>> good morning, everyone. all right, good morning. this meeting will come to order. welcome to the regularly scheduled meeting for the government audit and oversight committee. i'm supervisor malia cohen, i'm chair.

and to my right is supervisor katy tang and to my left is supervisor david campos. i believe supervisor eric mar may be joining us. we'll find out shortly. the clerk of the committee is the lovely ms. aundrea ausbery and i'd like to thank sfgtv for broadcast thing meeting. madam clerk, are there any [speaker not understood]? >> yes, there are. [speaker not understood]. items acted on today will appear on september 3rd [speaker not understood]. >> thank you very much. could you please call item number 1? >> item number 1 is resolution authorizing the san francisco fire department to retroactively accept and expend a grant in the amount of $376,700 from the federal emergency management agency for the fiscal year 2007 supplemental port security grant program for assets to enhance the fire department's water-based response capabilities and increase its

protection of the port of san francisco and the san francisco bay for the period of october 1, 2007, through september 30, 2012. >> all right. we have mark from the fire department here to present this item. >> good morning, supervisors. mark corso here to present the first item on the agenda, resolution for retroactive accept and expend [speaker not understood]. the board of supervisors approved an allocation of an accept and expend in the amount of $230,000 for fiscal year 2007 port security grant funding through fema for a variety of marina and water based projects. the goal of this funding was to enhance the department's water response capabilities. this funding expiration date was september of 2012 for the entire grant program with the department having to cease all grant purchases by june 30th of 2012. in august of 2012 the department was contacted by the fiduciary agent for this grant, that there was some additional funding available that had not been expended not necessarily in the city, but throughout the region, and asked the department if we would like to be able to expend it or if we could expend it over the next month in order to meet the grant deadlines. so, the department applied for and received an additional allocation of 3 76,000 above

the originally approved amount to expend during this period and that is what's before you today. i apologize for the retroactive nature of the resolution, however, given the extremely short time frame and turn around time of approximately one month, it wasn't possible to get full approval before accepting the additional grant funding. since there was no match required by the department and no funding for this funding and no other commitment, the department made the decision to go ahead and accept the funding and process retroactive formal accept and expend. and i'm happy to answer any questions you may have. >> thank you. colleagues, are there any questions on this item? pretty straightforward. i think we can go to public comment. mr. corso, thank you for your presentation. i'd like to open up public comment on item number 1. seeing no public comment, public comment is closed. [gavel] >> thank you. colleagues, can we -- oh, supervisor campos. >> yes, make a motion to move forward with positive recommendation. >> great, thank you very much. and was seconded by supervisor tang. this motion is forward with positive recommendation.

seeing no dissent, the vote is unanimous. [gavel] >> thank you. madam clerk, could you please call item number 2? >> item number 2, hearing on the san francisco public utilities commission tap water outreach campaign and the possible expansion of outdoor tap water stations. >> all right, thank you very much. supervisor mar is the sponsor of this piece of legislation. but is there anyone here to present on it? okay, thank you. >> good morning, supervisors. my name is christina [speaker not understood], public health department. and [inaudible]. so, i want to thank you for hearing this item on water and water consumption. i think supervisor mar may join us any moment to give a little bit of context, but i will start with my presentation.

so, i'm sharing with you our [speaker not understood], maybe we can call him [speaker not understood] sam that comes into the sutro valley every so often. i'm here to talk about the intersection between health and water consumption. here is supervisor mar. >> supervisor mar, welcome. we're just starting this item. i don't know if you want to set the context for the presentation, staff presentation. >> thank you. thanks to the department of public health for their great work on reducing obesity in our communities, promoting shape up s.f. and healthy life styles in our communities as well. i wanted to say that several months ago we called a hearing on our city's tap water outreach program and the expansion -- efforts to expand our outdoor tap water filling stations as an effort to reduce

the use of plastic water bottles, but also to promote more of a healthy living for everyone. many of us know that drinking water is beneficial, tremendously beneficial to our health and that tap water, unlike bottled water, is also good for our pocket books and the environment as well. and the public utilities commission, the puc, has worked along with the department of public health to educate residents to drink as much tap water as possible. i think [speaker not understood] and different efforts at the community level have been really beneficial, but we absolutely need to increase the ability of people to use their own refillable water bottles. and unlike bottled water, hetch hetchy tap water costs less than a half a penny per gallon. so, it's almost like costless in some ways. it's quality tested over 100,000 times a year and it's highly regulated by the environmental protection agency or the epa.

i think the fear of drinking tap water often has been caused by slick and really misleading campaigns by the bottled water companies and over the years there is a certain fear. but i think the countering with a strong public education program, community education, has been critical. and many of you know that my work to work with christina and others within the department of public health to combat childhood obesity has been a passion of mine. but drinking tap water and lots of water has been a key component of a healthier life-style in my family, especially for me as well, the health benefits have been tremendous. in addition to installing a number of water stations throughout the city in recent years,s there's been a lot of work to make water available in schools. i'd like to thank the school board, school district staff and others for working together with the department of public health for three summers and lots of other efforts to increase water usage.

the banning of sodas and sugar-sweetened drinks in schools has been significant over the years from many of the leadership of many officials in the school district. i also wanted to acknowledge that there's been a lot done on this board as well, our president david chiu and many of us also have been working to make water bottle filling stations more prevalent in private buildings, but there's a lot more work to be done in the public areas of the city. and the purpose of this hearing is to check on the results of our outreach campaign to date and to better understand any future plans. i think and to support future plans to increase tap water consumption in our city. also it's very important for us to understand the health risks of not drinking enough water and the corresponding consumption of sugary beverages as well. with that i'd like to bring up christina who is already up here from our department of public health who will present on the benefits of water and all the great work showing the risks associated with replacing water with sugary beverages.

>> thank you, supervisor mar. so, as supervisor mar indicated, i'm going to talk a little bit about the intersection between health, water, and what people are replacing water with. so, why, why do we care about water? well, as we're all sitting here we're losing water. water is constantly leaving our system so we need to replenish that water. we know that people, adults and children, are not drinking enough water, and that poor hydration can lead to all kinds of health consequences. academic achievement can be compromised. ability to be physically active, and a host of other issues which i will cover in a moment. most other beverages that people use to replace the water that they're losing contain unnecessary calories. and our tap water is fluoridated and that has significant dental health impacts and, you know, hetch hetchy, we've got the best water around and it's low cost

as the supervisor indicated. and we know that some of our lower income populations are buying bottled water, national date a. they're buying bottled water at a higher rate than higher income populations and they're the populations we want to be drinking tap water for a number of reasons. so, this slide gives you a quick overview of the fact that water really does impact every organ in our body. as i said, it impacts cognitive function, it can impact overweight, diabetes, cavity, cancer. so, i'm going to leave it at that just to say that water is a very, very important part of our health. one thing water can do is it can help us decrease our calorie consumption. what i mean by that is if you're dehydrated or you don't have enough water in your system, it can make you think that you're hungry. so, your body thinks you're

hungry so you eat when instead you should be drinking water. and, so, that can -- if you're drinking enough water, it can help you maintain a healthy weight. it also means water can then take the place of food or caloric drinks. and we know that calorickally sweetened disruption or drinks that have calories in them whether it's sugar or other sources are the largest source of added sugar in our diet. in fact, we get about 55% of our sugar from sugared beverages. and youth are drinking about 200, 2 24 calories of sugar drinks a day and adults about 200. and we know that in 2010 we're getting about two '02 to 300 calories of the american public adolescents are getting 360 or so. ~ in terms of what that means if you're drinking that, [speaker not understood], that's a lot of exercise for a drink.

and beverages other than plain drinking water are really the main source of replenishing the water that we're losing, the water that we need for optimal health. so, plain water is about a third of what people use to replenish their water, over two-thirds is really -- anything but water. sometimes it's coffee and tea without sugar, but sometimes it also has sugar. and i think this is really important and relevant in terms of, you know, what are we drinking and what have the trends been. as you can see here among children, milk consumption has gone down dramatically since the '60s and it is now overtaken by sugar sweetened drinkses consumption. juice has remained a relatively stable trend. among adults the same has happened. milk consumption has decreased and milk and sugar beverages have increased. i'm going to go into why that

matters more deeply, but we know that daily caloric intake from sugar sweetened drinks has increased dramatically. again, i talk about this in the context of the fact that these are likely replacing water and we're adding calories instead of drinking water. there is an association between drinking sugar baronet ened drinks and overweight. this graph will show you that as childhood overweight has increased over the decades, so has our sweetened drinks consumption and there is good research around that association, which is why we are looking at the sugar sweetened drinks piece as part of it. there are a whole host of health consequences with sugar drinks. i'm going to walk through some of these. when i saw this i thought it was bagels. this is the liver. there is a new disease on the horizon, nonalcoholic fatty liver disease.

what fatty liver disease is a result of, drinking more sugar drinks than others. large livers can lead to liver failure, cancer, and liver related death. we know that over 6 million children have nonalcoholic fatty liver disease and that newer evidence also shows that the risk of heart disease in children is greater to get fatty liver disease in children that are overweight and obese. this is a new phenomenon. fatty liver disease is relatively new. it's in association with our changes in our diets and drinking habits. a little local piece of data at ucsf, 25% of our liver transplants today are a result of nonalcoholic fatty liver disease. that is new, and that includes children. this is not just adults. so, where liver transplants

formerly were related to alcohol, these are now related to drinking sugar drinks. seriously, that's a serious consequence. notice this pretty picture of teeth here. these are fondly called one on the left, the mountain dew mouth and the one on the left is diet soda mouth, if you will. just to make the point that water won't do this to your teeth. [laughter] >> sugar and acid combine to create a really negative impact on your teeth. it wears away the enamel and leads to a mouthful of rotted teeth. it is similar also -- i don't know if you've seen pictures of [speaker not understood], these are similar. you can put [speaker not understood] underneath and it would be the same. it's the same thing going on in your mouth. again, the other consequences are osteoporosis. and this goes back to that chart i showed you earlier around milk and the fact that sodas are replacing milk.

and -- displacing milk. the phosphoric weakens bones and caffeine interferes with the absorption of calcium. when we see how many sugar drinks that adolescents are drinking at a really critical time when their bones are developing, this is -- this can lead to really significant issues down the road where their bones aren't strong and it leads to easier fractures and so forth. so, another maybe perhaps relatively obvious consequence of drinking liquid sugar is it ultimately can lead to overweight. drinking a can of soda a day which is a 12 ounce can add about one proud of weight gain every month and if you're a soda drinker, you're more likely to drink a larger size or more than one can a day. and, so, this is significant

because our bodies respond to sugar sweetened drinks, liquid sugars, however you want dual it. they act like it's food. your body will -- if you're drinking a sugar drink, your body will first focus on burning off the sugar. it will not work on the food first. it will work on the sugar. if you're drinking sugar in the morning, by lunch if your body hasn't finished burning through that sugar and you drink ail sugar drink at lunch, it will continue to focus on the drinks with sugar and then work on processing food. if you're drinking water, there is nothing to process. the water goes to your organs and provides the health benefits that you need. there are a whole host of studies around what happens with water versus sugar drinks and what happens when you replace. and this is just one of several. this was a study among overweight adolescents when they replaced sugar drinks with water, they had half the weight gain compared to those that

kept their soda consumption the same. so, when they replaced sugar drinks with your water, they gained only 3-1/2 pounds versus a regular diet that the others were continuing to consume the sugar drinks is 7.7. so, it's really half the risk there. on a more local level, we see what happens when water is readily accessible. our public health nurses and community health workers noted that in the child development centers that they're working with, when there were pictures of water readily available at the child care center, this is not a study they were trying to do, but they noticed some child care centers had fewer children gaining excess weight. and when they looked at the environment, they saw that those child care centers had pitchers of water out ease toy drinks. that became more of a default option. ~

those centers that had the pitchers of water accessible had half the excess weight gain -- i mean, children are always gaining weight because they're growing. it's that excess weight gain. they had half the excess weight gain in those child centers that had water readily available. and the maternal child health folks recognized that and are working to make pitchers available in child care center, very easy fix. what they also noted was that in african-american children, there was something about having a pitcher of water that really helped decrease the risk in half for cavities as well. it wasn't as notable in the other populations. they don't completely have an answer as to why. it may be that in communities like the bayview where there is one dental clinic for 33,000 people, there is limited access to preventive dental care. but again, i don't know that's the answer, but that may be one of the reasons. so, i just want to talk a

little bit about some requirements that we are now working on and by "we" it really is many of our colleagues working on this. at the federal level, they passed a law saying that those participating in school lunch shall have water readily accessible. and then in california, our legislature required school districts to provide free fresh drinking water during meal times in the school. again, a very -- it's a great, a great law and i know that our colleagues at the puc and the school district are really working to meet that requirement. on that note, our colleagues in the environmental health section of the health department conducted a study of water consumption in the school district and the goal was to increase students' overall water consumption, increase drinking water fountains in schools, and do some education and decrease environmental impact of bottled water. what they found through this

study was by providing bottles to students, students brought bottles of water to school more. they filled them more. teachers allow students to drink more water. purchased bottled water was lower at those schools -- the intervention. and what they found was regardless of the presence of the filling station, most students drink water at school and that's because there aren't a whole lot of other options. again, it's looking at how we create the environment and set the environment for success. and about a quarter of the students are drinking four more glasses of water at school. that's great. we'd love to see a higher percentage but that's a good start. so, some efforts to increase water consumption. through the health department, supervisor mar noted we've been doing a whole host of work. our otter, i think we're going to call him sutro sam, this is a drink water in the otter

booklet geared 4 to eight-year olds. our friends at first 5 developed something for lower grade level, 0 to 5 potter the otter english and spanish. i'll leave copies with you. we are also working with organizations to establish wellness policies and become soda-free zones. and we are working on awareness campaigns, it is a little more focused on the sugar piece of it, decreasing sugar consumption and increasing water consumption. we also are distributing little spa water bottles -- >> i want to interrupt real quick. people standing in the back looking for seats, we have an overflow room in the chamber just down the hall across the hall in room 250. if you don't have a seat, i need you to move into the overflow room. >> so, we've got these spa water bottles because we hear a

lot some people, water is boring, doesn't taste good. actually it can taste really good. my personal favorite recipe is cucumber and mint. you can throw berries in, water mellon, pineapple, makes it taste good and makes you feel like you're at a fancy restaurant, hotel or spa, whatever. i'll leave these materials for you. but those are just some of the efforts that we've engaged in. as i mentioned and i'm sure colleagues will talk more about what they're doing to increase water stations in schools. and we've had a lot of success working with organizations to institute healthy beverage policies. i do want to call out the rec and park department for really jumping on early with this and becoming soda free for their campers in the summer. and ask that staff not drink sodas in front of the children, asking children to not bring sodas to camp and not serving sodas. it is creating the environment and setting the tone.

it is about offering water. it's a lot cheaper that way, too. so, just a few strategies to look at increasing water consumption. i've touched on most of these, making sure that access to fresh drinking water is available really everywhere, not just institutions. looking at healthy defaults so that the beverage that is -- the first beverage of choice is something like low or nonfat milk or water. working with child care centers, continuing to work on organizational wellness policies, looking at -- systemic, there is a great policy around bottled water and not using our funds to buy bottled water as an environmental concern, but the concern that that raises sometimes has been that makes water not available and what are the other options that can be sold in a small package and offer something with added sugar. looking at those policies, unexpected consequences of what that are. and then lastly, continuing to do outreach and awareness, particularly with populations that we want to do more

outreach to. as i mentioned earlier, there is national data showing that lower income populations tend to buy bottled water. we don't want them to. for so many reasons. but if there are issues with cavities, then they're not getting the fluoride. we don't want them to spend money on bottled water when they don't need to be. if their pipes are good, they should be drinking water from the tap for all kinds of reasons. so, we know that immigrant populations also tend to buy more bottled water. so, ultimately what -- you know, i'm here to be an advocate for drinking water, an advocate for the efforts that you take on to promote drinking more water in whatever ways we can make that possible because -- i hope i've shown you today the health consequences, our health really depends on it. so, thank you. >> thank you very much. >> madam chairman, can i ask christina a question? i know that over the years when sodases and sugar-sweetened drinks were challenged by community groups and health

officials, more people resorted to bottled water and then several years after, when the u.s. conference of mayors and corporate accountability international and some environmental and health groups really challenged the bottled water companies, it led to more restrictions, i think mayor newsome and your office was really successful in the bottled water bans in different places. but i know you just mentioned that there's a challenge or a contradiction that if we ban water bottles without providing more access to tap water, it might lead us back to people drinking the sugar sweetened drinks. and i'm just wondering if you have ideas how we as a city could increase access to tap water and challenge the fears people have of drinking tap water as well. >> well, i'm sure our colleagues at the puc have thoughts on that as well, but i

do think making the bottled -- refilling stations for bottles more widely accessible. i love the one at the airport. i think that really helps. it's just really creating a system, a hydration system, if you will, that is clean, functional throughout the city. i do think that the awareness component matched with environmental components. so, raise ag wearness about the importance of drinking water, the fact that the tap water is clean and good and safe. and then making sure that people can get that water. wherever they are. i think those are sort of broad brush generalizations that i would make at this moment. >> it seems like it's a cultural change like carrying a reusable bag, a reusable bag, the culture has changed pretty significantly since the plastic bag ban. but the providing of the water bottles to students and starting at the pre-k and child care centers, to me that can

help change that culture that tap water is somehow bad, i think. >> yes, absolutely, i think. starting young, i know that my daughter who is in the audience is very much a proponent of drinking water and really is concerned about drinking sugar drinks and sodas. so, it started in our house [speaker not understood]. >> thank you. >> thank you. >> madam chair, we have one other presentation from radika fox from the public utilities commission. >> [speaker not understood]. [laughter] >> so, good morning, chair cohen and supervisors. again, i'm radika fox with the san francisco public utilities commission. i want to thank supervisor mar for the opportunity to share some of the work that the puc

is doing, both about helping our public, our residents, our rate payers understand where their water comes from and the benefits of drinking tap water. to start, i just wanted to -- i wanted to begin by just sort of situating our work around promoting access to tap water in the context of our broader public outreach and education efforts. a you all know, the puc provides water, wastewater and municipal power here in san francisco. and as we think about our public education work, we really focus on sort of the theme of one water one system. we want people to understand where their water comes from. it's pristine [speaker not understood] from the sierra nevada that travels by gravity to san francisco. but then what happens after that water leaves their tap, leaves your body, and to really help people also understand about our wastewater system and the work that we do to make

sure that that water is treated in a safe -- before it's discharged into the bay and ocean. so, one water one system is really a theme that guides our education efforts. so, some of the ways that we have been just helping to educate san franciscans about where their water comes from and why our water -- why we're lucky to have such a clean pristine water source. a couple of years ago, the puc received a water quality grant from the u.s. epa, it was about an $8 million grant and really the purpose of the grant was to help monitor potential contaminants in the water supply, but there was also a public education component to the grant. and, so, what we did is launched a education program that was really about what people should do if they were concerned about the water, concerned about water quy