committee. >> thank you. a quick snapshot of what we have accomplished since we opened in november of 2010. we have been rolled almost 800 patients, completed 2200 visits and 1900 referrals for needed specialty care and surgical care. 100% of our patients, once deemed eligible, are able to see a medical provider within two weeks. that is an important part of how we define access to care. one of the things we learned in our needs assessment was just how long people sometimes have to wait, even with our robust safety net for it -- with our robust safety net. it can be a very, very long time, months, to see a primary care provider. we are always evaluating our services and care so we have already done a volunteer survey as well as a patient survey. 71% of our volunteers have been

volunteering for six months or more. 90% of our patients are satisfied with the care they are receiving and 90% of our volunteers are very satisfied with their volunteer experience. in terms of our growth plan, we have been determined to grow incrementally, to make sure we have infrastructure we need to continue to provide high-quality care. our plan is to add a saturday clinic. our hours are tuesdays, 12:00- 8:00 p.m. as well as thursday, 10:00-6:00 p.m. i am excited to also offer a saturday clinic critz it is pretty unusual that a community clinic is open on saturday, so people do not have to miss work. we are working on developing a small dental program. we learned that dental is a huge need for every single person in san francisco. we are going to do what we can.

we are working with the san francisco dental society to do that. our goal is to become a fully operating, six-day per week clinic. a quick note about our budget and how we manage to do what we do. as janet said, we are 100% privately funded. we do not take any government dollars. we are committed to that so we can remain adept and agile responders to the community needs and keep our overhead low. a little over 50% from foundations and the rest is from small businesses, corporations, individuals. truthfully, the gift of time and professional service from all of our volunteers. as janet mentioned, to date, about $400,000 worth of professional services has been -- have been donated. that number will continue to grow. thank you.

commissioner maufas: thank you so much. i think now everyone has a better idea. i am overwhelmed with excitement every time i tried to mention it. i could not tell them all the details. thank you for sharing all of that information. i really believe that you are -- that you have filled this gap that is so necessary, particularly for our families at school, who do not have health care coverage. their busy lives, getting through with the hopes of seeing someone in a few months, it is just so daunting and such a discouragement factor, thank goodness you are there. that is why i wanted you to come to this particular meeting, not just the school district side, but to this combination committee, because i believe it is important that both sides

here what you are about. i know there are some questions. while you were speaking, we were chatting in amazement about all of the things that you have been able to provide and how you have been able to do that. i know the supervisors have questions. i invite them to ask. supervisor campos: thank you for requesting that this item be put on our agenda. i think it is very important for us to have this discussion. i want to thank director riley and ms. gibson for their presentation. many of us are speechless because it is so incredible to see this happening. commissioner mendoza. commissioner mendoza: thank you. this was wonderful. what a great gem. this is how we find out about things oftentimes and oftentimes we stumble upon them ourselves. thank you for the great work you are doing for our families. it sounds like it is throughout

the city and not just in the excelsior community. i am curious about how many of your patients are sfusd students or kids that attend public schools. is there anyway of knowing what that is? >> we do not track that currently. we do track when people come to our clinic, how they heard about us. we have been getting the word out through weekly bulletins in elementary schools. one of the things commissioner maufas was talking about was getting the word out more so people know about it. i do not know off the top of my head and it is not something we asked specifically. but i do know that some people have come in through the schools. commissioner mendoza: we work closely with our department of health on immunizations prior to the school year. with the mandatory whooping cough vaccine coming out, we hope we can work with you

closely to ensure that those who do come through the public school system are getting that opportunity prior to school. i look forward to working more closely with you. thank you. supervisor campos: thank you. any other questions? i want to thank you for the tremendous work you are doing. i think it is really incredible. the fact that all of this is privately funded is something that certainly we, in city government, like to hear. a couple of quick questions. how do people find out about you? i know you are tracking that information, but i am wondering how people know about the clinic and the services that you provide. >> the number one way people hear about us now is word of mouth. we do a lot of grassroots outreach. we have a volunteer and her primary project is to develop

community partnerships and oversee outreach. we have volunteers to put fliers in merchant corridors, go to transit corridors, connect with churches, that type of thing. word of mouth and fliers are the top two ways. >> we have a number of articles in local media and mainstream media as well. getting the word out, sometimes even door-to-door to tell neighbors about our clinic. supervisor campos: one of the things that just happened today is we had the last meeting of our task force working on the health care services master plan for san francisco. i am wondering if there was any communication you had with our health department so they are aware of what you are doing and could identify specific needs you are addressing. >> that is a great question. we do work collaborative late with them and i participate in those communities. we met recently with barbara

garcia. we are committed to being part of the safety net and working cooperatively. supervisor campos: thank you very much. why don't we open it up to public comment? this is an opportunity for anyone who would like to say anything to come up and speak on this item. seeing none, public comment is closed. again, we want to thank director riley, ms. gibson, and commissioner maufas for calling this hearing. madam secretary, i wonder if you could call item three out of order. >> thank you. it is the hearing on transitional kindergarten, sponsored by you. supervisor campos: great. thank you. what happens at the kindergarten level is something that is very important to the success of any child. we wanted to hear from the

school district and, as i understand it, we have chris from the school district but we also have the honor of seeing carlos, the associate superintendent for early education for the san for cisco unified school district. we welcome our associate superintendent. >> thank you. i have to say this has turned out to be one of my favorite conversations, wink. [laughter] this has been probably the most interesting ride for the last four-seven months around implementation of transitional kindergarten. what i am hoping to do is provide some context as to why this ride has been interesting, due to the governor's budget that, quite honestly, was not

very helpful. but also how we have been able to take that information and still be able to implement transitional kindergarten within our own community. before i get started, i want to thank some people who are not here. to actually implement a brand new grade for 25% of a population has been quite interesting when you think about the education system set up on 12-month cycles and it has been for at least 100 years. to do this brand new thing for a quarter of a year actually has put a lot of districts in turmoil. i will talk about how we have been able to monitor that process. to do this, it has literally taken legal, labor, epc, instructional cabinet, communications.

just to wade through how does one implement a process like this in a wonderful city like san francisco? and the pc -- epc means educational placement centers. thank you for taking this out of order. we have a 5:00 that we have to get over to that we are actually doing the meeting. we need to be there on time. otherwise, we make everyone late. but we are going to do this by simply talking about what is transitional kindergarten? we will quickly go through that and then dived into the governor's budget and what it has missed, not only for kindergarten, but pre-k. this is important to know because in this county, preschool for all, for the last seven years, has been a really big thing and a lot of effort

has been placed into building a sound and robust pre-k. you will see where the governor starts to intertwine tk with pre-k in his may revise. after we put some context to this, we will move to some of the things we have been able to gather from talking to our communities. i see a couple of my parents. i think heather and i must talk every other week. [laughter] at least. even though we talk about how many families we have actually met with or communicated with, it does not say how frequently we chat with our parents. we talk about that information and how we use information to modify how we are going to roll this out. still remembering that we are trying to maneuver the governor's budget and our

current budget climate in california. right behind me comes our budget, who will also put some context as to why this is kind of complicated. what is at tk? -- what is tk? in a nutshell, we have authorized the change of the kindergarten entry date. literally, where the kindergarten entry date was in september, for the next three years, we will roll back that entry date. for a subset of students, 300 to be precise, each year, we roll back and they are eligible for a 2-year kindergarten experience. i want you to realize. these same 200 children, there will be some kids who will also

receive services in pre-k because we have such a robust system in this county. the law states that this is a 2- year opportunity. we call it a gift of time. we give children enough time to be prepared for kindergarten upon entry. now, also embedded in that gift of time is some assumption that all children need some of this time. even though they built in a little system to allow for students to continue on to kindergarten, some of the ways they put it in their actually made it problematic for how to implement it. we have policy makers putting things together that are -- that do not necessarily mesh with what was currently in place. in a nutshell, 2-year, 3 years

to roll it out. this is for that subset of students to stay in pre-k for one more year. to give you an idea of what that means, slide 7. it is not in there. this year, we have 300 kids. the year after that, we will have 744 kids. at the end of this, we will have about 1000 students, 4 or 5 per grade. now that we are giving the children the experience, what is the experience? across the state, we are talking about 120,000 students. during this time, the students are to receive this one year of

service with credentialed teachers. we're supposed to have a development-appropriate curriculum. i want to take a moment to realize what that means. you have a preschool curriculum and a kindergarten curriculum. right between there, for those children born in october or november, you have another curriculum. so you can already start to see that a lot of this overlapping is well-intentioned but does create some problems. i will give you an example of the common conversation we have. we were talking about our new adoptions for english -- for english language arts. the individual had a pre-k treasures and a kindergarten treasures. which one would we do for

someone born in october? we are discussing, do we buy both? those are the things that have been created because of this experience. why is it so difficult for this particular county? as previously stated, we have preschool for all. 83-85% of eligible preschoolers go in this county. for us, we have the largest percentage of preschoolers who actually attend preschool. what is the difference? in l.a., their numbers are half of that number. who are the children who are not attending in l.a.? they are your lower income children. pre-k looks different for them than it does for us. we have pre-k students who will

do three years in an early education setting. two years in pre-k and an extra year in tk. the law, for us, is a little bit more problematic. the other issue around implementing tk in our city has to do with capacity. we have approximately 70 elementary schools. with 70 elementary schools and 300 possible students, that is about 4 tk-ers per school. is that a brand new classroom? or not? if you are in l.a. with 800,000 students, with a school that has 1200, you may have 4 or 5 or even 8 kindergarten classrooms.

of those, you might be able to pull out a quarter of your kindergarteners and make them tk-ers and have a classroom. for us, that is not true because we do not have the space and we do not have enough students. even after three years of tk, we would have only had, if you average it out, we would not have enough tk-ers for one classroom. if you take 1000 students, 70 elementary sites, average it out and you have about 15 tk-ers. are you starting to see the issues here? >> very complicated. >> yes. these are all the little things we have been working with for it very robust pre-k for our county. not necessarily true in other counties. why can l.a. implement so easily

and not us? it is because we are two different systems. we have different issues we have to deal with. what does all of this mean? here we are, trying to put together this new 25% of a grade. in the middle of it, the governor releases his first budget proposal. i want you to read what he said. he goes through this whole thing about how much money -- he wants to decrease the california deficit by. to do it, he is going to eliminate the requirement that schools provide transitional kindergarten. overnight, it created a flurry of, exactly what does that mean? tk is the law. what does that mean, you are going to take the money away from it? now we are having this dialogue with our state representatives about, ok, is it a now unfunded

mandate? how are we talking about adding to our deficit if we implement without knowing the money is available? what is interesting about this, i call it the shopping. if you do not hear what you want to hear, you find someone to tell you what you want to hear. it was simple. if you call this advocate or that advocate and they all have their different perspectives about how to do this. the ones who said that the moneys were there, i asked them one question. can you guarantee it? not one would guarantee it. they would tell me they were almost positive. again, that made us have to think through, how can we implement tk in our county knowing that no one can guarantee it? we waited for the mayor revise. we got it and this is where we

thought, for sure, he would clearly state that the moneys were there and there was no issues -- and that there were no issues and we could move forward. instead, he talks about the proposed elimination of transitional kindergarten requirements. it is still in the mayor revise even though we know that the houses all went against and declined to go along with this. we still had him fighting against this. he did not leave it at that. he went on to say, by eliminating the requirements and making it optional, he will be able to put back or restore the reductions to pre-k. so y -- so by taking back some of the money ofpre-k, instead of cutting pre-k as much, i can put the money over there. why is that important to us?

in this county, we have a large percentage of students who are in pre-k. he had -- he commingled the issues. even with all of that, despite this uncertainty, i think the district has been bold. to basically say, we are going to go ahead and go forward for it we are going to just chance it. instead of having -- we are going to talk about this. instead of having just two sites, we now have five sites and we have pretty much covered the city. even after that, when we went back to meet with school services, this is what they told us, this is how they put it. in the main revised, the requirements to offer tk funding are proposed for elimination. tk would be optional and a local

decision. we are good. it is a local decision. we decided to do it. i think we are safe. even though both houses of the government have rejected the governor's proposal, by the way, go ahead to plan to reduce tk but wait on staffing. these are the messages that we are trying to maneuver behind the scenes. on top of that, and i am telling you this for a reason, right behind that, preschool california has been amazing with trying to maneuver this tk issue. on the website, go to tk and it says it is fully funded. by the way, click here, sign this petition, send it to the governor so he will not eliminate tk. it is still on the table.

i am telling you that because clarity is not going to happen in the next few months. this conversation will be ongoing. do not be surprised if we look up in one year and this whole issue is gone. i want to give you a heads up as you start to hear the confusion that continues around this issue. despite the confusion, we are moving ahead. despite it. how are we moving ahead? we act with his fate in a professional learning community. we need assistance with this. we meet on a regular basis with the following statewide districts -- l.a., santa cruz, alameida county. i had a great opportunity to sit with 12 districts in alameda county. i left there feeling so

refreshed because i thought i was the only one struggling. there were districts talking about not doing it because it was just too confusing. but then you have oakland, who has gone full force. both sides of the story. we have individuals liked melissa, standing next to me, who will talk about how we move forward with this, how do we implement this process? the communication, we look at it in two ways. we are receiving information and trying to figure out what to do. at the same time, we are constantly in communication with the public. can you imagine -- and i have to say this, publicly. i am appreciative of the parents who are actually here who i've had ongoing conversations with. they will tell you that i am very honest. i tell them, no matter what happens, if they remove the money, i am not going to make you a promise but i will try to keep you abreast of the

information. you may not be happy at the end, but i am not going to sell you a good -- our we communicating on our web sites? we communicate through letters. we have one-on-one interactions. i have received a lot of interactions from commissioners and supervisors to respond to your constituents if they have questions. we respond to every last one of them and sometimes multiple times. we have community meetings. we have been working closely with first 5. 25% of all tk-ers are already in our district for it we talked to that -- we talk to them fruit site managers and our meetings. we are covering 25% of our population. we meet the other by a vote -- the other portion of our

population by working with first 5. they were just as confused as we were at times but they worked with us. we have responded to individual requests from not only parents here, but ongoing conversations about what is happening and everybody has been really good about it. supervisor campos: could i ask you a quick question? if i am a parent watching this, listening to this, and so much has happened or not happened at the state level. what should i know about tk? >> this is what you should know. i'm going to turn it over to melissa and she is going to give you the good news. perfect timing. [laughter] >> just as carla was emphasizing, we do appreciate speaking to families regarding this transitional kindergarten shift that we are undergoing.

i have been one of the people to take those personal calls and e- mails and face-to-face meetings with the parents and i absolutely understand their frustrations. we have been documented in all of the calls that we have received and i take it back to our planning meetings and tell parents that your feedback is being heard. because of all of the requests, we are finally able to -- are district has approved that we are able to have 5 tk sites this coming school year. there will be on our early education campuses. the 5 sites that we will have, the first is john mclaren. that site is in the bay view area. leola havard, in the bay view.