the capital and equipment already. on the work orders, a large number of the increase as a result of workers' comp. can you tell me what the department is doing to bring that number back down? is there something the department is doing to reduce the workers' comp claims? >> i am going to defer to alison on this one. >> good afternoon. we have arranged of the birds in place to get workers, back into control -- we have a range of efforts in place to get workers, back into control. to ensuring the safest and working conditions for our staff. the reality is the nature of a lot of the work that happens is very physical work. our department is unique in that we have higher risks when it

comes to workers' comp. we have a special obligation to make sure they are safe and that we are providing appropriate staffing to ensure employees are not overextended or put into harm's way. supervisor kim: thank you. this is something that i found confusing. your professional services line item. the way it reads, it looks like to a bowling spend 18.3% of your professional set -- a looks like you only spend 18.3% of your professional services budget. i was wondering if you could explain that. >> in 2011-2012, it includes part debt payment in respect to

juvenile hall. that is about $2.7 million. supervisor kim: that addresses the rest of the amount? my second question was on the capital plan. i know we are looking at hang back about 8% of the debt service this year -- looking at paying back about 8% of the debt service this year. in your 10-year capital plan, i have not seen a request for money is used to make the recreation area usable. that was one of the recommendations that came out of the youth commission. i know they have been in discussions with your office for the past year. i note it is a challenging issue. i do not think we want to go through all of the challenges and obstacles. i am hoping we should be able to find a way to make the recreation areas useful.

>> absolutely. that is still an area where it is a moving target. we have yet to obtain all the figures we would need to address not only its present condition, but in the design features that need to be addressed and adjusted. we did include this in our capital plan. it is underfunded at the present time. but it is not concluded either. let me use this as an opportunity to say that the work of the youth commission and bring in a bright light to this issue is already adjusted our practices within the center that has allowed youth to have expanded outdoor recreation area in another area adjacent to that center recreation area. we are greek default -- we are grateful for their leadership.

the adjustments we have made required no cost whatsoever. it was adjusting our practice and scheduling. supervisor kim: i know you talked a little bit about the last time. >> every unit has been directed to use an outdoor center in addition to the courtyard that is available. it has a regular scheduled program opportunities throughout the week. a report to me on a monthly basis, the dates and times that each of the unit used that large recreational area. we're also developing other items that can be used -- we are also equipping a second area with a volleyball net. that is a larger area.

once we complete some of our security measures that needed to be adjusted. >> if we were able to identify it funds, with the department be able to do this capital project this year or the next fiscal year? >> i do not know if we would be able to complete the project. we would always welcome the opportunity. we are already meeting the state mandated requirements for the square footage that needs to be available, but also with the time that the youth are afforded. the recreation is a program competes with many other programs in the facility that deal with and their management, substance-abuse counseling, life

skills development, yoga, and with religious programming. not enough time in the day often is the case with respect to those areas. supervisor chu: i would ask the chief as you think about its, i know there was a youth commission recommendation for this component, but i know when the capital planning committee reviewed all of the capital needs of the department, there were other things that surfaced as a more immediate safety needs or other needs of the building. i would suggest, as you speak to different supervisors about the potential of implementing some of these projects, that you also speak of those other daughter needs that have been prioritized by another -- those other dire needs.

supervisor cohen: i want to touch on what supervisor kim was talking about about the youth commission. i am interested if there were any other youth commission policy recommendations that you've been able to incorporate into your budget. >> i meet regularly with the youth commission members. i participate in a number of their discussions. we have another conference planned on the sixth of july. from what i understand, we are moving in the direction of creating a survey that the youth commission members will be able to distribute to the youth to get their thoughts on what their needs are. that line of communication is still open. i believe that is one of the

recommendations in their resolution. supervisor cohen: that is great, thank you. you might be influencing and inspiring the next director of juvenile probation. >> our involvement with the youth commission is -- has been a very positive one since i arrived here. the youth commission helped us develop our own juvenile advisory council. went to chicago with the members of the youth commission and adopted a model they were able to them and debate within our department. -- incubate within our department. supervisor cohen: i was wondering if you could speak about the needs that exist at

the ranch that relates to water. can you tell me how much that costs to bring that water system up to standard? >> we have a sense of the things that are problems with our water and our water treatment facilities, we are not the experts in the city. we have been looking to puc to help us understand where are shortfalls are. -- our short falls far.

we have been working with them closely in the last year to assist us with that. there is a little increase in one of four work orders to help us continue to work with them on these issues. off the top of my head, and knowing that we have three water storage tanks that are in very bad condition and the need to be replaced to keep them from leaking, the other issues we have are just that our state permit has been reissued recently and we are dealing with getting up to speed and complying with that. a lot of technical detail that we do not have the capacity to handle.

supervisor chu: where do you stand on the budget analyst's recommendation? >> we do not agree at this time. >> we are working with the department and we will report back to you next week. supervisor chu: we will see you next week. final department of the day, but also the largest department of public health. >> good afternoon. great to be here for the budget discussion. i do want to recognize the mayor's office. we do not come here with major cuts in our budget because the mayor's office support for the services. that helps us with the beginning of next year.

the health-care reform issue will require us to invest in people in our department and in technology. we do have federal requirements. we have been working on that for the last two years. we have received federal dollars for that. we do have revenue challenges in realignment as well as reductions in services. particularly in the hiv area. we also have major capital projects going on with the rebuild of san francisco general hospital. to review on our revenue issues, we have always been pretty aggressive on looking at revenue increases and trying to do our best internally.

however, we do have some challenges without. we do have a $42.5 million from the government. we have to earn those dollars to access and quality standards. the hiv and aids area, where we do have some reductions. we are working very hard on the improvement of our hospital revenue. we believe we can bring in an additional $8 million next year. to highlight a bit on the health care reform, they sure, we are looking at an additional $5 million in expenditures to ensure that we can invest in the department's staff along with the issue of $10 million in milestone.

the $42 million of debt talked- about. our it system, we are investing in our surgery information system and our electronic health records system. this is a major initiative in our department. in our capital area, the new san francisco general hospital building, $40 million for furniture and fixtures. we have a $170 million budget for that. we have the san francisco general hospital foundation working on trying to work with donors to bring in $60 million of that. i am happy to say we have a $2.5 million investment in the capital where we are trying to bring many of our mental health services in the southeast together with their primary care

center to build a new building that will be connected to the southeast help center. we will build a wing of pediatric exam rooms to allow us to increase our adult services. supervisor chu: $40 million have been budgeted for the second year? the 170, is that expected to be paid all in year 2? >> we're hoping we can go out to 2015 on that. supervisor chu: in terms of the san francisco hospital foundation, and you have an update? >> they are about ready to go public. they are not ready to roll those out yet. their goal is a 50-$60 million. we also have a new clinic that will be opening up. 220 golden gate.

that will also have 150 housing units attached to it. position changes, in terms of the need for additional staff, 29 positions. these are changes in the regulatory requirements along with pharmacy nurses and radiologists. we have worked very hard on this. we have a summer bridge program that will allow for unified school district high school students to explore behavioral health careers and more about entry points into post secondary tracks.

i worked with one of the local colleges and have created a scholarship program for employees to go back and receive their bachelor's degree. this is targeted to dph employees. we have a very diverse workforce. the certificate program to be, peer coaches. some of our doctors are learning it as we are moving into technology. we're looking at a development of working with young people who are much more tech savvy to come into the department to support our professionals to help them come to a skill level in our technology area. we will be looking at working with economic work development

and trying to support them. we have an extensive language access program, as you can imagine. in san francisco general hospital, we have on-site interpreters with the capabilities of 10 languages. we have the ability to support over 100 languages to our language service. language requirements for staff and primary care clinics, we have dedicated chinese, spanish- speaking neighborhoods for we also had interpreters. at san francisco general hospital, we are providing services to approximately 140,000 people. this was the number request. we are looking at the technology. it will provide video interpretation too many of our

primary care centers and will have a hub of interpreters. that is the end of my report to you today. we do have some legislation issues htat our cfo would like to share with you. supervisor chu: in terms of the department's budget, a lot of the new initiatives are all related to federal health care reform work. i am just wondering, given where the courts will come down, but if they have not already -- >> i brought you a memo that we have around that issue. the bottom line is, whatever happens with the courts, we will still have to provide the services. if the courts to not agree -- if they decide not to do that, we

will still have to continue -- california will still go to a managed-care program. we will have to continue to do the kind of work we are doing now. the individual mandate means there will not be as many people on insurance. the affordable care act does not cover the undocumented. we would still have healthy san francisco. it is great news if the supreme court supports any of those areas. if we do not -- if they do kick out any of those areas, we will still have to continue to do the work in healthy kids, help the families -- healthy families. supervisor chu: does it change any of your plans? i know part of it is electronic medical records, the expansion of our own primary care -- >> we have already received those dollars.

we will continue. those are still requirements. we're getting dollars for those. we will not have as many people having benefits and coverage. supervisor chu: do you have a sense of and whether the courts will act on the mandate? >> the mandate is the most controversial issue in the legislation. everybody is betting on the outcome. we do not know at this point. i do have a pretty detailed memo for all of you. we hope they do pass that because that would be helpful for all of us. it will expand some of the revenue base for the department. supervisor chu: why don't we go to the legislative items? items five, six, and seven.

>> good afternoon, supervisors. i am the chief financial officer. we have three pieces of legislation. the first is our annual update to our patient rates. these are the charges at our health facilities. the biggest dollar value impact is that san francisco general hospital. these are the rates that we charge our non safety net customers. these are not rate increases that affect our metical patience. they are not raise is that to affect our sliding scale patients. these are the rates that we charge our commercial insurers. we have about the grief -- we have about $4 million in

revenue. we did some research and some study of our rates and found that we have fallen behind where we need to be. we have been trying to catch up on our charges over the last several years. this is a continuation of that effort. the second is an annual fee adjustment. this relates to our public health food program. generally, that program is cost recovering. we recover those costs through cpi that is built into the legislation. there are some changes to the categories that we are making this year. that is the reason this legislation is before you. the purpose is really to just refine some of the categories so that we have a little bit more nuance in the u.s. bearing what share of the cost.

this program -- and who is bearing what share of the cost. wheat annually update our fees so that we can continue to fund that program without general fund support. the last piece of legislation is a package of grant approvals. these are a number of recurring grants that the department receives. rather than bring those to you individually, we try to package as many of them as we can during the budget process. at least the ones that are routine. so that we can appropriate dose -- appropriate those. i am happy to answer questions. supervisor chu: we do not have any questions on the legislative items at this moment. with regards to the budget analyst recommendations -- >>

hopefully, next to it we will complete those. >> we're working with the department. supervisor chu: i would like to thank the department for your presentation. we will see you again next week. thank you. colleagues, on the items before us, on item eight, 12, 14, 15, we amend the contracts or the legislation to show not to exceed amounts as reflected in the legislation. can we be did do we have that motion? ok, we can do that without objection. on items #1-12, these are items that have to be heard. as well as 14-50. can we continue these items until tomorrow? we will do that without objection. on on item number 13, the

department asked us to continue to the call of the chair. do we have a motion to continue that item? we will do that without objection. do we have any other items before us? we are adjourned.