nursing department i was here last year at this time and wanted to focus on staff retention we have an issue with retainting the nurses at san francisco general i went apartment at the general and would have gone to another .6 position but i started working at ucsf who professes to have staff retention they offer staff 6 positions i get paid $12 an hour more and work less and on a daily gas at ucsf it will come up every once to two weeks they'll be short staffing their staffing model is filed and makes a tremendous difference to the workload and the stress

i think a second part beyond offering a track to experienced nurses allows them to work at general and not get burnt-out to support find mettle to san francisco general more and our department has 40 beds in motorbike and children's e.r. has hundred and 8 beds they work with the same size with the ed management team with hiring one additional swing manager i very much think we need to hire additional management beyond the emergency department there is this energy staff in the night shift. >> thank you before we continue i'll read a few more cards

(calling names) please come forward and mary looks like - (calling names). >> yes good afternoon, supervisors i'm gloria pc organization at laguna honda hospital and i'm sure we can agree that low staffing levels is dangerous to taking care of people that as a hospital that have their lives in our handicaps we have to have adequate staffing i want to touch on something about staffing that is the disparity in the deficiency and staffing to have different ethnic groups in staff we did a by charts a few years ago one race was 80 percent and temple percent of the other race and the other 10 what's her name p percent was

the other ethic groups we have a terribly disparity ii want to see more staffing in the african-american and the latinos thank you >> thank you. >> thank you. next speaker, please. >> >> hello supervisors the evidence is clear and the conclusion is indid you believe the appropriate staffing level has positive outcomes they have increased patient safety and better patient outcomes and reduce the staff turnover and you increase the patient satisfaction the fejz effects are profound they're more cost effective than hospital procedures like cancer screening or strokes or heart attack the downsize of staffing miss opportunities miss revenue and money throwing out thrown out of the city and county one is the

lass lack i have staffing with the contracts this is a snapshot last week there are 25 contracting folks from the department of public health a few of the services we don't provide but services we could provide the answer to supervisor avalos question about the registry two of the proposals are for $37 million for registry use it is where you hire someone and pay a high overhead there are other proposals that are missed revenue opportunities we're trying to get the departments to help and dph goes - for example, the police department has a kr5k proposal to draw blood for patient so what we're heard the department say they're making progress we've seen the progress they say they're in place by the spring

of 2016 let's look at the hiring and the use of registry and the permanent versus temporary and the use of contracting ousted and looking what we are doing. >> there were a few cards that were around seniors for disabilities but i think for the next item i give them to the clerk i have two more cards thank you. >> good afternoon. thank you supervisors my name is sally a staff member of sciu i want to say that resolving the vacancy problems in comprehensively is so critical for being a provider of choice i want to step back and look at the larger picture

who core business imprefrdz increasing the patient and securing the management contract toful enrollment enclosing through covered california you have r.n.'s and patient care assistants that have the longest hiring time the patient care assistance that 2 hundred and 85 days and rosa parks is hundred and e 9 days there's been progress in restructuring but larry bradshaw my previous speaker presenter is right when we have to monitor this very, very closely sciu is doing everybody to partner with the hospital systems with the california association of public hospitals and with the state to secure a waiver renewable thousands of dollars for

hospital assistants and support system transformation from a last resolve to partner of first choice it is stealing difficult and not impossible for the dph to have the system transformation without getting this hiring problem resolved as quickly as possible it is cost effectiveness and patient experience and patient retention thank you. >> thank you very much. next speaker. and good afternoon. i'm bob ivy a registered nursed at san francisco general and this is for thirty years when we were bargaining we agreed to staffing in the emergency department has part of bargaining we those levels of staffing for the

present hospital have not been met ron has the numbers we are that promised 99 nurses and i believe i believe we're 18 percent under that prior to the opening of the new hospital this lean identified additional 29 positions in the hospital to do the work of the expanded emergency department it is did the to see the hire despite the efforts in bringing - we need to recruit and train and keep them i'll always said nursing no san francisco general is having a leaky bucket we hire 5 and losses two they go down to pro tem i'm asking to have is a

common sense attitude towards the recruitment and retention most notably endorsing the possibilities of incentives we day of away in our last bargaining based on the city when turned out to be false and exploring the hiring people that can come in to the dayshift with experienced nurses it is hard to get a experienced nurse to commit to 99.9 nights thank you. >> thank you very much. >> thank you. next speaker, please. >> supervisors aim rebecca i'm a puc nurse and the labor co-chair to the monitoring committee for the county the last update i got on vacancy was received by e-mail only one manager showed

up to the monitoring meeting required about the the mou i'm struggling with the function of that but the manager did real we have a problem with puc and 5 vacancies 3 vacancies in nurses family partnership and foster care nurses and in my 15 years i've not seen the vacancies in the public health there will be an exam it is imminent i've heard that for over a year the late update they have a newly hired person working on the exam but for the maternal child to deal with this a hire per diem nurses there will be moving to full-time employees now they're

hiring per diem public health nurses and they've not done that we need a commitment to convert few positions to permanent civil services i can't agree with the rosy pictures of the - that the city is painting. >> good afternoon supervisors i'm mary i'm from the laguna honda hospital launched supports the initiative to expedite the hire process we're ourselves somewhat increased the time to orientation while we continue to decrease and improve this we hired hundred and 1414 nurses and in part this is due to more efficient fingerprinting and this medical check italy up as well as using the technology to

have more control with the applications and hiring. >> thank you. >> thank you. next speaker, please >> good afternoon, supervisors 2011 a grant i'm with sciu 10 to one and represent the b h c i'm here to speak about the b h y and the fact that the b's h c is understaffed for years and operates on a skeleton crew to the point when anyone calls in sick or on leave or goes on vacation the quality of life care is impacted when employees call in sick or go on leave the staffing level is not staffed due to lower staffing not only it patient care effected but the staff to patient ratios are a not balanced and staff is put at

risk and assaulted by some piesht that's that's not addressed by the ph c but the union is hopefully that the aau new leadership are address those issues this issue want be resolved without a doubt more funding for ftes at the b h c and for that reason the staff of the b h c and ruin union are recommend that 3 mental health workers and team leaders and one social worker be added if true quality of care is important and to dph and you supervisors thank you for your time. >> thank you. >> thank you. next speaker, please. >> good afternoon, supervisors my name is ralph i'm here with the senior program those are

disabilities and my thing is right now issues about affordable housing and the elevators that need repair thing is you know a lot of seniors out here in the sro's and inferred with blood and things like that. >> i want to pause you, your speaking on the hearing following this one so the subject matter your ref to will be part of the next hearing i know it's been a little bit of a water but the next item that is called before us so if you could wait a little bit longer you. >> thank you. >> thank you. next speaker, please. >> and anyone else that wants to comment on staffing levels in the department of public health can please come forward thank you. >> good afternoon, supervisors and thank you very much for giving me a moment i'm ms. chapman a senior analyst at san francisco general i hire the

r.n.'s for the hospital i process they're hiring i have ombudsman with the city over a year i came in january of 2014 and when i start i was told by the people that trained me that it was fine for a hire pact to sit three or four months on the desk to wait for the management and that it was in the usual it took my hire over a year but i'm now in the department that does this and everything has changed everything has changed in our department through the work of the lean processes also the work of our new manager karen hill has been outstanding and brought our team together and participated proufrl or powerful with the hospital with administration and nursing administration and the nursing manager on the ground that's where it is happening and that's why we're out there hyphen and

no one has more concern especially the r.n.'s than i do i'll mention that the other job classes are equally being aggressively pursued pc and putting them not hiring process and very rapidly hire all those job classes to support everyone at the hospital. >> thank you any public comment on this item? so we'll public comment is closed. and department ofpublicity thank you, everyone for coming and speaking and more importantlyly want to thank them for their work and enduring the conditions of vacancies and under staffing that's gone on in the department

and how long it took to get hired it has taken up to a year it is a significant rate but the service you're providing for the city is very, very important and might have seen to people in san francisco so the questions i have are that came up that were important to address if you do so quickly we have other hearings was that makes sure we can just an upon the miscellaneous clarifications how to plan and summarize in terms of the expediting the clarifications i know on page 9 you have a summary of that a reduction but i'll i've if you reiterate that that would be great. >> should i go ahead and sincere that food service we staffed them up a contractor in there about a month ago they're gone and staffed by our employees

other clarifications are pc organization the patient care stamp is we're on track to hire the miscellaneous and some of the clarifications we've recently done a lot of hires so we're capturing fast. >> right what is important to san franciscans as well as the workforce is make sure we're hire people with diversity and meeting the diversity and language goals as well so is there a special effort. >> we have an initiative called the madam chair african-american hamming tennessee ton committee we've looked the giving me demographics and the demographics of our unit and developing plans to work with the managers to start the increased specific areas of diversity in the clarifications that's an initiative we're excited about. >> any relationship with the

training like the city college trying to create a pathway as well. >> a lot of 9 commendation is pathway how to get into the jobs weeping we'll be working on that as well. >> the last question opening to the new hospital and one of the persons that spoke mentioned there was a recommendation about 25 percent hiring increase to prevent a metal down at the hospital what is happening to prevent that meltdown. >> in los angeles. >> we have a schedule for hire it is bans the budget and based on the needs of hospital and we're hiring every month towards those targets i don't think we're going to have a problem opening and hire in the hospital wife added those into the picture they're in in the pool we're hiring we're on track and we'll be fine in opening the

new hospitals in terms of the leans h.r. did 5 lean event and maybe 27 lean events that is a different lean event in the emergency so i can't speak on that. >> thank you, mr. wagner and we'll wrap up. >> i'll add supervisor we'll be continuously evaluate as we get into the new building with motion and staffing studies for the workload that's part of our continuous evaluation. >> i'll appreciate that my office be appraised how things are moving along thank you very much so i want to thank my colleagues and sitting in on the hearing folks from dph and h.r. and the public it sound like one way or another we're on a good pathway but one i want to make sure we

monitor to have the new hospital happen seemingly and be a provider in the affordable health care act so thank you, everyone for pulling together and at times we're apart by the way, back together thank you. >> thank you supervisor avalos (clapping.) so colleagues with that being conducted i'd like to entertain a motion to file item one ash motion by supervisor mar and seconded by supervisor tang without objection. >> all right. call item 2. >> hearing open the state of the city's homeless services and safety net surveys and the home agency and the did you want and the mayors to report. >> thank you madam clerk. >> i'd like to ask for those members that are leaving the

champ to keep it quiet so we can continue to conduct business thank you very much so colleagues the hearing around homeless and safety net services continues with the string of issue based hearing into the cold war budget season so as we've had one open public safety and neighborhood affordability and quality of life issues i wanted to make sure we address those that are the most vulnerable in the city and talking to the city in working on the issues i want to thank all the agencies and let's gets started first up our h s a here to come speak mr. recognizing thank you for being here. >> members of the committee i'm the director we're loading our

presentation. >> great. >> thanks for holdings the issue based hearing around safety net and homelessness i'm going to present a dual presentation on the demographics and sort of what san francisco is looking at in terms of poverty and homelessness and sort of problematically what are we looking to do as an agency to address some of the data in the first slide and i have a few slides on poverty and the equally that's been in the news

nationally and statewide as well as locally and the mayor in his not only city address talked about the low employment rate and seeing if that reaches the adult the data suggests it is not h he proposed one initiative in next year's budget called 5 hundred i want to lay out some of the data you look at 2013 data over 55 thousand residents ross are not households recipe that are below 50 percent of poverty level it is an example as a family of 3 is $10,000 a year those are single adults and households that are poor in san francisco if you look at those families

excuse me. persons individuals that are blow hundred percent poverty 55 thousand below 50 is another 60 thours thousand or so 50 and hundred percent federal poverty given our standard of living it is still extremely poor in san francisco we look at in terms of designing our programs interventions 2 hundred percent of poverty is for a family of 3 is $4,000 a year we have over a quarter of a million individuals that are below poverty in san francisco if you look at income distribution and the income gap from 2010 what you find is quite telling graphic in front you have 3 bars

by in case the black is 190 and the gray and $2,010 your comparing apples to apples most notably significant growth in the number of households making $200,000 a year or anymore and addition for the whole sector of hundred thousand dollars a year has grown significantly since 1990 those are are 201010 numbers but the trend remains another point to look at that group between $25,000 a year and hundred thousand dollars a year we can define as the middle-income is shrinking we know most notably those households earning less than $25,000 a year and it has been

since 1990 what story does that tell the middle-income and the upper income households and the growth of low income hourlt that's what we are looking to address with pursuit 5 hundred and the departments notably the did you want what are we talking about we've laid out a number of dollars amounts you can look at and get a sense of where families lie. >> through the chair i want to ask a question for that slide our look at the past household distribution you high-minded that the growth of the extremely low income poverty level has increased significantly and is almost 75 thousand people so

it's the lowest income increases and the highest from hundred $75,000 to $200,000 and the highest one household above $200,000 is increasing 0 so did wealth gap is widening between the poorest and the wealthiest in - >> yeah. this is not wealth disconnection but significant when you say 75 thousand households in san francisco so the earning is below 75 that curb is widening and getting deeper so the aquarians to u one day and the wealth gap in san francisco like countries like u wander we're seeing that in family income mentioned how we

determine poverty and s h a you might look at 2 hundred percentage but families only earning $40,000 a year how can they pay their rents given the represented are going up. >> that's a great segue. >> my last want there are different nonprofits and justice organizations looking at powerful indicators and i know that dcyf uses the in sighted. >> the community development and an elderly index do we factor in a lot of things like the basic economic. >> we do and again that is kind of the next slide i want to rely to you. >> so there are 6 bars on here and really does get at the

self-sufficiency standard i mentioned the poverty level a lot of the plans are tied to those sf government and the state but hundred percent of poverty 2 hundred percent poverty your struggling to make end meet in san francisco as a city towards the self-sufficiency as our ultimate goal the hass has stayed out at the 2 hundred percent poverty level and things lying subsidized employment or unsubsidized tax credits those are opportunities to get the families to the next income where you know this is families on public assistance and getting food stamps a family of 3 is getting $14,000 a year in