[inaudible] off mic . I have not received mic but i would like to note that commssioner singer has to leave by six and you have a halfhour to ask questions. [inaudible] off mic one of the things [inaudible] i think also important for us to acknowledge as part of the work that we need to do [inaudible] there are a number of parameters were not at that we should be in terms of our own level of say level of activity and that goes all the way from the question of continued rising rates in the syphilis rates for tuberculosis [inaudible] but its in the data base but the process doesnt seem to allow that we would look at those as also being as important as some of the things impacting health. I mean just sort of absent all the way down psychosocial [inaudible] anything that talks about trying to address the known disparities [inaudible] off mic high syphilis rates [inaudible] and maybe its a process that doesnt actually able to acknowledge those are also very key factors that are important as we look at the health of the community [inaudible] off mic . Okay. Yeah. So identified health needs dont show absolutely every small data point in which we may not perform well. Theyre broad categories, and in the into graphics we point out some of the data points that support those and i know that as the Health Department were not going to stop working on the Communicable Diseases and we have robust programs on them at the same time when looking at death data the top killers are all chronic diseases, and so we definitely can look at the process to make sure that it is open to all of the health needs. [inaudible] off mic report card and in fact in those days determined that certain things would be objectives [inaudible] i am just saying [inaudible] medical health doesnt show up in the context [inaudible] off mic Community Health is very important down here [inaudible] so im not sure how to capture that. Im not saying this an inappropriate document for planning but is there some recognition there are other factors that are really important that are also going to be priorities for us . Right , right. [inaudible] even Health Assessment programs [inaudible] so this is a citywide Community Health assessment, and then it identified some specific needs at a city level. The next thing that is going to happen is bringing together the diverse stakeholders to come up with a Community HealthImprovement Plan that will have more specificity on as a city what areas we want to address. Now, the other thing thats going to happen additionally is as the Population Health division also develops a Strategic Plan thats even broader that addresses those things in the Community HealthImprovement Plan or chip or broader priorities so if you go back you probably dont remember but remember we have a Strategic Plan and we have a cross cutting initiative, so there is a bigger plan and the other thing to realize is that our Strategic Plan has to have some focus and specificity in terms of addressing the things that have the highest burden of disease, and so we need that for Public Health accreditation but our foundational activities never go away, so our core Communicable Disease for all of those diseases, tuberculosis, std et cetera as well as all of the Environmental Health activities so what you will be seeing is really a subset of all the things that we do but there are other documents when you put them all together paint the complete picture, but [inaudible] off mic . Yes. This is just the assessment, Community HealthImprovement Plan and you will see a new plan and strategic and again theyre high level and there are hundreds of things that the division does and you get updates through other means of std and tuberculosis et cetera. [inaudible] well, first of all the appendix is just wonderful. I went to sleep reading it and quizzed my wife saying guess how many of this in each district . It was a fun exercise and how well we can know our city and felt like a manual to San Francisco living and i want to thank you for that. No. I actually liked what dr. Argone said at this point and the chip is a subsection of the health plan and the question is how we would be hearing that data . And we can hear that at the Community Health subcommittee how the larger ph. D plan is brought up. I like the health needs. I was hoping the violence and prevention would be on the target and given were 49th or 57th, 58th county in california of violence in some neighborhoods so really glad of that and i hope the issues around homelessness are not just around housing and i see Mental Health and Substance Abuse are in there and i think thereby a lot of Integration Services when we get to the actual plan. I realize this is just the Health Assessment so the question is sorry for the prolong. How long is the plan and how long will it last . We do it every few years i understand. Its due out mid2016 and the group is currently working on it, and whether its going to be updated probably to reflect the timeline that the Health Assessment is on which is about every three years due to the alignment with the irs. So as you present the plan to us it would be nice to see things that were in previous plans that maybe we now decided we met goals or are less important so it might be success. And the new plan and going to see how things change. [inaudible] off mic part of the total programs of the department and [inaudible] as stated here and then becomes the only document [inaudible] i wanted to acknowledge commissioner chung had a question and i will go after. [inaudible] so this is like deja vu and i think when i was first appointed to the commission i had the privilege to attend a lot of the Community Meetings chip, right, the other meetings they went to were hip and i get confused with that and the chip and the hip and i want to say its really amazing. We just had the vision zero presentations. I remember these conversations vividly it came from the community as well, you know, about Pedestrian Safety, about you know like having more organic food in grocery stores, so like to me i definitely feel and think that you know like those process has translate to actual policy work here that the community was prioritizing, so kudos to you, so what i am seeing now is that were trying to build on the last plan and you know add some new policies and you know new priorities to it. Is that correct . Yeah. They did take into consideration that the previous 2012 chip that was definitely it may be reorganized a bit but some of those priorities are [inaudible] yeah. I would hate to see that we start a conversations from the beginning again, you know, when theres so much work being put into it. The question i have is youve identified language needs, you know, like spanish and chinese and since chinese only accounts for 18 of the asian populations. What are some other languages . Do you have any thought into what like languages that we need to prioritize for our communities . Im not prepared to answer that in detail right now. We do have a list of more than the highest ranking languages that are spoken in San Francisco in the appendix so if there was yeah, i dont know which table to refer you but it says the more common languages and we can certainly yeah, one other thing i want to point out with the graph of like ethnic composition i think you counted asian twice because you said api and asians. I assume that is Pacific Islanders and asians. I will be sure to check on that. [inaudible] yes, one of the things that were really excited about is because all these stakeholder come together like the hospitals, us and if you go across the country its not like this and its fragmentd and not all of this collaboration and because were able to come together with a collective vision allows the hospitals as they invest in the Community Benefits to align with this common vision and its also helping philanthropy, the grant makers Funding Health priorities that they have a framework in priorities. Were all going to be working for the same play book from my perspective is exciting and powerful and i wanted to share that with you. I just wanted to add to that and acknowledge our deputy directive colleen chela who helped frame this as well because you could have four different plans coming in front of you, and so weve did dr. Argone and michelle great work and it was awkward for the groups to sit together and they got through that and its been a great process for them and this also solves so many of the requirements for so many of the groups and as the doctor said its collective in that whole role collective path starts with the data and also the understanding of what the Health Status and thats the foundation of the department of Public Health is to assess the health of the community and i want to thank them all for a great job. Yeah. I want to thank you as well and i think its super helpful in many ways, scmi think our challenge from the plan and then to implementing it is making sure that the resources of the department are deployed in a way that reflects the conclusions of the department what are our biggest challengings, and i think its hard to do for a couple of reasons. One, we tend to make decisions serially and we get in terms of spending on programs, and we frequently have an ability to actually put it in the context of the wider spend, and this really gives us the opportunity to do that, so that we can actually go after things rationalely, and thats very hard to do in the context of so many stakeholders, the power of inertia in an organization like ours, not because anyone is equal but the reality of life and i am looking forward to the net set of discusses to see the connection of what is laid out here and how we actually deploy our resources. [inaudible] off mic . Yeah. And so i think [inaudible] off mic . Right. Then the next key document that is coming is the chip, the Community HealthImprovement Plan and will link [inaudible] off mic . Right, right, right. Exactly. May i ask in regards to the hearing, the presentation maybe presenting to the commission we could be within that cqi cycle so what were the lessonsern laed in the last plan and the last assessment and tying this presentation in and saying where we ended up and Lessons Learned and what we learned and new changes and add to the continuity and this isnt a new assessment. You have been working on these issue issues for a long time and in the historical sense and refresher and given the complexity of your capacity to solve these problems. [inaudible] thats my pet peeve almost in every report is i understand that sometimes because Transgender Community is not large enough to make a significant, you know, like data point in these datas, but it would be helpful you know at least as an explanations why when we look at you know different Mental Health and all these other physical health, its only being categorized by male, female and not without articulating the reason why some are being left out, yeah. Yeah. We can better know definitely in the Sexual Health section and other relevant areas where we have omitted data due to data stability issues. But i assume this problem will self correct later on in time with aca implementation and within other Data Collections were doing. Yeah. I hope so and i want to note in the Community Engagement transgender was one we reached out to and they participated. [inaudible] off mic . Oh in any instance where we had zip code data we didnt place it in the neighborhoods as you theyre not mutually exclusive but we presented that as zip code data and neighborhood data would be at the census track and rolled up evenly into neighborhoods. If we created neighborhood profiles we would definitely if we translate the zip code data into a neighborhood we will provide you that. [inaudible] off mic and depending where they live and what it was i mean we werent sure what categories we were in, and i am in east valley or castro or market . Maybe its just the map we need to find out how you draw these. In addition a key to the map and cross referenced easier. [inaudible] got it. Sure. Sorry to make this go longer here but commenting on that particular draft it is such a useful tool. I can imagine from a Research Perspective and citizens perspective and wont remain static and some of the state data systems its open and you can do public queries of that data base and by zip code, hypertension rates and stress rates and alcohol rate and if youre doing research on an issue a Wonderful Public Service tool. Getting this on real time server whatever quarterly intervals you could update it. Its such a wonderful tool that i hope you continue to make this Data Available and if we could make it real time it would be so much better. I am very, very pleased. For me that was worth the price of the report was the appendix you produced. Yeah. Its definitely in our interest to go from the report format and something more interactive and as we involve yourself. [inaudible] commissioners and because we have a lack of time i am suggesting that you all take the rest of the categories and report out. There is no reporting except for item 11 and postpone that until the next meeting. That is fine. Is there any objection . So motion for adjournment is in order. Motion to adjourn. Second. Second. Okay. All in favor of adjournment please say aye. Aye. All opposed . The meeting is now adjourned. [gavel]here. Good morning, everyone good morning isnt this a Beautiful Day yes. Im adrian the executive director of the office of Civic Engagement and immigrant affairs and were here today to celebrate the fifth anniversary of Community Ambassadors program and all the people that made it happen so were very fortunate to have a number of vips well announce them as we go along the Program First of all, were fortunate is mayor ed lee is here to open todays event the fact Community Ambassadors was the mayors vision in 2010 to rational tense it was a that time program in 2011 and today, were so lucky to be celebrating our fifth anniversary would you please join me in welcoming without the fact Leadership Vision and support of our dear mayor a police welcome mayor ed lee clapping. thank you adrian. Thank you to the was office of civic gave me and Affairs Thank you. I want to say thank you to the various agencies that have been working with the fact Mayors Office with the live and free program that has been instrumental in being a Funding Sources and a conduit we have organs lifework selfhelp for the fact elderly addresses the Neighborhood Services our administrator is here working with the fact Community Ambassadors and welcome supervisor peskin as well come on up supervisor hell be you are newest recruits for the fact Ambassadors Program you you know as you may recall i wanted that makes sure we have been knows the fact history that the fact Community Ambassadors program was born out of a lot of conflict that occur began in the bayview we knew that has roots about peopleism safe in theyre afraid community and at this point we had a number of seniors and some them taking muni and doing the work or visiting theyre afraid families that suddenly became victims of street violence selfinterest the interviews and the aftermath and the interviews with our Police Department that were trying to prevent this from happening and with any Community Leaderships we felt in cooperation with the fact organizations lifework chinese affirmative action and selfhelp for the fact elderly a number of communitybased organizations like the awe alive and free program we felt if we can have additional eyes and areas working with the fact seniors, working with people going to work particularly on muni stops we can have the fact kind of assistance that people needs and the additional eyes and ears to prevent the fact violence if happening we had a number of Community Ambassadors that lived and worked and raised the bayview to come and work with us vufrl over a period of time they knew everyone on the street and say high to folks and they were coming to tourists and they couldnt get to a police or get just basic information how to assess 911 or p. I. And basic information and the best routes to get to home or work those ambassadors became very big connectors to ordinary people everyday to what was going on and basic information theyve become invaluable to people