and so on this is a in the report itself. i wanted to move from who is looking at this to the what the recommendations were that came out of the group. the first one was for initiative run access for long term services ease supports it was interesting for our department it stated that we should take a leadership role and create a door. he know with a no wrong door approach is very helpful many folks have relationships with community providers and they need to keep those relationships but we need a place for community providers to come together and seek out other information as well so having that balance of making sure that all the doors in the community are strong as they can be.

and we've begun working on something like that we're expanding this work because of the work in this area. we're doing the transition from hospital to home and there are i think takes we do home delivery meals and it's a natural fit but it was great to see come out of the community partners as a recommendation. you can really look at some of the other recommendations and their pretty well clear. i wanted to highlight a little bit related to training for caregivers and also the recommendation related to helms and dementia research that's another initiative that the county is undertaken. we've got a long-term strategic

plan that relates to dementia in our county and other places have begun to use this for an example this data has found its way into the data this is a population that is growing rapidly. for us we see consistency with the recommendations here as we've seen in other plans as well. backing up a minute you'll see a list of some of the items. that determined to be crucial elements of any long term car system the behavioral health and nutrition he know people need. the last i guess there's a

couple of recommendations that we have been moving on. quickly because the opportunity presented itself and one of them was that there was a recommendation related to trying to make sure that nonprofit providers having had as much opportunity as possible to work in the business world of managed care. so in this last year the administration for community living in washington, d.c. had a quest of proposals out they were will i willing to fund 9 community in the country and the idea was exactly what we put so what the plan if providers who are unaccustomed to working with the medical community or selling goods and services to people who are going to want to buy those items for their consumers and

clients then people needed to be ready to do that. so it opportunity arose this last winter we accessed it and was selected as one of the 9 community and at this point are in conversation with the provider. another community several community providers in the southern california region are looking at doing some similar and helping he easter each other to be successful in this area. the last recommendation you'll see in your packet you can ignore the resolution at the end of the packet this is the reason we're here that is there was recognition there needed to be an implementation body just as

we needed an implementation body for the dementia program. it was recommended by this body that that implementation body would include the 3 departments dos and human service go agency and the health plan and in addition to the coordinating council. we're hoping to convene this group in may and dos will be providing the staff to the group and we'll be in its first meeting determining who should be this oversight body it's was broadly put together. again, we will not be implementing this cc i will not be coming to san francisco but in 2016. what we've learned from other counties remember this work started two years ago it's taken

the county to get to a place to implement something and only one of them is ready in april and hoping for too more in june. we believe as far along as we are in our collaborations with your county partners there's a lot of work to do to present. we believe that that work let's say managed care and the cc i never came it will help to us better serve the people in san francisco. we see a lot in the plan we can moved on whether cc i comes or not. with that, we will entertain questions. >> was there any public comment first and there's no public comment. >> okay commissioner melara.

>> yes. a couple of places ilene i'm familiar with the case by it would be good for the commission that don't know about this it's a great bottle to say in san francisco. >> the pace stands for the all inclusive care for the elderly it started in san francisco it was started over thirty years ago and it really is designed to focus on individuals who are certified to be eligible to be in a nursing home but want to stay in the community as long as possible it begin with medical services and primary care services as well as long-term services and community services. i think that where it is kind of a blend a managed care program but also a provider because

those programs operate their own centers and clinics where people come during the day it get a spectrum of services including home care. it is a complete package of medi-cal and medicaid services in addition to the services that the interdisciplinarian team and physical and occupational theorists put together. >> those buses you see on the street initially pickup those seniors from their home i even operate housing facilities. >> housing is not covered by the pace program but knowing how important housing is ease certainly san francisco has been a leader is housing is so important to having people stay in higher home and community and

getting care there soaps to going into institutions. definitely some of the non-traditionally home delivered meals are part of the package >> and the second and final question is this is more for ann as the leader of this. is what is comes to in my mind all the time is that those services are targeted for those people who are medi-cal eligible but we have another group of servers r search and seizure in your community that are falling through the cracks who were probability a hundred dollars away from not obeying being eligible for medi-cal we're a aging population for a comprehensive city and yet we have no services or least e at least the eligibility criteria

if we can in our future vision look at healthy san francisco where san francisco, california become the place to create a program that can look at expanding the eligibility criteria and cover people also in need but unfortunately basis of, you know, $30 or $20 kw4s nothing in usual city are truly falling through the cracks and not being served. some of the legislation both our advisory committee and commission looked is the asset limit and income limit on medi-cal. their share of costs program a great if you can afford the share of costs but a lot of people can't afford to pay that. so i think we have been looking

and every time we run into people one of the things i'm hoping that happens with the business collaborative we'll inevitable grow the dollars that exist within our community in addition to what we do as departments and mayor on board put together but find other ways to grow that pot that can help and use the innovative and creativity thing in the san francisco village we're looking at the cafe in chicago they've been doing looking at where those opportunities to do something that's not the same as what we've been doing by bring the education and other kinds of things that can be helpful to people and help connect to the things they can't afford.

a that's an excellent comment >> commissioner sanchez. >> this has been an excellent report we had on the population our public health committee a while back when presented in depth and also vice president ma letter was there and the presentation was quite in debt and brought out critical issues but the fact that this process has taken over two years you've been inclusive in the dialogues in which you've that been generating in a comprehensive program and i mean institutions such as the honda and our community input our community programs like central latino and

all have been parts of the dialog and found out how we're going to face the challenges in the future so your key he recommendation is to have this task force to really provide oversight plus the leadership through the aging is critical as we move forward and the projected date is 2016. there's only one question i had in reference you've presented 44 thousand was that the projection of 2014 or 6 and that will grow by 10 thousand and more was that your understanding >> it was scheduled to go. >> could you please speak into the microphone we're mindful because this is being picked up by our sfgov and requires we

speak into the microphone. >> so i can get you the exact date but i expect that number to grow. >> great a great report and long overdue and taken a lot of leadership and collaboration that's the spirit of how things get done in the city. >> commissioner sako. >> i agree it's thorough the questions i have, you know, being someone from the lgbt community it comes up about social competency and also when you mentioned the service providers setting on the working group was there any open house group part of that or the lgbt seniors were they part of the

planning body? >> trying to remember in the task force had been formed i don't think it had been so some of our staff was certainly involved in that and keeping in mind this at the same time, we through the net were trying to make sure we were 2011 everyone to the table also, because the communication of what's going on is so important so we did do a series of town hall meeting we're going to do more in the future to a gather back from people what's working and not working so again those are possible venues and there will be more in the future we'll be looking to do as well. thank you. >> i'd like to clarify you're looking for us to actually not

simply support the report that comes from the design group but it's not the xylophone group that carries on the work your suggesting we point towards the l tci implementation body as being a parent on that body. >> yes. that's correct. >> so it won't be the design group i was going to ask the director that the direction we're looking at we might be able to modify this commissioners, if someone would make a motion instead of continuing to work with the design group it would be to work within - to form - >> i participateed in the implementation. >> to participate or we're spotted to help formulas. >> right the language in the resolution i think where the language is off we know that

times are changing fast we don't want to come forward with a resolution to implement this because things could move faster we're wanting to form that implementation body and we believe it's critical for the partners that have been mentioned in recommendation 13 didn't have a package number that we go forward with that. >> okay. so actually you're asking us to continue to develop a implementation plan including the formation of l tci implementation body? because now we're not working with the design group. >> ; is that right. >> that meets with the departments.

>> absolutely we'll be more than happy to participate. >> yes. yes, that's why i'm trying to change the resolution so it doesn't point to the design group we take that out and instead we develop an implementation plan including the formation of an l tci implementation body. so if someone thinks about that i do have two or three questions and we can go forward >> i can move for us to add that amendment. >> okay. so why don't we hold that until i finish my question we can take the resolution then number one is obviously the program is a pioneer and this is a result of it which was caring for the frail and elderly is it intend to take care of and in order to subcommittee rule have

to be part of the elderly. >> so it's focused on the elderly unlike the other two plans serving san francisco it would be designed to take care of the dial eligible population so people who are well, but the pace program is focused on the frail elderly. >> so in terms of it's really wonderful there's no question in fact, it was a bicentennial so here san francisco got highlighted which is wonderful. so talking about unlock in the community and cultural competency as part of what we were talking about in accessibility how will the agency along with our doors be

able to respond to different ethnic sisters and language issues and even the communities along with the question where will the funding come for this? is that part of the states core program to fund directives for the central office and however we're involved with this? i hate to ask for the funding >> the coordinating care is coming from medi-cal and medicaid so programs are clear requirements of all the health plans related to accessibility and cultural competent and language assess so that's part of the health plans responsibility to meet the needs or reflect the needs of the

community. >> but if you're going to become one of the doors is one of the doors going to have the language capability to point you're talking about we're still able to look at many doors but the door at dos would be able to triage culturally. >> we see the door at dos that exists now is enrollment where people can enroll but not under the cc i the health plans have to do that but we do have programs in place that are assessment programs and advocacy programs help consumers to determine the options and which option would be best for them.

we already have a contract with the san francisco health plan for example, related to the health centers where money comes from the health plan to us we push out to a community nonprofit it does the assessments with the idea that the health plan doesn't have the expertise we fund other programs like that so it works within our capacity to keep the relationship with the nonprofit. we see the door not as on that enrollment door but help people sign up for other programs their eligible for. but also to help educate and lead people to doors that can help them discern the right

possible solutions to get them to an answer quickly >> you have the language capability in dos to do that. >> yes. and if in the traditionally program not only do our staff have the languages but your community partners are statistically placed around the city and are contracted with because of the language and cultural backgrounds and so on. going back to funding the programs are funded through medi-cal and medicaid how are the navigation services funded is that f this part of our program through the health department is there a southerner certain amount of money through the pilot >> i want to mention for the first 8 counties there's been additional funding for the department on aging to get more

resources like the medi-cal counseling program and so there are some new funding streams that are coming to help the initial counties but there's going to be increased capacities so there will be some in the future as well. >> the thing i didn't mention it was on one of the slides but i didn't highlight it enough. i ask the in house supporting services programs is one of the 4 mandated programs that is a program that sits in our department. we're already and we use the program obviously to enroll people in the program but we put people into the hospital and other types of settings we're talking to people who don't

qualify for this but something else. we've been coordinating this because there are 22 thousand people i mean home care is the basis but other things are neat. we're using that platform as a way to do this as well. i ss is a medi-cal funded - >> sure any further questions or are we ready for the resolution. >> let me make sure i have the amendment it would be for the resolve for the public health department will continue to work with the long-term care to have a implementation plan including the l tci for the long-term care

strategy for san francisco. >> well, you don't want the design group because they're not there. >> take out - >> take out the design work and we'll continue it to work with the design plan including the formation of - >> that works. >> and we can hand that over to mark. can someone second the amendment >> we have an amended resolution and a second. other comments or questions on the resolution >> there's no public comment commissioners. >> thank you all in favor, say i. opposed? the resolution is passed congratulations for the hard work and that looking forward to wonderful results. >> i thank the committee for

recommending we do the presentation today. >> our next item. >> it's the san francisco genre build update. >> commissioners i have to run back to my office i'm going to grab the thimble drive. >> i'm going to go ahead good afternoon. i'm with the rebuild project i'm standing in today

for keri he's unable to be here. so the san francisco general hospital rebuild project continues to progress forward with a lot of final touches on the exterior and if you wanted to reference which power point >> yeah. so there's no slide we're trying to introduce the topic. a great deal of progress and a lot of finishing touches on the exterior. a sight work for the walkways and plaza a lot of work there. right now a lot of focus on the interior. and the mechanic and electrical and putting in the drywall and the patient room it's exciting to go into the hospital and see the changes happening.

we're also actively coordinating the move in with the staff being involved in the planning and move power as requested in the february 11th jc c update we got feedback to include more feedback on the transcription and more information about the percentage rate for the bond and how that ties into the budget that information will be included in the presentation today. overall the project is on schedule with the construction slated for completion in may 2015. i guess i'll hold off on the next slide until the actual

power point. >> do you have copies in front of you i'll precede then. >> moving on the the transition program it refers to the planning and implementation of the acute services from the current hospital into the new hospital. so the transition fdr consultant they've