saint luke and include the discussion about the structure of the diabetes center. i heard the majority of commissioners on both commissions agreed that is a concern. >> i believe from the appropriate concerns around the diabetes center. >> why that was mentioned it would help. >> thank you, director. >> i look forward to working with director ram and i want to thank the commissioners because i worked with you during this process and will is the community along with cpmc. the department of course has the development agreement and we have the responsibility to prove this overall health in our city for example with

the ebola response we worked very closely with the hospital and made site visits to make sure they were prepared. we are obligated to ensure that when we hear things like diabetes and cultural competency i think we can work closely with cpmc and a stronger way to ensure that they are culturally competent. i don't see why i can't work with them closely to ensuring them. also the mso issue in the tenderloin, i think we can solve that. we tried to work very closely with the clinic consortium and there is an mso within that group and that is an example. so there is i think a possibility of that. we also want to work closely to ensure that the new hospital does provide and i'm talking about the cathedral hill or the sand hill that it does have a structural response to medi-cal patients. we believe that's important,

that's why it was in the beginning of our process and we'll continue to work with cpmc to ensure that and we'll begin our process to work with parties and i think we put a lot of effort into this and we still have a lot of work to do and we can improve those areas for at least the development agreement on the health side. i want to thank all of you and thank the cpmc for the work that they have done. >> thank you, commissioners are there any further comments during our joint session here? >> one question. i tried to look for the language around the tdm that it says 223 5 years for implementation. i couldn't find it. if someone can sent me that language on the agreement specifically that would be really helpful because i think that's where some of the disagreement

comes from also. >> i did have one further comment as we were talking about what elements should be put into the potential letter not only the issue of diabetes but because we are talking specifically what might be the necessary services of saint lukes and not get into business plan of the cpmc enterprise, to really discuss what the community, what part of services community did need and i think the diabetes issue is important, but i think it maybe only a harboring of what the underlying issue which is how do we meet the needs of the current residents of the mission as well as what would be an expanded need as the city continues to expand. i think that is the underlying concern whether it be just simply a diabetes

clinic or should be a gestational program or women's program or what not. so i think there should be not to subvert an overall master plan but understanding how one meets those community needs at the same time as it meets the larger needs of the world center that it is building. and i would suggest that it be part of it along with that cultural competency again is not just simply on the issue of diabetes but that would cross all of the other programs that cpmc has. i into -- know they have some wonderful programs and that's another area that director garcia pointed out that once again the health commission does have that responsibility to see that we are getting the best health for our residents and so

looking beyond just the saint lukes issue and we've had issues around renal care and how we deliver that care is there a better way than just the translator that you call by phone because that meets the minimum, but isn't it better that we have somebody who could be culturally competent and be able to take care of that and are those possible settings because this is going to be a wonderful system we set up and we need to have what we are trying to do the very same thing within our very own city structure we are trying to see that the other hospital systems would be also looking at a better way than just meeting the minimal requirements as for cultural competency. i would hope those would be part of the emphasis within our letter that is being developed by the

directors. so sorry, i took all that time. so we are back to i motion therefore for an adjournment is in order. is there a second? >> i think we can say it jointly. okay. with the president's permission. all those in favor of adjournment please say aye. >> aye. >> all those opposed. thank you. we stand adjourned. >> for the commission's hearing at noon will begin at 1:15.

>> good morning. welcome back to the department of aging and adult services commission meeting. could we have roll call. >> president edna james? >> present. >> vice president gustavo serina. >> here. >> commissioner itani. >> here. >> commissioner loo? >> here. >> commissioner ow. >> here. >> commissioner roy? >> here. >> commissioner sims. >> here. >> please note that director mcspadden is also present. >> can we have approval of the december 3rd agenda.

>> so moved. >> second. >> it's been moved and seconded that we approve the agenda for today. all in favor? >> aye. >> opposed, ayes have it and so the motion is carried. the november 5th commission meeting minutes, we have a few changes here, and then i will ask for a motion to accept. on page 2 of the minutes i understand it should be case report it should be december 8th. >> 6th, commissioner. >> it was 6th, but it should be 8th. >> on the case report, mine says "10." >> last sentence -- last

line. >> it should say "first" bridget. >> first? >> first. >> so is it the 8th or the 1st? >> the 1st, because we already had it. all right. so they had it on the 1st, that changes that. okay. so we do have a correction. that should be the 1st. and then i have a change on page 3 at the top. a motion to correct daas address to the commission bylaws on page 1 should read as the bylaws said, 1650 mission street, the 5th floor, suite 500, san francisco. california, 94103. the commission telephone number should be added in that.

on the same page, under "motion to add middle section." motion to add words on page 3 "duties of the president." at the end it should be "subject to confirmation by the san francisco board of supervisors, who will be renewed every four years." so that should be added on that page. and then the other correction was on page 5. where she has "5." and under that report to the committee chair, that should be no. 6. so those are my changes. instead of reading just a report, the number should be 6. so with that, if there are any other changes, i would accept a

motion to approve the minutes with the changes. >> motion to approve the minutes as amended. >> second. >> it's been moved and seconded that we approve the minutes as amended. all in favor? >> aye. >> opposed? ayes have it and so the motion is carried. thank you. next employee recognition. the department of aging and adult services commission will honor tanisha hogan in-home supportive services department of

>> good morning. so very happy today to be able to honor tanisha hogan for all the work she has done, and just like ann normally does i would like to have everyone from ihss stand up today. [ applause ] so megan and i work very closely together, megan and i work very closely together and i have been hearing for the past number of months how much work you guys have been slammed with and i want to say in ihss, when i go down there and walk around, people have such a great attitude and really know that you are doing this for the clients. and it's amazing to me, given all of the things that get slammed on ihss, more and more regulations and all of that, that people manage to have such a great attitude and really care about the worker that they are doing because i know it's not easy for you all.

everybody here is from a generic unit, but i know you are dealing with more and more complex cases and you are the ones working with some of our most difficult to serve clients and to be able to do that and have that skill is pretty incredible and thank you for for being here to support tanisha, but for all the work that you do together. tanisha, the people who nominate you had had some things to say about that you i want to read outloud, because i don't want to miss anything that they said. tanisha hogan has workeds a senior social worker for the in-home supportive services program for over five years. tanisha's work is exemplary and demonstrates accuracy, thoroughness and orderliness in performing her designated tasks and tanisha not only demonstrates a great understanding of how to administer the rules and regulations ihsr, but exhibits an ability to work tirelessly and diligent on a case load

consisting on a multitude of complex cases. tanisha approaches her responsibility to assist her clients with a desireness and willing tons resolve. tanisha's approach to her clients displays patience, tact and compassion. due to tanisha quality of work and positive and can-do attitude she has been designate and acting supervisor within her unit. tanasha's work has been acknowledged by her clients in the form of phone calls and letters of appreciation and gratitude. tinasha's dedication to her role as a senior social worker is an asset and greatly approached. on behalf of daas and on behalf of the commission, thank you so much forever for your work and congratulations on being employee of the month. [ applause ]

>> thank you. i do know that there is a great demand for our people in their homes, and i think that is one of the main problems in terms of what our job is how can we keep people in their homes and provide that care? we're really short of manpower in terms of people wanting to do this kind of work. so i know and i appreciate what you are doing, because it's a great demand out there and it's growing. thank you. [ applause ] >> next on the agenda is reports. the director's report, shireen. >> yes, good morning,

commissioners. so i just wanted to let you know and most of you probably know that ann is away in washington, d.c., she is on the board of the national association of area agencies on aging and she is there representing san francisco, which is great and will probably come back with great information about what is going on at the federal level. hopefully some of it good. so she did ask me to say one thing and that is that this year has been particularly difficult in terms of us getting our -- all of our money out of door, and dave can attest to this. but we had so many add-backs this year and we have been talking about this a little bit. we had so many add-backs that our staff has been working diligently to get the money out to our contract community. it's just been hard, because there is just really a huge amount and a lot of little things and some big things and

it's been a huge amount of work for our contract staff in particular and they have done a very good job, but it's just taking a lot longer than we had hoped. we have the nutrition nofa allocations basically complete and should have those decisions for you on the docket for next month. but if you are hearing things out in community about why it's taking so long, that is just the reality of what we're going through this year. i am going to give a little bit of the director report time to tom nolan. he is going to talk about the free muni for seniors and what is happening for that and he can speak to it better than i can. so he is going to talk about that. >> good morning madam chair and members of the board, members of the commission. it's kind of nice to be on this side of the commission. we sat here yesterday for almost five hours in mine. >> oh, my. >> it's a really good chance starting in the new year to

offer free muni for low-income seniors and persons with disabilities. it's something that i have wanted to do for a long, long time and we're finally able to do it. it's not fully set yet. we have a lot of advocates out yesterday and we appreciate that. i ride the bus all the time and i can tell you that the need is so great and you can tell how difficult life is for seniors with low-income and persons with disabilities. the third tuesday at 1:00 in the afternoon we'll hold a hearing and make the decision at that point and expect it to be implemented very quickly, because we directed the staff last year to begin preparations for this in advance. most likely it will be an honor system. we'll see how that works. i'm not sure if it's a pilot or do it fully all at once. i wanted to mention -- it's very important to the disabled community, the ramp vans, ramp vehicles and yesterday we waived the fees for ramp vehicles to incentivize drivers

to drive and pick up folks with disabilities. that is another piece of great news. you are welcome to come in january and it will be wonderful for the people of san francisco and the people that we serve. any questions? >> the good news, i just wanted to hear the good news again. come january, seniors ride free on muni. >> the second meeting in january, the second tuesday in january the board will consider that and most likely adopt it. there is strong support on the board and strong staff support and strong support from the senior and disabled community. it will be sometime thereafter, but it will be a great day. >> there are other cities that offer this, but it's first for us. it has proved very successful

and we think it will be a big help to seniors with low-income and persons with disabilities. >> can you tell us more about the young people with the free muni ride, is this for any time? >> yes. >> younger people? >> students are eligible for the free lunch program in schools. are eligible for this. get a clipper card and can ride any time they want. that is 30,000 kids who are taking advantage of that every day. and we're very proud of that one, too. >> so that is the only small amount of the kids that we have in the city? >> that is almost everybody who qualifies for the free lunch program. the senior programs we're not going to have -- it's going to be an honor system. we're not going to ask to prove how much income you have for this. >> so all the seniors? >> well, we're trusting you to be on the honor system here. i'm sure that the commissioners will lead by example on this, if you are, in fact, a

low-income person or person with disabilities, you can ride for free. >> thank you. >> commissioner serina. >> thank you, tom. one of the things that i have heard frequently at the in-home supportive services governing body meetings is the difficult of low-income seniors who live in certain parts of the city to get taxis to pick them up, to take them to medical appointments and in many cases they actually tell the taxi that they live elsewhere and change that information en route home. has that come up at any of your commission meetings? >> i haven't heard that. we hear an awful lot of taxis in general and things like uber and lyft. one of the reasons that i think we have things like uber and lyft, making a big entrance into all of, this sometimes taxis won't go into certain parts of the city. sometimes people call three or four cab companies and we're trying to bring some order to all of this, but it's really

really tough. >> thank you:madame president. >> are we talking about the fare amount is $2.25 for seniors? >> for adults. >> for adults? >> yes. >> so that will be going away. because right now -- are you talking about the paratransit van that picks them up? >> no, this is riding on muni and metro. >> not the vans that take them to appointments, that is still $2.25? >> yes. >> that is what i thought. well, okay. i am just saying while we're here and communicating, there is a problem in our community in terms of being on-time. the vans not getting -- having to wait an hour, you know, after for their medical appointments? and that is the biggest problem that i hear regarding the van picking the seniors up. >> it's a big problem in general in the city because there are so many cars, so many

vehicles out there. anywhere you go in the city there is construction going on, too. i'm very aware that people are going senior centers and are in the vans for hours and trying to work with folks in the community. >> i just want to be clear. >> just clarification, i am going -- i eat lunch over at the seniors and they are going to ask me a question, what is the age starting as a senior? >> 65. >> 65,yes. >> thank you. >> well, you are welcome to come to our commission meetings sometimes. they are a lot of fun, and they are just down the hall in room 400. >> they are just a little long. [laughter ]. >> commissioners just two more things. the first is ihss came back last week from baltimore where

i attended a meeting at the centers for medicare and medicaid about the transitional care program and all of the contractors for transitional care were required to be there once a year. and we got -- i think you know the transitional care program has been a little bit of a challenge in terms of us getting our enrollments up, but our program is running really well and we got good tips from the programs that are very successful in terms of percentages of enrollment. that is helpful and we're back trying to apply those. may have mentioned last month we got a 6-month extension on the program and so we're really trying to get the enrollment numbers up, so that we continue with the program after april. but at this point, we at least have the contract until april and we have a chance to make it really work in next six months. so it's a challenge, but the staff working on the program have really worked through a

whole, huge number of barriers with hospitals, with some of the other issues that have come up. so we're continuing to be very hopeful that we'll get an extension again after april. then the last thing i wanted to just give you a report on is that we talked a little bit about the fact that we're developing a senior and disability hub. where we'll be able to offer medical, cal fresh, ihss, et cetera, as well as the other more traditional daas intake services that we have and we're going to open a public site at goff and otis, right before where we're now and we'll have our intake staff and our ihss eligibility staff in there to provide those services. it will really help us further integrate with the department of human services. we're one agency with separate departments and want to serve

people in a more integrated way. we'll probably be moving in early 2015 and we'll keep you apprised of that. >> question. is that an increase in staff to populate that new location, or is that just a reorganization ? >> we're figuring that right now. we may add staff to the ihss side of the house, but what we're really doing is moving the staff over from where they are now, so that they are co-located and can really serve people all-in-one place. and addition to ihss and additional intake staff, we're going move the county's veterans office there as well. >> i have a question. i was wondering about the high-cap services. i don't think we have any

office services in our area. i have a lady who came in and she was very sick. so this is the enrollment period. so i don't think we have anybody in omi. we used to have an office there and when you sign contracts, i asked catholic charities and they didn't have a high-cap person and i need a lady that needs to be enrolled, who was very sick and doesn't have insurance. >> maria, you can probably speak to that better. >> commissioners, maria gegan, program analyst with office on aging. i understand that when we did have the adrcs operating out of episcopal services there were people stationed at different sites >> yes. >> now we, with the change, there might have been some

changes with high-cap staff or volunteers, but i will look into it. they still say that they have at least ten sites throughout the city and more. so what i can do, when i get back or even here on my phone, i can make sure that i can get you the information about where this person can get some service. there are volunteers that can go throughout the city with vital services. you are right, it's open enrollment right now and they are extremely busy, but i'm sure they can make way for this appointment. >> i know we used to have it at the it bookman center. >> right. >> when you change it, clients get confused and they think they should come all the time to the same place. so you can't change it too much, because they really just close everything up. so would you please, we're very much interested. i think we have space out there and we could use a high-cap

person in that office. okay? >> i will bring that up. >> thank you. >> madame president i have a question. >> commissioner. >> concerning the veterans office, is it true that eventually when the veterans building we open again across city hall on van ness, the veteran's office will move into that building? >> we are not planning on that at this point. we're planning on having it co-located with our other services that we provide for seniors and disabilities and most of the people who come into the city veterans offices are seniors or people with disabilities or they are family members. so we want to be able to offer them the range of services, including medical and cal fresh, as well as the other services that we currently have. so we have been approached about that and i mean even three or four years ago we were approached by that and that has been our position. >> thank you for the

information. >> i think i visited the office last week, and they do not want to move in that building because of the handicapped access is not very good. >> right. >> and they can come in off the street and the bus stop is there in front of van ness. it's just too difficult to get into the building. >> that is true. the space that they offered us is really not accessible. >> thank you. anything else? >> that is it for me. thank you. >> thank you. any more questions? advisory council reports. mr. schmidt. >> thank you. good morning, president james, commissioners. deputy director. the advisory council met on wednesday, november 19th. at that particular meeting, the president report was that we give an update