we provide currently and the biggest advantage of course, is being able to draw funding from medicare. and part of the services we will get with this pilot program is to offer a workshop, and this diabetes self-management program that meets all of the programming requirements for reimbursement. and trained for additional leaders facilitaters that can lead these workshops and graduate at least, 10, participants from this workshop. the, you have to budget with the details, indicated in the packet, and i am happy to answer any questions that you may have. >> commissioner, loo? >> i have seen, and operating expenses, and all of these contracts, where they were in the san francisco and the san francisco senior service, what kind of service are we

buying from them? >> i think that the column to really look at is the column that we separated out for diabetes self-management and this budget includes other health promotion programs which is not being modified at all and the only piece that is modified is the column that you know, the diabetes self-management, and so, what is your question, again? >> my question is, what kind of service are we buying by giving the senior center, 59,000 for three years? >> i am looking at the operating expenses, detailed. are they talking about the same thing? >> what page are you looking at? >> i am looking at, and it does not have a page number but i am just looking at the operating page. >> yeah. >> the last page. >> yeah. the last page. >> okay. >> and all right.

san francisco, senior center, the university of san francisco. >> right. >> that is actually, the health promotion program, and those are not being modified and they are not under today's request for the 40000. >> okay. >> okay. >> i have a question. how is this different than the regular health? and are they going to be directly about the diabetes? i am just, and because it looks like it is just extra --. >> no. >> and so, what is different about this -- >> what is different in this, than in the staff has and, this one. >> correct. >> so, this particular diabetes self-management program that we are trying to pilot, has actually more strict requirements, and one of the specific and it is targeting for the people with diabetes, and part of the requirement is that there is a dietician who will be

offering the counseling to the participants in helping them to better manage their diabetes and also, the participants will be required to provide authorizations and with their doctor, and providing lab results in terms of the monitoring and so, i know that the director of 30th street center is here and she has been very much involved in the planning stage, and she might be able to actually give a little bit more details of how this is different from the regular chronic disease, self-management class. >> yes, please. >> good morning, commissioners, this is really a clinical program. and the regular diabetes self-management program is not. and so, what we are doing with this funding, is exploding the opportunity to use the medicare benefit that sits and as i am under utilized throughout the

united states, and when the administration on aging mcneill, during the, moneys that were made available, and many parts of the united states, are trying to see whether community programs like a center like 30th street would be able to set up a system in order to be able to actually at some point, draw down that medicare benefit. and so, the feasibility of what you are investing in right now, which has already begun in october is really good to term whether a good old fashioned senior center can put a system together that meets all of the hipa and the clinical and has the agreements with and is accredited diabetes program. and so this is also, going to be paying for us being reviewed by the american society of diabetes educators and so it is very different, the only similarity is that it is a classroom setting and

it is the workshop and so it is the six weeks two and a half hours workshops, but the degree of the depth that we go with each of the participants is much, much, deeper. and we do need to have the critical information from the physician, that is also different than this standard healthier living and diabetes program. and so, we hope, that at the end, that we will have data, as well as being able to say, what would it cost, on an ongoing basis, to be able to do this kind of program in a community setting? >> right now, we don't know. and, i think that what we are doing as a community, is also trying to see, just like the transitional care program that you are aware of and it is now drawing down the medicare money in the past we used to call it coming home and homecoming which was totally funded by dos and so, the effort on a national basis is to see, whether now is the affordable care act,

changing and the hospitals and the health plans all being more having to take more responsibility for the patients this might be an opportunity for the community programs to draw down another funding source. >> i have one more. and i am wondering how would you manage the clients if some are on the, and if i have diabetic who is not on a diet but on a special diet and those that are not coming into the program, how do you plan to manage. >> this is a real commitment on the part of people, because you have to go through a screening, to make sure that you are eligible, and then, it is a commitment, and it does not matter in terms of where the people are at in their diabetes management at this moment when they get into this program, the hope is from the beginning until the end there will be an improvement in how they are managing their glucose and etc. etc. and so the idea is that you, you

basically have to have a diagnosis, of diabetes and not prediabetes and that is how specific this and we hope that we are doing it first on a small basis, sthaoe so that we can control the different factors including all of this clinical stuff that the physicians and the hospitals get nervous about how we are going to be sharing that and so we are developing all of the components and all of that review process. and so, if a person is on a special diet and they have diabetes and they are welcome to participate in this. but it is a commitment of 6 weeks, and we hope that the people who do it, not only see it as a benefit for them but possibly for a benefit for the community to begin to offer this kind of service. >> commissioner? >> well, i know that 30th street has a pace site there on the same campus, is there any inner face given the hipa

complaints? >> there is no interaction, because pace has a strict compliance and licensing and what we will do though is that we will use the expertise of the on log government affairs person who actually sets up and has the, and has the compliance on medicare down like a science and so we will definitely draw from the organizations background and expertise. >> great. >> but it won't be directly connected to pace. >> commissioner loo? >> you said the program started in october. how many clients do you have now in the program? >> so the first part of the program was research and development. and we did not know exactly what was going to take so we have not served any specific clients yet. i really want and i hope that the people will look at this as a feasibility study and setting up the structure and getting the right players and the right positions, and developing the policy and procedures. and i mean that we have a whole, administrative piece

of this that was starting way back in october and the pilot, where we are actually going to have the participants in a served is in april. >> and so, we are now in the process of recruiting, and we hope to get, maybe if we can, a 15 committed people and again, we are not doing the large numbers, because we really want to be able to manage it, and every single participant has a clinical session, with the rd, and both, at the beginning and sometimes, during, and even at the end. and so, it is going to and it is more intensive and it is more indepth and once we work out the bugs and we figure out how much that is cost and then dos and the community can decide whether this is something that is worth all of our while to go forward but it is really more of a development grant, not a lot of people who are going to be served in it at least initially. >> and all for your program. >> well, because i wanted to

be a small, we are basically we have an out reach person that is going out to all of our active sites and all of our healthy coalition folks know about it as well as we have a valley voice in march and the article, or the flier is there and how to get involved. and we are conducting it in english the first time. again, because of issues of getting all of the people together at the right place, and again, we hope that afterwards, we will be able to offer it to the folks of a lot of a different language, you know that 30th street has a lot of spanish speaking diabetics but we are not prepared to serve all of them, we are promoting it and it is slow, and making the commitment in 6 weeks and even the standard healthier living is quite a challenge. >> thank you. >> commissioner ow. >> enlighten me, i am

confused, i thought that you were using these standard wellness program. you know? it has been tested. and it works. now, you are telling me that you are doing a pilot program? >> okay, so commissioner, let me and hopefully i can be clear and i am happy to talk to you off line. >> there is a standard stanford model but they cannot draw down medicare money because they don't have the system set in place for the clinical piece and so the difference iss between the workshops and the curriculum, they are very similar. and the diabetes program that stand ford has created is similar. the difference is that the way that we conduct it, with the participants involvement in physicians and the healthcare involvement is much more clinical and the standard stanford model is not clinical, and it is very, peer driven and it is, and

they follow a curriculum and this difference is that we litarilely get the record and the medical information from the physician to use as a pretest, to the efficacy of the program at the end. and then, have all of the systems in place, that we get accredited as an enty, and then, we are establishing a medicare number, which right now, most community programs don't have to be able to build, and so it is, and it is a lot of layers, and i am actually quite amazed at how much, energy is going into this. but the hope is that we will learn something that could be useful in the long run. >> i don't know if that clarifies, but the curriculum is the same and the delivery is different and the reimbursement in the long run will be different if we get those pieces together and get approved. >> the standard model do not have reimbursement. >> no, right now dos is the

defender for the healthier living and thanks for linda and dos leadership we have health promotion programs that we never had before but they are it and if we could do something else and get it established by the reimbursement and other entities we will all benefit from that. all right, good luck and i hope that you have a successful. >> just a minute. i hope that you have a successful program. when you have the reimbursement and the dos recipient of the reimbursement. >> yeah, hopefully what that means is more for everybody at the end. >> yeah. >> and dos, the recipient. >> no at this point it will come through onwalk if we actually ever got medicare money it would come through our organization at this time. and we would just be able to expand more of what dos has already given us in terms of

the seed money for health promotion programs. >> at least somebody is getting the money. >> thank you. >> any other questions? >> hearing none, i will call for the vote, all in favor? >> aye. >> opposed? >> ayes have it and so the motion is carried. >> announcements? >> >> announcements? >> hearing none. and okay. >> commissioners i want to i am very pleased to announce and we have to share this with our providers as well, there is a tichi and the fall prevention, and it is a certificated trainer workshop two days, and on march 28, 29, and this is one of the programs that we will be helping to sponsor with the snap funding and i have some fliers that i brought on the table. and you are welcome to share it with any interested in getting trained and our goal is to have these trainers

being able to offer the simplified tichi program that is also evidence-based and it is another one that we wanted to be able to increase the type of activities that we can offer the seniors at the various senior centers. >> thank you. >> and could i ask a question. >> hello again, and i asked it, and, and we you set aside the money and the trainer to san francisco and is this the treatment. >> you have some good memories, and we will be actually bringing this information back at the april first, and commission meeting for contract modification, and the trainer is actually from the bay area, and you know, those will be shared, and but a discussion is still being going on and we don't have anything final yet but in order to expand and expend the grant, we need to get the

workshop and advertise it in advance and this master trainer has actual agreed and she knows that she is not going to be paid until we have the grants approved and all of that. but, this is going and it is part of that money, yes. >> thank you. >> thank you. >> now, any other announcements. okay. public comment? >> public comment? >> >> president, james, and commissioners, and steven, the executive director to the senior center, and i wanted to respond commissioner loo because i do have that information that 5,000 dollar, off side contract is to our marketing. committee communication and contract and services for us to produce, our brochures or our information or our out reach and part that have is

that the manuals are bilingual now and not just in english and we have to do for the clients, korean, and japanese and chinese and the other part of that is being competitive in this very competitive market and we have to have a website and the onlier founder, was morery and this year is the 45th year of coming in with a heart and a dream to do something for our senior and now we are the community service centers with our colleagues and this audience and it is a very, competitive difficult process, and the seniors are there, in san francisco, and the senior center just does not serve the japanese community, and we have korean and we have chinese and we have anybody that has a mobility to take a bus and come to our program and then come by the drills. and so i just wanted to be able to say that that 37 percent increase, and for us to try to do the services, and to do it right can only occur through the support of staff, and also the staff

that is out here and our analyst monte and to you commissioner to approve that as well the telephone calls are part of the higher calls now for telecommunication and cell phones which are trying to be competitive and trying to change old school kinds of concepts without losing the heart of service and trying to meet the needs of our senior and so thank you so much commissioners and staff and monte for your support >> thank you for response. >> thank you. >> any other public comment? >> hearing none, i will entertain a motion to adjourn. >> so moved. >> second. >> okay, it has been moved and seconded that we adjourn, thank you.

good afternoon i'd like to call to order the regular meeting of

sfrugs today's date is march 24, 2015, roll call please. commissioner president caen p commissioner vietor commissioner moran you chairperson wu is absent we have quorum >> before you the minutes of march 10, 2015 are there any additions, deletions, or changes to the minutes. >> i'll move approval. >> okay all in favor, say i. >> i. >> opposed? i failed to call for public comment which is common of my way of running my meetings okay any public comment on item the minutes of march 10 seeing none, the next item,

please. >> item 4 is general public comment. >> i have no comment cards i assume no comments moving on to item 5. >> item 5 is communications. >> commissioners any comments seeing none, moving on to item 6 other commission business. >> i am now going to take the next item out of order moving to the cac report thank you very much for being here. >> thank you thank you for commenting a little bit earlier on a buzz

workday our report the citizens advisory committee is growing and changing recently our vice chair stepped up to the plate down and rebecca lee appointed by sxhoud is elected to take her place as vp we conducted a survey by our members i talked about the diversity and we've provided that data where our collective strength and arguable diversities and educational diversity we have for our priorities 2015 we had a general manager update and talked about the survey and set up the priorities last month we talked about our treasure island plan had people coming from treasure island there's a lot of

interest in taking action we'll be talking about emergency preparedness as well as trying to do more around the vial update and more training for the cac members it is that constantly changing and members that have not bend from the program last year i'll be working with members of the cac and staff to make sure we're meaningful and you productive we will try to build a broad program for most of the issues and try to impact a few key areas combrrp our staff and strengthening the relationship with the southeast authority commission and through the training and tours i want to

raise the 1r0ish8 with the citizens advisory committee by co-sponsoring more events we responded with the utility commission and hopefully have our commissioners come and we'd love to see you there our meeting is a joint meeting between the cac and the southeast committee meeting on april 8th but we'll continue with our regular scheduled. >> next meeting is april 8th and we'll be meeting with the southeast utility commission. >> what time. >> i believe that's at 6 o'clock. >> and it will be a community benefit update that effects the cac and the commission. >> and at the southeast.

>> yes. >> and okay. your next scheduled meeting. >> the next scheduled meeting are the 13th day in may. >> well, i wanted to thank you for the insert in our agenda with pictures i like pictures. >> yes. >> also exactly who is on what district we lose track of that. >> we have people moving out all the time and new members coming in so - >> exactly right good. >> any questions or comments. >> thank you so much. >> thank you. >> next item, please. >> would you like public comment on that. >> (laughter).

you know maybe i should be fined like $10 all the time no, no, no >> okay public comment? i want to mention to not that i don't want to hear public comment i forget about it afterward >> all right. next item please. next item 7 report of the general manager. >> so the first item like to address the drought and since we've had a little bit of rain steve richie decided to give the report. >> i can take credit for .28 inches at hetch hetchy over the last 2 hours can i have the slides please we know where we're at at the drought a number

of slides are the same slide and format as far as shortage hetch hetchy is 55 percent of capacity we've backed up water into hetch hetchy to preserve it for drinking water we don't need the snow metal that's not much we're in a good position on drinking water and the water is before $250,000 acre feet so the coming year we expect to be able to use water bank as far as there is run off to trade off to get water into hetch hetchy reservoir our total storage would be on the order of a million acre feet and the water bank is down to its full capacity of seven hundred plus

feet the precipitation the red line represents 2015 matched up with last year's precipitation a good thing as hetch hetchy it relative last year was a banner year the concerning slide is the snowpack slide where you see the red line that represents this year the snow pack is continuing to go down since december it is now well below where it was last year at this time so the snow surveys are not showing very much up country at all the that is of great concern and got everyone upset most people in the state are in the same situation we're in warlt available to the city we have 50 thousand acre feet that gives us more than last year but

because of the snow pack we don't expect that number to get bigger unless late snow we might see that out there you never know for sure all indications things will stay dry for potentially the rest of this fiscal year we need to be presented for that. >> just flashing through the precipitation around the country we're at 13.75 each month is not good except for that december it is on the medium and the local front a big december not very much precipitation so running about 18 inches total the interesting effect of this you've got the stream flow from 0 alameda cocaine is running nicely from the hillside from the december rains

so it is an odd pattern those conditions are this year. >> this is our total deliveries and last week our demand was up again, it the city below 2014 that is acceptable but we're at the point we're starting to work and establish a campaign building off the last drought campaign as we ramp up towards summer get the word out that people have to continue conserving we're in a deep drought the worst drought and make sure that message is loud and clear our total water sooifgz we are ahead of the curve this time last year we shall trailing that's good news the line is