Ramaytush ohlone have never given up their land, we benefit from working and living on their homeland. We wish to show our respects by affirming their soverne rights as first peoples. Thank you, commissioner guillermo. Our next item is approval of minutes of september 19th, 2023. You have the minutes and i have reviewed them, if there are no amendments, can i have a motion to approve. Motion to approve. Public comment. And i dont have my script with me, but i will note that we always take folks that have received accommodations first and then we move to those accommodation. I see one hand, at the moment, were only taking those who have received accommodation for me. Please unmute that person and well give them three minutes. Caller hi, commissioners, this is patrick shaw, code a a. Please begin. Caller thank you. These minutes were at the chair me and others have continually raised the issue of what the Commission Long term plans are to prevent another reoccurrence. It appears that the commission, advise contract, when it expires in 2024 for a period of time. I think thats accordance to minutes for finance and committee. When commissioner asked if that contract was going to be extended again. Im wondering are they hiring for renewal, 10 Million Dollars each and every year in to reports payable is that . The plan . Is that your mission to laguna honda . Thats the only comment. Any questions or comments, if not we go to a vote. All those in favor . Aye. Opposed . The minutes are approved. The next is resolution honoring honoring lisa goldman, we have dr. Navina babba to present on this. The mic. Doctor lee has contributed to the health and well being of San Francisco for over 34 years. Her career has been multiple parts of the department, most relaoent heading the office. Through her previous presentations, dr. Goenld has to the department. Which has brought up the strategic. What i most appreciate lisa is her ability to quickly set the current state, understand the problem and develop counter measures. I have personally learned so much from her and will miss her Clear Thinking to complex issues and articulate the path forward. I wish her the best in retirement. I wanted to take this moment to extend my gratitude for contributions and years of service. And i will read the draft resolution before you all move forward to take action. Where as lisa golden have served the city and county of San Francisco over three decades in making tremendous contributions to the align tra taoej i can initiative and continuously improve the performance, where as dr. Golden has held several dph positions including medical director of ocean park center, medical director of Quality Improvement for primary care and most recently for dph Promotion Office. Where oversaw the task of developing this Strategic Plan and coordinating the complex implementation of the plan through the department, where as through her work developing and overseeing the promotion al office, dr. Golden create thed infrastructure that makes improvement employees daily work. Every new employee is oriented as central part of dph work and throughout the department. And where as dr. Golden convene with the dph executive staff every quart tore discuss performance across dph. Where as golden served as in multiple roles during covid from the first month of the covid pandemic emergency response. She also lead response, in our most congregate settings, she was both during the Pandemic Response to transition response back to the department operations. Where as dr. Golden is known for her innovation, creativity, and always being able to volunteer to address issues at the dph. Where dr. Golden leaves a legacy to support and improve the lives of all san franciscans, she will be dearly missed at the dph and communities. Resolve that the San Francisco honors lisa goenld for her Outstanding Service and leadership and wishes her well in her retirement. All right, before we go into any Public Comment or commissions or director of course, we will need a motion to approve the resolution. So moved. Any Public Comment . Seeing no Public Comment, folks online, were on item 3. Resolution honoring lisa golden, press star3 if you would like to make a comment. I see no hands. Well begin with dr. Colfax. I want to great dr. Goldens dedication. As you heard from resolution, she has done tremendous work and ive had the pleasure of working with her for these last few years and really so deeply respect, her wisdom, her patience and her consistency as dr. Babba had described, embodying lean principles and one of those principles is going to the work that is actually being done to observe and to ask questions. And there is a lot that goes in the department, and dr. Golden was instrumental in ensuring that in crisis, in complex situations, in situations where improvement need to be made, was instrumental in being a key resource in helping us think through, how do we develop a structure, how do we develop outcomes to improve, how do we ensure that we adjust as more information comes in. And how do we ensure that were always in mythology. I knew dr. Goldmans way were successful when people were asking how did that work. From doing test sites and vaccine sites on the ground to the covid dashboard, dr. Goldmans leadership was instrumental. Most recently she has deployed her team to laguna honda and moving forward with the recertification and all the improvement there. And these are things that are sustainable, and thats the thing that i really value so much about dr. Goldmans work. These are not shiny objections, these are things that get embedded. And she is, she is subtle and yet very powerful in ensuring that cultural change around Quality Improvement and sustainability takes route and forces across the department. So thank you, dr. Golden for your incredible leadership. Thank you, director colfax. Commissioners, any other comments . Commissioner chung . I was just going to say, i still remember when i first started, when i got appointed to the commission, thats when the dphs implementing the lien principles, sxifs asking the same question, i said how do you turn that into a culture. You can say you want to improve something and how do you make sure that everybody that comes after, would pickup the same type of practices. So i dont, i cannot picture that to be easy task. And thank you for like doing all the work and congratulations on your retirement. Vice president green. First of all, your contributions have been remarkable. When commissioner guillermo and i were first training and leading seemed overwhelming. And it was taught to us the way you distilled it, your ability to take complex concepts in terms of all the covid work that dr. Colfax just discussed but all the lien principles, it was overwhelming yet we were able to understand it. And every single time, we were at the jcc at the county, we see the benefits of all of your contributions. I dont think we can express it enough, because the kiezens and all the way that the lien has improved care for patients and for all the residents of San Francisco. Its the backbone and it could have gone so off the rails without somebody like you to shepherd this complex way of dealing with a Massive Department to the point where we are today. Which is so incredibly successful and critical for all of the achievement that weve seen. So we are so appreciative, well really miss you, and you make great choice nz sweater colors. [laughter] thank you, and dr. Goldman en, i would like togolden. When i first came on the commission years ago, learning about the principle, it was a very important part of that how this large complex Department Works and how the principles are infused across the entire department. Sxif no doubt that in addition to your work and leadership during covid, that your work in the kiez en Promotion Office put us in the country. Sol grateful for your work, really transforming along with your team, the culture of this department and put ing us in a very strong direction and really having us prepared for what was, unprecedented crisis where you were so engaged too. Thank you so much for your leadership and for your work and i would like to offer you an opportunity to say a few words. Before we vote. Hopefully to other agencies as well being spread. Thank you for that. I feel very privileged to have been been able to work across the department can so many incredible people and across other agencies as well. I feel like its a privilege that one does not always get in the department, so i really really appreciate that. And the fact that there are opportunities to build a career here, to actually develop oneself and to have a variety of different, activities, responsibilities and work. So thank you very much. I really wibbler the department and the Health Commission all of the best as you continue to do the good work promoting the health of san franciscans. Thank you. Thank you, i think we can go to a vote now. All those in favor of approving the resolution honoring dr. Lisa golden. Aye, opposed . Thank you very much. Mr. Secretary, do we have a photo . Okay, moving. Would you like to take a photo . Yes, lets do that. Commissioner can we get up to the front of the spending time up here in the dais, that almost felt like a field trip. Okay the next item is general Public Comment. At this time the members of the public may address the commission on the items on the agenda. With respect to agenda items, the opportunity to address the, each member may address the commission for up to 3 minutes. The brown act forbids, including those raised in. Patrick, this testimony is about items not on todays agenda. So please dont cut me off. During the board of Supervisors Committee as a whole hearing on september 26th, Roland Pickens answered a question from from supervisor Rafael Mandelman to present a report from Behavioral Health working group during the Health Commission meeting in october. About the plans to create additional Behavioral Health and Substance Abuse treatment in San Francisco in including, recommendations to expand Behavioral Health at laguna hospital. And since there is no presentation on this topic today, and mr. Pickenss report will be presented in october, did that report on october 10th or the 2nd full Commission Meeting on october 17th . Members of the community deserve to see, this board and its eventual recommendations. So we can consider the importation of whatever recommendations are presented about bifurcating and Long Term Care nursing patients, against Behavioral Health patients who have had no substance additional treatment that created in long term settings. They just meet those to but you shouldnt be robbing peter to pay paul by reducing the availability of traditional nursing facilities at the ex tense of San Francisco out of the county who need traditional Long Term Care nursing facilities. Thank you. Time is up, great. Thank you. That is the only comment under general Public Comment. Okay, our next item is the directors report, director of health. Good afternoon, good afternoon, commissioners. Im here to provide the directors report. Items, ill gl through them quickly and answer any questions if you would like a deeper dive. Glad to announce that dph announced the staff board, of the most resent Data Available in overdoses. And her update later today, doctor will provide more information there. Im also glad to give you an update on laguna honda to join our executive team as our new directors of nursing. Theyre tracy brown and Michael Collins who have remarkable careers in healthcare including extensive experience in Long Term Care. At laguna honda, they will have roles that are essential to restructuring the organization that we have created in our transformative work to turn laguna honda na a world class nursing facilities. Also please to announce that as of october first, San Francisco was one of the first 7 counties in california to implement as a Community Recovery empowerment, care act, also known as care court. The care act which passed the state legislature and signed by the governor last year, provides Community BaseHealth Services tho to resident who are living with schizophrenia and other disorders. Participation in the program is voluntary but were hopeful that that we can provide tho those not currently in care. Also wanted to announce that Health Coordinator for San Francisco san mateo and oversee Newcomer HealthRefugees HealthAssessment Services which is funded by the refugee and you can read more details in that item. And Community Partners including day that the lara sa one of 15 teams of rising Public Health and Community Leaders around the country to participate in the inaugural cohort. And this is supported by the number organizations and really pleased that they were selected as rising leaders for important program. We have now plateaued from the data we have and hospitalizations are even going down slightly and im pleased to say that regard with the updated vaccine, it took more time that we would have liked but we were able to secure vaccine for our publicly funded sites. Were encouraging every one for whom the vaccine is recommended to get that updated vaccine. So i will stop there and answer any questions from the commission. Thank you. I see two hands, and again we start with the folks who have received accommodations. Three hands, and given permission and accommodations. Jamie lets start with caller 2. Caller its patrick again, were encouraging that laguna hondas two directors of nursing tracy brown and Michael Collins have finally been hired. There is still no word on hiring federal director. Laguna honda paid invoices to the medical director for this and two on completion. Presented and 10,000 for a total of 46,000. That hiring laguna medical director. Did you receive invoice number 3 and 4 from berkeley Search Consultant . Or an additional 46,000 for the medical director. And hiring, mr. Collins for the director of nursing conditions. What were the two total cost of hiring, to two directors of nursing . Were they placed by berkeley Search Consultant or another search firm . Thank you. Thank you very much, jamie lets go to caller 7. Caller hi, this is dr. Lisa calmer, i asked for accommodation but i dont think i received your email. Dr. Palmer, i gave it to you before the meeting, i apologize in my tardiness in getting back to you. Caller thats okay, im just really nervous in getting admissions restarted and post political and economic pressure to have patients to laguna honda in order to serve the flow at the General Hospital. We do need more Behavioral Services and, a lot of, people that need services have. Have aged. People whos behavioral is uncontrolled, really cant accommodate it safely in a congregate facilities with frailed disabled and elderly people. And we really need to know, that mistakes have been made in the past are not going to be repeated. And i think, this was such a big part of putting the whole place into chaos. And clinical manager who were obedient and not competent. And i worry that not being able to attract the medical director is because of the unknown around this, the politics of being forced to agree to admit patients that are danger to themselves or others at laguna honda. And so i really would like you to be very transparent about this. And how laguna honda will be protected in its mission from the patients that are danger to themselves and others at laguna honda. The challenge of adequately Care Planning without without breaking regulations is once theyre in the nursing home and have all the rights, is also almost impossible. And its going to lead to more jeopardy if were not, if there is not a real realistic plan to not repeat history here. And we need services for these people, but not we need to not sacrifice laguna honda. Your time is up. Thank you so much. Thank you. Jamie, please unmute the last caller. Hi caller, youve got three minutes, let us know that youre there. Caller yes, can you hear me . Yes, begin. Caller interestingly enough, my concern is similar to dr. Palmers. I dont think there is been merely enough public discussion of the impact of the slow project on the seniors disabled resident of laguna honda. And possible adjustments or eliminations of that unsuccessful branding of population. What is the plan . Thank you. Thank you. Le there is last comments for this item, Public Comments. Commissioners any comments or questions from the directors report . All right, thank you, dr. C