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 produced 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 beyond a fragile neighborhood thank you.

>> other public comment josh. >> good evening. i'm also a tenant at post and polk i'm a few blocks and a community health care worker additional familiar with this organization they'll providing mental health services people coming to see their psychiatrist next to a hospital that already provides mental health services i don't expect my neighborhood will notice those people interest there is a wall walgreens across the street so if there's an issue of medication there's a walgreens there. i've lived in this neighborhood nor 20 years i've been doing outreach in this neighborhood

for about 15 and very clear about the kinds of people that do the sort of things we're concerned about. this is not this group not thirty this population. so thank you very much i hope you support to >> there are there being no other public comment. >> no, we haven't received any. >> commissioners we have the consent calendar the committee brought forgot a request for the approval roaming is there further comment there were also some caveats you had indicated in regards to its approval. do you want to also include those as part of what your

expecting within the approval for the site >> i think so commissioner, i will definitely propose that we make not of the protocols in place i don't have those in front of me. >> i believe that director garcia as i was coming in late during the testimony i was late in terms of the good neighborhood policy and it was asked by a couple of individuals also the board chair laid out the good neighbor policy looking at the medical issues the building and the camera and a buzzer at the door and monitoring the front of the building before and after the program closed. and keeping open a neighborhood

monthly meeting that will meet the good neighbor policy for the continuance and i encourage the mission to approve this relocation >> we do have one more public speaker wendy please. i just want to address this commission. i'm a resident of concern hyde a client of the high services i want this heather it would be great great to continue on to my emotional recovery. one other thing to point out one hundred and 75 feet from the proposed site at the corner there's already private mental

health services that's offered there and i don't understand the difference between public funded and private funded except as cost i was engaged in private mental health services at you know for $100 a pop well those who can't afford that and i can't afford that now public mental health is needed and i would like to continue my recovery. through the continued services at high street community services thank you. thank you. commissioners any further comments we have from the committee from a vote on the relocation of the hyatt street

>> i move we accept the consent calendar. >> well, because this became public comment i've accepted hass this as a motion on the part of the committee we can move forward we're prepared for the vote. >> i'd like to gralt congratulate commissioner ma guarantee in handing what is the right thing for the people's community and their health those are not easy to square but as a city we should be proud of this recommendation. >> i assume we're ready all in favor, say i. opposed? the approval has been passed. thank you very much. (clapping.) our next item

>> is the proposition kwfshgs hearing for the skilled nursing beds and there's a resolution for your consideration. >> okay. thank you. good afternoon. i'm co- lien the deputy director for the policy and planning here to provide you with additional information and follow-up to our last hearing at our previous meeting you requested additional information from the department of public health and i'm going to provide you with a brief presentation now. so this table was also included in our memo although it had a small error this is the correct copy but what the condition asked to provide additional information on the licensed beds they were planning for 2014.

the d mc provided the staff beds and the commission ask for the licensed beds you see there's a proposed reduction of staff nursing beds at 24. and a proposed license reduction of 95. and again c pmc indicated this rearrangement of the nursing care services to meet the projected demand is consist with the pattern for nursing services at the hospital they requested additional information on the impact of staffing at the hospital. d mc indicated while the numbers have not been finalized but 4 licensed nursing nurses will be in place from this reduction.

the commission asked for additional information about the impact of the restriction in stilled nursing beds in the previous memo i provided the key finding from the master black man plan but that's a most recently bed facility beds in san francisco i've provided some key fktsd those san francisco population is older than san francisco of the rate of the care beds is lower than the state one bed age 24 years is 4.1 compared to 5.1 in the state bylaw plus a current trend in health care that converts the long-term care to short term beds in this facility in the

stilled nursing facility thus reducing the care beds overall i should point out c mc plan was to serve patient in its own network. finally from the master plan given the information san francisco is likely to be seven hundred plus beds short by 2050. at the last commission meeting there was confusion i think about what would happen in the new hospitals post construction how many beds in each of the two rebuilt hospitals. so it's important to note neither cathedral hill nor the rebuild of st. luke's will have them so the chart at the bottom

of the slide shows the changes between current licensed bed the proposed 2014 licensed beds and the changed between current and rebuild so currently c mc is licenses torso. beds and st. luke's the service reduction is the change in the 2014 license bed plan this is the elimination of beds from california to zero and the increase in staff beds or the licensed beds stays the same as a insulting result of 2 hundred beds plus the post rebuilt the changes are california will no longer have the beds and 38 and dave's and the new st. luke's are not

scheduled to have more beds the overall beds between the two is one hundred and 74 that number is take into account in the shortfall recorded in the health care services master plan. so i also attached to our memo a copy of the loom report it's the department of public health review of c pmc master plan i'm sure you're aware it is required by the city and details any rebltd build project the local requires the hugh to look at the master plans and the loom group is the entity we've selected to do. those are the key finding reed