meeting of the san francisco health commission. secretary will you call the roll. >> yes, i'll start with commissioner chow. >> present. >> commissioner how. >> present. >> prept. >> present. >> and commissioner christian. >> wonderful, and commissioner chow will be reading the land acknowledgment. >> thank you. it's my pleasure to read the land ak novemberment, acknowledges that we're on the unseeded homeland of the ramaytush ohlone who are the origin hab tants. stewards with this land, the

ramaytush ohlone have ever given up their space. as guests we recognize that we benefit from working in their homeland, we wish to pay our respects to elders and relatives of the ramaytush ohlone and their soverne rights as first peoples. thank you. >> thank you, the next agenda item is something we look every year which is the work done by several teams that have contributed to the welfare and health in every one in san francisco. and i guess, dr.erliquor whoever is coming up from the team. are we going to read it now? >> yes, each of the commissioner has been signed. so we can begin there.

>> wonderful. so the first award is the department of diversity equity and inclusion. >> nominated csf team program is sophia and eshekipo, i hope i didn't butcher's somebody's name. equity is our goal. sophia common sense traits humidity in her leaders approach to the he quit. and cove i can't presents a multiple committee klugmanagement board room,

expanded executive committee and executive committee. her presentations are taylored to the audience. and has challenged the commission. since the sophia joinsed the fggs director of the ddi she has partnered with all departments to improve patient safety, tips, equity driver and has increased the participation from 50% to consistent 65% and above. she has a veiled herself to

partner with resources in the hiring process as well as retention. her support is palpable, it's not related in the equity metrics but a better understanding of the difference between equity and equality. as a data analyst, satisfying of the data and teaching and driving performance improvement with the information claimed from the data and assist in setting up the harm dashboard. both are believers in the commission, values and are deserving for the recognition of the continued work to

patient ans and staff. >> give them a round of applause. thank you. >> thank you, and now commissioner dirando will read the staff experience. yes. >> the group that i feel essential to the functioning of the wonderful staff. deserves the award to enhancing healthcare staff well being, reducing burn out and fostering a supportive and innovative environment through initiatives like wellness wednesday at therapy, and gratitude mounds relating in improved resilience and satisfaction among our healthcare professionals. their creative programming has had a positive impact on staff

and by extension patient care. this team's dedication and compassion, are truly exemplary and i'm going to add, absolutely necessary. >> and now commissioner chow will honor the cola vendor team. >> yes, the lavender team is necessary in many hospitals. they allow zsfg to help with burn out. health worker burn out harms all of us, but our code lavender team is there in a

compassionate way in the immediate aftermath of events in the hospital campus. this is a program that activates a harm team to hospital departments and unison that is focused on supporting the staff members at zsfg. the program, our staff members receive support during a trying event such as a patient death, severe injury or worse case of violence. because they're a wonderful example of this the dedication of our team members, by showing not only to our patients i think it's a wonderful idea that we have a team that supports our own staff that delivers that care to all of our patients. thank you very much.

>> and i have the privilege of honoring the women's center which is dear and near to hi heart. the women clinic team has provide high quality abortion service to see our patients and advocating for women's access which is so important now in the post op era. it's gone above and beyond to ensure that women have access to safe and comprehensive reproductive services, they even traveled to kansas where they provided care in sometimes hostile environment. this level of dedication to access to reproductive healthcare has been recognized by national organizations. furthermore, i would like to highlight the contributions of diane green, received a mcer

arthur fellowship what a recognition for her study the turn away study, sheds light on the cost when women lack access to apportion services. with her contributions has played an instrument al role in advancing our understanding of real world impact of reproductive health access. one achievement of this team is founding of the complex family partnership which aims to ensure that abortion are component of obgyn training, shaping and pro moteling the essential role abortion services in women's healthcare, wonderful. and the last is psychiatric emergency services team. for that, we will hear from commissioner christian. >> thank you, it's my extreme honor and pleasure to read this

award today. obviously psychiatric services anywhere but in our city, particularly are so fundamental to assisting san franciscans and people who are visiting our city, some of our most vulnerable times. and the times that we all need, we all would need amazing, the amazing assistance that we get from our staff at san francisco general, so i'm pleased to read this award. the ffcg crick room pes compassionate and efficient care. demonstrating parallel dedication, the team of psychiatry staff and providers delivers time intervention and patient center treatment plans

fostering an environment of empathy for patients in acute crisis. with a comprehensive approach that has cutting edge practices, they have reduced wait times and improved outcomes serving as a crucial level with individuals grappling with psychological distress. destigmatizing health issues along with its proactive collaborations has successful promoted awareness and fostered a more inclusive and supportive environment for those in need. to redesign the standards of psychiatric care, the pes has set a commendable precedence for houses truly deserving of this prestigious recognition. and i do want to thank everybody involved for their daily work, their hourly work to

ease the pain in our city. congratulations. >> yes, thank you, commissioners. is just wanted congratulate every one who got an award today. it really highlights the spectrum of care that they provide and the rich services. and i want today honor those who have won and appreciate the work that they have to better assist our patients and to the san francisco community. >> i think we're all, just so honored to be able to honor you for this work and incredible dedication. and these teams are in deed exceptional but they're emblematic for all the work that goes on. we have the privilege of hearing about it, during every conference committee. we are really very pleased to participate, thank you so much for all the work that you do. >> before i ask for public comment, can we do another

round of applause for everybody. so folks if you would like to make public comment on this item, we are on item 2, you can do by letting me know the folks in the room, i don't see any hands here or you can press star-3 online to let us know that you would like to make a comment on this item. okay, we see no hands so we can move on. >> all right, and next is the an actual report from the general and ceo dr.erlick. >> good afternoon, president green, commissioners dr. bubba, mark, i am so delighted to be here this afternoon to present our annual report. first i also want to thank you from the bottom of my heart for recognizing our teams. you're right they're emblematic for the work that they do at

zsfg. but i want to give my own thanks to tt department of inclusion and well being team, our code lavender team, our women's option center and our pes team. they're all exceptional and it's my privilege to work with all of them. so i am here to present our 22-23 annual report. i want to start by saying, a little bit about the theme of this report and you'll see that in the letter, but the letter is on a power point slide but as i thought about the theme, i thought it was about emerging into the new normal. this is a new report that has not focused entirely on covid, and that's really a relief in some ways. and this year has also brought new challenges that are common and to most healthcare organizations in the united states and even in the world today. and i also think that we met

those challenges and then really remarkable welcomer --remarkable work in spite of those things. next slide. most of you know, who we are, at zsfg, we're one of the two hospitals. we're the only trauma st, not just level 1 but the only trauma center for san francisco and northern san mateo county and that's deticketed on this map. we're the only 24-7 psychiatric service where you can see a psychiatrist and team of experts 24 hours a day. and we're a top center due to our partnership with ucsf. we serve about 100,000 a year. we provide about 20% of in patient care in san francisco

and our population is incredibly diverse, with many ethnicity and we love to be able to do that. next slide. our mission vision and values have been the same for as long as i've been at zsfg. and our vision is to be the best hospital by exceeding patient expectation and advancing community wellness in a patient center healing environment. our values include thirst and learning. next slide. these are the numbers, there are many more numbers in the report that you can proof. but these are the highlights, again about 100,000 patients served that's equivalent to 20% of the san francisco population. so we're important provider. 280,000 plus, outpatients visits.

and these visits of course span the continuium of ambulatory care to medical and surgical specialty care. 65,000 medical and psychiatric visits, 45,000 almost urgent care visits. 1200 babies born. this is a new record for us, we're really happy about that. at least in the resent past, a little more than 2000 trauma activations and then you can read the rest of this. we put covid at the bottom, it's the top in our previous reports but it's still an important part of what we do, many thousands of vackizations and it's mixed in with a lot of other great things, next slide. our financial, interestingly have not changed a lot. we, are budget is a little bit more than a billion with a b, a billion dollars a year. and we mostly cover that are

with revenue sxz we'll see more about what compromised that. it's more than in the resent years because of the assist apartment we got from the government for covid but klds other revenue that's comes in from audit settlements. it's about 10% of our budget only is supported bit city's general fund. it's a small percent but it's important to provide the level of care and service that we provide. next slide. so this shows our payer sources, they're stable overtime, the vas majority of our revenue are medical and medicare. we do have some commercial insurance and that's mainly from the business we get from the trauma center. next slide. so, as i mentioned before, the

partnerships we have really allow us to do the work as we do. and our most important partnership is with ucsf, you can see that not only are ucsf providers provide clinical care and educating the educators of tomorrow but also doing a lot of research. there is thousand, more than thousand research awards at zsfg, more than 300 principal investigators and total 208 million dollars. the thing that is so important to know about this revent, whether it is, you know, wet lab research, basic research, or whether it is based in a clinical setting, it's all about improving care to people on our campus and a lot have worldwide impact. it's a very important reason that we are who we are and we can provide the care that we do and draw the team that we do to

our campus. next slide. the other partnership that is really critical to our work is our partnership with the san francisco general hospital foundation. this is, this, this foundation is i believe the most successful public hospital foundation in the entire country. and you can see that reflected in the money that they've raised. we separated our 150th anniversary this year and we were able to take advantage of that anniversary to raise 2.4 million dollars and that part is proudly displaced, it's our 150th anniversary, it's displayed at the mezonee in the hospital.

social medicine, many many examples. and our behavioral health fund, 500 plus has been raised and it's doing important work in the areas that you can see. next slide. here's covid, we still are providing care with patients with covid, we're still providing vaccinations, and we have been as it says on the slide, cautiously eased restrictions over the year, although there are still plenty of restrixz, we still wear masks at the hospital for example. but it is not the primary focus of our work. and you can see we had a swift response, in particular, i'm so proud of the fact that we provided the vas majority of the city m pox vaccinations, that was an important way that we contributed to the health of the community. next slide.

staff experience and wellness could not be more important at this time. you just award, accommodations to our staff experience and wellness team. and i am just delighted everyday by the things that they do, and you can see cooking classes, exercise classes, yoga, wellness pop ups. we have the s pc a every month with therapy dogs in the wellness center. it's a terrific group who is always thinking about how to make sure that our staff are well supported and happy and the things that they do everyday. next slide. two, we've talked about the cola vendor team, and there they are with the cola vendor cart. last year, you gave them award.

and the burt team is an incredible supporter of staff wellness and a really, very forward thinking, cutting edge way of, of supporting our staffing and making sure that they have the tools that they need to deescalate situations. so it, i can't say enough great things about these two teams. next slide. this year, pride hall opened. it's a ucsf building. this building was probably 20 years in the planning. it came up from the ground pretty quickly during the pandemic. and now, is a bustling center, i was just there yesterday. it's absolutely beautiful and it's a beautiful home for all to do the work that they do.

really important member of the commission. next slide. we focused a lot of attentions on nurses. we have about ,000 nurses on the campus. so we support, we wanted to support their promotion and their career advancement. as well as bringing in as many nurses as we can. next slide.

and this was a very unusual year for mild stones. it was a fun to celebrate these ground breaking programs. i mentioned for us, 150 years of care to the san francisco community on our campus. and pretty much, i think, minus 6 months we've been 150 years of partnership with ucsf. and that partnership really makes us the special place that we are. 40 years, 46, 50 years of o top, which is our methadone clinic and 40 years of the--i'm not sure what happens this year but we had this wonderful culmination of all of these great programs that have been with us for a long time. and just not really providing service but setting the bar for treatment and for clinical standards in the case of 486 in the work that they do.

there is no end to surveys at our campus. we have a joint commission survey for stroke and we had another for our skilled nursing facility. these are just two examples of the many surveys. i think we have them, most weeks of the year. but these wednesday went particularly well. it's really nice since the pandemic which slowed down a lot of our capitol work to see a lot of movement in our capitol projects. this is so important, because you know, most of of it is focused on make ing 5 which is planned in the 1960 and opened in 1972. this is really does not need meet the needs of our patience or staff and a lot of the building that we're doing and really creating nice spaces for our staff and patients.

so, wound oasis is one example of that. the seismic work, and then we have another smaller projects like the security scanner stalation in the emergency department that helps keep our staff and patients safe there. this triangle should be familiar to you. this is our strategic work and it includes the vision mission and values which you talked about before, our six equity, and care experience. developing our people and fellowship and that's the way we engage our staff on campus. next slide.

this is our dashboard on the board. you can see on the left, you can see our metrics that help us understand, you can see variable accomplishments there. it means that we were not being ambitious enough. these are the metrics that we focused on last year. we worked op our hotion last month. every year we want to make sure that the things that we're working on at the executive level sxl driving through the organization are the ones that

are most important to advance our true north goal. you can just look at this, i'm happy to answer more questions about them and there is more on the report. next slide. we love celebrateding our staff. we do a celebration every year. and we honor a couple of people who have been with us for many years and have made wonderful contributions. so, who is a neurologist on campus, they both have been with us for more than 30 years. and just, tremendous work and it was, an honor to celebrate them. we had our nurses week, our trauma month, many ways that we celebrate our staff. these are just a few example of that. next slide.

and then everything we do is about our patients, so our quotes come directly from our patients. acknowledge, the experience they had, the focus that we had on diversion inclusion. these are great examples of how our patients feel about us. nothing can happen without this amazing team, i am so grateful to work with all of them.

they're incredibly diverse and talents. and all of us are focused on making sure that we all naoet our true north goals together. is could not be more grateful to them for the work that they do, the work that they do with one another and the way that they serve our staff and our day-to-day. next slide. and this is you guys, we couldn't do what we do without the support that we from all of you. we don't take it for granted. it's truly a privilege, thank you. next slide. so in summary, we're all about continuous improvement and achieving our true goals. those on the jcc, know that every single jcc, we're talking about this, and we're in pursuit to make sure that we're doing better for our patients and community. this year we've been focused on

wellness sxen gaugement with our team. it's, it's a hard time in healthcare. and we want to think as creative as possible to support those, who do such incredible work. and we also can't be who we are without support from the san francisco community. that is very clear. and none of us take for granted that we have the support that we do from the community, not every safety net hospital is as well supported or well regarded as we are. and we understand that that's a privilege that we work very hard to to protect. and i think, that is the end, next slide, just has a beautiful photograph of our wonderful place. so i'm happy to answer any questions. thank you. >> well thank you so much for sharing this report. it's so wonderful to see all the things being done and

highlights and mild stone that this incredible institution which in deed stands out among hospitals throughout the country and attribute and wonderful leadership team. we're so privileged to work with you and see you in action. your hands, your head, your heart, it's wonderful. is there any public comment on this item? >> hi, folks in the room if would you like to make public comment on this item, please let us know. folks on the line? we are on item 3. please press star-3 if would you like to make comment on this item. >> okay, how about commissioner questions or comments. commissioner giuillermo. >> i just want to congratulate you not just this year but all the years.

and all around you, and we are very fortunate to have the partners that we have. and as somebody who is, who had many friends and family, who have benefited from the services that zsfg has provided. i can attest personally to the care and concern that zsfg and every one involved there. notwithstanding all the challenges that come everyday. and selflessness i think that shows through, understated.

and then there is another thing i wanted to thank you for. the partnership that you have with laguna hospital in helping. process without the leader ship and your support i don't think that we've been able to get as far as we have, we would have, you know, there is no doubt that, as hard as everybody has worked as the folks that we have there, we would have got it but i don't think that, i do think that the partnership was with zsfg, has made a huge difference. so thank you for that. >> commissioner giraudo. >> i want to thank you too. this was an excellent report.

and i also want to thank you and your pediatric team, especially the mdak team at the general that we have been working together the last couple of months and fighting with the state for services with kids. and your team is wonderful but also so cooperative and i really feel that under your leadership, particularly, the focus really is 9 children and the adolescence of san francisco. thank you, we're continue to go push forward and it's great collaboration and i really enjoy working together. >> great, thank you.

>> thank you. you mentioned this has been a hard time for healthcare and that's an understatement. it's been inspiring and it really does fill my heart every time we come to a meeting and see and hear about the work that you're doing. you are our local heroes and you take care of us and keep us well. how much we see the work that you do and you and your teams do. i want to thank you so much for being what you are and doing what you do. >> commissioner green. >> you're muted. >> oh there, you are. thank you very much. for the opportunity to actually

participate again in this annual review of the general. year after year and especially under the leadership it has gone to greater heights, it has achieved, i think a level of care that many of us have said, and it continues to be. the best, it's definitely one of the best in the country. if not the best in terms of what the work it does and the research it is doing. just amazing, and i want to commend everybody to appreciate this report which is now wonderful yearbook of what has happened through these years.

and i believe when it was 2 money million, rather than 1 billion dollars due to inflation. but it's been money well spent. as we can see they have has grown and, i think it's light that we have been able to give the ucsf researchers and staff a place where they can do better work in terms of describing the needs of all of our vulnerable population. it's work that is nationally known. our patients are general is equal to, best that is will

even at the highest academic center. so very appreciative of the work that i've been able to do in watching and hoping that, some of our comments could be helpful to achieve greater heights and we're look forward. so thank the entire staff in general and physicians and our nurses and the leadership. i think this report just highlights the incredible work that you all do, the numbers themselves, everywhere from urgent and emergency services to babies being born. it's wonderful to see. i know you will not say it, but i will say this.

the vaccinations for covid was by far the biggest team providing the vaccines. we're very proud with that as well. as well as research and academic nature and milestones that have been achieved. but i think where this all comes from is the dedication of the staff. i have the pleasure of going to 6m every week and it's unparallel to see how much people care. i just really want to commend you on maintaining that. >> i accept all of your kind words and we'll keep doing the great work. thank you very much. >> and extend our gratitude to the general. >> absolutely.

all right, next is the elections and the president's is first one. we call for nominations. >> if i may, i would like to speak on behalf of nominating commissioner lloyd green as president of the health commission. it is it's really clear, especially in the partnership that she has had with our outgoing president, commissioner bernal through unprecedented challenges over the last few years, during your tenure here. i am very very happy to call

you a colleague and i think because of the just professionalism, clinical expertise, and leadership, dedication to the well being and health of san franciscans, the support of the department. it is no question that your leadership as president will continue to be a steady hand for us. on the commission and with everything that is going to be facing san francisco in the future. it does not get any easier, so the experience that you have and the smiles that you bring and the ease of which you, you extend that steady hand.

i'm happy to nominate for president of the health commission. >> i second it. and before you vote, i want it make clear to you and the public, the term is a usually a year, because elections happen the second week of march. but this one will be a year and a few months. >> yes, at the end of the we'll take public comment. i guess we should take a vote. >> yes, i'll start with commissioner chow? >> yes. >> and and every one else say aye. >> aye. >> aye. >> aye. >> any nays, no nays, congratulations president green. >> such an honor and privilege to be able to do this. it's very humbling because it will be very hard to fill the

shoes of commissioner chow, ex commissioner royce and vice chancellor bernal, they have set the bar so high and i will try to come close to their leadership and the skill that they brought to this job. and it's such a privilege to work with people wefsh at the general and every one within the department of public health. it has been the most gratifying career of my career and i'm pretty hold. so i cannot tell you, working with the other commissioners, we've become dear friends, it's been, really wonderful to get to know every one and people we've never known in our lives if it were not for this commission and just the spirit na is so, pervasive in this particular department. it truly lifts up, it's really a pleasure. i will do my best to make these

meetings purposeful and to do our citizens of our san francisco proud. so thank you so much. so the next is nominations for the vice president. i believe commissioner chow. >> yes, thank you, i'm pleased to have the privilege of being able to nominate for vice president, tessie guillermo. i'm pleads because i believe when tesy first applied for the job of director, asian american health and she turned into that national powerhouse of policy for asian american health. ists pleased to have the opportunity to work with her

and her work culminating in being chairman of the largest nonprofit shows that many years ago, we selected well. we even like to think that maybe we had a small part in her success. but, certainly, this commission has well appreciated the work that tessie has done as chair of our laguna honda conference committee. we know that that has been a challenge that we're now facing for two years. and one where our staff at the department and have all pulled together to bring up healthy recertification of laguna. but tesy was there on behalf of common sense on what was needed, we were not

understanding what really could help looking at it from the public's perspective. so i think that she and president will make an excellent team for us in the coming year and a half. so is nominate tessie guillermo. >> and i'll second that. >> president chow how do you vote? >> actually, i was wondering if, you know there were further nominations before we went on to elections, just as you know, giving the opportunity to everybody to nominate also. >> i believe there are no other nominations, i'm looking at the faces. >> we're happy with that one. >> all right, so you're calling on the vote?

>> yes, i'm starting with you because you're remote. >> yes. >> and all the other in the room, all the ayes. >> aye. >> aye. >> any nays? congratulations. >> great. >> i want it thank you very much for your faith in me as a copartner with now president green. it is so gratifying to be able to serve in my native ground. since my platforms have been national and state. i've had, i think in the twilight of my years, the the responsibility and honor of being able to focus on the well being of san francisco where i've raised my kids and

grandkids. soy want to make sure that everything that we do here on the commission, and with those who are the most concerned about, everything that challenges us as a city, that we work together and so i look, i look forward to the partnership and the support of my foe commissioners and president green. so thank you very much. >> and now folks in the room, would anybody like to make public comment? nobody here. folks on the line, if you would like to make public comment, we're on item 4. is city no hands. >> all right, any other commissioner comments? all right, seeing none, we will go to the next wonderful two agenda items which is to honor

both vice chancellor bernal and dr. horton. we will miss them, we're so excited for them and we'll start off with the resolution honoring bernal. >> yes, so if you can come to the podium to we can shower you with praise. i'll read the resolution, where dan bernal was appointed in 2017 and resigned on 2023 in order to accept the position of university of california vice chancellor community of relations. where mr. bernal was elected president in 2020 after serving as president in the previous year. he lead the health commission during the pandemic and pox outbreak. where as mr. bernal has dedicated his career to public

service having served as speaker, he worked in the white house under bill clinton and department of education as congress debated the affordable act built support for the ledge by convening stakeholders and coordinating activities with members of congress. continue to serve as a valuable for short time as a value resource for congressional delegation and keep policy lawmakers with the law to protect and affordable act. and has contributed in numeral ways to manly, to many under served communities. he's an hiv-aids advocate in the oversight committee of the california institute and was appointed to the treatment and cures accessibility and affordable working group. participated as working group

for the 23rd international conference, top fundraising 7 years in a row, served as a board member in the memorial aids foundation. cofounded and served as the president in the emergency fund and served as board president in the emergency fund. lived openly as a person with hiv-aids for over 30 years, where, i don't know about but i'm starting to get a little teary, where his apathy will be missed, now therefore be it soed that we woner dan bernal for all contributions. wishes mr. bernal well in his leadership position. >> wonderful. is there a motion to approve this resolution? so moved. >> second.

now we move go to public comment. is that a yes? is somebody coming up. mr. bernal maybe step aside. every one has three minutes to make public comment. i'll have a timer. >> speaker: commissioner i'm josie iep the deputy executive of aciu, i'm here to speak later on the agenda. i did not know that my friend of three decades and wonderful public servant was being honored. i did know about his wonderful career move, glazesing, we proud of you. i do want to say that dan has always stood up for working people in this city in our state and in the country. there is not been one time that i have not called him or talked to him when the speaker was too

busy to talk to me about all the many issues that workers face across the city and across the country. and never one time that he did say no. sometimes he would say, could you have given me more than 5 minutes to make something happen. but i want to thank you publicly for recognizing him and thank you dan, on behalf of the workers of our union and the labor movement and the city for always being there for us and we rely on continuing to count on your support and congratulations. >> all right, thank you. and i see no hands for further comments. commissioners you may go ahead. >> all right, commissioner comments? commissioner guillermo. >> it's hard not to get personal with this, but is just want to first congratulate you.

on a well deserved sentencey for your service in the government to the people in san francisco and beyond. again on a personal note, having known you for a long time. and as folks that i've done on a national level, and dan you've always been somebody that seems to respond to everybody.

you would very sincerely on and i want to you know on behalf of all of those that i've represented in the past and present. your legacy, your humanity will never be forgotten. thank you. >> vice counselor it's honor and pleasure to have known you for decades, let's not say how long. but i remember when i was organizing you know the one and only protest for, on the, on employment on discrimination act. and you immediately told me, that shock.

and i'm more ced to the hospital and i'm there to make sure that etcher is taken care of. i wonder with everything that has been said so far. you are, what helps to build those bridges between us the people and those who are in washington dc. and thank you for doing that. and i'm sure this is not the last time i see you. i'm sure that you know, like, in the future, there might be other opportunities for that too. thank you. >> mr. christian. --commissioner christian.

>> thank you, it's been a minute. i think about the times of just being with you in the community and getting to know you about a year ago. and what a pleasure for me to come on this commission and become a commissioner for the health department, and how belated i was that i believe, i was able to have the opportunity to work in a forum like this. and not necessarily politics on the street. and so, you know, i'm very sad that, you are with not us anymore but i'm so thrilled with you because, i think this is, it's like, you know have been working towards this your whole life and we're grateful for everything that you've done, i'm grateful for everything that you've done for the city and for the people that we care about. and i know you're going to be a super star in the new position

and i wish you well and hope to hang out with you in about a area or so. thank you. >> thank you. >> i just want to congratulate you as well dan. we got to know each other, a lot more here in the commission. and i do remember my first, my first committee meeting of the community and public health committee when you were chair. and you said welcome, welcome to the commission, welcome to the committee. and just want to let you know that, you're going to be chair for the next meeting of this committee. and i said, well, it's good to meet you as i'm the commission as well. but also, thank you so much for welcoming me on the commission. and as well as your collaboration with--over the years. so as well.

so, i don't know why we got interrupted but, thank you and i know you've been with our political family as well. your respective of the health department working together for the benefit of the citizens of san francisco for many years. so i thank you for that. and look forward to your next chapter and the differences that you'll continue to make. >> thank you, commissioner chow. >> thank you, dan as you've often said, i associate myself with all the good comments that have been made. that does not leave any left for me. i want to say that personally i've been really privileged to have been able to have this time that you've given us here

at the commission to work with you. your work, has benefited the city, and all of us in the healthcare by being self patient so wonderful in trying to get consensus, working together so that our commission was a smooth and operating commission that was always focused on, remained focused on the important issues of healthcare for our city. and have been using of course for many years with speaker pelosi when we had the opportunity to work with you and our offices on the congressional level.

but certainly, i felt it was an opportunity and i wish you well. as a vice chancellor at the unit. and i know that, they will find you as valuable. we are losing an important gym for ourselves in terms of how we have worked under your leadership and they will now be the beneficiary of your talent and services. thank you dan and personally, you know, best wishes for a wonderful future career. >> dan, thank you. thank you, vice chancellor. i just want to thank you for your for your, leader ship, going back.

and we're going back so many decades with regard with h.i.v. where you're such a leader in key in bringing the san francisco model to the work that happened at the federal level that saved many lives and then the work that you did with the affordable care act. and most recently as another health commission during a very challenging time starting in january of 2020. i think that's a few months after you became president and after i was here. i speak on behalf of the dph team. thanking for your kindness.

so please come up. i'm going to exercise presidential privilege here and say a few more words. >> we're grateful for leading this commission during these unprecedented times with covid m pox and you brought all of your resources to the table to help every one. and i don't think we could have moved as quickly or accomplished as much without your leader ship. we're so thrilled that you could have gone to the institution that you feel saved your life and you'll be able to help others and save others lives, it's remarkable, you've been the voice of the people without a voice. and you know, i, i had the privilege, there had to be a hearing because we had voted on

ucsf contracts last year and they had to give dan a waiver in order to take the job at uc. and i know dr. director wol fax and i had to listen to two hours of over 30 people testifying about what a wonderful human being we have before us. i'm not talking about anyone, former mayors, several supervisors representatives of several unions, representatives of so many organizations were under represented individuals and every single one of them had more passion about you than the next. i want today share with every one some of the things that were said. so represented when how you were represented when there were raids. you showed up for them, she said no matter what national and she called you my brother.

malcolm young of the china young recounted during the darkest days of the pandemic when the certain late president, was assailing african americans you gave them a spark of hope at a dark moment. worked to ensure that all can different safely and with dignity. recounted the work that you've done, saving thousands of individuals with hiv-aids. and you helped them recognize what their works are and among all the people were so many representatives that had high praise for you. i think what moved you most is xa michael said, the directer of interface council as well as

the past member of the human rights commission. i want to read you a portion of what he said. i've come to know him as a leader ethics and intes ril and unwaivering. he's unassume lea sistered in numerous efforts to interface harm maoe in our cities near and dear to our heart, islam phobia vandalism, lgbtq rights and to name a few. he, he moves with, he has quietly and unassumingly and with humidity leveled trusted relationship in order to move the needle to make our city a better and more just place. his work is calling that comes from a lifetime of experience nz relationship building which manifest in that innate voice

that pulls at your heart and moves to you sacrifice. dan we will miss your voice and we adore you and you've become a friend to us all. we wish you the best vice chancellor and we're so grateful to you for everything. >> and now it's time for a vote. before the man over there can speak. i guess i'll start with commissioner chow, how would you like to vote? >> yes. >> and commissioners in the room, all that say aye. >> aye. >> aye. >> nays. >> wonderful. >> sort of overwhelmed and speechless from all of this. it's been my great privilege to serve with all of you during

unprecedented and public health challenges facing not just our city but our nation and the global pandemic that took millions of lives around the world and m pox outbreak but stoked fear and stigma, a growing fentanyl crisis that increases in our city as well as recertification for laguna honda hospitals and through all of this, you all as commissioners and all entire leadership and staff have really stepped up to implement the most affective and inclusive covid-19 response in the nation among major metropolitan areas to really step up and establish an emergency center and inclusive and vaccination program to increase the ability of mental and behavioral health service to see help address substance abuse disorder and overdose crisis.

and of course achieving medicaid recertification at the honda hospital to ensure that it conditions to provide excellent care for san franciscans most in need. and we know that medicare is right around the corner too. so grateful for your friendship and i need you to call you out individually. i'll start with commissioner christian, we have been friends for many many years. and you bring a perspective to, with equity and criminal justice and it's something that is going ton so important. commissioner giraudo, you make sure that our work is around the chirp and their needs, not only in behavioral but in their health in general. and coming back to you, commissioner chung is international respected advocate for lgbtq rights and aids, thank you for your

longstanding friendship as well longstanding leadership on this commission. commissioner chow, the standard by which the leadership of this commission will always be measured. i leapeder so much from you, as president of the commission, you also encouraged me to form my own path. thank you. commissioner gi jer mobsinger vice president guillermo your tenacity ensuring that laguna hospital got on the path where we are today where we know we'll have medical recertification soon, thank you very much. and president green, it's been such a privilege to be your copilot through all of this and your humility and your grace and your sincerity has been overwhelming, and i only hope

that i would support you as well and i'm really excited to all the great leader ship that you all exhibit here. the staff to director colfax, your steady principal through all of these challenges has been something that has been so impressive to watch. i've only seen you break composure when you're standing pride and gratitude for the leadership and that speaks to you and who you are as a leader. dr., where ever there is work you'll step into it and you've been a reliable source and leadership. we have greg wag nor who is acting as a well. very important time during here in the commission, dr. suess an, dr. philip, just it's been a pleasure to work with you. and i know after a year's time,

we'll be able to work together once all of the requirements are fulfilled. and i just just have to say a special word about our commissioner secretary who has become a dear friend over the years. is could have served in this role without your help and friendship and support. you are the glue that loelds holds the commission together and the way you lead with sincerity and compassion, a clear need to understand people and to meet people where they are it's been a privilege to be your friend. thank you everybody this means so much, it's really humbling and thank you. >> we're going to take a quick picture, if we can stop crying.

>> okay, next on the jaentd is the resolution honoring dr. claire. is mr. peck ins here.

we'll read the resolution. would you please, yes. >> i wanted to introduce this item, dr. hoard on after many years with the department, in different forms is leaving for a wonderful opportunity that you'll talk about. i'll express my extreme gratitude for all the work she has done. for me, when i work with claire, she always up lifts those around her and finds way to thank others in such a gracious way and it improves moral and helps the work. and this past year, the department has really depended on her support. thank you for all the work. >> i'll read the resolution,

where as dr. claire hoert nn on has served the city of san francisco since 2020 and instrumental in providing operational vision and direction to the san francisco health network, and where as dr. horton has recently healed the duel position of chief medical officer and deputy director of network hospital chief of staff, physical as elections medical staff and includes a range of opportunities clinical operations to overseeing personnel matters. as well as medical director richard fine people's clinic. where they've served on the board of advisory committees association policy and advisory committee and california safety institutes public health and where as dr. horton cal aim including the enhancement,

enhance management and security support program enrollment of patients where as dr. horton dph work with under served population sxz provided innovations to improve access to populations. team, working to plan priorities and the face rollout. and where as dr. horton determinants of health. and where as dr. horton considered by her colleague's as a chair's friend integral teammate and expert who's empathy and experience will continue to impact those visitors and resident of san francisco. she will be missed by many. and wishes her al in her new

position for the national medicaid program for the kaiser foundation health plan. >> so is there a motion to approve this resolution. >> second. >> wonderful, is there any public comment? >> is there any public comment on the room? folks if you would like to make public comment, no. >> motion. >> commissioner guillermo. >> i just want to add my congratulations, dr. horton and i spent a lot of time together. again, the support and leader ship that you provided particularly around the laguna honda recertification has been a presence as we've gone

through all the iterations of reports and surveys and things that we've needed there. but also, i think it always seems like you're ready to jump in to something, to either add different information or to clarify or to support. i can feel it over online. so i can just imagine, how that reflects in, in-person and so, i just want to recognize that. and thank you for your service, and really look forward to the new things that you're going to be doing over there at that health plan. >> commissioner christian. >> thank you, dr. horton, so so sad to see you go from us, but kaiser definitely needs a lot of great help. so glad you're going there. and i had the opportunity to

see from a close distance what you are like as a physician, and i am very impressed at your compassion and the way that you jumped to assist somebody that i knew. and i was appreciative of your help. and happy to see the quality of the physician that's we work here in the city and that we have in our system. so, well done and best of luck and take care. >> commissioner giraudo. >> i also want to congratulate you and thank you. for two and a half yae,z you were a zoom person. but what i found something since i didn't know, or hadn't worked with you before. is when there was a question or

concern, they always turned to you. and asked for your input and expertise and thank you very much for not all the the wonderful things but, looking forward to your next chapter in making a contribution. as you go forward with the healthcare system. >> thank you, and dr. horton i've known for a number of years, just with our relationship down at the joint conference committee watching her. rise through the chief of staff into then, deserting uc and joining the city and then bringing us into a very high level of work at the san francisco network.

her work at laguna honda is part of that talent that went to help our effort was also noted, and obviously noted by many people. it looks to me we're a great training ground for people who go on to state and national levels. this is a national position, taken care of medicaid program and one that fits your passion of again helping those who are, greatest in need at help. congratulations, dr. horton and my very best wishes for you in this new endeavor of yours. thank you it was a privilege to work with you and i know that you're going to do great things for kaiser. >> i will chime in as well. so i think you're the ultimate utility player. you played every position in the team with such skill and

such grace, when i think about the time, you've always stepped in and you've always done such a fantastic job when you have. it's not an small honor to be chief of staff at the general. the quality and for you to have been identified as a leader as incredible on to themselves is emblematic of who you are. and in laguna, what we had about coverage and what would happen when we were dessert fied, you knew everything. and of course as others have said, you do check all the boxes because being able to work with your head, you work with your heart and it's known what a compassionate clinician you are and i hope you have an opportunity to do some clinical medicine when you're work withing kaiser and under your leadership, kaiser will expand their medicaid and cal roles because it would be wonderful

to have that institution more volve in caring for the under served in the country. so we absolutely wish you the best and congratulations and thank you so much for everything you've done for kf kf. i know director colfax wanted to make some comments as well. >> thank you, president green, claire, i just wanted to add to the appreciation and we've known each other for quite a while. dr. horton walked in as her first day of clinic as an intern and i was attending. and i remember saying, you're such a good intern. from that to chief of medical staff to cmo of the network, from covid through covid, challenges that we've had. just really want to thank you for always being there and

always keeping the patients at the center of what we're doing. and i think with regard to your, the way you approach things, i was, i continue to just be struck by your authentic relentless optimism optimism, you found a way to approach it in a way that was insightful and actionable and very positive and that is not always we find in boor xra see. i'm so glad that you're taking that to a larger system. and you can switch on a dime from talking about, you know, policy to a very specific clinical issue. and i believe you're going to be keeping your clinic. i'm so glad that that will be happening because there are a lot of patients in your family that will benefit. and i have to say, i'm sorry to see you go. i'm so glad that there is this

opportunity. kaiser made a great pick. whether it's in local or in dc, doing a lot of policy work, i have never found anybody so enthusiastic about policy and the details of medicaid. you couldn't, it's just so great, understand what all of these details mean and how they affect people's lives. so looking forward to what you do and always remember, you can always come back to dph, thanks. so it's time to take a vote. >> commissioner chow, how do you vote on this item? >> yes. >> and commissioners in the room, please says aye. >> aye. >> aye. >> okay, no nays, congratulations. >> wow, this is hard.

>> no, please feel comfortable. >> this is such an honor and i was really kind of floored when you all told me about it and i was really honored when i found out that i was going to be honored the same night as commissioner bernal. i just say, want to say quickly, that i was flashing back recently to being a 25-year-old med student coming to san francisco general for an away rotation when i was in medical school in the east coast and the beautiful lawn was there and thinking i wonder if this wonderful hospital will be part of my life. sort of a premonition, in the

east bay, the san francisco general and subsequently the san francisco health network and dph have been a professional home and in many ways personal home to so many close friends and mentors and people who have learned from. and actually just learn to be a human being and respect for. are there, i believe so much in the dph and the network and what we're trying to do in the city to create a unified safety net and to keep getting better and better. and i also wanted to end with something, when i was getting advise about this opportunity and feeling really torn about essentially leaving this personal home of mine, you know, she said this is an opportunity amazing opportunity and you will learn so much and i think you should consider it but you will never work again with such wonderful and i

suspect she is right. i may have to come back one day, but i would love to stay in touch and will be cheering from sidelines. >> photo op.

>> what a wonderful way to start our meeting off. now we'll get to the business, the next item is the approval of minutes of health commission meeting on october 17th, 2023 commissioners you have before you the minutes of the meeting. if there are no amendments or cexz, is there a motion to proof? >> so moved.

>> so moved. >> second. >> is there any public comments. i see no hands. is there any public comments from folks that is online. we'll give it a second. all right, i see no hands. >> all right, we'll go to a vote. >> commissioner chow how do you vote? >> yes. >> and commissioner please say aye if you vote aye, yes. >> aye. >> all right, the item passes. >> the next is general public comment. do you have anything you have to read, secretary? >> yes, i do. at this time, members of the public may address the commission of items on the public that are within the jurisdiction of the commission but not listed. each member may dress the commission for up to three minutes. they forbid from discussing any item including those raised

during public comment. please note--read statement frz individuals unable to attend the meeting. written may be sent commission to the following address. if you wish to spell your name for the minutes, you may do so during robo comments. we will first take public comment from individuals attending the meeting in-person, then from individuals receiving accommodation for disability. i've given these individuals two-letter code to use to prevent others from speaking at the same time. there will be a time out moment on 20 minutes that can be heard

on every item. all right, so i know we've got two folks in here that have have given me speakers card. we'll start with ms. lee. and again aye i've got a timer, know that your time is up. the last name is li. >> yes. i'm chuman li, we represent half the city's workforce but also felt on workers in san francisco. and in contract negotiation and we've been trying to order 3 union workers. and they received a lot of funding from dph and homeless

housing department and dph alone this year, felt on received 16 million dollars in this fiscal year alone to provide services. however we're concerned about the conduct as a public serving our most vulnerable communities and the most underpaid workers and using public union. while mismanaging their programs and services. multiple monitoring reports, submitted to dph show that felton they're meeting zero of their contracted target and performance objective, yet they're getting grants from dph year after year. staff and clients have brought up concerns about health and safety where people being expose today gas leaks, and child injury. meanwhile, felton is intimidating workers who are bringing up concerns and trying to organize a union so they can have a voice on the job.

despite having a contract and a neutrality, with the agreed, felt on turn around and order workers not to sign contractors with the union and fired workers spoke up. the union has filed charges with the national relations board and they have found merits. in the city and state government but their mismanagement has lead to high turnover and low morale. gave themselves a 70% rate since 2019 making him over 220,000 a year. we urge dph to audit the contracts and not to give the agencies another dime until they have cleaned up their acts. we have provided addition that has more detail information in terms of each of the things

that i've mentioned here. >> thank you. all right, the next person is, grassia. >> speaker: good evening, staff i have the privilege of organizing with these felt on workers who are educators, early childhood education, so they work with k through 5, housed people who are high-risk of homelessness, people who are coming out of probation, really the people we serve and they're passionate workers who are trying to survive and keep their jobs and to be able to afford housing in the bay area which we know is a big issue. so for them to try to form a union but be threatened with

coercion retaliation. just what my colleague said, we're asking to what felt on is really doing and it's due to high turnover. people are burning out, people are working multiple, their staff is either part-time by working full-time hours without that pay. there are educators who are managers who are suppose to do one and one therapy, teacher with jobs. this is many issues of why people are forming a union but they are being bullied and they're, they are getting busted. so i wanted to make you aware that this is matter thank you for your time. >> thank you. and the last card i've gotten is from brandon and jose, sorry, only one person at a time can speak. great.

all right, i'm good evening, i'm the vice president of local 21, i also work for the san francisco department of health. i'm here to inform you all about some of the things that felt on institute has been doing. first of all, the felt on institute has received over 16 million from the department of public health this fiscal year. but what are they doing with that money? they are using those funds to union bust and to, tell workers that they are not allowed to talk to the union, that they're not allowed to organize. now many of you know that san francisco department public health all of us are, are members of the union and this nonprofit they've been going problem after problem with the ceo treating them unfairly. having high level managers

follow workers to their, to their classrooms. asking them to remove sci paraphernalia, but they have the right to join a union if that's what they choose to. and there should be no interference from any manager or any employer, if those workers want to organize. so we are asking, i mean, after you, you know, you heard from the, you know, other folks, you know, we're asking that you inform the ceo who is receiving you know, dollars from the san francisco department of public health, to we are asking y'all to inform him to you know, stop union busting, stop interfering with the workers one to organize and join the union. that's why we're here. thank you. >> thank you.

all right, and then, josie muni. >> speaker: heli again, i'm still the deputy director of the union. i've been speaking to this commission for more than 30 years and never have i come before the commission with a heavier heart and more dis encouraged and more disenchanted about a nonprofit in town. i have to say that in my more than 30 years of being a union organizer and a variety of situations, i was, sorry i was executive director to the international president of sciu, i have served in this capacity for many years and i have never not seen the conduct

that we are seen from the executive director and his staff of felton instaoult. --instaoult. i don't know institute--it was recently signed by mayor breed, that department may not contract with organizations that union has. it's much nicer than i just said it. but the fact is that this has just been signed maybe in the last ten days and now the department is under orders from the mayor and the board of supervisors to take a look at this. i want to tell you that dr. colfax has been helpful to listening to us and being open and honest with us. so i want you to know that we very much appreciate that. but now we need the commission to take a position that it is

unacceptable to use public dollars to bust the union. these workers need to be lifted up out of poverty. they need to be treated with dignity and respect. they need to be honored for the challenging work that they do. but more than 80 of them have resigned in the last three years. now that says something about the conduct of the employer, and it says something about the discouragement of the workers who are giving up their work for very very low wages to offer a service to san franciscans who's families desperately need these services. but his turnover rate and vacancy rate is simply unacceptable. so 16 million dollars, this year, he is slated to get more than 5 million dollars on track by this department over the next decade. we ask you to review the new

language passed by the board of supervisors, we ask your assistance and holding al gilbert accountable as a ceo and we ask that he give the workers the 70% raise that he gave himself in the last five years and lift them out of poverty. >> time. >> speaker: and allow them to live here with dignity and respect. >> so there is more--this topic could be discussed at a later time but not today because continue not on the agenda. jamie, can you unmute that caller. >> caller: hi, can you hear me. it's dr. palmer.

>> hi doctor palmer. >> caller: i want to state my solidarity and the services that they supplier show important and the workers need to be able to pay rent. and my other questions are about laguna honda. san francisco is the city that cares, san francisco is a wonderful place. with good oversight and why, has laguna honda not had equally oversight and how can we make sure that it occurs. it's a distinct and very different facility in san francisco general and needs distinct and different management. has a chief medical officer been hired yet? and lower level of yet, have beds been found for them?

will laguna honda admissions committee be given the needed support to say no to inappropriate transfers from san francisco general given the pressure to place behavioral difficult patients anywhere? what are we doing about the shortage of board and care? and similar placements for behavioral disordered people in the city. thank you very much. >> thank you. that is the last public comment that i see. >> well thank you all for being here today. and for giving this information for sharing your concerns, we really appreciate it. i guess we'll go to the next item which is the director's report. >> good evening, commissioners. director's report and we have a

robust director's report so i will highlight a few items. one is san francisco and part of san francisco dph is preparing for the, to host the asian pacific economic cooperation leaders meeting and ceo summit, known as a-pac. this is an extraordinary opportunity where we'll see the leaders since the u.n. charter was signed in 1945. dph has a significant role in ensuring the success of aac20 if. planning and preparedness and healthcare system security and expanded health safety and support for special populations. next idea, chinese hospital unit update, the department has continued to support the development of new suber cute beds in the city. san francisco has only one

facility in the which is p accepting new patience. dph is working closely with chained hospitals. on june first of this year, received certification from the state of california, requirement prior to getting certification for civic acute beds. entire experience consultant to guide them through the--the cms certification. we anticipate that the hospitals will have to open an acute unit. so goodness there and we'll continue to update the commission. in another item, maria martinez center, have laufrmgd a contingent management program. this is contingency management is an intervention to help people to stop or reduce their

use, management is behavioral therapy practice in which participant right side sfrd gift cards of low monetary value to reenforce a positive behavior change such as abstinence from drug use. we're delighted to expand this given the problem with methamphetamine in the city. as you may know, dph partners with the school district to conduct oral health screens, that our mission and protecting the health of all san franciscans. we have partnered with a number of key entities which heads back to school every october to administer to all 74, san francisco unified school

district and school elementary schools and two other school base programs. and one thing that i would like to emphasize, this program is supported due to the soda attacks, we know that soda is very bad for for teeth and we're glad that the soda tax is helping this intervention. and speak the soda tax, i want to highlight that this week we're mark ing the five-year anniversary of the soda tax. there are multiple events across the city and promotion branch and in fact, earlier today i was able to join sucker burge general ground rounds which provided an overview on the soda attacks evaluation on the program which was found to be highly affective with other health intervention to see

reduce more bidity and mortality and pleased that state controller joined us as well as the, the former head of medal in zuckerberg san francisco, dr. gene. so nice event earlier today. and with our covid numbers, positivity is 7.4 percent. and we have 18 people who have hospitalized who are tested positive for covid. and i will take any questions from the commissioners, thank you. >> thank you for the report is there any public comment on this item? >> let's see. folks, please press star-3 if you would like to comment on this item. yes, we see one, jamie please unmute that caller. >> caller, are you there? >> caller: hi, dr. palmer again, at ww, i want to make a

comment about the sub be sub acute nursing. it's outrageous that we have not had a acute in the city admitting new patients since 2017. and that these very sick people have to go out of town far from family and friends. also, you may not know that of the 17, sub acute patients that were transferred from st. lucie to davis in 2018, only 4 remain alive. this very high death rate was due to transfer trauma and the need for intensive hands-on, are in care and good staffing. which was very rocky at daisies. and we need to have very very good oversight at chinese

hospital, sub acute tear is much more intensive and very distinct from regular nursing chair. they're vent laser independent and if anything goes wrong, their next step is icu, they need to be trained license staff taking care of them and a full panic of those, including therapist therapist and/or, and the doctors need to be very engaged. so i urge you to keep, really really good oversight over, the new sub acute unit. i'm really great that they're going to add 23 beds of sub acute care. but those beds have to keep people alive who have chosen to live under very difficult

situations on advance life support. >> on the director's report, commissioner durado. >> i have a question on the behavioral health services award, the grant award of 750,000 going to parent child interaction therapy. do we know yet where those programs might be? >> i will get you specifics commissioner on that, i'll follow-up with the behavior out team. >> i'll be most interested since it's something that i'm putting together with, homeless shelter for women and women.

>> absolutely, we'll get you that information. >> okay, any other questions or comments. thank you again for the report, a lot covered. >> oh, commissioner chow, i didn't see you. >> i was trying to use the little hand here but that's okay. i want to thank dr. colfax for giving us some inside as to what we were doing with the a pac and it began with an article that we had seen commissioner guillermo and i saw, that indicated that there was some disturbance among some restaurantiers in khaoun a china town that they were being picked on. but really, i thought exemplified the work that our department is getting back to doing in terms of making sure that all the restaurants are safe for our public and that it was not targeted because a pack

was coming. and, in fact, we donough, and i know that, the environmental services, people have tried hard to work with our china town restaurants. and i'm sure i i would have heard from the restaurants if there were any issues. i want to thank you, and the sub acute unit where i think has been something where even before the building of the new, cpm campus was in question so, the health commission has asked that there be the city that interest in the sub acute and it's really nice to see that it may be coming to fruition. and i'm not sure why it would take up to 2026 in order to put it into operations. do you have some ideas?

is it regulatory or are there issues of needing construction or what? >> kelly, he knows working on this issue. and, and doing a great job has some information to share. >> sure, special project management with the department. much of the delay, we anticipate getting regulatory having cms come out and do the survey, having cmh do the survey. the delays has been around cdph sign off on the kitchen and they were very specific in organizing special adser and making sure that we had everything that we need to get through that, evaluation. and then the secondary piece that we know that is going to take a little bit of extra time is staffing. so because of the staffing

ratio has to be specific to step into sub acute and to make sure that we have that in place before the survey is done. they get hired consultant and that's been helping a great deal to help move things along. it's been long issue like if it was going to take a longer term. if things go well, we should see them get certified sooner. >> very good. thank you, and sounds like, what we are experiencing also in terms of regulations and all. >> exactly. >> perhaps that's almost optimistic. anyway the sooner that we can get there, i remember these are one of those things that have been hanging over for many years and it's nice to see that we're coming to fruition on, putting back the unit into san francisco. >> thanks. >> thank you. >> thank you commissioner for

bringing up the two very important items that were in the director's report and thank you for that update. it's helpful to know what is going on. so now we can go to the next item which is the finance and planning committee update, commissioner chung. >> thank you, president green. and good afternoon, commissioners. the finance and planning committee met right before the commission meeting today and we reviewed the contract ratser and also the, type a few different contracts. one of the main things that i would like to highlight is the conversation we have, around how to support some of these organizations that might not be doing too well, you know, and to make sure that you know, like they have a chance to improve and continue to provide

vital services to the city and county of san francisco. the other things that we also discussed is that we want to make sure that when we when we receive the contract report, that the reason and the purpose are clearly stated so we know exactly, you know, what we are approving. so, and and, mr. goodwin also meant had already mentioned he's going to go back and work with the staff and to make sure that you know, that will be taken care of from now on. so, we shall see. >> okay. any public comment on this item? >> folks we're on item 10, if you would like to make public comment, please press star-3. i see no hands. >> commissioner questions, comments?

well thank you, and we're really delighted that you're both looking into how to help some of these organizations that need help but also that we're coming into better understanding of what deliverables and what objectives are focused on so that's very helpful. we look forward to hearing more of your report. i guess the next report, is commissioner chow from jcc, draout report including the ceo and human resources report which are continue to of course talk about how we were filling our vacancies. and in the staff shortages.

during the medical staff report, the committee recommended that they approve the anesthesia standard procedures which have been putting through, pact as consent calendar, with the exception of procedure 16 which dr. ortiz, the chief of staff asked to be removed because it's still under--in the close session, we approved the october staff credential report and that ends my report. >> thank you, is there any public comment? >> i see no hands remotely and any in the room. >> all right, any commissioners. the next is commissioner report. and we'll give some items and then we'll take public comment and one vote. >> yes, we want to specifically

extract. >> extract, the contracts report and within it, we're taking off one of the, contracts with bar d diagnostic and the reason is because we are still not clear on the, the terms, the contract terms because there is some discrepancy between what is listed and you know, in the narratives. and so, yes, so we asking them to come back, next meeting so that we can have that to the report for the next month. and that's the only thing that we, you need to be aware of. all right. and then commissioner chow,

they're, privileges that we have asked the both commission to approve and protocols. >> all right, all right, these are standard procedures that actually mirror what the chronicle services use for the medical privileges. and we ask that you approve those as i noted in my report, except for procedure 16, if that's still in your docket, i don't know if that was sent out or not, that should be extracted. yes. and if i can clarify proet you're 16 is one that is taken out. >> all right, so, we need to a motion to approve the consent calendar? and is there a second? >> second. >> now is there any public comment. >> folks on the line. we are on, item 12, if you like

to make a comment, please press star-3. no comment, so i will do roll call vote. commissioner chow, how do you vote? >> commissioner yes. >> aye. >> aye. >> if it's a yes. >> and i say no nay, consent calendar passes, thank you very much. >> thank you. the next item is other business, is there any other business? seeing none, -- ~>> i need to check for public comment. folks if you would like to make public comment on other business, please press star-3. i see no hands. >> all right, so the next item on our agenda is closed session. >> if i can jump in president, there are two votes, you'll vote one on a close session and then a close session specifically to 1 1-d, the settlement which also includes attorney-client privilege. so you'll do two separate votes. >> will you walk us through this. >> i will walk you through this.

please consider a motion to go into closed session. >> so moved. >> second. >> and we'll take public comment on this item? anyone that would like to make public comment. please let us know by pressing star-3. okay. there is no comment, other roll call vote, commissioner kho*u. >> yes. >> and other commissioners, please say aye, if it's yes, nay if no. okay. and separate vote to hold a close session for the settlement discussion. >> second. >> there is no public comment, because you only do public comment once. commissioner chow. >> yes. >> and other commissioners say aye, if it's a yes and is hear no nays. give me 30 seconds to take us into closed session please.

okay. back? >> no not quite yet. please consider a motion to disclose or not disclose issues that were discussed in closed session. >> motion to not to disclose. >> second. >> commissioner chow. >> yes. >> all those in favor, say aye. >> aye. >> i hear no nays. thank you and now consideration for adjournment. >> motion to adjourn. >> second. >> all right, commissioner chow, how do you vote on this item? >> yes. >> every one else. >> aye. >> aye. >> thank you every one for joining us and congratulation to see president green and vice president guillermo.

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