personnel and the issues that had resulted in poor management of the lease. since the audit they have done significant work and continue to have significant improvement in that particular area of their organization. in july 2012 we issued a report on our audit of sf mta having fully implemented 33 -- 23 of the 29 recommendations. however the department is contesting the implement of one recommendation. this recommendation comes from the audited finding revenue to not seeking reimbursement for providing traffic control activities for some street fares and festivals. recommendation 2 asks sf mta to include a traffic control fee as part of the permit fee paid by sponsors of street

fairs. however their response is they have made previous attempts to do so and have not had support of sf mta and policy makers. mta is here to speak on this one outstanding issue. >> good morning, chair breed, supervisor tang. a little bit, my name is cameron sammy. i'm the enforcement manager with sf mta. a little background. article 6 temporary use of or occupancy of public streets sf mta, the ability to collect

fees from major events which are defined in section 6.3. there is three primarily issues from collecting full cost recovery. they are prior to year 2000 cost for traffic control services for annual street fares and festivals were not covered under the code we deemed them grandfathered. the second piece which impacts parades and demonstration is under the 1st amendment rights and the thirst piece to this is that that when any festival is responsible -- sponsored by the city. the fees were not

collectibles. sponsors were required to pay fees for food permits but not dpt. today sf mta is charging and collecting fees for providing traffic control services from sponsors for new events, newly established street fairs and festivals. any festival or fair established prior to 2,000 are being charged for the expansion of those events but not for prior to 2000 established. so in other words, if they change or establish a new block, we do actually charge for recovery of our cost for those pieces. our ability to recover the full cost of enforcement services for street fairs is limited by the transportation code and my understand is that it's up to the board to change this code. and with that i

will answer any questions. >>supervisor london breed: supervisor tang? tang tang i -- >>supervisor katy tang: i know this ranges in different sizes. what are festivals going to be paying? >> we have an estimate of $529,000. this covers about 30 events annually for festivals and street fairs. >> let's say for example a small block party, 2 blocks, what would an organizer expect to pay for that on traffic controls? >> it depends on what services they need. they could need an x number of parking control officers that handle safety and traffic mitigation. other larger ones could be where

towing is involved. that depends on the festival itself. i can provide you with an example if you like? >> sure. that would be great, thank you. >>supervisor london breed: thank you. >> thank you. >> the next audit i would like to speak about the 2012 audit for kci for medical equipment. there were eight recommendations that focused on improving monitoring of the contract. dph has implemented three recommendations and reports implementing process of three more including creating detailed policies and procedures for reviewing invoices before authorizing payment. the two contested request to implement and document and over all

contract monitoring system which would result in the weaknesses for all dph contracts. dph reports will not implement those recommendations because it did -- does not have those resources to do so and they are here to address these issues. >> good morning supervisors. i'm here for anna cube or who normally facilitates the responses back. from the two contested recommendations in terms of implementing over all monitoring process and documenting as contract monitoring systems in the past three 3 months has been made department wide priority. we have now identified some resources, support the contract monitoring of a lot of these contracts including the ones we are formally contracted with on that boiler plate as well as blanket

orders. on the next to cts office we'll include that. we'll take any questions. >>supervisor london breed: so are you saying that this is not accurate that you now have sufficient resources in order to monitor this? >> at the time of the report it was accurate but since then we've made moves to actually be in line with the recommendation. so in the next update it will be more appropriate. >> do you know timeframe of when that will happen? >> 3-6 months of the departments that are involved with the specific contracts that require their expertise to be fully on board and tracking. >> okay. thank you. >> thank you. >> so we would expect your office to follow up with us on the implementation of oversight for these particular contracts. >> yes, we shall. and that

concludes my presentation unless you have additional questions of me. >> thank you. have a great day. >>supervisor london breed: i wanted to bring mta or dpt back to the table. i have a few questions. i know that you are not able to recover certain fees for certain festivals and parades because of the reason you stated earlier and i just wanted to have some clarity about sunday streets in particular. it's my understanding that sunday streets is it's own non-profit organization and they raise their own funds in order to

provide fun day streets. i know mta is involved but don't necessarily control the event. can you explain to me besides i know the signage and parking enforcement officers. are there any other expenses related to that particular event that we are not able to recover? >> not to my knowledge. only as signage and towing if necessary and pco's to help with mitigation of traffic or pedestrian. >> there are tickets given as a result. is there a comparison in terms of tickets and towing fees in order to address cost recovery? >> i can look into that. what it is is more of an offset. >> is that taken into account at all for parking control support. >> the number i have given you, no it has not. >> i think it's important that's taken into account

because before we tow we ticket and there is a fee that people that have to get their cars out of tow pay, in order to understand the real -- impacts, i need to see the numbers. >> okay. >> is there any additional public comment? seeing none, public comment is closed. any other comment? no? quiet today. okay. thank you very much for coming in today and giving us this report. what are we doing with this item? >>supervisor katy tang: i would like to make a motion to file this hearing. >>supervisor london breed: okay. without objection this

item is filed. madam clerk please call next item. city clerk: [setting the 2014 budget and legislative analyst services audit plan]1401282.sponsors: breed; cohenmotion directing the budget and legislative analyst to conduct two performance audits in 2014 and setting the priority as follows: 11 the fire department's allocation of resources to emergency medical services; and 22 the fire department's administrative staffing and strategic planning; and removing from the budget and legislative analyst's audit plan the department of public health's compliance with privacy and security regulations as defined by the health information technology for economic and clinical health act and health insurance portability and accountability act, previously approved by the city clerk: sf 212341234 >>supervisor london breed: thank you. i requested this report and they completed an audit from the practices to retain and perform fire staff. we reviewed this audit in detail and the fire department and department of human resources. frankly and as i said there were some alarming

revelations about services. people are calling 9-1-1 because a pedestrian has been sit and the fire department sometimes has no am ambulances to send. this is happening on an average of 8 times each days. these medics calls have increased by a large percent. if this is happening everyday what would happen in an event of an earthquake or other major disaster in san francisco. that's not all but under the agreement with the medical treatment authority the fire department is supposed to respond to medical calls in san francisco. remaining non-compliant can seriously affect jobs and to the department and overall safety. the fire department continues to say they are staffing and equipment shortage. i'm asking the

budget and legislative analyst to tell us exactly what the department needs, in terms of personnel, equipment in order to reach the required 80 percent of the call response rate. i'm also requesting this report to be completed in time to be considered in this year's budget process. i'm asking the bla to investigate if there are administrative staffing practices to help free up existing resources. as we craft another $8 billion budget i hope the mayor and board of supervisors include the funding needs in this upcoming fiscal year budget to provide city of san francisco with reliable emergency medical care. this is an important issue and i want to make sure we take it as seriously as it is. i noticed chief white is here to the

from the fire department. i want to give you an opportunity to speak even though we didn't make preparation to speak today but i would like to give you the time to make any comments you might have? >> thank you, good morning supervisors. we look forward to working with the budget analyst as we take into account the budget and staffing. i know we said a few months ago you should know that the fire department has always advocated for proper staffing levels on both the fire and ems side. many of comments and finds we totally agree with. in terms of the challenge that we have as you are aware, i know you were being a former fire commissioner. in 2007 --

2008 there was a decision made at the state level and challenged and no longer able to make the eoa status area. the department always said that we should have never lost that. there was a fundamental disagreement and myself. it was a huge issue and we fought desperately with the department of local management to retain and regain that eoa status but it came 4 years after the fact. we have done a lot, given there is 4 years of uncertainty, the staff has suffered. you should know in the budget before you, we are still speaking with the budget controllers office and we've asked for $10 million to support the staffing to get back to that 80 percent level. we are at 73 percent now. certainly any analysis by the budget analyst would be

helpful. i know there is an initial meeting tomorrow and then i'm going to sit down for an intake with the budget analyst next week. >> does that $10 million include equipment as well? >> yes. >> okay. the last time we had a hearing i vaguely remember the number being over that amount. you had mentioned a specific number closer to -- >> 12? >> i don't remember the exact dollars. >> it's was closer to $12 and and we came down to $10. any money is great. what we are asking for is a step to getting back to that 80 percent which is what we've always advocated for. i might be getting ahead, the second part is to analyze strategic

planning. also we have asked for in the budget the restoration of an h 40 battalion chief that has been defunded for years. we need more assistance on the advent side. both of these items you want evaluated we agree that we need to investor reinvest the funding in order to get the work done. thank you for bringing it to everyone's attention. >> thank you, chief. >> we is there any additional public comment? seeing none, public comment is closed. >> colleagues? supervisor tang? >>supervisor katy tang: i'm glad we are having this discussion prior to the season and the goals to support the

fire department to address the process. with that, i would like to motion to refer this to the full board as a committee report for march 4th. >>supervisor london breed: thank you. without objection this item is moved to the full board. okay. madam clerk, call the next item. city clerk: [reducing pharmaceutical prices]1400123.sponsors: chiu; wiener and camposresolution supporting city, state, and federal efforts to reduce pharmaceutical prices and increase transparency of the pharmaceutical rate-setting process. 1/7/14; received and assigned to the government audit city clerk: sf 31234 >>supervisor london breed: supervisor chiu this is your item. which >>president david chiu: thank you. the proposition placed this on the battle --

ballot, this is a measure overwhelmingly passed by voters and i have a cosponsor as supervisor wiener for the implementation and reduce the heavy burden that our residents and country faces from pharmaceutical drug prices. the united states spends more on pharmaceutical drugs than all of our country. even though the law addresses major problems with this. the issue of high cost is left untouched. to keep up with our cost, the department of public health has reduced by 25 percent over the last 5 years. we are paying $23

million of taxpayer money while drug manufactures have made billions of dollars in profits. these are tax dollars going to our schools and making our neighborhood safe. but unfortunately even our residents that have good coverage are spending this money on medications. there are a lot of complicated issues that under lie why drug pricing is so high. there are a couple things that i would like to note that i have certainly explored with city staff on this issue. we have very little transparency on the prices set not only with drugs but also prices paid by the city and county of san francisco. some of the out patients are eligible to receive a low price negotiated by the federal government in the so-called 340 b program.

unfortunately it's not accessible to in patients that we have in our local hospitals as well as our jails. i would also note that our city purchases many of our drugs for our inpatient populations and others with a contract through a company called innovation. unfortunately the pricing for those particular drugs are covered by non-disclosure agreement and we don't have the ability to understand how those prices are set. the resolution is asking for four things. it asks the department of public health to use consumer websites to provide comparisons for drugs in san francisco and asks for the drug pricing through all inpatient settings federal

legislative agenda for this year. we also state that the board of supervisors will increase transparency in pricing for health care and prescription drugs and also a firms our city supports for pharmaceutical prices and rate setting process. i want to take a moment to thank all the advocacy organizations and our residents that have been disproportionately affected by the rising cost. starting with the leadership and the disability action work and the san francisco labor council and many others. these are organizations that are really bringing this issue to our attention and are working with us closely to move things forward. i would like to invite up from the department of public health david woods who is the pharmacy director who can discuss some of these

issues from dph's point of view and then open up to public comment. mr. woods thank you for your work with our office and with the community. >> good morning, i'm david wootsdz from the department of public health. to reduce the price of prescription drugs is an important goal and one that is significant for the city of san francisco. with the passages of proposition d residents have expressed their opinion and with this has started a public health issue that is impacting many of our citizens. this resolution states the federal legislative body that san francisco support the national policy change which increases the profile of this issue. the department of public health is to protect and promote the health of all city san

franciscans. this message is enlightenment. the city and county of san francisco already does many things to ensure we get the low prices for medication. for example the group purchasing organization from hundreds of manufactures. the department also makes the use of the special drug pricing program 340 b drug program which allows the clinics and hospitals to purchase outpatient drugs at deeply discounted rates. the dph in turn provides free drug access to low income, uninsured and under in insured patients through the drug program, but

under through the level could this be changed. this resolution is far more reaching and will reach other populations in san francisco where there is the need. for example, some persons have to make large out of pocket copayment to get medications or fight with their drug plan to get the medication they need. they are required to provide high prices which is notable for some notifications. for example, some new medications which are considered breakthroughs which treat illnesses like hepatitis c can cost $1200 per pill. the cost is still very high for treatment. medication prices are not transparent to consumers as supervisor chiu

has said. in cases with high co-payments and large out of pocket cost for medications, pharmacies may charge a different price for medication. oftentimes it's difficult for consumers to shop around. many don't realize they can shop around for medication. they just need to know how. since transparency for consumers, websites are useful for sf residents purchasing outpatient drugs. some websites can help persons to locate lower prices for medication and generic and cost saving tips. the resolution recognizes the value of the 340 b program to benefits that it benefits the

most and patients in hospitals that care for low income persons and no matter what their level of insurance would allow the department and other safety hospitals to further serve city san franciscans even better. they share a cost for these persons. this program is only for outpatient. the advocacy that will serve will be a great benefit by an allowing the great service to customers and great programs that will improve care. >>president david chiu: i have a couple of questions for the public. can you tell us what drugs come under this

program? >> about 1/3 of our program. >> this program allows us to get from others. the bottom line is we are paying through one part of our system for lower prices because they are negotiated through the federal government but two parts of our drugs we purchase don't have that same level of lower prices. >> right. we use the organization to negotiate prices for the groups and it only applies to outpatient. >> on the drug purchasing that we do through innovation, my understanding is that the city and you are under agreement not to discuss the pricing? >> if i were to disclose somebody's price then the supplier might not be able to negotiate with me in the

future. >> i understand that. from the city's perspective, we as policy makers we can't compare them to know what other low prices are in other parts of the country. >> correct, the prices we pay. as far as the prices to consumers, those are public. >> right. could i ask our city attorney, are you familiar, i know we were supposed to have a deputy city attorney here to answer questions on this topic. could you tell us what restrictions we have as policy makers. oh, you are here. my apology. we are wondering why we can't get a little transparency on this pricing. the organization has negotiated with the city that these prices need to be kept secret and can only be negotiated with a handful of

our city staffers such as there is no transparency with anyone nor the public. can you help us understand what that entails. >> i will attempt to. i'm here on behalf of the city attorneys office. good morning supervisors. actually it was this board that passed this section of the administrative code section 15.104 which authorizes dph to enter into an agreement with basically a cooperative united health care systems that then in turn contracts with innovation to do the negotiations. now, in the very language of that administrative code section dp h is required to agre