Transcripts For SFGTV Board Of Education 20240712

S San Francisco has been doing a great job flattening the curve and sfds has been a big part of that. The stepsky foundation and Silver Giving Foundation at 225,000 and somaland foundation 476,000, linkedin, 146,000 and the Webb Family Foundation at 70, Golden State Warriors at 50 and walter and alysse haas fund and the Tipping Point community at 25, and the stepski foundation is 20 and i want to thank all corporate and giving foundations and individuals this is a Response Fund the ones their gave before throughout the year and this is the ones for the covid19 response. And toma bravo at 1. 1 and anonymous at 11,000, Golden State Warriors at 125 and the hellman foundation, 50,000 and palms against poverty is 28 and herbert and Gene Foundation at 25 and facebook is 20 and cohen elevators is 20 and the wells fargo 20 and google fiberton 10. Wellington management 10, the 697 and alaskas airline 5,000 and odell family and dennis wulliver kelly and these are all that have given towards are covid19 responses going to our meals program, to devices and technology and hot spots and were thankful for the giving during this really difficult time and we hope that other corporate foundations will step up, as well because this crisis is going to continue. So again, thank you very much. Section a, general information, regarding Virtual Meetings, ada accommodations and Translation Services and for the translation part, is this the appropriate time for comments . Yeah, ive included them in dr. Matthews remarks moving forward and hell be making that announcement and we do have can we also have at this point, our translators, make the announcement. Ill make it in english but if they could make the announcement of how to go to the rooms right now in spanish and cantanese. Great. speaking Foreign Language section b of 2020 and we need a motion and a second. So moved. And second. Thank you. Any corrections . Also, jensen, i have a limited view of people, so if you happen to see people raise their hands, will you let me know . Yes. Role call, please. Pai role call . Superintendents report. Thank you, president sanchez and good afternoon, everyone. As you just heard, im going to repeat that announcement in english now and transportation will be provided throughout the days regular board meetings and at all meetings moving forward. The translation for chinese and spanish will take place in separate google hangouts. For chinese interpretation, please call 484 8542388 and pin number 721609895 and for spanish interpretation, call 13193829676 and the pin number is 665996976. We also will have translators on the zoom meeting for Public Comment as needed. And as a reminder, if you need translation, make this request 72 hours ahead. Last week was the National Teachers appreciation week. During these challenging time, teachers have been true heroes for students and families and i cant thank you enough for all that you do. Thank you for fostering the 21st century skills essential for success and thank you for being a role model and thank you for caring about the students academic growth and Emotional Development and thank you for being a part of this community that is redefining School Together in service of all of our students. We continue to learn as we go and here are a few updates. As students wellbeing is our priority, were providing for the Wellness Check in addition to each system of communicationg with students and families and supporting needs where possible and connecting with them and connecting them to the resources in the community. We are about to hold our Second Community Partnerships Forum to help us organize around the most common areas of need. 15,000 students were mailed kits last week and students should have received those kits by now. 12,400 chrome book and 37 hot spots for wifi access have been distributed to grades 312. By the end of the day, 99 of Technology Requests made by families for technology have been fulfilled. The district will be hosting Summer Programs this summer but all programs will be virtual. As a result, the department of technology is spending the next few weeks focusing on supporting techniques for the summer. Tomorrow may 13th, is the last day to submit a request for a chrome book or hot spot for wifi access. And if you know of a student in grades 312 who still needs a chrome book or wifi access, they can visit our website a to fill out the online request form or call the Family Resource link at 415 3401716. We know the office of curriculum and instruction together with the department of technology is now deploying devices to the paraeducator staff in our district. We will continue to do so through thursday of this week. We will be offering Summer Programs remotely for summer 2020 and prioritizing our largest Summer Programs, college and Career Readiness at extended school year for students with ieps and these programs will begin june 10th and will be offered in a Remote Learning format. Students who are eligible for high School Recovery and esy will receive information about the Summer Program offers. And we are working with communitybased organizations and afterschool Summer Programs to identify other Summer Programs and opportunities for students. And well share more information on Summer Learning options as they become available. As we continue to make our way through the covid19 pandemic, we know that reopening schools will be a challenge and will require extraordinary coordination and planning. As a result, we have opened rfq, which is a request for a quote, from outside partners who wish to help facilitate and plan this work. The successful provider will partner with us to facilitate and plan the work for when we finally reopen schools. The rsq can be found on the sf usb website with our covid19 School Closure updates and resource page. Ill call on her and shell be out in just a moment. So shes in the other chatroom. Ill switch her out as soon as i get her. Were ready for your delegate support. Got it. Can everyone see me . We can see your screen, but not you. And now we can. The miracle of technology. I was panicking for a second. [ laughter ] hello, everyone. So student delegate campaign update. We would like to announce that the 2020 Student Voice survey student delegate election has been extended to may 20th. Our goal is to encourage engagement. The student delegate position gives students a platform for Student Needs and concerns. Its an amazing opportunity and we encourage every student. We would like to thank all of the candidates and second reading of the resolution. Last night at our sra meeting, we had a second meeting and in resolution works with our allies, the youth commission, to relocate education funds. They voted to have this passed and presented to the board of education and we would like to thank commissioner astro and the cacabinet team for working hard. Summer entranceship program. Every year the sac partners provide a paid opportunity for high school students. Due to the pandemic, this internship will be virtually ruled out for the summer internship program. The goal is to continue to provide the best mentoring experience for our peers. Our next meeting is monday on zoom. This is a Public Council and anyone is welcomed to attend our meeting. If you would like to attend, make a presentation or would like a copy of our open coming agenda contact the sac supervisor, mr. Salvador lopez and thank you. Thats all. Thank you. Item 4 is recognition and resolutions of commendations. This evening, we have a video recognition. The st. Warriors had a special surprise for Teacher Appreciation day on may 5th. So we will run the video and afterwards, ill describe what was happening. [ ] come on in, everybody video playing . Hello, everyone. Were going to start this meeting. You have a special guest here. Hello, everybody its good to see you. Thank you for everybody that you do and its special and near and dear. And we know that the youth is our future and on behalf of the Warriors Community foundation, were excited to share the news that San Francisco Unified School District will be granted 125,000. Tomorrow a National Teachers appreciation and we wanted to say thank you for everything that you do and you have been helping out the community and we know this is our future and as long youre taking time out of your day and helping out, well still do the same and we can help get through this together. You could hear what was going on, a video zoom call, a staff meeting and warriors players, damion lee and announced the Warriors Community foundation is partnershipped with the hewlettpackard foundation making 125,000 contribution to the San Francisco Unified School District. So it was a great way for the district to be honored, but most importantly for teachers to know how special they are and we thank the warriors for their partnership, for the hewlettpackard foundation bridging with us and for just recognising the special work that our teachers are doing, especially. Its all of the time, but especially in these times. Thank you. I got to see it without the glitch before and its such a wonderful video, so hopefully we can make it available somewhere. Kind of zoom bombing. So i have a feeling that well be teaming up with the warriors with some fun in the near future. And item five a recognising all valuable employees, awards are announced tad. Today and section c is Public Comment and so our host, mr. Steel, will call on speakers and keep the twominute time. Here is the protocol. Please note Public Comment will hear from the community on whats in the boards jurisdiction and we ask you refrain from using employee and student names and if you have a complaint about a district employee, you may submit it to the employees supervisor in accordance with district policy. As a reminder, board rules on California Law do not allow us to respond to comments or attempt to answer questions during the Public Comment time, as much as we would like to. If appropriate, the superintendent will ask the staff follow up with speakers and so well go into Public Comment items that are not on the agenda. Thank you, president sanchez. Please raise your hand if you wish to speak during Public Comment. Before you call on people, just as another reminder, because weve been having problems with this, at least at the last meeting, please make your comments germane to the topic at hand and this is all ims that are not these are regarding items that are not on the agenda today. Thank you. Hello, ben . Are you there . You have two minutes and you can go ahead. Im the news director at the San Francisco Unified School District and i wanted to give you a heads up about good news we had. Following up on the good news mr. Sanchez shared to the district. Our Radio Station has been honored with some really prestigious awards of late and i wanted to call your attention to that. It has to do with the learningwhileblack series that lee romney made, about the fight for equity in San Francisco schools. Supervisor matthews and others might remember an event we held at the Africanamerican Community center where we brought together members of the Community Around this reporting and that series has been awarded best news series in the Western Region by the radio and Television Digital News Association and it is one of many awards that this series received. So that is really great kudos to both our educational reporter lee romney and to the district where we have done this work. And also, the Pulitzer Prizes came out recently, and there was an audio journalism category for the first time ever. Several people trained for kaws Training Programs were recipients, including lina masitiz and she reported on a return to mexico winning the pugh liPulitzer Prize and other finalists for the Pulitzer Prize with the team from peer hustle. We trained erlon woods and nigel poor to do that work. I wanted to give you a headsup about the great training work and the awards that were recently given out at kalw. Thank you. Now. Thank you. Hello, michelle. Hi, this is Michelle Parker and im the vp legislation for the district pta and i just had a couple of quick things today for you, commissioners. The first one is that i appreciate the updates to the agenda on board docs where its more streamline. I wanted to let the public know the district is holding a series of meeting for the rest of the year and call 411 meetings for teachers across the district to connect and learned and weve had a district budget staff and weve helped to navigate in the community and navigate the pt business during these School District closures and well have our state legislators talking tomorrow night. Next week superintendent matthews will be coming on and talking about what parents can expect moving forward and then the following week, well have board president sanchez and mr. Lamb to advocate for more funding for our schools and you can find information at our website which is sfpta. Org and thats it. Thank you to much. Thank you. Caller, are you there . Hello, everybody. Can you hear me . Yes, you have two minutes. Im concerim kevin robinson. I would like to preface my comment, in response to Public Comments. The district does not own or have control of the Radio Station kalw. Students cant walk across the stage or field to receive diplomas or share experience with family and friends, it will be great thinking outside of the proverbial box to provide radio time to as many 2020 graduates as possible over the next couple of weeks. They have a license to and content responsibility for. Again, klw 97. 1 f. M. To make that happen. Beyond that, there should be more youth and educationfocused programming and that means hours, not minutes, made by for and about our youth for the social, emotional and educational enrichments. Thank you. President sanchez, that concludes Public Comment. Thank you. Thank you to the public for your comments and section d, Advisory Committee reports and appointments. We have the Parent Advisory Council. So if there is a representative, a representative we will identify you. Yes, good afternoon, president sanchez and commissioners, superintendent matthews, student delegates, staff and community members. Im Michelle Vegas and im coordinator for the Parent Advisory Council. And im joined today by a parent member herself. Michelle, are you there and can you introduce yourself . I am, but whatever just happened to my screen . [ laughter ] it took away my notes so hold on one second. I dont know what just came up on the screen. It probably took away your split screen. Thank you. Im michelle delaneny. Im the parent of a kindergarten and im here for the Parent Advisory Council report for the board of education for may 13th, 2020. The roles of a Parent Advisory Council is to represent parent voice expose perspectives t voices and perspectives. This is our first report in three months to the Advisory Group meetings. We would like to take this opportunity to present a slightly different report than usual, highlighting both the challenges and the situation that has been brought to our families, as well as express our ideas during this unprecedented times. Covid19 challenges for students and families. As families across our district, members have spent the past nine weeks trying to support the learning and wellbeing of their children and this juggling act has not been easy, especially for those whose students would be receiving aadditional support to be successful in their academic and social, emotional learning, including student whos are learning english as an additional language, students already struggling to achieve grade level proficiency, students who lack access to Additional Resources outside of school, students who rely on the social support of peers and site staff including teachers, afterschool leaders and Mental Health professionals, students with ieps, especially those who are not able to Access Services like physical and occupational therapies and parents who may not have the Skilled Resources to provide the supports themselves in the best of times. Let alone 24 7 in this highly stressful time. We recognised that taken families are frontline workers, restaurants and Grocery Store workers, delivery from transit drivers and so many more putting the safety of themselves and their families secondary to the needs of others in the community. We recognise this is a huge challenge for the district to adapt to a largely unknown scenario and in this time of unknowns. When will school start again and when it does, what will it look like and how can we provide all resources to the students in need, especially into the most vulnerable when we are facing a budget crisis and likely a recession . Coming together to support students and families, during this time of shelterinplace, we would like to acknowledge many people are coming together in a variety of ways to support the diverse needs of toker to st the students and families. The city will continue to receive muchneeded nutritional support and we would like to express or gratitude for the staff who adapts to the free meals for the children of San Francisco. We greatly appreciate the efforts in partnership with companies and providers across the city to provide students and now paraprofessional staff with access to muchneeded Technology Including laptops hot spots and Internet Services and to provide families with Young Children with learning materials and would like to acknowledge many district and communitybased Organization Staff who continue to work to support our students and familys needs. These are vital resources to help ensure the students to need to continue to learn during this time. Thank you, michelle. We are also pleased to see that efforts are made through the Community Partnerships forum, to the connections between the district, the city, Community Organizations and Service Providers and best meet the needs of students and families, not only in this time of crisis but Going Forward. We applaud the creation of the Family Resource link available under the familys tab on the sfusd website and by calling 415 3411716. And we celebrate the work of the studys task force is able to continue during the shutdown, as well. The Community Town hall meeting held wednesday was well attended and we look forward to the next gathering tomorrow at 4 30 and hope our youth will join us as they were a vital component of the task meeting. Update on the local control and accountable plan and Stakeholder Engagement. As we presented last wednesday and thursday, the California Department of education has made revisions to the process and timeline for this year and the shelterinplace instituted during the covid19 crisis is very limited about the Stakeholder Engagement that is conducted by the task force this spring. We hope to be able to conduct more robust engagement in fall in order to both inform the 2021 school year now due in december of this year and the new threeyear lcap in the spring of 2021. The district Advisory Groups are making arrangements to meet to review the component of the report due to this California Department of ed this june, to gather input from stakeholders to draft recommendations to present to the board of ed. Information can be found at sfusd. Edu budget and sflcap. They are recruiting new members for the new school year. And we include those from different neighbors, types of schools and backgrounds. This represents the arab, Southeast Asian and philippino communities, as well as those from lgbtq families and those with experience with foster youth, homelessness and secondary incarceration. They will focus outreach to include parents, guardians and caregivers from these communities and on finding ways to include voices in the work we do because we know not everyone can participate on a council. Applications to join can be found at packsf. Org and available in chinese, spanish and english. Applications are accepted on an ongoing basis. For more information or to request an application in a particular language email pack sfedu. This is a great way to get a sense of what we do. Our next meeting is tomorrow, may 13, and will be conduct askeconducted virtually. All are welcome. This month well be discussing impacts of School Closures on students and families and well be joined by members of the community Advisory Committee for special education and others. We invite everyone interested to attend an upcoming pack meeting and the meetings are scheduled tomorrow, may 13th and june 10th. If youre interested in attending a Virtual Meeting or have any questions or comments about this report or the packs in general, contact me michelle pack sfd. Edu. Before we conclude or report, i would just like to make a request that the announcement of the interpretation be given out at the very beginning of the board meetings before any other comments are made and i want to appreciate the ptas offer to assist, making it a little bit easier for families and others to engage in board meetings. And we are curious as to how families can be involved in helping to plan what school will look like in the fall of 2020 and beyond. Thank you. Please let us know if you have any questions. Thank you so much Parent Advisory Council and i dont recall if we open this up for Public Comment. Do we normally . Any Public Comment . Seeing none, president sanchez. Thank you so much. Board members, any comments or questions for the Parent Advisory Council and justin, i cant see again, everybody. So ill try. Ok, it doesnt look like it. I had one question. Go ahead, sorry. So i always appreciate parents, especially parents that are volunteering in this line role anrole. I want to say thankl parents in the pack and im grateful for their service and families that are interested in supporting our district to apply for the pack because its a great way to get to know how decisionmaking that you are maybe used to doing at school sites, how you can actually support all schools by doing that at a district level. So just appreciate that. Additionally, i had a question for you, michelle. I know that our district is engaging in family Wellness Checkins and i wanted to know how the pack may or may not have been engaged with in order to do this work that were undertaking. So i presume youre talking to this michelle, the coordinatorrer michelle. Yes. I can speak to the pack itself. Were not involved in the Wellness Checks, but i have been a part of a lot of meetings that bring together the head of the advisories and district staff and Community Organizations to try figure out how we make sure that all of the bases are covered and all families are reached. Thank you. Did you want to respond . As far as with our school, our principal is doing a great job of checking in with the families and really, really proud. I misspoke over there. Commissioner. Thank you so much to the pack. I know so much a challenging time and to meet, but its so much to express our deep gratitude to the advisory councils. I do want to spotlight for superintendent and staff how important it is to engage our parent Advisory Committees through this Fall Planning process and again, i think i appreciate that being lifted up and just wanted to echo the importance of engaging our parents, particularly before finalizing something and rolling it out. So thank you. Thank you. I want to thank you, as well. I appreciate your work executivi know its volunteer work. Its an added everything is added to with covid19. So i know its much harder right now to meet and deliberate. Go ahead. Hi, sorry. I juswe did meet with all of the coordinatorrer from the packs and michelle was a part of that meeting in designing the family Wellness Checkin. They gave a lot of input on the script and the process and they were involved in that process. Thank you. And, also, Going Forward, as we want a task force, for lack of a better term, parent groups will be involved in that process, as well as labor and multitudes of others. Were not doing this on our own. Thank you, president sanchez. Thank you. Section d is consent calendar, motion and second for the consent calendar, please. So moved. Second. In concert. So do we have any Public Comments on the consent calendar . Seeing none, president sanchez. Ok, any items corrected or withdrawn by the superintendent . No items. Any items removed for First Reading by a board member . And any items severed for discussion and vote tonight . Seeing none, we need a role call, thank you. role call . We have six ayes, thank you. Discussion and vote on severed for consideration and there were none today. Section g, proposals for action and if i hear no objection from the board, we will take action on the next policy items in one vote. And so theres a number and they are board policies 5116. 1, safety policy and number 500, accountability, number 4003, lactation accommodation, 5022, student and family privacy rights, 5131, student conduct and number 6143, courses of study and number 6178, career Technical Education and number 5117, interdistrict attendance and number 0420. 4, Charter Schools authorization and 0420. 42, Charter School renewal and number 0420. 423, Charter School revocation and number 02. 1 Charter School oversight and number 5142, safety. All policies removed and seconded at a prior meeting. Rules committee was met yesterday and well have a report out from commissioner lamb who shares that committee. President sanchez, just one note that board policy 511. 61, safety transfer process was amended after this agenda was processed at rules committee and in accordance with the committees direction, the following sentence is being added. The definition of a description of the investigation process incidents are described in board policies 5131. 2 and administrative legislation 31. 2 and i wanted to note that was amended and we will make sure the final copy that is posted carries that amendment. Thank you so much. Commissioner lamb. Was that to provide an update, president sanchez . Yes, just generally speaking, thats what when do when were about to vote. Yes, thank you. So again, weve reviewed the various policies. I believe its 15 in total and had line item by policy discussion and all were positive recommendations to the full board from committee. Ok, thank you. Sorry. Can i ask questions at this time for clarification . I dont see why not. Again, because it did get raised in the Committee Meeting for the policies proposal action 8 for career Technical Education. I know were updating it with the policy, but i just wanted to get from staff, an update of how that is reported to the board now that its moving to an annual base says. Do you want a response . Yes, please. Just for clarification, ratherring our progress against the lcap goals, i think what you asked for in committee is how are we currently doing it and under the new policy, how do we plan to do it . Correct, thank you. So superintendent matthews, since that doesnt need a recommendation, do we need to do that . Danielle . So with your permission, president sanchez, i would like to read one together. So our recommended action tonight is that you adopt the policies listed in items 111 as drafted with the exception that i previously noted around inner district safety transfer. Thank you very much. So well call on public speakers, if there are any. No. So there was one, but im unable to figure it out because he has an older version of zoom. So my apologies. If it gets fixed, well hear from that person later. Ok. And so any commissioners, any comments . Or questions . Seeing none, role call, please. role call . . Six ayes, thank you. Special order of business 2051 and memorandum of understanding with united administrators of San Francisco regarding sick leave during city shelterinplace order and we need a motion and second. So moved. Second. Thank you. Superintendent matthews. Yes. Chief officer of labor relations, carmello will be presenting this item. Good evening, commissioner, superintendent and all participants. What i would like to do is ask for the board recommended action to at few th ratify the action g sick leave and stipends during the citys shelterinplace orders. Is there anything in particular that stands out that you would want to share with us about the mlu . Nothing in particular, only that it adheres to all of the sick leave language that has recently been instituted, federal and local levels and, basically, addresses general working conditions, as well. Thank you. Any Public Comment on this item . Theres none. Comments or questions from the board . It doesnt look like it. Ok. So role call. role call . Thats six ayes. By the way, i just wanted to thank you, carmello, for all of your hard work on these mlus. Section j, discussion and vote on consent calendar, items removed at previous meeting and there are none tonight. Section k, introduction of proposals and assignment to committee. One public and comment on proposals and two a motion to 6. 1. 4, if needed. Now. So moved. Ok, any Public Comment on this item. There is none. Any board comment to this First Reading. It doesnt look like it. I just had a question and it doesnt need to be followed up. I wanted to know how this is different than im assuming that its an amendment or revised revision and it would be great to find out whats different. Mr. Sanchez, did you want me to address that now or follow up separately . Follow up separately, unless other commissioners are interested. I would be interested. Go ahead. So this item is actually memorialized in our current student hanbook. Therhandbook. It includes languaa and one thing, we have noticed over the years that many of the items that should be board policies have been codified in the student family handbook as opposed by the board. So were trying to make sure as we catch these things that we transition them to board po policies and we reiterate them in the student handbook and this is one of those items, but we dont expect this to be a change in practise. Again, this is just to memorialize what were doing and if we want a longer discussion about changing that, we can do that. But were trying to get the status quo adopted. Thank you. So unless i hear otherwise from legal council, im referring the policy to the rules committee. Great. Great. Section l, proposals for immediate action on the rules and there are none tonight. And section m, Board Members reports. Ok, so the following Virtual Meeting have taken place since the regular board meeting. And budget and Business Services, which was wednesday may 6th. And that was at 3 00 p. M. Commissioner lamb. Thank you. So we got a very detailed update from cfo, megan wallace, and with young lee and embarking on our process and knowing, also, with histori historical deficitt we had initial projections, both for this coming year, coupled with some additional covid19 examples. And we went through and the power points presentation is available to be able to demonstrate closing out this year, the Budget Solutions for this fiscal year onward to next year, what that deficit looks like. So i believe under the leadership of pelosi, theres a great push in the coming weeks to see if we can get what the next package will look like and so again, all hands on deck, both within the district, our city leaders working with the state legislators as well as our federal leaders around what that will look like and the summary there. You dont want to press us with the real numbers . The initial protection for next year is upward of 80 million. The staff presented some initial budgeting solutions that worse Case Scenario with the Budget Solutions, were nearing about over 55 million. Thank you. Go ahead, superintendent. The may revise comes out then and well have a much better i was going to say a better picture but it wont be a better picture. But at least the governors first projection after this pandemic, so it will have what he is seeing and what he views as the effects of the pandemic on the economy. So well have more after thursday. Great. Thank you. Before we move on, engaging with the public and so that similar how critical it is to engage our stakeholders to understanding what this would mean as far as tough decisions ahead and tough conversations. Thank you, commissioner lamb. And any reports from board delegates to member organizations such as csba and cgcs . All other reports by Board Members . Actually, i have one question about the budget. I was looking through the agenda. Are we coming back to this . It is not on our agenda. So just one thing quickly i wanted to say to the proposed changes i looked through. I just have questions and i would like somebody to follow up with what the cuts to those positions will mean around the affinity work. Thats critical to the students that we serve to those programs and i know that is one of the proposed solutions to the cost measure and im not trying to get into it now, but i just wanted to make that public and for someone to talk to me about what they see as the impact on those students, when those positions are filled. Commissioner collins. I had a question because i had raised questions and its related, somewhat, to commissioner cooks question i had raised, some specific questions that i said i wanted and i thought i wanted to get followup on. Theres was a whole bunch of positions that were eliminated in the students Family Community support and i wanted specifics and im just wondering, i think it would be helpful for all of us as a board to get that information, and i was hoping in a report, i would like a dialogue and i am wondering if we could put that up on the calmeeting agenda because staff is supposed to respond. I think other commissioners will be interested and i think its more after dialogue than one way. Ok, so when we do agenda review, we will make sure to fit it in more. Thank you. So the next is calendar Committee Meetings and i dont know, mr. Steel, if i know youve been in contact with the different Advisory Committees. Yes. So i have been gathering information on whos ready to report and im going to bring that to a general review for us to continue to schedule for the remainder of the year. And as far as our Committee Meeting, does any board member have a date and time for their next committee . It is posted in the agenda, mr. Sanchez. Oh, they are, ok. My bad . Ill read further. The upcoming meeting on Student Assignment which is monday, may 18th, at 5 00 p. M. And then budget and Business Services Committee Meeting is wednesday, june 3rd and this is at 3 00 . Yes. Great, thank you. And thats all we have right now. And i would like to schedule a meeting, but ill be sharing that once its scheduled. Thank you. Thats for curriculum. Section m, other informational items are Staff Reports and one with updates and two, the may williams quarterly report. Section o is memorial adjournment and i am going to ajourn this meeting in memory of marlene kayhaus. We will ajourn our meeting in memory of marlene who passed away after battling with Ovarian Cancer and survived by her mother, teresa, her sister who is 51 and her only daughter, michelle. Marlene was born in San Francisco, california to el salvador immigrants. Marlene grew up responsible, mischievous. Marlene loved family and grew up in a family with grandparents, aunts, uncles, cousins with precious memories along the way. Growing up, marlene went to russian river, playing and listening to music and summers in el salvador with her family. Alongside family, marlene loved education. Marlene was fond of the arts and was a phenomenal student. She had a great economic career where she met many lifelong friends. Marlene went on to attend Mercy High School and met more of her lifelong friends and they grew up listening to motown music and disco. She studied to be a nurse. After a long deliberation, marlene went on to live in el salvador with her family. It was there that she realized her true passion for helping others, specifically children. In el sa salvador, marlene workd for her uncles clinic. Upon her ru return to the u. S. A, marlene changed her major and pursued an major in education. She pursued an masters in education. As her passion and skillsets continued to grow for education, marlene began working at the San Francisco Unified School District. Marlene spent 37 years in the district and received many awards, recognitions and named principal of the year and marlene transcended diversity,en conclusion by being the first latina principal. In addition to leading, she was the principal at the Spring Valley and er Taylor Elementary schools. In her tenure at usfsd, she was with the commodore stockton. Par lean was always kind, open and loving mentor. Marlene always touched the lives of her students and teachers with her positive attitude and was always searching for ways to improve in the futures of unrepresented children and i personally will never forget her smile. The board of education and superintendent of schools extends sincere condolences to the family. So wit at this time, well take Public Comment who wish to speak to closed session items and there will be a total of five minutes. The board will go into closed recess and well the board approved contracts for two principles, the board voted seven ayes for the principles. And the board seven ayes approved the contract for one interim assistant principle. And the board approved the contracts for one supervisor in the matter of p. S. Versus s. F. U. D. , and case 202 on 251, a vote of seven ayes. And case 20021 to pay up to the stipulated amount. The board by a vote of aches ayes and one absent approved the nonreelection of two provisionary zero certificate employees. The board by a vote of, i guess seven ayes approved a Settlement Agreement with one certificate to administrator. Okay, are we done . I think so. I dont hear anybody. Okay. So that concludes our meeting. The meeting is adjourned. Thank you. Goodnight, everyone. Thank you. Goodnight. Goodnight, everybody. Mayor london breed good morning, everyone. I know that many of you have been tuning in to our press conferences for updates on how we have been responding to the coronavirus pandemic. But often those updates really dont give us a chance to talk indepth about some of the really complex issues that our city is facing. While everything continues to shift and change, we will continue to hold these press conferences. And update you all on the latest programs, services and resources as well as what were doing to prevent the spread of the coronavirus. But we also will hold talks like this and this is a first in a series of talks that we think that are important to make sure that the public is aware of what is going on and the decisions that were making and what to expect. Theres so much uncertainty. This has been a very fluid situation and at any given time information can change. So we believe that it is critical that you understand how were making those decisions. And some of the experts who are leading these efforts are important people that i think that everyone should know and should hear directly from them. So today were going to dive into the statistics are and the criteria our Public Health officials are looking at and what they need to see for us to continue to reopen and advance our recovery efforts. Here in San Francisco, you all have been doing an amazing job. And as a result of following this order, and i would say maybe not everyone but for the most part a lot of folks are, because you have been following these social distancing requirements, you have made it possible for us to just move further into the stages that have been outlined for our reopening purposes. So we need to continue to do that. We have heard from many of you that this is one of your biggest questions. And so today to talk specifically about just whats happening in San Francisco with the curve and everything and how well we are doing, although that could change at any given moment, is dr. Grant colfax, the director of the department of Public Health. And dr. Colfax was a Public Health leader during the h. I. V. aids crisis and has been leading us through this pandemic. So we appreciate his leadership. Were also joined by dr. Susan philip, the director of the Disease Control and Prevention Branch in the department of Public Health. Shes been leading our testing and Contact Tracing efforts in response to the coronavirus. So what we want to do today is to talk specifically about the criteria related to ill start with the information related to where we are in terms of testing and hospitalizations and other information. And the criteria. Where do we need to be to begin to open up safely. And then also an outline of those phases. Phase one, phase two, a and b and so on and so forth as to what is possible if we continue to follow the social distancing requirements. It is possible that we can get things to a better place, sooner rather than later. So the goal is to also to go into depth with dr. Susan phillips around testing and where we are with testing as well as Contact Tracing and how those things are going to play such a Critical Role in helping us to get open sooner rather than later. So with that, i want to just start with dr. Colfax, just to talk a little bit, you know, about where we are in terms of the numbers. And then how fast the numbers can shift. But, more importantly, if we continue to follow the requirements that are put in place, what can we expect for the possibility to open up sooner rather than later . So dr. Colfax, i know that is a lot, but lets get started. Well, okay, thank you, thank you for your leadership during this really challenging time. And i just want to reiterate that what youre saying this is a really changing dynamic. A changing situation as we learn more about the virus and how the virus spreads. And i also want to extend my gratitude to San Franciscoians for their support of our shelterinplace order. The orders are one thing, but it really takes the community to come together and to support each other in doing this. And its been remarkable. Its about Public Health, but its more about community and how Community Supports one another. Our families and our neighborhoods, to to do our best during this really difficult time. And i think that everyone is doing their best right now. And its really been remarkable over the past few months. You know, it was just in february, mayor, where you declared a state of emergency before we even had a single case. We then went forward with a shelterinplace order and things have really evolved. Theres been scary moments when we were worried about having a situation like we saw on the east coast in new york where the Hospital System got overwhelmed. And where so many people got terribly sick. And, unfortunately, many passed. We have avoided that worstCase Scenario in San Francisco and the bay area and im just grateful for your leadership and the support of the public in this work. I think that a couple of things. One is that we as we work to enter this new phase of a gradual reopening, its really important to emphasize while were hopeful that the situation can change quickly. When this virus takes off, it takes off really fast, right . And thats what we have seen, again, in jurisdictions. Thats what we saw in china, thats what we saw in italy, thats what we saw in new york. So we have to be cautious as well as optimistic and hopeful that the work that were doing now in terms of Wearing Masks, in terms of the social distancing, that that really needs to continue for us to be able to live together and also to live with the fact that the virus is in our community and will continue to be in the community for the foreseeable future. So far we are the gain is going relatively well but were only in the second inning of a long game. This is a situation that is going to last for probably 18 to 24 months. A vaccine is still a ways off. We saw hopeful news today but even the most optimistic experts think that vaccines will probably be at least 12 to 18 months off. So maybe i could just mayor, could i just show some of the i want to show a curve because we have talked a lot about flattening the curve. And i just want us to id like to show the curve that i look at when were talking about that. So this is this is our slide of people with the hospitalizations of people diagnosed with covid19 in the city. So its a bit of a complicated graph. So im going to explain it, take a little bit of time to explain it. So this is looking from april 13th to may 16th. The vertical bars are the total number of people across our hospitals, across our nine hospitals in San Francisco, who have been diagnosed with covid19 on any given day. So you can see that on april 14th, on the far left of the slide, that there were a total of 88 people diagnosed with covid19 in our Hospital System. There were 63 people in acute care. And 25 people in the intensive care unit. So those are the people in our city who were sick enough with covid19 to need hospitalization. And we really want to follow also the numbers of people in the intensive care unit because those are the people that are sickest. And we want to make sure that were able to support them to the best of our ability in the medical setting. So this curve is important because it represents the sickest people. You can see over time that that curve this graph has been relatively been flat. If you just look over time between april 14th to about lets say may 5th. That if you drew a line across those bars on the top, that would be a flat it would be a flat curve. Right . So we have really flattened the curve in San Francisco, which means that we are having the situation of many people getting sick and many more people dying because of covid19. So the news also gets a little better right now, which is that if you look from may 5th, so look at that 80 number, may 5th to may 16th. You can see that those numbers have actually dropped. So whats really fantastic about this is that for right now that our curve is not only flat but its actually decreasing in terms of the number of hospitalizations in San Francisco. So this is very hopeful and its really good news. And as we go into these next stages of reopening we have to be very careful that we maintain our masking and our social distancing and our hygiene efforts in conjunction with the shelterinplace, because these numbers can change very, very quickly. So as we go into the next stage of the Curbside Pickup, we increase our commerce in the city, which is good news, and we have to make sure that as we move around that the virus doesnt move around more and actually get more people sick. And thats why were watching this curve very carefully. So if this curve starts going back up, and gets back to where we were at the end of april, you know, 90 or even above, that you would have to look at that very carefully and not only consider whether we dont go to the next stage, but whether we we are more conservative in actually closing things down to some extent again. So thats where, mayor, youre exactly right, this is a changing situation and we need to look at the data on a daily basis. Im hopeful that with the collaboration of San Franciscoians that we will continue to move forward to the next stages. But, again, this could change relatively quickly and were going to need to be watching these numbers so that we ensure that were protecting the health of San Franciscoians as possible. So how are we going to do that . Mayor london breed lets give the criteria of what youre going to be specifically looking at and how youre going to be making decisions to move . Because, i mean, we get questions people want to know when are we opening schools . When are we opening hair salons . When are we opening places where people will have direct contact with one another . So thats because we cant give people specific dates, this is what youre saying, that everything is contingent on what happens with these numbers. So i know that you want to talk about the criteria. And then you want to go into the phases and what we can expect in terms of a general timeline around these phases . Thats right. So im going to go to what were going to be watching Going Forward. To determine how soon and how quickly we can move on those stages that youre asking for, mayor. And then dr. Philip will talk in more detail about our scales of testing and the context. Does that make sense . Mayor london breed yes, lets do it. All right. Can we have the next slide up, please . So these are the basic five indicators that we will be looking at to assess our progress in reopening. Mayor london breed can we just show that slide on the screen, this one slide . I think that it is. Oh, i think that it was being shown. Mayor london breed it was shown but it was some other stuff on there too. I think theyre trying to mayor london breed there we go, all right. Yes. So we are looking these are the five areas that we will be looking at across the city. A number of cases of covid19. The Hospital Capacity across the city to take care of people who are the sickest from covid19. And our testing efforts to scale up our testing. We know that theyre so important for people that have access to timely testing for covid19. And our Contact Tracing. And the need for personal protective equipment. So, mayor, id like to talk a little more in detail about each of these before we get to the phases. Is that mayor london breed yeah, we want to do a brief overview and get into the phases because i think that we want to have dr. Philip talk about the Contact Tracing. So in the number of cases well watch that hospital curve, because those are the sickest people. And were also going to be looking at the case rates as we scale up testing. So this can be a little confusing because as we test more people we will find more pieces. So then the total number of cases are going to go up. But what were really looking at in that situation is the rate of positives. So are 10 of those testing positive . Or is it 5 , 1 . So as long as that rate is going down, well be comfortable with that number. The Hospital Capacity is really ensuring that we have enough capacity in the hospitals in the event that our numbers start to go up really quickly. And ill just give you a concrete example. Right now our covid19 cases are occupying about 6 of our Hospital Capacity right now. Which is really remarkable. 94 of our other hospital beds are filled with people who have other conditions. So we want to make sure that Hospital Capacity doesnt the People Living the people in the hospital who have covid19, that that Hospital Capacity which is currently at 6 , doesnt go above 20 . With regard to testing, dr. Philip will talk about this in more detail. We have scaled up testing dramatically in the last few weeks and over 1,000 tests a day and aiming to get to about 1,800 tests a day in San Francisco on a regular basis. Contact tracing, we want to make sure that were investigating the cases and supporting People Living with covid19. And also making sure that if theyve been in contact with people, that those people know that theyre supported and they get tested. Again, dr. Philip will talk about that. And then personal protective equipment, for us to do our work as medical advisors and First Responders we want to make sure that theres adequate personal protective equipment across the city, including masks and other facial coverings to protect ourselves and others from the virus. So, mayor, unless you have questions about this. Id like to go to the stages. Mayor london breed lets go to the stages. Thats what were here for. Okay. So this is the governors framework for reopening. So phase one we have completed. And right now for phase two today with the Curbside Pickup were now in phase 2a, where we are its exciting because of that curve. Were on Curbside Pickup. And also allowing manufacturing and logistics to support those businesses with Curbside Pickup. And in the next few weeks as we watch those data, we would hope to be able to relax restrictions in phase 2b. To adapt retail, and to reopen schools, offices and child care. Mayor, theres also were working hard to ensure that theres guidance and potential for camp, summer camps for kids. So this would be during that phase 2. Mayor london breed so you think that as long as for example, that the numbers either are stable or decline, that the possibility to maybe have summer camp is possible . I think that its a real possibility. Its going to be a little different than it was before because we have to be cautious about social distancing. So its going to be different. But i am cautiously optimistic that if these numbers hold up that we will be able to to go in that direction. Again, as you said, the situation could change. Mayor london breed can we pull that slide back up, the phase because i think that what is helpful is to just kind of getting a feel for the timing of these phases. So, for example, today we are in the 2a, right . Thats right. Mayor london breed so in order to get to 2b, the five criteria need to be met, number one. And then, number two, how like, if the five criteria are met and then were able to maintain them over a certain period of time, whether d time k that 2b would be able to go into effect, you know, based on just an estimate . I want to be clear this is not the city saying this is going to happen, but based on the trend and what we have seen happening based on the numbers, theres a possibility that we could get into 2b at what point . Or phase three at what point . Yeah. So i think that for phase 2b, and we wouldnt just open up all of 2b up at once, but i think that generally we would anticipate another two to four weeks of watching the data, learning from what we have learned in 2a, and ensuring that people are able to continue to follow the social distancing, the hygiene and the masking guidelines. But that generally in the next two weeks we would then be able to adapt to move to 2b if the data holds up. So somewhere in that two to fourweek window. Mayor london breed which means even longer for like hair salons and nail salons and churches . Thats right. So thats phase 3, yes. Mayor london breed so that were talking about, again, maintaining whatever these numbers are at a flat or a lower rate. And were still talking about those places even a month away . Oh, at least, yes. Mayor london breed i think that part of what is helpful in the course of this conversation is to also to provide people with some guidance so they know what to expect. So i think that and we wont get into it in this conversation, but get into it in a later conversation, you know, just the specifics of how we get people back to work. Because it has been i know very stressful for so many of our businesses and so many of our religious community and folks who are just desperate to come together. And also those who are struggling financially, which as you know as a doctor that this creates a whole other Health Challenge around Mental Health and a number of other issues. So we definitely got to make sure that we keep that in mind, although we know that this is one of the most important things that we need to focus on to prevent the rapid spread of the coronavirus, which even though our numbers may look good today that the fact is that those numbers can change at any given time and we could, sadly, be in a situation similar to how new york or italy or other places have experienced. I think that ultimately the goal is to get people used to the new normal as well, to get used to the masks and the social distancing and all of those other things that are going to help to get us through this. Not just today or tomorrow. But long term. So lets lets talk a little bit about, you know, dr. Colfax, can you tell us again, i know that we cant provide people with specifics. And i want to get to dr. Philip. We cant provide people with specifics as to when, but, you know, i guess how are we going to how do you propose that we make this adjustment . You know, this has been hard already and its been, you know, like over two months. And it is a struggle for just the average person, but especially those who are dealing with financial challenges. And those with kids. And elderly who are already isolated as it is. How are we going to get through this . Yeah. Well, i think that its a really important question, mayor. I think that theres a couple of key things. One is to make sure that people that Mental Health and social supports that are needed and i think that were going to continue to work on connecting emotionally and socially in ways that allow us to social distance. So i think that is a really key piece. And if people need or are asking for Mental Health, Behavioral Health support, they can go to our we website and find those resources. I also think that one of the key things, mayor, in how we support this Going Forward is that the more that we can adhere to the social distancing and masking and hygiene, the faster that were going to get to those different phases, right . So, you know, one thing that i really emphasize is that, you know, wearing a mask is something that is really important because it protects others, right . And so we create a community where Wearing Masks and social distancing is respected and well get to these phases sooner. Because we know that is what slows the virus. As we go back to the workplace, we are working with your departments leadership and others across the city and in the Business Community to really to as quickly as possible and as safely as possible to develop what the new workplace will look like, right . So people who cant commute from home, will work at home. And to ensure that the workplace offices are safe as possible and that workplace transportation is as safe as possible. And that people get the information that they need so they know when they go back to work that they can be as safe as possible. And the other part of this is the testing, right . So that people have access to testing. Because we want to make sure that people can get the cure they need both for themselves and to ensure that theyre as safe as possible. Mayor london breed so, dr. Philip, lets get into some testing and also Contact Tracing and how important that is to helping us to transition into these phases sooner rather than later so that we can get our city open. Yes, thank you, mayor. As you were saying and as dr. Colfax was saying that testing and Contact Tracing are pillars, they are key indicators of moving forward. Mayor london breed dr. Philip, i want sorry to interrupt. I want people to know that if you exhibi exhibit exhibit, you. If you are an essential worker and you have no symptoms, you can be tested. Call 311 or go to sfgov. Org. And whether you have insurance or not, whether youre documented or not, it does not matter. Well test anyone. And so anytime that you need to be tested and that you are tested, but more importantly its not as if one time youre tested and all of a sudden everything is okay. So i want you to talk a little bit about the opportunities and also explain how Contact Tracing is important to helping us to really flatten continue to flatten the curve. Yes, mayor, thank you. Yes, very correct. Go to sf gov to see what the symptoms are. And anyone that works in San Francisco as well, because theyre equally important to the health of our residents. So testing is really important. We need Public Engagement in testing. And were continuing to open up sites in areas to make it more accessible for people to get testing in their neighborhood as announced today. And that the testing in the tenderloin and at city college and a new location in bayview. And so we continue to emphasize making testing accessible. Testing alone is not going to solve the problem. A big point of testing is to get care to people who test positive. But then also to work with people to make sure they have what they need to stay at home so they dont transmit to anyone else. And then to voluntarily ask them who else they may have been in contact with so that we can reach out to those people to support them too. Thats what is Contact Tracing. Its voluntary and its confidential and it has nothing to do with immigration status or any other type of law enforcement. So we want to engage as partners just as the public has partnered with us to shelterinplace and to get us to where we are today and to make us safer and to move closer to the next phases of reopening. We need the same engagement with testing and with Contact Tracing. And were continuing to build our capacity in those areas in partnership with every resident and worker in San Francisco and in partnership with the rest of the city and all of the teams continuing to do that work. Mayor london breed can you tell us what we can expect for Contact Trace somethin tracing . What are the questions they get asked if they test positive . And if im contacted by someone, how should i respond to that . Yes, thank you. When we find out that someone has tested positive, and by California Law all of those tests get reported to the Health Department and we reach out. And the first thing that we want to do, does that person have what they need to be healthy and to be safe . Thats our number one priority. We assist with food and housing and other resources they may need to stay home and to stay isolated. Then we ask them about the other people in their lives they may have come into contact with at work or at home. And we talk to those people separately. So when you are contacted because you have either tested positive or because youve been in contact with someone who has, please engage with the staff that do that. We are working very hard to have language capability. 54 of our case reviews have been in spanish. So were working with communities and organizations that have that ability to bring on more staff to do that work in a culturally appropriate way. So we want to engage. We want to support people who have been exposed and people who test positive. In doing that were going to be able to reduce the transmissions throughout the city and get us to the next phase. Mayor london breed yes, thank you. Well, i just want to go back to reiterate to folks because i think this information is really helpful because im not a doctor and i think that most people who are not doctors may not completely understand exactly why. Because you know that im always asking you, well, why cant we do this, why cant we do that. And im very concerned, of course, like we all are about the future of our city. And the Financial Health of our city. And as well as, you know, Public Health in general. So, for example, when we talk i want to go back to kids in particular because we know that the parents are probably had it up to here. And i just think about when i was a kid how i probably would have drove my grandmother insane with 21 questions. And the fact that i couldnt play with my friends. Or like my nephew saw a slide and cooperate slide dow couldne slide and started crying. Its just the emotional issues associated with trying to explain to children why they cant play together. And i think that what we have to keep in mind of course is the challenges that we face, but we also have to think about human nature. And if were talking about opening camps for the summer, im excited about that. Any kid would be excited. But at the same time weve got to be realistic. To expect kids to have to wear masks and gloves and to not, you know, to interact you know how kids are. They touch each other. To expect that, thats going to be difficult. So i think that when were thinking about criteria, i mean, this will be our normal as you said for at least, you know, the next 18 months. So theres an adjustment, of course, that we need to make. And its a lot easier for adults to maybe make that adjustment. And harder for kids who deserve and need to interact with one another. So i do think that what is great about where we are as a city is because the majority of the people in the city are complying and following the orders and going out of their way to, you know, to be a part of the solution although we know that theres a few people out there breaking the rules and not doing what theyre supposed to be doing but thats a whole other conversation. But the fact is that because we have so many San Franciscoians, it gives us the opportunity to go further. I know that its not happening as fast as people want it to happen. Trust me, i am desperate to see more happen faster because i am concerned about, you know, the longer that were in this situation, the worse off that its going to be for a lot of people. So i hope that you are getting creative and taking these things under consideration because its not just about the data and the science, its about peoples lives and their livelihoods. So how do we theres a way for example, if this is going to be with us for two years, the hairdressers and the barbershops, you know, they already, you know, are prepared with systems in place and theyre going to be able to open im sure eventually, theyll have to wear masks and gloves when theyre working with their clients. And just quickly, why not sooner rather than later . Because i think that thats what people are trying to understand. Why cant we do this, or why cant we do that . I get that it is about, you know, limiting Human Interaction but for the most part you can tell that people are, you know, they are hungry for more, but theyre also willing to follow the rules as theyre given more. You know, so lets talk a little bit about that and what we can do to maybe even move this along faster because, you know, we appreciate that theres Curbside Pickup at retail, but, you know, for most of us, like when i go buy my candles im going to walk in there and im going to walk around even if i cant touch something. Lets talk a bit and then wrap up the conversation because i know that theres so much that we can talk about and we wanted to try to keep these to 30 minutes. But how can we move this faster . How can we get better prepared for reopening as an everyday citizen . Yep. So i think that, mayor, so really important thank you for emphasizing the need to move forward and to get creative and innovative as we go forward to this new normal. I think that one of the key things is that we need to ensure that as much as possible that were masking and social distancing because if we can keep the virus under control in this stage, the next phase will come sooner. So thats one important piece of information. And the other piece is that were working across businesses to ensure that were getting out information as quickly as possible about what people can anticipate. So theyll be ready, right . So that rather than saying oh, now were ready to open and these are all of the things that you have to do, that we have guidance in advance so that people can be more prepared, right . So that as we think about these camps, for instance, that theres guidance being developed in a scientific way, but also in a way that is responsible and accountable to what youre saying. You know, that kids you know what kids do, right . So realistic items, that is responsive both to the situation but also addressing the new normal that were going to be in. And i also think that ensuring that were working with community in an equitable way, including around testing and partnering with other organizations and that were engaging with the businesses on the ground to better understand what they need and what theyre asking, so that we can ensure that the testing requirements that are likely to go forward and the social distancing and the hygiene, that those are things that people are ready for and support. We dont want to be in a situation where, you know, were saying this is what you have to do an, right . So those are key points Going Forward. And to keep moving it faster, part is scaling up our testing and our partner notification, because the faster that we do that, the faster well know where we are moving forward. And when we know where we are in terms of the epidemic, that will help us to know where we are in terms of the stages that we want to move as quickly as possible. Because certainly there are Health Consequences to the shelterinplace order and Mental Health consequences and physical onc consequences. And its not like coronavirus is over here and Everything Else is in business, we need to make sure that were doing a balance of being as prepared and responsive to the pandemic. But also supporting the economy, which is necessary for supporting peoples health, especially in communities that struggle every day and are struggling now. Mayor london breed yes, and dr. Colfax, i appreciate that because im being aggressive because, you know, as much as i want science to guide us and the data, im focused on that i dont continue to bring up the hair salons and the nail salons and places like that because im tired of doing my hair. I dont bring it up because of that. But if these people are not working theyre not making money. They cant pay their rent. Not just their rent at their homes but their rent in their commercial spaces. And in some cases, being harassed about getting their bills paid when they have no money and theres no way that theyre possibly going to be able to pay it back. So if were going to be living in corona, right, how is it that we allow these people to open up sooner rather than later safely . Because, you know, it is thats what im most concerned about. You know, are these kinds of businesses that theres direct contact, whether its a masseuse or barbers or whether its nail or hair salons and places where youre a little bit closer to people than anticipated. Again, because people are so anxious to get going and to get their businesses started, to cover their bills, that, you know, theyre going to be even extra careful when doing this. So the sooner the better and i know that im being pushy and i know that we have these conversations on a regular basis, but i really appreciate both of you and your leadership and the role that you play in helping to lead us. I know that there have been lives saved because of the efforts of the department of Public Health. And so we are grateful to you, your team, and the nurses and the people on the frontlines every single day. Yes, i have pushed, pushed, pushed, but i also appreciate your creativity. Were going to eventually get over this hump and get to a better place and i want to thank everyone for joining us. Again, this is the a first in a series of conversations that will continue to happen around the reopening and whether its issues around equity or around economic recovery and those will be the kinds of conversations that well be having over the next few weeks just to really to try and to get to the point of whats important or why decisions are being made. Im San Francisco mayor london breed and i thank you for joining us here today and thank you for allowing us the opportunity. We know that people have sent in questions and we will be working to respond to those questions directly. Thank you again dr. Colfax. Thank you dr. Philip for your work. And we appreciate you all for continuing to cooperate with the Public Health orders. And we hope that you have a wonderful week. Thank you, everyone. Thank you, san my name is doctor ellen moffett, i am an assistant medical examiner for the city and county of San Francisco. I perform autopsy, review medical records and write reports. Also integrate other sorts of testing data to determine cause and manner of death. I have been here at this facility since i moved here in november, and previous to that at the old facility. I was worried when we moved here that because this building is so much larger that i wouldnt see people every day. I would miss my personal interactions with the other employees, but that hasnt been the case. This building is very nice. We have lovely autopsy tables and i do get to go upstairs and down stairs several times a day to see everyone else i work with. We have a bond like any other group of employees that work for a specific agency in San Francisco. We work closely on each case to determine the best cause of death, and we also interact with family members of the diseased. That brings us closer together also. I am an investigator two at the office of the chief until examiner in San Francisco. As an investigator here i investigate all manners of death that come through our jurisdiction. I go to the field Interview Police officers, detectives, family members, physicians, anyone who might be involved with the death. Additionally i take any property with the deceased individual and take care and custody of that. I maintain the chain and custody for court purposes if that becomes an issue later and notify next of kin and make any additional follow up phone callsness with that particular death. I am dealing with people at the worst possible time in their lives delivering the worst news they could get. I work with the family to help them through the grieving process. I am ricky moore, a clerk at the San Francisco medical examiners office. I assist the pathology and toxicology and Investigative Team around work close with the families, loved ones and funeral establishment. I started at the old facility. The building was old, vintage. We had issues with plumbing and things like that. I had a tiny desk. I feet very happy to be here in the new digs where i actually have room to do my work. I am sue pairing, the toxicologist supervisor. We test for alcohol, drugs and poisons and biological substances. I oversee all of the lab operations. The forensic operation here we perform the toxicology testing for the Human Performance and the case in the city of San Francisco. We collect evidence at the scene. A woman was killed after a robbery homicide, and the dna collected from the zip ties she was bound with ended up being a cold hit to the suspect. That was the only investigative link collecting the scene to the suspect. It is nice to get the feedback. We do a lot of work and you dont hear the result. Once in a while you heard it had an impact on somebody. You can bring justice to what happened. We are able to take what we due to the next level. Many of our counterparts in other states, cities or countries dont have the resources and dont have the beautiful building and the equipmentness to really advance what we are doing. Sometimes we go to court. Whoever is on call may be called out of the office to go to various portions of the city to investigate suspicious deaths. We do whatever we can to get our job done. When we think that a case has a natural cause of death and it turns out to be another natural cause of death. Unexpected findings are fun. I have a prior background in law enforcement. I was a Police Officer for 8 years. I handled homicides and suicides. I had been around Death Investigation type scenes. As a Police Officer we only handled minimal components then it was turned over to the coroner or the detective division. I am intrigued with those types of calls. I wondered why someone died. I have an extremely supportive family. Older children say, mom, how was your day. I can give minor details and i have an amazing spouse always willing to listen to any and all details of my day. Without that it would be really hard to deal with the negative components of this job. Being i am a native of San Francisco and grew up in the community. I come across that a lot where i may know a loved one coming from the back way or a loved one seeking answers for their deceased. There are a lot of cases where i may feel affected by it. If from is a child involved or things like that. I try to not bring it home and not let it affect me. When i tell people i work at the medical examiners office. Whawhat do you do . The autopsy . I deal with the a with the enou with the administrative and the families. Most of the time work here is very enjoyable. After i started working with dead people, i had just gotten married and one night i woke up in a cold sweat. I thought there was somebody dead . My bed. I rolled over and poked the body. Sure enough, it was my husband who grumbled and went back to sleep. This job does have lingering effects. In terms of why did you want to go into this . I loved science growing up but i didnt want to be a doctor and didnt want to be a pharmacist. The more i learned about forensics how interested i was of the perfect combination between Applied Science and criminal justice. If you are interested in finding out the facts and truth seeking to find out what happened, anybody interested in that has a place in this field. Being a woman we just need to go for it and dont let anyone fail you, you cant be. With regard to this position in comparison to crime dramas out there, i would say there might be some minor correlations. Lets face it, we arent hollywood, we are real world. Yes we collect evidence. We want to preserve that. We are not scanning fingerprints in the field like a Hollywood Television show. Families say thank you for what you do, for me that is extremely fulfilling. Somebody has to do my job. If i can make a situation that is really negative for someone more positive, then i feel like i am doing the right thing for the city of San Francisco. Mark, the executive secretary and welcome to the may 19, 2020, commission meeting. Commissioner bernal. And commissioner green. And commissioner giraudo, commissioner guillermo. Are you here, commissioner guillermo . Unmute yourself, commissioner, so we can hear you. Yes. Commissioner guillermo, are you there . Commissioner guillermo im here. Clerk thank you. And is commissioner chow on the phone by chance . Commisioner chung yes, i am and i will try for the visual connection as the phone goes on. Clerk okay. And commissioner bernal, i believe that you have smgz to say . President bernal thank you to my chigdzers and welcome to all of the members of the public who may be viewing the Health Commission meeting for tuesday, may 19th. Before we begin i wanted to let everybody know that the commissioners and i have sought to with the support of the mayor, beginning in june to meet twice a month with remote meetings. So on the first and third at a new time at 3 00 p. M. The meeting on the first tuesday of the month will include a covid19 update and a d. P. H. Update and contract items and d. P. H. Program updates. And the meeting on the thursday tuesday of the month includes covid19 updates and well focus on the General Hospital and the laguna honda related issues. So with that lets move on to approval of the minutes. Clerk actually, commissioner, do you mind if i do my intro with the Public Comment line. Sure. So, hi, everybody, i am mark morewitz, the commission secretary. And were using Microsoft Teams which is a remote technology. And as everyone knows by now theres some glitches with these. These meetings dont run as smoothly as the inperson meetings do so please bear with us as we do our best. And the meetings are televised by sfgovtv and we thank them for their assistance today. But if youre watching at home, there will be a delay, and possibly 30 seconds to two minutes, and so know that. And if youre interested in making a Public Comment, im going to give you that information in a second. But, please call in the item before the item that you would like to make comment on to be sure that youre not missing out, depending on the delay of your visual experience. So heres the number and ill put it on the screen real quickly so that everyone can see. Give me one second. So if you would like to make Public Comment on any item, best thing to do is to call in soon or anytime before the item starts, and the number is 888 3634734. And theyll ask you for an access code which is 241350. And the instructions are listed here, and youre able to make one Public Comment per item. You are still going to be timed for two minutes so that you everyone can only get two minutes and ill cut you off after that. And once youre on the line you can listen in realtime to the meeting and if you would like to make Public Comment on the item you hear 0, 1, and youre in line for that item. And i will flash the slide several times and i know that this is tedious for everyone but its the best way that i know to make sure that everyone understands the process. To that, moving on to the next item. Thank you for your patience. President bernal and, thank you, mark, for keeping us all on track and facilitating our new meeting format. I very much appreciate. And item 2, the approval of the minutes from the Health Commission meeting of april 21st. Upon review for the minutes, commissioners, is there a motion to approve . So moved. Second. Clerk commissioners, before you call the vote, i want to note that based on commissioner chows review as i emailed you all, theres two corrections that have been posted online. One is item 11. I made a mistake of putting in laguna honda where it should not have been and i put the wrong resolution at the very end and it should acknowledge the fache contbecause to the Covid Response. So i want to make sure that everyone knows that youre voting on that. And before you vote we need to check to see if theres Public Comment. Public comment line, can you let us know if theres anyone on the line for this. It looks like theres no Public Comment. So you can all do a vote. President bernal mark, will you call the roll. Clerk yes. Commissioner bernal, yes. Commissioner green. Yes. Commissioner guillermo, yes. Commissioner giraudo. Yes. And commissioner giraudo can you keep your commissioners on while youre on the camera and commissioner chow . Yes. Great. Thank you. So that item passes and we can move on to the next item, the directors report. But dr. Colfax is having trouble logging in. So if we might because he has the next few items, if we may go to general Public Comment if thats okay with you all, commissioners . And lets give everyone a few minutes to make sure that they in case theyre watching and theres a lag time, that theyre able to see the instructions. And lets just pause and ge give mr. Colfax a chance to log in and to get Public Comments. Again, thank you for your patience. Public comment line, please let me know as people come on. Thank you. So, mark, commissioners, i will be on the phone and then watching your video. Clerk all right, thank you, thank you, commissioner. Mark, just give us a signal when ready. Clerk yes, sir. Im actually the Public Comment line is having a little trouble and were still waiting for dr. Colfax, so, again, please give us one minute. I apologize. President bernal thank you. No need to apologize. Clerk so i have suggestions since were waiting for these two the issues with the folks who cant log in. Is mr. Wagner on the line because we could move to item 6 and move forward and go back to Public Comment after that. Mr. Wagner, are you here . I am. Can you hear me . Clerk yes, i can. Are you on video or on just audio . Lets see. I am. Clerk you are . Fantastic. So, commissioners, is that okay, and commissioner bernal with a thumbs up . Fantastic. And ill put you on the screen to say hi before we put the slides on, okay. Okay. Clerk and, greg, im hearing double are you watching this indiscernible . No, i dont think so. Clerk okay. Im not hearing it anymore. Does that sound okay . Clerk yes. Ill mute myself. Commissioners, greg wagner, c. F. O. So we are just kind of lat latebreaking information coming out around the city budget and i dont think that any of this is a surprise. Theres been recognition for the city and county and state, etc. , and theres a Significant Impact on the economy and, therefore on the city budget of the covid19 pandemic. And were at the point now where the city is regrouping and reevaluating its budget process. And so all will recall that back in february that we brought under the normal timeline to the Health Commission Budget Proposal which you gave provided feedback to and approved and sent for in the Mayors Office. And that occurred about three weeks prior to everything really changing. So now that we have a little bit more visibility into whats going on in the economy, the Mayors Office and the Controllers Office and the board of supervisors and budget analysts have reevaluated the Financial Outlook and then published that and just as recently as yesterday afternoon issued new instructions to the department. So im going to just summarize a little bit where we are on that and then there will be more more coming as we go through the process. But its going to be a little different and its going to happen fast. Normally we would have had the mayors balanced budget submitted on june 1st to the board of supervisors and then the board would have gone through hearings in month of june. But because were in may and were just now kind of getting a handle on what the Financial Impacts of this is, the city is going to do an interim budget which allows the mayors balanced budget to be submitted on august 1st instead of june 1st. So an additional two months above the usual budget process and that will give us a bit of a time to advise the budget submissions and allowances. So the next slide, mark. So, again, the report came out last week and instructions just yesterday and today, looking at the shortfall for the current year and the coming year next slide. Next slide, please. And so in march the city had done an initial estimate of what the impact of the changes in the economy would look like and provided a range of 1. 1 billion to 1. 7 billion over the current year and the two coming budget years which would be our normal twoyear budget horizon. In the may projection that was issued last week, as that has solidified and it looks like its at the top of that range and a little over the 1. 7 billion. So definitely not a good scenario in the changes in the economy really are in addition to all of the other things that are going on in everybodys lives, their health and their economic situation, this will also affect the citys budget. Next slide. So this is a little bit of a look. This is the citys normal fiveyear financial projection format. And the negative numbers are deficits, so this is the general fund deficit. For the current year that will end on june 30th, there is a 246. 2 million shortfall and then in the coming four years of the Financial Planning horizon, you can see that number really jumps. Its at about 750 million per year over the next two years. And then growing in the out years. If you go to the next slide ill give you a little bit more information about whats underneath that. You can really see a couple of things that jump out on that first line, the general fund sources, negative 487 million in fiscal 20202021. And that is the result of the effects on the economy and we dont really need an economic projection. If you just take a walk around the city. But this is things like sales tax, hotel tax, property transfer tax, and it really has stopped very significantly with the changes in the lifestyle of the city and the bay area around the resulting Health Orders and the covid19 response. Theres also a decline projected for our revenues and the Public Health department. This is really driven by the reduced volume of outpatient, elective procedures, and outpatient visits. All of those things that would just be at our ambulatory care clinics and also our Behavioral Health clinics, where we have reduced visits and reduced reimbursement based on the fact that a lot of those visits that are occurring now are telehealth, etc. And so theres a revenue shortfall that is projected to recover at a moderately slow rate over the next several years. And then at the same time we have the growth as we did previously have projected in our ongoing operating cost, salaries and benefits, and other city operating costs. And so that is how we get to our projected shortfall. Next slide, please. Another piece of this which is actually not fully incorporated into the budget deficit because were all still working to get our minds around it is the Financial Impact of the response to the covid pandemic. We found an initial projection here and this is a citywide projection of 373 million that is likely to be spent or encumbered in the following fiscal year. And some of the big pieces on this are a lot of the response that the city is doing, so the city has been leasing and staffing hotel spaces for isolation and quarantine and for other populations to shelterinplace in. And weve been buying large amounts of personal protective equipment at elevated rates. And the Testing Program that is ramping up. So all of those things that we have been talking about in terms of the response, you have been hearing here and from other forums and beginning to get our mind around what the cost of that is. And it is a massive effort and it does come with a big price tag and it will be worth it but it has financial implications. We have been getting some reimbursement from the federal program. So in our financials for the current year, were projecting significant revenue to the hospital from the cares act. And then the city will is also in the process of developing and submitting claims for fema reimbursement. So that federal reimbursement will help to offset the costs and the revenue also associated with covid. Although there are questions about how long we can count on this and how those Funding Sources will match up for the duration of this. Next slide, please. So the priorities that the Mayors Office has made clear is that they understand that theres going to be some difficult choices associated with this economic downturn and the impact from the citys budget. So theyre asking us to meet reduction requirements which ill spell out in a moment. To prioritize core services. And then, of course, to evaluate how things are changing in the covid environment. I think that it is clear that from everything that i and you hear from dr. Colfax and the Public Health Leadership Team that this is going to be with us for some time and that our response is going to be with us for some time. And the city is certainly going to prioritize investing and all of those strategies and tactics that were going to need to to keep the city safe and healthy. But that is going to change things and its going to change what our priorities are. And other aspects of this is that the ongoing although there are incredit mental changes to it incremental changes to it, and the ongoing restrictions on how we will live will affect the city now that we have a Public Health crisis. And then lastly prioritizing the vulnerable populations and equity in what we do. And that is, of course, perfectly aligned with our mission and our approach precovid and during the Covid Response. Next slide. So the instructions from the Mayors Office are to make proposals that would reduce our general fund support by 10 for the first year of the twoyear budget. And then that grows to 15 in the second year plus an additional 5 contingency. And effectively at 10 in the first year and another 10 for a total of 20 in the second year. So that is a big budget target. It is significant portion of our general fund support. And this is also an instruction that is relative to its almost like were going to start again fresh on the budget. So in our previous proposal that went to the commission in february, we had balanced our budget around some initiatives that we prioritized as a department. But we will have to again to reevaluate and rebalance around those to the extent that were able to go firs forward with the initiatives in the new budget environment. Next slide. So the timelines the reduction plans are due to the mayors Budget Office by june 12, 2020. So its a very fast turnaround and that is driven by what i described before, the fact that weve got a short turnaround time and were very late in the budget process where weve had i dont think that we have or i have never been through a time where we had such a dramatic and unexpected change in the financial picture this late in the budget season. And so this is going to require us to do some fast planning and to turn around the ideas to the Mayors Office by midjune. And weve got to talk with internally and with you, commissioners, about what this looks like in terms of how we interact with the commission on our Budget Proposals. But we do want to make sure that we figure out how were going to keep you mostly involved and aligned with ideas and decisionmaking that goes into this process. Next slide, please. So then just a little bit further out on timelines so, again, here we are may 19th, weve had a lot of news as i have described in the last week on the local and state budget. And then we will be submitting our balancing plans in june. The Mayors Office will introduce an interim budget as i said to buy us two months of extra time to plan. And then submit on august 1st, the balanced budget to supervisors and budget and finance hearings in progress and then in september, just the budget will go out for approval and the mayors signature. And so everything is pushed out about two months. So ill just say lastly that we as i had mentioned that literally less than 24 hours into into getting this news and starting to digest it and weve known that some of this is coming, so we have been doing some thinking on it. Our budget targets, were waiting for the exact amount, but the ballpark estimate each 5 , well, 10 is about 70 million to 75 million. So that would be our first year. And then growing beyond that into the second year. And well have exact figures on those once weve gotten the exact targets from the Mayors Office. So we have been working on it, but this is going to be a challenge for the department of Public Health. And for the city. And it is a large it is a large deficit. A large one compared to even some of the prior recessionary periods and there will be some challenging decisions that we have to make. We are committed to making sure that we do what we need to to keep the city safe in terms of the Covid Response as we go into this budget and theres more to come from us. So im happy to answer the question to the extent that i can. Clerk commissioners, before we go on, is it okay to see if we have Public Comment on this item . President bernal okay. Your conference is in questionandanswer mode. Press 1, and then 0. Clerk do we have any callers on the line . Are there callers . Any comments for this item . Oh, no comments. Great. So, commissioners, go on to questions. Im sorry, greg, that you were on the screen the whole time. So could you raise your hand, commissioners. So commissioner barel in can see if you have any questions. I cannot see folks so they could just speak up. Clerk sure. Does anyone have questions . Oh, this is comigde commissir chow. Could i ask commissioner wagner would have any idea it sounds like the interim budget is just sort of a budget for appropriation, but that the real budget that youre talking about us all trying to have input into would be the one that goes into the august period, is that right . That is correct. As a matter of law and process, the charter has a june 1st deadline in it. And so june 1st theres a placeholder budget which is essentially continuing the current years budget. And so that it meets that charter requirement for the timing, but then it will buy two months of additional time to submit a budget that has kind of the substantive response to this covidinduced economic situation. So youre right, dr. Chow, it will be a place holder and the august 1 budget that were shooting for to make new decisions and address the new economic situation. Commissioner chow so do we have an approximate 2 billion budget. And i dont remember the exact fund let me put it the other way, nearly 2 billion shortfall were really talking about 20 of that being part of our cut in general funds. Woulwhat would that look like to give the commissioners an overview and how you would, as you said and i appreciate the offer there, to be part of the dialogue about this. But what does this actually mean in terms of dollars that we look like were cutting . I mean, 20 of what . Yeah, okay, so our base budget for if you look at last years twoyear budget, adopted budget for 2021, so next year, at about 750 million of general fund. So of our 2 billion plus, its a 2. 4 billion, so were at about about high 20s, and low 30s percent general fund. And the rest is made up with revenue. So the percentage reduction, the 10 in the first year and the 15 plus 5 contingency in the second year are a percent of that 750. And the 10 is about 75 million and then that grows in the second year. The other piece which probably sounds technical but is also very important is that that that target is after we have taken into account all of these things that were on these charts that drive the costs. So we have salary and benefits increases. And we have operating cost increases. Those are going to grow. And then theyre asking us to trim back against that, against that increased budget amount. So its not that we will have a 10 target against what were spending now. It will be a reduction but it will be partially offsetting that growth that youre seeing in the budget that is driving some of the deficit. So that will be our approximate target in the first year. And then growing by 50 in the second year. Commissioner chow okay, thank you. Clerk i believe that commissioner green had a hand and then commissioner giraudo. In that order. Vicepresident green given the presentations that you and your team have done in the past i have great confidence that this will be thought out and a welldone proposal. I have two questions, and one is probably quite naive. But is everything on the table . We have all of these longterm contracts with various c. B. O. S and is there any flexibility there . I mean, some programs may not be able to proceed because of social distancing and it may continue and so forth. So im wondering how all of that fits into this. And then the second question is, given that a lot of the additional expenses do fall under the Public Health umbrella and yet all of these various departments are supposed to be cut by 10 . Is there a recognition Going Forward of the additional cost burden on doing everything that we need to do from Contact Tracing to testing to so forth, and the manpower that would be required. Has the salary increases that youve been looking at taken into account this very likely longterm group of individuals and teams that we need to work on on this pandemic and its long tale of aftermath . Yeah, thank you. Thats a good question. And ill take that second part of that first. It absolutely is the case that the city, both the department and the city, need to understand that because of the situation that were in that there are necessary investments that are going to have to continue our progress on the Covid Response and also to be prepared in case we do have additional surge. So some of those activities are the things that we have been talking about at our previous presentations on that. But it is epidemiology and surveillance. It is Contact Tracing. Testing. And then its surge response preparedness. So we have been setting up excess hospital and postacute capacity in the event that we do have a large medical surge. So well have all of those initiatives and well be moving forward and i think that there is a recognition that we are going to do that and that is going to take investment from the city. So it will not be the case that the department is being asked to cut 10 and then do everything with that reduced budget. But we are going to have to make reductions in our general fund support in order to make that possible. So theres not an unlimited tolerance within the city budget for making all of those investments and i think that if everybody had the choice and they to some extent do, they understand that is a priority. But theres just the arithmetic of the citys balanced budget requirement. So i think that part of the way to view our Budget Reduction target is were being asked to cut back on some of the areas where we use general fund and to allow that savings to be invested in some of these Covid Response programs. So i would expect at the end of the day that our budget is not going to be 10 or 15 smaller. But there is going to be significant realignment in how we use the resources that we have that will shift a lot of the way that we do business. And to gear it so that we are better prepared for the ongoing response and the potential surge. And that goes with the first part of your question, i think, that, yes, everything is with a deficit of this size and i think that everything is on the table. And we do have options. Some which are not going to be pleasant. But i do think that a big piece of this as i said is going to be thinking about the resources that we have and how can we kind of get double mileage out of those resources by having them serve a function that is aligned with or associated with the Covid Response activities. So how can we use our our existing staff to beef up some of that epidemiology work . How can we use some of our existing staff to strengthen the services that were providing in the hotels who are leasing, etc. So i think that is a lot of what the budget conversation is, reevaluating our current responses and thinking how it can be aligned with the needs of the present day. Clerk commissioner green, does that take care of your question, can we move on to commissioner giraudo. Great. Commissioner giraudo, youre up. Commissioner giraudo thank you for this presentation. Its a little frightening to look at Going Forward, and what youre facing. I know that you have a very short timeline to look at the to do this realignment. Will you be able to give us an idea prior to your submission our next meeting is june 3r june 3rd of what your realignment is going to look like so that were aware of this upfront before it goes out into the Mayors Office or the public . Yeah, thats the goal. And this is as you say the timeline here that is really tough. Because 3 1 2 weeks to do this is extremely, extremely challenging. This would be extremely challenge figure we had the usual threemonth timeframe. So i think that what were going to have to do is to have a few conversations between dr. Colfax, mark, and commissioners about what does this look like in terms of kind of timing and process, because we, you know, we obviously want to make sure that the commission is understanding where were headed and weighing in on it. I think that the question there is just procedureally how and when do we do that and what was the process for that. And we will have that june i forget exactly june 13th or whatever that deadline is, that will have to submit to the Mayors Office. And then after that point there will also be continued back and forth over the subsequent month also before the mayors budget submission is finalized. And so part of this is the role of issuing these general fund targets to the departments is to cause the departments to put ideas on the table which can then be evaluated and weighed and prioritized against other considerations or other options that have been put on the table by other departments. So in addition to what kind of whatever the process i dont know what it is today about how well communicate with the commission, there will be ongoing conversations beyond june 13th before the budget is finalized. So between the two of those, we will work out what the best way is to make sure that youre informed and giving us oversight and direction. Commissioner giraudo great. Thank you very much, and good luck. Thank you. Clerk commissioner bernal . President bernal yes. First of all, thank you so much for your presentation and for sharing this with us so quickly after receiving instructions from the mayor. It is a frightening scenario. Given the cuts that wed see from general fund revenue as well as the outpatient and a lot of outpatient with visits and procedures and ambulatory care, are there any areas in which you might anticipate increased revenue from any existing sources or even some new sources of revenue that could emerge . Yeah, good question. So a couple of things that come to mind. Of the negative impacts of this epidemic, there are probably some i guess you could say silver linings. One for our Health System is that we are likely to see increased medical revenues as more people are pushed down to medical because of the economic environment. And we would rather not see that. But if it is going to happen, that revenue will help us to offset reductions and to be able to better care for that population when they come into our system. I think that the other big pieces out there are going to we do have some continued work to do on evaluating what we think that revenue impact is going to be from covid and were revising it and making sure that were not too conservative or aggressive. But i think that the other big category is going to be on the state and the federal level and what interaction between those levels and the counties looks like. So big pieces of that is our the state is obviously in a very difficult situation. Theyve got a projected 54 billion deficit. And so some of the areas where they have been able to help i think are probably constrained. And that includes previous to all of this happening, we were in the process of negotiating a new replacement section 1115 waiver. And the successor programs which are a big chunk of our state and federal funding. One of the key pieces is going to be to figure out what is since those plans have been thrown off track by the change in the circumstances, what is the interim Program Going to be and at what funding level. That is potentially the opportunity for some shortterm relief at least. And the other is the larger federal contact. So talked about the fact that there are questions around fema reimbursement, the duration of that, and the level. And then, of course, there are the potential actions by the congress to offer additional relief and there is discussion active right now as you all know about democratic proposal to do another funding package which would include the support for state and county governments. That is not a slamdunk by any means. Its a controversy around that. We read it in the papers every day. But to the extent that there are the opportunities for further federal support for some of this response, that could be a big issue. And to the extent that offsets either the losses that we have or it offsets the general fund cost of all of those investments that we talked about that we need to be able to sustain the gains that weve made on our response, that would help the picture. So i think that those are a couple areas and there are some opportunities out there, but a short timeline and a lot of Hope Associated with some of them. Clerk welcome commissioner guillermo. I wonder if you have any questions since you just joined . Commissioner guillermo no. A number of the questions that i had were asked by the other commissioners. So i just thats my concern is, as others, that, you know, this is a pretty dire situation for us. Especially since the end is not near and so i just feel like we need to be able to follow with you and to get as much information as things develop as is possible to share. Understood, thank you. Thank you, commissioner. Clerk dr. Colfax, any comments on this before we go to the other item . Well, just to thank greg for his amazing turnaround time and his team. Theres a great deal of work ahead, commissioners. I appreciate the concerns that you have expressed and that, again and greg may have said this, im sorry, i had difficulties getting online here. But i think that one of the key things as we face this pandemic, at least through the medium term is how to ensure that our programs adjust, not only to the new normal for what they would have otherwise provided before the pandemic, but if were able to deliver the services that were delivered before the pandemic as well as address the pandemic concerns. That is certainly an intersection that were going to be looking at as we think through our priorities. For instance, some on the Behavioral Health side, were already seeing the challenges of Behavioral Health overlaid on top of the challenges around both preventing covid19 and preventing covid19 from spreading among populations with serious behav Behavioral Health issues. So that would be a place, for instance, to look not only at the ongoing need that weve always had, but foreseeing that the pandemic has only made those needs more apparent. And very specific in a way that wasnt happening before, obviously, with regard to pandemic control. So where there is that intersection of the needs that we had before that only continue, and then in some cases are made more apparent by the pandemic, i think that is where well prioritize our resources Going Forward. Mark, could i just have two more comments after dr. Colfax here. Clerk sure. Im done. Clerk yes, commissioner . Yes, thank you. And im just reflecting on the processes and the fact that as we move forward that we know that in the past when weve had to make significant cuts, there have been a need to really reach out to the communities and obviously to our own employees about what needs to be done. I think that requires really a very strong message from our director and a need you know, to have the commission to define what are those priorities. So im not sure how within this very tight timeframe that we could do all of that and try to also to get the public to understand why these are being, you know, done at this point. Obviously, the state tried that already with having put out that state employees would have potential cuts if it actually gets through the entire legislature. But i think that its important that everybody try to be on board to try to work the best we can out of this very large budget cut. Those of us who have been through budget cuts before know that there are very, very passionate and vocal advocates, rightly so, for their populations. And were going to just have to Work Together on seeing that theres understanding as to what is the priorities needed because of this significant hit to the finances of the city. Clerk thank you, commissioner chow. Any response from mr. Wagner or dr. Colfax . Well, i think that, dr. Chow, thats exactly right. And in this compressed timeline and in this time of social distancing, and the many challenges that we have, your comments are even more salient. And certainly youre committed to achieving the goals within the timeline but also getting as much input as were able to during this period. Clerk all right, thank you. Commissioner bernal, is it okay to go back to item 3 to the directors report . Oh, youre muted, commissioner bernal. President bernal yes, thats okay. Clerk dr. Colfax, and the directors report . Yes, and, again, i apologize for my delayed participation in the meeting. We were having challenge with Microsoft Teams. And so good afternoon, commissioners, grant colfax, director of health. You have the directors report in front of you. And much of what im going to talk about in the covid19 response is going to be covered in that discussion. So there are some details here that i would i would leave in the interest of time for you to ask any questions about. And then the covid19 presentation to provide a high level perspective of where we stand and wh where were headedn regards to the pandemic. I did want to highlight one piece of welcome news. In terms of a new key staff person on the team, a new member of our executive leadership is dr. Clara horton. Some of you know dr. Horton already from her role at zuckerberg hospital. But she has been at zuckerberg, San Francisco hospital, since 2008 as a faculty member. At the department of medicine. And over the past 12 years shes served as associate medical director and then the medical director of the peoples clinic. And then since 2018, shes served as the then elected position of chief of staff for zzfg. And shes a dedicated educator and she focuses a lot on the Health Care System and change management. She has a tremendous amount of skills. I can say personally they worked with clare over a decade ago now, maybe at any rate when she was an intern and i i attended the peoples clinic, she has political acumen that helps her to be a better administrator. And i always learned as much from her as she learned from me. So im justice delighted to have her join just delighted to have her join the department. So its a great announcement to make to you all today. And then i, again, i will go through the covid19 update as the next. The agenda item and i am prepared to take any questions. Clerk thank you, dr. Colfax. Commissioners, before you might have any questions. Number one, can i ask everyone except actually everyone to mute themselves except for dr. Colfax right now. I see a lot of microphones on and were hearing someone typing. So everyone would please mute yourselves. And then the Public Comment line, any Public Comment for the directors report . Lets give it one second. Im going to share the Public Comment line info real quickly. Okay. There are no questions from the public. Im going to put this line up quickly for that in case number is watching. Commissioners, if you have any questions for dr. Colfax on the directors report, please raise your hand. Commissioner chow this is dr. Chow. I cant raise your hand. I wanted to congratulate you on having dr. Horton selected and in spite of everything that is going on that we havent lost sight of keeping our eye on trying to get key administrative people to fit into our department. So thank you very much. And congratulations to dr. Horton. I dont know if you can hear me but thank you so much and thank you for the nice introduction. Clerk thank you, dr. Horton. Hi, dr. Horton. Hi, dr. Horton. Thank you. Clerk great. Shall we move to the next item, commissioners . Okay. So let me pull this up quickly. Item 4 is a Coronavirus Preparedness update and, again, this is dr. Colfax. Hi. Good afternoon, commissioners. I think that the slides are up. Clerk actually, no, give me one second dr. Colfax. Okay, now theyre up. Great. So good afternoon, commissioners. This is my this is the covid19 update. I would say that its a preparedness response and recovery update. I think that one thing that i would like to share with the commissioners is that not only have we been in this unprecedented preparedness and response mode now since february, but now we are the department is also simultaneou simultaneously doing the recovery part as well as our ongoing response part. So youll recall that in those situations that theres a more linear flow from the response and then one goes into recovery. Were both remaining vigilant in our response while we simultaneously enter at least a partial recovery phase. On top of that recovery phase as we just heard were facing a very challenging budget situation as we also want to help to assist the city to recover in terms of providing the best Public Health guidance and assure acing that investmene made in public are health, and providing guidance and advice. As we also look to have our own ber surprise for what the new normal looks like. So multiple challenges in the department right now. I am confident that we will be flexible, be resilient, and realize the care and services that we are committed to delivering, to reinforce the fact that the things that were doing, the recovery, response, Budget Adjustments and then our fire service is adjusting to this as well. So lots of work ahead in the next in the next era of Public Health. Next slide, please. So this is where we currently stand in San Francisco. And some of these slides look familiar in terms of the format. And i have updated them obviously from the last time that you saw these. But we currently have 2179 people diagnosed with covid19. Unfortunately, there have been 36 deaths. I will say that, you know, clearly one death is too many and it is terrible that we have lost these San Franciscoians due to covid19. It must be said though that our death rate is significantly lower than other jurisdictions. Again, i think that is that we are remarkably 37 times lower than new york. Weryork. And our rate is lower than many other local jurisdictions as well. So i point that out not to minimize the suffering that the city and the community has in San Francisco has had, but to also to reinforce the fact that the actions of San Franciscoians and the community with the shelterinplace has literally saved lives and i cant overemphasize that. Next slide. These are the San Francisco cases by zip code. And this really, again, rreinforces our commitment from the beginning. The reinforcement of the need to protect the most vulnerable and recognizing that the pandemic exploits the fault lines of other inequities and including social and economic inequities. And these maps as you know look very similar to maps that other both Chronic Health conditions and Infectious Disease patterns in San Francisco with the greater concentration of covid19 in the tenderloin and the mission and the bayview neighborhood. And as we go forward you will see some of the work that were doing in order to address these concerns. Next slide. So these are our this is our covid19 response so far to testing. And im sorry, im having a challenge with my Microsoft Teams indiscernible sorr sorry. Oh, okay, one way. So this is now looking at our both our cases and our testing data since april 15th to may 18th. You can see a couple of things. I want to call your attention to the testing data, the covid19 test reported to the Health Department and the proportion of positive results daily. You will see that we have escalated our testing since the end of april. Our numbers in the last few days always look a little behind because not all test reports have been reported for that day. But you can see in general that we have been testing over 1,000 a day. And we are on track to reach our goal of testing between 1,600 and 2,000 within the next month or so. A couple of bar bars that do std out that i think is worth noting on may first that very large number of almost 4,000 tests. We had the tests that we have done as part of the mission study. And the latino commission. The Health Department. And partnering with them on that. And then you also see on this graph the Positivity Rates of our tests. And you can see that for the most part theres been a drop in that Positivity Rate. And you can see in midapril, it was up somewhere between 11 and 12 . Its now decreased dramatically to the range of 2 to 3 . And that really reflects the broadening of our Eligibility Criteria as our Testing Capacity has decreased. So remember that early on in the epidemic we were focused on testing folks who work in the hospital and those symptomatic. And the eligibility extended to people with close contacts and new positives. Were now testing not only that continue to test that group, of course, but testing people im sorry testing essential workers, regardless of whether they have symptoms or not. And so as we assess eligibility, our Positivity Rate decreases because were testing with the goal of finding as many covid19 positive cases as possible. And in terms of our cases, well see on the yellow bars here on the top left of the slide, striking a number with regard to the disproportionate rate of diagnosis with the latin populations, 43 and are among the latin ex population. And reinforcing our efforts in the Mission Neighborhood an ande population. And then you will see a large portion of cases are Race Ethnicity unknown, likely due to the refusal of the testee to reporter on a lack of caution of information by the testing agency. These are tests across the city and not just the Health Department, but by other Health Care Providers, private entities and so forth. Just to remind you that we support the health order that require all covid19 tests to be done through the department. We have done almost 46,000 tests and a percent positive of 7 . Again, thats the average at the time. Next slide. So this is our hospital these are our hospital numbers. And when we talk about flattening the curve, this is what i look like because these are the people who are sick in the hospital with no diagnosed covid19 and since were not able to test everyone, we count on this curve to help us to understand where we are in terms of the virus in the city. And you can see this is the top bars are the hospitalization numbers. Again, from april 15th to may 17th. This curve is not really a curve, which is a good thing, its a flat curve. This is what we had been aiming for since the beginning of our preparedness in february. And you can see, if anything, starting starting may 2, that we have seen a city decrease. And the curve is not only flat but it appears to be decreasing. On the 16th we were down to 53 cases and we saw that decrease a bit. And on the 17th, that line over the past number days is statistically significant. So im really delighted that not only are we able to say that this curve is flat but that in the past few days we have been able to say that it is decreasing. So thats very good news. And then youll see on the purple bars that those are, again, the number of people who are in the San Francisco Hospital System who are suspected to potentially to have covid19 based on symptoms. But are awaiting a test result. And these numbers have remained fairly stable and just to remind you that when you see these blips like on may sixth, that is generally due to testing suspected cases at the laguna honda hospital. So those cases get counted as indiscernible in our database. So overall, very positive picture right now. We know, of course, that this could change, especially as we gradually decrease shelterinplace restrictions. Ill get to that in a minute. But the graph right now looks positive. Its something to be thankful for. While also, obviously, reflecting on the fact that we still have a number of people in the hospital receiving care. Some of them in very serious condition. And as you can see in the light green bars, the number of people in the intensive care units. Either the light green bars or in the light purple bars. Next slide. So this is looking at a Hospital Capacity with regard to hospital beds available for covid19 patients and you can see theres a lot to take in on this slide. Im not going to go into a tremendous amount of detail here. But to say that we have adequate Hospital Capacity in our system. We have 419 i. C. U. Beds available and 866 acute care beds available at this time. And overall that covid19 patients have represented in the last few days about 6 total of our hospital patients. So lots of capacity available. On the lefthand column under Hospital Capacity as of 51720, for instance, you could see that 9 of the i. C. U. Capacity with covid19 patients, 53 are taken up by other conditions and then 38 are capacity with the intensive care beds. And then our intensive care Surge Capacity is up at 100 . So basically this reflects indiscernible . And i do think that its important though as we go to the next phase and ill show you some models on it that this could change very rapidly. And we expect this capacity to change independent of actual covid19 cases. As hospitals go back to more routine surgeries. As people who have been staying out of the hospital do need to get care. So those green bars in the nonsurge areas will likely increase. As you know our own hospitals with San Francisco general which, by the way, have had about half of the covid19 cases recently, and i expect that the capacity of that hospital to increase rather dramatically over the next two to four weeks. Next slide. So i mentioned our Testing Capacity has increased rather dramatically as well has our analytic capacity. These are maps that were just compiled a few days ago. And on the left of the slide are all tests done in San Francisco across all providers in the last seven days. So this is not where the test was done, and this is where the people reported their zip code of residence. And i have to just say this is a tremendous amount of work by the testing and the Data Analytics team to be able to literally take every test done in the last seven days and to geomap it on to San Francisco. And then you can see the positive test results in the past seven days. So i think that theres a couple key points on this slide. We are testing a broad segment of the population in San Francisco based on where they are living. And also you can see that our testing density actually does correspond with the density of the virus. So were basically testing where the virus is most concentrated. You can see the darker oranges in the areas of the bayview and the mission and the tenderloin. And then, again, you can see that those positive tests do tratracksomewhat in the last se. This slide is not just a graphic to report to you, but it will also help us to iterate on our testing mobilization, especially as we increase our low barrier testing. As we execute on developing more mobilebased testing. And as we think about especially in this challenging environment where ongoing Testing Services are provided. Next slide. So this is a complex slide and im going to take a minute to explain it. This is really focusing on the past two months with regard to the propagation of covid19 through the community graphed on the activity of San Francisco overall. When i mean with activity, how much people are indiscernible . So the y axis on this slide is the mobility index. That mobility index is a method that is used to determine mobility in populations based on cellphone movements on any given day. And the blue line, the blue jagged line going from march first to may first, shows that mobility in that through time. And you can see quite dramatic decreases in that mobility. And that is starting in that first week of march and dropping dramatically with our shelterinplace order which went into effect on march 16t 16th. You can see that mobility index was very low for the past month and a half as shelterinplace orders have been in place. So this is not so much this is about the order, but its also about the fact that people stopped moving around because of the order. We are on this chart with the reproductive rates of the virus. The estimated reproductive rate of the virus. And this is been calculated this is an estimate, theres no way to know the reproductive rate of a virus exactly in the population. But dr. Peterson developed this slide and super imposed the rate estimate that she has developed based on looking at the data in San Francisco. The reproductive rate of the virus, remember, is the rate at which the virus propagates through a population. And r1 means that for every case, every person living with covid19, that person passes the infection on to one person. And at r2, every person infected with covid19, that person passes the virus on to two people. And a reproductive rate of. 5 means that for every two people infected with the virus that they pass that infection on to an average of only one person. So you can see that the estimate by dr. Peterson is with the reproductive rate of the virus was a very, very high reproductive rate number of 3. 5 in early march because of the really aggressive actions and supported and directed by mayor london breed, and our medical Health Officer and other Health Officers, that reproductive rate dropped to 2. 6 by midmarch. And then the reproductive rate, they estimate that it dropped to about 0. 94 with the shelterinplace order. This is incredibly important because it shows that the more that we move, the more that people move around, that the more that the virus moves around. You can see that when we stop moving, the virus stops. And the other key concept here is that we need to in order to prevent a surge of hospital numbers and in order to keep that curve flat and going down that the reproductive rate needs to stay below one. We have a narrow window here based on these estimates. That reproductive rate is. 9. Im going to stop here because that was a lot of information and i just wondered if there were any specific questions about this slide and theres more to come. Clerk commissioners, raise your hand if you have any questions at this point. Commissioner bernal . President bernal george colfax, first of all, thank you and your team for the stats. Its very informative. Is there anything that we have seen from the jurisdictions that may have loosened some of their shelterinplace orders that suggest that their replication rate is increasing with more mobility . Well, thank you, commissioner. Yes, we are seeing some of that. As we have seen recently we have sent out outbreaks internationally in some countries that have reduced their restrictions and tracked and seen outbreaks. In the United States theres foreseen increased cases in texas, maybe due to the relaxation of shelterinplace or other restrictions. We have not seen a dramatic increase in cases or deaths in georgia which was one of the earlier states to relax shelterinplace. But i would say that theres more data coming in now but certainly well be obviously be watching this. President bernal thank you. So ill go to the next slide. Unless there are other questions. Clerk other commissioners have questions, dr. Chow, anyone . Okay. So this is, again, a model that was developed by dr. Peterson. This is, you know, data that is projecting into the future. Obviously, we dont have data into the future. So i just want to make sure that everybody understands that this is a model. But it really shows what could happen if the reproductive rate goes to 1. 1 . You will notice on the y axis here that these are the number of covid19 patients in the hospital over time. So this is based on being at. 94 right now. And then shelterinplace being lifted on may 15th. Now it wasnt lifted, just to be clear. Its been theres been more activity allowed so its not as though shelterinplace was lifted. But the key point here is that the reproductive rate just increases by 20 , which is not a lot. From. 94 to 1. 1. And the reproductive rate of this virus is very high. So its somewhere in the range of 3 . So if Nothing Happened and every person infected would pass the virus on to three people. So a reproductive rate of 1. 1 is pushing the virus down to, you know, three times lower than it would otherwise propagate. So that still takes a lot of control. What you can see here is that the number of covid19 patients in the hospital by august 1, is 250. Which is right now over six times the number that we have right now in the hospital. So this just emphasizes the need for us to continue to be vigilant, to be gradual in our reopening, and to look at two and fourweek windows, and one or two incubation periods with the virus as we relax our restrictions on activities. And i also think that we continue to emphasize the need to mask, to socially distance, to implement a strong hygienic measures as we move forward. Next slide. This is what happens if the reproductive rate increases by 50 to 1. 4 . Which doesnt sound like a reproductive rate of 1. 4 , it makes all the difference between. 9 and 1. 1 . And then 1. 4 we get into very serious very serious challenges. You can see here that on the patients on the hospital, note the change in the y axis where we have a thousand patients in the hospital. Off a hous thousand patients ine hospital by august 1. So we have narrow windows and we need to stay vigilant and the key concept is that we want to keep our numbers low as much as possible. These are general population estimates. These do not account for outbreaks which are almost surely going to keep occurring in certain settings. We will be vigilant in trying to manage and control those outbreaks. This is a reproductive rate that would be generalized across the city, just to clarify. Next slide. So the other component to this is that we are in this for a substantial amount of time. Most scientific experts believe that we are in this for an 18 to 24month period at least based on prior flu outbreaks. I think that its unrealistic to expect a vaccine anytime soon. And these are plausible future scenarios based on a Public Health policy think group, cidr18 which happens to be directed by a world famous epidemiologist who directed many Public Health programs in minnesota for many years. And you can see that these are plausible scenarios based on other flu pandemics that we may see unfold with covid19. A peak and valley response, a fall peak response where we have there is a seasonal variation and we see a fall peak much reflective of our flu challenges. And then a slow burn where we may have an initial peak and then indiscernible we dont know which of these will happen. But this does help us to conceptually as we can report about our preparedness and the capacity to respond. I think that our need to be flexible and resilient in our response. Next slide. So these are the key indicators that we will be watching in our covid19 response. We will be looking at our covid in terms of cases and the number of cases and our covid positive test results rate. You saw that has been going down, which is good. And the daily count of confirmed positive patients admitted to all hospitals. That in many ways is our best indicator of the status of covid19 in the city because thats where people will come and we have as you know a robust Hospital System so its unlikely that people who are very sick would not come to the hospitals for care. That also gives theres a delay in that in terms of where covid19 is in terms of the surge because it takes anywhere typically to take a week, even who weeks, for people who have covid19 to get sick enough to maybe come into the hospital. Were continuing to manage to watch our Hospital Capacity. The goal is that fewer than 20 of our nonSurge Capacity with covid19 and you can see that were at 6 pr 6 now. And our goal is to get as high as 2,000 tests per day. And were approaching that goal rapidly. You can see our Contact Tracing and these numbers have dramatically even in the last week and were now reaching 80 of covid positive cases and 68 of contacts. And then our supply of personal protective equipment or p. P. E. And we need to make sure that we than we have a 30day supply Going Forward in order to protect our Health Care Workers and First Responders. Next slide. So as we move towards this next phase of reopening, i think that, again, its important to remember that the virus doesnt have a timetable. I think theres been a little bit of i dont know if its a misunderstanding but perhaps the cadence of the Health Orders which was on a 30day period sort of psychologically adjusted us to thinking in 30 days, in a period of epidemic, that the virus doesnt have that timetable. And we are in i think the second inning of a long game. Im not usually one for many sports analogy, but i think that a second inning of at least a nine inning game is appropriate to think of here. And we have we are in phase 2a now of opening up lower risk workplaces. We announced yesterday with the health order, issued a Curbside Pickup would now be permitted and that the manufacturing and logistics change that allow that to happen will also be opened. I would just remind the commission that on may third that the health order allowed construction to to restart as well as outdoor businesses. And in addition to the lower risk workplaces on phase 2a here, we have also issued orders allowing nonessential surgeries and other health care to resume. And then you can see over this next period that we will be looking to move into phase 2b. Allowing retail to potentially to adapt and allowing the reopening of schools, offices and child care. And i would just say that as part of that work that we are working closely with the city stakeholders to determine the safest way to potentially to reopen summer camps for children. We then move on to phase three and phase four. So this is the state, the california stages of reopening and well obviously adapt this for local use. And dr. Eregon, and the office of workforce development, and the city controller, and the city assessor, and other key business stakeholders to to ensure that not only are we looking at this through a Public Health lens but theres a True Partnership developed with the Business Partners so that we can provide insight, guidance, data, to help them open as safely as possible. And then we will also, obviously, look at those key metrics Going Forward to ensure that this these relaxations are not associated with dramatic increases in covid19. Again, i think it needs to be said while were hopeful that the masking and social distancing and hygiene will be effective in preventing that, if in the event that we see concerning data that suggests that a surge is imminent, we potentially would need to go back to restrictions on activity and possibly businesses as well. I think that is the last slide of the presentation. And im obviously happy to entertain any questions that the commission may have. Clerk commissioners, before we move forward with any questions from you, we should go to the Public Comment, all right . Public comment line, can you let me know if there are any callers on the line . No callers. Okay, great. So, commissioners, any questions, raise your hand. Commissioner guillermo. Commissioner guillermo thank you. And thank you dr. Colfax, for the very comprehensive report. Very informative. I had a question that goes back to that mobility projection set of slides. And im wondering theres two parts to it. One is how does that model incorporate or could that model incorporate and modify to incorporate the types of activity . Because as informative as it is, given the mobility information from the cellphones, does the type of activity that people are doing change the model projections in any way . And if so, even if not, how do those projections fit into how we are going to in San Francisco to make the decisions about moving from any one of these phases to the next. And is the data that were going to try to gather related to th that . Yes, thank you, commissioner. Thats a great question. And ill talk to dr. Peterson about whether she can provide more specific whether there are databases that allow for more specificity in terms of that activity. I do think that the question is also i mean, i think that one of the key issues is whether as the activity increases and whether people will still move around by themselves with their cellphones and that curve will go back up. But because theyre Wearing Masks and because theyre soarg distancing and because social distancing and because theyre washing their hands and cleaning surfaces appropriately, that we would hope to see that activity level will go up, right . So thats one of the key questions Going Forward. I think that the indicators will be what we will really need to use. The models are really helpful for us to think through what the implications are of our increasing. And the r is very its only an estimate. And its not something that we can rely on on a daily basis or even a weekly basis. It takes a very large data set to make r. And so wed look at the numbers in terms of our testing and our hospitalizations to determine whether in our Surge Capacity to determine whether these are moving to further restrictions Going Forward. And just determining, you know, whether people are able to adhere to some of the social distancing. Thats going to be a huge determiner of whether we can keep the r below one, the masking and the social distancing piece. Does that answer your question, commissioner . Commissioner guillermo yes, it helps and i wanted to just say first to thank you and the department and the cooperation that you have been having and leading with all of the other departments in the city. Because i think that that leadership and that model of cooperation has really helped the residents of San Francisco to more easily to take on the types of behavior that we need in order to keep the numbers as low. And the infection rates and all of that as positive, relatively positive as they have been. And so just looking for more of that exemplary leadership and information that the department and all of the sort of visible evidence of that throughout the city, i think is very, very comforting. And it is helpful. I think that it is an important piece of, again, why San Francisco county has been able to weather at least to date this pandemic to the extent that we have. Thank you. Clerk commissioner giraudo you had a question . So looking at the projections for what might happen with the replication rates, two questions about as we enter into phase two. I do understand that when youre looking at curbside retail were not requiring applications or filing of plans or anything for the smaller employers. But do we have an indication of the extent to which retailers are opening up or intend to at this point . And then the second question, perhaps you can answer these at the same time theres been press coverage about predictions that we may move to phase b2 in two to four weeks time and is that something that should be father qualified than what has been in the press . Thank you, commissioner. So with regard to the indicator, i dont have a metric that i can share with you about how many retailers have started Curbside Pickup. I do think that theres been, you know, a qualitative feel that has had activity in the last couple weeks. And dr. Peterson emphasized is getting that mobility table to track Going Forward as well. So it will be key for us to look at that. With regard to entering into phase 2b, these are the state phases for reopening and our phases, again, will be tailored to the local conditions around this. And we will need, again, to look at the data over particularly the next two to four weeks to determine whether we are ready to move into the next phase of db. So i 2b. So the balance here is for us to be resilient and to be reasonably hopeful, but also not to be rash. And, again, to realize that the virus does not have a timeline, right . So i think that theres a question if we can stage this, is this going to be appropriately gated so that people can feel comfortable and safe going about their activities in a way that is not going to create an unmanageable surge in the virus. So i think that two to fourweek cycle, because two weeks is one incubation cycle and its going to be vital to determining whether we can go on to phase 2b. If a week from now that hospital surge is ramping up instead of down, were going to have to take a hard look and to better understand that and to take aggressive action, depending if, you know, why we think that is happening before we would be comfortable in moving to phase 2b. And just to be clear, any discussion of a twoweek to fourweek period of time has more to do with incubation intervals, the point where wed have more data to make the determination . Thats right. Thats right. I said that the virus doesnt have a timeline, it does have a calendar in fact that it has a twoweek incubation period. But remember that the other thing that we have to think about is that these are added steps, right. So can we keep the reproductive rate below 1, with Curbside Pickup. Can we continue to keep it below when we enter phase 2b. And i think that its also important to emphasize that i and the department have recognized the negative Health Consequences of, you know, a prolonged shelterinplace and the economic crisis that were entering. There are profound Health Effects to that as well. Obviously, widespread covid19 pandemic on top of that makes things that much worse. But i also want to emphasize that we understand and have a Delivery System or seeing Behavioral Health issues and Chronic Health issues and other things that are happening that are associated i think with this these prevention and aggressive efforts that we have taken to prevent covid19s spread. So were trying to, again, to balance the increase in activity with the fact that we want to make sure that as we increase our current activity that the virus doesnt as much as possible. Thank you. Clerk any other questions commissioners . Mark, yeah, i have several if i can. Clerk yes, please. And to thank dr. Colfax for really an excellent summary of all of the things happening in the last several weeks. Theres several questions that i had and one was simply technically in terms when you share a 30day p. P. E. For this, and i wonder if youre considering that as a need for the other elements of our coalition, including the hospitals and practitioners . Or and, if so, how you measure that. And the second question had to do with the longterm care facilities. I throa note to say that they sd be testing but your reports seem to indicate that we were doing this seqently first at laguna and then reading on. And maybe its a misreading of that because it seemed to me that once we put in the orders, that ought to be done at the other facilities on whatever resources that they have. And not wait sequentially. And i think that, thirdly, more of an overall philosophic issue i should say third is that you did mention restaurants and the state guideline. And in San Francisco this is a very real issue. And, you know, we dont have a lot of outdoor space at a number of places that can be used for being able to spread out more. And im just wondering how we are working with the restaurant people in trying to see what was viable for them. And i guess that, fourthly, is more as the different counties are in different phases, how do we think that that will affect this county which is sort of the center of where the office is and the commerce are being done, right . Its one of the places. So if one county said that you can do offices, do we do that . But then people often travel to those areas which also might be potentially more, you know, prone to covid, right . So im sorry to give you those questions but i thought that if you could answer those, id appreciate it. Yes, thank you, dr. Chow, commissioner chow. I appreciate those questions. With regard to the p. P. E. Issue, as you know that we have worked very closely with the Hospital Council throughout this throughout this pandemic and coordinated the efforts very well. And has been a remarkable leader in that work. And our p. P. E. Issues in some ways were the most challenging across the network of providers and they assured us that their p. P. E. Concerns have diminished quite a bit. And we think that as long as our supply chain is strong, theirs is probably even stronger. So we basically have developed a system where we dont require them to certify they have 30day supply, but we have regular checkins with them to make sure that they are able to have that 30 days. That hasnt been a major concern recently. With regard to the longterm care facility, i appreciate you pointing that out. And just to be clear, we issued not to be clear, but to remind the commission that we issued and they issued a Health Care Order requiring longterm care facilities to test patients and staff for covid19. Basically screening every two weeks. Those numbers i do not believe that are reflected this those purple lines. And that would be if theres a patient at, laguna honda, for example, who might have covid or something who is symptomatic. And our testing has increased dramatically in regard to testing. And im trying to bring up those numbers. Let me just tell you this is routine testing at laguna honda as part of that effort. In the last few weeks we have tested 2,087 residents and staff at laguna honda hospital. This is the routine screening so not symptomatic. And 718 residents, 1369 staff. And as a result of universal testing we did detect four new positives who are asymptomatic. So that type of routine screening is yielding the desired well, its yielding results. Obviously, we prefer to not find any cases but the fact that we found a number of cases that were asymptomatic ensures that we are able to then do contact investigation and tests, close contacts, and hopefully contain the virus. We are assisting other nursing home facilities across the city in implementing this routine testing. Weve already worked with numerous entities over the past few weeks and were continuing to scale that up. So i hope that answers your question about the longterm care facilities. Its a change for them in this new era. And our expectation is that they will make investments in getting their staff and their residents routinely tested with a twoweek cadence in that regard. And another question that you had was about restaurants i believe. And, again, that is obviously a key industry in San Francisco. And i have to say from a personal note i really miss our restaurants. And, certainly, we are working the Health Officer and his team is working with businesses to look at the guidelines from the state and other jurisdictions with regard to safer dining practices. But there is a lot of work that still needs to be done there to determine what would be a safer environment for people to dine beyond the pickup and takeout that we currently have. And then the last issue that we have in place excuse me i could take out and pickup, yes. And so the last question was with regard to the regional approach. I think that one of the things that is really remarkable and should be celebrated is the way that the Health Officers across the region have come together and aligned our pandemic response. And we know that theres a lot of flow back and forth across the region. I think that theres been a lot of theres been a perception that that coalition may be less cohesive than it was previously. And i dont know that is the case. I think that for the most part that we are continuing to focus on the data, science and facts and overall the cautious optimism is aligned. Again, were going to be looking at very similar indicators Going Forward. And i think that well continue to learn and to work with each other to ensure that not only the jurisdictions are directly accountable as much as possible but that were working lockstep in regions because our focus continues to be on fighting the curve and to especially protect the most vulnerable who are most likely to die from the virus. Thank you very much, i appreciate your responses. Clerk commissioners, any other questions, raise your hand. Commissioner green. Vicepresident green oops i muted again. Clerk youre on, youre good. Now youre off. Now youre muted. Vicepresident green there i am. Thank you so much. And commissioner guillermo said it so eloquently and the other commissioners with our gratitude for you and the teamwork that you have demonstrated across all sectors has been remarkable. And nationally, now nationally acknowledge and publicize which i think is a great celebration of your work. I had two questions. One is there any worry that Testing Capacity we talk a lot about having enough p. P. E. Is there enough worry about having enough test kits as we try to expand the questioning . And the other question that i had is theres a lot talk about things coming back and that second graph that you showed and a lot of indicat inds what would be what youre following to indicate that we might have to roll back some of our phases. So im wondering what your vision of that in other words, not only are there certain parameters that you would weigh more than others, but do you think that theres regional consensus if that came to be, especially in the winter. What would be the lagtime if it were necessary between the gathering of data and the institution of a potential rollback of some of these or a reinstitution of restrictions . Thank you, commissioner, for those insightful questions. With regard to the testing challenges that we continue to face, our supply chains for testing have strengthened considerably. I think that where we are facing challenges is in a couple of ways, in a couple ways. We have a vision of universal access to covid19 testing for the city. And that has sometimes been translated into the Health Department is going to test everybody in the city on a regular basis. That is not feasible. So i think that from our Population Health approach, we will be supporting various entities to supply Technical Assistance and to help them to invest in testing and think about if youre a business, for instance, what is your health plan under the covid19 response. And how do you encourage and help your employees to get tested by their health care provider. So i think that theres that broader component where we set our goal and focus and in some cases the requirements for testing but dont necessarily conduct the test. And the other key component of this is as we look at data coming in from the communities that we have historically served, the vulnerable communities, underserved communities and so forth, how do we not only provide testing sites, but were ensuring that were providing low barrier culturally relevant, appropriate testing and services, right . And this clearly has a history of both challenges and successes in the h. I. V. World and i think that we really need to draw and accelerate on that work and not ry learned the lessons of hard way on that. But take the lessons from the epidemic and apply them as quickly and effectively as possible. There is a lot of demand for testing in some communities and among some stakeholders. And then i think that theres real barriers that people have about being concerned about testing. For instance, now that we know that there are a significant to portion of cases that are asymptomatic, how do we ensure that workers, particularly workers who may not have paid sick leave, or who are on, you know, episodic employment and are already struggling to make ends meet before the epidemic, and how do we determine what policies need to be implemented to protect them, to encourage them to get tested and ensure that the consequences of the public test results are not the loss of a job or economic downturn. So we are going to be working with communities and listening and partnering to develop, again, robust lowbarrier testing that really meets the need of the population that is most in need. And also applying this broader Population Health perspective that are with testing and asking other Health Care Providers in the city to do their part and to support testing for not only their patients but also with their workforce and then, again, extending that effort to the Business Community and other stakeholders as well. And then i think that you were asking about the indicators and how we would how we would respond in a way regionally if the indicators started to go up. I think that would just probably be a process where the communication across the different regions would continue and there were signals in adjacent regions that suggested that there was a surge either there or that there was a surge coming, that we would have to look at the data and to make a decision about whether that would require the immediate or the medium term response. And some of those similar conversations that happened in february when as you know that the first outbreaks were really being focused concentrated in santa clara. And so we would just need to continue to look at that information and to determine whether a targeted shift would be needed or a more regional shift would be appropriate. I hope that answers your questions. That was a long answer. Vicepresident green very much appreciated. Thank you so much. Clerk any other questions, commissioners . Okay. So before we move on to the next item, which is going to be item 7, the d. P. H. Human resources update. Im posting the comment Information Online and ill keep up it for 30 seconds and mr. Brown and karen hill, would you turn on your microphones and cameras. Before i go i wanted to acknowledge the incredible effort ever the d. P. H. Team. We literally continued to have hundreds of people at the Operation Center and people have been working 18hour longer days on the ground and anywhere from working in the hotels where were placing people who have covid19, to dealing with treating people for Substance Use disorders and Behavioral Health issues. And setting up testing policies and studies and Testing Programs like overnight. And working on these data analyses like that geomap that i showed. Its just been an incredible effort the part of the team and its very inspiring for me to be able to support so many people in the department. And also across the city. And i just want to thank the commission for their support. I know that you supported and delivered some support to us directly and theyre not in the room but the team thats on the line and far beyond that team, the literally hundreds i think that thousands of people in the department, who are doing this work every day across the city to support our pandemic response. And its just been a remarkable effort, unprecedented. I think we always you know, it reflects our core values and principles, but, certainly, its been realized more than ever before. So, thank you. I want to express my gratitude for that and the commission. President bernal thank you. And no expression of gratitude is enough for the extraordinary work of you and your team and every Single Person in the department of Public Health and our other city agencies to help to address this pandemic. So thank you, again, and well continue to seek opportunities to say thank you and express our gratitude whenever possible. Clerk thank you. So now we move on to item 7 which is the d. P. H. Human resources update. And im going to host mr. Michael brown, the director of h. R. On the screen. Mr. Brown, welcome. Thank you. Commissioners, thank you for allowing me to speak with you today. And, you know, since i have been here since november 4th, i remember the exact date in 2019, and this has been a whirlwind of events that has been going on. I am pleased to present to you some data in terms of what we have been doing in terms of hiring. And with me on the call is karen hill who is my director of merit and staffing. And can explain some of data that we have already provided you. I think that there were some questions and were here to answer those questions if you have any. Karen, are you on . Yes, im here, can you hear me . Yes. Yes, im here. So wed like to start with the questions that you may have unless you want to go through the data on the forms and explaining it to you. Clerk commissioners, you received a report in your packet and i emailed you some responses to questions that commissioner green had sent in a few hours ago. So does anyone have any questions or would you prefer that miss hill and mr. Brown go through the data they have given you already or do you want to start with questions . Commissioner giraudo looks like she has a question. Commissioner giraudo hello. I have one economy following commissioner greens request about the lease indiscernible across d. P. H. And those were answered as far as percentages. Do you have information on the type of leave that has been requested by the employees . Is it family, rather its medical, on what the kind of i know that you dont have that percentage data, but what is the breakdown or what you see as the possible breakdown of the within the leave request . Hi, commissioners. This is karen hill. So the majority of the leaves are fmla. So regardless if theyre covid related, covid leaves run concurrently with fmla. And so the breakdown of the type of leave that an individual would request, whether its covid related, child care related, if its their dependent or their spouse or their parent that theyre requesting a leave for, it will run it would be identified as an fmla leave. But their benefits would be tied to covid. Clerk can you turn on your camera, please . It should be on. Can you not see me . No. Oh, you know what, there we go. Sorry. Clerk thank you. Miss giraudo, any followups to that or did that suffice to answer your questions . Commissioner giraudo no, that answers my question. I assume that is what it was. I didnt know if you had a further breakdown out of the fmla leave, whether or not it was more child care i mean, if you had any subgroupings of family leave . We can break that down if you want us to do a further breakdown, you know it would take some time based on the amount of leaves that we have. But were working on a system where wed be able to break down a type of leave because theres different categories now associated with covid and we never had to go into that granular level. And now that we are we are working on a process. Commissioner giraudo okay, dont do it just for my question the answer to my question. But as youre Going Forward with your own data, i would be interested just because i have the same issues with my staff in looking at the number the different categories of family leave. So it would be of interest as you are crunching your data to please share it. Thank you. Sure, sure. Clerk any other questions, commissioners . Im not seeing commissioner green, could you let me know that youre on here . I think that we might have lost her. Vicepresident green im here, sorry. Commissioner chow here. Im impressed with how well were able to move our hiring process and we have been struggling with this for a number of years literally. So, mr. Brown, what do you see in the future if we can do this in an emergent situation which almost sounds like a normal way of doing hiring, how are we going to ensure that in the future and im taking you at your word that by may 31st that you actually have filled your vacancies. How do we keep them filled . Because if we go back to our way of taking up to a year, if not more, to try to hire people well be back in the same situation. So how do we take advantage of knowing new processes and work s