Imperative upon to understand these people that have done these jobs many, many years, actually granting them some expertise that could be a qualifying factor to retaining these jobs. I would love to see a recent analysis, also, about those people in temporary and exempt positions by race and wage levels. Because when we took a good preliminary look at this, we saw that many people in management positions that were exempt were actually white individuals, while we see in the temporary positions, very lower positions that were paid much, much less, they were primarily people of color and African Americans and latino. So i think were in agreement, mr. Ponder, that that is absolutely not acceptable. And i would just want to say that i would suggest to you and also to miss ng from the Civil Service commission, that we are putting people into training positions, that we should be also allocating a pathway to permanent Civil Service. That anyone that comes into a training position, that they are quite aware that this is a training position, that there is a pathway to Permanent Employment with us at the city because we have heard many times in this chambers that they have been in this position 25 years, and i think that is unacceptable to all of us. I would like to also add my voice to request this hearing be continued to the call of the chair as we have brought up many issues today that need some data and also some follow up. But, again, mr. Ponder and local 21, i just want to commend you on coming together with an agreement that, in recognition, also, there are many other public union public unions that actually have some of the same complaints and some of the same problems within our system. Thank you very much. Chair mar thank you. So, yeah, i just wanted to also thank supervisor fewer for calling for this hearing on on such an important topic, the misuse and, really, overuse of temporary positions in our city and how in t, in the future, w ensure that our city and temporary workers are treated fairly, and ensure High Quality Services for the public. Thank you so much, mr. Ponder from d. H. R. , and, also, miss ng from the Civil Service commission for sharing your updates and engaging the discussion. I think as my colleagues have highlighted, this is something that we this committee and the board want to continue to oversee and engage and ensure that we move move the particularly the negotiations with the other unions forward. So so thank you, and we colleagues oh, supervisor peskin . Supervisor peskin i do have one question apropos the hearing that supervisor haney referred to at the government audit and Oversight Committee meeting yesterday. And this is not a personnel question per se, mr. Ponder. And you may or may not be able to answer this, but in this committee yesterday, we came to understand that in the higher echelons of public works exactly half of the senior manager actually, more than half, if you count the acting director in public works, which we all understand why we have an acting director of public works, sadly, but that 13 out of 25 positions were acting. Now, this is a form of temporary exempt behavior little bit different. Not covered by the charter, but the same notion of acting also puts those people, albeit, theyre all exempt, at the potential of being unduly influenced or exploited. So the question i wanted to ask, and i did not want to put miss ng on the spot, is when we will have a permanent director of the Civil Service position. Im not familiar with that position, so i dont have that information, but i will follow up. Supervisor peskin if in it a followup email or continuing meeting, we could answer that. I would like to have a permanent Civil Service director sooner rather than later. Thank you, mr. Ponder. Chair mar well, thanks, everyone, again, for this hearing. Colleagues, can we continue this hearing to the call of the chair without objection . Great. [gavel]. Chair mar thank you. So we have a special order item at 1 00 p. M. , so were actually going to be calling a recess right now and reconvening at that time to call that item. Supervisor peskin and, mr. Chairman, i will be at a meeting at the bay im joined by supervisor matt haney and ahsha safai who is filling in for aaron peskin. Mr. Clerk, do you have any announcements . Clerk clerk yes. Please silence all cell phones and electronic devices. Copies of completed speaker cards and documents are to be submitted to the clerk. Items acted upon today will appear on the march 10 board of supervisors agenda. Chair mar thank you. Can we excuse supervisor peskin without objection . [gavel]. Chair mar i think its important that we make an announcement for our first cases of covid19. Mayor breed declared a state of emergency locally, and Governor Newsom has done the same for california. I dont mean to alarm anyone, and i im grateful for the wo by these departments and their staff. The reality of this Public Health crisis makes this subject all the more important. The ability of our staff to be well equipped is vital for a good outcome. I visited San FranciscoGeneral Hospital in preparation for this hearing and toured the emergency room. Ive met with nurses and labor leaders. I have immense gratitude for their work, and i have questions i hope to raise during this hearing. Im grateful for the nurses and Public Employees here today. We will be hearing from quite a few presenters today, so in the interests clerk mr. Chair, sorry to interrupt, but at the time, the balance of todays agenda hasnt been called. Should we do so now, before chair mar sorry. So, yeah, mr. Clerk, please call items 2 and 3. Clerk items 2 and 3 are hearings to address concerns raised by zuckerberg San FranciscoGeneral Hospital registered nurses standarding staffing, the use of contract registered nurses, hiring time frames, safety, and bilingual support, and requesting the department of Public Health, zuckerberg San FranciscoGeneral Hospital, and department of Human Resources to report. Item 3 is a resolution urging the administrative of the department of Public Health to include front line registered nurses and resident physicians in their decisionmaking process to implement, to the extent possible, an expedited hiring process to less than 90 days from receipt of application, to aessupplementing staffing requirements with contract registered nurses by implementing, to the extent possible, a ceiling of 5 or less of total staff, to provide annual violence prevention and Disaster Preparedness training for all staff, and to support its bilingual staff. Thank you, mr. Chair, for allowing me to call the items. Chair mar thank you. Supervisor safai, the floor is yours. Supervisor safai thank you, chair mar, and supervisor haney. We called this hearing not because we have a crystal ball, not because i know more than anyone. I called this hearing because the public nurses came out and spoke out in this chamber. Its not often that nurses will come wearing their garb, standing in line, and willing to wait. What they said was theyre overworked, theres staffing issues. Well probably hear some different opinions, but i want to clarify when i say staff. I mean permanent, fulltime positions. Not temporary positions, not parttime, but fulltime positions that will be there when a crisis is faced. Fast forward to todays announcement we just had our first confirmed coronavirus cases. This is a serious Public Health issue, and in the places in the United States where its being dealt with, we are seeing that front line First Responders are having to selfquarantine themselves. Theyre having asking theyre being asked to quarantine, and theyre being asked in some cases in some cases, theyre the ones that have contracted the virus. So that makes todays hearing even more important. Because if we have a hiring crisis in terms of timeline. We originally asked for terms of 90 days, but im going to push the city and ask them to come up with a hiring plan in 30 days or less. We have to have the appropriate fulltime staffing in our department. So were going to hear a lot from the nurses today. Theyve taken time from their busy schedules themselves. Were going to ask the departments to come up first so we can hear their initial responses. Im going to read the initial order of speakers, and as chair mar said, were only going to have anyone speak for five minutes or less so we can move to public comment. I just want to underscore that this is something that has been asked for for years. Not only do we have a crisis on our streets, we have a crisis in the city and county of San Francisco. In the opinion of many people that ive heard from and listened to, it has gotten worse and worse. And because of that, these nurses are at the front line of defense in many cases that are dealing with that. So that if theyre overworked, if im getting messages on christmas eve, theyre being asked to take mandatory overtime. Theyre not going to say no, especially if an emergency room is full. But this isnt just about the emergency department, this is about all the different divisions within the entire San Francisco general. It is the only Level One Trauma Center in the bay area, and we need to treat it as such. Lastly, ill say that it is important, as part of this process, that we hope one of the outcomes will be that there will be much clearer lines of communication between management and frontline staff. Because when i went, like supervisor mar, i went and did a tour myself. I just listened to the nurses and the things that they had to say. And the thing that i listened to was morale was very low. Morale was very, very low, and if thats true, theyre not going to feel very enthusiastic on their job. Again, this is not trying to beat up on anybody, we. Were trying to have an open and honest conversation. Currently, it is about 200 days to hire a nurse in this area. If you ask the average person in the bay area, will you wait seven months to get a job, the answer will be no, i have to work to support my family. So i just want to lay the framework for that. I really want to thank my staff for putting this together, working very closely in particular with the leadership of seiu 1021, but the frontline staff, julie, krista, heather, theyre there every day, put transgender on the line, and they have tried to be a put for putting it on the line for every day for the people in the city and county of San Francisco. So i know the situation that were dealing with and the crisis that were dealing with, i dont want to take anymore time. Were going to have a lot of questions, and i know that dr. Colfax and others are going to speak, so the first person im going to call up is dr. Colfax, the head of the department of Public Health. Good afternoon, supervisors, chair mar, supervisor safai. Supervisor safai five minutes, please. Fellow committee members, glen colfax, director of Public Health, San Francisco. I just want to emphasize how much i appreciate the importance of this issue. I trained and worked in the zuckerberg San Francisco general, including in the hiv aids epidemic. I know firsthand that nurses and their care are the foundation of the hospital. Staffing, and the quality of that staff, is paramount, as is and always will be worker safety. This is not only an issue in the emergency room at zuckerberg, but an issue in our health care in San Francisco, our state, as well as nationally. Covid19, or novel coronavirus, has only highlighted these issues and concerns, and i want to be very clear. There is no space between d. P. H. Management and the unions on this on these very important issues. We are taking key steps to address concerns. I have made changes in h. R. Leadership in order to address the long hiring process, which i consider completely unacceptable. You will hear about those steps. With regard to workers safety, we have taken a collective approach to addressing those concerns, and you will hear about some of those data today. But i have ensured that during this challenging time with coronavirus covid19 that the leadership is here to answer your questions, listen to the frontline staff concerns, and take action together. Thank you, and unfortunately for the remainder of the hearing, i do need to turn it over to leadership at the hospital, especially given the recent reporting that we released with the mayor today around the two cases in San Francisco. Thank you. Chair mar supervisor ronen . Supervisor ronen before you go, i know you really have to get out of here. Sorry . Supervisor ronen yeah. I just had a couple of questions. In terms of leadership from d. H. R. , is Mickey Callahan here by chance . Supervisor safai im sorry. I went over the list of leadership here from d. H. R. Supervisor ronen because weve got a crisis, and we have to fix it quickly, but it is happening all over d. P. H. Its not unique, its in every single program. Ive talked to hiring managers in several of your clinics, and every time they hire someone, they embark upon the hiring process, theres new rules and new inconsistencies. And they expect the fill position will be about 18 months. Thats why im asking if Mickey Callahan is here. We have a crisis when it comes to hiring in the city, and so i just wanted to hear from you a little bit more first, i wanted to just share that i got a copy of the workers satisfaction report that shows that 32 of your staff in d. P. H. , you ha d. P. H. You have about 3,000 staff feel that their department is adequately staff. That only about 34 of them feel like management adequately communicates with each other. These are shocking statistics, and so i just wanted to make sure that you hear the level of urgency we have, not only about this particular situation that this hearing addresses today, but about your entire department, number one. The second thing that i want you to know before you leave is i got a copy of the steps in the hiring process. There are 30 steps in the hiring process, 30 steps. I talked to one manager, who told me to get through steps o 1 through 10, its taken nine months, and they havent even taken any information, its just preliminary steps. I couldnt go through the endless information i could go through with you today, because i know you have to run, but this is just the very beginning of this process. Im planning, together with supervisor safai, to hold a number of hearings on this issue, because we not only need to fix hiring at s. F. General, but we need to fix hiring in general. Supervisor safai yes, supervisor. We have the Deputy Director of d. H. R. For Mickey Callahan. Supervisor ronen i think that is great. Supervisor safai we had spoke with them in advance because we knew this was going to be a series of hearings. Supervisor ronen yes, but supervisor safai, i thought it was very important to send this message to dr. Colfax because he is head of the department . And this issue is not limited to nurses in general. It is a sustained problem in the department, and i want him to hear from me on that. And i believe the problem starts at d. H. R. , and i believe that, in the future, mickey calh callahan needs to be here, and i will communicate that to her. Supervisor safai dr. Colfax, did you want to say anything on that . Well, i think Michael Brown is our new director of h. R. Were not only talking about the hiring metrics, which are concerning. But i need to focus on cultural differences, and there also is evident over the years that we were not optimizing our relationship with d. H. R. , and im very pleased to say with director browns help, were identified places where some of those steps arent even necessary. So were clearing out what we dont even need to do in order to focus on what we need to do. And he will go into that detail, but were making clear progress in that work, and i just want to emphasize clearly with the nursing work ive asked michael and the staff to focus on this nursing issue. D. H. R. Has been a wonderful partner in that, and i think thats really going to accelerate progress in this area. Supervisor safai thank you, dr. Colfax. I think before you leave, supervisor walton wanted to ask you a question. Supervisor walton thank you, dr. Colfax, for being here. I understand we are in the middle of a crisis, but i have some questions that i have that i feel you as the head of the department to answer. The first is we have break nurses in a ratio of 1 4, and that 1 4 ratio, which is contractual and probably lawful, we get up to about 1 8. How do you deal with that . So i have the director of zuckerberg general and the director of nursing supervisor walton all of which ive met with and had conversations with, but id love to hear from you. I know they will make presentations later today, and i assume you will get answers to those questions. Supervisor walton second, is it normal [inaudible] supervisor walton versus hiring permanent, fulltime workers . I have always placed an emphasis on hiring fulltime workers. Supervisor walton i think one thing that is pertinent, and d. P. H. Will correct me if im wrong, it is wrong in hiring temporary staff in general. We are frustrated with that process, which we know is ludicrous. Just the last thing i want to say, because you may have just been getting on board, but over six months ago, i asked the department of Public Health to send me a detailed Public Outreach plan that we can use as a framework that tells me all the additional recruitment strategies, all the recruitment strategies, how your