That weve been doing coastal rescue drills. Thats consistent. We have our p. L. O. Go out and hand out materials, and we talked about that in the past because this is a heavily travelled area for visitors. And so we do a lot of handouts and fliers, and also, all of the companies that are on the coastal stations, theyve been doing constant drilling out there. So theyre doing rope rescue drills, theyre doing water drills im sorry lowangle drills, highangle drills, boat drills, everything that involves coastal drills. I can list them for you next time, if you like. I have some of the pictures in the slides that i gave you. I knew this was a little bit of a longer presentation, so i shortened it and took some of that out. Chairwoman no problem at all. Then. Lets see. At the chase center, are you going to have an afteraction report for that, you know, when you have the drill . We will. We will. We will have the take takeaways from it, for sure. Chairwoman i think all of the commissioners would be interested in seeing that, as well as areas of deficiencies, in order for everyone to be able to sleep well at night, atim any time there is poll when iparticularly for a lf the musical events. At sports events, i think they dont drink as much as they do for musical events. And things can go wrong for that reason. Egress and ingress can get a lit scary. I would like to see any concerns memorialized from m. T. A. , saying these are the things that we think really need to be addressed. And if you feel that you cannot do what it is that were asking you to do, then please tell us why in writing. I agree. We have a report with a lot of questions that jay center and s. F. M. T. A. Is going to have to answer for us. And not only that, it is not just the full box for a fire, but once we get locked in there, we need an ambulance to get out of there. And we have the fire engines blocking the fire lanes, and then we have another issue. So were going to not only throw a full box, we might do what we would send to an active shooter. So we can see if the first ambulance that comes in, how is that first ambulance going to get out when weve got five ambulances behind it . Were going to try to give them some of our toughest scenarios. Well show them. After we show them our response, were going to sit down and do a table talk and try to discuss it. So this is a first of a series of drills that well be doing with them. Chairwoman i think it is very important for the public to know that the fire marshal and our Homeland Security expert are both expressing concerns. And i dont know why anybody would argue with these two people . [laughter] chairwoman about anything. And there are 200 events. Chairwoman yes. And a large number of them coincide with the ballpark at the same time, so. Chairwoman yes. I stay awake at night because of this. Chairwoman thats why i said i want everybody to be able to sleep well at night, when everything is in place and, you know, we have a plan that we think will work. So if you need me to knock on a door or two, then please let me know. Because the first events are going to be happening very, very soon. It is already july. Yes. Chairwoman all right. Well, ill save my medical questions for captain thomas. Thank you. Thank you. Thank you, Vice President. Vice president covington. Commissioner varinisi. The president s comments a moment ago, i think i know where he was going. I would hate m. T. A. To clear the bus lines because you guys are coming through it just doesnt make for a realistic scenario. So to the extent we can keep everybody out of the loop, i think that would be best. In other wordin regards to tu for identifying the homeless address. I wanted to see if maybe you could do this for me so on page 21, you have station one, and station one received 409 calls on one month. And its next month it was 423. And the next month it was 427. Yes. There was recent news that the Homeless Population in San Francisco had gone up by 30 . That was probably a surprise to a lot of people, but i believe if we were to look at these numbers, we would probably see that. You can see how the percentages go from 39 to 37 to 36 . So the percentages are going down, but the actual calls are going up. So do you see what im talking about . Correct, yes. So i wanted to see if you could add just a single column at the bottom of each one of these that adds them all up, so that we can actually see the actual calls are going up as well. Because if were saying, oh, well, the average citywide is 38 , and its been consistently 38 for the last three years, but if you actually look at the numbers and the homelessrelated calls are up by 30 , that is a pretty important number to know as well. Okay. Because you can stay consistent at 38 of the calls, but if the homelessrelated calls are going up by 30 , then i think thats an important number to maybe share with the department of homelessness. Saying, hey, by the way, there is probably a good chance that your Homeless Population has also gone up by 30 because our calls have gone up by 30 , and everything in proportion. In other words, have somebody take a look at this statistically. That was not my strength in college. I think that is a significant number, and this chart doesnt show the actual increase in calls, or, for that matter, if it is a decrease, then thats a good thing because somebody is definitely doing their job. I definitely will have that for you. Thank you. Thank you, commissioner. Commissioner hardiman . The best news in your report, chief, is i love to see all of those ones in the multi no multialarms. Everybody knows we have the right to do a second alarm, but the fact they didnt have to, thats good. I hope every month to see that. That would be the best thing in the world. Anyway, i hate to do this on your time again, great report. The whole report is fantastic, the details that you presented are, from you and your staff. Thank you. I guess i have to run this through the chief. The significant number of promotions that you just did within the last few days is very encouraging. There are a lot of deserving people on that list that you have promoted. I was just wondering, the number of retirements since the last meeting . Did july 1st have a significant number . Does anybody have that offhand . Ill look it up and get it for you today. Im just curious. Thank you. Thanks, chief. Thank you. Thank you very much, commissioner hardiman, and thank you, chief, for your comprehensive report. Madam secretary . Im five, update from assistant deputy chief, sandra tong, on an overview of the e. M. S. Division. Thank you very much, madam secretary and chief tong, welcome. As in the tradition, since chief nickelson has been part of the administration as chief of the department, periodically were able to have the various deputy chiefs present as well. And in the flavor of that for this commission, and with the subject matter that is very important, we thought it would be appropriate for you, assistant deputy chief tong, to come and make a presentation in terms of the data from your perspective. I also wanted to note that dr. Clemen yea is in the audience as well. Good morning Vice President and commissioners, chief nickelson, maureen, thank you for inviting me. Let me try to get my power point going here. So just to give you a little bit of a background about myself, really quickly, i worked at d. P. H. As a medic for about 10 years, and then we merged with the fire department. At that time, i started working in the dispatch center as a rescue captain, and that was a great opportunity for me to learn the ins and outs of the fire department, and how some of the things work, the command structure, the organizational structure. So i was there for about four years, and then i went into the field as a rescue captain. And then during the course of my career, i pretty much worked in dispatch, in the field, and then also at station 49, when that opened up. During the time i was here in the fire department, i was able to go to graduate school, and that was one of the benefits of having the kind of schedule that we have. And then after 28 years, i retired for about 16 months or so. And after relaxing and kind of wondering what im going to do, chief nickelson called me and ive been very honored to have been accepted into this position. So thank you. I just wanted to give you sort of my approach to management, and i really believe in sort of creating a participatory process. One that recognizes and respects the chain of command, but then also solicits the expertise of the people that work for us. I think we have a lot of people who know a lot about the work that they do, and being able to garner that information and expertise i think makes for better decisionmaking. I also believe that decisions should be datadriven, but also personcentered. I think it kind of gives us a balanced approach in how we look at issues. So my two top goals, and maybe the first one is really more of a kind of visionary thing. I really want us to provide the best Emergency Services possible. But i want it to be based on gathering information, soliciting participation of the stake holders, identifying and determining best practices, revising bet policies and procedures, and finally implementing them. I also want us to create e. M. S. Strategic plan, something that will give us a framework to plan and provide the best service possible. Where we identify priorities, support funding requests, and implement changes. Those are the kind of things we can do with a nicely developed Strategic Plan. So i want to talk a little bit about some of my objects. The first is to examine and improve how we provide hospital care in San Francisco. Aside from looking at some of the metrics, such as response times and system management, i want to look at how we can deploy our resources in more efficient and affective and creative ways. And were starting to relook at all of the data, how we collect it, all of the parameters we use to collect it, and all of the assumptions we have when were trying to look at the data. Were researching different ambulance schedules, and were going to continue to expor explore alternative vehicles. Another way we can improve how we provide prehospital care, i want to increase opportunities to learn. One of the things is with training. Ive been working with chief payne with e. M. S. Training, to create more opportunities for us to do handson training. We have opportunities to work with some of the hospitals to do Clinical Skills practice, and he is working on trying to include the ambulance crews in training exercises for suppression. And next to that is trying to do more research. There is really a motivated workforce that we have, and with that kind of a workforce, and with the diverse population we have in the city, we would be actually an ideal place to develop Research Projects that identify and address prehospital issues, and hopefully can improve prehospital care. And then the other area that i would really like us to explore, and we have an expert in both captain pang and then chief tangerlini in regards to paramedics. There is a trend towards globalintegrated health care. With e. M. S. , weve been able to reduce our call volume, and were also being able to address some of the various needs that they have. By also expanding into Community Paramedic programs, we have another area, patientcentered type of services. And we can improve the health of the community. One of the other areas i wanted to look at is to address the morale at station 49. It is a very hardworking workforce, and theyre interested, and they want to get involved in things. Some of the things they want to do to garner the optimism that they have at this moment, especially with the inclusive messaging of our chief, is to increase the twoway communication. Were having forums, were having some focus groups. They had a townhall meeting which chief nickelson and two other chiefs did at station 49, which was very wellreceived. And we also want to increase opportunities for the members to participate in providing input and recommendations on the things that matter to them. So we have already i think you saw in the report work group on schedules. And we also want to include them in deciding at what kind of vehicles we want to look at, uniforms, supplies, and how we want to continue with research and training. And i also want to keep the members safe and healthy. As you know, because it is such a difficult job that they have, i just want to make sure that we address their stress and their burnouts and the injuries that occur working on these ambulances for such long shifts. And then the other area that i really have concerns about is just really improving our disaster preparedness. I would like us to really develop our search capacity. Right now we want to look at what our available suite is, what kind of equipment and supplies we need in order to be able to address any kind of surge in call volume, whether it is a disaster or the heat emergency we had recently, really to determine what are the needs we have and how we can go about funding those and making sure we have the appropriate resources. I also want us to, as soon as possible, develop check lists that i think can help people in the field to be able to immediately look and see, what are they responsible for, what are their duties, what are the things they need to think about, just cues for them when something is happening in the moment, that you have something to refer to. And then we need to plan and train for different types of disasters and levels of response. So when i first was asked to come in, and i was thinking about what i needed to do, i wanted to do an assessment with all of the members of the r. C. S, the command staff, i wanted to get all of that stuff done. And i still have that plan, but i also got immersed in a lot of the other work that came about, such as meetings and discussions to deal with some of the immediate concerns that we had, operationally, working on the schedule and on the ambulance fleet, and on the m. T. Hirings and stuff. So those things happened. Some of the other things i did during the first 60 days, the first couple weeks was an orientation that i received from andy zanoff, and that was very helpful for me to kind of get a lay of the land of what was happening. And we selected a section chief, neil tangalini, and we were providing some budget support with the chief, data gathering and research, and some of the immediate needs working with the e. M. S. A. And we got some ambulances on board and permitted, and as youve heard, the level one ambulance e. M. T. Process. Also in that time, we had the heat emergency, and i think i have a little bit of information in the e. M. S. Report around that. Ive gotten some orientation into our new station 49, a. D. F. , and working on the pride parade preparations. I would like to identify the issues that need to be addressed in the e. M. S. Division, and working and conducting 101 interviews with the members, having small group discussions. And looking at the data, and looking at what Additional Data needs to be reviewed, identifying the gaps, investigating those further, prioritizing the issues and then deriving solutions. And the most important thing hoping to implement some of them. Some additional areas that we also want to be looking at is continuing to compile supportive data to justify the staffing needs we have on the e. M. S. Side. Looking at alternative service models, continue to review our clinical performance, look at alternative funding sources, and explore the use of green technology, possibly, in our vehicles. So right now there is a lot of energy, as well as a mandate to get things done. I want to harness that enthusiasm, and in the words of the chief get to work. Thank you. Thank you very much, chief tong. At this moment, ill call for Public Comment on item 5. Any member of the public . Seeing none, Public Comment is closed. Commissioners, in terms of questions and comments. Commissioner cleveland. Thank you, mr. President , and thank you, chief tong, for your report. It is great to have you back on board. Thank you. A couple of questions on the Strategic Plan are you pulling out of the Larger Department of Strategic Plan, pulling the e. M. S. Spies ou piece out ad expanding on it . Yes, im looking at those points as well. I actually participated in that process. So pulling from those and looking at other areas as well. I think it is a great idea. We need to update our Strategic Plan in every aspect of the department, but certainly e. M. S. Is probably the top priority in my personal opinion. So i applaud you. So do you have any sort of timetable for when you have those recommendations and revisions for the Strategic Plan for e. M. S. Ready to be reviewed . I mean, i would love to have something in the next six months or so, but i think that that might be too fast given all of the things that happen in the day to day you have a lot of daytoday responsibilities . Yes. But you would say in the next six to 12 months, perhaps . That sounds fair. And please share it with the commission. Definitely. You mentioned alternative vehicles responses, and i think thats an interesting idea. And i would like to have you expand on it. Im sorry . The alternative vehicle response . Yes. We have the q. R. V. S right now, and it is not just necessarily the vehicles, but how we staff them. I think in england, they have nurses that respond with the ambulance crew. It expands the way you can offer services. You can go to peoples homes or you can provide suturing or you can do other types of things that might prevent having to take a patient to the hospital. There are alternative ways that you can provide care, aside from just taking them to the emergency room, which you had spoken about earlier. Has there been any discussion about maybe utilizing privatelyowned vehicles to transport . Like uber . Yeah. I dont know. I think that would have a lot of considerations. It may have been, or maybe is being, explored in some of the other areas. I think there may be opportunities to garner funding from them to help support maybe what we do. But in terms of utilizing them, i think there is a liability aspect to it they may not want to take on. And obviously, it would have to deal with only less severe calls. Correct. Maybe some of our frequent fliers perhaps. That are overutilizing our system. Thank you very much. It is good to have you back. Thank you very much commissioner cleveland. Chief, i know youre still kind of getting your feet wet in the job, and i appreciate everything that youre doing. It is not an easy one. Your depart