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And i think that that is something that as a city and we as a Health Department with be proud of because we are leading the way for good and really appropriate transgender healthcare and with that i actually have a question. And it is really about the role map that that you have mentioned at the end. And the providers of the surgeries and i believe that there are some conversations happening before, and at ucsf which is teaching institute. And so, creating a center of excellence through this partnership. I think that is a great question and i think that the workers working on this, and include...

California in healthy San Francisco including hiv will not have to change providers and that will give us time to look at the impact of the transition of d into c to see how that will impact them before we make the changes to that population. I just want to note that there was any Public Comment at this point and we will go on to the commission comments. I have not received any at this time. Commissioner karshmer . So i have a question about the jail, when you leave the jail is that one of those life qualifying events . Yes. Open enrollment any time. Yes. Have you said that. True, i believe th...

And i think that that is something that as a city and we as a Health Department with be proud of because we are leading the way for good and really appropriate transgender healthcare and with that i actually have a question. And it is really about the role map that that you have mentioned at the end. And the providers of the surgeries and i believe that there are some conversations happening before, and at ucsf which is teaching institute. And so, creating a center of excellence through this partnership. I think that is a great question and i think that the workers working on this, and include...

And that will give us time to look at the impact of the transition of d into c to see how that will impact them before we make the changes to that population. I just want to note that there was any Public Comment at this point and we will go on to the commission comments. I have not received any at this time. Commissioner karshmer . So i have a question about the jail, when you leave the jail is that one of those life qualifying events . Yes. Open enrollment any time. Yes. Have you said that. True, i believe that is true. That is an ongoing opportunity to enroll people when they leave the jail...

You have obviously the costly it is. So i would encourage you to really think this true, and possibly under the umbrella of the department. And i greatly appreciate that is in the alignment on it and it is in alignment with the chiefs that i have spoken to at San Francisco general great. Commissioner taylormcghee . Thank you. And clearly there was a paradigm shift in 2010 when medical cited that transgender surgery or sexual reassignment surgeries were medically necessary. So obviously that obviously helps to pave the way particularly that it relevant you lated the insurance commissioner and t...