in the airport are great shikz it up. and then we're going to garnish it with olives. and some lime and a fresh stalk of selly. right on. >> we like >> the commission will please come to order and the secretary will call the rolling. >> commissioner pating is stepping in commissioner singer commissioner president chow arrest sdmung sxhashg the second item on the agenda is the approval of the

minutes february 7, 2015. >> so the approval of the minutes are before you a motion is in order. >> is there a second and any corrections to the minutes. >> hearing no corrections we're prepared all in favor, say i. >> i. >> opposed? the minutes have been adapted next item. >> item 3 the director's report. >> good afternoon commissioners i wanted to give you the latest update the board unanimously accepted our gift plus the naming of san francisco hospital to the phyllis and mark zuckerberg general hospital as he trauma center and all the supervisors supported that i wanted to give that lastly update from the boards meeting california enrollment ignore

2015 ended on february 2, '10 east so it has an enforcement period for people that were unaware for not carrying health insurance this is for the marketplace eligible persons not exempt if 92014 penalty fees but have a chance to avoid it later in 2014 i wanted to announce the development of our new dpw office of privacy affairs help to coordinate the efforts across the department this will have a specialized report for the health sdposhg and please line up on the screen side of the room pleased to announce many martinez as the director of the privacy affairs with the dpw privacy office and bangz many,

many years working on interagency changes and she served as the program presiding officer reporting to her at dennis herrera will be l f w with the public health human resources implementing the compliance and privacy are the utmost importance for the depended to help to specialize our services in that area. >> project connection 58 the first homeless connect is around the corner with while term rental is on for health homeless success 58 events on march 8 the co-prescription is the research unit received firnd for the california health care foundation for the academic delays of primary care providers

for the participation of on alienates part of the efforts to talk about the offer dozen in san francisco the first time the she didn't have wide staff we are ready to listen and respond to help providing the highest quality of care the department of public health is commented for a wide staff and providers understanding their feedback and level of engagement is vital to the success from march 2 to the 5 the engagement survey i'd like to announce that as you recall i talked about the passing of michael baxter one of our applicants four young people in the community and also founded many of the community clinics throughout the community and

city we're having a memoriam only wednesday march writing to at city hall we would like to invite the commissioners and county to come 0 memorialize his efforts within the department and several of the staff were being acknowledged dr. deborah coning and michelle and our own colleen chavez received the management award in the next coming weeks thank you commissioned any questions of the director's report. >> we have one public comment commissioners before we ask a for your questions san francisco and for everyone making public comment i hold a timer when the beep goes off your time is up. >> i'm san francisco the

director of the justice advocacy so linking thought director's report i'll be talking about confident the freedom of information act i think it is high time that what the director as said is put into use because oftentimes when we ask something we get a letter and then it is very difficult to bring that to the attention of the director i recently made an acquire about violence preservation and intervention in previous years i worked for law enforcement and i also worked for as a congressional liaison for 6 united states congressional liaisons i'm privy

to a lot of information and has to be given and i got 0 information but it was very basic something i could have gotten from anywhere so what happens in life is that people that are awe soot who are learned and have experience and if they ask certain questions is not to put down any agencies but to address the concerns of the constituents ask the director of environmental justice advocacy i'm very interested in quality of life issues and i believe that if we have a war zone in certain areas of our community there is no way we can address quality of life issues i also know that if there recent pollution and concentration and it effects our constituency we

cannot address health issues is that my time. >> that's your time. >> okay. thank you very much. >> thank you, sir. >> commissioners your questions to the director. >> are in order. >> commissioner singer. >> dr. garcia i was wondering to relating to california how we did the enforcement. >> we don't have a contact with covered california i'm not sure we can looked california wide but not showing that in the numbers we have a contract with contact california we're in the myth of that but another some point very soon for medi-cal numbers on april 7th we will have an update. >> commissioner karshmer i'm sorry i thought you had a question okay.

>> director garcia's i was curious of the orientation and exactly how we were helping i guess or collaborating it and if you could debate on what staff is doing. >> i'm looking to the audience joe any up to date update on the elevation written up in the director's report if not commissioners we'll bring that to the health committee. >> i think this will be interesting. >> okay. thank you we'll do that. >> any other questions to the director? if not we'll go on to the next item please. the next item is general public comment. >> we have one general public comment mr. frank.

>> commissioners in the past we've come here as a community to address the contamination at hunters point now the same at candle stick point so the eir done by lamar was rushed and i want you commissioners to be very cognizant of the fact that the first time arsenal hundreds of our children, our women and seniors were that neglected die i i today, i have a gentleman suffering the consequences of working at the shipyard and if someone is sick and gets

this type of blood cancer it's very, very reexhibit no. 7 our city is not addressing that again and again i've asked this city if we have a qualified toxic cost working for the city not ucsf i've not gotten an answer do we have a qualified toxicologist you've seen me talk before i'm about compassion i'm about the owe that decreases and nurses people that work for those that need health so they can get the best care we're the city that knows how we're the city named after st. francis let me bring something to your attention this belongs

to the learned up to 1977 we went on the register we have came passion therefore it is for everybody thank you very much. >> thank you, sir. >> our next item, please. >> item 5 is the update from the finance and planning committee. >> good afternoon, commissioners finance committee met right before the commission meeting today and we have gone through couple of new contracts that involve software licensing and we have recommended approval of the contract reports which is a contract with bart the methamphetamine clinic and also another items that is on this consent calendar that we all

will be voting on after this the site approval for location of nag net a clinic that provides testing to the gay community a the castro and their moving from 18 to castro not a huge move but it makes the services more acceptable those are the 4 items on this consent calendar we had a presentation on the meaningful use of the health and we have also you know like raised some questions around you know like with all the software licensing want to make sure that we still have a plan that we're city of

chicago to in terms of of updating an electronic medical health records so just to make sure that we continue on that track and not just doing piece meals and putting programs together those were the discussions we had. >> any other commissions. >> commissions are there additions or questions to the chair if not thank you very much for your report and we'll move on to the next item. >> item 6 the consent calendar commissioners. >> the consent calendar is before you from the finance committee we have 4 items and we will take them as a whole unless there's x transactions any x tracks in the consent calendar in which case that item will be discussed separately seeing no

extractions a motion from the committee all in favor, say i. of the consent calendar please say i. >> i the consent calendar has been adapted indifference to the number of people that came from item 7 on the massage amendments with the permission of the commission we'll hear that item next and the budget would follow commissioners any objections to that reverse of order if not mr. secretary call the next item my yes item 8 is the massage establishment in san francisco and classification of state law in amendment to the san francisco health code and the resolution. >> give me one second to be prepared to go first

(inaudible). >> we have two guests one from commissioner chan's office and one on the status of women coming to speak as well. >> oh are they here? one is coming >> sir north korea nobody it prepared to present. >> considering it may take them 5 minutes let's try to make sure the pittsburgh public didn't dr. to stay for the whole public comment i think we should continue with the budget concerning the time. >> do you want us to proceed with the budget and when the guests arrive or. >> that would be fine. >> because i think we still would like to indifference so why not begin the budget discussion if someone notifies

us when the guests arrive go on to the other item mr. wagner. >> good afternoon, commissioners greg chief executive officer here to present et seq. hearing on the proposed budget for the fiscal years 2015-2016 and 2016-2017 i'm sure you're aware of we had prior hearing eulincoln the themes in the budget and some of the initial initiatives at this hearing we're going to talk about additional proposed initiative and how that feeds into our it program which has been one of the main subjects we've been talking about over the past months we have proposing a budget that

will be approximately, $1.98 billion for fiscal year 2015-2016 and that will be drawing $1.3 billion in revenues and the balance is joint chiefs of staff apart if the city we'll show details in the presentation the numbers i'm showing you today are estimates because of the continue to move throughout the process as the city makes adjustment to the growth and other assumptions flying our budget but that's the general picture you'll see you'll notice the total amount is very close to compared to last year one of the primary reasons i'm sure you're aware of we've had for each of the last two years a significant expenditures associated with the new san francisco generalize

including the foreclosure and fixtures and equipment program and that's leaving the budget it is offset by other growth including employee salary and benefits and operational costs associated with the new hospital you end up with essentially something that will be close to a wash so the big picture for us as and discussions last time we've been focusing on how to continue to make progress on some of the initiate from the past year's budget those are focused on the implementation of the affordable health care act and the integration of the department at the same time move forward with the next major implementation an investment in our it system we've tried to structure this

budget so we're living within our maples and balancing around the investment we anticipate will be required for next week to move that the electronic medical records and some of the it infrastructure programs forward at the pace we believe we need to get to the timeline that bill will be presenting later today, we verify in this proposed is budget $19.7 million dollars available to fund it that's the estimated amount the it division has called out to meet that program aggressively. >> so i will briefly go through some of the proposed initiative you have detail in your packets i'll not try to describe everybody or everything we're

happy to respond to questions we've breakdown those in the past into categories the first of those is the budget nile initiatives changes in primaries but initiative that are either cost neutral or generate sufficient new revenues to cover the costs of investment the first is a, you know change general medical clinic at san francisco general hospital and adding staff there to improve our revenue capture and billing we believe that will be cost neutral probably a little bit more down the rod but we're budget it as costs neutral that was in response to some analysis we've been doing over the past 6 months to a year internally with the controller's office that identified that opportunity and the second review neutral

initiative informed and nutrition services this is a swap where we've been urging a contract provide at san francisco adjoin for food address nutrition services brichg that with the expiation of the contract bringing those services book in house taking the a statement from the contract and applying those to in house staffing to support the program mental healths we've received fund in h s a to provide the mental health services to children in foster care they have the funding and asked us to increase our services to those kids we're adding staffing that is fully supported by revenue recovery from the budget neutral place it is a good opportunity to expand some important programming mental health services act we've

talked about that and hearings at this commission over the past several months additional money coming in and this is a statewide tax on those with incomes over one million dollars a portion to support of the mental health services act and gotten additional revenue because of the program for initiatives including the implementation of the laura's law program that the commission go discussed in 2014 and we have the mental health director here if i have questions on details about that. >> so the next section emerging needs is the new expenditures

there are a few items first and i kit psych services at general hospital especially the j fcc we've talked about some of the needs we've identified some needs for improvement at sf g h on lightens management to make sure we're having the right level of care for the patient and in service quality we've got new staffing we're polk projecting that will be a cost in the first year and necessary cost for that program and in the second year as we improve our reduce our lower level of care to offset those costs so it will be a pragmatic improvement to result in more revenue in the second year workforce development this has been a big priority for the

department as we're landmarking down the road turn over in the staff and significant increase in the upcoming retirements and in addition to that looking internally how to make sure our staff have opportunity for movement and growth within the department and opportunities to advance so we've not go got on initiative to program those dollars towards that effort shall we - >> keep on - okay the cost in the second year is offset by savings we're going to be moving some of the it systems for human resources on the system that allows us to get out of contracts and we reprogram

those savings for if effort as you can see the general fund costs in the second year is small since we've leerlg funded it internally arrest jail health behavorial health services a prey reprogramming of some contracted staff that are currently staffed through health right 360 we're moving some of the staff in house to improve the coordination and integration of those services but there's a cost associated that state population health division again has been one of the main focuses over the last couple of years and in particular how to build the infrastructure and any coordinate the efforts of population with our networked so the two are really working handing with one another a

number of additions and populations in the health division that division has seen some deterioration through grant offer the last several years and lacks the flexibility it need to be able to use general fund dollars for core programs and if you have questions on that tom as is here we're anticipating we'll continue to make some investments in the population health side that's been underfunded aid really try to focus on creating capacity to do the population health management that aligns with what we're doing on that side of the house at the it helped and black african-american health initiated that is a program we've talked about quite a bit at this committee there are

staff positions and contracts funding included in that initiative to move forward aggressively on that savings noicht we have a couple of expenditure changes we're using to balance all this out and fund some of the it investments own pharmacy we have two years ago or i guess 3 years ago appropriated an increase in pharmacy costs for the protecting height program which we needed at the time since that program is being phased out and those people that were foreman in the program have been moved on to insurance we have general fund savings we're able to pull out of the program and reprogram for other uses so that is $7 million per year the second line is a combination of second see third combination

of various staffing changes throughout the department we are not ramping up our spending and primary care as fast as anticipated in last year's budget. >> couple of new initiative that have not increased at the rate we had budgeted that included potential xoongs into a new facility but also just details in being able to ramp up and doing the hiring as fast as we hoped budget one time primary care for the first year and in the second year we have a cost which is what the needed at san francisco general for the new hospital this will be funding that allows the hospital once the hiring to ramp up the goal of 2 hundred and 10 staff beds

this is part of the commitment to hit that number at san francisco general hospital you have savings in the first year and cost in the second so big picture and now i'm moving through this at a curry level it comes down to as you can see the balancing picture here revenue increases costs and savings all add up to $19.3 million at the bottom right on this slide that's the balance that is available and we're programming that balance again towards our it program and we'll in a couple of minutes later in the agenda have more details from bill kim about the programs but that's our commitment to the electronic records project we'll be