost of Prescription Drugs. Year after year, pharmaceutical Companies Continue to increase the price of brandname drugs. We all need to ask the question, do Prescription Drugs really have to be that expensive . Wild drug purchasing practices are complex, we must look for and implement Innovative Solutions to reduce these costs. Federal policies have not done enough to control drug prices. In the absence of federal leadership, local and State Government need to partner and need to think creatively about how to leverage our collective buying power to negotiate better prices for our residents. Last year, Santa Clara CountyValley Medical Center spent more than 120 million on pharmaceuticals. Giving the extrude nearly high cost of Prescription Drugs, we have been looking for opportunities for savings. We welcome the chance to work with the state and with other partners to explore options to reduce these costs. As you know, public helps it Health Systems play an especially important and unique role in delivering care, services, and treatment to the patients in the communities we serve, especially the uninsured and the underinsured. We are a safety net Healthcare System that is proud to offer topnotch care to all who need it, but to do that, we need to explore all opportunities to reduce costs whenever possible so that our limited resources can better be spent to help the homeless, the mentally ill, and other vulnerable members of our community. A number of years ago, the county of santa clara was the first county in the nation to ensure that every child, regardless of immigration status , could get healthcare services. We are especially proud to support the governors efforts to become the first state in the country to provide coverage to young, undocumented adults. Thank you, governor for leading the way for these young adults. Santa clara county and the state of california have aggressively implemented the Affordable Care act. It has been a huge success. Just a couple of numbers. In Santa Clara County alone, more than 100,000 140,000 residents gained coverage through this expansion. Another 45,000 plus have subsidized coverage through coverage california, that is just in Santa Clara County. And most important, the bottom line number, the uninsured rate in Santa Clara County has dropped by 50 3 . So the time is now to take the next step. We are fortunate to have a governor who is a champion for these important issues. We look forward to working with the governor to make Better Health for all, californias highest priority. Thank you very much. [applause] thank you, miguel. I also would like to take this opportunity to introduce someone who has been a champion for laguna honda, our supervisor for district two, Catherine Stefani is joining us here today. Thank you so much. [applause] and now i would like to introduce our governor, who we all know was a former mayor of San Francisco, someone who led innovative programs, pushed to really change San Francisco and california for the better, samesex marriage, he was the one who put forth the idea and opened the doors for so many people to get married at city hall, when so many people attacked them on this issue, and now it is gone global and has been recognized throughout the United States, 311 was just his brainchild, this innovative resource that we use to call to deal with a number of challenges in the city, so many incredible resources that we use today, and now, is a governor in his budget , he will continue to provide the support and the resources that we need to address many of the challenges that exist in San Francisco. We also should know that he really led the charge on the rebuild on the hospital to the new facility that we see today. The governor of the state of california, gavin newsom. [applause] thank you, thank you. This is fun coming back. The couple of you were showing me photos ten years ago, pregrey hair, and this is remarkable that this place opened. I remember standing here during the ribboncutting, and i think i used a line, which i am now reminded of, at the time we were doing something with a Skilled Nursing facility. Also ten years ago, that was novel and no one was investing in this place. People so the county couldnt afford it and we had to move in a different direction. We get it when it comes to Skilled Nursing facilities and keeping people in place. We are on the leading and cutting edge and doing something no one else is willing to do. I remember saying that the mayor of athens said, he says, we do not imitate, for we are a model to others. I say that then, nine plus years ago, i will say it again today in the context in the spirit that brings us here together around the issue of Prescription Drugs. We do not imitate because we are a model to others what we are advancing here today is new, what we are advancing here today matters what were doing today is what i expect others to be doing tomorrow, not just other counties joining californias purchasing pole, but other states joining californias purchasing pool. Leveraging our resources, big buyers mean lower costs. The fact is, in the state of california, 13 plus billion dollars a year, your tax dollars are currently being spent on Prescription Drugs. I will repeat that, 13 plus billion dollars a year. The problem is, we were isolating the purchasing. We had jails doing their purchasing, we had the state hospitals doing their purchasing , we had our retirement system doing their purchasing, we had the va doing their purchasing, we had our medical system, which is 13 million strong, we were only leveraging 2 million of those 13 million in our purchasing pool. Just combining the medical system alone, taking the 2 billion and leveraging the purchasing now with 13 billion is going to drive hundreds of millions of dollars of savings on an annual basis. We project in our budget that we just submitted a few weeks back, or a week or so ago, that we will save conservatively 393 million because of this purchasing effort. Thats just on an annual basis, 400 million of money that we otherwise would spend that would allow us to provide discounts, to provide additional subsidies to reduce those c