Secretary to change two things that was quoted as saying the car of homelessness it the number one priority is it so one of our highest priorities. What line oh, what section are you on. I dont have the minutes in front of me. Here we go. Ive got it. On page 4 in the middle the page i have noted it councilmember cates noted that homelessness it the most Serious Health issues he wants to put it is one of the most and commissioner karshmer have paid participant i suggest to make to the commissioner said it be considered for example, perhaps looking at model lifechanging like the stop model as showed effectiveness from the population the under the influrence is on we be innovative with the issue. Okay. I see those as corrections from the speaker to the tint of hire his talk and they would be added unless there is opposition okay. So the motion is. Im going to go ahead and commissioner pating on page 7 under the health just want the second paragraph from the bottom id like the intent to be clear what i was trying to point out that we received a presentation with data which was showed some positive things about the quality scores it is t at San FranciscoGeneral Hospital were at the j. C. Cbc we see quality scores in certain areas that are concerning relative to our peer group as defined and i just want to point out that there was that discrepancy and im going this entirely captures that and ill explain on the statement to make that clear commissioner. Hey, is the discretion related to different perimeters that were being measured in the quality or i think thats y what dr. Chin pointed out that is reasonable to say in saying that i dont want to lose the thought that and give the public the impression were anywhere near the level we all including the people at general will expect of our quality scores we have a ways to go not prospective how i feel about where we are in the quality scores. Ill make that clearer. Okay okay i think from what youre looking at those minutes we think we would like to get a just what we had said better that will be helpful to articulate that so the secretary can take a verbatim our secretary will work with commissioner fung how that paragraph workouts. Ill accept it from you commissioner pating. Commissioner pating actually have words laughter so it would be that will be helpful we wouldnt have a misunderstanding. Ill draft something and send to commissioner singer and let me know if that works so everybody concurrence well allow it to happen for that paragraph are we prepared for a vote . If. All in favor, say i. I. Opposed . The minutes are approved. Thank you, commissioners item 3 the directors report. Good afternoon, commissioners the california starter legislature adjourned on friday september 11th jorge has until october 11th to act on the bills passed and is high profile set of bills for a regulatory for medical cannabis and the right to die bill and need to reduce the high rate of prescription and allow the state to request the amendments 1115 waiver mike the waiver is not met and the California Children services to medicate managed care and failed to reach on agreement only the organizational tax which is the special section called by the governor weve discussed in the past mayor ed lee opened the Medication Center directed to Homeless Individuals mayor ed lee announced that week this last week, we would be looking another Navigation Center and tried to set up a fund for that that he is looking for a fund to be matched by private sector and the location of the navigation have not been selected were working with the city and theyre looking at other location for that service the department provides the Homeless Outreach team that engages the individual community and help with the housing component and also with the Case Management support to the staff is it are all right. In the Navigation Center i would assume it is the same thing of services than any other Navigation Service on tis the mayor ed lee and supervisor president breed announced to increase the Affordable Housing in San Francisco by 10 thousand units by 2020 the 5 Main Division one thousand depressed unit and affordable units and the housing priorities for neighbors and amendments to the City Inclusionary Housing Program and the establishment of additional incentive for affordable units wanted to just make sure we all knew you have a maternal update there were among 31 San Francisco employers recently recognized for Family Friendly work there is a recent vision zero study featured not San Francisco chronicle in puritan working with the transportation that a Marketing Campaign it stops here and stressing the pedestrians have the rightofway at intersection the increasing by the yielding for pedestrians when paired with enforcement. Also you know we almost forget about our administrative staff that both e do the backbone whether scheduling the processes or helping with the staff or the public that come into 9 office we did will have a gathering ever september 4th to acknowledge a lunch for our staff want to let you know that administrative staff is appreciative and laguna honda created a band that went into effect no longer allow for banning sugary drink beverage see r sugar sweetened beverages from their campus as the whole system in the care depth the wanted to mention cash was thank you for the opportunity 50 are years old there were more Public Health speakers centers and not in primary care but particularly with the Castro Mission that was a clinic that saw in the beginning hiv and aids we want to work with that and the development over the years it is an incredible heartache center for services as well and 80 percent the serious most Heart Disease among the low income africanamericans and latinoamerican healthy San Francisco opportunity i say city mobilizes the health care to give patient the prescription throughout the city their be holding an event on tuesday october 29th and feature the presentations by physicians and fitness provider and our own population heartache leaders i want to acknowledge jackie and others if there are any other questions about the report i object to answer them. Commissioners, i guess we dont have the same copy we have an addendum only a directors report in our packet and that is oh, am i correct. Do you all need full copies. Does everybody have the directors report it is required to listen to it much more carefully laughter . Oh, i see, i see so therefore there might not be questions. I have a question of the addendum the high profile bills which ones did the city support. You can give us that information in the study. Good afternoon with the office of policy and planning actually all of these bills within on the watch list but for the support by the city. Im sorry. All the bills you see here. Those are the notices we saw we supported. Not on the support but the watch list. Oh. Well be present the finalized version. Can i ask in the special section on health that was pit here how does that work the special sections continue and when do they end. When they figure it out the managed care packet like it says it causes a 1 billion hole in the medal if it is not resolved by next may they want to figure out that out so the committees have the option and the leaders can call the session back with before january otherwise in january is is sold and r solid and any bills passed during the special session will be announced. So in terms of the spell Session Committee as written would be able to continue if they were to choose to do so. Yeah. I think if there were impetus to do so if they think a solution can be reached. All right. Thank you. So questions to the director on her report . My apologies i sent the email i should have spoke about the newspaper. My other question weed whacking track the impact thought possible one billion dollars shortfall for the services i dont know if so this a shortfall to the general plan or medicaid the state will be short. It is to the health pa plan to the San Francisco health plan and well have to see how that looks at you know thats as i said to the nonprofits have been holdings tax and theyre trying to give us tax bills in terms of the go tax well find out more and let you know. Thank you. I definitely see the navigation sites and the additional funding you had come back as those are developed and let us knew. Were collaborating with the Mayors Office and involved in the process as they develop the sites well probably not be in charge or that but well be insure they get even though help they need and will there b be some point how the expanded program is working. Yes. A dashboard that is by the Controllers Office we can give you an updated report to those dashboard a great percentage a significant percentage of people gotten directly into permanent how do we do that . And lofsz services theyre receiving and onsite with the mayor and saw the announcement that original Navigation Center is quite impressive. So is it fair to say in a quarter well see that. Well develop a program and invite denver to talk about that with us. Thank you any further questions no our appreciation and well move on to the please call the next line item. Yes. Thank you item 4 general Public Comment ive not received any requests. So we move on to item 5 the report back from the Community Health committee i want to thank dr. Chow we heard from dr. Curtis the maternal delinquent health for the efforts to reduce preterm birth the goal to reduce preterm birth with the Health Network and our Health System to reduce the reflex factor we are presented with straevenz that both the Health Network and our Population Health division is trying to take on one to improve the Womens Center of prein all care and the second is to examine determines of health that effect the term of outcomes and the preterm bitter is determined by race and zip codes and paternal prenatal care you family it so many factors it was quite mr. Ginsburg to see the department sort of out a list of priorities theyve begun to implement the first to put together the preconception care passageway package that will include the Family Education and nutritious education and insuring that dlults and other services for women with that are planning to get a package of care particular those at risk for preterm birth and finally those that are looking citywide at to continue to integrate the lower and preterm birth with smoking and employment safeguard for women were looking what were trying to explore in our Community Population division is how to look at issues in this case preterm birth across the network and city seeing there is efforts and a lot of overlap between the general Health Efforts and Population Based efforts were presented with the first year of Strategic Plan that came together in a grant we were both impressed with the competitiveness of that so it is too early for outcomes but both divisions are involved in the forest and well track their process the second effort we heard on oral health in the city with part of the adolescent the framework how are we impacting the mlk with the goal of zero dental care inside and outside the Network Within the network we heard a new benefit for medical patient that was implemented called dental cal full dental services at a minor disbursement that explicit cover everything but services are covered under medal this has a huge burden on our primary Care Planning within the network theyre addressing by increasing the staffing of dental were hiring two new dentists and showing arrival of 27 to 40 percent increasingly if adult visits that koudz out the children and youth Getting Service but when we add the two new dentists that will less than e help with the excess demand that is driven by benefits and in the area of Population Health weve been looking at how the city p will there the underscore itself and commissioner chow saw the lectures to the community i understand well be doing similar presentations to the africanamerican in the bayview and in the mission this is part of an effort to both prompt the practices to integrate those practices in primary care and an evaluation youre seeing the population height and our network working together to help the health in our community again still in the first year we dont have the results but have a coordinated effort for both departments in the hopefully, ill be able to come back more and more as we do as we do and say as we do for the city and within the network for prehealth. Questions of commissioner pating. Okay clarify im not an expert on dental care identification at the chinatown presentation in order to support and is that was an Important Health initiative especially some of the few times chinatown has total red the worts in the city i was courage or courageously that be restored and that we actually put a great deal of effort and actually in the meeting a number of agencies that were within the area of chinatown were actually expressing that they have been trying to seek dental care i think that dr. You and from our department have been working along with the Public Health lives center it bring those together so people from the schools and people from the pediatric units were beginning to converse and find a way to get the kids to get tare Preventive Services that was what i was there for and but only to encourage i think the presentation i heard only the first part that the session today actually helped move our agenda for our coming planning meeting in which we are looking to understand what is happening at Population Health all the things and how does that work with our Delivery System and how does that work with the whole health of the city i think the brief one was one ill courage we look at our next Planning Section in terms of where certain major needs of city are going to be addressed through not just Population Health or not through our Delivery System but some sort of integrated efforts so. If i may commissioners that is an important attribute we have the Public Health division and the delivery gentlemen, i had an laments concerning bringing the agencies and theyre separate agencies in los angeles and it falls under the purview the board of supervisors is trying to bring that altogether the law times editor was asking how we did that in the development if you think about it were under one agency but bringing 4 agencies together to say quite a feat i know that the doctor is ready for that goal i think it is saying a lot for us having the two divisions and the two divisions in the department when we look at the Public Health departments thought the country theyre struggling for survival to fund that preservation component and it will come later were in this to have to activities one looking at Community Health and the other individuals heartache if that is a major goal for my career how to work to tell the truth together to insure we can leverage that. Were going to be hearing today on Emergency Preparedness for the whole city and a presentation on what is emergency precipitating in and out of the framework that will allows you to if we can move the City Services in some ways deal with the those you know great social needs i think that is also a way to show were making progress so youll be seeing this dynamic Population Health level in todays Emergency Preparedness and sxhirsz my questions of commissioner pating and i might point out also as director garcia in terms of the uniqueness in which our Health Services with Mental Health hospitals are under one agency and the strength of that dr. Who is the form heads of cdc and is back in general also have highlighted that nationally saying that the San Francisco model is one, if anywhere we were going to be successful in health it should be in San Francisco. Our please call the next line item. The update on Public Health and Emergency Response dr. Balancing by a. Good afternoon, commissioners it was a great introduction this kind of combination of the Population Health side and the ambulancey care and ill talk about the population height side how we partner