Pg e and preventing us from the robust roll out and less funds to do build out this is a direct attack against our cleanpowersf Power Program two resolutions to say ask the California Public Utilities Commission not to approve those increases that is dramatic two increases for the residents i think that is important to talk about some of the things going on behind the scenes thats been going on earlier this year we put on two measures on the ballot the lafco and city put on proposition h that was really about move forward with our cleanpowersf program and have a clear statement about what kind of energy were producing the iuoe under stern have put out their own version of the property g do undermine our effort would be they realized that the city was probable going to prevail on our measure that would not be good for them and their measure would lose and it very well well, did to you make sure theyre not attacking our measure and stern from i b w worked very much to try at one end promote the measure he was going to try toy kill prop g earlier this week, i was tarnishing to mr. Stern he said the energy fee that is working its way to the Public Utilities commission was all but settled our resolution before us today regarding the metering was really not important anywhere i dont believe that is true and talking with lafco jason fried sdrook interest the California Public Utilities Commission has not made a decision on the Net Energy Metering and talking to a liaison who is here in 9 puc whos name a cody he said the decision is not made either so heres what howard stern told me are signed the metering decision is pretty much set nothing it changing and i dont believe that is for what ive been hearing that is true things are locked up between ibw and the California Public Utilities Commission to present and let us know what we have before us. Sure jason fried executive director for lafco on those matters ive invited speakers if a statewide level and have presentations on each of the items into a local level how it impacts San Francisco directly so we will take them in the order on the agenda and our presenter from solar to present followed by a receptionist in the San Francisco Environmental Department talking about the impact the lafco and the pc i a and having lean energy present on a statewide prospective and have the sfpuc how to impacts us with that, ill call of sue huhuh h h sue is an do the presentation and the next presenter after that. Convalescent Committee Members thank you. I am supposed to say sfgovtv goes to the power point so, yeah im susan the west coast with go solar a nonprofit Advocacy Organization that is working around the country to bring solar into the mainstream about the efforts to slow down the rooftop by attacking and policy called net meters were in the middle of the debate the commission has not made a determination i could talk about this topic for many hours but keep it to 5 minutes as a context to start important to note were reilly in the midst of a rooftop innovation in San Francisco we serve 3 percent of big incurs demand the average price has dropped by more than half by 2009 and tripled the solar on the rooftop since 2011 and seeing 2 3rds of the rooftop solar installation happening in lshgsz neighborhoods it is good news for the state but prompting a backlash that seize it as a threat is their directly attacking net meters not only in california but dozens of other states across the country an explanation of what net metering and simple method for crediting people so when a roosevelt is producing more energy than the confers needed it get sent back the grid owe the skpz sell it so the metering makes sure that the similar customers get credit it allows their meters to roll backwards and give us full Retail Credit for kilowatt for the clean theyre paying the utility when necessary buy the hours so legislationer passed it in the early 2000 and have it in place across the country but in 2013 in response from the utility the legislator passed a law that told the commission by the end of this year determine what the net goals should be when they reach a 5 percent cap what 5 percent of the peak demand is served by the rooftop solar and pg e will hit that cap around the middle of next year and so all 3 of the utilities as a proceeding in the puc have submitted proposals to end that 3450er9 and drastically reduce the solar bill saves and each utility proposed a different proposal but at pg e they have a host of different proposed changing reduce the bill by more 50 percent that ends the metering you get the same credit for what is returned to the grid and on top of to add a 3 theres per kilowatt monthly demand charge it is pegged to the maximum demand that a customer buys from the utilities so it is hard for residential customers to predict we see anywhere in the country the utility has levied levied a demand charge the customers dont know their maximum demand will be and it is difficult charge to manage more them as well to pg e is proposed to disallow rolling over the bill credit that is part of our net metering structure and theyve made other proposals ill not get into detail but you know it is essentially if pg e proposal was adopted by the puc it will drastically reduce the savings to the customers and dramatically slow down continued solar growth and so you can all utilities theyve proposed this combination of reduced to credit for exported clean energy and add fees on top of that for solar customers so you might be wondering you know how which of that is impacting the solar customers bill in pg e territory and that gets complicate because it matters what the customers demand and the size of solar ray and so on we crunched the numbers in an analysis to the puc look at an average residential scloo solar customer in fresno a hot spot for the state right now this graph shows a customer who is under net meters the status quo and have got solar with a no down payment even though up as many solar customers do on net metering the customer saves over 20 percent a month before they got solar but pg es process is adopted by the puc the savings go down to 3 percent youre talking about a decline of more than 80 percent in solar savings to customer under the pg e proposal compared with net meters so you know in response to those attacks from the utilities weve got a number of pro solar voices including my organization is advocates for the preservation of net metering and for californian not make it more expensive for low and middleincome and an out power of the preserve more comments as in the puc has seen on any issue we have a very Broad Coalition of voices from City Government to save organizations not only organizations urging the commissions not to adopt but stick with the metering so where we are in the process raw the c puc about issue their appropriately decision and another a round of applause do comment and thirty days before they adopt a final decision wont happen until middle january so definitely time for the city to weigh in and definitely think that is a great idea if they decide to do so ill stop there for any questions. From our last comments were nothing is definitely soda up. The proposal has not been issued so by no means decided. So permanently no decision on the proposed decision. No proposed decision out yet. And the proposed decision public input and we get to see that public input can influence what comes out in the final. Exactly often changes between the changes and the. Youve answers my next question. How common is that. It is quite common the commission seize heavy lobbying by stakeholders who want to make changes so, you know, i think in this issue thats been so important to the public and controversial i think there is absolutely more time to look at this from the commission. Thank you. Commissioner crews. Thank you so much for your presentation it is remarkable that the different solar customers in fresno 0 no will see to have the net metering changed do you have numbers for San Francisco. Unfortunately, i took this out of an analysis earlier this year i think that the results will look not too much different than San Francisco but fresno customers buy more energy so probable the impact on savings would be somewhat less in San Francisco but still looking at pg e proposal adopted a severe reduction in savings all throughout pg e territory. I more example friends that bought a house looking to add solar panels and people that are you know financing their solar panels and theyre looking for the cost association the cost Savings Association with the build in order to pay for the solar installation do we see them going underwater with solar panels. One thing to note the puc potential of net mooefrt will apply for customers that go solar in the future after the utility hits the 5 percent cap if i have solar the Commission Says you get to keep the program for 20 years and move over 0 the new program is the puc is you know theyre seeking to provide certainty so if youre under the current rules youll stick with the rules the question what are the rules for the future customers. Right so people who before all of this financeing you know flexibility is offered to go solar people that went green early on are going to stop being the seeing the benefits. Yeah. For current customers and customers went solar in the early days when is serve years ago they will see good savings but this is going to throw you know a possible big change in added fees for solar customers and create communication in the market for customers that have solar and those going solar if you look at a whole bunch of confusing fees and demand charges it is really going to put a chill on the market from the simple system of solar to a complex and thats one of the reasons weve urged the puc we have a program that works well, were macro solar affordability to ordinary californians now is it so not the time to change could you say but to maintain this program and keep reaping all the benefits. Okay. Thank you. Commissioner campos. What is the what could possible be the rational by the utilities for what theyre proposing well open this up for Public Comment what are they saying trying to understand. The one side. Yeah. Can anyone keep a straight fast, no pun intend. As ive said i think their ulterior motivates on in their part the argument making sure that all customers including the solar customers pay their fair share for the grid what is the fixed costs every customer should be paying pg e incentive to have their rate basis is the idea is were moving into a future with a distributed grids customers will provide clean green choices the idea not for the utilities to build out the expensive grid and require the customers to pay for it ever they dont need it yeah pg e argument has been around solar customers shouldnt be allowed to zero out their bill and not pay towards the sgridz the fact solar customers pay not zeroing out theyre bill theyre paying their fair share. Okay. Thank you commissioner mar. Thank you for the presentation i just wanted to add my 0. 02 he feel pg es out arraign and the other utilities out arraign forecast it disincentivizes but grad glad you made it clear i have a question im not sure you can answer may cal or other from the department of the environment but in the materials it says about 5 thousand San Francisco homes we know of have solar installations or 5 thousand solar installations around San Francisco that that are similar 10. 5 megawatts do i know how is are low and you mentioned solar in homes is expanding to more low income and middleincome homes. I dont know that offhand i know there was recently a report that look at the average incomes of the zip codes for solar being installed over the last 5 years a distinct move from solar in higher income neighborhoods i dont know what the politician for the solar already installed by the across the country as the costs come down most of the installations with disconnecting of in case of less than 70 thousands or less. Maybe cal knows about the 5 thousand installations are we seeing an increase in the lower and middleincome homes. Thank you commissioner, i cant answer that question but certainly try to get an answer for you. To finish up my political 0. 02 pg es actions are outrageous bus the climate submit and the protests around the woodland is out praejz what is happening around the Public Utilities commission. Thank you commissioner mar and sir, thank you for your presentation so i have two maybe hear Public Comment or an explanation of the changes from mr. Frieds and Public Comment. Before we do that we have cal has a quick presentation how to impacts california before we get there. Commissioners, thank you very much i said to painted a picture of a larger picture were electrifying our electric vehicles moving away from natural gas to electrify our spaces heating we need more electricity resources and we the more we have in house in San Francisco the better off we are what is proposed with the net metering is more difficult part of the charge of the department of the environment to think about Green House Gas emissions so i want to point out that the pucs our puc sfpuc go solar with the metering has installed the 7 hundreds plus solar installations in addition those are providing about 23 megawatts of capacity the late number and want to make the point weve been employing people prosecute Disadvantaged Community in those programs as well as installing solar throughout the city including the southeast and other parts of city that are lower income and finally the point i think not been in the comments before those improve the reliance were working on a project to provide batteries and scombrrg storage to back up the systems when we have a major broadbased quarter we have resources that will come from rooftop solar not a solar installation in the valley the more we can do to put the solar on our rooftops that improve our conditions here thank you. Thank you. So chair avalos to have Public Safety and neighborhood chair wiener to take the a good deal of and read in the amendments those amendments are a quick synopsis they are clarifying and clearing up up a few things weve produced that and gotten feedback from go solar about technical changes that are necessary we took the comments and your staff he provided edits and something that the Public Safety committee tapes not a lafco item ill get into that at the ends the difference and what the Public Safety Neighborhood Services committee and after reading those amendments sgoerd and then we should if you want to get Public Comment on this item or have a presentation on the pc i a ill yield. Do pc i a read the comments or do the presentation all the stuff together. If you like. Im not clear what i have. Maybe. So i would do at this point call up shawn and shell do the presentation on the pc i a and have sfpuc do that and the amendments then. Okay. Thank you he everybody nice to be here im shawn with lean energy jason can you help me with queuing up those slides. Super. Thank you. Before i get started into this topic i think that will be helpful to set context and let you i know i was asked to give a 5 minute presentation highlevel and brief ill be happy to answer any questions but what is the definition of this power charge in different adjustments this is a long term form f 50 an exit fee it is also categorized as a departing low charge an annual calculations based on the advantageing the Pacific Gas Electric has engaged in or entered into on behalf of the customers and so in order to keep the fundamental rate payers whole you have to pay a departing low charge for the case of Community Choices aggregation or cleanpowersf and want to be clear at this point we are not disallowing the need for a low charge we understand that is an obligation in particular not necessarily so much of the utility but the fundamental ratepayer is not unduly impacted by the departing load has to do with with the way the p kay is calculated and the mitigation strategies to handle some of these more intense rates we see proposed this year with that, well sort of recap what we see as the owner currently before the c puc. 2016 it is scheduled to go up nearly 100 percent in cleanpowersf case actually a little bit over 100 percent this is the highest in history so it is unprecedented that estimates or calculates out to 2 point 3 cent and kilowatt hour the communities have to add into the generation rate to for the wholesale power rates from the market in order to then come up with a full rate at the end of the day needs to be competitive with pg e you can imagine a 2 pointed 3 kilowatt hour charge is actually pretty hefty charge but this means for cleanpowersf is a potential hit of 8. 4 million in 2016 that is just for a partial year and only for phase one customers you have youre rolling out a modest phase if i look at 24 over the course of the Program Actually a potential for a much larger financial hit Going Forward Peninsula Clean Energy the ambulance in san mateo that is 40 million in 2016 and that is also 2307 for the Phase One Program and the pc i a has a hard hits on care customers they rely on programs that help them meet in their olympics low Income Customers that are undial burdened by 100 percent increase in the fee per it also reduces cleanpowersf and other cia ability for the clean power this is something to have into our rates it effects our revenues and the ability to have the excess revenue and definitely creates uncertainty in the marketplace we believe the effect is anticompetitive it is essentially contrary to save policy the policy requires corporation from the utilities 19 it also requires the urban bundled customer is made whole but some things in the calculations that satisfied both needs the other issue at hand the calculations are done in a black box manner commissioner last week knowledgeed how calibrated those calculations are the costs in ass not to my knowledge uhhuh annual calculations are unknown because of the cost information was not available to 9 parties our question what are the assumptions underlying and what is in this quote quotes black box it spits out a fee that potentially approved by the c puc we know undermines the California Public Utilities Commission go credibility of the end result that brings us here today to a number of remedies that have been proposed we are hopeful an additional decision to the proposed decision before the puc potentially schedule to be heard on december 17th and potentially defer a final decisions into january giving me additional time for mitigations to be povrnl considered one of those to increase transparency and craigslist by conducting and third party audio and verification of the calculation and more importantly the assumptions underlying those calculations what are the contract that are going into this black box and spitting out this number we dont know what is going into that we that will be helpful for the puc to have the third party verifies theyre given comfort theyre about to approve is valid the second mitigation that has been suggested is to consider a balancing or smoothly account to mitigate those types rates as i mentioned this is unprecedented doing so will is an annual came it could be 15ers or 50 percent but something that provides some relief with the ability to amnesties the balance of those over a period of time so you have a smoothly effect and not have this hit on rates the figure out is to request to open a preceding at the sfpuc other issues about the exit fee including a potential very visiting obvious iuoe circulations u calculations work the memories and the policy behind that as well as how long does the p ccii kay cia we dont see a theyre no longer able to procure but monopoly has been defined so those are the remedies that lean as suggested and many others that have merging with the commissioners we dont know for sure there is relief for the 2016 fee some indication of a willingness to engage if the structural fixed to the p cia that is a step in the right direction if you can join us for to press conference next thursday december 17th prior to the Commission Hearing wed love to have supervisor avalos or anyone else a number of local officials to talk about the impact of the p cia on their program and the program Going Forward so with that, i the finish my remarks and im available to answer any questions. Thank you for your presentation and thank you as well for the invitation actually, i will not been able to make that i have my kids i take it school at it time in the morning but well, my fellow commissioners to be able to go if theirable. Thank you. And work with jason fried to see which one of us can be inherited over to the press conference. Very good thank you. Okay commissioner mar youre name is the only the roster okay. Commission. Thank you. I have one question. It was a great presentation thank you. I thinks that is very complicated and to stay within the timeframe was highlevel going back to one statement you said you thought no relief in sight what do you mean that pg e is not required to procure energy on behalf of the p cia how did it play into the p cia a continual charge. As far its been a continual charge ongoing discussions when a when does it at the end pg e entered into a contract maybe 25 to thirty years at what point is there a cross over between that timeframe when the p cia halls procedure the power on behalf of the parties and is obligation to pay the load theoretically it should be wrenching down over time and go away at some point some said it should go away after the first year it is not feasible but after 10 years they have the ability to go on the market and sell the contract the p cia is calculated on the benchmark price and what they cracked for we want to make sure we are innovate liable for the loads and the calculations is fair and that there is in no way a double dipping or making money and turning to and chair mar us. Forgive me if im new to understanding p cia it is a dual component theres a something that the ratepayer pays and the p cia pays isnt that correct. Yes. But the way it works the cca agency scombetsdz the p cia charge so ultimately it is bundled into the overall rate for the customer. So the customer doesnt get this you know thanks for leaving you owe us x amount of dollars its rolled into the future bills with cleanpowersf. Yes. If i understood you correctly but the bottom line in other words, for the program whether it is cleanpowersf or Lean Clean Energy for them to retain competitive they have to take into account the generation layer in the exist fee and the administrative costs and come out hopefully competitive to pg e and this year we know for sure for example, lean energy will be more expensive. Thank you. I understand it but thank you for clarifying it thank you so much. Any other and colleagues, any other questions okay. Anything from staff . Ms. Harold good afternoon barbara hale assistants general manager for powell at the San Francisco puc thanks. Taking the time to review and lean and marshall for reviewing the p cia since for the last couple of weeks weve been pulsing over how to reset our cleanpowersf plan to in the event if pg e is successful in their request at the California Public Utilities Commission our commission on december 8th adopted a resolution similar to the resolution bra you today it rejects or urges the California Public Utilities Commission to reject the proposal pg e offends it ports it asks the puc to support the ultimate resolution as ms. Marshall described that helps mitigate the impact of the p cia request ton cca programs and p cia customers and finally the sfpuc urged the p cia to reexamine the calculation method and the application to cleanpowersf program and other cca programs in state law requires that the investor on collect this fee to maintain the differences for the remaining customers to other domineers departing the San Francisco Public Utilities commission it in challenge it san franciscans San Francisco is made up of bundled customers and you know customers that will join the cca program we need to keep both the ratepayer groups incomes and were asking the California Public Utilities Commission to do the same they should be keeping in mind the bundled customers by the but the cca customers it is not at all unusual for the California Public Utilities Commission to apply its practice on a rate making issue and see the result oh, that is has a heavier impact on customers and rate payers than we think is appropriate quarry moderate that the puc resolution requests them here and the resolution bra requests the California Public Utilities Commission to do to moderate the impact weve spent sometime today, i spent time talking with California Public Utilities Commission staff i think that the issue one of the issues that is most troubling ms. Marshall be mentioned it pg e the proceedings that pg es asking for making in request is a proceeding that started back in june of this year parties had an opportunity to review the materials, to put their point of view on the formal records on november 5th is when pg e changed their request to make it a more dramatic higher than previously requested in june that was november 5th, november 13th shortly after the assigned Administrative Law judge grantdz pg e request when we look back then on the filings the filing that pg e made on november 5th i have with me going to the transparency issue this is a filing that pg e made with tremendous amount of redictated we cannot see a this is a more than a tremendous amount of redacting. We cant see the calculation so part of what were asking the California Public Utilities Commission to pause look at the real calculations here make sure that they understand it can and moderate the impact on our customers and Going Forward look to see how can we assess a charge that protects bundled customers and didnt unfairly hits the cleanpowersf and other cca customers commissioner crews. You were asking a question specifically how to affect cleanpowersf customers like other ccas were doing when we are proposing rates for the cleanpowersf program as were trying to make sure that customers will be neutral to whether you you know on a bill basis to whether theyre in the cleanpowersf program or in the pg e program we know that pg e is going to include on the cleanpowersf customer will include on their charges page the exit fee times the kilowatt hours a separate charge each customer will see weve tried to do in setting our generation rate to take that how far take into account it means we have to be 25 percent cheaper in our our Electrical Supply has to be 25 percent what we were cheaper in other words, to be cheaper pg e so were when ms. Marshall said were amending that were saying youre costs have to be cheaper by the cost of the p cia in order for our customers to have no bill impact by joining our program. Okay. So that i think this is ill stop there and take any questions you may have thank you. Thank you very much i dont see other questions so why not go ahead and hear from our director jason fried. I want to do a quick summary and giving us an understanding from the board of supervisors you know we have a couple of resolution in front of you i understand technical amendment to the resolutions today and thats a good way for the board of supervisors to go that is best if they do it set up a Committee Report so go in front of the the board of supervisors on tuesday and they vote prior Internal Revenue to the meeting the c puc especially from the skraik from a lafco prospective looking for the final reductions on the letter writing side and things like that lafco what about more nimble and support what the sfpuc and lean is doing stone the p cia and support what the department of environment and the go solar and other net merchant well be taking part thats little directions ill be encouraging to give the instructions when 33 these 24e7kz occur between the merge and draft letters the chair then reviewed them and gives the final sign off thats generally, the way it is downey done in a supervisor has a on or about well incorporate you into 0 that loop but draft the letters with the chair giving final approval with the lafco ill recommend at this point and still, of course, have to have Public Comment on those two items actually. Great so why not do Public Comment first actually what we have before us a technical amendment i passed out to my colleagues adding a few words here and tloo there to see the expectations of the California Public Utilities Commission could be just changes in the title that referenced to solar customers and changing language that go helps to clarify around the Net Energy Metering and it is really minor changes here and there on the second one around the power charge and different adjustments adding a line that jason fried discussed a therefore, be it resolved and this is not underlined by the board of supervisors directs the clerk of the board to transmit copies to the California Public Utilities Commission and the San Franciscos representatives of the legislator thats the last on the line that of that the power charging adjustment resolution thats new okay. So we can decide to bring those well vote on those amendments or the Public Safety Neighborhood Services committee will vote on those amendments after Public Comment lets go to Public Comment. Good evening commissioners eric brooks with the San Francisco green party and the local grassroots i come forward with the clean power advocates and are for the Energy Choice that hepatitis to lead the charge in sacramento to stop bad bills that will undermine Community Choice so ill just stick to the exit fee the plaintiff cia fee because of limit time i lean has done a great job of calling your attention and dust kicked up and getting Public Comment unprecedented Public Comment to the commission on this but i would kick it up a notch we have a number this p cia charge was happening and now a situation where there are 40 the last number i saw 40 city and counties cities and or county pursuing the choice and la that county is pursuing 20 or more so pg e and the other utilities know full well the market is drastically changing and a lot of the Services Territory will be taken over by Community Choice program what the p cia ill call you to ask for it to be rapidly changed it is left the the way it is it sets up a situation where corps like pg e not only the Choice Program will stand up to the territory can sign up for 20 and thirty years knowing the next year x number of customers and those customers will be dinged in perpetuity for the 20 and thirty year contracted so this is hi a point of order we should get double the times im jed i cocoordinator and spent time on the board a party to the puc and definitely involved in the p cia weve worked on the deconstruction of fossil fuel and provide a Healthy Future not without turning on the clean power those issues are extremely critical a Climate Crisis we need more 5 percent of residents to have solar on their roof and heard from the gentleman about the resilient so it benefits everyone and the only party is the corporation that didnt benefit that wear discussing as far as the puc ill make sfpuc and make the comments again, the pentagon proposal is to instill fear statewide and effect the Public Policy that by g a dictionary dispensation is economic terry recidivism a hostage taking with 8 and a half millions pictures rotted away from us money from the peninsula it is unacceptable the public didnt have a big role with the San Francisco public works ill urge to get involved with the c puc supervisors to move the pools actually this hearing an is 17 despite all the feedback theyve heard the p cia charge patrol is still it on the consent calendar this is the level of respect for the process we have over there this 8 and a half Million Dollars is real money well have here on behalf of the appellant. Do you have imagine to add. Yes. Thank you. We heard from the sfpuc hearing theyll been losing be potentially 8 and a half Million Dollars in this the plaintiff cia increase goes through weve think thinking how to use this money back into the Promissory Note Program we tell them the mask of the Community Choices going devotes this is is transfer of wealth and for money for build outs going instead to a maneuver in a conceptual way it is poor planning by this Year Corporation to be back stomped by the public not happening in any other industry ill back up under brooks we need to look at the blunt of this but the funding of the p cia thank you very much. Thank you. Next speaker, please. Dashing through the snow in a solar powder slay over the city hills we go green power all the way. Bells are again to ring keeping spirits bright and bright i hope the item turn out right hope that goes well and hope it is swell and hope it sells oh, what fun to ride in a solar powder sleigh offering oh, no place like solar and green be able for the holidays and no matter how far away you room if you want to be economical in many ways for the holidays it great powder energy way to go. clapping. . Well, i guessed that is taking my green ride to a whole new level is there any additional Public Comment seeing none, Public Comment is closed and i think this is where the Public Safety Neighborhood Services can take over. Chair avalos any questions about the amendments can we adopt the amendments for the net metering item without objection. And thank you let me say two different items before us and if no questions weve heard Public Comment can we. The new on the power charge on the adjustment resolution that you combined asking the board to send a letter to the California Public Utilities Commission and to our representative that serves the city for this c puc not only a lafco motion but for the Public Safety committee and it this is for the Public Safety committee. So for the p cia can we accept that amendment without objection great on both items support 0 those with the with a positive recommendation. Look forward as a Committee Report. So moved. And moved to the full board of supervisors on tuesday december 15th and doing that without objection thank you. Back to the chair avalos. Other items for the Safety Committee or close that one out so we can adjourn the Public Safety committee and go on to the lafco. Any other business before the Public Safety committee. Theres no further business. Well conclude that Public Safety and mr. Chair they need to witch over to lafco. Okay. Well pause a switc okay. Well pause a minute. Sfgovtv is really. Very good and so those items are open on our lafco agenda jason fried. Theyre open on the lafco staff 80 so we have it read into the record to take part in the letter writing campaigns and to work with the chair to get those letters done in a timely fashion. Okay commissioner crews. I wanted to make the motion to have the staff to write the letters on both matters please. Okay. Thank you and i think thats a motion and seconded by commissioner mar and take that without objection ill work with jason fried on working on the letter. Okay thank you very much and lets go to our item number 3. Item 3 the approval the lafco minutes from the october 23, 2015, with the San Francisco Public Utilities commission. Colleagues, any questions or comments on the minutes okay lets go on to. This is related to our minutes so no members of the public well Public Comment is closed. And item 4 you need to take a motion to approve the minutes. So moved. Okay thank you and seconded by commissioner mar and well take that without objection. Item 4 the Community Activities report for a report on the clean power and b status on the California Public Utilities Commission. Okay ms. Hal welcome. The general manager for power at the San Francisco Public Utilities commission i wanted to provide an update if i may how were doing with the clean Power Program marching towards launch on the november 10th we made a presentation to the commission that dooementd the Business Plan the reflex that we were facing and our strategies for mitigating those risks the revisions relief talked about the p cia we reran our model and looked at the stability of the program we on the 10 were able to an november 10th able to inform our commission it looks like a 8 percent operating margin that well be funding an operating reserve well funding a Rate Stabilization and providing a gastroproduct with very a good basis of financial so well be able to grow the program and ultimately get a Credit Rating more sufficiently reinvest and along the changes that pg e is asking for in the Administrative Law judges is saying yes and we ran the fingers it shrinks with the new numbers and funding an operating reserve no longerable if edging successful no longer able to fund Rate Stabilization reserve the importance of the reserve having that reserve allows us a returning give us an account we can turn to for contingencies like a change in the p cia well not have to immediately pass those costs onto the customers but absorb them until the next opportunity to adjust our underlying costs so that cushion having that lost that cushion is concerting we made the presentation to our commission of the changes on the 8 of december we are still moving forward their comfortable with that we are watch a number of factors the pg e change being one that is was the one more impactful between now and the first of the year or the first week the first of the year of the new year well be getting a price refresh from our suppliers and hoping to see those costs come down and we are going to finalize the negotiations with those bidders 3 active bid option one bidders were talking about with two active specified renewable projects we expect to finalize those over the next two weeks and have the pg e raised come in on january 1st, well know what the rate is were competing against the generation and the p cia not only will we expect to be acted think or defenders by the commission on the 17 of december; right . On january 1st pg e is scheduled to publish new rates based on a number of decisions the California Public Utilities Commission is making is on january 1st, well have a new rate well have a calculator on what the p cia is and able to do the math to fourth we know what our costs say we have the best and finally over from our suppliers and know what pg e rate is costs are on the plaintiff cia and able to say okay. Can we cover our costs and including funding and operating reserves at a rate that is. 25 percent less than the rates pg e is charging today, if we are able to say yes, well continue on our large number path in not at this point thats when we pittsburgh hit the pause bottom in between and then continuing to work on refinancing the numbers looking at and ooefg what sort of a mitigating factors we might be able to recommend to our commission if we do finds ourselves on the pause path also known as to the launch path wear expecting to be on the launch path blue in the expectation were wrong so our schedule remains the same. Just im going to pause you right now. Yes. What do you mean if we were to pause what will the range looked like and the time i understand you have to look at contingencies im not what that means illegally how our program is considered by the California Public Utilities Commission but in terms of their Decision Making but i get nervous when i hear the word pause it feels like all the work youve done and the puc has done could seriously be a waste of time so, please let me know what you mean by pause. To what i mean by pause staff has been given direction to launch this program assuming were able to over service at a rate that is affordable theyve defined affordable as being a rate that is zero 25 below pg e. I heard that. Yes. And so we will know what pg es recreate is on january 1st, well know weve been estimating our costs; right . Using the bids weve received from the suppliers those the approach were taking consistent with outing how things work in the electrical market theyve over us a best and final price wherever we ask for that we will when we know in the pg e rates are that supply is 70 percent of our costs of the overall operation of the program is it it is a fundamental piece of our cost pie reporting or; right . Once we know what the actual supply costs are and the actual pg e rate then well be able to judge when a whether we meet the affordability yeah. Our costs below can we offer services as 25 below pemgz and recover our costs. Well ton do so if he can well got rid of if not the question about the pause part. Okay. Is that like a pause that is a better rate if pg e. What i mean us looking at i know weve not been able to change pg e rate quickly; right . Thats a long term advocacy efforts but well be looking at with the pause what are some of the other tools we have available to modify the cost of our program we for example, have a target power content our green offering of 35 percent if were not able to launch the program not meeting the cost benchmark consider reducing the 35 to 240 well be in compliance with stating an option that lowers our operating costs we could look at it and were 86 looking at modifying the mix of customers that independence the receive stream eco system a mexico of customers that have more business than residential that might provide us with a revenue stream that allows us to afford to provide the service at that you know extensively affordability. I have a lot of resistant it is down the pathway of paws im worried about that i have a lot of questions i feel like it is a slippery slope to Start Talking about what the pause i was not contemplating that right now. Im trying to demonstrate to you that we, keep is short. What. If were not successful with our advocacy at p puc if the costs coin higher are reprepared and thinking that is, yes we are. I. Now is not the time to discuss that. I would rather do is that closed session. Commissioner crews. I have a question on timing if we should have a pause to reevaluate to configure the program to still lead with affordability what can that mean in terms of launch date . Were Telegraph Hill knowing to minimize the launch date we need to begin the opt out process in midjanuary to stay on our path of the lauven in march so any dwla on that in january would cause a delay in the actual start of program and again, were not expecting to be there but i just want to assure you, we are prep and thinking it through if we find ourselves put in that position. Thank you. Director fried. Jason fried exclusive officer i dont want to jump go into a hornets nest but what is the worse Case Scenario they have not yielded participated and right now their staff is foouth kwhaepd in pg e they like to mess with San Francisco what if pg e is figuring out a way to come in cheaper weve testify grafted not higher than per diem and so theyre trying to figure out what happens in those cases there is not a pause in the program i do feel that the staff and everything theyre working towards getting getting the launch theyre doing their Due Diligence to anticipate if pg e 2r50iz to mess with us and put a price out there thereless lower than other anticipated lake the p cias charge they mess with our finances you know with feed to is have a discussion the financial needs to be there i will or know theyve been wards on the avenues what occurs the one benefit we have pg e is getting a lower price we should be getting a lower price for any contact wire mirroring the market in pg e is laboratory lover our hopes are contracting will be lover it therefore well oath set and well get a launch i see the work their staff is doing internally everything is full steam heads but calm the nerves no one is expecting a pause the staff is part of their commission wanting to make sure that he everyone is on board from a financial stand Point Commission said hes happy with the work theyve done all the worst Case Scenarios theyve been able to deal with any worst Case Scenario and theyre continuing to go down that pact one thing i wanted to highlight i dont see a pause not any their staff is foouth how not to be a pause in the program and i heap that one january comes around well see the program moving forward. Yes. I dont want to cast anything on the puc staff but get freaked out there isnt a lot of carol about what decisions will be in the California Public Utilities Commission that makes we worried i am concerned about this giving air to what where we are right now is that doesnt make us feel like we are doubtful but other people maybe a closed session discussing the matters or rather than having it you know before us i think it make sense to talk about it pubically as well that is my concern. I agree with you completely and each of the elements eave heard this outside the chambers i ask the same questions i think we are working on the same path to move forward we can and have our agenda when mergers are the next lafco will be after all the decisions are made but try to schedule a meeting in january if something needs to be scheduled or right after the holidays if i want to have it closed session and staff can have the meeting with each personal individuals. Lets have a meeting in between and then. Why not move to Public Comment any Public Comment . Good afternoon, commissioners again eric brooks with all the groups ive mentioned previously those are in the various capacities is just to we had a pretty good meeting with staff last monday and they kind of reassured us to the extent that breeding e director fried did it looks like the price of renewables is going do you think thats what your hearing so the likelihood of a pause is pretty unlikely, however, it i would also agree with the notation of the having lafco and the board of supervisors ready to have lafco ready to have a special meeting in january and the supervisors ready to act in case pg e plays games to the board of supervisors can pass whatever legislation to undermine those pg e games and keep the 0 program on track so at the puc meeting on tuesday advocates cleanpowersf advocates and outlets whoirldz supports the Commission Decision to go ahead and vote for their package and their Business Model moving forward and we think that the things look good but be prepared for january in case of the games one quibble in the Business Plan staffed agreed to sit and pleading will be involved the frontalss for what the build out starts in the best plan are 2020 and enernex is sooner that that basic where we do it sooner hinlz on the financing so thats little with an thing to should tell with staff to get the build out started within a year thank you. Thanks jed from 350 sf again, we had a good meeting with staff and i think the sfpuc meeting on tuesday was a positive one i just really wanted to give from an outside prospective kind of back up with director fried said you know the sfpuc staff is under pressure from their commission from members of the commission to really look at the worst of the worst and protect basically the rest of the power enterprise that could happen to clean power i think that it is important to keep an eye on on the fact that puc really potentially taking more direct measures to halt the launch of this program than previously but i think at this point the way for us to move forward is to hopefully do this together outside organizations the board of supervisors, lafco and the sfpuc to basically move forward as a city tee help undermine what the correspondence of the regulated monopoly might be dont go certainly they can watch those meetings and everything is out in public verse the redacted record we say early i expect when the rates come out in january theyll specifically be geared to take a loss for a short time to gain a competitive interest in other Community Choice programs we cant do anything about that but Work Together to be trickier and dirtier than they are for a future i want to back up the sfpuc staff the 8 and a half millions of theyre required tee account for how this money is distributed because of the commissions request and despite this large hit they maintained to their commission they were very certain to move forward albeit it with a smaller margin and reserves than they like we back up them in getting positive and focused on doing this question agree this is happening no matter what they throw at us wed like to collectively surpass that thank you. Thank you very much. Just a corrections on our Public Comment it was tremendously redacted and also i agree i do in my comments to ms. Hailey said a tremendous amount of work your staff has done and dont want to lose sight of that so this is an informational item next item. Item number 52016 lafco meeting schedule. Director fried. Executive director jason fried in the package the proposed dates for 2016 how we distributed how we came across for it to o thousands meeting you have the schedule in front of make a motion to accept that schedule and put that in as our regulating schedule meeting we may have a joint meeting but for the calendar 2016 when we were well be meeting. Before that go into Public Comment is there anyone from the public that wishes to speak and Public Comment is closed. And a motion from commissioner crews you want to an our schedule. I think i tediously director fried ill not be here in february ill be traveling for the moss month. Okay. Everyone else okay with the schedule can i get a motion from motion from commissioner lindo commissioner lindo cant make a motion. The motion by chair wiener and commissioner campos without objection thanks for making the motion though. Next item. And item 6 executive directors report status update with the city and county of San Francisco can do to increase the voter turnout. So jason fried our executive Director Office and also thank for the commission well have those in february for the utilities itself for the report were continuing to move forward with enrique the intern has been reaching utilities to the academics we have a meeting schedule next week with the department of the elections that john is interest well ask him perspectives and were starting to reach out the Community Groups were continuing to be in the raven phase my hope by the middle of january had all the meetings we need to have and drafting and reporting so at some point you know ends of january beginning of february timeframe well have a rotator and put it out there commissioner crews you want to look at the drafting process well dont we we can and ill avoid all in one big blast i know you have that request and his own that request once more in depth and if any other commission wanted to hair the draft it is very early draft well have but ill be happy to to share what we have thats all i have on the study itself and the only thing january is normally the election of chair and having to keep in mind for anyone that wants to stay in their positions within the bodies as far as chair or vice chair those happen in january thats all. Commissioner crews. I have a consecutive statement slash question for director fried. I in terms of of the report voter turnout i want to reiterate i want to make sure that our research is reaching out to the Youth Commission to go talk about the vote. Yes. Weve talked about i pefrm sad with the youth to talk about that. Super thank you commissioner londo. Ive been receiving the nominees and know that is not always easy well continuing having the emails trying to at the time set up the meeting. I maybe coming to some of you the most responsive if you have a relationship with that that group ill come to you to get those meetings acceset up t you. Ill let him know that. Between the last meeting and this meeting i preenrolled for super green for cleanpowersf and founded a it was very easy to do less than 5 minutes so im my office is putting out information a newsletter how to sign up and if people can talk about the program it goes a long way i know that commissioner crews has a whole stack of packet and been swell at getting that out dont our part that would be helpful. Director fried. Ive been helping the puc to do the Community Meeting youre correct 50 percent signed up for super green it was very easy to do so people should be encouraging all the Commissioners Office and commissioner crews got the cd what a bunch the low log these ill be happy to to work with the puc to get you that information. Great on the executive officers report well open up for Public Comment. Eric brooks again with all those groups good afternoon, commissioners and first on the last point that was raised and to the public that will hopeful watching this hearing we build that cleanpowersf is definitely going to start in april of next year things are looking pretty good and you caprice enroll for the program it will be lower price than pg e or a few bucks for more for 100 percent as the chair said and to the public you do that easy go to cleanpowersf. Com that is one word cleanpowersf. Org and get our energy if the city not pg e i want to raise and point what happened in the november 3rd election really made a powerful statement about process we need to include in how we educate ventilators in the last election for mayor 3 of the campaigns purposing ran together as a blocvote 1, 2, 3 for us in the process of their purposing running together they did a lot of education to the voters on how and why to do that that is the first time it any candidate in San Francisco if you look at the previous election and this election how rank worked out both mayoral it was profound a lot more voters knew and properly transferred their votes to candidates and resulted in one of the candidates getting 33 percent of the veto a providence defensive than the last election which was none of that candidates getting much at all to lets thank you. Ted long time san franciscan whos regularly baffled in and december gusted by our low voter turnout when people have dying around the world to have a stake in the future i think unfortunately, our society is convenience space i did a lot of Data Analysis on this election for a campaign that plain clothes officers mentioned and ink we have under half the registered voters vote when you take the eligible they could vote you cant force the horse to drink to water but lead the horse are better to water i hope were looking all mail ballots and theres rank Choice Voting education unfortunately, i see the ads on muni permanent the only person that looks up at that in trying to educate peep in the election voting in this cycle the goal was to say eye rate voice e Choice Voting how you oozed use it and trying to clear up misconceptions the departments have spent millions of our money trying to clear up those campaigns as well intended theyre not penetrating so increasing the turn out helps but when people feel like not only the 39 proscriptions they dont understand they dont understand how to vote for their choice no further so rank choice is great should encourage people to vote thanks for the education thank you. Seeing no other members of the public coming down Public Comment is closed. General Public Comment is now open and seeing no member of the public general Public Comment is closed. And next item. Item 8 future agenda items. Colleagues, any future agenda items any Public Comment . And seeing none the future agenda items are closed Public Comment and adjournment. Were adjourns december 1, 2015 good afternoon, the commission will please come to order and the secretary will call the roll. Commissioner [inaudible] commissioner karshmer. Approval the minutes of the Health Commission meet ging. Motion is in ord orphthe apruchbl the minutes. See moved; and is there a second . Second. Are there corrections to the minutes. Hearing none well proceed to the vote. All those in favor say aye. Opposed . The minutes are passedue naninously. There is no Public Comments for the next item [inaudible] good afternoon commissioners. Today is worlds aids day and there are lots of events going around in the city, but just want to acknowledge because it is worlds aids day and [inaudible] who has stay would the department for i believe over 20 years and shell tell usill have her come up and say a couple words. She doesnt know this yet, Tracey Packer is the Program Director fl for the San Francisco aids foundation is a incredible leader in the aids field. [inaudible] where there was no treatment so as we moved in our medical advances she is leading in bringing that prevention and treatment together so want to bring her up for one minute and give her a hand. Please correct me on the number of years you are with the department. 23 is a half. Thank you very much everyone. It is true you become the pract director . Senior director of [inaudible] it is a very exciting opportunity because i think we will get to 0, the San Francisco aids foundation will support that and the programs i will over see are 1035 market. Those [inaudible] i think it is a exciting time. Thank you for your commitment and your entirewe look forward to the work. She is not leaving us and know she phone call away from me. [inaudible] thank you very much for your services. I also brought [applause] there have been articles in the paper about needle and Syringe Access Services and the department as big leader insuring people have access to clean needlesx clean needles to save lives. The consequences is there is little to that issue and we have a great person in the department who is working at this with other partners in the department where we do have partnerships diz poles of syringes so would like to ask [inaudible] to come up and give a overview and take any questions since this is a emerging issue in the papers. Hi everyone. So just to give elean lockren and work in the community helths health. I work with our funded syringe access and disposal program. So, in response to the issue around discarded syringes, we are utilizing several mechanisms along with our programs doing heightened education to the clients that utilize the programs. I also work very closely with other city dw apartments, Police Department, the supervisors and department of public works to get a handle on the discarded syringe issue. Things we are working on in our branch is towe are in the process of hiring and working on developing a Rapid Response onse team and what thaet team will do is be in the community squurking up cleaning up the discarded syringes in real time and engage with drug users and emphasize the importance of safe disposal and be able to provide resources and referrals. We recognize the problem and that is why there is multiple strategies and we are really looking forward to actually this coming here because we have not only the Rapid Response team, but also other ideas in place to address the issues such as Community Clean up events, additional partnerships. I handed out a handout that all you have. On one side is a map that shows our outdoor disposal boxes we throughout the city. Most of them are placed in the tenderloin and it is based on need. The way we assess need is from 311 data reports and also Community Complaints and calls [inaudible] then we go through a thorough Community Process to get those placed. On the other side where it shows the visual, that shows all the Different Community partners we have working together on this issue of discarded syringes, so it is a collective impact approach of addressing this issue together. Are there any questions . If there are questions for ilean commissioneri guess one question is, you selected a number of places for these, but are thereis there a way of understanding that or are you already know from collection that this is widely known and used by the community of users, or do they offer other suggestions . I think the papers indicated that there were other areas outside of the immediate downtown, right . Yeah, the way we get the assessment or boxes is i get regular reports from 311 so i look at the number effcalls and go to Community Meetings and Police Department Community Meetings and that is how we got the placement of those boxes. A lot of times i get a call that we need a disposal box but after a assessment and using the data it turns out it isnt a hot spot per se but it seems like there is a situation that came up and we can address that by sending crews out to do sweeps of the area. That might beif you think back on battery turnings, some of the pharmacies take some of these. Have we thought of pharmacies being a deposit point for these or are they willing do so . Wallgreens accepting syringes. If someone returns a disposal ben of up to 1. 25, wallgreens will accept it and give a empty ben. All the syringe sites take back dirty syringes and give out either a disposal ben or a lox like this called a [inaudible] this is perfect for someone who [inaudible] because it can easily fit in their [inaudible] and holds 20 syringes. So, [inaudible] would you actually be listing wallgreens or is this not for public this particular flier is just for Community Meetings but in a different flier that we have for participants of the syringe sites we list out all the different places they can dispose of syringes and wallgreens is listed on that commissions any other questions you might have . No we have relationships with the Fire Department for restroom access and maybe we can include the Fire Department on this list. I think people may be more likely to go in the Fire Department. That is a great idea and something that is own the list of trying to expand our relationship so i mean that is great idea and think that we should move forward with trying to expand the relationship with the Fire Department and other first responders. Do clinics have these too or not . Clinics are disposal sites and that is listed on a flier for the clients, but we didnt put disposal boxes on that in particular. Do we know exactly why people dont use the Disposal Services and is there a reason maybe they need an incentive like we do with refundable cans or what not . That is a good question and one wree discussing internally a lot. In the next few weeks we will have focus groups with injection drug users and they are the questions well ask of what is not working and what can we do to help us come up with ideas that will be more effective. Anecdotally, i think it seems like people are getting moved around a lot so they leave their packs behind or drop stuff andbut you know, education about proper disposal is a key component of the service. I think what we are working on internally is that our Syringe Programs have more of a system that ties the board of education process of like every time you have the one on one of like, do you understand the importance of proper disposal and the mechanism for proper disposal, so we are working on enhancing that. Is there a downside of having hundreds of these disposal boxes . Eightyone one of the challenges with outdoor disposal boxes is we found it takes a good 6 months before people start using the boxes and there is always differentsomeone may not cross the street for whatever reason, so no different than using a garbage can, if you walk down the street to through it away it is easier to toss it. There may be a downside for having lots and lots of them, but if they are ubiquitous it is easier to not just drop them. I think a challenge is that in placing the disposal boxes we have to get a Community Process and community input. That can also be the biggest challenge because while someone may support disposal box, they dont want it across from their house or their neighborhood, but we areit is ongoing conversation about increasing boxes. It is just whether or not it goes throughit meets the criteria and goes through the different mechanisms to get placed. I was going to ask if infact there is a optional unit now, mobile unit or 2 and there sole function is to go throughout the city when different calls request for service pertaining to this areaas a example it says park and rec and syringe clean up, but let me tell you, the movement of people. You go out to the park this morning you will have more than 20 tents out there even around the play ground and conservatory and aaround the academy of science. [inaudible] move people when activities move and the same time when there are functions that park or in the communities [inaudible] there are different activities a lot of the next day or that evening i have a number of syringes and other things close to Buena Vista School and Rafael School and you get complaints from the teachers and they are afraid to work through and call 311. We have like one or two units and the major function is work the pick up and educate at this point. That is something the Rapid Response team because their sole function is clean up syringes and provide that education and that is what was miss ing before. The funded providers all do sweeps of syringes and in our office we respond to calls as well but it is not our sole function so i think having this team of 3 out there and being able to be proactive and respond will make a difference, because one the challenges now is if you see syringes on the street and call 311, it can take up to 2 or 3 hours to pick them up. Commissioners we hope we will be hiring as rapidly as we can the 3 individuals on a temporary basis and annualize that in the budget and maybe have to grow that team if we see they are very busy during the time period we have them on, so this is a Important Team that we just put together to respond to this issue. Well give you an update as we see that. It is dark side of a very Successful Program so i look at it as somewhat of a blessing we are having this problem. We know clean needle distribution saves live jz have to deal with the outcome of that by insureing the public hasthere is concern for their safety fraurm dirty needles so hope the Response Team is part the solution but scr lots of partners helping as well. Thank you very much. Look forward to the update but the department is moving forward to respond to this issue that is in the papers recently. Shall we move to the next item . Yes. Item 4 general Public Comment and i received no request so we move to item 5 which is report from finance and planning committee. Thank you, in place of commissioner chung and was privileged to chair it with commissioner pating and we went through monthly contracts report and are reviewed that and are prepared to ask you for recommendation just as a brief discussion, our San Francisco Community Health authority is asked to continue to administer the Healthy Kids Program and well provide the private providers which is the second contract. The third contract includes not only administrate was services but developing the subcity Program Infrastructure for our program that we had voted on the bridge to coverage. That amount of money is not just merely for administration of healthy San Francisco, but the expanded healthy San Francisco and the covered options that we had passed under the bridge to coverage program. Lastly, is the contract for the regions of the university for [inaudible] care of the amount of 2. 1 million which is the same amount that we have set aside in the past and it does serve about 800 Different Services for us per year. So, for those services that we dont have as of general. We reviewed the year revenue and expenditure report and we are positive the First Quarter. It is only the First Quarter and mr. Wagner pointed out the big unknown will remain. The 1115 waver formulawe are scheduled to get a update on that in the early part of next year, but at this point in time they are continuing to use the same formial through the rest of this year through december. I put into risk for the second half of the year, the first half of the year, the First Quarter is what was estimated at this time. The third item that we took up was a review of the San Francisco annual report outline and well look at that and have added comments. Lastly, we are in discussions of updated the contract review process. We are very pleased that under the new process that we are able to actually be more diligent on the large contracts to represent 90 some odd protect of the contract dollars and yet we will be able to have a list of the other contracts and understand those services. So, our recommendation on the consent calendar is to pass the contracts report. That leads to item 6 which is the consent calendar. If there are no questions in that well move on to item 6. We are prepared for athe committee put forth the proposal for the passing of the 4 contracts so we are prepared for the vote if there is no extraction of the items. All in favor say aye. Opposed . The consent calendar is approved item 7 is getting to zero update. Doctor good afternoon, [inaudible] direct bridge hiv which is based in the helt department and the Steering Committee getting to zero which is a broad consochium of [inaudible] working to get to zero hiv infectionsjust looking for my slides. Here we go, zero new infections and zero stigma and discrimination. Today is World Aids Day and we made substantial progress and appreciate you inviting me back to speak. So, i thought that i would begin by saying where does getting to zero fit in the Strategic Plan and it is how [inaudible] item 6 on that graphic of the Strategic Plan, but we do also have impact on our others in particularly the issue of black African American health because African Americans are disproportioninate ly effected by hiv throughout the u. S. And San Francisco is no different but we are doing better. I will show briefly updated slides and i wanted to remind that this beautiful annual report that susan sheer who is sitting in the audience who heads the [inaudible] group she and her team put out year. If you would like hard copies we can get your hard copies and it is on the website and it has Interesting Data soben that wants to dig into this in more detail, if you like hard copies let us know. I believe i may have shown this at the summer meet ing which shows we are at the lowest number of new diagnosis in 2014, [inaudible] and deaths living with hiv [inaudible] the death rate is lower. This is new diagnosis by race, ethnis te. This is the total number of new diagnosis per year from 2006 to 2014. The blue line is white individuals, the nob nub line is black individuals and you can see there is a significant decline in both groups. If you were to adjust this for the size the population, however, again we still have a disproportioninate impact on African Americans and latinos. The good news is that in 2014 we only had 14 new diagnosis in women so we are making headway in most populations but still have room to move. I showed woe had 177 among People Living with hiv. What you see is the decline in blue on deaths among that population that are hiv associated that are caused by hiv and non hiv deaths in raed so we tremendous progress in the hiv associated death. I want to show the non hiv causes of death over time and point out the green line is drug overdoses and the purple line are suicides. Both of those are increasing and so we are doing a very Detailed Analysis now of what has happened with those individuals with drug overdoses and suicides and be happy to report back to you if you would like to hear about that the next time i present, but again, doctor sheer and her team have been doing a fantastic job of digging into the data. Is that [inaudible] or opiates . It is both. It is both. It is methadone, it isit isnt heroin, it is methadone, senththeticopeoids like oxy conten and different kinds of stimiants and it ask also unfortunately benzodiazepines. In the green line is San Francisco. I dont know howthey ratio up differently on your handouts. The middle line is california and the yellow line is the entire United States and what you can see if you start with the group infected, we only have 7 percent of those lichbing with hiv in San Francisco who is unaware of the infection. We are doing better receiving care and prescribed [inaudible] and viral surepress so wree at twice the rate that exists in the United States but still have room to move, so i wanted to then talk very briefly about getting to zero initiative. Preexposure, [inaudible] these are brief updateswe have now prep nav gators at 3 dph clinics and dh money allocated for nav gators at Community Clinics will be announced this month. We got a 1. 9 Million Dollar a year grant for 3 years from cdc under doctor urgone and doctor phillip who are heading this effort for prep scale up and out reach particularly with emphasis on people with color and transjnder individual. We are dog doing a lot in building capacity and building awareness and building a tracking system to measure impact and well see the first data from the tracking system after this worlds aids event. Rapid has been shown to make a Significant Impact on time from diagnosis to vieral suppression and a protocol is developed and implemented city wide. In terms of retention and quer the same cdc grant had nearly a Million Dollars a year for retention. I think you aware of the [inaudible] grants given of 500 thousand dollars specifically for retention nav gators that are in the field and we are looking into the data on oferndose suicide and deaths. We will never get to zero without dealing with thes issues of stigma and disrimination so we have a committee that is formed that has a plan in place. I willthese are the collaborations i know we are short on time so dont want to take time away from other peoples presentations but just to let you know there is a fast track city that is highlighted on the website. Many peoplemany cities are signing on, our mayor signed on to it, we are the furcher north American City to be signed on to this website so we have a lot to be proud of. Are there questions i can answer . Thank you. Commissioners, questions or comments . I do think since our other fellow commissioners are not here if we can get a copy of the hiv report you eluded to that is helpful if is hot demand this year. It is a beautiful thing each year so glad it is getting so much use. [inaudible] so proud of this initiative and what we accomplish. I still share with the visions that dont believe it and say you have to be kidding. We are turning the [inaudible] the possibilitiesbuilding a sense that the amount of what we accomplished and the number of heads that we still can turn with this is amazing and the response i get where people see what is possible is more than amazing. They get very excited for us and our nation and thank you for leading the way. It is the whole department that has done this from the beginning and under director garcias leadership. We are partnering now with alameda county. Could you on the slide of the hiv [inaudible] 93 percent where diagnosed and aware we had 69 percent under treatment, so what happened to the other segment . Is it lots to follow up or is there opportunity there to be helpful . Nationally that is the biggest drop off. For people that are newly diagnosed, it is like 83 percent i believe who are linked to care within 6 to 9 months and are working on making that better. That is points otrapid. The issue is getting people to stay in care. When they get into care all most everyone is in treatment among the people in care, but the challenge is keeping people in care and so this is representing all of the people in San Francisco living with hiv. I will say there is a underestimate because there are people that moved out of San Francisco. This is a great example of collective impact and the fact this is in the long haul, this isnt a short term that the department is part of this whole agenda for a long time and it is exciting to see it pay off. Y i want to recognize Susan Phillip and susan sheer and Tracey Packer, they are working diligently towards this effort. Very good. Thank you again. Commissioners, item 8 is std update. There is no Public Comment . Not for that item. Okay, next item. Good afternoon and thank you commissioners. I am Susan Phillip director of disease prevention and control and std controller in San Francisco and want to thank you for inviting me back to speak with you again about std and glad to do it on World Aids Day along with my colleagues doctor buck binder and all the others we work with closely. This is the same framework. There is specialized expertise with std that resides [inaudible] we have the biomedical std clinical work as well as work with clinical providers and disease intervention i control which i lead and then we have Important Community engagement and assessment eeffort that are happening with the [inaudible] branch led by Tracey Packer. If we lookthose are the specialized areas but where std prevention lies . It goes beyond that throughout the department and community och providers and everyone at risk in San Francisco. If we look at the cross utcutting efforts std work is important in black African American health, mu turnl and adolescent health and health for people at risk living with hiv. When we think fwt std we need to understand what drives transmission of std and any infexs disease because if we understand the factors then we taylor or nrtd ventions to group together to address any of these. If we take the example of infexs syphilis, the likelihood of transmission has todo with several areas. One is how likely is someone exposed to a infexs partner. Those can depend on what the local std epidemology is, how privilege are the infections and what is the sexual behavior people are uner taking and screening and treatment that this includes notifying partner and getting preventive treatment out to people. We also want to impact how long a partner might be infexs and screening and treatment is the primary way we are addressing that. How many people have partner jz sex with partners without condoms. Factors that influths that are how accessible are condoms and it goes back to sexual behavior and do People Choose to use condoms if they are available. What we are trying to impact is the population curfb. What are the std rates and how to bring them down and i showed them to you in the past so i want to take a step backthat is what we care about, but as a department and a branch within a population health, we also need to be aware of and work on quality and improvement on the factors that we do control. This is looking from 2010 to 2015 at the speed with which we initiate internally contacting a person who we are notified through a laboratory provider has a case of infexs syphilis. The standard is contacting within 3 days. That is the red line and you see we increased from over 50 percent to 94 percent which is good but we can do better. We are focusing on contacting within one day because sooner contact is better. It is fresh in the mind and may be able to remember part ners and show there is improved ub89 ability [inaudible] we are focus on contacting with 1 day and up to 78 percent and will try it do better than that and try to get that to 85 percent. This is a internl performance measure to work on to contribute to the larger goal oof decreasing stds. I will turn focus to look at a couple populations that are of highest priority because they have disproportioninate risk of std and the first group is men who have sex with men. This is a similar relate today the slide you saw earlier. Superimposed hiv and std curves now. The gold bars are hiv diagnoses and they are declining. Superimposed are the std rates for gonorrhea, chlamydia and syphilis. What is true is std and hiv are very much linked in a couple ways. One is it is critical to understand the std work is essential to getting to zero work and thank doctor buck binder for the acknowledgment of work for the peoplet thado std function. One way we know from our epidemiology and colleagues around the country having infections, particularly rectal like gonorrhea and syphilis and chlamydia [inaudible] a person that is hiv uninfected those are the people we want to perform hiv testing on and if they are positive get them linked into car and if negative we should offer prep. The other effort is Partner Services so for infexs syphilis we attempt to interview all cases and interview the partners. Those people are offered hiv testing and this is a wiwe do case finding and integrate Sexual Health services [inaudible] the biomedical advances that allow us to get to zero, also will allow people at times to have sex without condoms and have seen that is reported in surveys over time there is decrease condom use so at the same time the biomedical advances allow decrease in hiv there is decrease in condom use. That is true opprep but primarily true of prevention that are hiv positive. [inaudible] as a result we need to think differently and think about new approaches to decreasing stds because the old advise of using condoms for hiv and std are nolt always applicable. The decreased condom use is reported, but we do need to increase our efforts to promote condoms, understand when condoms are acceptable and make sure they are available and reinvigorate the conversation around condoms. This is important to understand this isnt something that is happening in San Francisco in isolation, it is happening national and throughout california. We are on the leading edge of this in large part because of our success with biomedical miv re prevention. The rest the country is looking for us to lead this. We are working closely with cdc and partners throughout cities and state and the Nation Coalition of std directors and are looking to for our input. We are invited to tog about our spaerns at National Panels and we are one of few cities invited to present at a syphilis consultation at cdc next month. Because we dont have prep for std and vaccines but we very much hope thaes become available in the future we have to fall back on behavioral intervention and Sexual Health behavior. Using condoms and working us to notify partners. Those are the key things that will lower rates and will take new expertise and be anal to understand how to motivate people to do those things and how we can make those activities easier. Make them the default. We will engage with a [inaudible] and they will build on the work we have done with focus groups and town hauls. Summaries were in the background materials. We understand that this engagement work andmunity activation work and feedback will be the key for std among gay men. So, some the new actrivties and the groupings here have to go back to the slide to show what the key interventions would be based on what causes infection to transmit in the community. We want to have this behavior come on board and anticipate that will happen in january is whatory target date is. We are thinking about new condom education and std education campaigns in the First Quarter of 2016. In terms of decreasing time a person is infexs we continue to do base line efforts and supporting San Francisco aids foundation at magnet and other sites and increase Community Base screening by the [inaudible] brarn that happens where people congregateer bars and gyms. How do woe get people to think about increased condmom use . Some hof that work is done with Community Engagement and town halls. We will try to coordinate with all the efforts happening around getting to jeero including the cdc grant doctor buck binder mentioned. [inaudible] leverage of new dollars to think about Sexual Health broadly and includes std [inaudible] and do retention and hiv clinical care. Here is a quick post thorf town hall we had in july to give their input of what we can do better. The second group at highest risk are young women particularly young black African American women. We are thinking ways to decrease likelihood of exposure. Some of this is overlapping and will try to leverage but the messaging has to be slightly different because the communities are not overlaps and want to make sure twee are relevant and culturally comprehensive. So, in partnership with San Francisco Health Network [inaudible] is a really critical piece of this and the [inaudible] in just a moment well hear more about that. To decrease the time is a person is infexs we want to think about a pilot and one way is home based screening that way they dont have to come to a clinic and increasing condom use. [inaudible] focus groups and particularly town halls and try to do parallel wurb with behavioral hemth consultancy in order to really understand what the needs are and what the key messages might be and where we can assist and provide information. Ill turn it over to my colleagues doctor bennett who is a board satisfied pediatrician and interim medical director for [inaudible] foundser and exectev director of the [inaudible] okay. I think we have 7 minutes, so im going to let myself be very brief and let you expand me with question because that i think will maybe get us out of here in a timely fashion. There i go and i learned how to use it. Our goal is all the 15 to 25 year old women in the city will be screened appropriately so not just testing women who are symptomatic but women who came with a cold and havent got screened will get screened. The things that underlie that are somewhat different dependent on the clinic. We have youth spinge clenics that operate different thanly the childrens clinic mpt the questions are the same, the answers may be quite different. What are the current screening rates . Getting data from the emr to work with data from city clinic and making sure we are aware who is infected and due to screening. They were not as simple as you may imagine and work on it and hope within the next few weeks we will have good baseline data. Susan ask i have for years have some collaborations from site to site but how can we do a better job around these issues to have every clinic have good robust reslaigzships with population and who they are screening and are there resources to ugment impact of screening and letting them know they are infected [inaudible] will people be able to use condom and willing to use them and what are the behaveer and resources in the communities that change the diseases [inaudible] that isure cbos and schools and there are other actors in this outside of this. So, our first steps are coordinating with planning planning and preconception helths. [inaudible] is director of Family Planning. The title 10 program , office of Family Planning with state have a intense interest in chlamydia screening but those services are not necessarily coordinateed well with the clinic so suvon, myself and susan hopefully will be the Network Prevention and population and those programs together to talk about a coordinateed approach. We get the baseline data in the next few weeks to month. We are looking where we are doing well. The youth Testing Centers have a higher testing rate. There are fewer competing issues in the health of the population. We are not trying to do this as well as Diabetes Care but they developed more robust [inaudible] we document what those are and trying to create some solutions to the barriers or ways those practices can be operationalized in other places. Part of that is doing pilots on how to improve testing and make it easier. Is that giving a testing packet for something at home or picking up at wallgreens or rapid [inaudible] do their sample and drop it off as a Wellness Center. We will test all those. Third street is the ink baiter and that is in place before i got vauchbed and will take time but we hope as we move through had process we will approach clinics to look at their individual issues and offer them a menu ways we know we can tweak the system to make them better at completing this task and let them know the standard we expect them to get to. That is the [inaudible] brauject. Those pilot projects and there are several we will try to get done, we are not sure which will work, maybe they wont send in the mail and get them in the drop off and be incorrectly collected. We will have to work through and see what will work and then we will know what we can offer. Any questions . Are you done that is susan continuing. We need to same biomedical prevention like we have for hiv. People have said we are not worried about std and worry about hiv andinate others. We do worry because there are cases of ocular syphilis and in seattle some have permanent visual loss. [inaudible] the great work that is happening for treatment but treatment is expensive and dont people to get these infections if they dont need to. We need it think about advances and are on the forfront of that so we need vaccines and rapid tests for stds. We need prep for stds and we dont have that now. We need condoms people want to use. There are no advances in condom science in the entire condoms have existed and need to be at the forfront och all that chblt we vagreat resource here in the department here and that is sit a clinic. People want to come to us to test new treatments and new diagnostics and work with those areas to try to advance for the people of San Francisco so we are grateful for the staff and the patients that come to try to get treatments and diagnostics. City clinic is at the forfront and are trying to do std prevention and have great partners like doctor bennett and the rest the network and leadership of director garcia, i think we will make strides in this area, but there are challenges as well. Thank you and either of us are available to take questions. Questions . What is the timeline for the [inaudible] please come to the like mike roophone. The larger project the timeline will differ from the other focus areas. For ours we hope to get through the pilot phase and document the best protects thaz youth clinic in the next 4 to 6 months at the most and over that time talk to the larger clinics but what their barriers are so we can start looking at implementing some type of intervention towards the later part of next year. Some of the ideas will also test out with the men who have sex with men earlier part of the presentation . That type of overlap. What we really want to do is get the Behavioral Health consultant expertise to help us understand whatyes, that concept of pilots and trying new things is important but we want to know what we should try and where to put the emphasis. We are trying to [inaudible] making sure we have screening and emphasize condoms and what would help turn the dpurfb with stds is help the community inform us. We have a lot of hope because this is a community that turns hiv around in San Francisco and think 23 they put their mind to it and commit to it we will be able to achieve the goals for stds as well. Commissioner sanchez, i think it is a excellent report and follow up. I justone area that is always a ongoing challenge and that deals with 15, 16,[inaudible] founded child abuse and had integrated services in schools there were a lot of misconceptions about where the cohort would be and at that time we had military basis around and one of the initial studies done the largest cohort was children of ranking military officers. These were some of the cohorts that were brought to the center and a couple folks at that point and who started the program and it was shifted so forth and so on, but when you deal with this type of information and protocols and whatever, especially with our unique populations and many refue gees coming. It doesnt matter if you are irish, italian, latin, we have to be aware and respectful and at the same time provide some or think about how could we if we do get something on the radar how do we make sure there is a positive intervention protectingstill make a positive impact for the community because it is tough and it is really hard because of the uniqueness of our communities and as you said so well, the different cultures within the communities. A lot of the communities are no longer white and whatever, they are diverse as they have always been but the community shift jz gives the schools and Health Clinics that are very very necessary another unique eye to look at how kids are being treated and what we can do to provide interventions if requested i think that is why we are trying to be flexible and keep our cbo partners, the schools and other people in the loop and as part of our response because that immigrant child where we have confidentialalty issues and what the family thinks they are doing, those are kids maybe we should contact at the school in the Wellness Center and dhat is the only way we have contact with them. The traditional age use have other issues where they have access. It will be have to be tailored to the population in each clinic but that means people have to be nimble and know their options and now i dont know if we have a good enough menu of options to be flex b89 ability. I have so many questions but i think what ill ask is we heard this at the Community Population Health Committee but may ask we come back sooner to get a more details assessment. I have always known std issues are important from a Public Health perspective but relative scale of overdose obone end and getting to zero on the other, the community thought is my hiv is being treated, so stds, what does it matter, i can get a pill and take my pen sellen and be back in the game or community so where think it is falling off and messaging is important. I want to ask if you can speak to the importance of this a little clearer and secondly what is your thought about our ability to flatten the curve. I guess i want to ask specifically with regards to msm is rising and probably related to hepc, but what about with African American women, is it rising at the same rate . We are on a down slope, it is not helping to decrease the disparity greatly because everyone else is on a down slope. Young African American have quite a peak. There was quite a peak that is coming down but that gap persists regardless. Yes, there is some improvement, it is not rapid enough. [inaudible] African American women there is a big disparity there. Terseiary syphilis and gonorrhea and in infants [inaudible] are we seeing a lot of sequelae or do those come down . We are not seeing a lot of sequela in San Francisco. Syphilis is not primarily in women, it is ovwellmingly in men. We have not had a congenttle syphilis case since 2009 to 2014, so the sequela are not as apparent. I think doctor bennett was saying the disparities are so striking and even though they are coming down it is unacceptable disparity and the fact it is associated with public infamitary disease and [inaudible] women ithis age range so we want to make sure we follow those and pay the most attention with the groups with the highest disparity and here that is African American young women as in the other parts the country. I also think sequela [inaudible] that person by the time they are 20 are flirting with a life of infertility at a time in their life where that doesnt seem important but will seem more important at 30 and that is true of the added [inaudible] of hiv and other sex wale diseases [inaudible] women getting hurpys and hiv those are not as dramatic and interesting and dont trickle to the community to add lat level of fear. [inaudible] so many at risk behaviors it seems this is worth while. Reducing stds and reducing Everything Associated with that in terms of affiliated consequences and associated disease, that is why we brought [inaudible] because we integrate the project with pregnancy prevention parts the department with pregnancy access to help of young women center around a few issues that go together. Thank you very much for helping me understand that. What i would like to do because this is a very important topic we have been following for several years and at this point it looks like we have taken a number of new steps to try tobound this curve back down or continue the downward slope of chlamydia in the African American community. Is that as commissioner pattings we have a follow up to see how well we are doing or where we at the Committee Level and perhaps in 6 months we can hear futher. I think the documentation of focus groups call for a integration and with your consultant that would be something i would hope we can hear that is moving forward because the message remains the same and seems clear on the side of the men with men that they are not recognizing the importance of the stds in their lives. Those that have gone through even beforei wasnt there before penicillin but pretty close, recognize the importance of trying not to consider that these are just colds that can be taken care care of. There needs to be all that type of education and the fact you are getting a conceltant will be helpful. On the practical side they did have comments about the availability of the city clinic after hours and i hope that would be addressed and be looked rep. At Committee Level to be more responsive to the community or if those are flukes. I think you are right, a lot of people rely upon it and looks like woo can be more responsive to answer the immediate needs rather than [inaudible] some problems with the phone exchange. If i can focusinterested on the educational strategies and messaging and the other is access issues, access of condoms and clinics, access tothe relevantwhatever the key elements in the screening to detection streement. We think this is a good start that we have heard that we are taking a new initiative, bringing a consultant and work with our hiv partners where is where the sexual message will get out and using our consultant expertise to really make that as effective as possible so thank you from the committee side we follow that and will have it back at the commission in about 6 months then anddoctor garcia would you like to make comments . I want to thank the staff. We challenged them to come from a new direction and think they have done that. Particularly i like the initiative where we are using Public Health side to influence the direction of our Clinical Services and i know it takes time because of the issues we talked about that the clinics are focused on the whole person care and that is a lot of Different Services at least in the Youth Clinics we can give this a focus. Alameda county started a Initiative Like this as well so we should look to them as the work they have done as well but want to acknowledge both of their works and think we will see progress in quirking to the community. I appreciate our intimately the 2 divisions are working on this. I know this is something we are working towards and to see it is great. [inaudible] that is where we are trying to get to. One logoyou can connect one bridge to the other bridge. Be careful. [inaudible] we just had conversations about that thank you. Really appreciate your presentation and you can see that we are very interested to make sure that we can move the needle on this i very much appreciate the commissions interest. This is important area that doesnt always capture attention so appreciate the opportunity the think through this with you. Any other Public Comment . No Public Comment to this item. Due the the issue of timing, commissioner sanchez has to be at the foundationsthank you to the donors today this afternoon that we would recommend deferring the remainder the agenda to the next meeting with jour consent and is there any other Public Comment that we need to take at this time . I did not rev requests we prepared for vote for adjournment all in favor say aye. Opposed . The tuesday, december 8, 2015, is now called to order ms. Casco roll call. Ms. Fewer mr. Haney ms. Mendozamcdonnell ms. Norton mr. Walton ms. Wynns dr. Murase and ms. Chin and mr. Totiano. Please join me and to the republic for which it stands, one nation under god, indivisible, with liberty and justice for all. If no objections from any colleagues there are many members of the public who are here for the Mission Press item id like to move just that item 1511 south park one so immediately follow want student delegate report any observation lets see we want to thank commissioner Vice President haney for preceding over the last meeting i was in the unwe have celebrating want to worry about superintendent carranza a very happy birthday. Item a the approval of the minutes of the regular meeting of november 10th may i have a motion any corrections seeing none, ms. Casco roll call. Ms. Chin mr. Totiano ms. Fewer mr. Haney ms. Mendozamcdonnell ms. Norton mr. Walton ms. Wynns and dr. Murase 7 is members of the public are reminded that if you irrational 0 wish to address the board of education you need to
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