The year ahead. At the close of the year, we close the books and produce Financial Statements that disclose the citys actual Financial Condition at the end of the fiscal year. To ensure that those documents are full, complete, and tested, the board of supervisors retains an external financial auditor that reviews them and other things and then reports to you on their findings. The goal is to ensure that there is a reasonable assurance that what were representing in the comprehensive Financial Report is accurate. So what we have here today is the external auditors reporting to you on their audit work for last fiscal year, the 17 18 plan, and the cafer for the close that were working through now. Ill say briefly as a bit of backgroun back background fo, a bit of a challenge because it was the first time we were closing the books in decades. People cut over were cutting off the famous citys former system which was installed initially in 1980. So the first time in any close in a new system is a challenging one it. It meant that the cafer is so late. And were now closing the book for the second time, and finding it a much simpler process. We would expect to have this years cafer in early december. With that, i will turn over the floor to annie louie, and she can provide the report from the auditors. No material weaknesses. Good morning, i represent the audit firm. You all have in front of the presentation. First all go over the audit reports from fiscal year 17 18, and then ill go into the audit plan for 18 19. There are two audits as well as compliance audits. On the left side are the ones that we are responsible for, and then on the righthand side of the slide youll see all of the ones that kpmg performs the audits for. In terms of the audit results, we seek unmodified opinions for all of the audits, as well as the compliance audit. And then the report to the g. A. O. Is our direct communication on information that you dont necessarily see in the Financial Statements, butt we need to communicate to you as the governing body. These are the required communications, and you have the details of this in your package. There isnt anything atypical in terms of the required communications. I want to highlight in terms of the qualitative aspect of the audit, the city implemented new accounting expenditures, and that put a fuge a huge financial situation. It is a large number that is different from the previous year. In terms of the significant deficiency alluded to before, we reported a finding in the financial close process and the current process, mainly because of the newly implemented system that the controller had alluded to just now. And youll see in the pact packet the full management response, but we are working actively with the control managements office for improving the 18 19 close. With that, ill go into the audit plans for the fiscal year 18 19, and this is a joint presentation with k. G. M k. G. M. B. , and they couldnt make it here. There are no changes in terms of the audit scope from fiscal 18 to fiscal year 19. We have two lead partners at the top and separate audit teams for each of the main departments and the city, over all. And this is the audit team for k. G. M. B. Our auditor responsibilities, the highlight i want to make is we are here to provide an opinion on the fairness of the Financial Statements. It provides reasonable assurance as opposed to absolute assurance. If we have any findings over internal controls, whether over compliance or Financial Reporting, we would report that to the g. O. At the end of the audit process. In terms of management responsibilities, i want to highlight Financial Statements are prepared by management, and they are responsible for the fairness in presentation, as well as the compliance with the applicable compliance requirements. On the timing, we actually start the audit process in early march april. We come out usually in may, the june timeframe, where if there are any changes that have occurred in the fiscal year, and we the financial close is in september, through january, for the various departments and the city cafer audit, as well as the compliance piece, the single audit. Starting around november, all the way through january, which is usually for the compliance piece of it. There are two new standards that are new for fiscal year 19, and one is for retirement obligations, and the other one we listed at this point dont expect any significant changes in terms of the accounting of such transactions, but you will see Additional Closures related to the transactions that the city has. With that si will take that, iy questions that you have. Chairman i have no questions. Were also going to hear from somebody from kpmg . Unfortunately, the kpmg could not make it this morning, so ms. Louie has presented their portion of the presentation here. I did have a question, just given the one main finding from the audit in around relating to the sort of late how late it was to finalize the Financial Report and then the audit this year. I just wanted to ask if that had any sort of impact or implications for our city and terms of the impact or implications for the timing . Yes. It certainly made everything is little harder. Where we end one fiscal Financial Year is preparing the budget for the year ahead. So to have it occur to have us kind of complete the process this year in march with preaudit results available in february, mentor tha meant thatt first Building Block wasnt known until a little later in the budget process. So it created some challenges. There are a lot of different parties that have an interest in the citys Financial Statements, investors and others. One of the key constituencies that really uses the cafer are our organized departments. It did create some challenges in them have timing access to information in the process. So, yes, there were certainly challenges with timing. It is one of the reasons im so anxious to not have it occur again in the future, and im confident it wont, given the fact that we now have experience with the new system. And for the new system thats in place uhhuh. You expect the timeframe for the subsequent years financial back to our former timing. For the fiscal year that closed on june 30th, were well along in the process, months shaved of aheadf where we were last year, and im confident we will have our cafer released and on a december timeline. Im always happy when i see no material weaknesses, and i have been on this panel when we did. And i have been controller when we did, so i am pleased by it as well. Obviously, we take a deficiency seriously and we are working to remedy it. In the citys single audit, which had no single audit findings this year. Way to go, mr. Controller. And the team behind me and throughout the Controllers Office and the citys Financial System is what makes it work. My thanks to joshlin and carmen and the broader family of professionals in the Controllers Office and throughout the city that makes this good work happen. Of all of the things we have to worry about, your shop is not one of them. Thank you. Why dont we go to Public Comment. Are there any members of the public that wish to speak on this item . Seeing none, Public Comment is closed. And i would make a motion to file this hearing. Is there anything we need to move to the board . Not for this item, no. So without objection. So i think for item number two, were going to need it would be best if president yee is here for that. Maybe we can take a brief recess. I do have a committee i have a president ial action memo that would appoint him as a member of this committee starting at 10 30, which is in about 15 minutes. I could change it to 10 15, if he could make it here in one minute. Why dont we take a 15minute recess. Do you have another item . If i could go grab him chairman is he here . I dont know. Should i call the item. Chairman mr. Clerk, please call item number two. Number two sa hearing regarding the status of the laguna hospital patient abuse. That safety and wellbeing are safeguarded from any potential abuse. Chairman and were going to take a brief chairman the board is back in session. Mr. Clerk, can you please read item number two. Agenda item number two is the hearing regarding the status of the lag gene lagua hospital, measures to make sure that the patients are safe gardened from any potential future abuse. Chairman president yee, the floor is yours. Thank you for your support for calling for a public hearing into the current status of the laguna honda hospital. After allegations of abuse at the hospital were made public in july of this year. Let me be clear that this hearings focus is on the turnaround plan for the hospital. The public needs to know exactly what the hospital has done to turn itself around and to ensure that patients are receiving the highest quality of care without any risks of exploitation or abuse. To summarize briefly the situation that triggers the need for this hearing, a City Attorney investigation originally initiated by the Human Resources complaint uncovered evidence that 23 patients were subjected to privacy violations and abuse by staff between 2016 and early 2019. On june 28th, dr. Cofax, the director of the department of Public Health, stated that the department would be taking immediate action to develop a turnaround plan for the hospital, and would be able to report back within the next 60 days, which brought us into september. The hospital first presented this turnaround plan to the Health Commission, and now they are presenting it to us at the board of supervisors, with a Progress Report since the execution of the plan itself. There is no excuse for what transpired. Families like my own depend on laguna honda for care. They should be able to trust it is going to be the highest quality. I think it is critical to hear from the hospital regarding the protocols that they have in place to ensure that abuse like this never happens again. We cannot ask our residents to entrust the care of our loved ones to any entity that cannot prove that they have an effective system that guarantees the safety and wellbeing of every single patient. And if there is ever a hint of violation of any patients rights, that there is a system in place to immediately identify any possible violation. Steps taken so far by the city have included conducting patient wellness checks, retainin retaining retraining of staff, reporting of violations, contacting all state and local regulatory and Law Enforcement agencies and more. My office has been contacted multiple times by concerned families and individuals, and im sure that other offices may also be dealing with those concerned about the situations. My office has been in touch Wit Department of Public Health and has shared with you exactly what im looking for as far as information today. So let me just note now, for the record, that the two main issues that i would like representatives of the department of Public Health to respond to are details of the turnaround plan, including the oversight that you have in place to ensure that any possible violation of any patients rights are immediately identified and addressed. Number two, the status of any investigations by state regulatory agencies, as well as local Law Enforcement. And i would like the department to have to share with us just the status of those investigations, if they are still active. If they are closed, then please share any findings that are relevant to the hospitals operations and subject matter for this hearing. Now, would any of my colleagues like to make any comments before we begin . No. But i thank you, mr. President , for bringing this muchneeded hearing. Okay. Then i understand that we have, first, today to present is maggie ro ryecowski. I am maggie, and im the acting chief executive officer at laguna honda hospital, and im here with my colleague, troy williams, the chief quality officer for Zuckerberg San Francisco hospital and Trauma Centre and laguna honda hospital. We are here to talk to you about our reform plan and things that we have had in place so we can get laguna honda back on the right track. Okay. And so were going to just very briefly go over not briefly, but troy will be going over the Regulatory Compliance of where we are in the investigation, and where we are today. Well talk to you about the leadership, quality and safety, and what were going to do to prepare for the future. So this slide is a snapshot of the timeline of the incidents at laguna honda in february of 2019, is when leadership was made aware of the incidents was made aware of the incidents. At that time, all of the appropriate regulatory agencies and appropriate individuals were notified. A lot of work has been done between february and now, and i can tell you that were very proud that on october 15th, laguna honda was found to be in Regulatory Compliance with the state. Laguna honda, for over a hundred years, has taken care of generations of san san franciscans with dignity and respect. This is the last several months of investigation of problem solving by numerous and other staff and state agencies and regulatory bodies. As supervisor yee mentioned, on june 28th of this year, mayor london breed, our president of the board of supervisors, norman yee, and grant coulkofax reported to the community about the reported abuse of patients at laguna honda hospital. A reform plan would be developed and presented within 60 days. On september 3rd, the plan was presented to the Health Commission and to the mayor. In the reform plan document, that youve been provided, you can see an overview of the findings of deficiencies and corresponding items and plans for improvement. Many deal with gaps in patient care and quality and safety. While our California Department of Public Health plan of correction and this reform plan outlines the work that continues at laguna honda, we plan to make good on our promise to restore the publics faith in the ability of laguna honda high quality, safe, and abusefree care to the next generations of san franciscans. Next im going to turn it over to troy williams, who will talk about compliance. Chairman i will pointer out the reform plan dated september 3rd refers to a former member of this body, subsequently in cars rapisted, rathe incarcerated, rather than the president of the board to my left. This is norman, and this is le leland, f. Y. I. Hopefully you can correct that. Apologies for that. Good morning, my name is troy williams, and im the chief quality officer for Zuckerberg San Francisco general hospital, and i was asked to come to laguna honda for investigation and improvement in their quality program. It is important to note that upon discovery of patient abuse in february of this year, it became evident there was assistance needed at laguna honda, Additional Resources specifically in Quality Patient Safety and Regulatory Compliance. To that end, the Health Network deployed staff from areas like myself, and other team members to go to laguna honda and assist with the investigation. As was previously shared with the Health Commission back in september, the California Department of Public Health did issue a plan of correction. You may hear the term 2567, or statement of deficiencies, and theyre all the same thing. Outlining specific areas where laguna honda was found to be out of compliance with state and federal regulations. Prior to the receipt of the statement of deficiencies, the plan of correction, as president yee had pointed out, there were a number of things put in place even before that time, and included a lot of staff education and training, wellness checks for the residents, and also the removal of the employees that were responsible for these heinous acts. But overall, so the reform plan and the summary of the plan of correction that you have as a part of your packet, has more details around the specifics of the plan of correction, but there were some overall themes we found as part of the d. P. H. Investigation and the c. P. H. Investigation, and im going to go more in detail on those in a little bit. First i wanted to give to your point, president yee, a little bit of an update on the investigation and where we stand. So the investigation has been an interim process. Since mayor breeds and director kofaxs press conference, there are additional situations weve had to report. Based on the forensic analysis of the cell phones taken from the Staff Members that were involved. Very unfortunate. We reported additional photos and videos to c. P. H. On a rolling basis up until midaugust. So as a result, there will be more c. P. H. Compliance the laguna honda. But it disappear from our conversations with c. D. P c. D. P. H. , weve had a very good openness and theyre many pressed with the improvements that we put forward, and feel like were getting to the root cause of what led to these events. But there will be more activity. Important to note that as a result of this forensic analysis and the additional photos and images, no new employees have been identified, having involvement with the use of chemical restraints or images or text messages. It is all the same employees who have been removed. A little bit of update on the numbers. Frustrate original 23residents that were involved, and that is the current plan of correc