Being terminated within the department it is in that parameter if you and your office make a recommendation if the member can be medically approved to prove on. If the member cant be medically approved to move on, you make that determination . Correct. For work related injury always under the guidance of the division of Workers Compensation. If the division of Workers Compensation accepts the findings of the independent physician, we have the obligation to follow the guidance that is handed to us by the division of Workers Compensation. For nonwork related injury, it is a totally different path. That is a process that is handled through the division of Human Resources. And the appeals process in that avenue, again, goes through the department of the division of Human Resources and it is separate from the department. Last question. It says on one of your bullet points return to work. Perform fitness for duty examinations at the members request or request at the department. You get requests from the individual members for fitness exams . Well, for example, if they have undergone treatment with their personal physician for nonindustrial illness or injury and their doctor has advised them that may be they shouldnt perform firefighting or some other task or job, they may come to us. They may say, hey, my doctor said this. What do we need to do to rule it in or out . Then we engage the member and say talk to your doctor about doing this test or this functional test. Lets find out where you it is in this continuum. It is for them to get support from you and your Doctors Office so they can have some case justification to return be to work, is that what i am hearing . If the doctor says i dont think it is a good idea t to go back they can say, hey, look, we understand your concerns. You may not know there is a functional test to use as guidance for deciding whether it is appropriate for the member to come back or not. There has been a handful of situations where thanks to that functional test we were able to keep the member at work. You answered my comment in terms how many incidents. You said a handful. Thank you. At the request of the department so the Department Officers make requests for you to see a member, is that correct . Yes, it will go through chain of command and administration will call us to evaluate the member and the member will come to our office. Thank you very much, chief nicholson. Did you want to speak . Just a quick clarification. The urinalsis testing is supported by the San Francisco firefighters Cancer Prevention foundation. 798 is a donate or and supporter. I have been told there is an individual in the room who would like to make Public Comment, misunderstood you asked for im beforehand. If you can open it up after, that is up to you. Commissioner hardeman you had something to verbalize . Thank you. I dont know if you have the answer to this question, doctor. Can you clarify the financial or other distinctions that go, including return to work when a person is on workers comp or state disability . How does that person financially affected and return to work affected if they are hurt off the job versus on the job . Two different scenarios. If they have juror illness that prevents them from working and that injury or illness is not workrelated, then they have to use their accumulated time balances to restitute their pay. It will be sick pay or if they have time coming, vacation, the department has leave policies in place that facilitate use of the members accumulated time balances, but they actually have to petition the department. They have to give the Department Notice they need to use their accumulated time balances. As related to their seniority and their pension, do you know what those differences would be . I am not sure i understand the question. If they are in an off the job injury, they fall down stairs at home or break a leg or something, what effects does that have on their pension . Do the pension benefits continue when you are on the job injury . That is an hr question. As long as the member is being paid. If they are able to use sick pay or vacation or if they are on a temporary modified duty, as long as they are being paid, they are covered. It is when you are not being paid. I am not sure what the time period is that those benefits can become at risk. As far as seniority . Na stays. That stays the same. They dont get ducted for being injured off the job . If they off on leave without pay for a year, that will affect their pension. That year wont count towards their pension. Does that make sense . I didnt think you had all of the answers but i had to go through you. Thank you very much. Commissioner cleveland. Doctor, one question. In our meeting the other day i asked you what is your biggest challenge in the job as Department Physician . You answered that it was dealing with the power culture ingrained against being healthy and fit, and that you felt the union was not supportive. Can you elaborate more on what you believe are your Biggest Challenges as our Department Doctor . One truth is that health, a Persons Health is very personal. I understand that. If someone is not in good health, meaning they have some illness or some injury, they are not going to talk about it much, and they are not going to talk about it much because it is personal. They dont feel the need that they need to talk about this with anyone else. They may talk to their doctor about it, their personal physician. That is always welcome. But they may not talk to anybody at work about it, okay. Including you . Including me and anyone in my office. I think the fact that individuals hold their Health Information close to heart, you know, you can say that about anyone in the u. S. Work force, but it is a little bit more acute in the Fire Department. That is not a criticism, that is just a statement of fact. Trying to work within that belief system can be very, very challenging. It can impact the exchange of information, of necessary information, when our office is tasked with deciding whether it is safe for this individual to come back to work or not so they may not provide full disclosure. Thankfully, that doesnt happen commonly. It is an uncommon occurrence but it is one of the challenges introduced by the fact people hold their Health Information close to heart. I am not being critical. It is not necessarily a bad thing. Thank you very much. At this point i think we have concluded. I am going to respect the request of chief nicholson. There is a member of the public to comment. Thank you very much, doctor. We have to go through the process of the rest of the agenda. Please remain. The member of the public that would like to comment, plea approach the podium and identify yourself. Since you have came here we would like to afford you this opportunity. I am dan casey. I am an ems captain in station 49. I am here in my role as director from the executive board of local 798, and we understand there are updates and reviews of the physicians office. I will try to be brief. I want to address a couple things that came up. This has been our first formal opportunity to address our members lack of confidence from doctor Raymond Terrazas performance. This is our first formal opportunity. Two main categories. Interactions fall under people who have had uncomfortable and sometimes inappropriate interactions with the doctor and unnecessary obstacles and delays in the return to duty process. I personally have worked with three members who have engaged the same attorney in order to facilitate their return to duty when they have gone through our physicians office, been told they need certain tests, they get the tests then they are told to see an additional specialist. The doctor does not take these specialists opinions, and then further moves out the return to duty process and causing great stress to our members. These are people who want to come back to work. They are people who actually have been deemed by outside specialists as able to do the job. They are facing unnecessary and Unreasonable Expectations from our physicians office. To address commissioners question regarding preventative care. We have in the care had a Health Check Program that was collaborative between management and labor. Participation dwindled because of lack of confidence. Members are not willing to share Health Information with the physicians office. We understand that the Department Physician has a difficult job and must make some hard decisions in terms of whether or not a member is fittor duty, and that can mean someones livelihood. At the same time if the members do not have confidence they are going to be dealt fairly and in an ex pedish us manner that destroys the ability of the Department Physician to adequately serve the membership. Thank you. President nakajo thank you very much. Any other member of the public wishes to give Public Comment. Public comment is closed. Thank you very much. That concludes this report. Item 5. Report from cleave of department on Current Issues and current activities and events within the Department Since the Fire DepartmentCommission Meeting including budget, special events, communications and outreach to Government Agencies and the public. Thank you very much, madam secretary. Chief nicholsochief nicholson. This is my report from two meetings an go since i missed the last one. I i want to thank chief wyrsch for standing in for me. In september i spoke on the 12th at the Mission High Schools first fire and ems program. They have a great thing going there. I hope we can continue that moving forward. On the 13th we had a Department EmergencyManagement Policy Group table top exercise. That includes a lot of Department Heads from the controller, police chief, mayor, and so forth and so on. That is an ongoing effort through the dem. You may have seen i was interviewed by channel 2 on the level zero issues. That came out on monday night. I was interviewed by heather homes. On the 21st we had the battle kickoff. We picked up a lot of bags of trash. It was really well attended. Cd2 and 3 have met with father green regarding his upcoming retirement and where this department is going to head in the direction in terms of chaplains and spiritual support. We are speaking with several members of the chief deputies, sort of their chaplains and spiritual support people to, you know, get a good idea in terms of what we need to do next. As you know, fleet week is here. I know the chief will speak more about that. I really want to acknowledge the preparations going on for months, and chief cochran has done a great job with that. The reason i wasnt here for the last Commission Meeting, i was attending the fire chief conference in ontario, california. The three main topics were ems, firefighter health, Behavior Health and cancer and urban fires in the state of california. Those were the hot topics this year. Just to clarify, we had a meeting regarding the San FranciscoFire Youth Academy funding, and commissioner covington is on that with us. We are moving forward with that. The money from last year that supervisor cohen had designated for the Youth Academy. We are moving forward on that. On the weekend of 28 and 29 we had the Northern California first alarm fire camp at Treasure Island facility. We had 50 Girls High School age that participated in all sorts of Fire Department related activities from cpr to actually wearing the scotts and going into burn rooms to climbing the aerial. It is a leadership empowerment activity based on firefighting skills. I attended a youth town hill and summit in the bayview. Also, with chief scott and amos brown. We have been meeting the fourth. Thank you for coming to the 15th e. M. T. Graduation. We had 20 graduates. Some started on saturday. Also, this past saturday i spoke at the black firefighters Youth Academy for an hour with the kids. This week attended the mayors signing ceremony for the heart trouble benefits legislation where it is making cardiac and some lung, specifically pneumonia issues presumptive for us, which is a great help. Also on the seventh, we welcomed 55 recruits to the 126th h2 academy. They are in the third day now. I wanted to also just i know chief ellis spoke last time about our new battalion chief parks who is our health, wellness and safety battalion chief who is inundated since she started a couple weeks ago she is works on all sorts of things like Behavioral Health to cancer and cardiac. She is a great team player. I played basketball with her in the 1990s. I would like her to come up and say hello to you all. She played center. Good morning, commissioners, president. I just want to introduce myself. I am battalion chief natasha parks, new health, safety and wellness chief. I will be glad to work with the department in getting our members healthy and talking about cancer, Behavioral Health, health check, things like that. Thank you. How long have you been in the department . I have been in the department for 22 years. And she did play college ball. Yes, i played at uc irvine. Thank you. I appreciate it. That concludes my report. Thank you very much. At this point if there are questions. Thank you, battalion chief can you return to the podium, please. Can you give us a little more of your background . My background. I have been with the department for 22 years. I was also with the Sheriffs Department for a few years. I have been a cap at thi captaid lieutenant and firefighter at station 13 for 8 years. I went to uc you are vine. Uc irvine. Very good. Thank you. Vice president does that conclude your questions . Yes, i wanted a fuller picture of her background. President nakajo commission. Come on up. We will keep you walking. I had the pleasure of meeting you at the mayors signing the other day. I have high hopes for your position. That psychology degree will come in handy because as you saw from doctor Raymond Terrazas testimony one of the problems is convincing the members to come to the department for their health and safety and wellness. I look forward to everything that you are going to be doing. I dont know if it is to ask you if it is just let me know. Have you and if so we would love to have you back once you have gotten your feet back you can give us a sense of what your goals are in this position, and i understand if it is too early for that. Do you have a sense what your goals are in this position . One is to get the health check to the members. We have set up a meeting with 798 to discuss topics about getting members more willing to do the health check. I am also a member of supervis supervising the stress unit, and the peer support team. We have a peer support class coming up next week. Then the stress unit we want to get more Data Collected so that we can strengthen the stress unit with more members. We are partnering with the Cancer Prevention foundation to get information out about best practices on preventing cancer. Great. Fantastic. I would recommend we can talk offline. Cal fire got 6 million towards mental health. That is a big deal. They are working on best practices for structure of peer support unit. Chief, i know we are coming on the oneyear anniversary of the resolution this commission passed in regards to peer support. I imagine you will have something to do with that as well. We look forward to seeing that. Thank you and welcome aboard. President nakajo thank you very much. If there are no other question, we will bring up chief victor wyrsch. Vert ogreater alarm fires, emy medical services, bureau Fire Prevention, Homeland Security and airport and update on drone program. Thank you very much. Welcome, chief. Good morning. I am deputy chief of operations victor wyrsch. This is my Operations Report for september. We had one greater alarm in the month of september during this reporting period. Second alarm on 9 25 at 29 thornton. No injuries. Arson investigation has deemed this undetermined for cause. This was a fire started in the rear of the fire building in a makeshift storage area against a cd corner of the fire building. Paint and batteries were stored in the rear of this building, and they dont know if it was caused from heat or if somebody lit the fire. Right now it is undetermined. It had smoldered for an extreme period of time. The fire ran up the rear exterior of the building and entered through the eves of the rear. Due to the location up against the zero property line, some of the fire spread to the exposure d corner. Lines were deployed. This was able to spread through the attic of the fire building. It burned through the ridge beam of the roof causing the rear of the peak to sag and drop on the interior ceiling. Companies were returned to extinguish the rest of the fire