better with the tools at hand thank you. >> and then dr. colleen reilly. >> good evening, commissioners and directors thank you i want to take the opportunity to speaking speak laguna honda is a hundred and 7 a bed we provide

the nursing services and rehabilitation one of the few that are public library owned, of course, we're proud to be on or about integral part of the san francisco network last year, we saw 12 and 18 patient 5 homicide women we cared for the demographics after hearing the general demographics on race in particular were interesting so thirty percent of our women are white and 29 percent are african-american and 25 percent are asian and 13 percent hispanic latino so quite is a disparity we i wanted to highlight a

couple of services we provide to so we have a unique integrated pain and heavily clinic we started in 2011 we've seen over one hundred and 40 patient there now this is a masculine where we have medical providers acupuncture and music and different types of movement and massage as pharmacy all happening there at once so about 45 percent of the patient in this clinic are women r our respite services provided religious pit for patient that are cared for in the home this is a service that is actually used more heal will i by women patients we've served 56 percent that are women

we have a 60 bed unit and serve about 60 patients that were female that came there and probably the largest section is our skilled nursing session we have 3 hundred and 33 patient and women make up 45 percent and the top two diagnoses were stroke and dementia and with rehab about 80 women came there our physical program and the top diagnoses is stroke but post physical trauma we have a i think a very kind of a one of a kind hiv aids unit in 1989 a 60 bed unit last year 22

women and a pretty active substance abuse treatment and 33 percent of our rfrlz were from women i wanted to quickly share one story because the roll of honda is not in the numbers when i first came to the honda in the 1990s i was a physician on the hiv aids unit shortly after i got there i ended up taking care of a mother and daith date who had hiv the mother was in her 60s and had a pretty hard life living in an sro it burned down a couple of months later her daughter arrived they hadn't seen each

other in years but she recognized here right now and came up to me and said my daughter is her should had a little bit of dementia so i didn't believe her at first but her daughter was ill with insensitive nights she made an amazing rove and the mother ended up being diagnosed out in the hydrohad cancer and died but the daughter recovered they were able to share a room and the daughter did some of her care taxing and the daughter eventually recovered to a point which a year and a half was daze charged to another setting so i appreciate the opportunity to 1956 with you and thank you so much

>> further explanation? i do appreciate the fact that the department has worked hard at this and they have highlighted several things i'm wondering as we move into the new health network that we actually will be doing a lot more measurements in the actual performance and outcomes of the work we're doing health network is tint on developing a series of perimeters we gave you the kohlman report to show you what could be done with one disorder it was number 6 as overall women and the problems they're the disparities in which in certain

populations and we've heard a little bit of that already like the black community the diagnoses are later and so i think this creates a challenge into our system to say that while that is an overall san francisco profile our network mirrors that and give us an opportunity to look at how we can do better we'll be taking not only common but those factors that are important for women care and developing a dashboard as well as we do for all the rest and this will be a subset of the dashboard that will allow one to fellow how well, we were murray the clinic al height of those taking care of in the population so we thought that would be good and heard the preliminaries as to

where our health network is 2i7b9d to get to >> i was going to say that ac a wants to clump those together and smaller is better as we look at the the code the highest rates of poverty among the asian asian pacific islanders living in the sunset but it's good to know that the clinics are a part of san francisco and that accounted for us looking at hearthier we have high rates of asian asian pacific islanders that has federal bureau of investigation reduced breakfast tissue now doctors are sending those mailers along with mammograms like the notes i have breakfast tissue issues and given our population it happens

in more asian asian pacific islander that's one thing i would like our department of public health and commission to focus on. >> just to note we have a clinic in that area ocean park and not only part of our san francisco but part of our network with the contract we've established with them they're great providers our hope is that ac a has come and we're able to oracle orientation into a network our screenings should be much better than now because this will become part of the routine in the care coronation we've heard of then the team is finding even within a commercial area which c chp all asian-americans for the most partying part their

mammograms are close to if not greater than 72 the normal of public the normal public is 65 percent so again as a group our health network and as ata creates and creates the nation we'll see an improvement. >> the asian asian pacific islander women do we go favorite than the traditional mammograms that's on an open and a question. >> let's hear the expertise. >> it's an important findings we do in but it's hard to read the fine perspective you wanted to have a discussion with our patients what's the next steps all the services are available should they choose to be seen in

a breakfast clinic and mri you have to weigh it if what is going to help them the most we have data on the choices women make on if cancer diagnosed it's a personal choices but a conversation that providers will have with the patients fortunately we've got the resources to make the referrals. >> and particularly if they're limited to be proficient. >> that's where the team comes in we ask i know we're fortunate to have the workforce development young people in our centers that can act as health coaches not necessarily a practitioner but someone that

takes time to find out what they heard and understand and make the next decision. >> thank you, commissioner. >> i'd like to ask a question about lark i was glad to see you have a lark project but i'm wondering how far has it begun in terms of public education it's probably the most safe and reliable source of conservatives for women but the numbers are low due to provider bias that it might increase project executes you might know that right. >> i'm wondering how much have we done in terms of public education and awareness around lark in san francisco. >> dr. a james. >> we're ableers there's no question about that so i believe

to date 3 of our clinics have gloen the training it's a real clinic wide effort from the person answering the phone to you know the janitor everyone is on board we want to support women in those choices so and then the rest of the clinics we're hoping to bring that over time we have 3 pioneers it started this they've doubted their rates of ivs and the public awareness campaign and you know, i think the h pc are v is something we've been successful not only for the young women but young men as well. >> dr. would you like to - >> dr. you wanted to say a

couple of words. >> in terms of of the long acting we have a birth outcomes initiative that is going on right now it has two main strategies and one of them to improve the sergeant of lark and this is focused on the disparity and access to family planning and lark for young african-american women so we are working with the initiative that's a collaborative with many partners including the clinics and this pilot project but there's a workshop that is focusing on lark in particular and the public education piece of it is on their agenda this is one of the main strategies with the idea we have to really focus on the health of the young woman and that's going to lead towards better birth outcomes for the family yeah, that's one thing i

wanted to add. >> any other questions? >> i just want to make a couple of comments especially around those really personal stories that you all shared and it's really heart living and when i look at the way that the community oriented prim care 52 percent of those patients of women i think that those become important as we continue to move into the ac a era when we look at the patient retention and outreaching and 345shg9d the services we provide i think there will be more and more opportunity with those stories to be shared, you know, so it's not necessarily the stories we

hear about primary care (laughter) but 101 you've seen one of them it's important and i think that's part of what we haven't touched on how do we really educate those who are eligible for our services that you know the transfer of the services we actually especially in this case it looks like it will be more women a than men ceasing those questions. >> i wonder if the director of the health would like to respond to our strategy. >> good evening, commissioners i'm roland director of the health network in terms of respond to the community i'm sure you're aware of the health network we're in the process of rolling out a marketing and

branding campaign which you'll be hearing more about on the october 7th commissioner meeting but part thought is both an internal and external communications plan we worked for the last 6 months on the external and now moving into the face of the overall community part of that will be the development of a newsletter that will be administered by the network and distributed to the patient who are assigned to our network same we're part of the san francisco health plan that actually has a robust communications system already in play so we'll continue to strengthen our partnership with them in terms of getting out the information of the services we provide. >> thank you so the other questions i have is the do those numbers include the other community clinics signatures

martin and the free clinic and i see the deputy shaking his head and nate's that's our network by the way, u. >> because those are somewhat of a speciality clinic so serving the women in the community do we see any value in creating a medical home oh. >> oh, absolutely some of the clinic consortium have a contracts with us but did you say larkin. >> no, no lion martin. >> lion martin has been absorbed by h.r. 360 with a large contracted they're a primary care clinic they've been providing speciality and hospitalizations so they're a

vendor or contractor within our network. >> so in the future will we see their data included. >> probably through the health plan and so certainly we could share that information and get access to the health plan providers and translate that to our network and that's something we can certainly is provide you. >> absolutely ze we have a strong collaboration with the san francisco clinic consortium we meet with them and the medical directors work together again, we provide the hospital care so they are we consider them part of the family we plan together and implement together and share data together. >> at this rate they'll out grow us first (laughter). >> i have one comment i think

this goes to healthy san francisco when the date of the clients is important i notice it's mustard together with another organization i want to know if you can keep the data separate the highest rate of solicitation are in oakland i've been taking language classes at the college and taking mandarin they've wield i widow he would away a lot of the programs so if we don't keep the statistics of the languages we can't help our social workers that want to be medical interpreters. >> we'll take that suggestion. >> we'll not received public

comment requests but there are there any public comment. >> general public comment. >> no for this item. >> any other comments commissioners. >> so the item is concluded i'm wondering if the president would rodriguez want to make comments how she feels how i'm wondering some of the things we might want to look forward in working with you. >> i know the hour is getting late i will make my comments short and sweetie think this has been an and we'll productive joint commission hearing i've found a lot of enlightening

information and perhaps for further collaboration and i'm sure all of our commissioners will probably like to make comments but i would ask if the directors might like to make any comments about kind of a path forward for future moderation. >> i'll echo that a lot of us have discussed a lot of temptations and a new magnetically health system we ask our directors where it is to have the intersection and where it would be appropriate to report back to the commission to see the progress that's being made on the subject being made her here and other subject i'll invite both the 0 decorators to

ma make their comments. >> thank you very much i want to say that 9 leadership has been meeting are director garcia on a fairly regular basis by 24 reinforces i need to meet with director garcia a number of times we look forward to working with you. >> i was writing notes back and forth an organization closed and it's an appropriate comment we remember working on the human trafficking that organizations have difficulties so we'll be working closely with the director to look at how to continue to provide those services with one less community-based organization that's able to do that so we'll commit to work and i've been taking notes on the areas we're

talked about and create a report for the commission and continue to work on some of the areas i think this issue of trama and the impact of trauma i think the pictured it very well an entire impact on the health statutes and you, add many things and you talked about splitting. >> i'm on number 2 i think we certainly have common items to work and a on and learning our work as commissioners also as the directors we forward to working with you. >> i love the high-level reports they give a view of the whole city but i was laborer for maybe next time either by, you know, health network service

area or by zip code or something we might look at the issues in terms of the service programs or population issues like for example, the health relate breast cancer screen rates you can compare the clinics and rates and stuff. >> any further comments if comments otherwise we'll call the next item. >> general public comment we have one card submitted and son-in-law. >> i'll call the card submitted we have 2 minutes rubbing deny e benefit goldman. >> i'll hold the timer up when you're finished. >> president curtis and honored commissioners i'm a dual diagnosed mental health consumer

at mission that is part of the mission mental health services i'm under the excellent care of my psych social worker and my psychiatrist recently, i spoke out about a violation of the admission agreement between myself and the board and care i stay and mary in her house i've been living there for 4 years without incident my incident and stable illicit has been an important part of my wellness and recovery the violation of the admission agreement builds down to one sandwich the facility agrees to provide 3 meals and two snacks i was out all day working busily when i

thought were good works and returned to the occur, if you will, if you time of 10:00 p.m. was given my lunch and requested my diaper the administrator is donya herself defenses refused me the sandwich i called the sfpd to be witnesses to her refusal and i mentioned i was going to state licensing following that a few days later i received an eviction notice regarding thirty days notice dear mr. goodman i give you thirty days eviction notice because our 52-year-old we can't meet our needs. >> mr. goodman.

>> they were quarterbacking this if anyone was expertise to share please do so thank you. >> thank you, mr. goodman that was one other public that wanted to speak also. >> reroberta and staying say our name. >> i'm the co-chair for a e w san francisco when is for the university of women i come to the commission meeting open a regular basis and it's been griffin to see the issues that the cross over between our commission and the women's commission items i just wanted to update that on the women's side we were very interested in stem and getting women and girls into