6 techs we trained they left they're making a couple of dollars less and they just graduated we have lots of proximate causes in the staffing and equipment working equipment the patient you know we don't have the resources to give the exact chair that the places are giving we're competing this is not a competition we're going to win. >> thank you>> thank you. next speaker, please. >> good afternoon. i'm terry representative of sciu i'm new to the bay area and starting representing folks in the last few months i'm impressed with the city. >> what you have going as much as i'm impressed i have to say at the 60 or so clinics i'm

decimated what i'm seeing we want to address that although the issues are started throughout the 60 or 70 locations two examples right here in the neighborhood that is at golden gate that was a vacancy of three to four eligibility workers and rather than getting those filled there were two eligibility workers at b 7 ivy rather than filling the vacancies at golden gate they'll take one of those eligibility workers from 50 ivy and move them to golden gate to left leg the load, however, it left one person at ivy and backed up things and in addition it created another problem the person they took away from ivy

was the spanish speaking person now these folks disfranchised that needs someone to interpret i think that needs to be address in addition speaking to those clinics we have an issue as far as security and if i can go past my for a minute. >> sorry your. >> if you could wrap up i should have done it but finish our thoughts. >> the shortage is of not having the armed folks guarding the folks is putting stress on the folks working there as a result thank you. >> thank you. >> good afternoon, supervisors my name is ride share a registered nurse at san

francisco general i work in the critical care department for over seven years and i can say that i'm proud to be a nurse another san francisco general i enjoy my job and the people i work with but ever since i've worked there staffing and hiring has been a concern especially in terms of safety patient and staff safety making sure we have applicable people to turn to feed people and give the proper care you know a lot of times we push our staff ratios to the brink when patient numbers if you can wait and patients are sick we need bodies on the floor to help us to do the job safety i safely and getting give good patient care with outcomes i want to say as a shop std

across the table i appreciate the efforts of supervisors and city h.r. to be more transparent in the hiring process and encourage them to upcoming continue to you know expedite hire for nurses and other ancillary staff and miscellaneous numbers in the department we have people that turn patients safely and get them out of bed and help the nurses to help the patient outcomes and physicians on that in those staff positions unfilled at that time that is problematic and as of a former ucsf back injury i'll encourage them to push those positions forward thank you.

>> thank you very much>> thank you. next speaker, please. >> so people that watch i believe the count down clock with red numbers make sure you follow that there will be one thirty seconds i'll hear a tun and thirty seconds left for your time. >> hi i want to address the board of supervisors and the directors and thank you for making this hearing possible and i'm here to talk about what was already said incidentally you can't pronounce my name i'm a member of the team and i want to address the seriousness of having separate and additional funding for emergency medication this was not taken seriously i

want to talk about the seriousness of that that as a trauma center we need more emergency medication that is has to be ready i work night and sometimes we have to call everywhere stanford ucla and medications have to come from somewhere so that was why i indicated we need at least separate funding for medication and then we also need staffing i work with the department and especially the 2450s and 09 to take care of the critical shifts the iv and narcotics we need your help so thanks very much. >> thank you. >> thank you. next speaker, please good afternoon

supervisors my name is kearney stand before you today first to say thank you, thank you for this hearing and thank you to d h.r. to recognize the need of the department of public health and practices trying to hire and what was wrong with the process it was taking so long in a city that leads in striving for excellence and providing for excellence why not in our department of public health have that same excellence i'm glad to know that the problem was identified in how long it takes people to get hired and now move to the next step we fill the vacancies that have not been filed we have placed with our nurses and ancillary staff that truly need it's a team we work as a result team when we are

missing eligibility workers or food service workers and environmental services workers the team is broken we want to make sure the whole team a complete that is step one but we need to move further and thank you to you to help us get to step two thank you team. >> good afternoon, supervisors i'm jason a nurse in the emergency department and san francisco general i want to remind people in 2008 with the law hospital moved into their facility the staff forced the closure of department and san francisco general we're walking into the same situation i had the privilege of being a part of lean process that ron spoke to with the right staffing

model and the permanent staff on hand we met last november to staff the emergency department that will be thirty percent more beds when this enter disciplinary team with the medicine director and the emergency department evaluated we concluded we needed 25 more percent of staff to cover the beds no commitment to any of the hiring in the last of months what do you mean it will mean a rupture to the time of issues in the current department we were thirty percent vacant and our new state of the art fat will leave us less able to help folks

this is not under scoring the medicine assistants or anyone live he will why are the ceo and the mayor unresponsive to this committee and why not meeting the new staffing in the facility when we run into enclosures god for bid the safety issues who is held accountable for that (clapping.) good afternoon my name is pete i'm a nurse n at san francisco general for 5 years i've been impressed at the rate by which we've been hiring in the 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