Transcripts For SFGTV Immigrant 20240705 : vimarsana.com

Raising three children under seven years old and needed child childcare in order to work. Now, decades later, i think of all the communities in San Francisco struggling to find childcare that will be disproportionately affected by the mayors proposals. Corrupt systems are in place in this country that do not support equitable opportunities for intersectional families. There is no doubt that they will be harmed by the proposed budget cuts from the mayor. If you want a Better Future for our children and educators, you cannot take away funding from their Early Education, which is crucial for their development. I am urging you to vote no on the mayors proposals to make changes to the voter passed prop c. Thank you. Thank you, sarah room. Its time for sharing your comments. Can we hear from the next week of place . Were back. I will continue to come back because of her fighting for children who needs us to fight for them. I love you, by the way. Okay so imagine youre in a sandbox, right . Youre eating your little candy and someone takes away. And give it to someone else. Justices what London Bridge is doing. Theyre taking away ourselves to give to someone else. Its really sad when you think about it. And according to my middle school. Hoover um, math teacher. You cannot mess with kids. Thats unnecessary kind of evil. Um please vote no on both propositions. And. Im so thankful. Perhaps my mom was hospitalized last week, and im using all my prophecy money, too. Pay for her, um, impatient tells and that wasnt what i was you i wanted to go back to school, but you have to do what you have to do. Thank you. Thank you for sharing your comments with the committee coming from the next speaker, please. Hello, supervisors. My name is anna wilder. Johannes and i live and work in San Francisco district five. I was a preschool teacher for over six years. I stand before you today asking with hundreds of others that you vote no on the sublease ordinance and not entertain any subways, proposals or amendments. The Early Childhood committee over three and community sorry over 300 last week over 300 today and hundreds more in classrooms right now stand behind, saying no to cuts to baby prop c and this budget reflects the priorities and values of our city. What message . Does it cut like this say its not only our childcare community, but the voters of San Francisco. I say that the city should show a commitment to children and families, our citys future and long term stability by utilizing other sources of funding for families, children and food security. Thank you to supervisor mel gar, ronan walton and preston who understand that when we need to make budget cuts, you dont start with essential workers are essential services to the most vulnerable populations of the city. So please vote now. Thank you. Anna wilder. Johannas for sharing your comments coming from the next speaker, please. Good evening to you. Board of supervisors. My name is sudar, makiko lovell and i have been an Early Childhood educator in San Francisco for the past 14 years. Currently i am employed as an infant toddler teacher at compass, clara house, a transitional housing facility where visa 13 families who are experiencing homelessness. We also enroll children from nearby shelters when on site families do not have Young Children. All the families. We serve low income and some with no income, and some are undocumented immigrants. At helen hawk children center. We take care of children who have experienced a lot of prenatal trauma. And they deserve to have child care that is safe. As a result that are many Success Stories at the childcare sector by the children get to play, learn and become socially and emotionally competent. Despite their family struggles. Many of the families i serve up economic answered, we have to hear from the next speaker next. Sorry to catch you on behalf of myself and the families i serve. I ask that you stand up and protect baby property. Please come forward to the lectern. Next speaker. Thank you for sharing your comments of the committee. Hello my name is amy letterman. Um thank you. Supervisors for your patients today and listening to community voices. Im a mother of three. I live in district 11 and i work in district eight for Childrens Council of San Francisco. Um here to ask you to not sweep the potential and hope that baby prop c has brought the community and to families and children. Childrens council has had a front row seat to r e ce industry struggles as a nearly 50 year old organizations serving the field. We know that we have come a long way. But we have so much further to go and the promise of babysit perhaps e should not be taken away from children, families and educators in our community. Respect the voters and keep baby see whole. Thank you. Thank you. Amy letterman for sharing your comments with the committee. Can we hear from the next speaker, please . Hi my name is naima. Im with the Childrens Council in the sfc c Advocacy Coalition. We had over 300 people come last week and over 300 come today. We also just had a bus 45 minutes ago have 60 more childcare providers come and theyre showing up because they care. They came all the way after advocating for sack against more cut to childcare at the state level. So do these 700 voices matter . We urge you to vote no on both proposals. Even the biella speaker earlier said the he could only theorized to be somewhat effective when 700 childcare providers came out and said it would be detrimental to their businesses. So listen to the people. Um if 700 white men , male Business Owners came out and spoke against the bill, i know you all would be quiet. But somehow because their woman of color theyre seen as an educated and we keep getting told, were standing the ordinance. Were not misunderstanding the ordinance. You dont want to listen to women of color, and its that simple. So were speaking out today and we had to come to you because not everyone. He wouldnt even meet with us to speak with the people. So you cannot. You dont want to call it cut. Thats fine. Call it whatever you want. But youre redirecting 150 million from child care to others to other areas, and thats not right. Thank you. Thank you. Name a charles for sharing your comments with the committee. Do we have anyone else in the chamber who wants to provide Public Comment specifically on agenda item four and five from whom we have not yet heard. If not, we have a few callers on the remote Public Comment. Q. Do we have a color speaker . Please come forward to the lectern. Good afternoon. My name is hruska. Tivo. I work in for Childrens Services teacher for 22 years. Come over here begging you. Please helping us with the proposition. See because, you know, im working for 22 years with the children and i can see the differing of things. So we can thinking that were gonna cut their future for the children. We need it because you not. Were working with more children. And we thats the base we found in the base for the life. Look at the city a lot of shootings. A lot of people killing because they dont have education. You cut the budget. We dont have a they dont have. Were gonna close the school, they could have closed the school. You know the children gonna harm very, very minimum opportunities to going to school because they need to cut the cut the budget, no money for the other school. Youre not like us. We have a like a 14 school. But we dont have no money. Theyre gonna close the school and theyre gonna make it smaller clubs. Please thank you with sativa for sharing your comments bless you thinking about our children, please. Thank you. We need to hear from the next speaker, please. Thank you have anyone else here in the chamber who has Public Comment on agenda items four and five called together from whom we have not yet heard. Lets be connected. If we may to a remote callers who have comments on agenda items four and five. I understand there are nine of them. Can we hear from the first place . And before we actually get connected to that first caller, its actually very challenging to hear the remote colors here in this room, so if we can keep the volume of the cheddar in the room down a little bit, the panel can hear the commenters who call in remotely, please. Thank you. Supervisors my name is sheba banded them. Im a Public Policy manager at home rise the parental Supportive Housing Party Provided in the city. Um, we have our largest family portfolio in Treasure Island for the one side and the tenderloin. We also have to transitional sites, one in district six and another in district two. We are so grateful to be a Service Provider for these two populations and hope to continue doing the best we can to keep them held. Unfortunately that wont be possible if the 60 million in funding is cut. Im calling to urge you all to say no to the cart. The cut for the youth and families. Please support us in keeping our communities held this year. All the city departments have emphasized the need to put equity at the forefront of the budget. Um, in order to solve these historical disparities regarding race, um aids and economic inequality due to homelessness. It is important that we recognize the impact of underfunding these two very vulnerable population data shows that 50 of people facing homelessness. Thank you. Sorry to cut you off. We do have to limit each commenter to one minute. But thank you for sharing your comments with the committee. Can we hear from the next speaker, please . Hi my name is julie marquez. And im not parents. Parent voices i am urging to honor property of the jesus sent me democracy democrats and we have to go and on what the voters want them. But one we knocked on doors. We had signed petitions signed. Please honor the commitment of property and do not allow that funding to go to funding and yes for any issues with the mayors budget because we needed for our children who are and who will be leading us the future for thank you so much. Thank you, lily marquez for sharing your comments with the committee. Can we hear from the next speaker, please . Good afternoon supervisors. My name is chris. Right . And im, the Vice President of advanced has set an Organization Made by the citys leading employers that is dedicated to the Economic Vitality and the ability of San Francisco. Where the past 18 months or organization has worked with our city business and Community Partners to advocate for a downtown economic core that is more economically diverse and rich with experiences. Franciscos Economic Outlook requires a shift in the citys approach to business taxes. The mayors tax proposals or important First Step Towards changing San Franciscos reputation is one of the worlds most expensive places to do business. These incentives will help though they can other spaces while maintaining the flexibility and resources to support the programs that benefit all city residents. We hope everyone will keep an open mind and remember that this is 2023 9 2019 at San Francisco needs to rethink health can help retain the existing businesses and attractive employers. Well, there will ultimately be further cuts. The citys social safety net. Thank you. Thank you much, chris, right for your comments. How mr xu, next speaker, please. So we have democratic process. Maybe. Topsy was put on the ballot. It is illegal. Got early illegal. For the mayor to do what hes doing. Yes, man has lost her mind. Anything she touches. Duds to something. That is a like to a madness. Any human being. Turned harms our children. Be ashamed of themselves. Thats mayor. Its despicable. Thank you very much. Thank you much francisco the cost for sharing your comments. Mr soon next speaker, please. Hello speaker. Sorry my name is barbara. My name is barbara and i work in San Francisco and the Mission District and working childcare and im urging you to vote no, and not consider either proposal put forward by the mayor to make changes to the voter passed prop c behind closed doors. Thank you. Thank you much for addressing this comment. This committee barbara mr student. Ex speaker, please. Yes hi. My name is june bug parent voices as chef. And i just want to say that you know, baby pop c is the dream. The blueprint the legacy to help build the infrastructure into expand our childcare, and it is not okay. Um that the mayor is trying to, you know, make this proposal on, um, suspending the sub leased taxes that would fund baby prophecy. Um it is not okay. The voters voted for the its in 2018. Im very appreciative for melgaard, speaking today at our rally in support, and i just want to call out soft, i e like, how can you call yourself a childcare champion . If you go ahead and support something that would actually dismantle, um, funding for baby props. See, it is not. Okay um maybe property would help in so many ways to expand services that we need as a parent myself with a child with special needs. We need this money. Um from baby prop c. So that we can also support our children with special needs. We need more providers to be train. Uh, again. I apologize for cutting anybody off, but we are typing each speaker one minute, but thank you for addressing this committee. Mr soon next speaker, please. My name is casey. I was with a group of children this morning at city hall step and it was hot naptime came. We had to leave so proud and impressed by all my colleagues who were stayed all evening and are still there. Please do not take money from perhaps see the changes that are just starting in San Francisco is theres a revolution in quality childcare. It is going to change the kind of city San Francisco is for families. Any um, any take any money taken away from property is going to stop these changes from happening. Please um, keep your promises about childcare. Weve seen you at the ribbon cuttings. We know youre there with us. When the photo ops your children are there. Show us now that you are still with us. Please do not take any money away from the voter approved property. Thank you. Thank you so much. Casey for addressing this committee. Mr soon next speaker, please. Um, my names oscar saturnin. Im some francisco rather than, um, my family runs, family, childcare and my friends do it. My moms do it. My wifes do it. My brothers doing it. So um, yeah, cutting into childcare is not, uh, solution. I urge you not wont note on, um softly ordinance and do not entertain any place proposals. Or amendments that community saying no. Those funding changes to their baby property. Mhm new cow. And then peel and motive and, uh, doing the on or they dont play one be maybe property that you can thank you. Translate the later part. I request voting no to the sublease our ordinance and do not entertain any of the ordinance. Um our Early Education sector cannot change the props, see funding and we need that. Thank you so much. Florida one and also oscar for addressing this committee. Mr soon next speaker, please. Actually rises. Alex, the best chefs easy Advocacy Coalition somehow im sure what i can say. You know, a lot of these folks shut down, their child cares. Lost out on wages to come speak to you. Some of them started on a bus at 5 a. M. This morning went up to sacramento to advocate can back down on a bus. In traffic to talk to you guys to advocate again today that so much, perhaps see funding means to be folks. And what have we heard from the Mayors Office that these folks need to up . Their hard fought funding to revitalize downtown to help the economy. Well, i was just saying to the biella and very intently to the economist, and it seems like that may not be the case that it might not even make back the general funds that it loses. So if you still believe that argument that its going to do that, then i got a bridge to sell you so please vote no on these proposals. Thank you. Thank you much for calling in to address this committee. Next speaker, please. Hello my name is sheldon ethan and im a resident here in San Francisco and a Small Business owner out in the bedroom district, and i want to echo what everyones been telling you incessantly that we should not make any unconstitutional. Changes to prop c keep bbc alive. Thank you. Thank you, matt. Sheldon nathan. Mr steve. Next speaker, please. Hi good afternoon. My name is maria chandras im a parent, a leader with term voices and also Business Owner in the city. Um, i urged that to vote note on on this sub leased tax or maybe cropsey. I myself worked on that campaign because talc its really important childcare is what keeps, um our city working and more world that we are. We need. Calgary social thank you. Thanks so much for calling in marianna. Mr speaker. Next speaker, please. All i want to. Yes leader voices. Francisco became our landing number. Francisco latino. He can. He can. The. Its because you have. To hello. Good afternoon. My name is jacqueline radius. I am a mother, a leader of the community in San Francisco. And i am here speaking on behalf of parents and families and small children and babies who cannot speak themselves all over San Francisco, i ask you to please protect proposition c during this, uh budgeting season. And do not consider any other proposals that one to take away funds from kids and the parents. They need them because its Early Childhood education. Thank you. Thank you much. Thank you much, mr fernandez and thank you, jacqueline. Raise for your comments. Mr su. Next speaker, please. Hi there. My name is biharis soltani. Im a homeowner in district two and work as a diversity, equity and inclusion corporate leader and downtown San Francisco. Im early urging all of you much like my colleagues on the phone here and especially my supervisors, stefanie to vote no, and not consider either proposal put ford by the Mayors Office to make changes to the voter passed property behind closed doors via the budget process. Um, like many of the other folks on this call has side investing in the early care and Education Sector is crucial to ensuring equitable opportunities for Young Children and their families, especially black and brown children. On top of that black early educators experienced poverty as much as double the rates of their white peers. We will not be able to close this parity grafted you take gas. Excuse me if you take those funds away, and of course , the folks who are currently working in tan francisco today are incredibly important part of our current economy. But thank you, buhari. So, tony for addressing this committee. And just doing one final check. Madam chair that completes her cue. Thank you, mr clerk and seeing no more public common public common is now closed. Um colleagues i first want to, i think just thank all the public commanders that came out. Uh especially the young ones, even though i know that some of them have to go home, which makes a lot of sense. Where approaching evening hours. Um i think that nonetheless. Uh we can hear theres a lot of, um, passion in this issue. I think that we have earlier discussion as well. Just kind of thinking about, um downtown recovery and then also , you know this today, this particular item four and five. Really item five. Its just about the sub lessor. Um deduction. There is actually i just want to flag for your item 14 today again, thats a separate conversation still related to the, um the tax itself in terms of allocation. Um so with that. I hope that we can continue these conversations around. I think even yesterday we have continued some of the conversations around some of the legislation impacting Small Businesses, i think, just continue to move this conversation along. Not not not just about one legislation, but really about the budget as a whole. Um, if i could have, um if theres a i just wanted to put it out there in my thinking is that i would like to make the motion to move item for which is the Film Commission programs. Increasing the film. Uh fees, uh, two full board and then continuing the item of five to next week so that we can continue to have this conversation. Um second by vice chair. Um. Or or civilized you . Actually i think he said the first. So um im gonna sorry, supervisor walton. Thank you church, and i just wanted to tell the team that w d. Nice photo on slide. Eight page seven. Now i want to see what it is. Um ah, um with that, um. Can i actually mr click, can i actually also to can i wait my motion . Uh one to just more vote out item 42 full board and continue. Item five to next week. One motion very clear. Madam chair sounds good one. Motion second by supervisor sapphire he wrote. Call, please on that motion to forward the ordinance in item four to the july 11th full board with the positive recommendation him to continue the ordinance as item five to the june 21st meeting of this committee. How have i turned seconded by member saffet . Vice chair, mental men. Gentlemen, i remember stuff i hey, i remember running running. I remember walton. Walton i church and i have five guys. Thank you in the motion passes. Thank you. Colleagues. I really appreciate all of you. Um and all of your patients here. Uh i want to quickly flag and also want to thank the department of Public Health as well. Colleagues i think i want to fly for you that you know, with all these Public Comments has also a lot to do with the trailing legislations that unlike years past difficulty there just fee schedules, but, um its an unprecedented years with all these legislation coming before us, particularly does that are not easy to solve. Um so do we have department of Public Health here . I dont blame them if theyre not, but of course, dr colfax, youre right on time, and we appreciate you. Thank you. Should we start, please . Good afternoon supervisors. Thank you so much. Um im grand kovacs, some of the director of health and we will get right into our budget. I do want to start by by thanking, um anna dunning. Do you mean of the at the Mayors Office for her work and support . Um at the budget off as leader of the mayors budget office, and then jenny louis, our budget director did an incredible amount of work. And just as you will see, in our in our presentation. That we have met our targets without any reduction in Service Levels despite this very challenging environment, with the exception of continued stepped down of our covid 19 efforts, which i think is appropriate given, thankfully , where we have come from in these last three years, and weve met our targets, primarily through revenue and focus limited growth in key areas. Next slide, please. So our mission and vision in the department of Public Health our mission is to protect and promote the health and well being of all san franciscans, and our vision is to make San Francisco the healthiest place on earth. What we do we do a lot. Um as you know, we are a Large Department with many charges. We assess and research the health of the community we develop and enforce health policy. We prevent disease and injury. We educate the public and trained healthcare providers. We provide quality, comprehensive, timely and culturally proficient Health Services. We ensure equitable access to healthcare and we continue to focus on reducing Health Disparities and increasing health. Equity. Next slide. We are an integrated health department. I think this is incredibly important and to the citys advantage to ensure that we provide our services. When people want them and need them. Youll see that we have two major divisions. We have our Population Health branch, which is responsible for protecting the General Health of San Francisco residents, workers and visitors. This branch will continue to be at the core of our covid response, but also does many other things, including. Prevention and control of other Infectious Diseases does regular Health Inspections for facilities does. Research, including on hiv and promotes the health of all residents. The Population Health division is 7 of our total budget. Then we have the same Francisco Health network, which is 87 of our budget. This includes zuckerberg San Francisco hospital, which is the only Level One Trauma Center in the area. As you know, a 24 hour facility. Laguna honda hospital , the largest Skilled Nursing facility in the country, and the Skilled Nursing facility, that we continue to work very hard to ensure that it is not only re certified, but the model for what a sniff can be for the future. We have an extensive Behavioral Health service network, which is continually improving and expanding and meeting the needs of our community. We have primary Health Care Clinics throughout the community, which serves tens of thousands of people a year, mainly those with medicaid or without any medical coverage. We have jail Health Services, and we also have other Services Within the network, including maternal child health. Health at home, hiv services and a very important component of ensuring that we provide Seamless Services is the Electronic Health record, which again sits mainly in the San Francisco Health Network. We also have an operations branch, which is 6 of our total budget. Next slide, please. The overview of our dph budget youll see on this side again. Um large components include zuckerberg San Francisco hospital, which is 38 of our budget. You see Behavioral Health 20 of our budget and then the other large. The Third Largest is tied for our laguna honda hospital and health, other Health Network services and youll see both the budget and the fts for each of those areas. The budget increases by 8 compared to the current year and then remain stable for the second year. I think its important to point out to additional emphasize to other additional points despite our growth. Our general fund support is reduced from 33 to 27. And also the fact that we leverage 70 of our budget through revenue. Next slide. I know that youre was asking in preparation for this, uh, presentation how the departments work to alleviate poverty. And what is Language Access in your in your in your department. I just want to emphasize that access to quality care. Its not often talked about in health care. It is a major factor in alleviating poverty and just to give you some examples. Medical debt is one of the key drivers of people falling into poverty. We prevent that, um by keeping by providing services either through medicaid through charity care through healthy San Francisco, um and other key components of ensuring that anybody who needs health care in San Francisco can Access Health care and that its not going to cause them and you financial hardship. The other component of this is the fact that staying healthy, preventing disease and managing what chronic diseases you may have, um, is a key predictor of ensuring that that that that you maintain your economic stability as much as possible, so healthcare is directly related to preventing poverty and alleviating poverty. In terms of language, Language Access. We have, um bilingual clinical staff throughout the Department Interpreter services are available in hospitals and clinics. And we do outreach in multiple languages, including the languages listed on this slide. Next slide. So there are many dph programs to address Health Disparities to improve Health Equity across our systems. These are several key. These are key programs that we listed as examples. I will not read through them. But just to say that you can see that we have very specific programs and maternal and child health. Through Behavioral Health and all the way through to two Population Health so really, at every level of the department, we are committed to Health Equity. Were driving change in that work, and you can see from this, uh, list of services, which again is not complete list of programs. We continue to make sure that that is one of our north stars going forward. Next slide. And then, um, supervisor walton was specifically asking us with regard to understanding programs for black birth. What were doing to address the disparities that we see in African American black birth outcomes, and we have multiple programs that are focused on on reducing this Health Disparity towards south equity, including the abundant birth project, which really it goes beyond the direct medical service care. That is an important point, but we also now know from the research that you need to go, you know, beyond the traditional level of peri natal care in the Health Care Delivery system to really broader Socio Economic supports for people who have poor poor people who who have poor poor populations that have poor birth outcomes. So that is part of the abundant birth project work. We also do doula training and access to duly care. Where do look care to support pregnant people again going more upstream fruit and vegetable grocery vouchers vouchers being provided to 150 families at risk for poor birth outcomes and you can see the other pieces listed here. We also understand recognizing are addressing the issue of Behavioral Health as it relates to, uh, poor birth outcomes. And you see on the last heart last bullet on this side that were making new investments in that area, so that provides an overview of our department. We try to touch on some of the priorities that we understood the supervisors, uh, would like to see and we will now get into the nuts and bolts of the budget. And for that, i will turn it over to our budget director jenny lou three. Thank you. Afternoon supervisors jenny louis dph next next slide, please. Okay um, im here to talk about more specifics about our budget, um, including our approach, as well as specific initiatives in our budget. So our strategy, um for meeting the general fund, the dutch reduction targets included leveraging as much revenue where, where possible. We did realign expenditure line items to reflect expected spending. We continued the scale down of our covid 19 response to a level that we feel is appropriate. But other than the covid 19 response and pleased to say that the department has no Service Level reductions as a result of our proposals to reach general fund savings, we did prioritize and limit areas of new investment to areas that, um were critical in terms of operations and includes areas around Opioid Epidemic and Behavioral Health, as well as sustaining laguna honda hospital. Next slide, please. In terms of Behavioral Health in street conditions, investments we invest about 14 million and i know, annualized operating dollars, um, for wellness hubs in the budget, youll see 18. 9 million, which includes, um, the two year budget of 12 million for operating costs. Alls 6. 9 million in capital improvements. This is would fund approximately three hubs with a staggered start over the two year budget. It would also including community bassedas ears that support, um around each site. But and, but it excludes any costs related to see consumption , which would need to come from private funds. Russell expanding our distribution of naloxone about 1. 7 million ongoing but we have 5 million the first year and well be focusing this in high risk areas, including stross Entertainment Venues in schools. Uh were also backfilling, the addiction care team, which is a Successful Pilot program at csf g Collaborative Team of clinicians and patient navigators, which help patients with Substance Use disorders to navigate the system of care while theyre at the general and beyond. Next slide, please. In addition, we have allocated seven point 2,000,002 other high impact interventions , as identified by brian Health Services Team Includes contingency management, sober living medications for addiction treatment, as well as addressing Racial Disparities in the opioid use disorders and connecting those two karen s. R o s, which has been identified as a high risk setting. Next slide, please. Um outside of opioid. Um we are expanding our Behavioral Services in the area of care courts with the 4. 3 million for assessment, evaluation and treatment of clients that may be referred to the courts, um, as well as a 32 million grant that weve received from the state over three that could be used over four years for transitional Housing Stabilization unit as border care patches for care core clients. As well as Housing Navigation for those clients as well. In terms of proposition c. We are sustaining all components of the 98 million operating plan that was approved in prior years. Theres no significant changes to that spending plan. We are, however, using one time balances, um, during the two year budget to offset projected revenue shortfalls have been projected by the Comptrollers Office. Um finally with mental Health Services act state funding. We have 1. 5 Million Investment in our peer program. Um, and then a three year um 15 million pilot with the Human Rights Commission for talk therapy with a focus on black African Americans. Next slide, please. Our budget also continue continues to step down of our covid operations. As youll see in the current year we had 56 million budgeted, um , and as part of last years budget, we had 25 million approved moving forward in this two year budget. By the end of the second year will have about 21 million appropriated related to covid. I will note that about 13 million of those 21 million is really related to our hospital and clinic costs, um, that continue to be increased post pandemic. Um and then this leaves about 7. 9 million towards Population Health infrastructure to sustain the infrastructure weve developed as well as maintaining focused, um Community Testing and vaccine support for hard to reach populations consistent with our equity goals. Next slide, please. Um and then, finally at laguna honda hospital. As you know, were going through recertification effort. Um, its an incredible initiative that was really making hundreds of process improvements within the department. Um and to make sure that we sustained improvements that weve achieved. Were investing out 3. 5 million to support laguna hondas infrastructure oversight. And that includes positions around Patient Care Experience as well as the grievance team, um, seven positions for the department of education and training to support nursing and clinical staffing to positions around medication, safety and quality improvement. Six positions to support 24 7 stationary engineering staffing throughout the facility. And two positions within network leadership. Um, next slide, please. In terms of capital improvements. We do have significant investments, including, um uh, 33. 7 million grant to support youth Behavioral Health services at the smg, which includes both inpatient and outpatient services. 18. 3 million for an Outpatient Care center, as well as two Different Community care expansion grants from the state 7. 4 million related to board and care operators that will work with most cd on and 9. 5 million. Related to the step down units over on Treasure Island. As well as a state grant for the build out of the crisis stabilization unit. Um sorry before you move to charlene legislation, let me call the items and then and then we can we can go on with that. And mr clark, could you please call item 6789 10 11. So six through 11 together. Yes madam chair items. Six through 11 item six. His an ordinance amending the administrative code extend the board of supervisors delegation of authority under charter hood to the department of Public Health to approve managed care contracts to include contracts ending on december 31st 2028 and to exclude from the requirement of control review those managed care contracts that are based on rates set by the california department. Hi california department, Healthcare Services or on actual Healthcare Delivery costs. Heard him seventh is northern, cementing the healthcare to set patient rates hand rates for other Services Provided by the department of Public Health for fiscal years, 2023 to 2024 and 20 20 4 to 2025 items eight and nine resolutions approving the memoranda of understanding. Between the following and the department of Public Health to establish the roles and responsibilities of each party for purposes of fundraising in Capital Projects head to authorize the department of Public Health to enter into amendments who or modifications to the mou s prior to their final execution by all parties that do not materially increase. The obligations are liabilities to the city. And unnecessary to effectuate the purposes of the mou or those resolutions. How item eight is with the San Francisco Public Health foundation and item nine is but the San Francisco General Hospital foundation had him 10 is a resolution authorizing the acceptance and expenditure of state grant funds by the San Francisco department of Public Health for fiscal year. 2023 24. And item. 11 is a resolution retroactively approving an agreement for a term of september 15th 2021 30 june 30th 2025 between the department of Public Health and advocates for Human Potential inc. Having anticipated revenue to the city of approximately 1. 9 million hand to authorize the department of Public Health to enter into amendments or modifications to the agreement, how prior to its final execution by all parties that the non materially increase the applications are liabilities to the city and are necessary to effectuate the purposes of the agreement or that resolution members of the public who wish to provide Public Comment on any one of these items from six through 11 should call for 156550001 with the meeting i d have to 5928931263 then press pound twice. And if you havent already done so, please dial start three line up to speak. He promptly indicate that you have raised your hand. When the system indicates you have been muted. You may begin your comments, madam chair. Thank you, mr clark. And as you go on with your trailing, um, legislation presentation, please do i know that i on item seven. You do actually have an amendment to it and if within your presentation to also address the amendment, so when we move and make the motions, its already clear and stated publicly, please. Thank you. Go ahead. Great. Um so for the first piece of legislation, managed care rate review. Um we have delegated authority to enter into managed care contracts. Um, as a matter of practice, the Comptrollers Office has been performing benchmark reviews on all of these contracts. There are many contracts in which we enter. We are either using, um, were using a Standard Department of Health Care Services rate. Um, and so theres not a deviation from the state rate, which is considered a benchmark. And in addition, we have a healthy workers rate, which is a rate developed on a fairly straightforward formula of both actuals with the c p. I applied to it in these two areas and the Comptrollers Office after auditing our rates for several years, feels that this is theres very little risk as were following these fairly standard protocols. And so the legislation proposes just reduce the Administrative Burden of requiring Comptrollers Office review when were using rates formulas such as these in terms of the patient rates. These are rates that are charged as part of the proposed budget. Um and with the exception of the Behavioral Health rates, basically it just, um theres no significant changes to the rates work six, extending the term of the rate for a second year of the budget, along with the cp adjustment, and again, its important to note that these rates are really used in primarily in the instance of commercial insurance and has little impact on our patients themselves. As weve implemented several programs to avoid adverse impact to our clients also include which includes, um, working with outpatient, um patients who are out of network to ensure that theyre not charged more than what they would have been charged with their existing insure, using our charity care and sliding program , sliding scale programs as well as improving Patient Communications in terms of expectations of financial responsibility. The Behavioral Health rates are adjusted for this year, and this is part of a state change under callum, where they are converting all of the rates for all of the countys, um to, um, to relate to whats called cpt codes. Um and so we are adjusting all our rates to be consistent with those of the state. The proposed amendment for before you add two rates related to two services for interactive complexity and sign language under rural interpretive services. Is that were omitted from the original legislation once submitted. The next two items are related to our found foundation. Mou s in response to the Public Integrity work by the Comptrollers Office. Um you know, weve been working with two organizations zuckerberg San Francisco journal foundation, as well as the Public Health foundation to comply with the work thats been put forward by the Comptrollers Office, as well as the ethics commission. So in order to be able to, um, comply with acceptance of gifts as well as control and audit authority, um and working with the Comptrollers Office, the City Attorney and ethics commissions were pleased to bring forward these two m o u. S that will be in bring us in compliance and now allow us to resume receipt of funds from from these two important organizations. Um and then next is recurring grants. This is a list of grants that we have in our budget that require board of supervisors legislation. Its similar to legislation that the members of the board of seen in prior years um and these have all been appropriated included as part of our budget. Um and then last, we have an approval of our re approval of a grant resolution, um, working with the City Attorney. They noted that there were several clauses and grant resolution and agreement that was already brought forward to the board, and they know that they were nonstandard items and therefore they just wanted to note that in the resolution moving forward for the boards awareness moving forward, but the full agreement has actually already been approved by the board. With that that concludes my, um pre presentation and trailing was legislation. We also have additional slides related to some operations questions as well as analytical performance metrics. Were happy to continue with the presentation or should the committee prefer that we um , answer questions, but were happy to do what the what the committee pleases. Thank you. Um. I dont see any names on the roster for questions or yep. Supervisor ronan hmm. Thank you. Thank you, um, for the presentations. I had i just had a couple of questions about vacancies in a couple of questions about the wellness centers. Um whoever is the best person. Ill try. So um, im trying it. I was trying to look at your charts that that, um. Director. Louis didnt have a chance to go through. But so. And surprise. Surprise im particularly interested in Behavioral Health, although it looks like you have a lot of registered nurses also vacant, um but it looks like. The vacancy is have come down to stan sha li. In Behavioral Health, which it lets start there, which is great to see, um, wondering if you could just talk about that a little bit. Um sure. Thank you, supervisor greg wagner, chief operating officer. Um so a couple of things moving in Behavioral Health. As you know, we started. Uh major hiring. Push. Um i guess i dont remember how long ago but and we have been working hard to, uh increased hiring. Weve changed our process quite a bit. That is the progress there. And so there has been a lot of progress there. That progress is partially offset by the fact that, um theres uh, there are challenges, particularly in the Behavioral Health clinician class. Uh, where there is a regional and National Challenge and identifying candidates. Uh but weve been working very hard on that and weve also added quite a large number of positions. Um, so our net number of employees is up. Uh the vacancy that it continues to be a moving target, though on the vacancy rate as weve added positions, and were trying to keep pace with where we are. And catch up to those new hires that were included are new positions that were included in the budget for the current year. Um, so without those new positions, we would be at vacancy rate and Behavioral Health lower than the average for the department. But but we do have some work to do to get caught up on those new positions that were added this year about 100 positions. But it looks like other than Health Worker to you have more eligible applicants than vacancies in every category. Yes um and i can if anna if youre listening if you could move to the slide for dph side 25, i believe if mine is the correct one. So there is a lot going on in terms of our process and we could go on for quite a while on the changes that were trying to make and working with the hr that were really, um enthusiastic and optimistic about. We have. You can see the vacancies by class on that chart. And a lot of those positions are moving through the pipeline. So on the slide, thats uh up on the teams right now. You can see that we have about 1500 that are at some stage in the process Department Wide and those could be a lot of those are in the recruitment phase about 750 there about 300 that are candidate has been identified and is in the on on boarding stage. The biggest class and Behavioral Health in particular as again the Behavioral Health clinician class. We had a new list that was recently adopted, and so the division is in the process of doing selections. Most of those are at Behavioral Health. And so we expect over the next coming weeks and months as those go from selection into hiring an on boarding, we should see a pretty significant decrease in the vacancy rate for those positions , but there are still ongoing. It is one of the challenging spots for the department in terms of hiring. Sorry but i just want to just taking Behavioral Health clinician as an example. Looks like you had 206 applicants for 44 vacancies in 120 of those 206 are eligible so that i mean, thats better than ive seen in the past. Thats that looks good. Yes so that was so, uh, exactly so 206 applicants 120 that have been deemed eligible and are remaining on the list. And that will move as candidates are vetted. And then you can see compared to that we have these 44 vacancies, and those are the ones that are in the process right now. Where the department is selecting from that eligible list, so we hope to make a big dent in that those 44 vacancies and there soon. Those are all funded and ready. Those are funded. Yes, yes. Soon as you can get. Okay, great. And then, um, i just wanted to talk about the oneness helps. I know we meet a lot in our office and youre with your office about the wellness hubs. But im just wondering if you could talk a little bit. Hey, you know publicly about timeline intentions where the three are are at, um and what you expect to see this fiscal year next fiscal year. Um in terms of the actual opening of those oneness tubs. So thank you. Supervisor and dr hilary cummins, whos our behavior . Health charger is, um well fill in some of the details, but i just wanted to context that a little bit here because, as you know, in our Overdose Prevention plan, um and as a priority in the city, uh, the mayor spoken to this. I know youve spoken to this having wellness substances key component of our Behavioral Health response to the fentanyl crisis, and there are some real barriers to establishing them. Uh mainly right now is as as you know, at the federal level and quite frankly, to some degree at the state. Level. There has not been passage of legislation that would allow us to do this legally, and there would be great risk as as a result of our our executing on this as safe consumption on site, right, so there are a number of things that were doing there is that the new york model, which is non profits . Um uh administrating the safe consumption site component of the site. So dr cousins will give you details on what were thinking of. And the timeline for opening the first sight, to the extent that were that we have clarity and were able to share thank you. Good afternoon. Supervisors hillary cannons, director of Behavioral Health and mental health, sf um , as dr colfax just described and as you well know, supervisor ronan. Uh we are been working a lot on getting ready. We hope to open the first wellness of this year and will continue to work towards the other. Uh an additional two sites. Um we know that barriers remain, and we are aiming to overcome them with our city. Private and public partners. And in terms of the location, soma tenderloin i know. I know the tenderloin say it. I mean, obviously you have to rfp these out so, but in terms of in terms of the three neighborhoods that that deeply need them mission soma and tenderloin. In terms of opening one this this year, and by this year this calendar year. Is that is that one can do. Do you know the where is it so much tenderloin . Her mission do you have that figured out . I think that, um you know, as youre describing, we want to. We intend to locate services in areas of high ah overdose rates in the city where, uh, where we could potentially see the most Public Health benefit. I think, as you know, and we know that we always face challenges in terms of appropriateness of sight. Ah both for the service and for the community. We want there to be community acceptance, and we want there to be a site where people are willing and interested in going and has a nice, uh, serves the purpose of for its intent. So i think sort of naming specific sequencing and sites feels um, premature, but we hope it will not feel that way. Soon as we take the next steps, okay . Okay, thats all my questions. Thank you, supervisor ronan and vice chairman norman um thank you. Church. Chan um, thank you for the presentation. Um id like to answer premier be, unsurprisingly, talk a little bit more about where we are on beds. Um and so we are continuing to rely on this 2020. Point in time. Not exactly about the back of the envelope, but not something that i think anton aggressive land would have said, ought to be the guiding direction for the departments bed strategy for four years, and so where are we on getting a more robust and complete analysis of our need for beds . So thank you