historical and we're going to try to chip away at that over time in the coming budgets. so again, not a whole lot of big changes compared to what you've seen before, but we are really in a place where we're watching the big federal dollars carefully and watching our enrollment information carefully to try to narrow down some of the uncertainty about where we're going to be coming into the coming year and refine our projections, but we're in a much better place than we were in the past, especially on our expenditure. i just realized one thing that i do want to point out that i skipped over on the san francisco general hospital slide. i skipped one of the slides on the expenditures there.

we have -- on the expenditure side we are living within budget. you'll see that we have a projected $16.6 million favorable variance in salary and fringe benefits so we're coming in below budget by $16.6 millions. that is due to a couple of things. we have a couple units that are under their budgeted agent census so we've incurred some savings there and we also have some savings from our delays in hiring. i wanted to point this out because this is something that's come up at a couple of the last commissioner meetings and it's also come up extensively in our meetings with our nursing union as we've talked about their contract. we have -- despite the salary savings, that is not coming from our inability to fill our

clinical positions, although that is a very serious issue for us. we have about 80 nursing positions at san francisco general that are unfilled and we are working overtime to fill those positions, however, from a financial perspective we are back filling those shifts with per diem and registry, so that's not what's driving these savings. it's the units below census and the other positions we are having trouble back filling, which are things like our information technology, we've had a hard time hiring there, clerical positions, interpreters, etc. i want to point that out in particular because we know it's an issue. repeatedly every chance we get we've expressed our commitment and desire to get that hiring pipeline moving so we can staff up the hospital particularly in

our nursing area. so that, i think is the story as we are within budget on our expenditures and we have a little bit of good news on our revenues which we've been able to turn around and turn over to the mayor's office and it's translated to some positive things in our budget so i'm happy to answer any questions if you have them. >> i'd just like to say we're very appreciative of the mayor's office supporting us and this may be one of the first non years which means we use today have hearings for any reduction in services and we sit for three to four hours listening to community about why we are reducing it and the consequence of that so this is a good year for us in terms of getting back any of the reductions, particularly for our community based

organizations. it's not that they did something wrong, it's the fact we did not have enough money to meet the needs of the budget so we're very appreciative and i think it shows in terms of our bottom-line. >> is there any public comment on this item? >> i receive no public comment requests for this item. >> okay. commissioners, any comments? >> yes. >> commissioner singer. >> i have one quick one. many people have expected that with the aca the problem of bad debt would shrink, but in this last quarter or your projection for the year, your bad debt at the general hospital goes up 11%, i think. 11.7% to $98 million and i was wondering is that because we expected it to get so much better and it didn't get quite that much better or -- and we can probably take this offline because it's probably not something on the --

>> i -- that's a good question. what i would like to do is kind of dive into the details, but really or bad debt projection is a function of multiple things on our actual, so if we have higher billing, our bad debt will go up because it's a percentage of our billings so what we'd need to do is take a look at the fee for service, analysis and where we're withholding dollars in terms of what the billing is that's out there. further questions? >> i just wanted to comment that i wabted to thank you for you continued clarity, the clarity has been made even more clear by the fact that we don't have to juggle this, you know, invisible set of words with the mayor's fix and i think it's also amazing and another

reflection of this city's commitment to healthcare that the cbos were being able to be given their raises, they didn't take back, but were actually resfoered. stored. we're putting forth as part of two year budget and funding most of our initiatives which we need to try to remain on top of all the needs that aca has given us to be able to develop the integrated system. and we can see it more clearly because the numbers no longer are being, you know, confused with this problem of -- yes, the expenditures are [inaudible] because we didn't

fund it or it wasn't funded from the city adequately. i think the unintended consequences are we're much more able to manage this budget and i think again, that's a commitment that the administration has made towards the improvement of our healthcare system here. so thank you again for bringing that -- >> one of the things i wanted to note was the fact that the community based organization has a 1.5% increase as you said, but they received a several million dollars to help them with their increase cost of rents prices in the city. >> on top of that. >> on top of that. >> i didn't understand that part. that's even more of a commitment for health here in the city and so our thanks then to the mayor's office and we're hope tg board of supervisors will see that that is the road to take. next item please. >> yes, we move to item 11,

which is the update on the proposed amendments of the healthcare security ordinance. >> thank you. >> when i was here at your last meeting we talked about supervisor campos' new program that would provide subsidies to individuals purchasing health insurance on the exchange. we indicated to you at that time that while we agree with the intention of the program, that there were some concerns about locking us into a specific pathway forward at this early date while so many things are still in flux. so since your last meeting, we met with supervisor campos'

staff and have come to an agreement on language that's included on the revised resolution and have provided in the key paragraph of the cover letter to you, which is intent language that requires the department of public health to develop a plan that will bring to the health commission of 2015 that will address the affordability of health insurance and in the interim we would continue to operate the current programs, the medical reimbursement accounts and healthy san francisco in a manner that's consistent with the principals of the universal healthcare council which are affordability, prioritizing health insurance and such. we're pleased to say we were able to come to agreement. the revised legislation passed out of the neighborhood services and safety committee last thursday and will be headed to the board of

supervisors next week for its first of two readings. and additionally, we haven't stopped since we got a little relief on the october 1, 2014 initial timeline for implementation. we have not moved forward with planning on what to do about affordability. we have arranged a meeting this coming week that is between the cover california plans in san francisco, the five cover california plans, plus san francisco health plan, plus foundations that are interested in healthcare will also be there and cover california will also participate. we want to get their best thinking about how to address the affordability issue. we're moving forward on that front also. >> thank you.

commissioners any questions or -- so it does sound like the cover san francisco is not really in the legislation anymore and that we're talking about what is the best way to take the existing programs and make them affordable to our public and how to encourage getting into real insurance bill. >> that's right. or the plan could be a different program that doesn't look like the cover san francisco program that was prescribed in the previous version. >> that's possible too. >> that's possible too. >> director garcia, any comments on the work you've been doing with the campus legislation? >> well, i want to thank supervisor campos, who was flexible with us, particularly as we move into exchanges. as you know, president chow,

there are a lot of issues in terms of how do we do these subsidies, but i think they're not unsurmountable. cover california isn't quite ready for us yet so in the meantime we'll look at local health plans. we need to think about how to make this simple because of the node to get these funds to people as quickly as possible and i know nothing's simple in our health area so we'll try our best to do that. on next week after the health plan meeting we'll have much better understanding of how the health plans can help us in the program. >> very good. commissioners, you recall from our previous resolution had said that we were asking the department to continue to update us and bring at the appropriate time, resolutions as needed in order to be sure that our residents have

affordable insurance programs, so are we looking at maybe a month from now having a report or -- >> yeah, i think monthly would be sufficient for us and we'll have enough to be able to report to you. >> commissioners, is that acceptable at this point? >> if there's a significant encounter that we find that we'll need to bring to you we'll bring it sooner than a month. >> monthly reports and earlier if needed. >> absolutely. >> thank you. >> thank you. >> any further comments? if not, thank you again colleen and we'll go on to our next item. >> item 12 is other business. >> commissioners, any other -- any comments or any comments from the public. >> no public comment. >> i wanted to ask about just as a follow up item, we had in our packets two meetings ago i think a letter addressed to uz from us from cpmc about bed

allocation between facilities and at some point i feel responsible -- >> that was the [inaudible] and it's a prop q hearing. you want to tell us -- i think we have it on the calendar. >> right. that's going to address the prop q setsing up a meeting with -- -- >> you don't need to cover this now, i just want to make sure we -- >> yes, we want -- >> you're scheduled to have a prop q hearing at your next meeting. it's on the reduction in skilled nursing facility beds from 99 to 74. >> and we are currently working with director garcia on the response that cpmc gave us regarding the diabetes clinic and we'll see and report back to commission what their response will be after we get further clarification of nurse

services. any further questions, i will move on to -- >> item 13 is report back from the joint conference committee with [inaudible] during this past meeting period. >> it's the law gu that honda jcc met on may 17. at that time we reviewed the hospital report and the third quarter financials. we also heard a presentation on efforts related to patient flow in and out of laguna honda and in the open session the committee [inaudible] in closed session we approved the may credential report. >> any questions? if not, we'll go on to the next item please. >> item 14 is the committee agenda setting. >> any -- just to remind you that our planning committee meeting is -- >> august 19. >> -- august 19. okay. and we've been able to obtain

the same facilitators so pleased with what will be a continuity from our last meeting. >> and since our last meeting, the commission must ask the women and health commission are worked on a date and it's a date of december 16 for a joint meeting, which would focus on women's issues, both from policy and department public health perspective. >> okay. and we're working on an agenda for that too? >> oh, it's all very preliminary. i just wanted the announce it. yeah. >> i think if anybody has any items they think the joint commission should take up, then we should give those over to the director now so that we can see if those are of mutual interest to the commission -- the other commission. >> all right, you are now at

item 15, which is voting on closed session. >> any public comment on closed segsz? >> i've received no public comment. >> first a motion for closed session? >> i move we go into closed session. >> is there a second? all in favor, i. opposed? we'll then go into closed session. thank you >> the information from the closed session. >> second. >> i.

>> turn off all of your cell phones or pagers so that we don't get interrupted and we would like to thank sf gov tv for fulfilling my weather girl fantasies and putting me on tv, and so thank you for all of that. so the first thing that we are going to do is have public comment, which is... sorry, we are going to call the roll. >> commissioner al perez. >> here.

>> commissioner akers. >> here. >> camp angoli. >> here. >> and hyde. >> and we got an e-mail from president tan who said that he will not be here this evening. >> public comment on anything that is not in the regular agenda, do we have public comment? >> good evening commissioners thank you so much for having me unexpectedly this evening, i know a couple of you commissioner akers and hide, and my name is stephanie ashley and i am the director of the saint james infirmry to tell

you know about an event that is coming up on june 5th is the 15 anniversary of saint james and it is the first occupational health and safety clinic by and for the sex worker community in the nation. so, every five years, we have a major fund-raiser to celebrate our existence, and we are having our biggest one yet this thursday at temple nightclub and i see dave peterson here from temple, and they have been very generous and helpful in getting this party off the ground. and it is going to be a great night and we are going to have some celebrity djs including david harness and ricky sins and we are going to have a dungin and the former lefty ladies and i am going to have a photo booth and a lounge area, and basically just stars of the adult entertainment industry

coming together to help support the work that we do and we would love to see any of you there you can make it june 5th at temple nightclub, 540 howard street and 9 p.m. to 3 a.m., have you to stay up way past your bedtime on a school night, so thank you. >> thank you. >> is there any other public comment? seeing none, public comment is closed, item two, review and approve the minutes of may 20th. >> i move to approve. >> second. >> okay. >> ready? >> public comment? >> okay. >> is there public comment on the meeting minutes from last meeting? >> okay, seeing none. public comment is closed. >> thank you very much. >> commissioner campagnoli? >> aye. >> commissioner lee? >> aye. >> joseph. >> aye. >> akers.

>> aye. >> perez. >> aye. >> hyde. >> aye. >> now we will have the report from the executive director. >> good evening, commissioners. it has been a while since i have been here. and i was in edmonton and i will get to that in a minute and i wanted to update the commission on a couple of items and one is a very exciting late night integrated transportation plan, that we are moving ahead with the task force has been created and invitations to the first meeting have been sent out and about 30 people have or rsvps from the local transit agencies and the sfpd and the labor unions and the taxis and the early morning other early morning industries, and we are hoping to, you know, have a robust conversation, in the first meeting and break into smaller groups.

we have been working with the transportation authority as well to assist us with data collection and analysis and obviously that is going to be vital to producing a document that is worth while and that the people can use going forward and so we will report back to the board of supervisors in about six months but as we go forward i will continue to update the commission. the plaza program got the final read today at the board, and so happily, rob, and the group have decided to have a cocktail party to congratulate each other. and we expect to continue working with oewd as the plaza program becomes, or goes into implementation phase and so you will probably continue to see and hear those things and then, as you know, that we will be using llps to activate music and outdoor stuff, on those plaza as they get created. so, that is exciting. update on the economic impact

phase two, basically the revisit of the impact study and the controllers office to add the fairs and festivals and so that began with the data collection at the how, weird street fair at the end of april and early may and the breakers and the haight street fair where they intend to survey the people as well and we are assisting the controller's office and hopefully through all of these fair and festivals happen and we will get the data and crunch it in the last part of the year and in theory we will have something early next year, as far as a number. and sort of a version two of the economic impact of this addition, to what we can consider sort of entertainment/day life, night life in san francisco. the reason again, that i was not here last meeting was that i was in canada and i was invited to represent the city of san francisco, at the

international hospitality conference, and which took place, may 21, 22, and i was able to present the work to the commission, and the city, regarding the way that we handle the night life and it was joined by paul davies from the uk, and discussing his purple flag program which is really cool and it is accreditation program that will work excellent in the towns and villages and managing the nighttime economies and there are other programs like that, that were discussed, that we can all look towards including beth bar none and all of the things that i will be trying to bring to you as we can integrate the stuff into what we do here and then i was intending to go to speak on san francisco at other conference on june 12th but that got canceled so that is not going

to happen. the hiring process for an additional inspector has been concluded and hr are in the process of checking references and fingerprinting before they can make the normal offers but all of the work as far as the front loading and the list and the interviews that are accomplished so we hope to have somebody new on board, in the next few weeks and so hopefully, if not, the next meeting the one after that, maybe we will a new staff person. so, took a long time, but hopefully before maybe, before the end of the fiscal year. i don't have any corrective actions to report. oh, yeah, but i did want to mention last night was the i think the third round of sfheritage bars and restaurants and so i am going to show you these things, it is a map they created. so i don't know if there is

another one coming, but, oh, right, okay. but, this is really cool, and i think that there is probably more if you want to take those, we can get some more, you know, to spread the word about where, it is a map, for the people that can't see it. and we will know what you are looking at all of the heritage bars and restaurants in san francisco, and so that is that. and cami reminded me that our july first meeting is canceled, based on a motion that was made months ago, by this commission. so we did issue a cancellation notice, however, we do have a meeting after this one. so, the next meeting is the 17th of june, however, july 1 is canceled. so, put that in and don't show up. because you will not be here. and again i have nothing in terms of corrective action to report and i am going to hand it over to inspector burke.

>> thank you, director, and good evening, commissioners. two things to report, this week. a couple of outdoor events that went very smoothly at cafe cocomo on sunday at 524, they are doing a few events this summer. and at an outdoor courtyard and we have established a good decibel limit and that limits the amount of sound escaping into the neighborhood around them and we also had an event at market and powell for matt cosmetics and it was starting may 30th and then saturday and sunday we are concerned about the sound effecting the flood building on market. and we have kind of the inclusion that no reports were

made, or no complaints were made to the commission and they are from the sfpd as well and so that went off without a hitch. one administrative citation was issued since we last met, for managua to place on the mission street. and after a notice of violation, a couple of months ago and one reminder in between, we went ahead and issued them a citation, and they should be coming in this week. we received a complaint for the revolution cafe this past week about prolonged amplified music that goes against their conditions on their permit. and made us stop by this past weekend and we had noticed multiple violations of the good neighbor policy and we will be sending out the notices of violation to them this week. and i spoke with a or their manager on duty and who was a

former manager of cafe revolution and she said that the current management has been having the trouble staffing and there is no security on site and there is more of a crowding and there was a door left open and so keep an eye on them and we will see if we can't bring them into compliance. red jack saloon and we received a complaint about them and they were not permitted by the entertainment commission and i sent that over to the police department alcohol liaison unit and we do have an interesting new complaint for the procidio theater about a religious event that takes place on sunday mornings and so i will be going out this sunday to take a look at that and take a listen to that right before i check out the haight street fair. i think that just about wraps it up, any questions? >> are there