the trees we have been planting in the parks the last few years, so i think it would be good if we could get some attention on the department at some point. the third thing i wanted to highlight, again, the replanting at the golf courses. that was something i was not aware of because i am not a golfer, but that seems like something is broken their. at sharp park, there is almost nothing. except very mature and dying trees, so we need to have some kind of plan for the parks and squares and especially the golf courses. president lazarus: thank you. i share the view this is an important subject. i regret in a way that it came at the end of the meeting, but it was worth just listening to all. after all, what are the park's, if not at the beginning, places of nature that you can enjoy i would love to hear you come back as we make project on this fraught, if that is a luxury

that we can afford to be kept abreast of it. >> it would be my pleasure. president lazarus: great. ok. >> don't be taking the tags off the trees. >> is there any public comment on this item? seeing none, public comment is closed. and any other commissioner comments? commissioner bonilla: in approving this item, because it is an action item, are we then supporting the recommendations that we do this 50/50 plan and we did the reforestation? what exactly are we approving? those seem like big steps. >> good question. >> the next steps are the director of operation will work with stack to develop proposed improvements -- will work with staff to develop proposed improvements to develop or achieve some of these items.

there is a lot of work to get there. what you're doing is accepting the findings of the report. this is sort of the first time this has been presented to the department. when i went to urban forestry council, we all looked at these numbers and they are tough to take, but they were all very happy this report has been done. it is a document that i think will be helpful as we move forward. so you're director of operations will be working with the general manager to come up with the implementation steps and a plan. commissioner bonilla: those are yet to be determined? >> those are yet to be determined. we would develop the plan, implement improvements, and that would be in the spring of 2011. commissioner bonilla: ok, which may include some of these elements. >> yes. commissioner bonilla: ok. >> mr. ginsberg?

>> i just want to thank the team, danny and rick and caring and gm and kelly. -- and karen and jim and kelly. i feel like i am in class when i listen to jim. commissioner sullivan, thinking long term, echoing the conclusion of the report, is duly noted. i think we obviously have had a lot of conversations about identifying sustainable funding sources, but a subset of that, i think we need to come up with a strategy to figure out how to improve the work we need to do on this front. it is a concept that a lot of things come before this commission that are divisive. protecting our trees is not. i think if we take that sort of consensus opinion and figure out how to translate that into a policy idea, to dedicate funding for that purpose, i think we

could actually take a very significant step in that direction. so i will do it to things, not remove the trap -- not remove the taxgs, and i will be thinkig about what this team how we can comeback with a strategy for augmenting our resources in this area. >> i think the good news is in the last fund, the first time, the city of san francisco was able to come before council and put $4 million in four major tree work. the most important properties that need this work will get a huge shot in the arm. that will start happening over the next year. there will be removals' and conversations and the public will become more educated about the parks. these are big, new efforts of the commission that will be taking place. commissioner lee: i just want to

say the trees have a tireless advocate in commissioner sullivan. it is a service to all of us for the commitment you have to it. thank you. commissioner sullivan: thank you. thank you. >> on that note, there was no public comment? do we have a motion to approve the report? >> i would move. >> second. and all those in favor? >> aye. >> opposed? hearing none. >> item 5, general public comment continued at this time, addressing the commission on items within the future agenda. these are four items that are not on the agenda. >> good evening, everybody. i know you must be tired, having been here since 2:00, but for

the benefit of the commissioners who did not attend the meeting on july 1, i will make my comments. there is absolutely no valid reason that a certificate of appreciation has not been presented to me to date for my priceless gift of the number one the prime location on the waterfront. it was $600,000. everyone thinks me for this fabulous popular park except reckoned park. the recipient. unbelievable. what is behind this? it is now approaching the 10th year. i want to know why. we must keep politics out of the commission, if that is what is going on. try walking in my shoes. how would you feel if you worked tirelessly for this project and then you get no piece of paper in return?

it is not a big deal. it is just a piece of paper. but to me, it means a lot, so i can show my grandchildren their future. life is a two-way street. is give-and-take. think of it as a goodwill investment that will pay you big, big dividends. i know that. so a little kindness goes a long way. so guys and gals, please do it. please? it just do it. thank you. >> thank you. >> nancy? >> i will now put on my hat as co-director as the professional dog walkers association has to mclaren park. this may or may not be appropriate for mclaren, but it is definitely not compatible with the new outreach area where 10 of 18 holes are proposed. this would create conflict amongst dog owners and golfers.

many professional dog walkers, in addition to dog owners, use one of the largest legal owned runs in the city. dogs being dogs will naturally want to chase the disk. people involved will be in danger of getting hit by disks weighing as much as one-third of a pound, averaging 25, 30 m.p.h. or more. that spca estimate is 40% of households own dogs. the need for this is critical. we, the professional dog walkers association, are in support of shared use, shared space with other recreational users, and many people without dogs walk in these areas. but disc golf is not a good fit. thank you. >> can i ask a question? are you just post to that one area? otherwise, in mclaren park --

>> definitely, we are definitely opposed to it being with that area. and the majority of it is in that area. >> you have an opinion on other parts of mclaren? you don't have to speak for the group. and i personally? -- >> personally? no, i don't. i don't have an opinion. i am very torn, because i know some of the disc golfers and i have had discussions about this, and they are nice people. on the other hand, they already have one course in san francisco, and there are other courses throughout the bay area. i am not sure. >> ok, i did not need to put you on the spot. thank you. >> thank you. >> is there anyone else would like to comment under general

public comment? ok, public comment is closed on the item 25. item 21, public comment on all matters pertaining to closed session. it is there anyone who would like to comment on closed session? seeing none, public comment is closed. commissioners, we need to vote on whether to hold closed session. >> motion? >> so moved. >> all those in favor? >> aye. >> opposed? none. >> we need to ask everyone to >> we need to ask everyone to please leave while we >> we have reconvened into open session, and you need to make a

motion whether to disclose any or all of the discussions that were held in closed session. >> i move that would not disclose. >> move and second. all those in favor? >> aye. >> we are now on items 6, commissioners' matters. are there any commissioners' matters? >> hearing on. at any public comment on this? public, disclosed. we are on item 27, which is new business, agenda setting. comments from the commissioners? >> none, but i don't want to lose sight of commissioner bonilla's, about moving toward a committee structure. i want to direct staff that you work with the commission on directing how that will best work. >> is there any public comment on this item? seeing none, public, disclosed. -- public comment is closed.

we are on item 28, communications. is there any public comment on this item? marilyn, are you coming? ok, sorry. it is hearing on top -- seeing none, public, disclosed. >> item 29? >> item 29, adjournment. >> so moved. >> yay!

when a resident of san francisco is looking for health care, you look in your neighborhood first. what is closest to you? if you come to a neighborhood health center or a clinic, you then have access it a system of care in the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs. the cole street clinic is a youth clinic in the heart of the haight ashbury and they target youth. tom woodell takes care of many

of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional focus of that is is to provide care to women and children. women find out they're pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. we initially will see them for

their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates. our doctors here are family doctors. they are able to help these women deliver their babies at the hospital, at general hospital. we also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. >> it's for the city, not only our clinic, but the city. we have all our children in san francisco should have insurance now because if they are low income enough, they get medical. if they actually have a little more assets, a little more income, they can get happy

family. we do have family who come outside of our neighborhood to come on our clinic. one thing i learn from our clients, no matter how old they are, no matter how little english they know, they know how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. they can be child care providers so our clients can go out and work. >> we found more and more women of child bearing age come down with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. how do parents tell their kids they may not be here?

what we do is provide a place and the material and support and then they figure out their own truth, what it means to them. i see the behavior change in front of my eyes. maybe they have never been able to go out of boundaries, their lives have been so rigid to sort of expressing that makes tremendous changes. because we did what we did, it is now sort of a nationwide model. >> i think you would be surprised if you come to these clinics. many of them i think would be your neighbors if you knew that. often times we just don't discuss that. we treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. there are people who come in who need treatment for their heart disease or for their diabetes or their high blood pressure or their cholesterol or their hepatitis b. we actually provide group medical visits and group

education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. and it validates the experiences that you have and so you learn from each other. >> i think it's very important to try to be in tune with the needs of the community and a lot of our patients have -- a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isn't the top priority for them. we need to understand that so that we can help them take care of themselves physically and emotionally to deal with all these other things. they also have to be working through with people living longer and living with more chronic conditions i think

we're going to see more patients coming through. >> starting next year, every day 10,000 people will hit the age of 60 until 2020. . >> the needs of the patients that we see at kerr senior center often have to do with the consequences of long standing substance abuse and mental illness, linked to their chronic diseases. heart failure, hypertension, diabetes, cancer, stroke, those kinds of chronic illnesses. when you get them in your 30's and 40's and you have them into your aging process, you are not going to have a comfortable old age. you are also seeing in terms of epidemics, an increase in alzheimer's and it is going to increase as the population

increases. there are quite a few seniors who have mental health problems but they are also, the majority of seniors, who are hard-working, who had minimum wage jobs their whole lives, who paid social security. think about living on $889 a month in the city of san francisco needing to buy medication, one meal a day, hopefully, and health care. if we could provide health care early on we might prevent (inaudible) and people would be less likely to end up in the emergency room with a drastic outcome. we could actually provide prevention and health care to people who had no other way of getting health care, those without insurance, it might be more cost effecti