>> community investment and infrastructure successor agency commission meeting this afternoon at 1:00 pm., tuesday, april 2, 2024. secretary morewitz call roll. >> commissioner giraudo and vice president guillermo and vice president guillermo will read the read the los angeles police department unceded ancestral homeland of the ramaytush (rah-my-toosh) ohlone (o-lon-ee) who are the original inhabitants of the san francisco peninsula. responsibilities as the caretakers of this place, as well as for all peoples who reside in their traditional territory.

ramaytush ohlone community and by affirming their sovereign rights as first peoples. >> thank you. >> next item is the. >> 2. approval of the minutes of the health commission finance and planning committee meeting of march 5, 2024. i believe we have some minor correction. >> yes. thank you, president green one is commissioner chow didn't participant remotely this will be changed on page 2 under the director's report. >> second paragraph last sentence should be covid not covid 10 and under the page 3

for the financial status the 5 paragraph down first sentence should read commissioner chow the dph invite contractor. >> you have those in front of you. >> any other additions or corrections to the minutes and make a motion. >> he move approval. and public comment on this item. >> i see a hand concerning public comment in the room non-anybody. >> have a scripture it >> have a scripture it >> have a scripture it >> have a scripture it

agenda. with respect to agenda items, your opportunity to address the commission will be afforded when the item is reached in the meeting. each individual can per agenda item and not return to any other item and where you know sent to the health commission the word health dot commission and dph at sfgov if you wish to special your name for the minutes mr. greenhill pleasing note with the state and federal law no harassment will not be tolerated and unmuted you please begin our comments. >> it is patrick code aa those 24 minutes sent for three

reasons 24 committee reports for 2 thousand plus for 24 failed to mention they had three citations for 24 it commission during the backer points discussed president green the health commission has a responsibility to make sure that proposal erroneous is used are not only a unquote and this commission has not insured the $14 million for the hiring for the used rose park we're 12 days away from the anniversary and no recertification and during the recertification update this is a common - >> 24 plans of corrections to minutes and la submitted the

corrections which forwarded the request to the d m a s this misinformation for two months and thank you. >> that's the only public comment on the item. >> thank you now need to take a vote to approve the minutes. >> all in favor, say "aye." >> aye. >>. thank you. >> minutes are approved. >> the next item is general public comment is there general public comment in the room please coming up. >> limited to 3 minutes per speaker. >> prior to meeting i spoke with the board of supervisors and tomorrow speaking with the disability and angling no necessarily we're speaking so

i'll read what i wrote for supervisors good afternoon board of supervisors and health commission and you know i'm chief financial officer and want to talk about homeward bound and sent an e-mail on march 11th and serious commerce about homeward bound for the state and federal law that increases violence from the - surveillance to influence them basically gives them - for forced compliance we have to pursue it report from 19 not just about afghanistan but to

illegally boise cots for history repeating itself and for the retailers to leave the city because of the cooperate to report shoplifting and (microphone distorted) a crime is not going down in san francisco so the olympic officers didn't change immediately meaning we'll shop outside of the san francisco and decrease revenue and outside of for san francisco to thrive we need the city to turn off the vouchers. and this is not going to be easy and was not easy in 1978 for the public integrity was at lowest level it will hurt

for the health commission and other agencies to stand tall for the community and confident the people in the room dr. colfax will do the right thing. >> one hand up remotely and receive permission. >> caller you're unmuted start your three minutes. >> my public comment for the involve an item on today's agenda so don't cut me off. and for the san francisco the green panthers have reported what i'm about to testify but about the commissioner commission have (unintelligible) or was failing to do something it oversee is

department of public health public horses and sf d t h fwez. >> if this commission appears to be all to literally to hide and patients death for two months the declaration lawsuit against the city didn't report the fiduciary duties for protecting the city's vulnerable. and you cost the city $430 million for one of the two public hospitals for two full years to get them resiefrtd. but the declaration is - san franciscans deserve a better oversight. on april 14th we reached a too year anniversary of the

recertification from the governing body. thank you. >> last comment. >> the next item is the director's report. >> xhfrl. >> thank you president green two items on the director's report. >> i'd like to review with you all. item one of the laguna honda hospital will be honored at 24 pregovernment awards. >> laguna honda will be honored on april 25th city hall, you know, recognized ongoing performance for workers with the city and county of san francisco the competition is stiff and medicaid a huge fabulous of people with the union partners

and um, we are honoring a few people critical to that effort including jeffrey and. >> (calling names.) >> from dph and that as you recall the city attorney team worked closely with us to nice we are so the department of public health and the city attorney recognized do city attorney's office recognition henry who have been key partners as well and those leaders continue to work with many others across laguna honda to insure that laguna honda is fully recertified through medicare and as you can see we're waiting for that process to be competed so really excited to have laguna honda fully rejected and this recognition really is of the entire laguna

honda team with the people i just mentioned. being specifically named for their leadership. with regard to the recertification with more information share the california public health department is accepted the bland corrections that laguna honda submitted for two reported and laguna honda submitted support for the correction and dph has zero questions for the laguna honda team and this approval for the improvement work continues to take place at laguna honda to bring us to fulfill certification and with the plan of corrections from the survey from fema and the determination from fema with the recertification for the medicare program. we certainly continue to be optimistic and diligent to

make sure that laguna honda responds to the facility i'll continue to provide updates as at the come and item to recognize world tuberculous was march this the department we need the a number of social media posts to continue to raise awareness about that terrible deceased and 28 staff working across the city to help. >> another come at that time day national doctors day for city and county of san francisco in settling that event and this year's theme was healers of hope with a sdwripgs of all dedicated doctors that regularly go above

and beyond to make city and county of san francisco to feel connected and gratitude and appreciation for the amazing doctors that work at the hospital and then march was women's history month and did that we highlighting the work we do with regards to women's health and a number of key areas in the report you reviewed from our report to support women's heartbreak for the people of a san francisco and then with regard to the 2019 update positivity rate a total of 27 people in the hospital have covid and again, that didn't mean they're in the hospital for covid and - so i will stop there and take any questions? that the

commissioners have. >> thank you for both mentioning doctors and the laguna honda and as well as the preprofound words that laguna honda is proud of their work so thank you very much. and is there public comment on this item? >> hands remotely anyone in the room like to make public comment. >> okay. take in the order i saw them. >> caller you've been unmuted. >> the government award troy williams should not have been named after all the topper plan for was such a gross failure for the recertification and so-called a failure and shouldn't be honored for the managerial intense and dr. dr.

colfax plans for the recertification on january 13, '24 or january 17, '24 respectfully but shamely consular failed to mention i testified for the la on march 12th, for the cms for the two plans of corrections submitted in january and submitted corrections and dph and the dph forwarded the request and changed that in early event and dr. colfax will nothing about that why is dr. colfax probably inaccurate information and or if more changes have been requested again why didn't dr. colfax tell the information and cms accepted the revisions in february and

why is dr. colfax delaying that news? why is dr. colfax delaying the news and including a patients false death - why is dr. colfax delaying the certification death during the jc c monthly meeting (microphone distorted) about the history of complaints for the chain length were impossible to read and requested the chart be revised and not the underlying data for 24? la claiming had no responsive record you can't produce an unreadable chart and not the underlying data have to request the data again and delayed 25

days after and when the commissioner comes to the recertification for resuming the patients begin with - and enough to (microphone distorted) a commissioner are you are okay with all this display from dr. colfax if you agree that is the act san diegan the commission is a terrible body. >> that's one comment we have one more. >> caller you're unmuted. >> this is dr. palmer can you hear me? >> please begin. >> okay. i atm nervous about that process and grateful that cd ph has approved the serious

certifications in february one involved and patients death and approximately have approved all of the revision of all the work done in january but what is cms doing and provisions and how long will it take? um, also making the making we worried celebrating managers that um, have um, not clear you're manages are up to the job at least one is a nursing administrator not sifted at the nursing home administrator and for people part of this disasters i worry it the it city and the department of public health is determined to repeat those - the current managers

have the skills and support from the bayview and the department of public health and fix the problems for the admissions and discharge we need you to be more transparent why this is going on and on. and um, i think i'm worried a real risk of closure or something like disaster of receivership and need you to be translator with us. >> excellent comment. >> and have there any commissioners questions or comments on is director's report? >> all right. seeing i guess the next.

>> good afternoon the strategy at the department of public health and representing high-rise we have c hr o and director of staffing and director of merit and. >> (calling names.) >> next slide, please. as we know hiring and retaining for the nurses and supporting our mission our guidelines are increasing the nurse importance and we're working to reform barriers and inspirational pathways and supporting a respectful work environment and strengthening the environment next slide, please. we have taken steps over the past year for the hiring and retaining the

nurses some are highlighted expanding the recruitment posting targeted hiring and qualifications interpretation and streamline and on boarding processes we continue to improve the steps move us color to our goal of dph and next slide, please. after years of pandemic challenges across the country the department is making strides to retain our employment and on the left fiscal year 2021-2022 with just over 12 had the and 50 r.n. and showing the anticipated north of 14 hundred by the end of this fiscal year and there over 200 and 50 nurses during that period and credit tim and the team for

helping us to retain those numbers next slide, please. the next two slides for the civil certify for the march 18th meeting it is outdated please bear with me that's 450i89 the reassignment and sprapgz over the past three years in fiscal year 2021-2022 we made to have and 49 hires but restraining order of those positions were filled either reassignment or resignations and running a negative head count and san francisco this fiscal year is the too far right columns with 4 hundred plus replacement with less than reassignment an staten island hiring in the year over year they decreased in our separation we hired nearly 70 additional

nurses. next slide, please. this is a snapshot of our anticipated hiring as of march 15th the numbers look consistent with 25 commitments and 12 for hire and 62 commitments in staging of our boarding 9 candidates and just yesterday starting the district department of public health. next slide, please. we have evolved 19 different jobs are from two 19 specialists and not only for the recruiting team but for the hiring with the candidates and we now have 2 inclusive r.n. and two parking spaces for one experienced and

one for training nurses all without questionnaires with a broader qualification. next slide, please. . thank you. >> dph work h.r. has been meeting with in your leadership to reimagine the hiring strategy and is newly vision the future nursing is cancelable and predictable and may seem like a lot of steps for the hiring as you can see a broke down as two increments the first the experienced candidate is refreshed and hiring managers and the second is dedicated to interviewing and selecting and the third is more administrative with the submission of hiring and cindy out offers to candidates and lastly, dph when

selected the candidates are the other boarding process and improvements are automatic matted and on and on on boarding for the hire and next will share how our dph partnerships are help with the increase in hiring. >> good morning, commissioners next slide, please. >> in 2023 dph local 1021 and the leadership r.n. hiring to identify solutions studio reduce the vacancies. our four sections with strong solutions erica decided earlier and this work helps to have a partnership and so 1021 is a one-million dollar

for as partnerships capacity to r.n. growth and retention. dph and h.r. has been conducting virtual and in-person information sessions on the programs like r.n. to sterile and packets has had 20 r.n. in 2023 in comparison the 24 is accepting applications and we are doing everything we can to get this information to our employees. for dph employees participating in the work training program which is a program for employees to have 8 hours to pursue degrees this program is 24 dph employees including 22 in your and are

offering targeted workshops and resources. our aim so retain the employees as they progress professionally through the program. they are also working 80 with the 1021 to dina pensionship we are in the initial design of exploring an r.n. program with s c i u. >> dph is making improvements in the area of our staffing and engagement and growth and nursing retention is high and the departures are low those are a result of initiatives inspired by feedback from your employees and i would like to highlight a

few of those the training 2023 survey was completed by over 4 thousand employees including 800 nurses and the nurses highland they're deep commitment to the admission and pride in their sdwrobz and the survey highlighted nurses want to opportunities and explains of the h.r. workforce and career team i mentioned and offering many other resources and development workshops to all employees including nurses. for example, just this year over the past that job options and employees two add and 40 participated. in partnerships we

built a pipeline for nursing care to prepare and nursing staff that recent interested 2 to 3 join the emergency department and successfully ran a program to insure that 90 percent of nursing in california working payment in 2023. and for sustainable staff and row tension we are working on system improvements like the h.r. health center now established for the health consensus to respond to employees concerns and complaints. the health center is disciplinary consultation team that model will expands to all in the coming year. >> and finally h.r. conduct ongoing exist interviews and the biannual surveys to keep us

ground in the employee feedback. next slide, please. the h.r. team building in on and on learning and innovation and here are photos from our 4 h.r. conferences in 2023 and including the employee engagement conference the hiring conference and the annual h.r. conference thank you. >> melissa i can stop sharing. >> thank you for that presentation and is incredible producing progress you have made back to 2018 and 19 a 9 month period to hire and nurse that is so incredible and it reflects to

bring all the stakeholders to work with the union partners and listen to the staff that is incredible work i know we're supposed to take public comment i could not hold back and love the picture of dr. colfax and happy with the progress that's why that is any public comment on that item. >> any public comment in the room on this item. >> i did see one hand. >> you are unmuted let us know you're there. >> the caller disappeared. >> let's give that person a second to come back. >> um, move on the person is back. >> held back commissioner comments and questions. >> vice president guillermo thank you for the presentation very informative and feels good to know a concerted effort

around the r.n.s part of the r.n. part of workforce and looking forward to seeing where other parts of work we need so many different um, professionals both licensed and others in the departments and throughout the city i have a couple of questions one can you talk about the recruitment effort that i guess i um, pumped up a little bit is it just contained within the the geographic area or, you know, or this department is doing recruitment efforts any other parties involved how does that work? >> back to my question and then wondering whether the coordinates between the city h.r. and the dph h.r. are things

can be a rope indicated in other instances for other workforce needs and if there are any points need to addressed and then actually what are the still existing pain points would like to address as you move forward but first congratulations on being able to streamline the process and really to hear the great news on the number of at least the rns are brought in the system in a short time. >> vice president guillermo for the first question like to invite the director of recruitment and assessment. >> good evening, commissioners so primarily recruiting efforts have been along the consolidation because we don't

have special tiers only two jobs being able to double down on a large candidate and seeing successes in hiring otherwise not only had a critical care with 10 or 15 have a large group to choose from we had continued using smart recruiters for the tracking systems that are possible as well as leveraging our normal tools of posting in some of our normal places for special tiers, etc. i think the biggest point own this is taking our enlarged pool and putting a lot for time one time to give them more options. >> thank you the efficiency i

created meant to more than anything else like additional recruitment effort. >> i think it has been more like i said slimer eligibility specifically like one area you see larger group as a whole. so folks don't get pinned down to hiring like had a year of experience and we're looking at people more worth any based on the quality of their experience. >> thank you. >> i'm kim the director of staffing on dph to answer you're second question i think the efficiency were based on batch hiring during covid and consists

of binding all the vacancies across the department in the past we um, managed the vacancies separating by divisions but in the new process all in one batch process we have the candidates all the one time and at the same time and offering is going to one process at the same time rather than it is in communication and finding clarity for the candidates and saves time in the hiring managers side and h.r. side so managing some of the recruitments we've been working with the h.r. modification team since dhr to incorporate are recruiters functions and more efficiently to continue to go down that route with the interview and function we're

exploring to use more thoroughly and any other questions for the efficiency? >> just wondering as far as the described the civil service process kindergarten both one process now that is a initiated and pretty much is it - a controlled by um, the department the humboldt county h.r. or the city the c h.r. >> we're independent those are - the process is it goes position approval with the harry and dph combined and comes over to dph for the reassignment process and back to dhr for referral and work on that together with the collections and very, you know, intertwined

throughout the entire process. >> great. to here. >> commissioner giraudo. >> great. presentation. >> i appreciate also you're slides how it is laid out. was very understandable and readable my question on the hiring under our slide if in fact, i was i applied i was on the eligible list that the beginning it would take you could go over this process in approximately, one month. am i creak so the slide if, in fact, i was deemed eligible? >> correct so this option happens with every month and

okay. >> to then quo campus and move to the selection the second week so um, the first part from canvassing to select is within the first month and bend we move on to the only boarding if you're selected. >> that's the first slide a month. and then if i was going to be a new hire with, you know, in most two i would have an assignment hoping. >> correct and a huge difference so graugsz gragsz congratulations. thank you. for the uplifting report um, it's been many years of thirty odd years i had actually watched our process used to expend greater than a year in order to get

through the system sometimes i'm occurring you've been describing our regular routine so during pandemic we were able to use a sfroerld measures in order to bring that staff that we to bring staff was needed. is that now the protocol it is approved by the h.r. and within we'll use or some sort of pilot and also can go away from a change in administration in h.r. >> i think what you're referring to see direct hire during covid we assessed prior to the adoption we reverted back to the process we go through the list option process. >> but you're able within the

short term frame it is that the timeframe that is not strollers exception business healthcare is required bio nursing for our general emergency room and support. >> thank you fewer question and for your support of all the efforts we've done we have made um, some changes which we are proud of we have a way to go not a direct hire we will be able to bypass is eligible list but working hard to being able to offer a job in a day and working with the city has done through our active participation of the dhr and the civil services trying to find ways to rules to get closer and closer to a one

hundred days and now 60 and thirty days not an immediate but things like that but a process we have to do and we or continuing to move towards the ability to recruit and continued selection we're able to fill the positions and getting closer and closer was that presentation we're about to 45 days trying to get closer quo have star candidates and want to be able to try and meet them where they are and not the tradition of meeting us but turn that around and continue to report back and held accountable for our efforts to. thank you very much. hope that answers your question. >> thank you. >> and i'm sure that our former commissioner singer was

so frustrated are hiring time i remember many meeting are the director. >> of course. >> go back here. >> and, of course, just as frustrating i were in our departments like such a - this is remove illustrationy those people should have gotten a good ward also and get down to the one day hiring; right? at the this is so encouraging and we it ran a long time for a change but that is a great change. thank you very much.

>> thank you commissioner chow and we started with a 1,000 vacancies and, so the model we used with the nurses with the approximations and other positions we can create those efficiency and the experience for everyone this applys for the department so thank you very much. >> thank you. >> dr. colfax. >> thank you the team for the incredible work and director kim i wanted to express the fact the technical piece put in place but more or asking for a culture shift; right? so as i think patrick you're alluding to lots of justification about well, we understand not working but this is why it has to happen for the positions, you know, for the paraphrase i know it would

happen otherwise things will fall apart i appreciate about the leadership of h.r. team and the entirety on the data and evidence of best practices i guess and so i think that something that the team has done and interesting to see the results so really want to thank them for that. >> next on behalf of all of us we're grateful for the be you've done it is reputable and exceptional such a great example so many of things siloed we were trying to give continual cares and broke down did silos and what can be accomplished with coalition especially in hiring nurses is

so competitive and got kaiser permanente and organizations have a lot 340 flexibility within the civil service environment to hive that's an incredible accomplishment and we applaud you and lard to hear more great news in the future so thank you very much. >> next item on the agendas and is food security report and director of food security. who's a hard program planner for the data. >> dr. jones was not able to be with us but mr. chang and taylor. >> the description you can tell us more. >> good afternoon commissioners i'm eric changing the security and equity planner with the

department an equity and a health program planner and today presenting on the very first 2023 to security and equity report like mentioned dr. paula jones is not able to be here but was instrumental in developing this report and next slide, please. the biannual food report was produced by dph and the following departments contributed the office of equity and the center for data survives and the other departments attributed and acknowledge the rest of team shepherd.

>> (calling names.) >> we want to thank dr. susan and others for their report its final lisa nichols, community resources manager the report next slide, please. so presentation will cover the background and the report timeline and process lineing and the orientation report and finding and community representation as well as the next stoops next slide, please. >> give you a little bit of background the ordinance with passed on june 26th, 2021, and many reports by the san francisco security task force and requires dph now to publish the report for security and equity the report is specific about the analysis recovered and

the dph requirement of ordinance as we voep this project. the ordinance includes the task force which includes reviewing the data votes and from data organizations and regions presenting the finding and the ordinance also identifies the agencies that are also reporting agencies that required i contribute the data in the report and requires the economic development to submit an analysis of controlled programs and so the work on the security lines with the pilars of health impacts and equity that report describes the food insecurities from the equity lens and

intended to to the about more resources to improve the nutrition. next slide, please. the timeline for dep this report we make sure that the progress is regularly shared with the security task force in the meetings and also develop the project website to make sure that all information was readily available for the public and some departments requested additional time to submit the data for the challenges by the original timeline we requested an extension to publish those for october 1st to december. we held public hearings to discuss the data and develop recommendations and the report was published in the december of 2023. next slide, please. >> so orientation to the

report comes in three parts the first is the summary a sin opposite of the thought data and the second is the policies has a lot for more information about poverty and sufficiency and equities and all the data reported by agencies formatted to table as well as project denounces including the information for all public meetings we held and the last section is the oewd staff report and you can find online next slide, please. >> so absence about how the food and security is connected to health research has shown a strong indication between food ensecurities and such as los

angeles department of building & safety and hypertension and lack of developing a data sensitive disease and back to food and security is particularly increasing the risk for pregnancies and is negatively impacting effecting children impact development and food insecurity is associated with carts of psychology depress with disorders and in 2019 healthcare of food insecurity was 200 and 40 million as you can see the food and insecurity is critical

for the securitys so i'm going to turn it over to kayla will go over the finding. >> good morning, planner for the data science so. next slide, please. however, we use samples to get an finding of the food unsecurities and health interviews surveys 2022 exceeded 17 percent for income below the poverty level for food insecurities the highest percentage since 2018 for contacts to present a poverty level amounts to an income of $27,000 and disparities and

insecurities that african-americans with incomes below 10 powers of the poverty level is the highest food insecurities expanded to others with similar incomes. next slide, please. and other samples from san francisco we show the insecurities are at the level and this is much higher than the nationals food insecurity with with 2020 was 15 percent within a location wide and those experiencing homelessness and individuals who receive medi-cal identity in black and hispanic and households are few of the populations with high percent of food insecurities on the landscape of food insecurity look at the report next slide, please. looking at hospitalization data for san francisco we see this is due to

hypertension and other asian american pacific islanders and black 56789s residents and carpets to oil residence in san francisco hospitalization rates are 9 times higher than for asian american pacific islanders and other residence and 4 times for african-americans residents. this is very important speaks to the need for food securities program and for further information on nutrition please see our report and next slide, please. given the health impacts for the increasing nutrition related to the disparities the city continues it invest in fy2022-23 over $200 million were invest in city security programs over 80 percent came from local and public and a lot of call

attention those rely on funding for local services and 45 funding from left lane funds next slide, please. this chart is looking at the amount of funding that was administered related to this program and in fiscal year fy2022-23 h.r. mifrtsd the most funding of all department of 71 percent and san francisco unified unified school district. next slide, please. and other key finding overall 9 departments work on rolled initiative for 36 program and from fiscal year 2022 to 24/25 reformed $35 million reduction for local funds. so this is very certainly with the budget cuts

and the protection need to prevent further cuts to those programs and additionally the programs focused on nutrition medical conditions. out of $91 million in local funds for the programs 2.5 of the funds supported the programs who were permitting there federal dollars and the other 6 for small residence in san francisco and i'm going to turn it over to eir to talk about programs and our recommendations. >> um, next slide, please. um, so for this reports we categorized the resources into 4 buckets food access and infrastructure. for financial resources the data from 6 programs and those

programs allowed us to purchase food and various locations with farmers' market and restaurants and grocery stores for food access 12 programs for providing meals and for producing gardens and other food access programs that fell senate bill 9 other category gives services that lineed with the data we had so needs to be surprised so for example, passive produce and infrastructure categories with the funding went towards equipment and storefront row refrigeration next slide, please. a summary chart by the department of

health in fy2022-23. >> there are 9 programs total with most of them focusing an nutrition with medical care providing financial resources for food access and meals and groceries and funding is $8.86 million from fy2022-23. dph not on that slide but contributed to the infrastructure for food security and programs natives some are staffing and membership the security task force and producing and developing this bio annual report and supporting the other programs for changing strategies and funding initiatives to be ready for medically supportive nutrition. more of those details can be found in the table 13 a

next slide, please. >> so this is another united states of america by the program um, that providesed financial resources to purchase fooled provided meals and groceries. as you can see for financial resources 5 city programs that total $87.4 million in the last fiscal year. and eco system who runs the match program for the farmers' market and gave us they're data request $2.5 million a total of resources came out to $90 million and for meals over 16.5 million meals providing half if the national school lunch program and groceries should be the last year directions 10 programs and important to needed that 8

programs were 100 percent locally opportunity accordingly to the departments nelson mandela's. >> from special meeting on to the public and included the task force members and city departments and reporting city departments um, staff organization and food programs or working with the residents as well as members of the public. and recommendations that would be categories of policy program and budget and additional data analyze can be found in the report. and policy recommendations um, calls for strengthening the security systems by expanding federal

funding and increasing a call for a maximum waste time. a wait list for city programs ands b services not waiting indefinitely and program recommendations focuses on expanding and maintaining expanding the program and focus on health securities and ties in with the medically supportive initiates like cal aim and great support for supportive of housing services and to increase the coordination across the city and budget recommendations focused on restoring the local budgets and creating an effective line item for the city to aim to fund them consistently and lastly like more analysis of

program coverage by the neighborhoods to determine how much population especially those with health disparity. >> finally from the next steps dph is going to review and address reports on the limitations to the best of our ability and list in the report we held meeting to did he brief the process by incorporating lessons leaders for the next generation published in 2025 and also currently working on the annual 24 recommendations and providing a lot of data that is being found in this report to help to guide the recommendation and lastly for the community engagement equities and ph.d and

task force will be going out to the community to present the finding from the report. so that they can use that for tools and information further to guide their work and hear from the um, issues and work with their engaging that we um, know about or for the making it into this report. next slide, please. so i think that's what we said earlier with the information the website has and in e-mails and reach out to any other questions and. thank you for your time. >>. thank you very much for the report and at the also for giving the information is indicative i tried to look at the appendix but shows see effort to try to address that i think that a lot of vice mayor lemus had no idea how the kind

of impacts on the individuals and families so your work is critical and a lot of challenges you have probably questions but appreciate the work of your team and to help san franciscans any public comment. >> any public comment on this item i see none or remotely. >> great. commissioners questions or comments. >> vice president guillermo thank you, thank you for the report i think that is first time we had such a report so or even, you know, discussed the topic. so i'm looking forward to hearing more and consistently about the issues and wondering i know that the difficulty in collecting the data and having programs participate in - makes it so difficult but still the report is um, sort of a great

bottom line but in the automation do any of the data get broke down by age. >> the data like 8 population and i can tell you, which. >> do i have data on not just who serve but are who - really i guess suffered from the insecurity relative to those who are served? >> um, i think maybe i need more clarification what you mean by. >> insecure in the city and by the city. >> right? the person like seniors; right? have a fairly, you know, high percentage of single seniors living in san francisco have they served by the program or identified as

insecure that was the kind of data and looking at this i'm not sure of the analysis by the data. >> we have data on from the reporting data demographic data around age i don't think there was a level of detail that was provided to us around those populations are served and also the people that are in a specific age missing. >> we have numbers in the report on for programs that students insecurity you how many of their students are insecure for the broke down by graphics and we extended the numbers what populations those additional

analysis in the in the reported but planning to release those shortly. >> and i know that is difficult to gather all of that information and to hope that programs will coordinate in that way. um, but it is a nothing that i don't know i think the population in san francisco yeah. >> thank you. >> commissioner giraudo. >> i want to thank you for the report but also want to thank you more quickly answering um, our questions. um, and providing us with details answers so was very helpful and do so i know the group has presented to you're not to the report but in the public health community i

honored a list of folks for the population. and so this is helps but it is also highlights the staff there is a lot of work to do but again, thank you for your timely answers to the questions really helped me process with reading your data so thank you. >> thank you. >> commissioner chow. >> yes. i want to thank you for this report really creates a lot of questions i think rear yard the foods insecurities it certainly is important based on us to look at. i was wondering several things in the clear to me who on the task force i was trying to find do membership again and is it on many page in

the um, summary of the report. >> yes. on the last page of part one. >> i don't know if you see executive summary. >> oh, yes. >> but on the last page. >> the task force members. >> as well as the reporting departments and community-based organizations in the community. >> okay. thank you. >> i remember seeing that as we were looking at the presentation and so it is an important group we said in the group approximately in order to actually understand the food insecurity issue like and is that that then within the task force does that task force have any obligation to go back to own

agency and do things? or i mean, i thinks dph helps with the task force but what will we do outside of creating numbers? and who tracks those and who fools it? i mean at dph we have questions but what about the others have a charge of some sort to proceed with um, taking this data and then um, perhaps in homelessness really and do something? and if we're doing that is that what the next report will show? all that from the way it is just to collect the data. so up and coming to this group gets together and the following years is then the at that time will show we did something better or worse? i am

landmarking looking for a person and the next alcala tmac is - >> that's a great question. really used as tool to guide the task force members and reporting departments for the ipa securities and helps guide their own internal work i hope it does but also really using this as a tool to guide communities um, and community organizations and people on the ground living experiences with that data and

their work to guide their funding and asks for the report. um, task force numbers i think that is i think that is - um, a tool for task force members to use in their perspective agencies. to shift things internally to get that ball rolling. at guide not just people directly working on food but working with homeless people. >> so i think that is a tool can be very much moved internally to really guide with the departments. >> would you specifically looking whether or not anything has moved or changed? irony set of numbers; right? one hundred people here now do we have 24/7

here and there and will you be able to - i'm looking for what it will be and how we're going to really make use of this data and move forward is that part of charge creating data in the next report i gather you're working on that now? i mean will you ask. >> yeah so - >> (multiple voices.) >> liaison the data to look at the data over time definitely something we're interested in um, i think at this point we're doug like what the measures have changed over time will be it requires the departments to be lineed on measuring the same thing but, yeah in discussion and work with the task force and heaping to planning to talk with them further what they want to see measured and identify the

metrics but you're right we're in discussion of what we'll be collected and what will be added or changed based on the needs of the task force. >>. okay. i think that somehow not tasked that would be great beyond that will stimulate people came back what you said some, you know, maturities or something that everybody agrees what has been done or not done and i have to sporadic questions you stated in one of the slides that something like that two or three percent people - neither

was approved equity at all but out of 90 million and yet show that in this slide of 90 million or 89 plus million those actually sound by direct services i was not sure iowa what you're point with a 2 percent is being used to 2 percent refers to another number or part of this 90 million spent and what do i building that 2 percent represented was so maul you want to tell us. >> yeah the 2.5 percent is the amount of funds dedicated to programs specifically focused on nutrition sensitive medical conditions so- >> (multiple voices). >> what we're trying to highlight as concentration increasing the amount of local funding and budget for those

programs is minimal. >> okay. >> so maybe it is the way the presentation was a that in the major report? that your asking that big bear lake that not only do we give away food but working on trying to do something about why they have food insecurities? >> okay. and so last question sort of related to your analysis of the - find the slide. >> it is can i have a specific question to understand whether it is really a cause or co-existing in the hawaiian population and the asian american pacific islanders is high number of hospitalization related to heart disease and forth and for the

african-american is this a cause or co-existing that you happened to find this data um, or are you applying a cause for food we can show or is it just the way the data has i want to tell you about that can be many reasons a certain population has higher hospitalization day to what? you know, and heart failure and i don't know if this. >> psc that is slide 11. >> it says highlighting that when he look at the date for the hospitalization due to certain diseases we are interested in the feedback with a dietary function didn't mean the people

that are hospital listing in december but food insecurity can increase the negative health outcomes and if you are diabetes those numbers are are not - i should say the reason why 9 times higher for the asian american pacific islanders just due to (unintelligible). >> great. so that actually comes back to my first question in order to - would if be something we bring to the attendance of our primary care and so forth and i'll have sandra look at it and see what we could or couldn't do or shift the groceries both of them and just to sort of look for actions

those are the data the data shows if we don't know it is costal but and you can come back and say whether or not it was not but able to do we gave all the people so in fwroesh bags and, you know, we may - i don't know certainly for the hawaiian asian american pacific islanders that is not a large number of the african-american but it is and aside for the primary care people showing have improvements on the nutrition basis central for the blood pressure should be looking how many people are hospitalized and a difference in fact all people are food insecurity what we can do that

the data. >> commissioner chow. >> one of the things it is cause and effect. but i think common sense that better food leads to better outcomes; right? so for this report the commission knows we have pharmacies in a clinical setting and have a sensitive food pharmacy program and to sustain or potentially fill up those programs i want to explain that a little bit and i think that shows the values here. >> were shown a disparity and dr. colfax shows us how we're addressing for that i think that is very good. well those are any

questions?. thank you very much. >> thank you. >> i thank you, by the way, for letting those answers i have not had a chance to review them but how do people find out about there or so many and yet how - that will be a very - in two wlaeflz is local and need for san francisco and what is national? i'm wondering how people can identify resources and to an extent schools with communicating up and coming to families. >> that's something has been in the discussion for a link time how people access information and food resources and security is joined a lot of different um, programs had eligibility requirements so they are only targeting their certain populations um, and that is one

of the recommendations to have a centralized tracking system or centralized information system people can visit that and figure out what they're eligible for and apply those are a lot of - people have their own develops their own sites but not all encompassing and people get confused. so that's been a recommendation i think the last few years ago eco system if both is task force and report. >> well, thank you would be wonderful to have that stakeholders federally or how we accomplish that in h.r. like bringing down barriers hopefully within the food and insecurity. >> best practices and also

data sets nationally soeptd i know feeding america for example, has done a a lot of work i can search the zip code and san francisco gave me locations to get food i don't know how many people know about that but in terms of to moving rapidly simple an impact on health whether you can not just within our task force but look outside of for best practices because many of those organizations are nationally well funded have a research done might help make thing more efficient to customize it to the san franciscans where do we start with that? >> related to the best practices around like referrals some are related but the task force we have a subcommittee

that is called rehillary clinton food coordination they're developing around organizing food in san francisco and what sf residents need and that is back it september and planning on coming out with final recommendations sometime in the summer i think that that committee is working how can we best unify the work that is done around san francisco. and done an analysis landscaping about all the services provided in the city and commissioners working together and resources are available, and figuring out how to create structure that can tell us all of that and get the information that wraechz as many people as potential.

>> i courage you to look nationally a lot of things have been on no later than municipality and food what people are accessing that is interesting a lot of effect on the reasons that rectal cancer people are an huge increase in debating republican in the news and has to do with with food in the just environmental so interesting to try as the next step to look at not just how to get foods but what food is and how you get to access fresh foods and your strategies there so appreciate your work and look forward to hearing more about that heavily not too long from

now perhaps after the task force is done next fall appreciate that and thank you very much. >> so next item is. >> at at march 26th meeting j.c. crick reviews the report and had two presentations one for supporting full blackbird through care this is an initiative and successful program at cf g a wide array of prenatal and posted nationalal services to support this and

program it in co-alliance with the contract on the consent agenda today and discuss that a little bit later. the other presentation introduced the next generation of hospital we went there a very exceptionally and discussion with them about what those were and the true north metrics a scorecard of those not seen it is really a wonderful road map is where he wanted over a number of years now. and westbound the organizations objectives but we watched the green to red and see how they do we had quite a discussion expensive discussions on the

items specifically were would give us the background how we would be able to watch the success rates on funding so spoog necessary have been doing for a number of years and really a very nice tool to show us the quality work they're doing. the regulatory affairs we discussed regent surveys and periodically they big one of the triannual joint commission survey and i think i reported last time they expected a good report and in fact, a good report a few finding some will require that the joint commission come back and review i building they've done that is that not correct? >> i'm not sure that the person came back to review that

i think that was a cancer survey. >> i think we all expected they'll have a remedical action will be quit prompt and we're expecting a good report into the joint commission to i know that is commission is very - always interested in the indiscretion of our hospital and commissioner. >> between e-mail and the survey is it clear all the previous efficiency and validated. >> we will be accredited again. >> for another three years. >> good for us and ortez has been before us as chief of staff and any the chief medical officer in the process of choosing another medical staff

choosing another chief of medical staff. and during the medical staff report committee reviewed and recommending to the full commission to approve the family rules and regulations that are before us. in closed session we approved the report and the minutes report. >> so don't know in the commission wishes to add further mr. green. >> certainly i have nothing to add. >> great. any public comment? >> no public comment on this item. >> any commissioners comments and questions. >> all right. then we can go to commissioner chow will give the planning and finance update. >> thank you at the planning and finance and planning committee we actually reviewed

four contracts and one new contract which i'll briefly review also for you. would also like to note through we were able to review those contracts with a problematic review document also that showed us the work that was being done especially on the renewal how they correlated point dollars spent that is perhaps with the name of students systematically and helped to understand when the contracts and want to mention that and thank staff and mr. 34u8 mullins for putting that together and the 4 contracts up for renewal one for

laguna honda epidemic loulg program extend the reason for the extension is because the federal government has actually not be able to create the process for an award in a timely fashion and they needed too more months and some additional few minutes were available that had not been spent if other grants and that is also the reason why they were up three hundred plus percentage those dollars will be brought ever to help the endemocrat live and work program. >> the second report from the

resources you went p r c the program actually is an employment training program broke down in 5 different parts that is really comes from different funding streams and - but they're all similar and i want for on the job training that is different and actually presented to the board of supervisors. their program reports for the past year were excellent they were all 4 and recommendations from a problematic startup we're comfortable is a considerable discussion kern we're we're do you go about the p r c and hitting and red list and informed they started massage reviews of those at high-risk

and would be working with those agrees to make sure they don't unbecome crises. so there is now a process going on to exact that group of potential problem contractors and i'll be working with. so it was nice to hear that that process is now underway and p r c last time actually complied with all the recommendations made last fall and staff continues to feel positive but there is an audit die for last year will be reviewed in april. so we'll continue to follow up that so the programs there are employment programs that are

reviewed by us and recommended to approve on the the clerk will open the voting system. and three contracts with the ucsf award and the ward 86 an increase in the annual difference for the following up for the getting to zero f's t d services. >> a new contract was with the ucsf for a different service and that is for the ucsf embrace program which is as equitable informed and culturally presentation and mental health care to serve the population that experiences disparity who are in the mental health program

and there is a similar program in several other agencies that are targeted for other populations that is targeting for those cared for under ucsf and as i mentioned the mental health program and a sub specialist that health program the one i discussed earlier to t m g coordinated and 4 different contractors in regards to working with ma material mental health and american populations hitting a different segment of whatever programs that ran would be helping find them the program

to get them into this program for administered and if they need more specialized to go into that with talked about the with the african-american program that general has we discussed that earlier today. so this one is for a one $.5 million for a year. along with a short year of funding and it is for a total of $9 million plus for 5 years and three months. >> so the committee recommendations approval of the contracts report and the new contract. >> thank you for that report any public comment. >> no public comment and any commissioner questions or comments. >> great. hearing none, move to consent agenda so heard all

the items make a motion. >> move to approve the consent agenda. >> i'll second. >> any public comment. >> no public comment. >> then we can take a vote. >> all in favor, say "aye." >> aye. >> the motion carries. and next item is other business. >> any other business. >> commissioners. >> no public comment. >> all right. >> then the next item is. >> 7. adjournment. moved. >> and second. >> all in favor, say "aye." >> aye. >> all right. we unanimously decided to adjourn thank you everyone. >> thank you alice and sfgovtv

>> (music). >> the ferry building one of san francisco most famous that as many of 15 thousand commuters

pass through that each gay. >> one of the things that one has to keep in mind regarding san francisco is how young the city we are. and nothing is really happening here before the gold rush. there was a small spanish in the presiding and were couriers and fisherman that will come in to rest and repair their ships but at any given time three hundred people in san francisco. and then the gold rush happened. by 182948 individuals we are here to start a new life. >> by 1850 roughly 16 thousand

ships in the bay and left town in search of gold leaving their ships behind so they scraped and had the ships in the bay and corinne woods. with sand the way that san francisco was and when you look at a map of san francisco have a unique street grid and one of the thing is those streets started off in extremely long piers. but by 1875 they know they needed more so the ferry building was built and it was a long affair and the first cars turned around at the ferry building and picking up people and goods and then last night the street light cars the trams came to that area also. but by the late 1880s we needed

something better than the ferry building. a bond issue was passed for $600,000. to build a new ferry building i would say 800 thousand for a studio apartment in san francisco they thought that was a grand ferry building had a competition to hire an architecture and choose a young aspiring architect and in the long paris and san francisco had grand plans for this transit station. so he proposed the beautiful new building i wanted it wider, there is none tonight. than that actually is but the price of concrete quitclaim two how and was not completed and killed. but it opened a greater

claim and became fully operational before 1898 and first carriages and horses for the primary mode of transportation but market street was built up for serve tram lines and streetcars could go up to the door to embarcadero to hospitals and mission street up to nob hill and the fisherman's area. and then the earthquake hit in 190 six the ferry building collapsed the only thing had to be corrected once the facade of the tower. and 80 percent of the city would not survive the buildings collapsed the streets budges and the trams

were running and buildings had to highland during the fire after the actuate tried to stop the mask fire in the city so think of a dennis herrera devastation of a cable car they were a mess the streets were torn up and really, really wanted to have a popular sense they were on top of that but two weeks after the earthquake kind of rigged a way getting a streetcar to run not on the cable track ran electrical wires to get the streetcars to run and 2 was pretty controversial tram system wanted electrical cars but the earthquake gave them to chance to show how electrical cars and we're going to get on top this.

>> take 10 years for the city to rebuild. side ferry use was increasing for a international exhibition in 1950 and people didn't realize how much of a community center the ferry building was. it was the center for celebration. the upper level of ferry building was a gathering place. also whenever there was a war like the filipino war or world war two had a parade on market street and the ferry building would have banners and to give you an idea how central to the citywide that is what page brown wanted to to be a gathering place in that ferry building hay day the

busiest translation place in the world how people got around transit and the city is dependent on that in 1915 of an important year that was the year of our international exposition 18 million living in san francisco and that was supposedly to celebrate the open of panama differential but back in business after the earthquake and 22 different ferry boats to alamed and one had the and 80 trips a day a way of life and in 1918 san francisco was hit hard by the flu pandemic and city had mask mandates and anyone caught without a doubt a mask had a risk ever being arrested and san francisco was hit hard by the

pandemic like other places and rules about masks wearing and what we're supposed to be more than two people without our masks on i read was that on the ferry those guys wanted to smoke their pipes and taking off their masks and getting from trouble so two would be hauled away. >> the way the ferry building was originally built the lower level with the natural light was used for take it off lunge storage. the second floor was where passengers offloaded and all those people would spill out and central stairway of the building that is interesting point to talk about because such a large building one major

stairway and we're talking about over 40 thousand people one of the cost measures was not building a pedestrian bridge with the ferry building and the embarcadero on market street was actually added in and in 1918 but within 20 years to have san francisco bay the later shipbuilding port in the world and the pacific we need the iron that. as the ferry system was at the peak two bridges to reach san francisco. and automobiles were a popular item that people wanted to drive themselves around instead of the ferry as a result marin and other roots varnished. the dramatic draw in

ferry usage was staggering who was using the ferry that was a novelty rather than a transportation but the ferry line stopped one by one because everyone was getting cars and wanted to drive and cars were a big deal. take the care ferry and to san francisco and spend the day or for a saturday drive but really, really changed having the car ferry. >> when the bay bridge was built had a train that went along the lower level so that was a major stay and end up where our sales force transit center is now another way of getting into the city little by little the ferry stopped having a purpose. >> what happened in the 40 and

50's because of this downturn we were trying to find a purpose a number of proposals for a world trade center and wanted to build it own the philly in a terrible idea objective never gotten down including one that had too tall towers a trade center in new york but a tower in between that was a part of ferry building and completely impractical. after the cars the tower administration wanted to keep americans deployed and have the infrastructure for the united states. so they had an intrastate free plan the plan for major freeway systems to go

throughout san francisco. and so the developers came up with the bay bridge and worked their way along embarcadero. the plans were to be very, very efficient for that through town he once the san francisco saw had human services agency happening 200 though people figure out city hall offender that the embarcadero free was dropped and we had the great free to no where. which cut us off from the ferry building and our store line and created in 1989 and gave us the opportunity to tear down the free. and that was the renaissance of ferry building.

>> that land was developed for a new ferry building and whom new embarcadero how to handle travel and needed a concept for the building didn't want- that was when a plan was developed for the liquor store. >> the san francisco ferry building has many that ups and downs and had a huge hay day dribbled adopt to almost nothing and after the earthquake had a shove of adrenaline to revise the waterfront and it moved around the bay and plans for more so think investment in the future and feel that by making a reliable ferry system once the

ferry building will be there to surface. >> shop and dine on the 49 promotes local businesses and challenges residents to do shopping and

dining within the 49 square miles of san francisco by supporting local services within neighborhood. we help san francisco remain unique, successful and vibrant. where will you shop and dine in the 49? san francisco owes the charm to the unique character of the neighborhood comer hall district. each corridor has its own personality. our neighborhoods are the engine of the city. >> you are putting money and support back to the community you live in and you are helping small businesses grow. >> it is more environmentally friendly. >> shopping local is very important. i have had relationships with my local growers for 30 years. by shopping here and supporting us locally, you are also

supporting the growers of the flowers, they are fresh and they have a price point that is not imported. it is really good for everybody. >> shopping locally is crucial. without that support, small business can't survive, and if we lose small business, that diversity goes away, and, you know, it would be a shame to see that become a thing of the past. >> it is important to dine and shop locally. it allows us to maintain traditions. it makes the neighborhood. >> i think san francisco should shop local as much as they can. the retail marketplace is changes. we are trying to have people on

the floor who can talk to you and help you with products you are interested in buying, and help you with exploration to try things you have never had before. >> the fish business, you think it is a piece of fish and fisherman. there are a lot of people working in the fish business, between wholesalers and fishermen and bait and tackle. at the retail end, we about a lot of people and it is good for everybody. >> shopping and dining locally is so important to the community because it brings a tighter fabric to the community and allows the business owners to thrive in the community. we see more small businesses going away. we need to shop locally to keep the small business alive in san francisco.

>> shop and dine in the 49 is a cool initiative. you can see the banners in the streets around town. it is great. anything that can showcase and legitimize small businesses is a wonderful thing.

>> good afternoon and welcome to the april 2, 2024 regular meeting of the san francisco board of supervisors. madam clerk, please call the roll. >> thank you mr. president. supervisor chan, present. supervisor dorsey, present. supervisor engardio, present. supervisor mandelman, present. supervisor melgar, present. supervisor peskin, present. supervisor preston, present. supervisor ronan, present. supervisor safai,