chiu has an investment in this area and any questions of how we are efficient as possible, we have much more available information. >> the department it holds the stake holder meetings two or three times a year to bring our stakeholders including our department's staff along with our -- communities that we fund to talk about the budget and also to plan out how we will meet our targets. over the years, we have tried numerous ways to reduce our budget. we have talked about looking across the board cuts but we also looked at some of the issues about non matched general funds. 2/3 of our general fund and realignment are used to draw

down federal revenue. dph is a provider of last resort. this takes up about 100 million of general fund. but we cannot leverage those for revenue. there is a majority of remaining, about 70 million that is contract it. that basically leaves 70 million to prioritize our reduction. most of this is contacted services and community programs. another part of that is that of the community programs, almost 2/3 is contract it out to the cbo. question as to clarification on the difference between the hundred million and a 70 million? >> this is 375.

we spent 100 million in the areas of jail supportive housing. these are not matched, not not leverage. >> this is where he would not any finding anywhere else. >> for the individuals and the jails, for supportive services. >> we have no reductions in children's services, prevention services, hiv health services, long-term care services, and medication support. we did try to preserve some of the services that we felt where our highest priorities. >> this is the 13 million

contingency. why would we accept the efficiency measures? >> one is the reallocation of -- to ada housing. we do have new housing pipelines coming in. this was a way to relocate some of these clients into what i believe is better housing. we also have several housing -- several hundred stabilization beds. we will provide permanent housing as a way to save $1 million which includes a couple of full-time equivalents. >> these are not necessarily administrative efficiencies. >> these are program efficiencies. >> we have done a number of the

program efficiencies. last year, as you can recall, we cut several hundred clerical positions. we have reduced our administration clinic directors, primary care directors and we also created a business office last fiscal year that reduced administrators as well. this gives more detail to the reductions and efficiency measures. under our behavior services, we are cutting 4.1. important to talk about the difference between non match fund and percentage of the total funding. in our substance-abuse area that

is also an area that does not have a lot of leveraging. when you think about those community-based organizations, some of them may have more general fund than others. those that will get a non matched general fund. the total category i 2.1%. something not leverage dollars. that could be a real cat. -- some to not leverage dollars. that could be a real cut. >> this is 2% of the investment? >> this is 2% of the modality of

contracts. that represents 16% of the unmatched funds. these contracts represent a 15 and a half percent of these non matched funds which is about 1% of the total funding. >> the total of those cuts are 4.38. >> we have also included civil service reductions of about 10 positions representing about 1.1 million. residential treatment reduction is probably one of the hardest ones i had to put on this list. we have a very strong residential treatment system of care. we don't get a full complement of leveraged dollars. this represents a 10% cut for the programs. we will have to work with each

organization very closely. those are somewhat more difficultdo not have to close ee systems, entire modalities. and then the transfer of the boat 125 clients. that represents a service reduction. the next slide, we will talk about security, but just to make a couple of comments. security, we are not an organization that manages security. we are in organization that provides health-care services, so this has become a debacle a process for us -- we are an

organization that provides health-care services, so this has become a difficult process for us. more civil service cuts. i will let our cfo talk about this in more detail to you, and then any questions, i can come right back up. >> good afternoon, supervisors. i am cfo for the health department. just to introduce this a little bit more, obviously, our priority in trying to balance our budget begins with trying to do everything we can to improve revenues, he thereby improving our collections or by trying -- improve revenues, either by improving our collections or by trying something else.

we managed to meet most of our targets with the approach. and we look less costly ways of doing what we do, so we have only service cuts remaining. the purpose of this is really to minimize the negative impact of further cuts to services, because that is really the only other option we can identify right now that remains for us, so we are resubmitting a proposal that we have submitted in the past to contract out security services that are two hospitals, san francisco general and the laguna honda hospital. this is with ongoing work of the sheriff's department and is also an alternative to an initiative that was approved last year to try to move to a civil source

security work force. -- a civil service security work force. we are committed to a no-lay off way of doing this. we want to return all of our sheriff's deputies to the sheriff's department so that they can return to work either in the jails or in other locations that the sheriff identifies where their priorities are calm -- are, and there is a likely increase in the jail population with some of the state proposals. it creates an increasing need for those deputies to be available to supplement their staffing. that will help them reduce their overtimed and theoretically reduce their expenses.

-- reduce their overtime. there are officers that are currently in the sheriff's department budget that would move back to the health department budget, and we would deploy the institutional please at our clinics and at our minister of locations, -- we would deploy the institutional police at our clinics and at our and ministerial locations -- our ministerial locations -- our administerial locations. we brought over a chief deputy, and we have been paying that 100% to help us move forward with the civil service option,

and what we have learned, number one, first, it is more costly than what was included in the budget. the budget did not include any of the costs of recruiting, training, background checks, or, and most importantly, backfill. if we had a civil service security force in place at our hospitals, we would have to backfill for our paid time off, schedules, and unscheduled time off for all of the civil service workers, .-- paid time off, scheduled and unscheduled time off for all of the civil service workers. it assumed we would be fully converted to a civil service work force by january 1, last january 1, and in six months, on july 1, we would have done all of the work, the hiring, and we would have it in place within the six-month time frame.

the reality is it will take us much, much longer to make that large a change ups -- at our hospitals. we would be moving into the following year before we could complete convert san francisco general hospital, so it would be a long process, and during that time, we would be incurring expenses of the current high cost. the other issue that we became aware of as we look at this is that we fear that if we were to create a security guard work force of the hospitals, the most capable and best qualified would note -- note create a security

guard work force out of hospitals, the most cable and as qualified would be -- the most capable and qualified would be moving out to better positions. certainly, you would not want to stay in the way of somebody getting a promotion and getting a higher paid position, but there would be a revolving door on the continued recruiting, training, a background check, deployment, and turn around process but -- trading, background check, deployment, and turn-around process. we know from our own experience. several years ago, we did manage our own security force, and we did not do a good job at it but we do not have the

infrastructure to provide the command and control structure that would need to be there. we are not skilled in managing police, and what we found was we were incurring really excessive overtime and a very high level of inefficiency with that work group when we were trying to manage it ourselves. our motivation moving it to the sheriff was specifically because we felt we could not do a good job of this. so our analysis, essentially, suggests that we would save $3 million in this coming budget year, assuming that we could get this program implemented november, december, and get the work force in place at the hospitals, and then in the following year, with a full year of implementation, which would save under $7 million for the 2012-2013 year. on the one hand, we have a

savings of $3 million, $6 million later. if we did not go forward with the civil service plan, we would have to ask for an augmentation in the budget for what is not in there, the additional work force costs and the higher costs of the civil service work force that really was not built into that plan, so it is really a choice of spending more or saving money, and in either case, looking at a deeper and more painful cuts. chair chu: the civil service plan, you have mentioned a number of problems with the implementation of it and some of the unknown costs at the time. what was about to of the savings that you were anticipating from the civil service plan? >> let me see. i might have something that shows it. in the year we were going to do this, six months of the work

order of the sheriff would have been $4.30 million, and six months of the civil service costs would have been $3.10 million, so that is a difference of $1.20 million. that is a $1.20 million differential for a six-month period. that would be a total savings for a full-year period of $2.40 million. the civil service dollars are understated, and as a consequence, that savings would really be far less in reality. chair chu: so you get anticipated for the full year savings about $2.40 million in savings? >> that is right. chair chu: but the recruiting and training would have eaten up at $2.40 million? >> what would have happened is first off, it would have taken us longer, so we would have had a longer time with the work order, number one, and the background check situation alone

works out to be about $10,000 per hire, and the reason is you do three background checks on three individuals at $3,000 each, and the experience at the sheriff's department has been that one out of three passes the background check, so you are spending $3,000 times three to identify one hire for a security person, so that is certainly a portion of it. we have detailed accounting on all of the background training costs as well as the hourly rates as well as the backfill expense, and we can provide all of that detail to you and are happy to do that. chair chu: i think that would be helpful, because the way i see this, since this was a plan that was part of the budget, there are only several ways that we can go about this. one is to continue with the civil service plan, where you

say the savings will not be realized by the department, so you would have to find a way with that. the second option is to reverse it and go back to the way that it was, and that means you would have to pay the $4 million to pay the sheriff's department for the work order, and in the third is that you go forward with this option, the prop j option, which is a difficult one, but it would result in savings. >> this si -- is the first year that we have looked at this. chair chu: so for the options that we have laid out, if we reverse it or continue on with the civil service plan, we would have to make up for that

somehow. and then in regards to -- i think you alluded to in a bit, but we really did not speak too much about it. -- i think you alluded to it a bit. that money would be taken from our general fund reserve. can you tell me what this means to return, i guess, the deputies from sfgh and laguna honda? >> we are looking at that carefully. the critical issue for answering that question is what we end up believing to be the impact of the state realignment program. so there is a current your supplemental -- a current year's supplemental for staffing costs at the jails, but we will also

have to increase staffing at some point in the budget at the jails. right now, we have a budget that assumes that the little jail stays closed. we're going to receive a significant increase in the jail population as people are sentenced to local jail rather than state prison. we will likely need to expand staff at the jails, or expand ours at the jail -- hours at the jail, and the first is to use overtime, and the second is to have more positions. a third option would be to move the deputies who are currently staffing the health department back to the jails. they could provide some of that staffing which would be needed for the new, higher jail

population, and that would offset the hiring or overtime to offset that. there would likely be assuming that the realignment process goes through. chair chu: we do not know the details yet, but we believe that there will be increased costs. either way, we are looking -- you can either do that with overtime or hire new people, and this would be potentially neither one of those. this would fill the need for staffing. >> that is correct. chair chu: and then, just a question for dph, on like the

other proposal, where they laid out where the cuts would occur, what is the plan here? is it going to be a targeted approach to rid the cuts are made? or is it a percentage, across the board -- is it going to be a targeted approach to where the cuts are made? >> , chief non matched general fund we have, and it will be a 15% -- it would be how much non- matched general fund we have. we would work with each of those organizations in determining how they would want to realize those. chair chu: do you think you will be able to share some of those details with us? >> sure can. we're happy to share those with you. chair chu: ok, if there are no

further -- oh, supervisor wiener? supervisor wiener: i have a question about the security and the contract out. i know this is an annual political event. significant cost savings. the effectiveness of these, i would ask you to comment on that. i know that at sf general, there are security needs, and i know

that from various positions and others who have commented to me, again, not in the context of any union situation, but just as individual employees that they do have concerns about that. >> first, alan lee county help center, highland hospital, et -- alan lee county note -- alameda county health center, highland hospital, and another have been happy with epic. -- it. i really believe that they have, number one, the experience, and i do believe they set a very high standard. the people who work need to have certifications to work in the

health-care setting. and to provide security in that setting. that is my first point. the second point, and i think this is important, is before we went to the sheriff, before we went to the sheriff work order, we had a 100% security staff organization that we supervised ourselves. it was not sheriff's deputies. but it was a salaried security force supplemented by assistance from the police department when somebody needed to be arrested and transported to a jail or managed from a police standpoint. that is exactly the arrangement we would have under this situation. we would have a group -- we would have a security force that is not the sheriff's deputies. this goes back. they were not shares dipodies before, but they would have certification. a contract to work force also of

police officers or sheriff's deputies. we would have an arrangement with the sheriff's department to provide with transport and booking note -- and booking, that would be a component of what we have to make available, and i think at the end of the day, the reality is people who are brought to the hospital by police are brought by the police, and they are there when patients are brought in, that is a significant amount of the presence that exists in our emergency departments. it is frequently the police department's -- the police department as well as sheriff's deputies. the contract workers, the background checks would be at the level of armed guards. whether we may ultimately decision -- the decision that they would be armed or not, they would be passed, qualified, and

eligible to carry firearms, so this is a very high level background check and would require a fairly high level of training. supervisor wiener: tell me what the pay rate is. there is a rage, in there is also probably a certain stereotype -- there is a range. >> number one, we are not looking for minimum wage with this plan. when i spoke with the organization, i have only spoken with one organization just to try to gather a little bit of data, but i talked to them about, how do you deal, for example, with collective bargaining and things of those natures, and their response is they provide services in many states across the country, and there are many states where their forces are not unionized, and there are other localities where there forces are, so if they are supplying forces in new

york and boston, in san francisco, that is really a necessity, so they work with what the local needs and requirements of the community are, so, number one, this is not a minimum-wage situation. i think it would be competitive salaries and a full benefit package that we would be looking for. we, obviously, we would do, werfp, -- we would do a full rfp. you know, i am not aware -- believe me, if there was a problem at alameda county with this, and we would be seeing some newspapers. it would not be anecdotal accounts. accounts. you cannot have a trauma center