Any comments, commissioner . I would move that on page 10, under comments on section six, i would just add that the statement that i have there would seem to sound like ucsf is the only other provider for the Cardiovascular Surgery, and thats not correct. I think my question was who were the other providers, and i think we heard that cpnc and kaiser. I will go back to the recording and clarify that. It sounds odd. Thank you for the clarification, commissioner. Other comments from commissioners . Motion to adopt . So moved. Second . Is there a second . Second. All those in favor, signify by saying aye. Thank you, everyone. Item three is the directors report. Good afternoon, commissioners, brian colfax, director of health with the directors report for august 6. So the big news is we are at the go live. We went live at 2 00 a. M. On saturday, august 3 . So far, all systems are running well, and i just really want to thank the incredible team. Literally hundreds of people, thousands of hours, millions of dollars to make this all work, but so far, so good, and while there certainly have been some issues brought forward as expected, the problem solving has acted at every level across the organization and the support for the clinicians, and i think most importantly our patients are continuing to receive the best care possible is really key. And youll remember this was literally the go live for zuckerberg hospital, laguna honda, and our clinics really connecting the data as never before. Just to give you a perspective, many of us were at zuckerberg hospital for go lives. We were walking the hauls of zuckerberg general and same then for laguna honda, looking for that change. And yesterday was the big live because yesterday was our first full business day. There was some issues in terms of data expected to show up that didnt show up, but those things are being worked on as much as possible and then triaged by the great support teams. Just to give you the numbers, zero patient harm events, so thats a good first step. 4700plus Service Tickets opened, and the majority of those have been resolved, so thats a really key thing. And then, i think in terms of service desk calls, so far, theres been a less than sevensecond twotime wait call for that, so really good data there. Going down stairs to tom lidell clinic, i was talking to some providers, and literally, i turned to talk to someone else, and there was a person helping them, solve problems. Keeping it real, i think there are some frustrations and challenges, but i think overall, were expecting what is to come in the system change. And finally, i just wanted to state in meeting with the ambulatory care leadership in the trailer at zuckerberg general. One person had gotten a low potassium on a patient that had come into the care clinics. And because of our generalized data, they were able to determine the person was at the Sobering Center and able to make sure that persons potassium was being corrected. Before, we wouldnt even know where that person was. Had to track down that patient, and this was a very clear example of how in the first few hours, we were making patient care better. Im confident that there are hundreds, if not thousands of examples of that going forward. Very excited and will provide more detail to you at our next commission meeting. I also wanted to mention on a few other pieces of our report, we are continuing to cooperate with the California Department of Public Department with regard to the laguna honda investigation, and we received a formal statement of deficiencies from cdph on july 3. We filed a response on august 2. It describes how were implementing standards to establish standards set by our regulatory partners. I also wanted to remind the commission that we continue our Operations Center in response to the increases that weve been seeing in congenital silvsilv syphil syphilis. Im actually serving as Incident Commander for the month of august, so its great to support an amazing team thats working on this and more focused on collaborating across the departments and communities so we reduce the incidents of congenital syphilis going forward. So you can read the rest of the report and i stand ready to answer any questions or comments. Thank you, director. I did have a question on the go live. Is there anything youre especially hypervigilant, especially things that might still be coming up. Even though things have gone incredibly well too much to expect. Well, i think the things were most hypervigilant about is making sure that the data thats there when a patient is coming in so that the provider can prepare the best care possible . Also with a mapping from older systems to the new epic system that there have been occasions in the system where the mapping didnt go to where we thought it would go, so correcting for that quickly and effectively. I think also because of the workload that continues to be in the clinics and in the hospitals, that were ensuring that providers have the support that they need in order to continue to provide the level of care and services . And then i think finally that were provide the work necessary so theyre not workarounds that could harm our system, so making sure that people arent going outside of the established protocols that are necessary for the whole system to function . And i think whats really key, and i just want to acknowledge this because it cant be said enough is that the super users in that persontoperson support, and when you look at epic and the implementation, its about making sure we just had a discussion at the finance committee, that theres robust numbers to help people problem solve is really key. Thank you. Any questions or comments from commission . Commissioner . Yeah. I had two. One was on the Hunters Point Shipyard Building 606, which was the police department, how are they accepting the report and how are we working with them . It was a great report that they are not now in danger. Have they received that in a positive fashion or is there still dialogue with them because this was a huge yes, yes. So dr. Aragon will provide some details of that, and thank you for pointing out. I did skip that item in the report in the interests of time, but dr. Aragon has more details. Good afternoon. Is the question about building 606 or is it about parcel a . Building 606 because thats all the report is on. It says that weve come to a weve come to a report saying that there was no problem. Correct. So they did extensive testing both they did a radio logical scan looking to make sure there was no exposure . They also did dusting, and they also did dust testing for asbestos. So all the testing that has been done over the years has been negative. The only problem they did find was early on, there is some lead levels in the water, so theyve been providing bottled water for that site for years, so no ones had any exposure from the lead to the water. So thats same accepted are they still occupying the building . Yes, the building is still being used, and the building is completely safe. Okay. And since the late 1990s, weve had an industrial hygienist from d. P. H. Based at the building to provide not only testing but also address concerns over the years that has come up. No, thats helpful. As you know, public reports have sort of portrayed it otherwise. Yeah. Most of the reporting has been primarily about parcel apartment where they have apartment buildings. I know people confuse them. Thats why i brought it up, because thats the perception people have. Thank you. Yeah. My other question was in regards to the supplemental budget. Administratively, we had some decreases in the recommended budg budget which were not going to affect your administrative capacity. But then, with the new proposed programs, is it that we are going to be able to put those in feis in the budget year that were talking about . Or were they already there and were now just getting more funding for it or whatnot . So i can get you more information on that that specific one . Oh hello. I will let our budget director respond to those questions. Yeah. Commissioners, jennie lui, d. P. H. Budget director. They are ambitious. Most notably is the 2 million you see for residential treatment for youth. The parentheses you see, it means we have two years of funding for it . So we can spend that allocation over two years. I expect it will be a new program, so were going to have to identify, so its not started up at this point today, but we will work with identifying an available c. B. O. Through appropriate contract to get the services started, and then, we have the ability to Carry Forward the funds into the second year. And some of these are potentially continuing projects and some that are new. So we will work with contracts and michelle rugals staff over the course of the fiscal year. Okay. Thank you. Any other questions . Next item, please. Theres no Public Comment request for that item. Item four is general Public Comment. Ive not received any requests. Im not seeing any now, so we can move on to todays report on the budget and finance Planning Committee. The budget and finance Planning Committee met immediately before this meeting. We reviewed a few separate contracts. There are four separate contracts to provide pharmacy Registry Services through december 31, 2021. Two of them are existing existing contractors and two of them are new contractors. So as well be considering in the next item, the consent calendar, theres a caveat on those two new vendors, we will receive to the board to review, and the secretary, mark, will be getting those. The reason that we need of course these pharmacy registration temporary Personnel Services is to cover vacation times, times when theres high vacation activity, and times when persons are being trained on epic. We have additional contracts with regard to network and Security Support Services as well as epic go live activation and adoption plan. And then, we have three different contracts relates to healthy related to healthy sf and kid is in particular. I would like to say that while healthy sf is being sunseted because kids are being moved on to medicaid, that is everything that is on the consent calendar. Commissioners, questions . Comments . We can move on to item six, which is the consent calendar, and as commissioner bernal stated, the Committee Approved the report with the understanding that i would receive the board of directors from the two new vendors with the understanding that i could forward them all to any questions that you have about that. Thank you. Were going to call for a vote. So all those in favor. Of accepting and adopting the finance committee report. All right. And ill note that theres no Public Comment request for that item. Item seven items seven and eight are going to be presented together. Item seven is the closure of st. Marys cardiovascular center, and the other is st. Marys spine program. I wish to recuse myself for these two items. And commissioners, dr. Kol f dr. Colfax, and i am recusing myself. Oh, and commissioners, and im sorry, for the public, these items were introduced at the last meeting, and today, you will vote on them. All right. Good afternoon, commissioners. Im here today for the second of two scheduled proposition q hearings on closures at st. Marys Medical Center, and the first hearing took place on july 16 at the last meeting. As a reminder on april 29 of 2019, st. Marys notified the Health Department of two closures. The closure of the Cardiovascular Surgery program, and the closure of the spine center, which is a licensed hospital outpatient clinic. You all received a memo that had detailed information about the closures . And for todays hearing, you received a memo that contained Additional Information based on the information that was requested during the last hearing. So for todays hearing, im just going to be briefly sharing points that are addressed in the fullout memo. I do want to note that dr. David cline, director of st. Marys Medical Center are here to represent st. Marys and answer any questions about this brief presentation. All right. So as a follow up to the Health Commission hearing on july 16, st. Marys provided data on the number of plans versus emergent cardiovascular procedures. To look at this chart, there are four types of surgical patients . Elective, meaning, the patient waits at home or the surgery is scheduled far in advance. The next is urgent. Next is emergent, meaning the patient is very sick and it is not safe to wait for surgery. And then finally, its emergent salvage, which means that the patient has no pulse. And so based on st. Marys data, the percent of total cardiovascular surgeries that are nonelective vary from three to year, but from 2013 to 2018, about 30 of nonelected cardiovascular surgeries. It should be pointed out that since 2011, st. Marys hasnt had any emergent salvage procedures. So upon the closure, its the nonelective cases that will likely have to be medically transported through van nuys or parnassis as those are the closest hospitals to st. Marys that officer Cardiovascular Surgery. So then, looking back at the 2018 data, that would account for approximately eight Cardiovascular Surgery case thats would have needed to be medically transferred. So a few questions raised in the hearing were about surgical and nonsurgery card know vascular patients. With the closure, theyre going to be referred out if surgery becomes necessary. So regarding the ability of physicians to follow their patients who are referred out of st. Marys, st. Marys has stated that theyre fully supportive of their cardiologists practicing as other hospitals and realize that some of their cardiologists already do practice at other hospitals. So while saint marys dont have a comprehensive list where their cardiologists provide active duty care, they did provide a roster of their cardio laskar care and the location of their offices . So some have offices located at cpmc pacific, van nuys, stanford Medical Center, ucsf parnassis, and at al Alta Bates Summit Center in oakland. St. Marys cardiovascular surgeons are also credentialed at other San Francisco hospitals . And that includes cpmc, ucsf, and kaiser. All right. Also during a last hearings, there was a few questions about transfers . The map shows the locations that offer cardiovascular procedures that are comparable to the Services Provided at st. Marys. So for San Francisco, this includes ucsf parnassis. And then, for other cardiac care services, cpmc, ucsf, and kaiser all have cardiac catheterization labs, and those hospital locations are designated stemi centers, which means that theyre equipped to treat emergent coronary heart attacks. So for any cases that need to be medically transferred from st. Marys, patients will go to cpmc vanness or ucsf parnassis. So regarding a network of care through a review of the accepted insurance plans that st. Marquiss accepts, all but one plan is accepted by cpmc and ucsf . Both especially medicare, medical, and chai accept medicare, medical, and Chinese Community health plan. Went too fast. So another question was also raised about Hospital Capacity and the current ability of San Francisco hospitals to take on the average of 30 patients that are seen at st. Mar hess annually for Cardiovascular Surgery . And st. Marys has stated theyve had conversations with cpmc and ucsf, and theyre knowledgeable about the case log and theyre prepared to take on these patients. It should be noted that cpmc and ucsf have higher volumes of hard yo la cardiovascular patients than st. Marys. And then, finally, as a part of the formal transfer protocol that i spoke about at the last hearing, both were spoke about during that transfer protocol with st. Marys. Okay. So to close, id just like to restate the conclusion that was presented during the july 16 hearing . In that despite st. Marys low surgical volume in the general advancements in minimally available surgical technology, San Francisco does have a growing older Adult Population and card low Vascular Surgery services are going to become increasingly important . That the closing of the Cardiovascular Surgery unit may also have impacts on the level of care provided and the complexity of patients that may be able to be seen . And that finally there will be an average of 30 patients annually who can no longer receive Surgical Services at st. Marys. So the closure is a reduction in services, and for that reasons, and the reason spoken before, the closure will have a detrimental impact on the community. So i just want to note that on page seven of the packet, the memo follow up, you will find an amended resolution, 1911 for the closure of the Cardiovascular Surgery unit . And the regulation in your packet includes red lines, based on the discussion and feedback that took place at the july 16 hearing . And then specifically as suggested by commissioner chow, i added statements about the history of st. Marys and their impact on the field of Cardiovascular Surgery. And so that concludes my statements about the cardiovascular closing, and im happy to take questions, and the staff from st. Marys is happy to take questions. Im dr. David cline, the president of st. Marys and also st. Francis. I know there is a question regarding quality adult afrom the program, and we were able to go back to ashpa data, up to 2016 to show that the program had good quality. Most of the quality thats occurred in quality analysis up to that point is discussed through our quality cardiac care committee, and im told even though ive only been there a short period of time that the quality has been good throughout the program, but were not able to share specifics because of patient privacy concerns. Thank you. Is there any Public Comment . Theres no Public Comment requests for this item. This item is in the hands of the commission. Dr. Green commissioner green . I remain confused about this balance between patient volume and safety because even if the surgeons are operating in personal sites and there are have a lot of personal surgical experience, these types of surgical procedures require quite a large team to make sure that from admission to discharge, these patients have the highest quality of care. So i wonder if somebody can elaborate more on that. I wonder if there are only 11 cases as you listed here, and the ancillary question im not a cardiologist, but ive read a lot about the safety of p. C. I. In the context of lack of available in immediate cardiac surgery. There was an article not that long ago saying it is quite safe, but if you have the choice to do the procedure electively, its probably better to go to a place with surgery. I formed a different conclusion than the literature, and i wonder if you knowing more than i can comment on those two elements. Sure, commissioner green. I think its clear from the literature that low quality programs dont have the outcomes that we do. When you look at when you look at the regulatory bodies, a lot of them dont speak to organizations except leapfrog, and when you look at leapfrog, theyre not able to maintain the individual competencies of the team to not able to care for those patients. Regarding the p. C. I. Question, i think it is the standard of care to operate freestanding cardiac cath labs. Ive operated a number of them in other states and including here in San Francisco and that was at zuckerberg general hospital. The answer is because they are so precise, there are seldom complications, and when there are, you have some time ahead of you to transfer those patients to locations where you have cardiac teams standing by. Back in the day when i was a surgeon, stand by is different than it is today. The team is prepped and ready to go in case you had a complicatio complication] theres no longer thats no longer the case. It could know take an hour to now take an hour to two hours to get a physician back when you have a system setup for the patient, it really is beneficial for the systems and care of the patients. Commissioner green . Thank you. Can you comment at all about what the future holds in terms of cardiac interventions . It seems that pervasive cardiology is a lot less common. Im wondering if as we look at the demographic shifts in San Francisco, can you comment on the ratio of procedures that you might that might be anticipated. I would say over the course of a number of years, clearly, the last 20 years of volume of open cardiac surgery has decreased. I think if you add up the numbers, theres probably less than 1,000 thats done annually. If you look at it years ago, it was double or triple. The numbers regardless of age have gotten much, much better. And although theres still going to be cases for open cardiac surgery, those numbers are going to be less because of the advances made in noninvasive cardiac care. There might be some procedures that have a notable risk, such as a transaortic procedure, things you wouldnt do in a cath lab, but we intend to continue the cath labs and most of the physicians that perform those procedures can be performed in a freestanding clinic such as what we intend to have. Thank you. Thank you. Commissioner . Thank you. Weve received letters from some of your surgeons who maintain they would be comfortable in maintaining the current type of surgeries at st. Marys. Are you confident that they support this move and understand the reason for it but would otherwise then continue to bring their cases to st. Marys or will this begin to affect that . You know, i think that all things being equal, i think they would prefer that we keep the program open. I think theres a lot of emotion surrounding the discussion because its been a longstanding cardiac surgery program. Like any closure, theres going to be a period of mourning when we stop to do those procedures. But likewise, when we explained our concerns and our inability to maintain staff quality, although they dont love it, they do understand that its just you know, we did 14 procedures last year. We just finished up our count for last fiscal year. We did 15. We just cant assure safety and quality, and they understand that, but i think all things being equal, they would like to keep the program. Commissioner green just sent me a copy of the new england journal of medicine from october 2012. They listed sort of a table of characteristics for p. C. I. Programs for that onsite cardiac surgery, part of which was to adhere to the relevant guidelines within the cardiovascular and im sure youre well beiacquainted withe paper. Because the paper didnt say one or another way but explained some of the complications that could occur which were actually much more the reason for the difference in favorable results between high volume and low volume, but facilities that have cardio thoracic surgery, for those problems that arise. Would it be and i imagine st. Marys meets most of those criteria. Yes, sir. And so that would actually be what you would be following in order to try to maintain the competence of these cardiologists and their staff. Yes. Theres selection criteria for what we can do and cant do, but ultimately, we would leave it in the hands of the practitioner what theyre comfortable with. We would never second guess the physicians decision, but i think there are standardized guidelines as to what is appropriate to do in a freestanding center and whats not, and we will adhere to those. And in the papers that commissioner green circulated as background, there was somewhat a suggestion that the recipients to treatment may actually be made to be should be made aware whether or not cardio thoracic surgery would be valuable or how it would be valuable. Is that something that youre all planning to do also in terms of disclosure to patients . Yes, sir. Thats part of all the possible outcomes, what were able to do and not able to do. Thats not just in Cardiovascular Surgery but any surgery, thats correct. But your most recent example was impressive, to say that in an hour you can be at ucsf in the operating room. Yes. Would that be part of the disclosure that there is a transfer arrangement . Yes, absolutely, that is a part of disclosure, that in the event they need advanced surgery, they are aware preop ratively that they would be transferred should that need arise. Thats very explicit. Thank you. Those are my questions at this point. Mr. Secretary, we the resolution is within our packet. Are we going to read the resolution before we take a vote on it . We usually dont, but im happy whatever you would prefer to do. And the vote is on the bottom line is whether its detrimental or not. Before we get to that, i want to thank miss lindsey and dr. Cline for your testimony and for your presentation to us as a commission. So that is in the this is in the hands of the commission. We have seen the resolution. A motion is ordered to either it will have a detrimental impact or it will not have a detrimental impact on health in San Francisco. So is there a motion on either one of those options . And again to remind you, the d. P. H. Has reminded you to vote it is detrimental. Mr. President , i would move that it would have a detrimental impact on Health Services in the community and i would like to explain my reason. Go ahead. Recognizing that st. Marquiss has tried very hard to preserve a marys has tried to preserve a service that they were a pioneer in the nation, it doesnt negate that we have one less choice and one less possibility even though patients may be placed at a greater risk and they are aware of that risk, i think its commendable of st. Marys to say this is a program that they can continue or wish to continue because of the issue that may arise in terms of quality and due to low volume and all the other reasons that we have heard. I dont think that changes, however, the fact that San Francisco will have lost one unit. And whether or not there are other units throughout the entire bay area or even nearby, the choice of st. Marys has is a detriment. Its a detriment to chinatown because the cardiologists that theyve been working with and the cardio Thoracic Team were people that were acquainted with them. And while they have privileged with them, i think the culture sensitivity that st. Marys has given to members of that community cannot be underestimated, and i think that will also be part of the detriment in terms of losing this service to our community. Is there a second to commissioner chows motion . Second. Call for the vote. All those in favor, signify by saying aye. Opposed . Hearing none, the resolution is adopted. Im sorry. I missed that. I was helping someone else. The closure will have detrimental impact. Okay. We can call the next item. All right. So as a reminder from the last hearing, st. Marys plans to close the spine center, but the s. F. Center plans to open a spine center just two floors above the current clinic at the st. Marys center. The closure of the spine center should not have a detrimental impact on the community. There wasnt much follow up since the last hearing. Youll find the follow up, and specifically the finding of the closure is nondetrimental is conditional upon what i just said, the staff maintaining the current level of services. St. Marys can provide a timeline and opening. Thank you. Dr. Cline . Thank you. As of today, we have yet to file a formal request with the attorney generals office. Once that starts, we will keep the commission informed and regularly update to what the status of that is. In specific regards to the hospital employees, as previously mentioned, there were five employees which could be affected, two of which have been given positions in other areas, and the other three are waiting to see what will unfold with the new facility. We are waiting to see if they will hire those three individuals, but they havent to date. Thank you, dr. Cline. Questions for miss lindsey or dr. Cline . I dont believe theres any Public Comment. I dont have any slips here, so were going to move to adoption of the resolution that it will not have a detrimental impact on the health of San Francisco. So moved. Second. All those in favor, signify by saying aye. The resolution is adopted. Thank you. All right. So we can move to the next agenda item, which is agenda item nine. Ashley . Hi. Were waiting for okay. Great. I want to thank you, commissioners, for having us . My name is ashley scarborough, and im working in primary care central . Its my pleasure to represent a large and Interdisciplinary Group and working to include lgbt in the group, so thank you . For this initiative, its really more than Data Collection . It offers an opportunity for staff to align with our values and moving towards True North Equity creating culture change and ultimately providing more inclusive care for the lgbtq population. I want to recognize the longer term efforts in the department for gender equity Data Collection . And just the staff advocating for this data and advocating for this community so aligning with that over the last few years has also been structural policy incentives and mandates that have been elevating the priority of Data Collection, including local ordinances authored by scott wiener, state legislative bills, and payforperformance dollars, part of the prime program over three years, 1. 7 million for the collection of Sexual Orientation and gender identity data . Each of these mandates have focused on Data Collection, and i think one area of strength of the Department Overall was our leveraging of these incentives and mandates to build out our own goals for lgbtq equity . So this is a a sort of detailed slide where im going to talk about the robust and thoughtful planning process that staff and workforce along with patients from the community put into this project . First of all, there was an emphasis on training, so there was a desire to not just develop workforce for collecting the data but also ensure that staff had what they needed to respond appropriately to this community and act with nondiscrimination, of course. There was a Large Department wide effort with the train the trainer model where our internal Training Resources were trained and developed to disburse this training throughout the department . So Division Leaders came together, developed a curriculum. It was a modulized curriculum, so we could be adaptive to the needs of star aff and their go. Theres a threehour training, theres a shorter one hour, and theres online. We let staff know that one, they were required to ask everybody, and two, patients could decline. And patients also had training material explaining the purpose of these questions, and they had the right to decline to obviously any or all of the questions . And then, i think one element that were all proud of is the continued focus on patient experience. The best example of this for our project was focusing on name and pronoun to make sure that we were expanding just collecting this information about peoples identities and also making sure that we were providing the best care for patients by addressing them appropriately and affirming their identity throughout their experience in the department. To do this, we had to in g legacy data systems, we had some complicated work arounds to be able to do this to be able to have chosen names printed on wristbands, and im excited to report that epic is a huge improvement for this part of our initiative. And i know the commission had some interest in that, so inside of that this is a test record you can see the persons name and their pronouns available in the header of every, like, chart thing . And there was also interest in legal sex because now california does have a third gender, and so this was available in epic, so we have more opportunity for our patients to identify correctly throughout the network and department . I want to talk a little bit more about our training . I think this was a huge Department Wide effort, and its still going on with the department of Population Health where you can see they had just a slightly later start than the rest of the department . For the first column, i just want to add a caveat that this was an estimated denominator of just d. P. H. Employees and of course multiple employers and organizations are working in the department who are also trained, including ucsf and various contractors, so those numbers dont always match as far as enumerators and denominators, but total touches in the department, over 8,000 participated in either im sorry. Over 5,000 participated in either inperson or online training. Approximately 70 of our staff have had some encounter with the training. And there was another question about laguna honda, and i wanted to recognize the leader, ami fishman, as far as coordinating the development and disseminating the training for the department. You can see theyre kind of ahead of the rest of the department as far as making sure their new hires are also trained . And so thats why we got over the 100 , and so i think theyre a model, and were exploring ways as a team to maintain training on board as we acquire new staff so they can be acclimated in our values. Okay. Here is a broad overlook of each this is our primary care populations. These are people who have interfaced with primary care, and you can see that over time with this initiative, weve had good progress, including just a 33. 24 increase just this year . And that represents 19,202 patients as of may who actually have data complete in their record. These numbers also show that weve met our payforperformance targets all three years as a program, so weve reached the 1. 7 million attached to this project. And additionally, i think we would all like to see these numbers even higher. I think that as a city and as a system and as a department, theres a lot of interest and engagement with this, and we would like to be a demonstrator in lgbtq equity around the country . And well be watching for improvements that are attributable to epic in going forward, and we know that theres variation among sites. And again, these reports in the last year are based in our legacy data where theres some challenges showing the very variety around the department . Im going to jump ahead a little bit where i can show with our l. C. R. Encounter data how were doing by division. And you can see that theres quite a widespread in encountered in may that had data complete. So i think this gives us, like, an idea of where we want to work towards in the next year as we get acclimated to especially, where our target sites are being and reconvening some of these data from patients so we can have even higher numbers going forward. And skip back again. So even though these numbers, because its demographic collection, we would be getting it on every patient that we did see in the department. Were not there yet, but the exciting news is that we have more data on the population than weve ever had before, with over 50 of our population being complete, we can start to see trend dos. And im just going to walk you through these really quickly. This is in the population really quickly. So for our adults over 18, weve had a primary care visit. Weve had almost 14 in the sexual minority population, and those identities included gay, lesbian, neither, and experimenting. For transitional age youth, age 18 to 25, we see a bump again for 15 , and then in our homeless population, you can see a disproportionate number of lgbtq patients. I think that one interesting thing about these early trends is they do match with what people guessed and assumed as far ased the majority of these patients being seen at castro and mission and positive health. But the one i want to hit is that everyone around the city in each of these clinics. No one gets a pass from building lgbtq equity at their site. I think thats really important to keep in mind. Here again for gender minority populations . And this includes people who recorded for their gender identity, transgender female, transgender male, gender nonbinary or not listed. And we see about 2 for adults 18 and over. For transitional age youth, you see a lot more gender freedom for younger populations, and again, thats an incentive and motivation to get more prepared for meeting the needs of this population. And again, disproportionate number in our health care for the homeless population. And i would make the same point here. I dont think anyone was surprised that we had a higher in mission castro, but we have a widespread of patients touching our sites. I wanted to share a story i found moving for curry senior center. Right when we started, jen gurley was the primary care director. She reported one of the patients was moved to tears for the first time being recognized and affirmed and sort of seeing for the first time having these questions asked at the clinic. So, like, had the opportunity to go back to our seniors who did so much for our Lgbtq Movement and fold them back into the health care measures is really meaningful. And im going to take you drill back down into our encounter data across the department . You can see that were having pretty even spread for our sexual minority population and where theyre being seen throughout the network is slightly higher in primary care, and these are the encounter with surgery complete in may. And this does the same thing for gender minority populations . I think that whats most striking about this particular slide is that high percent in psychiatric emergency, and they reported that anecdotally to us, and were heavily involved in the roll outof this initiative, and rollout of this initiative. And theres just one caveat. They do have smaller numbers than the rest of the number. But in any given month, they will see this percent of gender expansive population and receiving their services. And i saw this a lot during the training, so its not, like, biological or faded that people with expansive gender identities will have psychiatric concerns or Mental Health issues. Its definitely a product of our society and how these people are treated. It affects their capacity to
vimarsana.com © 2020. All Rights Reserved.