that such 5ud listed to the processing to help streamline it is we are also committed to that. >> thank you commissioner. >> one more point you know, i want to make sure we're not overstepping on other departments like policies and recreations i hear different things for us to you know from the the licensing you know and you know and really the inspections monitoring the massage parlors and also the public health implications so you know like massage practice so on and on on the other hand, i think that is really a conversation we need to like push back you know put back on the mayors court you know around how to support a lot of the small business owners, you know who are trying to start

businesses like as practicing you know massage therapy in the city that part is not a community purview per say so i think you know i'm struggling a lot because we talk about a lot of different things here. >> there's there's a lot of moving parts in this legislation. >> it has nothing to do with to do with the apps so i just you know yeah. >> so we'll work with the departments that are reflective of this clearly this is our under our jurisdiction we have the authority to pass this resolution i understand that commissioners want to work into the bid and that's good and if you like to - if there's anything in there you don't want to pass we've come back the 23rd 23rd we'll do that april 23rd do

you have a timing issue. >> it might be a timing issue because we are trying to get this legislation scheduled for the board in april so you know is it would be my preference to an my good faith to provide me with amendments i'll incorporate them and pass that with amendments i know the next two meetings we're unable to meeting meet we need to move forward and get it scheduled to get it done by the end of the fiscal year that gives us plenty of time between now and the end of april to work with all your constituents to make sure that that is rescued within the regulation i'll happy to come back on the 23rd but a possibility of pga the resolution today that would be appreciated. >> and commissioners if i may i'm sorry to interrupt

commissioner further results of the health commission transparent and education i recommend or encourage you all to consider that and pass this we can add a list of the amendments based on the sxhaungz office fact sheet you have that in front of the of you and the worse thing based on something real. >> i'd like to ask two things ask director garcia is this an amendment or request to you again to work with the members of the california massage therapist community to mitigate to work to mitigate the process cost of burden of regulation awhile maintaining our cost neutrality is a good balance for that that is the policy you know

you'll adapt or has to be sent he e sent to you and condominium to doing an evaluation of the changes in health or the improvements in health in massage the massage therapy industry as well as the contingency health improvements that are amenable one or two years i don't know if this is needs to be amended. >> commissioners those are appropriate additional resolves those will be quiet helpful in the light of the discussion here if you wish to do that further resolved i'm concerned with the language urging the term illicit

mass alp 80 for us to effectively regulate illicit massage isn't what we're trying to propose so i would suggest that area if as we're modifying that this is just a small word smith by the way it's written leads to misunderstanding thus proif appropriate oversight it you much clearerer what wire trying to do we're not trying to keep illicit or massage parlors in business. >> so commissioners we have a timeframe i don't believe we should be listing all the

amendments that is legislation under consideration and it is being changed i think that the staff has heard a grateful of where the commissioners feel quite semiathletic to the legitimate agencies that have very good points to make it does not sigh they should be regulated to we heard you don't have to be because we've pass that that is like saying a position didn't needed a licenses because we passed all four years of medical school or recertification; right? with that time constraint if and i've heard commissioner karshmer say it is okay. we could move this resolution and the two resolves i thought were well written by commissioner pating here with the change of the lapsing also from us regulating illicit

to what i just said and if we could have a motion we'll then ask that we have a followup on april 21st to the progress of the legislation and if we then want to add anything in terms of amendments are endorsements we can do that. >> so moved i hear a motion is there a second this will incorporate all the resolves the additional resolves that the commissioner pating brought to the table and the change to the word removing illicit and among other things out the language oh, yeah. removing awhile any further discussion if not, we're prepared for the vote all in favor, say i. >> i. >> opposed? >> our resolution is adopted thank you very much thank you everyone for your testimony we're interested in

we're interested in seeing there's a safe and productive massage parlor in san francisco. >> we go back to item 7 would you like to have discussion and questions on the budget or go into the id. >> item 7 will include the presentation of item item 9 with we'll discuss item 7 and 9 together. >> great. >> so good evening, commissioners

commissioners. >> it may work oh you notice that the director of it has grown. >> i'm very low tech (laughter). >> i thought i'd lifestyle the meadow. >> thank you, commissioners thank you for allowing me to speak and update the commission on in support of the budget proposal that is actually a brief update or interim update in terms of the it implementing i committed to provided you an update every 6 months that is important

substantial with the milestones is that it is having said that with the budget process moving forward i thought that was timely we actually do help justify some of the huge costs we're expecting to see in the it investment so first of all i'd like to bring your attention to the title this is really an update occupy top priorities we have many, many things happening in the she didn't have but i'd like to brought to your attention the things we're focused on this is very important so having said that, i'd like to actually start every slide with slide deck with a slide from a previous slide to give you a in his transition this is as you recall the timeline we're working towards in terms of what we're doing in 2014 from 2018 this timeline i'm going to say

is non-on tracked, however extremely aggressive we're trying to stay on track we've ambassador working hard in 2015-2016 and continue to 2015 to pain and suffering for the building of the new generation record system with the good live expected in fiscal year 2018 so, please note that is fiscal year not calendar year before i proceeded to talk about the budget aspect of this presentation i'd like to go over with you top current it focus number one focus at this time is the sf g h rebuilt targeted to open in 2015 december it involvement t is stealing significant and many of the items it to insure that the building opens on time the next item top provided we're

working on a daily basis is the united health records much decision bureau the budget source the product selections and participating opportunity like uchls in other that county as well as our ongoing h.r. readiness prepared activity other items are just as important from security and risk prospective we have it 10 and x p litigation all our devises are being placed and many of the servers we say approximately 5 hundred servers and many other key initiative like population and health information exchange system and keeping the lights on every

day so having said that, i'd like to focus your verdict to the two prim technical high-level status the rebuilt currently we're tracking the target date and budget she didn't have it team is fully engaged in moving forward we have some issues with the contract negotiations that needed our pressed timeline many of our work effort has buffers built in we can mitigate some risks we experience outside variables that potentially delay we are expensing some concerns we expect to see many of those things resolved and move forward and be on time from an it prospective, however i'm sure you're aware of there are many other aspects that play into the complex project i would to share good news i got

texted one of the previous effort we're trying to get under was at pb x phone contract just got approved it had to go in before other technologies so awhile my team is engaged in working hard the it leadership is really shifting our focus and icing the unified health record we're trath a date we have been having discussions around the capital budget source with the options of the city and county of san francisco that have been brought forward to the committee on committee on communication many discussions around the budget office right now looking at several options to fund part of the debt services as well

fundraising as well as re reallocation of as much as typically we give back to the city in terms of the operational budget and probably the most important aspect of the presentation the fact i'm pleased to announce with the help from she didn't havedph includes the budget for f r 16 it is critically important it takes so long to hire people it is an active decision to try to hire people a year before we typically need them if we think that takes a year to do so as you recall from my previous presentation we're not concerned

because we're taking the steps i work to try to hire people if i were in the private sector we would be in trouble having said that the budget that we're requesting is (2) 000-0000 above the it budget of $76 million please note that is ann 26 percent increase some will eventually be direct contributions for our effort now i'll go into the detail of what make ups up we've engaged our partners at ucsf as well as other county and actively in decision in due diligence specifically to find the right

model and the right costs to be expected to commit to in planning prelims and operation and at the same time, we're really focusing and continue to focus on h.r. readiness that the people capacitate prospective before i go into more detail where did the stemths come from the study you've landmark was an option as well as the sierra study that looked at railroad.org dph it was the internal analysis that has been incorporated not fy 16 budget request we'll continue to need refining

especially around the cost estimate and need to continue to go forward with the selection of our solution and partner so what are we're going do spend the money it really means a couple of things it means doing some system improvement such as cleaning up our master person index unidentified h.r. requires some things some things can't be downey deposit without these things in place we're looking at cleaning up the master. rightone: and shoring up the infrastructure but importantly right sizing our team by 89 people that be indian with my own study before i looked at the sierra study and this is the

assessment of my internal leadership specifically we'll be putting into a position two applications integration that has not truly existed and as well as the help desk and p mo and creating a new program of italy's trainees so in 3 years time we'll have san francisco resident who are now joining the workforce will be here to be trained for the next two or three years having said that, why are rehiring now and why is. the reality commissioners in order to start preparing for the planning of dph h.r. i need to free up people from my operations to do that currently i on have enough people to do operations which means i have 80

add more people to get trained to free up but subject matter experts in the it that can help build the system this is a precutters to the prelims those people move forward to an operational area to support the next generation e m r for example we currently don't have a help desk if i said during the presentation during the positions they center to call the regular help deck and wait thirty or 40 minutes or an hour before someone helps them through resetting their password that's assuming the help desk person can be there when i look at the landscaping of other wvrl locations we're

dedicated to supporting just in time the clinician when they need help if we're going to be committed inform spending hundreds of millions of dollars to change the environment into 9 electronic health records we have to put the support structure in place and the $20 million commissioners will help us going get it ball moving and aggressively so i'll numbers but here's a picture of what it looked like over the next few years over 2025 before i go into that details one of the things is actually not refinancing the prelims and the operational cost but we're going to look at run on investment with the united height operation wrestling we'll

have many systems that will be decommissioners take this shied with a grain of salt i'm already engaging we're trying to set up a meeting by providing not only a p m but a business analyst but a budget analyst and so we will have a lot things going on we have - we're looking to bring that information to we have few pro tem options we need to be sure this is a solution we'll live with more many, many years to come so one thing you'll notice in orange dark orange $12 million from across dph it is described across the organization

we estimate based on the study interesting based on the right sizings the organization done by sierra and the input from my team is $20 million we have to come up with that when greg and myself and barbara and others are working hard on we feel more comfortable then we did we'll be asking for a lot of help from a lot of potential funding resources this is for the health records we needed to ramp up dph with the proposed budget it had help us to ramp up our teem that is critical to the actually strategy management we can't

continue to hire people ad hoc like google and facebook and other organizations we need to create a instead stream of students right out of school maybe while in school we can pick them before they get to the job market and working with human resources to actually adopt the program we'll be spending 20 train resolution that should give us thirty employees to pick from in the third year and we'll be doing that as and a we move forward we need to find the funding source the ongoing cost of $20 million is once approved by itself mayor and the mayor's office is

doable the option are debt serviced fund raising as well as city profit change specifically reallocating the changes to the budget the selection of the solution we're still targeting june of 2015 we believe we will take approximately a year to get through the prima facie case what that means by june we know as a organization what direction we're heading it is in the right direction. >> also we know we can pay for it and working actually with ucsf to create a model it will show us how it is supported but

anymore importantly a timeline because ucsf bag angle organization like any organization has priority we need to be sensitive of we're conscious of that and working close to make sure our priorities and strategies align with theirs we're also looking at cerner because cerner is only in the market it the not a good option until we're firmer on the options we are going to select those are back up options for some unknown reason is didn't workout we have to start over other options we're looking at just in case option one and two doesn't workout but symmore

importantly their strategy in nature for example i'd like to be clear discussion with other counties on leveraging each to create a common skill to get better pricing this is for h.r. alone it is not h.r. is a small piece of the escape lib many private hospitals to get the burying power to leverage the power the county is railings standing alone we can't succeed very well so, so what one of the things we proposing for example instead of each think of us doing an r f q or rfp but only one rfp or one r f q why do it

ten times and more importantly he'd it sooner all of a sudden we're not a one county hospital but many hospitals asking for a better price having said that commissioners one of the things we're actually actively pursuing is asking us to do what we've not done gives a pricing that's not been achieved until now because safety hospitals are not big enough to demand such a thing the consortium might be in an early stage whether that pandz out we'll reap the benefit of convincing the people of the world to look at the consensus. >> commissioners that's all i have for the presentation i'll take questions. >> i think what we'll do have

the questions combined with mr. wagner's why not have both of you here to have the commissions get more information one of the first questions actively related to mr. wagner's presentation where you showed i'm hoping you'll provide us those nicely done slides that show the percentage of change the last 3 but workplace it the primary care which wyoming we've been talking about the trend of the future showed a percentage decrease over the two budget years and while you've given explanations on the others in terms of particularly the f s and e commitments we want the

primary care commitment it actually decreases. >> a good question so to come up of moving pieces within primary care the first is associated with ramp - there's one way to look at a reduction and one way to look at it compared to where we were prior to last year's budget we included a couple of initiative a big expansion of primary care and we've seen we've gone into the current budget year there was the primary care unidentified call center we're actively implementing and other positions for revenue neutral initiative to secure an additional primary care loeblgs we had a site in mind for that one that d