Like to acknowledge and we have Jeff Critchfield here on the medical staff and of course our ceo in roland, many who have done many many hours and getting prepared to move into the new building. The San FranciscoGeneral Hospital foundation played a tremendous role in raising support to furnish and equip the building. I dedicated partners at ucsf and public works of turn our shared vision into reality. So kudos to the entire hospital staff, the nursing staff Facilities Management in financial services, i do want to acknowledge it today they tell me they only have 10 orders and they were on 247 during the process to ensure it was up and running. I believe they did a great job as well. So, everyone from communications to food service so i have talked to every Single Member of San Francisco general theme. Mayor lee presented his proposed balanced budget for fiscal year 201620172018. Here olivia more about that just today i will go into that too much. I do want toi want to make sure ron is here. Yes. We did have a memorandum of understanding and negotiated with local 101 nurses and teamsters 856 supervising nurses. By directors report we have all of the areas that we did negotiate and have an agreement. Just to know, the agreement was for one year. So well be right back in it up in the mind of march. We also have a time study doubt be happening right before that. Because as i just talked about the new hospital, time study will be important to ensure we have the right staffing for the building. And if you want after my directors report any details regarding the mou ron is here to present. I want to acknowledge and also just announce that we are working on Electronic Health record. They will be our health chief director. Along with bill kim. Newly working in their already working many many hours already. We had men meeting so far with ucsf just a meet and greet. We will be bringing, and we have named adopted the apex or affect, for our Organization Get it called dph at that. Of course, it requires a complex multistaff analysis on a clinical revenue cycle, technical governance and contractual relationship with ucsf. So, our goal is to reach a point by the end of september with both dph and ucsf. We have a path for. We will be bringing ongoing updates to the commission every six months. And one should be coming shortly for you to know we havewe are working i think very diligently on right now with ucsf staff to start the process of a negotiation. Only to invite all of you too much with the department of Public Health contingent in the 2016 tricare not. This years theme is for racial and Economic Justice and we like to invite all the commissioners to march with us at the great day two and we are moving and merging all of our activities together. So, will have participants from all over the Department EvenSan Francisco general, please bring your family and five. I will leave it there and if theres any other questions any other items. Commissioners, any questions on some of the topics will be discussed later but questions at this point for the director, please . Seeing none, thank you very much. We will move on. Yes, item 5 is a report that the Financial Planning committee. Commissioner chow shared that today. Okay. Yes, i im now looking for all the notes. Hold on. Im sorry. I received no quest for general public, and so thats why we are moving on to item 5. Yes. Commissioner singer and i meant they productively over the last several hours and we heard a report on the relocation request for the institute of i can. In fact, it is an extension of their service, an extension of their service into the excelsior from where they are because they feel percentage of their population that they have been serving actually lives there. So, this brings the services directly into their neighborhood. It is a site location and the testimony from the public and also the services that the that will be rendered there will be a culturally competent for the latino population that has moved into that area. So, we will be providing a recommendation for you at the consent calendar to accept this oppositio facility siting. The next item that we also took up was the contracts report. We heard of the three contact reports that are before you that were in the packet, are being recommended for approval. These were actually 10 year contracts for which a fiveyear contract was released and i and this is a renewal of fiveyear contract. Along with a costofliving increase that was passed by the mayorsthat was proposed and passed for these contracts. The fourth contract is being at the moment withdrawn aswes i get the first three contracts, therefore, would be forwarded to the consent calendar with a recommendation for it to pass. There was also been a long discussion on the dph solesource process. For which we heard the protocol that is written policies and procedures that are used to place organizations onto the dph solesource contracts list, which we will also be asking for your approval. Under chapter 21. 42 of the administrative code. There were two other reports that were present and in your packets. One is the report that is submitted to the board of supervisors under the sunshine ordinance, which then, outlines whatwhich contracts have actually been awarded under the solesource contract. In a second report, which also shows the usage of those contacts for this year. So, this was a product. The reports and the protocols were a response of the department to our request that the finance and planning meeting for more explicit process for the sole sourcing so that when you see the document for the contracts approval at the consent calendar , it will have a column that will alsothis is new and being distributed. You will have a column that says these are being continued and a column for those that are actually new contractors, and then a delete column showing that there is, in fact, a process of reviewing these on an annual basis and looking for which would be contacted. The solesource list is only a potential list of contractors and is not the contract. But, if there were to be a contract to be awarded, within agencies who are on this list, then there could be a solesource contractor. So, it is a process for convenience of theof our process in the city for contracting in instances in which there are needed services and for which, then, would take time to propose our rfps and the usual city process. And has been a process at the board of supervisors had given us to be able toto be able to answer the need for services while going through the regular formal process for the contract proposals in the future. Most of the commissioners are familiar with the source source list and you will now see them that the sole source with as a process for being updated with this protocol. What that usage was last year, what was the report that was given to the board of supervisors to describe the contracts, and then our own requirement for us to pass this in order for the department to have an approved solesource list for possible use for this coming year. So, the committee then also continued its discussion of contracts. The contracts process including this time completing a review of the manner in which contracts are awarded and how they are being monitored and we will be continuing a series of this discussion over the next several months. The documents are all available for each of the commissioners to read and im sure that also, we will be happy to staff would be happy to fill you in on any of the discussions on those, if youre not clear. We will try to then, after that, overall exposition, bring a summary to the commission at the end of our discussion in terms of the entire contract process we are monitoring. So, commissioner singer do you wish to add anything to that . Did i omit anything . The only thing i would add on the last point which is kind of up monitoring and compliance thing am a i think we really are trying to be do things once get appreciation for what goes on in terms of monitoring and compliance, both from a regulatory standpoint and an outcome standpoint. Particularly, from a regulatory standpoint, then, go into the second big issue, which is just trying to understand are we allocating our compliance and monitoring resources disproportionately to the areas where we in our contractors have the greatest risk. I would say we are far along although not complete in understanding the process, and i think we are starting the dialogue on becoming convinced that were actually allocating our precious resources in the places where the exposure for us is the greatest. Thats a work in progress. I mentioned, in fact, the discussions have indicated the wisdom of centralizing all contracts management for the entire department and that we are actually now able to understand and, i believe, the department is more clear in terms of how it and is doing. Its contracting its monitoring and we will soon be agreeing to how they actually have been in the contract developing the criteria for the performance, and then how then these are being used for evaluation and renault and so forth. So, i think the work i want to commend the work of the department to bring enough forth to us so we can have this dialogue and be able to be sure we can be also supportive of the process. Are there any questions about any of these topics . Puppy happy to answer them. If not, thendr. Singer i would just make a comment pertaining to the new satellite clinic. You know, this organization is really played a significant role within the Latino Community for many many years and its presence in its site now has really been a major significance. Its a block away from the Mission Cultural center. A used to be very active for horace mann which was very active two years ago. A number of the other school seasoned seo travis elementary, you name it all the way down. But things change. Horace mann is no longer horace mann. Its now when a vista which is next to accept general where we have many programs there. Bryant elementary was moved to point a vista. There were at least 28 Family Restaurants and facilities that play a critical part within the past three years that are no longer there. From nicaragua, venezuela, when rico salvador and mexico. The mission is already changed and i am so glad to see that we are on the alert to follow where our patients and our students and our kids need the support service. You used to see many many kids lined up at 24th and Mission Going down a block away to this center and back and forth and back and forth. You look at it today and there isnt that many kids taking a 48 and these other buses. There are people dropping suvs and dropping people off at horace mann into mortuaries that were around the neighborhood now private schools. These are overfilled and theres all sorts of changes going on. But what i did want to say, and i think this commission should be acutely aware. I know the director is, this group has held steadfast. I mean it involves in activities when we used up Mission High School and others in the park, there will be a cooling off her not get the provide resources aboard and work with the community but as i said things have shifted now. The challenges are different now. But, they are right there and there supporting what we are about and without department is about some back to see this new opening of the satellite clinic which is really going to serve kids that are risk now that were not or didnt have the services before. Any comment . So i would support the motion i would just add to that dr. Sanchez, thank you so much for acknowledging [inaudible] and we had to staff numbers yeartodate and i want them to send back their message to their ceo, which is dr. Who called me not very long ago to tell me that she has completely paid off their building through a lot of hard work and so they havethey will be there for a very long time. Because now they i can and i have not seen a nonprofit in our system really go to that length. We do have on them for many years but [inaudible] and is the sole owner of this beautiful mewling on a mission another saboteur were very proud of the organization and are doing great work so thank you so much dr. Sanchez and think of for your hard work. Thank you. Yes, commissioner speak harsh karshmer thank you for the report about the process youre going through to better understand the contracting process. Im looking forward to a primer on that when you get it all sorted out they have begun with a primer i think were going to go through. We can all you can slow it down for us. Dr. Chow, is your point contact on that. Thank you thank you. I think well appreciating the work. We know everyone has been doing the work and this is its like the documentation thats required to evaluate how well everyone is doing. Just to know, does represent about a half billion dollars of our services the muscle it would be great to have some highlevel review for the full commission for you to understand. We will be happy to do that. We will be doing that. Thank you. Any further comments or questions . If not, then shall weany Public Comment . No Public Comment request for this item we can move onto item 6 witches consent calendar and ill note again, on the conduct report the website contract has been taken off. So, as you consider approval just note that report will not contain that contract. I guess i did forget i didnt let me go back, on the consent calendar let me make a comment then because which was on the new contact. The better world advertising is going to be has been proposed. With a cdc grant for 470,000 and i did not explain that. It will be a social marketing assess, particularly, beginning with the private program in the latter part of this month, and will be encouraging the promotion of crap along with also then theas said already in the proposal, looking at the healthy sexual approach towards the use of prep. So, this will be a program that we did ew eight and also are recommending for approval and i did forget to mention that during my report. So i want to be sure we have that before you in case anybody would like to ask any questions on that. Otherwise, we can then proceed with the consent calendar. I move acceptance of the consent calendar moved and seconded. Further questions or any i should state any extractions on the consent calendar if not lets proceed to the vote. All those in favor say, aye. Opposed . The consent calendar has been adopted. Thank you. Thank you. Item 7 is the zuckerberg San Francisco general with action on heritage with our general committee. Thanks martin. A delight to be invited to speak with you today and im appreciative of dr. Sanchez already setting a tone, a reflection and shared celebration. Just as context, ive given this part of this of a talk four days before the new hospital opened and really the idea is its important to know your roots, as you look backwards at you know where you are going its important to be good to know whats important to you in the midst of all this distort change thats happening. So, ill bring this up and then ill begin. It should be on the left. This one . Thanks, mark. So, initially, it came out of talk we gave about Care Experience. The chief medical extent officer but creating a sense why, why do we care about the spirits of our staff in our patients and although the focus on the general because were opening in four days of what youll see is a theme of how are also integrating it across the community. So, here we go. The details of this map are not that San Francisco. So, what i want to start with is before we even got to the hospital at potrero, was a hospital that state Marine Hospital built in 1851 and thats all and actually north beach because the cholera outbreak the state of california put together 50,000 and will keep track of the money about the billions they go on, 50,000 for 150 bed facility that very quickly at 400 patients in it. They had to move in this then brings us more to the potrero. They go the hospital on 1872 at potrero. It was a wooden building because it was going to be temporary. Of course. That one went for 250,000. In 1872. Whats going on about this this is cholera, this is diphtheria, smallpox thats happening in the response from the department of Public Health to meet the growing needs of San Francisco group and particularly around infections not surprisingly. Importantly, this also you begin a Training Program in intermission and sign the contract with the city to do a Training Program after at this hospital was going to become ucsf and then also Stanford Ucsf has maintained the relationship since 1873 and the you would stanford went out. I was in the 1950s and the contact we had with him also went away. So, that relationship, the training and the next generation really began in the 1870s. How can you talk about the history of San Francisco without mentioning 1906 at 1906 the earthquake importantly for the temporary building that Still Standing in 1906 survived the earthquake. It was solid ground there. Then, susanshe began on and taught me around the same time with all the disruption of the earthquake was tons of that that i cannot everywhere and twitter normas bubonic plague outbreak around this time, and that the hospital did not survive it so, we were treating lots of patients with bubonic plague at the hospital. The dph folks came and collected freeze from that and determined that those fleas cause sf general had bubonic plague burn the hospital to the ground. So it went away. Around that time, then other parts of the city started to pick up the slack and this is an iconic picture as you may well know, this is the administrative building of what then was the buildings they were building in 1915 on. On this one, you can see i took this picture is not too good. The gate that is down front is extent. Thats still in place and the building to the left the tower of there is also there. This is on tuberculosis but we had set at this time San Francisco had the largest rate of