not least, because it is a hearing, we will just go back to the board for a revised approval? >> and every once in a while, a motion or a resolution, can be generated in the committee, and that is what this is, and so this is a hearing out of this hearing, the committee will generate a motion, which you will send to the full board for its consideration. >> okay. >> and supervisor christensen? can you please repeat what you are requesting so that i can make sure that i am on the same page. >> so we have -- recommendations, from the grand jury, and one concerning the amending of the building code and one concerning the creation of a local working group. and my motion is that since both of those recommendations are being met, under currently existing programs, that we not implement the recommendations by the grand jury and it will

allow the other programs to accomplish the tasks that they have outlined. and i got you, thank you. >> any other questions, okay, seeing none, this will be a motion made, and is there any objection? >> okay >> with no objection, the motion is passed. >> thank you. >> could you call items 2 through 6? >> a closed session, before we convene to closed session, is

there a member of the public that wish to speak on items two to six? >> seeing none, public comment is now closed. and colleagues, is there a motion to convene in closed session? >> so moved. >> second. >> it is passed and now we will >> deputy city attorney, job gibner, during the closed session the committee voted to forward item 2 through 6 to the full board with positive recommendations. >> and colleagues, could i have a motion to not disclose what happened in closed session. >> so moved. >> sir? >> okay, with no objection, the motion passes, and madam clerk, is there anything else on the agenda. >> there is no further business. >> okay. >> if there is nothing further, this meeting is adjourned..

>> good afternoon, everybody welcome to the san francisco budget & finance committee for wednesday, may 13, 2015, i want to thank the members of sfgovtv jonathan and jim smith mime mark farrell i'll be chairing this committee i'm joined by supervisor kim and supervisor

yee and commissioner eric mar and supervisor avalos i want to thank clerk linda wong madam clerk, any announcements? questions madam chair questions madam chair please be advised the ringing of and use of cell phones, pagers and similar sound-producing electronic devices are prohibited at this meeting. are prohibited at this meeting. use of a cell phone, pager, or other similar sound-producing electronic devices. item one the staffing levels avoidance at the san francisco general in relationship to the affordable health care act and the opening of san francisco general and requesting the duplicate to report. >> thank you madam clerk supervisor avalos. >> thank you supervisor farrell and colleagues for hearing this having this hearing in the biscuit thank you to the members

of the public and the department of public health and the human services department to put together the presentation this hearing is kind of like the second part of a hearing i'll called last year about the cannabis conditions of san francisco general and the concerns the length of time to hire people especially nurses within the department of public health over at the judgemental hospital we want to get a progress report how things have moved tin last year last june a plan that was shared going to reduce the time it took to bring nurses on to work in the department of public health especially the san francisco general but we have to make sure that we're prechg the work necessary to open the new hospital and be on track with the hiring with the new hospital

making sure they bring the maximum benefit that we would have a with the affordable health care being implemented here in san francisco i wanted to thank barbara hale the did you want director for her work preparing for this hearing i did a little bit work i actually went a second time last year, i not to the san francisco general and this year to the san francisco general and got a sense of the concern from the workers and various rapid quick half an hour but to the emergency department and some of the clinics adjacent to rad metrological and went into the cafe as well and overwhelming a concern that the staffing levels were not where we were and people are maxed out doing

student work that the clarifications were doing having an impact on the stress levels of the work but also on the level of care the quality of care as a city and department of public health we want to make sure we can be as strong face to face we can especially, when they are opening up the new premium general hospital call up barbara hale and share with us the presentation and i think there is going to be 3 parts. >> 2 parts. >> so thank you supervisor avalos to you directly thank you very much for keeping track of us and marshall we came back with accountability and thank you to the president and the vice chair and all the supervisors i'm pleased to be here and present the departments

health care reform is part of the deliver system and the hiring f that we've made to provide the best possible patient care to san franciscans today is a joint font the unions i've been meeting with the unions they've worked with us closely we heard them and trying to respond the best we can to improve our process for hiring the health department is helping with the necessary hiring improvements to serve our patient in our san francisco health network one year ago we laid out hiring process and taken the steps in insuring results in debt in today's presentation i'll talk about the ac a and our human resources

decoration and dph representative. >> director garcia before you start i was in some confusion perhaps where the dups is a current affordable health care act provided and one is medi-cal expansion there is our largest footprint and the other coverage california for the last two years that'stions program through the public california and for the last two years we've benefit in negotiation providers in san francisco the chinese community heartbeat plan we've been in negotiations to provide for a contract we're still in negotiation the target population is about three to

four thousand but medicaid it the largest population we have enrolled over hocking thousand individuals. >> for medicaid. >> ac a is the law of the land you have the medicaid and insurance expansion and covered california is an component of that. >> accident framework to become. >> within the next couple of months we're no negotiations now for the first negotiation had to tend end because of the enrollment time and started up to have a completion of the negotiations. >> great 3 parts to the ac a the medicaid and cover california all and, of course our own healthy san francisco to note that many communities around the country and the biggest health systems and los angeles is work the past

leadership to begin another healthy la so to speak but we have almost 18 thousand people in the healthy san francisco for those who don't qualify for the ac a and left that open for the individuals in san francisco to be able to afford the covered california. >> in colonel 4 million people enrolled a 50 percent reduction in california and in san francisco we did an enforcement effort with human services agency doing enrollment efforts in san francisco we saw over 54 percent reduction in insured 41 enrolled in covered cool and others in medi-cal and healthy

san francisco was a universal health care system and we had a runway for healthy san francisco we were able to get people into healthy medical holmes and we transitions over many to meld and that meant they automatically were enrolled with a special program called sf path a reduction of 50 percent that of natural because most people got enrolled in medi-cal and covered cal california. >> as you can see the enrollment over the last 2 years we've reorganized and spoke about this we've created the san francisco network n that networked is the combination of reorganizing our thousands being a stronger system of care and it is funded structure and during

the first year of the implementation we enrolled increased the number of managed medi-cal patients within the system all the systems also in our community were part of healthy san francisco and were part of ac a we've expanded to over 29 thousand almost thirty thousand as of january with medi-cal partied and also we're targeting for the potential eligible in our program right now to 4 thousand patients for immortal once we get the contract to look at the target population is our medi-cal population and it is higher telethon the natural transition for many of the san francisco patients. >> so we've actually, if i look at this chart a correlation for

people that 2k3ishd enrollment healthy san francisco more people are in healthy san francisco. >> prior to ac a with the new changes for single individuals in protect we are on medi-cal you had to be disabled or more woman that had children. >> thank you. >> so health reform readiness is an important of the strategic investment last year as you recall to bring us to into balanced budget we've provided a large amount of dollars 0 for the access under the affordable care act to reduce the use of hospitalizations and part of our goal to really decrease the

waste time for primary care and down the avenue we're ready to open within the next year a new san francisco general and part of our key priorities for us is our investment in information technology this is going to be a chief process you'll hear about in this year's budget in terms of how to implement our electronic health record present prosecute or presently we have electronic records and make sure that our care and quality are increased. >> kind of a guiding principle if we are looking at those 30 components that are part of overall approach covered california and healthy san francisco and medi-cal. >> uh-huh. >> a person that is a patient or a client anyone of those

areas are they going to experience the exact level of care and benefits how does that work. >> we have a standardized level of care you'll be treated in the same manner the benefit for us may be different but for the patient they don't have a tier system of care depending on the revenue. >> thank you. >> so hiring for us really needs to focus on the top priorities to meet our patient care goals as well as our financial we've had the significant growth in the positions in fiscal year 2018 and 2015-2016 budget as you can see we are hiring to fill a large number of new positions in addition to the agency that requires capacity the process improvements we're looking for a total of 2 year budget to

increase the san francisco general number of vacancies hundred 50 and primary care about 29 this didn't include the rest of the department we have over 8 thousand in the department we have attrition a type of of the vacancy we have and the position which require a different approach to our hiring you'll hear hear about that in the process as we see improve including the fact our human resources we've doubted their staffing to make sure we meet the ongoing need so the infrastructure had to be approached in the hiring issue. >> i'll leave it there for our human resources department ron to really respond to detailed our goals from the 2014 budget

but any additional questions if you like to i couldn't i'll be happy to. >> thank you for presentation thank you. >> thank you. >> good afternoon. i'm ron the human resources director for publicity i was here a year ago and gave a presentation similar to this i want to let you know we've followed up on items to better track our hire and supervisors are informed and monitor the process we implemented 5 event one in audubon society august of 2014 and that was at that time, we find the nurses hiring was average hundred and 93 days and we wanted to knock that down our goal to reduce