Ramaytush ohlone community and by affirming their sovereign rights as first peoples. Thank you. Next item on 2. Approval of the minutes of the Health Commission community and Public HealthCommittee Meeting of march 19, 2024, meeting. I believe secretary morewitz a few corrections. Im sorry on the bottom of page 5 the word um, skilled should say guide. And actually i need to run and get a copy of the minutes. So i wear my sneakers and on page 6 commissioner chow asked for a correction so at the top of the page states out of the 91 million spent on Health Services on the spec addressing medical conditions. Any other any additions or deletions to the agenda . All right. Seeing none, a motion to approve the minutes. So moved. Second. Second. And any Public Comment and then short statement about Public Comment autopsy lets see in the Public Comment in the room first on the minutes. There is a hand before we begin i have a statement members of the public can make comments up the three minutes. Feedback in the individuals and community the process is in the meeting for the Public Comment to engage with back and forth with the commissioners and members of the public when discussing items making requests and individuals will have an opportunity to Public Comment maybe sent to the Health Commission the word health dot and commission and. Org if you wish to spell your name for the words with the state and federal prohibits harassment and all right. So we have one hand everyone gets limited to 3 minutes per speaker as i noted before and first caller let us know youre there this is patrick code aa 24 minutes on page for about the march 12th la j. C. Meeting and the court asked how many appeals the results has been unfortunate despite my records request the commission never answered me simply to file an appeal and that is totals 34 people with 10 cases unexplained and on Troy Williams come out to be get the Good Government award with dr. Colfax in 2019 to change the recertification and williams was there then and now the quality officer by choice failure to have for decertification and might not had the 26 million for insuring the process is against mr. Williams is bad and then promised to reform the program in 2019 but causing the recertification so not honored for something that was partly responsible for creating and owe would resign in disgrace. Thank you. Thats the only Public Comment on that item. Take a vote. All in favor, say aye. Aye. Thank you. Next item is general Public Comment and the script i read before answers one additional statement you may address the members of the public on commission from taking action or discussing any item not appearing on the posted agenda, including those items raised at Public Comment. I believe we have one one minute sir, to bring it up. Go ahead. As you know im chief Financial Officer and previously talked about the illegal system and provided you that led to the patient harm like sherlocks and others and into the home invites people with solutions and outcomes but talking about a citizens arrest can execute one. I prefer not to place individuals under arrest. I prefer we let people to stay in their room and move forward without compares and today, im your honor, the Health Commission to have a criminal complaint on multiple people this is illegal. And people talk in a negative way and i ask you include in our health those charges and recommendations should have california code 502 damages and unauthorized access to Computer Data and systems and california penal code makes it a crime to send Electronic Communications with reasonable fear for his or her immediate family and i urge you the Health Commission to kwefrmg youre the right people at the right time to make that happen to put San Francisco back in the right direction within our gentrification i want to read what several people said you have the right to remain silent anything you say can be held against you in the if you cant afford an attorney do you understand those rights . I will make myself available for questions or comments for the Health Commission, however, i strongly urge to assist with needs and tomorrow to the Commission Information technology this is coming out and i think i would urge us to get ahead of that and i would recommend getting the Department Heads and communications so anyone that is miss using it people are dying over doses suicide because of this so i urge your assistance in this whole communication. Thank you. We have also a remark Public Comment. Are you unmuted please begin and it is patrick again. Ill provide written communications for this agenda item. Thank you. Thats all there is. Thank you. And i would say definitely read all the written communications we received secretary morewitz sends our way we to review them indeed the next is the directors report dr. Colfax. Thank you, president green and good afternoon, commissioners we have the directors report in front of you referring to that ill not read all but provide highlights number one, is the laguna honda hospital with the center recertification update the hospital diligently working for recertification for the centers for medicare and medical and called that in august laguna honda member mathews row certification and now to recertified or service the laguna honda submitted the plans for the ems recertification safer the Fire Life Safety was submitted on january this year and the Health Portion within january 17th this year we eagerly await in the department of health and the next steps towards april ems recertification and in addition in march of 24 laguna honda submitted the response and we are pleased to share those communication have correction for it and this department has an ongoing work with laguna honda and brings us closer to full recertification. We anticipate that we must successfully complete the safer for the laguna honda to be recertified in ems. And laguna honda team working with the survey and decided yesterday saferers arrived at laguna honda and have currently conducting a very expensive survey. Keep i updated as when that more information becomes available if cms and dph is leveraging from across the departments for reducing overdosing in San Francisco and this on increasing access to treatment we epic that the two key treatments for disorder and medicating done are cut the risk of death by 50 percent. And that which is remarkable if you think about others like diabetes and people are effected and want to get the word out and make sure that people have access to the treatments. And ore dozing team making progress targets those goals and strengthening the goals and support for high risk for overdose and in the last month dph has expanded access for people with disorders in the south of market and between the night Navigation Program and worked with the state regulators to standard the retention across San Francisco and specifically Assembly Member haney has a bill that will modernize the mebt done in the state of california and along the lines of california policies around medicating done with the federal modernization of messaging done so the state is more restrictive at that point the makes mepth done more flexible we are in strong support of the bill and hoping that that will pass the state so people can access medicating done and speaking of surveyors in march had three survey teams and with the followup from their training and in their cancer surgery the health surveyed the psychiatricy department and looking at at the system care and it went well and one surveyors or our was impressed and wants additional level of finding so she continues to be responsive to surveyor finding and quickly addressing the issues and then finally, i want to recognize Health Information information week which started yesterday information professionals week this week and our dph helped the professionals work with data and adoption for the quality patient care and so many more i want to thank the teams for theyre important work in supporting this and making sure they have access as well as revenues can be generated for the department and personally for the Health Information i appreciate the work to make sure that that system is up to date and are secure so thats my presentation and ill be happy to answer any questions you may have thank you, any Public Comment . None in the room but one commenter. Mr. Shaw. Again happy anniversary of the recertification think april 14, 2022, and a half month later dph hired to clean up the mess by the managers miss managing our key hospital and reservicing the physicians and a senior agent director dated april 15th, frour to be recertified and years and years and still no progress we need an update and though dph has chief quality officers overseeing this and a 60 day rereform program so many gives to service 2022 and a lot of microphone feedback decertification. And up to one hundred and 27 million in actually costs and potentially one hundred and 54 million. Why has recertification been to lenient and for two years doing it and another Facility Survey inspection adding another 6 months before theyre recertified . Thank you. That ends Public Comment. Any other Public Comment great. Commissioner giraudo. A couple of questions. A couple of questions. On the overdose work is there data how many people were actually engaged in the outreach of this 26 supportive of housing sites . As well accessed to tenderloin at the reach outreach. We have those i dont have those numbers in front of me but can get you those numbers to enforce what were doing here. Will be helpful just to really give us a better multiple voices . We have them. Great. My other question on um, the Public Safety inventors and Response Branch im wondering in the Branch Members of the branch folks are members of the National Pedestrian erratic coalition . Because continuation worst asking if they have excellent nationwide training virtual for pesticide trick im aware of their training im not aware of that until a couple of years ago. I dont have the answer but we can for the. The pesticide erratic National Coalition not thought of as a separate group. Thank you for raising that. Another commissioners comments and questions. Commissioner chow. In regards to the fine work for the Environmental Branch is doing im wondering there is a percent on here of the number of additional enforcement operations i wonder um, if there is a way to understand how this has actually impacted those communities in terms of at the im not sure after hours operations at giants and warriors people went home that is what were looking at there and in the others have we been able to bring this to a minimum or what will it take to that as we heard in the report that unpermitted food vending is unhealthful i want to know aside what it looks like increasing our activities but um, can we say what is still out there on the streets . So i think ill clarify if i understood youre wondering in the after hours operation what we. Yeah. Thats a sort of a separate thing i was not quite sure what after hours are but i understand a pregame multiple voices . Oftentimes ive exercised and others when a game is over, or shows at night a number of vendors line up and many vendors are not permitted so there is lots. multiple voices . Okay. Thats the case in that situation and in terms of the other question you, you asked about i believe online virtually provides more context to that. Patrick are you available . I am my video ive been looting my video it it takes time sorry. We can hear you fine. Great. I want to turn that on. Thank you dr. Colfax and commissioners for the question. There is quite a little bit of vending that remains and otherwise and has grown after the pandemic and remains a challenge i you know our Environmental Branch is tasked with making sure the safety of the food that people eat and unpermitted food vending on the street is an ongoing risk so quite a number of situations and quite a number of incidents a large number of people who are selling food without permits including dr. Colfax mentioned with the special events but in the neighborhoods of San Francisco. As a followup a wonderful feature in the chronology of the night market in chinatown and talked about the thirty or show booths were those all permitted in terms of having varies foods appropriately um, i guess supervised . Yes. Yes commissioner that situation in which again, our Environmental Health branch is involved to make sure the food safety that was a fully permitted venue that is that is a way in which we hope to encourage that type of food vending but not in a way that has oversight and aware of the safety is better for the public that is eating it. Thats great i appreciate that and like to ask one more question flarmdz to the Current Survey what do we think will be a step will be taken either from, you know, past and present it sounds like there for a few cases and after that do we expect a report back from them and have the usually back and forth. I know may not know but i want to understand the steps following the survey. I take the question and it is had a right to speculate. Theres not a do you mind um, protocol but baselines what has happened in the past the surveyors complete their visit and there is a period of time can we get the report back with finding and have to respond to those finding i expect that will happen the same way. Right. I want the public to understand what were expecting with the surveyors go on friday or something all surveys find issues that needs to be resolved i understand and therefore we again respond and um, of course, any point if they have to like what they saw they can tell us; right . We can get them recertified. Thats their option. So i think again, it is very hard to speculates what will happen theyre there to look at the different following up on the correction plan and to consolidate the correction plan and again, i think will get a response sometime in the future to see what theyre finding and once we respond to those finding well see what happens. At least waiting for sometime for them to be able to look at our correction plans and our review of the work that was done so at least that is a another move forward to our recertification so that way is important we submitted the questions in january. And it is april. They provided april 15th to come and visit for the corrections. So lets see this is helpful for any other finding addressed quickly. Thank you. Thank you very much. Any other commissioner questions or comments. All right. Seeing none, hope for a favorable outreach for the survey we know youll keep us abreast what is going on and the next item were looking at for the neighborhood the written presentation was exciting. Thank you, commissioners. For having us. And um, she is remotely diagnose her slide and just say next slide, please. Im kathy less than im the Program Manager for the program of the 2023 national hiv Behavioral Surveillance and willi mcfarland, md, phd, director, center for Public Health research with healthcare for people experiencing homelessness and next slide, please. A today, were going to do an overview at the stuart street response and go into more details about our street care teams within dph to answer the questions that was asked and then will discuss the recommendations next slide, please. Um, so im very proud to share the citywide has made a lot of progress theres a motion on the floor part of cross effort to work instead of in silos to find out how to do that together and wrap around people and with the dependents so we work closely with the department of Emergency Management and the Fire Department and department of homelessness and Supportive Housing and this is no not only communicate but make sure the timely responses are and with the department of Emergency Management you asked explicitly the street coordinator the manager somebody whom i started with and been in context and helped mow move forward seeing the essential coordination well talk about a little bit more next slide, please. As with a lot of healthcare we love our acronym and so i think youre familiar with that street ore dose Response Team many past year was the launch of homeless engagements for Response Teams and um, and that is this is the healthy street Operation Center that organs San Francisco hot street medication and the post Overdose Engagement Team the office of triage team and my program and using thos