we only have 7 nurses. who do we judge what patient we should take, the 15 year old over the domestic violence mom? how can we justify, you know, to see over 200 -- >> thank you. first time moms over 2000. thank you. >> thank you. (applause) >> supervisor avalos, i wanted to thank the speaker for those really vivid stories. it really hits at right at the heart of what safety is. but thank you so much. >> great. next speaker, please. my name is [speaker not understood]. i'm a public health nurse with field nursing as well. i'm a little shaken up from hearing that story. but i brought some letters from [speaker not understood] who would have liked to be here today but they couldn't make it because they're new moms. one of them said, i need the service for the nurse to come check on me and my baby because the nurse gives me orientation on how to care for my baby and

myself. all women that give birth need this service and i am grateful for the nurse who took time to come see us. another one said, first of all, i would like to give a cordial hello and thank you for the opportunity you provided us and the advice as well as the assistance with our babies. this is two sisters. we thank you because with your help we are able to under the need of our babies and how to better care for ourselves as well. we thank you so much the help you provide for pregnant mothers and babies. and we hope to god you are able to continue this assistance. thank you for your attention. and i'd like to share a personal experience as well with a client of mine who declined public health nursing -- nursing with partnership services because she couldn't deal with the long-term commitment. she was a teenage mom with a

premature baby, 34 weeks, 4-pound baby who started [speaker not understood] when i was at the visit. i was able to demonstrate what to do with a choking baby and the next time i came in and saw her she was so grateful because the baby choked again and she was able to assist the baby and not have to call 911. thank you. >> thank you. (applause) >> next speaker, please. my name is ernesto cacho. i live in [speaker not understood] hospital and i've been working there 26 years. let me tell you how staffing affect hospital reimbursement. i do assessments and from these assessments we submit the paperwork to the federal government and also the state government. and from this -- from this

assessment we have deadlines to meet the dates. and if we don't meet the dates for these deadlines, the reimbursement for this hospital will be at the default rate, which is much, much lower than if we had met the deadlines. thank you. >> thank you, mr. c york cha. next speaker, please. ~ cocha good afternoon, my name is trina oats. i'm a third generation san franciscan of district 5 and i work for west side community services, [speaker not understood], the crisis center. everyone is here talking about staffing and it's the same at west side. we have clients from everywhere. not from just san francisco, but they all come into west side, needing help with their mental illness medications and

just talking to a nurse practitioner or, you know, psychologist/psychiatrist for their problems. as you know, west side takes care of the most vulnerable, the poor and the homeless here in san francisco and the clients, they get up -- they have to be at west side at 7:00 in the morning to obtain a number until the doors open up at 8:00 and then to be told that we can only take three appointments and they have to do this repeatedly day after day after day. there is not enough people to staff to see them and, you know, they just keep coming back. and it's very disheartening to see people in crisis, in mental health needing refills on their medication and we're just not able to provide that service. and i think it would be a shame that the city will propose these budget cuts to nonprofits like mine, to west side, that take care of the most vulnerable. we keep a lot of people out of general hospital. we give them medicines, bed, lunch, all different programs to keep the money -- budget

down for the city. if you take that away from us, it's just going to come back to bite you in the rear. thank you for your time. [laughter] (applause) >> ouch. next speaker, please. i have one more card. donovan bing ham and anyone else who would like to comment, if you haven't heard your name or you don't have a card, you can line up by the windows on the side. thanks. hi, i'm brandon dawkins, eligibility worker, [speaker not understood] urban health center. i've been there for about 19 months. it is very important that we provide better staffing for our clinics. i'm at a clinic where we serve the homeless population, transgender and hiv. it's already bad enough that patients have to wait for some time five months out for their appointments because they can't get access. and with inadequate staffing it's not only going to make it a lot harder, but it's going to

-- we can't provide the services we need to our patients with inadequate staffing. and patients are going to get mad, then they're going to go elsewhere because they can't come to the public health system of san francisco and get the service that they deserve. so, at the end of the day, if we don't beef up our staffing, the only people it's going to hurt at the end is our patients and we can't afford that. thank you. >> thank you. next speaker, please. hi, i'm donovan bing ham. and i have been -- i'm an lpt, licensed psychiatric technician. i've been with the city for around 25 years. i worked at san francisco general approximately 15 years and now i work in the community. and i really wanted to address some issues pertaining to the changes structurally and otherwise at san francisco general and how it's impacting those of us in the community, meaning that the department of

psychiatry has been cutting back on beds and shortening the length of stay. and, so, releasing people who are not doing very well into the community. and i think it's nothing short of a miracle that nothing more significant has happened thus far. i can give an example of a young man i've been working with over 10 years now, both on the acute side as well as the outpatient side who had tried to get hospitalized and treated for the last 2-1/2 years. well, he he finally managed to get successfully hospitalized. he's now in the jail system being treated by jail psychiatry. and that's the way it's been going more so and now he's looking to go to wi health court who is going to mandate him into treatment. that's after he assaulted somebody in the mission right in the parking lot of the mission police department. so, you know, i think that there is a tendency to be comfortable if not complacent with, you know, not spending money on one end in that it's

going to be transferred to the community, it's not really happening. we're getting short-sighted on the community side as well. we're not getting staffing support. we're not getting clerical support. we have a lousy, lousy charting system that is a huge time suck. it does not work very well. never been addressed. it's always come back to the staff as you guys need to be more productive. but the computer system does not very well. it's a lousy piece of software to work with. i would really -- and the budgetary aspect of things, like you to look at what's going on at san francisco general. but also what's going on in community behavioral health services where the clerical situation not getting clerical support as well as the software we're using. thank you. >> thank you. the bell rang a little while ago. (applause) >> any other member of the public would like to comment, please come forward. hello, i'm larry edmonds. one minute, i'm thinking two minutes. just going to he show you, i

got this from san francisco general -- i mean [speaker not understood]. guidance they give staff, [speaker not understood] will not be tolerated. it said [speaker not understood]. they gave me so i could take it to my apartment where i live ambassador. and [speaker not understood] now we go over to golden gate and i went there and it said you had to have ten days to register and get an appointment to see a doctor. my doctor is dr. [speaker not understood]. my social work was [speaker not understood]. and i told people all the time, i been going through this for three years, abuse and now it's all [speaker not understood]. people abuse the people. i'm the one that get evicted, but everyone hit me.

the people at taiwan knew i was having thing. i would take notes there and let them know, talk to the social worker. and you all going to do this here. listen -- the head will be long. our climb will be steep. we may not get there in one year or even in one term. but america, i have never been more hopeful than i am tonight that we will get there. i promise you we as a people will get there. ~ i hope we can do more because this is what trauma [speaker not understood]. i feel i can't stop talking about trauma [speaker not understood]. unable to concentrate, unable to teal ~ feel [speaker not understood]. you can't to keep people out. you want to make people criminals to get housed and services. services because we need to stop this. you know what, i'm glad i got help to under this to this

point. thank you. (applause) >> thank you very much. any other member of the public who would like to comment? and seeing none, we'll close public comment. [gavel] >> like magic. i want to thank everyone from the public and people who work at general hospital, the classification of general hospital and in the field. thank you for your service and your amazing dedication to your work, especially working with the lack of resources and conditions where the staffing levels aren't where they need to be. i really think that it's something that is not alwaysed or ever acknowledged by the city and the general public. so, your work doesn't go unnoticed. it is so valuable what you do saving live. i really -- you know,

appreciate your presentation from the department of public health and from the general hospital. in terms of moving through our dhr problem, i want to make sure that we're tracking how that's happening. i would like this hearing to be continued to the call of the chair so we can actually, you know, call again and hear an update, status update about that. i believe the issues are critical, especially as we are trying to meet our goals from the public health department, to have high-quality care, to have access to care, to be able to practice the kind of innovation that we can, and to be ready for the opening of the new general hospital, critical event we are actually meeting our staffing needs this year. so, i would like to call this again, probably in september after we get back from break to hear an update on how we're moving through on our staffing

plans. and, again, i really appreciated the tour. ~ i got of general hospital of the emergency room last friday and i would like to be able to go back again, especially this year, i'd like to go back and see if there is any difference after new staff have come on. i'm expecting that they will. we don't have anything before us today in term of a die significance about adding anything to the budget. that will be during the budget process which will occur in june the third and fourth week of june, but we'll be in touch with the representatives from labor as well as staff in dhr and department of public health to track how this is moving through our budget process. so, want to thank people for their presentations, the city side, on the public side, and we can -- if there are no other comments from committee members, we can -- motion to continue this to the call of

the chair. >> so, can we do this on item number 3, continue to the call of the chair sometime in september, estimated time, can we do that without objection? thank you. [gavel] >> and then for item number 2, can we file the hearing on the department of public health budget? >> so moved. >> thank you. without objection. [gavel] >> ms. long, could you -- my understanding is we are going to continue items 4 and 6, but i guess we should call them so we can open up public comment. >> that is correct. >> so, let's call item number 4. >> item number 4 is a hearing to receive and update on the human services agency budget for fiscal years 2014-2015 and 2015-2016. >> so, we're going to continue this to the call of the chair. but let me open it up for public comment. is there anyone from the public that would like to speak?

this is approving the transit fare from city of san francisco -- >> no, juicy, it's item number 4, human service agency budget. number 4. >> so, we already continued them as well? okay. please continue, mr. edmonds. well, i just hope the budget for the 2014 to 2015, that you under there are innocent people out in this city that are harmed by -- i think it's the eviction. it's another term from tndc where i stay at that they moved there. they think tndc is a very good place. it's in a good building,

[speaker not understood] the building, kelly coran building. it seems like that's part of what's going on now. my landlord -- my doctor is at my landlord. i'm at the landlord. i've been having problems with the landlord for a while. i hope with the budget that we can clearly keep where you get your doctor bill and your landlord separated from each other because that was my feeling that when i talked to my doctor, i call a social worker. they tell me [speaker not understood]. i was a good [speaker not understood] for everyone. i hope in the long run there is a link between my [speaker not understood], my doctor and the rent, tndc is not the place where i want my doctor to be. that's why i would like to go [speaker not understood] myself before 2015 at san francisco general. but there is a connection and i think it has to do with the rent. thank you.

>> thank you, mr. edmonds. seeing no other public comment, public comment is closed. [gavel] >> so, colleague, i think we've already moved and decided to continue, but can we continue item number 4 without objection? [gavel] >> thank you. is there any other business before us, ms. long? >> no, mr. vice-chair. >> then meeting adjourned. thank you, everyone. [gavel]

hmm. [cell phone beeps]

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