i's. any other i's and therefore, noticing nobody to opposed and we've unanimously approved the minutes >> the director's report. >> okay director garcia. >> good afternoon, commissioners the san francisco interagency couldn't on homelessness starts soon on june 20th century the mayor ed lee mentioned a chondroand the council will collect and utility data and collaborate on the homelessness program that brings all the federal government agencies together i think locally it will help us to have effort to reduce and eliminate homelessness. the director's report there are instructions of the roll or

california open enforcement change has recently stooind signed for the next open enforcements on that thought federal exchange for the 2015 year people may sign up between november 15th and december 15th we'll a note those opportunity. medicare enforcement remains year arena for the hacking option the airlines accident at san francisco international airport challenged san francisco hospital and our mental health services that's been a year ago ton june 30th that was a panel

discussion. the discussion highlighted how the hospital opening december 2016 and the general and department of public health will be more prepared for the next disaster incident. we had our 2014 san francisco pride i was proud to join dpw employees we took all day during the parade and had lots of staff that make sure that was a great day i minds to acknowledge trashing and others for in their efforts in organizing a great parade float on on june 27th in sunny daily at the hurts praurgd there was a shooting and homicide overdose children playing dodge ball along are the staff the suspect prevented to

be engaged in the game he do fire his gun and killed the member of the staff this last thursday and since that night our critical respond teams have been engaged with the family members and children providing services to this day we went to a county meeting last week and engaged with the community members of sunny daily and we have a list even if needs and requests from that community we'll are working on and i'm working with staff closely to make sure we improve the services in sunny daily and for the commissions to note about 6 e.r. 8 months ago we opened up a health incline and this is a you our first transformation of trying to provide services over

a year ago we opened up another clinic in the housing area with a very comprehensive set even if services we want to replicate. i want to commend stephanie and her and her staff have done a tremendous you don't believe along with other folks we're getting really good at this this is something i get concerned with in our emergency responses we are working collaboratively with the other dependents to make sure we're providing the support to the sunny daily families. a new medical director dr. berry he's been with the department over 23 years expert in the

health care and his credentialed as an hiv specialist under his great leadership during the budget process this year there was dollars 3r0i9d for h-3 medical team the team will be joining forces with the fire department to reduce the 9-1-1 calls to make sure we're doing pro-active work in san francisco. cover california relieve to the hospital association there are a list that top producers. endorsement production refers to the number even if enforcement for the certified under the california covered system we placed in 34 statewide and 3 as government eligibility i want to acknowledge the staff that worked to make sure that people

got coverage i'll leave my director's report there at the if there's questions thank you, commissioners. >> questions to the director? and there is an addendum that the director had >> yes. i thought we could get our h.r. director this week we tried to get a increase in the number of people hired i wanted to acknowledge our human resources director highly give you an update we was able to secure more resources from our department this week and i'm thankful for his work. >> good afternoon. i'm ironing the human resources director so in the report essentially i'm giving you some updates two new

san francisco general and one on the honda and most people are critical to get requisitions through we have a manager over the merit they do our exams so we're producing a lot more examines and as a result of that we're getting a lot more people in for progressing and as we reduce vacancies i get a backlog in the processing to this wagner week the director suggested i get more staff and in accounting to get 6 temporary staff tomorrow and made the request phenomenon monday so we have specifically ratting at san francisco general we're getting a lot of staff and the other

areas are the background checks abuse the fingerprinting the county as agreed to come in on the weekend to quickly get the staff on board and make arrangements for the medical to getting up get it expedited up and talked to one of the staff on july and talked about roll changes i won't be go over the entire report but as we get new staff on board it's important to change are parts which the culture we are stooet to see the feet on the ground so if you have any questions, i'll be happy to answer them otherwise you can read that in the report. >> thank you committees commissioners. >> thanks ron i'm going to turn it over to it's near and dear to

my heart i really appreciate both the energy you're putting into this and some of the creative approaches you and the department are taking i have one question the request is for you and mrs. garcia it's important to get an analysisal report to track our progress much more retrospectly with numbers with all the twald things you might want to see on a summary the question is and this may to a large degree come from my lack of findings in the scomplekt but i'm wondering how much of the issue can be solved by the things you're doing now inside

dph and how much are you hospital knowledge to tangle to the processing that goes on in the city and county outside of depending dph. >> first an little analysisal i've hired an analyst on monday to get a grasp on the numbers so i can provide you information. on the processing part we say as much of 60 percentage is internal from the hiring manager not submitting the form to the f d e and i'm not getting an schedule and putting the energy into turning in the notes 60 percent of the delay is in our control and the 40 percent is primarily with civil service rules when i get 6 are seven

hundred applicant and have to treat them fairly it's a huge task a that's where a lot of the difficulty comes in. i mean, i'll able to give you more information as what we trek track those components and working with the director we've working on getting a vacancy report and i can give you a better analysis coming up but a large portion is in our control we're fixing those things >> that's great as you look at other municipalities are around the crisis that phase the same challenges who comes to mind that that didn't it super well, we can learn from. >> i don't know many public entities that do the process

there are no xhashldz we can change the rule and this would speed it up. the municipalities i'm aware of don't require the same strict policies we have so it values both ways wu i might give up some of the process for speed; right? so we'll have to work with the civil service commission we work with the rules and this will take work but everyone is on board let's make changes to the civil service commission >> director garcia what's a reasonable timeframe so we can begin to look at things similar to vacancies like at the hospital. >> i will ask ron he's lifr i

hiring something else someone. >> can i give us some rough data you'll appreciate it. >> as you are developing this we'll get the reports during the progress so we can work with you and understand in your getting through the difficulties of both our internal and external challenges okay. any further questions any public comment on the director's report >> i don't see any. >> next item. >> the next item is general public comment. >> okay. we have one general public comment it will be allowed for 3 minutes (calling names) i'm sorry. >> hello commissioners. i'm rue ben benefit good man and . >> by any chance and it's for

public comment? okay. well your is that okay >> commissioner chow there were a few extra ones did you get those. >> is your microphone on. >> okay. all right. . okay. so we have a at this .3 and the fourth public comment that will be (calling names) if by chance others would like to make public comment they should submit it to the form (calling names) >> thank you commissioner chow. >> i'm here as a private citizen for the past seven months i've asked to look at the

number of patients discharged and from the mission of laguna honda were being discharged it's going hand to hand with what happens after spending $5.6 million of the sf get care database over the last decade or dph and the department of aging services dph ac director for transitioned in the san francisco health network nancy dph pi o claimed the $5.6 million database didn't work how can i spend that kind of money on something that didn't work our director xhichld to me that sf get care works

perfectly well as designed. then he claimed no response of records in the data underlying field names subsequentially keeping you informed mother did an about face and said she'd look begin but said yesterday they can't find a field dictionary or database list they couldn't have possibly pduced a list spooef what field names they not being tracked it had obtain part the contract you can turn user turn to rtd and provide it to me because i'm unfairly certain the sunshine ordinance will agree with me.

then ms. eir motto claimed to supervisor campos she reran the report it didn't work earlier and discovered only two county discharged in naivete it is after i was provided a 3 inch provider with 2 and a half years of management reports those hard copies clearly show one hundred and 88 deversions in that 2 and a half year and there had to be other dennis herrera versions from other facilities and patients at home that - >> time. >> this commission has got to start taking seriously how many

patient are being dumped out of county. >> thank you next (calling names). >> my name is bryan aim a volunteer with the physicians organizing committee we wanted to raise a certain to our figures and nurses and staff for the management center we know they were trying to hire youth and other .4 fte center and neiman he know from our members we've seen one person she was unable to get appointments for the last two weeks and having in traitors and having laid off our staff that makes it hard to schedule appointments and this

is she needed a excess around section by losing the care of the diabetes center more children with shoulder issues because they were you know the diabetes and their to mother was properly managed and meanwhile sutter we had $75 million a year in tax breaks and actually provide charitable care in their 2013 financial statements they're looking at a negative outcome because they're getting investigated by itself attorney general and anti tries violations so perhaps they're t their squeezing i'm sorry the employees and the management center cutting the skilled nursing facility and things like

that this looks great if you're running hospital with financial position and looking at debt i have to pay back but in terms of health care and all the tax breaks with the diabetes management center as a staircase example of how they run hospitals why didn't they deserve the nonprofit status and demand the health commission and local agencies hold them to restoring immediately, the three staff they laid off. >> time. >> thank you very much our next speaker please. james green resident employed by the city as a paramedic recently someone called a 9-1-1 the first

responding medic said she have a previous situation and with rapid drop in blood pressure we immediately called the responding ambulance group this was fairly close and bring a backboard because is when he couldn't be moved the ambulances came and she was transgender. in route the two paramedics started iv when they passed out and became enconscious she made it to san francisco general hospital and required 5 unit of blood and required a c session and mother and child are fine

the reason the municipal service is at a crossroads we have things hanging over our head but primarily we're in violation of several state mandate and not meetings the local will agency requirements for response times. in crafting to what the mayor said in open session 20 the board of supervisors the only thing mattered was getting you a paramedic in 5 minutes of less this think an example with the ambulance is working with a team played a critical roll in the outcomes positive not also with critical patients that are injured or seriously ill the appointed tests by the mayor i'm asking for on behalf of the ambulance service if you have

any influence with the mayor ask him to fund the proposal by the fire department and get it up to where it should be i won't belabor this upper given a document with a cover letter and in great detail it gives us a clear understanding of the problems we face but the solution funding we're in the same boat but if you have flunls with the mayor we greatly appreciate your help >> thank you, mr. goodman. >> honorable commissioners i'm ruben goodman i wanted to extend my congratulations to dr. berry

for his motion to director i was fortunate to have him as my physician during the time i was homeless in a severe crack co- cane position he was my primary physician dr. dead man was kind has a tremendous heart and the first physician to recognition systems of bipolar are disorder and encouraged me to make contract with the mental health clinic and feinstein get the treatment i needed. i just wanted to extend my congratulations to dr. barry and he's a true man >> thank you and i'm sure dr. sdef vin is most appreciative of

our had appreciation. >> i have no other - >> is there any public comment? >> i may mention to the public we appreciate the comments we actually take the subject at hand and will be reviewing with a you have told. next item, please. >> next item is the report from the community and public health community. >> the community and public health community heard a transformation initiative how it's integrated into the health improvement plan, which has a comprehensive wellness model that includes exercise and pedestrian safety we heard from nearly 40 people from the

relocation of the height street community services to hyatt street the residents voiced their he concerns and the supporters spoke about equal access the committee approved the relocation and urged the continuation for dialog among all parties so i think we'll request that the full commission take a vote on this. >> thank you there is one comment on the consent calendar which is permitted and that's patrick. if anyone else wishes to comment public comment is taken on the consent calendar and you're welcome but folks this is the only one i have please dr. chow

>> my public comments from 6 to 5. >> 6 to 5? yes >> you are on i see you're correct. you are moving it - okay. we're still on 5 so okay. your comment will be in 5 >> on number 5. >> before you take action on number 5 okay. and on 6 not on 5 i would strongly urge you to table any motion to accept our report as inclusive until the consent calendar is brought into the next agenda hematemesis i'll speak at. >> okay. is there is there any

additional public comment on item 5. okay your correct there's no public comment on item 5 we'll call the next item >> next item is the consent calendar. >> the next item it is the consent calendar and you're in order to comment. >> imagine me board of governors being in order (laughter) ; right? so i've lived at center and high for thirty years the neighborhood is deraider i get up 594:30 or 6 o'clock go down for my morning coffee and cigarette i'm shocked the parade up and down the street at 4:30 in the morning i'm also one of the neighborhoods concerned

about community safety in this neighborhood because of the mental health clinics at the granada hotel you can tell when they're not taking their psych meds. several of them have been barred from being able to use the sidewalks cafe tables in front of sutter side street because they're bizarre behavior i'm not talking about one or two but six or eight pr our neighborhood is not needing more mentally ill people coming in as transients throughout the day we need to find more appropriate locations for those services i know that

mentally health funds are lack but this is not the sleuths i'm wondering how many of the hyde street clinic patients will be facing the same situation in the dialyses pashtsd would have faced if we were relocated at laguna honda they'll get various levels of mentally health care gathered around town increasing their transportation and the burden they face getting before and after for appointment. i think this clinic needs to be more centrally located why they're getting other services and