the commission will please come to order and the secretary will call roll [inaudible] the second item is the approval of the minutes of the health commission meeting of february 10. >> the minutes are before you and understand there amended minutes that commissioner san chez and i want to

chanccommissioner sanchise. would you like to introduce your amendments? >> i believe these were distributed to the commissioners >> the commissioner are marked in the section here >> yes, they are available for the public as well >> they are available to the public >> i [inaudible] these are the minutes of february 3, not february 10 >> these are february 10 >> these are feb 10. >> this isn't my day. this is why i need minutes. in essence there very first part of the letter from doctor chow was red into the record, i was asked to [inaudible] which we note in the amendment that request of doctor chow and noted the exceptional gift of the family and how it was reaffirmation of

the highest quality of care for san francisco general hospital which served san franciscoens for years. [inaudible] quality care. that is amendment number 1 in that sector. after that we go to section 4 and the gift acceptance and under that we have commission comment and there has been a change in the wording. [inaudible] under the first paragraph, one of the main [inaudible] working on this and pam and i [inaudible] the foundation, also the capital campaign who have been working for allocating the [inaudible] but also working under the radar with the grants. we wanted to make sure

that was noted. we also thanked again the key participation of the city attorney and noted the contributions of james e joseph the attorney representing the [inaudible] these people wanted to be contact squd be part of the record to show the great collaboration that is on going. the next paragraph we will eliminate that because it is redundants >> you want to eliminate the following paraglf >> yes, after that we had one more and that was the chairman of the foundation [inaudible] was brent and she is [inaudible] so noted of our directors. in essence talking about the collaboration and how she notified each of the

directors of the foundation within the short block of time and requested there be a vote taken on which [inaudible] and it wasuenanimous and that was part 2 as me move forward. from there we came here at 2 o'clock and we voted it and it went straight tothe board of supervisor jz from there to the mayor. that is the [inaudible] cony chan and [inaudible] the only other change i would make is that i suggest on the closing the action taken. the very last sentence where we added that part and thanked everyone to contributing to the foundation and to the make san francisco general ocontinuous

leader in providing excellent medical care for all san franciscoens regardless of country and place. those are the brief amendments written and noted and hopefully we have helped to document the internal process in the collaboration that went on within this great effort to provide adequate funding for opening of our new san francisco general as we meet the needs of the future. i would propose that. those amendments to the commission. >> there is a proposal for those amendments to be added to the minutes, is there a second step? >> [inaudible] >> so there is now a motion to add these as items on the amendments and we'll vote on the amendments before we vote on the minutes themselves.

this is for the vote on the amendment that are being proposed. all in favor say aye. this thereis a amendment on my part in the first section that i would request that we-i would like to move that in roll of my letter that it need to consider the resolution and recommend the acceptance of the doimation. i like to make that motion do i have a second for that >> second. >> if there is no discussion all in favor say eye rr aye. opposed. now we are prepared including the amendments, are

there public comments >> i have not received comments >> all those in favor say aye >> [inaudible] >> i reck let you talked a lot at that meeting, that is what i remember >> #2c3w50d afternoon commissioners, director garcia is in florida at the emerging leaders in public helt and their first meeting so she is sorry she can't be here today but i'm here on her behalf. the first item in the directors report and don't need to say again is the recognition of the fantastic doimation from mark zucker burg and [inaudible] 75 million dollars for san francisco general hospital. also in the directors report was a measles update, but you

will get a communicable update [inaudible] last weeks shootings in chapel hill effect us. [inaudible] community members, doctor suzan [inaudible] we are grief-stricken with how to support or friend and colleague. a candle light individualual is held on february 12 in memory of [inaudible] and the others that were slain in north carolina. as a nation we are witnesses change in health care including accountability for helt out come and [inaudible] more and more the [inaudible] assure patients staff, funders and business partners we are protecting their assets and safe gaurding privacy and

[inaudible] to coordinate these efforts director grar r garcia formed a office of compliance. this office will have over site for compliance and privacy throughout the department and will report directly to director gar suea [inaudible] mariea brings many years of experience working on interagency cross departmental changes and aserved as the xhunty programs [inaudible] behavioral health, population health, transition and jail health and managed care. i'll conclude the directors report there unless you have any questions. >> thank you. was that state

read from >> it was a new addition that i was just handed before the meeting >> okay because >> i'll make sure you get a copy of it >> the one we have is the new director of scrurt squrkss i think [inaudible] was introduced here before, but i think he is here as well. >> i think you ignoreed receiving the 2015 good government award >> i may have done that. >> i understand because is a great honor. the work that you did and the work that was done by the department on [inaudible] is outstanding and will last for a long time in the city >> thank you very much >> you are well deserving of that award. any other questions to choline in regards to the report from the

director? doctor san chez >> it is-i was going to note our director was there at the at and t fund raiser, heart and hereose for the foundation which is the 10th year and she was there and we had 3 commissioners there and there was over 1075 people there supporting general hospital foundation. it is the largest number ever. this was in the lunch. i understand there [inaudible] attended the att after night party which was another fund raiser and we are dancing away many many hours rchlt i don't know if the director was there, i want to again thank our san franciscoen and corporate community and others involved and the kaf stuff and the rewards were

awesome. it was a testimony to the city and san francisco againeral. [inaudible] it just happened and- >> thank you. >> commissioners any other questions >> i want to second. both congratulations to coleen for the good work you do supporting our commission every day and every week we meet. and also to all the member thofz san francisco general hospital staff and the foundation for a wonderful valentines event and public event showing the true strength, diversity and commitment to the communities of all the members and entrepreneur and philanth ropist squz health community. thank you very much for a wonderful event. i can't wait for the holiday party at san francisco general hospital after the opening, i will spect

it to be just as good >> thank you. any further questions or comment from the commissioners? if not, can we go on to the next item? >> item 4 is general public comment and haven't received any requests. we'll move on to item 5, which is community and public health update >> welcome back [inaudible] would you like to give the report or you would like doctor [inaudible] to give it >> commissioner [inaudible] >> i want to thank commissioner [inaudible] for being here today and allowing me to sfep in to chair while she was out. we heard 2 important items on the committee on public health, one is on the establishment of regulations for massage therapy enterprises in san francisco following the 1147, which was

passed last year, the city now has new capability for making sure that we have safe and legitimate health massage practice. well over 30 percent of the massage parlers [inaudible] there was a resolution to support supervisor [inaudible] and the health commission to work with the public planning department for a set of regulations consistent with [inaudible] a full resolution will be coming to the commission next month i believe to endorse with regards to opposition on those regulations >> commissioner, the full commission will [inaudible] march 3 >> that is next month >> the next meeting

>> the second is on integrateed behavioral health surbss is the model with san francisco is taking a grite leadership on. this is integrating behavioral services into primary care services and [inaudible] behavioral health clinics and the effort to enroll clients into the program. we are making impacts with regards to showing this pop ygz have better health outcomes and is well appreciated by the professional staff and the clients receiving those services. there is questions about how it rest of the health system will become integrated but at least through the primary care clinics of the health network we have made strides. i would say we are the state leaders for moving forward the depth of the integration at this point and now we just need to expand to

the whole health network. >> commissioners, were there-i should ask [inaudible] high prais coming from your perspective on the state level. do you envision that we would then be able to actually integrate eeven without colocation because there are colocation challenges come igin a few months >> i think the question i will ask doctor [inaudible] at the full commission is those members not part of the network, how do we bring them in so they become integrated. my understanding from speaking with the department director is we have 35 thousand individual members under health network services and 40 thousand, that is 20 thousand each pot

receiving mental health and services not part of the network so how do we bring those clients into the full medical system so they receive medical and mental health services? right now there are several silos that we haven't figured how to bring together yet and i'll be interested in hearing later on [inaudible] we are limited by the different funding streams into the degree we can fully integrate, but those in the helt network receiving primary care, i think we are on a gad path for them and receiving integrated het care >> any other questions to commissioner [inaudible] on the report? if not, thank you for your report and our next item >> next item we skipped item 6 because there are no items on the calendar so the item 7 is

[inaudible] parking overview. [inaudible] >> good afternoon commissioners, i'm cathy [inaudible] dpreckter of facilities and capital planning of public health. we are excited about the completion of the new hospital, however that won't be the end of changes to the campus. in the competitive world of health care we now live in, we will need to continue to evalve and develop

programs that meet the needs of our patients nord to are owe retain them in the net workism accessibility is a factor in that success. [inaudible] reasonably acceptable to the patients and this? cludes being able to park at the point where they are reaching their care at the campus. today parking can be a very big challenge for all patients and staff that work and come to sfgh for care. this will be exaster baited by new projects that we look forward to over the next years. [inaudible] including the development and construction of the new ucsf research building, relocation and expansion of ambultory care services,

relocation of dph programs that are residing in compromised buildings, the increased staff for the new hospital, and then post 2020 when the brick buildings that will be vacated by ucsf research will bring additional demand for parking to the campus. so, i want to focus on this slide as i talk over the next few points. when the new hospital is opened in december we are projecting the new staff will need 16 additional spaces for parking. in addition we'll use significant amount of parking on 22ened street we lose 55 spaces, the emergency access is on 22ened sfreet which is our

only access [inaudible] the parking congestion that is created by both having delivery vehicles and emergency vehicles trying to traverse that roadway requires we eliminate those parking spaces to avoid delays for maernsh access. also during the construction of the new hospital we had off site parking run by web corp and located at the chronicle building. maybe some have been there to see the new hospital. peek parking demand from the consultant opinion, we have 50 staff parkic there on a daily basis and that parking will go away once the hospital is completed. some time later this year, but no later than december we anticipate. when the new research building is completed we will lose probably up to 130 spaces that will be permanently lost and once that building is occupied by a new

staff coming to the campus another 72 spaces will be added to the demand. post 2020 after the research programs are occupied in the new space we'll see another 411 spaces being needed in order to serve the [inaudible] brick buildings. this slide which i won't go over shows the detail of how we calculated the preand post peek parking demand. we are fortunate enough to work with a great consultant with these numbers. if you have questions i can answer those. so, we come to the proseal to expand sfgh garage, which is a solution to had parking prck. the garage was originally designed to accommodate, 116 smine 9 spaces. the parking

operates a full capacity and this includes valet parking. the parking capacity as you can see from this slide from the parking, the airline view occupies a full city block already and by building out the original design we would occupy the remaining portion of the block so if is possible to do this. when we work with [inaudible] if we can push this forward, they will expect a very robust transportation demand program that goes hand in hand withgy additional parking they allows us to build. even with these programs we sus spect there will be a deficit in parking. [inaudible] post 2020 well over 900 spaces will be needed if

there isn't additional parking. for the past 2 years we have been in a lot of discussions and meeting with sfmta ofern how to solve the parking delima at sfgh. including the concept of the expanding the garage rchlt in jan of this year the sfmt director [inaudible] said they would recommend we go before the full bord of directors to take this concept of the parking garage and also working with them to find other solutions possibly so we will go before them in march to try to get that approved. this friday we'll go before the policy and guv rns committee to get additional readings on what they are thinking. there is resolution in front of you.

that basically says we encourage you with very strong language sfmt board of included feedback from san francisco general hospital. it's the s [inaudible] the concept to go forward then we'll have to look at finalizing [inaudible] 5, how we do financing strategies for the garage. >> if i can jump in, the resolution was reviewed the prezitation was reviewed and the resolution got feedback [inaudible] >> happy to answer any questions if you have them. >> yes, commissioner [inaudible] >> thank you for your prez nlitation. i have a question about the process of joint helths commission city planning

approval process for changes in the city, the building changes-would there be any liveerage if this was endorsed by that process that would have a stronger impact on the yeasing the likelihood of parking >> i this can you are asking if the helths care services master plan [inaudible] only for a medical use and don't think the parking is a medical use because it isn't supervised-there are not services provided in the space by pedicle personal el >> would it not be possible to leverage the fact that the medical use of the rebuild of the hospital directly is affecting the parking to leverage the planning commission to weigh in on this >> we can look at this >> it is a big deal

>> absolutely >> any leverage that can move thish forward is a important one. >> that is a great idea. >> other commissioner comments? i also had one, i know that at the-during conference when we were speaking and have a section under wheres, speaking to the increase use clinically on the patient level, you specifically say 1, 2, 3, 4-about the 5th paragraph, increase patient visits for dialysis and other relocated clinics, relocated staff from relocated clinics and i think we asked that you should be prepared to be able to speak to mta about how many clinical issues and the clin ical needs on the part of the patients are really going to be

effected by this. it isn't just merely staff parking, i think that we should try to emphasize how much is necessary in order for patients to be able to access the serviced we are talking about here. this is just part of going-if be are going before and also the mta because i think it needs to have a patient focus. so, that would-if we can enhance or describe better in the wrs where as. i think we can pass this and word [inaudible] increased patient visit by some type of volume so that people would really see-when we talk about staff parking, it is important because if you don't have staff you can't have the services, it really go back to

how many patient visit squz services and the fact that we have more open beds and the fact that we'll have more clinic type of activities and therefore this follows that we will have to have more staff in order to do that so staff and patients have to be able to get there. i think that is really where i believe we were at the joint conference in terms of asking for an increase emphasis on that because i think that is what the public wants to hear >> i understand your intention and can work with [inaudible] on another where as. >> if we can do in addition to the whereas. >> absolutely, i think it shows in the demand tabble so we can pull those numbers out there that shows the dialysis and [inaudible]