this shows how the work first locations which are the high injury intersections and corridors, over lay with a map of income, and you can see there's actually an strong correlation between the location of where people are getting seriously hit and killed in our public rights of way and where our lower income population resides so we'll use this kind of analysis for all of the elements of funding in this go-bond to make sure we're closing equity gaps as we expend these dollars. the transportation department does have challenges awe you've all raises and as mohammad has experienced, there's good things happening on the streets. dpw has paved one out

of every five blocks in san francisco in the last three years or they will have. we've made street skate improvements such as jefferson and chavez street which has redesigned those roadways and it's safer and attractive places for people to travel. we've made investments and i mentioned the pilot, the church street pilot which we've expanded, and various parts of the city. and the bike way just outside of this building, a short and critical note in the bike industry has made that stretch -- it has made it more functional and better for all road users. what these examples demonstrate is that we know what kind of interventions will be effective and we have the

ability to deliver them. we just want to take these up to scale so we can make improvements that are going to benefit the greatest number of san franciscans possible and make the city safer. as voters and the city has demonstrated we can deliver since we started the city's ten year capital planning program, there's been a number of initiatives, a number of ballot initiatives, many of them obligation bond which like this one wouldn't cause an increase of the tax rates. we've made the public library system and we have ongoing program to improve our rec centers and our parks and fire stations and our hospitals, so i think what we've demonstrated is that we as voters recognize these

needs and the importance of the investment and that we as the city has demonstrated we can deliver once the voters give us that support. it has been a great interest of the board to insure there's coordination within the city family and within city agencies and again city agency and with the community as we go to develop projects, this graph or this chart or this map of the city shows how we're over laying the various components of the projects that could be funded in this bond to see where there are opportunities for coordination and collaboration. there are many walk first locations that overlap with muni forward locations so as we implement those improvements for muni in the public right away, we'll at the same time get the pedestrian safety benefits done as well

just as an example and through all of these projects, we've got a lot of curve ramps constructed and improving access ability through the city. supervisor tang made reference to this. it's an important point. it's a policy of the capital plan that we only recommend to the board, in the form of general on obligation bonds and issuance of those bonds such as -- the issuance doesn't require an increase in property tax rates and we issue new debt as old debt has retired or as the property tax base grows that can accommodate additional debt without requiring tax rates so you can see the bond program going back a number of years, we're able to continue to issue this debt to make these

investments without an increase in property tax rates. in terms of project selection, this is detailed in the bond report. but for all the different categories of funding, there's common criteria we look at in determining where in the city to make these investments and for bike and pedestrian improvements, we have specific criteria we're using to drive this. and as i mentioned with an over lay -- as we're making these improvements that we're closing any equity gaps that we identify. supervisor tang made reference to the oversight. the city has built a strong robust and transparent process for the management of these obligation bonds. starting with the city's citizens general obligation bond oversight committee that is staffed by

the city control's office which has review and auditing of all general obligation bond programs and importantly just to remind you, every time that we issue a series of bonds, and for a $500 million program, it would be three or four series that's we would come to on each one of those issuances and it requires approval from the board of supervisors and appropriation that goes with those. each time we come for those approvals, it's at that point we have a specific list of projects and programs for which we're seeking your approval for the investment and then the reporting to go along with that to the committee to the board of supervisors through public websites that we've established for these bond programs as well as part of the

annual capital budgeting process. so that's what i want today cover today. mohammed are here to answer any questions you have. >> colleagues, any questions to mr. ruskin. >> i want to say on the upgrade of obsolete muni and visiting some of the balboa park or the muni yards where the light rail vehicles or other vehicles are being maintained, i saw firsthand how facilities and capital needs to create more state of the art maintenance facilities can help our whole system run better and extend the life of our vehicles as well, so i'm appreciative of seeing it firsthand and understanding how critical that bond is. i did want to

ask the question that some of the advocates on public safety on the streets and in many of our neighborhoods are asking, i know up until last week when we have a vehicle license fee, many of us was hoping it would move forward with this go-bond that there was a $13 million commitment to additional projects that would support our vision zero and i think many are feeling there's a $13 million hole in our needs to have vision zero fully implemented. i know this budget, that fills $3 million it, but i know that you mentioned that you feel that 60 percent of the whole bond goes towards significant vision zero type infrastructure upgrades, but i know many still see that roughly, 10 to $13 million hole, so i'm wondering what could be done to

fill that hole within this bond, mr. ruskin. >> to supervisor mar and the chair, the first thing i would say, we tried to strike a balance in the ordinance between enough specifity for the board and for the voters with enough flexibility to so as we work through the process and through the years that we have flexibility to make adjustments if needed, the bond report does recommend an expenditure plan which reflects a balance of needs we have in the city, so i think -- i feel comfortable advancing the program we have at this time. we did have a total of $33 million and we still do and we're in the second year of our capital budget that anticipated the vehicle license fee being on the ballot and getting approved this year, the two

year delay does mean that we have a $33 million gap to fill in the second year of our budget and we'll likely have a gap in the next two years. we have plenty of time between now and fiscal year to work with the board the mayor's office to figure out how to best close that gap, and that's what i would recommend. >> and i'm going to be supportive of moving the bond forward today. it has to sit for a week, is that right? but i did have questions and i know many others would like to know, one is there are a number of projects within the dlf funds allegations that are bond eligible and the question is, is this bond flexible enough to accommodate those dlf projects and how deeply can we search for projects like cal trans like mel assessment

district for downtown and they pay their fair share given that they'll benefit from the transit improvements in the transit center area. number three, what commitments can the mta and the mayor can back field the gaps by the blf given the mayor stated support. lastly, i'll do my best that my office and i are following up with you and fill the hole, but thank you for the presentation. >> thank you. in terms of flexibility of the different projects, there are some thing that's were proposed for the funding that are not go-bond such as fleet. state law -- everything else or

most of the left of it is somewhat flexible and the ordinance is awarded that we do on have that flexibility. with regard to the cal tran contribution, we as the city, i believe also the transportation authority signed an mou committing to $60 million worth of funding. this is a possible source for that funding. it doesn't preclude us exploring other sources but i think we do want to send a strong signal to our regional partners that we'll absolutely honor the terms of that mou, that we signed onto. in terms of committing to fill the gap, what i can commit is to work with the board and i appreciate your offer to work with us on that, and with the mayor's office to close that gap, again, both in fiscal 16 and in fiscal 17 because it's two years of impact from the two year delay of the vehicle license fee, but we're committed and my board was the first to dopt

vision zero and we want to make sure we're doing what we can to raise the revenues so we can implement it as fully as possible. speaker: i look forward to the conversations. thank you. >> supervisor wiener. >> thank you, mr. chairman. i want to follow up on a few comments and questions from supervisor mar. in terms of cal trans and cal trans success in terms of its ultimate extension to the trans bay transit center, it's in san francisco interest to make sure we keep up our commitment of a $68 million contribution but we make it work. a lot of san franciscans rely on cal trans and it's all of benefit. so we need to make sure we keep that commitment in the bond. it makes sense to make that capital investment. we know

the reality of how things work with mta's budget. that's going to come out of mta's operation budget and that's going to be a detriment of muni and street projects. in terms of the mello rus, that was intended to provide funding to the downtown extension if the -- downtown extension. that money is being divert today the trans bay center, so the mello rus money, that will be coming to the board and we'll talk about that. it's a disappointing occurrence in my view. finally, i'm in agreement in terms of

the need it figure out how we're going to fill the hole in the 2015 and 2016 fiscal years that were left by the two year delay. that's $33 million for mta that was delayed two years. i'm not saying we're going to figure out a way through that entire $33 million, but we have to make a good faith effort and we can't kick the can the next year. we need to figure out how we're going to do that. colleagues, i hope in our add-back project, we'll be generous with vision zero and the mayor has to be involved. so i think over the next few weeks, this is going to be an important conversation as a board and with the mayor as well. >> thank you, supervisor wiener. any further comments? okay. at this point, we'll open it up to

public comment for 6-8. anyone who wish to publicly comment on these items. >> good afternoon, superviseers. my name is leah with the bicycle coalition. thank you for the support and the mayor. as apart of the task force, we were involved in these discussions. i want to remind everyone as you have here, that there is a hole. that we all expected the go-bond to move forward with the vehicle license fee. we're one of the groups that's disappointed, but it does leave a hole. we look forward to it moving in 2016. i would emphasize that points have been made by the supervisors, this is a real hole next year in our safety priorities. the mta budget assumed $13

million for bicycle and pedestrian -- thanks for the support from this board, vision zero, almost every agency we know from the planning commission to the public health department, have committed to vision zero. the only way we'll do that is if we fund vision zero. we have a $13 million hole thanks to the mayor's $3 million in the proposed budget. we look to you to think creative whether it's assessing go-bond or creative solutions and we hope you'll live up to that for vision zero. thank you. >> any other members of the public who wish to comment? >> good afternoon, supervisors. my name is nicole. i wanted to express our strong support. right now it's going to fund a

lot of different pedestrian safety and vision vision traffic safety improvements. i think there's also -- echoes what leah said, there's a big hole left now that the vlf has been postponed to 2016. the problem with this hole is that the longer we wait to make vision zero improvements, the more people on our streets suffering from traffic collisions. the improvements and investments now will last generations. there's an urgency. it is not on other projects where the funded isn't needed right away. echoing leah's comments, i encourage you to take a strong look at the different options

to fund vision zero looking at the go-bond and other avenues through add backs, et cetera. and i'd like to say we're completely supportive of transit, investments and investments in multi transportation safety. so i think vision zero is about making our streets safe for everyone and preventing injuries and fatalities and we look forward to continuing to work with you and continuing to follow your leadership on this. thank you. >> thank you. any other members of the public wish to comment? seeing none. public comment is closed. supervisor tang. >> i want to thank everyone, especially those who came out to testify. i hear you loud and clear. i want to also restate what has been presented to us from the mta. i think that $300 million out of the $500 million out of this

bond is going to be funding some level of improvement that will help with pedestrian safety and i really -- although there has been a hole that has been identified or that wear aware of, i want to remind everyone that this is one of most significant investments we have seen in history. think possibly about this. we're making investments for this bond that will help us for future generations so i want to encourage everyone in seeing it that way and support the go-bond. >> thank you supervisor tang. we have the amendments circulated previously. can i have a motion to receive these. we can take them without objection. colleagues, we're going to close out today's meeting. just a couple of house cleaning items. have a motion to continue 4, 5,

6 by friday. >> we can take that without objection. >> and then our regular scheduled meeting today, can i have a motion to continue items 3 and 5 to friday. we can take that without objection. and continue items 6, 7, and 8 into next meeting. we can take that without objection. madam clerk, is there any other business before us? >> no, mr. president. >> okay, everyone. see you tomorrow.

when a resident of san francisco is looking for health care, you look in your neighborhood first. what is closest to you? if you come to a neighborhood health center or a clinic, you then have access it a system of care in the community health network. we are a system of care that was probably based on the family practice model, but it was really clear that there are special populations with special needs.

the cole street clinic is a youth clinic in the heart of the haight ashbury and they target youth. tom woodell takes care of many of the central city residents and they have great expertise in providing services for many of the homeless. potrero hill and southeast health centers are health centers in those particular communities that are family health centers, so they provide health care to patients across the age span. . >> many of our clients are working poor. they pay their taxes. they may run into a rough patch now and then and what we're able to provide is a bridge towards getting them back on their feet. the center averages about 14,000 visits a year in the health clinic alone. one of the areas that we specialize in is family medicine, but the additional

focus of that is is to provide care to women and children. women find out they're pregnant, we talk to them about the importance of getting good prenatal care which takes many visits. we initially will see them for their full physical to determine their base line health, and then enroll them in prenatal care which occurs over the next 9 months. group prenatal care is designed to give women the opportunity to bond during their pregnancy with other women that have similar due dates. our doctors here are family doctors. they are able to help these women deliver their babies at the hospital, at general hospital. we also have the wic program, which is a program that provides food vouchers for our families after they have their children, up to age 5 they are able to receive food vouchers to get milk and cereal for their children. >> it's for the city, not only our clinic, but the city.

we have all our children in san francisco should have insurance now because if they are low income enough, they get medical. if they actually have a little more assets, a little more income, they can get happy family. we do have family who come outside of our neighborhood to come on our clinic. one thing i learn from our clients, no matter how old they are, no matter how little english they know, they know how to get to chinatown, meaning they know how to get to our clinic. 85 percent of our staff is bilingual because we are serving many monolingual chinese patients. they can be child care providers so our clients can go out and work.

>> we found more and more women of child bearing age come down with cancer and they have kids and the kids were having a horrible time and parents were having a horrible time. how do parents tell their kids they may not be here? what we do is provide a place and the material and support and then they figure out their own truth, what it means to them. i see the behavior change in front of my eyes. maybe they have never been able to go out of boundaries, their lives have been so rigid to sort of expressing that makes tremendous changes. because we did what we did, it is now sort of a nationwide model. >> i think you would be surprised if you come to these clinics. many of them i think would be your neighbors if you knew that. often times we just don't discuss that. we treat husband and wife and they bring in their kids or we treat the grandparents and then the next generation. there are people who come in who need treatment for their

heart disease or for their diabetes or their high blood pressure or their cholesterol or their hepatitis b. we actually provide group medical visits and group education classes and meeting people who have similar chronic illnesses as you do really helps you understand that you are not alone in dealing with this. and it validates the experiences that you have and so you learn from each other. >> i think it's very important to try to be in tune with the needs of the community and a lot of our patients have -- a lot of our patients are actually immigrants who have a lot of competing priorities, family issues, child care issues, maybe not being able to find work or finding work and not being insured and health care sometimes isn't the top priority for them. we need to understand that so that we can help them take care

of themselves physically and emotionally to deal with all these other things. they also have to be working through with people living longer and living with more chronic conditions i think we're going to see more patients coming through. >> starting next year, every day 10,000 people will hit the age of 60 until 2020. . >> the needs of the patients that we see at kerr senior center often have to do with the consequences of long standing substance abuse and mental illness, linked to their chronic diseases. heart failure, hypertension, diabetes, cancer, stroke, those kinds of chronic illnesses. when you get them in your 30's and 40's and you have them into your aging process, you are not going to have a comfortable old

age. you are also seeing in terms of epidemics, an increase in alzheimer's and it is going to increase as the population increases. there are quite a few seniors who have mental health problems but they are also, the majority of seniors, who are hard-working, who had minimum wage jobs their whole lives, who paid social security. think about living on $889 a month in the city of san francisco needing to buy medication, one meal a day, hopefully, and health care. if we could provide health care early on we might prevent (inaudible) and people would be less likely to end up in the emergency room with a drastic outcome. we could actually provide prevention and health care to people who had no other way of

getting health care, those without insurance, it might be more cost effective good morning, everyone. welcome to the san francisco budget and finance committee. my name is mark farrell and i will be chairing this meeting and we'll be joined by mr. alvarez