i feel the different sides have not been able to explain to me how apple's compared to apples. one issue that continues to be raised is around actual safety and security. the suggestion the department has made is that you believe if we contract out these services, you would be better served from a safety standpoint and public health standpoint that you are currently by the sheriff's department. could you explain that again? it's a little counterintuitive. >> we put this up but to increase our safety ability but to not have to cut as many health and human services. there would have been an additional $4 million in cuts. i'm looking at the proposal brought up, what with the next best alternative would be? the next alternative we felt was the security going out. we can get armed private security. we know that they can help us with our health care teams in

terms of detention. we know that causing issues are on perception from the shares perspective and having the share of verses private security. we felt this was the next best option in terms of not having to cut health and human services. we also have a great deal of concern regarding the safety of our staff, the safety of the patients, and the safety of visitors. that is one of our utmost concerns. there are differences between what the sheriff can do in terms of detaining and what private security can do, but this is not something we put up because we wanted private security as opposed to the sheriff, we did it for savings for health and human services. supervisor chiu: kenya enumerate what private security would be able to do that your shares deputies would not? >> patients leaving the

hospital due to health conditions -- it they're trying to hurt themselves in the midst of trying to leave the hospital or in the bed, the sheriff can and has not been willing to detain the patients like that. family been willing to -- they have only been willing to detain patients that are 50/50. according to the sheriffs, that is what they felt their rules with -- the rules of engagement was. we have had several conversations with the city attorney's on what they would do and would not do. supervisor chiu: i have a question on the budget. supervisor wiener: i understand there is the issue of the cost savings.

i know that is a factor and i think that is one that looms large for a lot of us given the cuts we would love to avoid. you are saying the cost factor was the primary motivator, but i also heard last week, dph was saying there would be non- monetary advantages, which you just described for security. >> as i explored this issue with the leadership of san francisco general, i was surprised they were concerned about the role of the sheriff and what they thought about the contract. this has been a development process of trying to go to a contractor. those issues have been discussed over the last six months. we discussed the opportunity of a private contractor and they felt that would solve some of the other issues that had been going on.

supervisor wiener: for me and for others, the cost issue is important as we try to save critical safety net functions. i also want to make sure that the employees at san francisco general and visitors are safe. no. 2, the hospital is able to manage itself in a broadway -- in a broad way as effectively as possible. what i'm hearing is there are operational advantages to having private security. but also hearing in some of the high-risk areas of the hospital like the emergency room or the psych ward, there could be some safety impacts. that's why i want to come back to the potential hybrid model. at any given point in san francisco general hospital, how

many deputy sheriffs are present in the hospital? >> 39 -- 49. supervisor wiener: if you were to just have deputies in the high-risk areas, that would strike me as a much reduced number. >> i would have to look at that. supervisor wiener: there could be a hybrid model that achieves the lion's share of the savings we're talking about but does allay some of the concerns we have heard about, gang members chasing people being brought to the emergency room or issues where people get out of control -- perhaps it would be safer and the employees would feel more comfortable having peace officers there. >> through the development of these conversations, we would be supportive of that.

it's important for the public that the perception of safety be there and having surest there at the most high-risk areas of the hospital, i think everyone is in favor of that. supervisor wiener: other than the emergency room and cyc, are those the only high-risk areas or are those the only ones? >> those are the highest risk areas. we can work with our hospital staff to determine if there is another area to look at. supervisor mirkarimi: just to return back to the discussion -- i think you are getting the drift that it's hard for us to fathom a $13 an hour security guard would actually be more empowered that a sworn peace officer that would be a member of the surest part by 2 has been the primary safety person inside

our public institutions. when the testimony last week by the department of public health suggested, asserted there would be more authority given to a security guard, i did ask the surest apartment and i have talked with legal counsel to understand what and how we would be able to rely on that difference of authority in a rent a guard verses a peace officer. i can see where there might be a splitting of hairs, but i walked away from my query of them thinking our gut feeling is right. a peace officer unquestionably is more empowered statutory away to be able to do what's -- statutory early to be able to

do a security guard is not. even if there is debate, knowing the industry of private security, or you have high turnover cali have people who are typically not on pension and have very little benefits. the fact we would actually rely on them in situations that could be high risk for more at risk situations based on a proposal submitted to us i think would automatically make anybody question how the practical expectation is that this particular security guard would subject themselves to something a more well trained, armed peace officer would be. that is where we are at this particular place. relative to the question of the 49 members of the shares department, how many would remain if we were to move

forward on the proposal that is before us? what they all be evacuated? with their be some remaining? there has been a floating number. >> if the contract did this out, there would be no assurance. supervisor mirkarimi: 5 understood there would be a least two remaining. is that the case? -- i understood there would be at least two remaining. >> there are differences between a police and a security guard, so we do understand that. supervisor mirkarimi: i asked this last week and it got a little misunderstood -- in the scenario of transferring 49 peace officers, who would effectuate a citizen's arrest? >> security guards can do citizen's arrests.

they can also call the police to come on to the scene. supervisor mirkarimi: that is true, but they also incur a significant liability if they themselves are taking action that could potentially be a challenge as a violation of somebody's civil rights or acting inappropriately because they are not as trained as a peace officer might be trained. that is a consequence that may not be seen as a factor on the front end, but on the back end, it makes me wonder if we're taking on something that could only make us regret later on. i think that goes to one of the streams of thought about this discussion. >> we understand the concerns of the supervisors regarding the safety of our patients. that is the number-one concern that we had in this process, what the best next thing we could do from the sheriff's

perspective. you can see some of the other hospitals and maintain a contract employees in this way in terms of security. we do know that having sheriff's with guns does create more safety from a public perception than security guards. but these security guards can create a safe environment. they do in other hospitals. that is what we proposed them. supervisor mirkarimi: well, the gun is hopefully something that never has to be used. it is the question of the escalating use of force that is empowered by the penal code to that peace officer that a security guard does not possess. so that is why i really still stand unclear on how we justify that. but to round this out, instead of the transferring of all 49, has there at least been a discussion of some hybrid, so

that there would be -- i think this goes to the intimation of some of the other supervisors, of there at least being a decent posse of deputy sheriffs on hand? >> no, there have not been. supervisor mirkarimi: thank you. supervisor chu: thank you. just a question for you -- just a question. i know that the model which the office articulated the potential savings, that was the same thing proposed for the current year, but we were negroes -- we were never able to implement it, right? >> right, exactly. part of the issue has been the ability to start that process. it takes at least three months to do the checks on all of the employees. it is a long drawn-out process. we started working on this as of this fiscal year and continue to do that until a decision has been made. supervisor chu: ok, so the

proposal before us is a proposal that has been a year in the making and has still not been implemented. it is not a new proposal. >> yes. supervisor chu: and with regards to the -- i think supervisor mirkarimi brought up this question. i did want to ask perhaps todd to address this. the way the department explain this in the past has been that, given the budgetary pressures, the department had to think about all the ways that you write your operations and look at where you can make a change -- look at the ways that you run your operations and a look at where you can make changes. i know it is a difficult task. the project a proposal that came out at a lot to do with meeting that budgetary pressure. from my understanding, as the conversations and proposals went for word, from the staff's perspective, the idea of this proposal actually had the opportunity to actually improve

services in a way that we felt that we were limited with the current deputies that we have. not saying that they are not good security guards, but that there was an opportunity to do more. i wonder if todd could come up and speak to that. >> very good, thank you, supervisors. it might be helpful to go back a couple of questions, maybe with president chiu articulating a sense of disconnect about how security guards can provide better security. that is a general sentiment that folks are struggling with. there are two security issues. there is the violent criminal element that can come into the hospital. you mentioned the gang violence that may spill into the hospital or other violent members. and the law enforcement officers absolutely are better

equipped to handle the kind of security issue, and they handle that extremely well. the other safety and security issue is the patient who is suffering from acute medical crisis, like i discussed last week, where they do not have control of their functions and mental capacity or are behaving irrationally, may be aggressively, compromising their care, there and safety, and the safety of staff and patients. that is where we have a gap with our current security system. the sheriff's feel legally bound that they cannot intervene in those medical crisis situations with patients, because they're in a law-enforcement and they are bound by regulations that control law enforcement officers. how can we handle that differently? well, as medical personnel, we

have a duty and obligation to keep our patients safe in those situations. and we have a responsibility -- barbara mentioned at the joint commission. we're mandated to provide a safe environment, especially for our most vulnerable patients who are in those crises and are confused and irrational and causing potential harm to themselves and others. we can -- i mean, the doctors and nurses can constrain people. that is not a great situation. we're not trained to do that. a compromise is our relationship with their patients if we're physically restraining them. but we can have hospital staff, or staff for part of our medical team, assist us in restraining patients in those situations. that is where we have a gap right now. the sheriff's cannot do that. security guards could. that is what we're trying to

address here. i hope that background of separating out the issues helps you to understand the situation. supervisor chu: thank you. president chiu: thank you, and i appreciate that explanation of the first question i had. i think it helps to clarify things one missing party today someone representing the sheriff's department to help us understand why they do not feel that you can help intervene in a very real security situation with your folks. i have a couple questions to the controller's office in the mayor's office. having received proposals, i have been going back and forth trying to understand how to compare apples to apples. they have proposed what they believe will help to save the budgetary savings that we're looking for here. from the controller's perspective, you say this is apples to oranges. we're talking about a few fte's

doing the work. sciu said that was because they did not feel that as many managers were required to manage the situation, and they believe that they could achieve the appropriate level of security without such a high management structure. i am wondering if the mayor's office or the controller's office can respond to that, on whether the staffing level proposed could address the situation and what that staffing level is compared to what it is currently. >> the numbers we provide you when we are certifying preposition proposals are endeavoring to remove the question of what the appropriate staffing level is from the equation and provide a comparison of if you replace a model currently providing civil servants at a certain account with a light proposal using contractors, what is the difference in salary, which is the question with prop j.

the numbers i provided earlier are controlling for reduction in staffing levels that the union has discussed. i think the health department could speak most appropriately to whether they think the current level of civil service staffing is appropriate and what a reduction in the count would mean to security at the hospital. >> i think the numbers of security of the sheriffs that we have today is inappropriate. less than that would be questionable. supervisor chiu: what is that level? >> it is 84. >> one of the issues -- but director -- budget director through the chair. what the issues with regard to alternate proposals and the difference between 63 and 71 are not management staff so much as supervisory staff who are working staff. so in the model that the health

department has currently, there are staff classified as supervisors, but they're not people who sit in the office and manage security guards. they are working staff the or security staff -- who are security staff. if you remove those fte's from the question, it is not just a reduction in management. it is a reduction in the level of security personnel who are operating, and that has been one of the discussions that we have had with the union and through the alternate proposals, and also one of the reasons that we asked the controller's office to do the apples to apples comparison that you suggest. if we were to replace those working supervisory staff where it -- actually, just using the non-supervisory security

personnel, there would probably be a very slight difference in the change in the cost per fte, because the supervisors are paid at a slightly higher rate. the savings will not be equivalent to removing 8 fte from the floor of the health department facilities. it would be just a slight difference in the pay rate for those 8 fte's. supervisor chiu: this feels a little bit like groundhog day. we keep having this conversation year after year. i had hoped that between last year and this year, we could have started the conversation earlier to engage in figuring out how we find these savings. i think we absolutely have to find these budgetary savings, given how little room we have in the budget. but, on the other hand, neither of these illusions we're looking at feels exactly like they are able to address all the issues we have here -- neither of these solutions we're looking at feels

like they are able to address the issues. is there a way for us to get to and achieved some very real savings? i hope that we can actually get there in a way that would be satisfactory to all parties, but i want to get a sense from within the department what kind of conversations you have had over the past year around this topic. >> we have had prop j, as far as the budget, for several months now. we have not had conversations with the union about security. they have not come up in my conversations with the union. supervisor chiu: ok. >> i want to a knowledge that over the past couple of months, this has been, as we have discussed, a longstanding issue, and in the budget for the cuent year a year ago as we were having this discussion, we did spend a significant amount of time talking through these issues and ultimately ended up with the ipo model in the

budget. that has been an ongoing discussion. just in recent weeks and months, i do want to a knowledge that the union has been very engaged with us, and we have been spending quite a bit of time -- i have, i know the health department, finance, and my office has been working through the various numbers and proposals with the union, and that has been, from my perspective, a good conversation. so we have been trying to work with them to talk through these issues and look through the numbers. they have been very productively engaged with us in that regard. supervisor chiu: i appreciate that. obviously, i feel like we're not necessarily there at this moment for us to make a decision. colleagues, if it is ok for us to move this decision to tomorrow, i would support that. but i think if there are additional conversations that we could have, and over the last few days, i have been going back

and forth between his department and sciu to see if there is a place we can get to that will work, but i am willing to keep doing that over the next 24 hours to see if we can get there. >> and so are we, supervisor. we're definitely open to have more conversations. supervisor chu: thank you. supervisor wiener: i just want to underline the issue of the police is being brought up. in my conversations with san francisco general, and with others, it seems like there are issues around the institutional police. i think the department has been very clear that it does not want to form and run its own security service in terms of the institutional police. given that, i really want to reiterate that the potential blend between private security and the sheriff's department is

one that we need to look at. i think the sheriff needs to be very much involved. i know there may have been some conversations in the past about this, but given the timing, i think it is important that we quickly engage the sheriff to see what is possible, so that we do not have a sort of this gaping either/or kind of situation. >> and we also feel that if we have that conversation, we would be open to that. we think that the ipo issue is the big management issue. we do not think that we could get to the savings this year if we went to that model. that would be the other alternative. supervisor chu: thank you. and to the department, can you speak to the budget analyst recommendation? >> yes, i think we're almost there. i know that mr. rose may have some corrections to his report. i will see if he has those. we want to thank his office and

also don, who has been very helpful. supervisor chu: thank you. budget alice recommendation. >> our total recommended reductions are $1,098,840. of those, 80.9% our general fund reductions. $345,000 are ongoing reductions. we also recommend closing out an expended general fund incumbrances, which would allow the return of $64,709 to the general fund. the total savings of $1,000,000.106 -- and we come to the total savings with the general fund. what the department was referring to in terms of the correction, the report is correct except on page 73, which

does not change the bottom line at all. on page 73, where you see the recap, the general fund impact isshould be $543,623. the total would be $888,840. the non general fund would be $210,0000. the totals would be the same. so my citation of the original general fund savings are correct. supervisor chu: to be clear, from my understanding, the report shows savings in terms of total recommended reductions of 1,000,098 belt -- 1,000,098 $840. it should be $888,804.

>> and that number on page 64 of our report is stated correctly, where i initially commented. supervisor chu: can use it to the number is again? >> of the recommended reductions, $888,840 our general fund. in addition, there's another $64,709 to close out general fund encumbrances bit of the total recommended savings would be $1,163,549. of those recommended savings, $953,549 would be sent to the general fund. supervisor chu: is the department in agreement? >> yes, we are. supervisor chu: if we do not have any objections on taking those reductions, can we do that without objection? we will do that without objection. thank you very much to the department. are there any further questions? i know that supervisor chiu

mention the desire to continue the conversation to tomorrow. supervisor chiu: i did have one more question. to the director, i understand, with regards to the security situation, 20% of the staff are managers. is that correct? >> i have no idea. i am not sure if our staff knows. 28%. supervisor chiu: 20% of the staff are managers. -- 28% of the staff for managers. is that correct? it seems high. >> i think the question is, what is a manager? in a hospital setting where you're running 24 hours a day, 365 days a year, you have a working supervisor and my your staff that is working. we do not consider that to be management, but we consider that to be the person who would be authorizing overtime in case someone did not show up tok