of the bridge activities i want to see from the public health division to the network so that dr. phil ips expertise and knowledge can be provided to the network. i know there is a commitment to make that happen. >> thank you, i had several comments. and thank you for the report. sadly, the report from the last time as you have already noted is not any better over the past year. and i think most of the comments here are really appropriate for what we need to do. i'm first struck by the fact that i can't get my handle on where the real problems are. first i don't know if we take other men and females in your reports as to whether that's also a problem. is it too high, too

low on a national bases or on a state bases so i can get that out of my mind and consider that that's sort of normal std management and there is a level that we will always have and therefore i can ignore it and maybe i can't ignore it. i can't tell from the data. this lack of aggregation and the data that you are presenting and i'm sure that you do have it. also doesn't allow whether to focus on, in chlamydia was it in, let's say the african american population for the sake of argument versus an older group of hiv or lesser. in other words i think we are not understanding the targets as well. and i think that goes to some of the public comment maybe some of our campaigns or not hitting the right people for the right disorders.

but it's hard to tell from the way that the data is aggregated now because then when we get to the african american slide, it's just a lump of std's and i don't know if it's actually perhaps chlamydia is a higher problem or it's within youth and we know that we are talking about it. but within youth is it gonorrhea or syphilis. we need to be more focused. i think it's important to be more positive about this and also to show that it seems that in your interest -- interview process that we think we can solve things quickly and if syphilis undetected until too late can create problems. that's not

to scare people. it's not demonizing them but giving them information to understand what are the potential consequences if you may have contracted it and it's gone on too long. that hits a certain population as versus say a younger population that says, you know, is this good for you, is this not and is this healthy or isn't? the disappointment, the challenge is that over these last several years we have been seeing the same and increasing levels. i'm not sure what our targets are here and what we should be trying to reach. so i can't tell how far away we are getting from where we are going and is it within which groups the things are and which programs

we are targeting and maybe we are not focusing well enough. but that's hard to believe because i think you've had these demographics for several years. so an approach needs to somehow change. so you've said that yes, you are looking at that and we are looking 5-10 years out for a result. i actually think that's too long. on the public health level and public health campaign we should know how to hone down burt -- better and know the targets. to come in with a 5-10-year plan to say the next level of commissioners will need to hear the results, nor do i think that's fair to the public. these are infectious diseases that i think we owe to the public to try to do

our best to inform them what needs to be done and how they need to act to be careful. i don't see the targets that we want to do and i think that's what we are missing is exactly where are we going to be going and if you think it takes 5 years, let's say. it's really out of line in my mind in terms of public health issue, then it isn't that we don't want to put that down because we might not be successful. we have to give ourselves a chance to know where our targets are because if we don't have that and we keep saying, okay, i'm going out to this population and i want those numbers down, at least we know where your targets are. do we have some targets in mind already , or are we going to figure out where

those targets are? >> you need to know where the targets will be? >> yes. are we the no. 1 county at this level for the state? >> for std's? >> yes. >> per population? >> that's not good. >> we are second to los angeles who has a larger. >> second to los angeles. that's not good. that's one that we don't want to be second. we don't want to be one or two. that's what i mean. where are you envisioning where we need to go and with each population where are we trying to get to so we break these down a little bit more to get these numbers and watch the rates keep going up. does some of that make sense? >> it does make sense and these are challenges that are happening in california and united states. this is not isolated to san francisco and there

are multiple approaches needed within san francisco and elsewhere. i think that's well-taken. we have all this data broken down in all the ways you can possibly ask for a the limit of a 15-minute presentation and we can get you all that data and formulate something more specific. >> it's i think we need to monitor this more and not just have a yearly report and we need to see your progress and the targets made towards it. can we get to no. 5 or 10. i know we have a very large population that is susceptible to this. we need some targets and we need to know what would therefore be potential success and we need to then understand whether we have met

them or what other resources we need to try to reach them. >> commissioner chung? >> i think commissioner chung made a good point that and this is where i am where i look at this if we look at los angeles, if we look at san francisco, we are probably some of the most liberal progressive cities in the country where you know like you know like majority of the time communities have quite positive and they are very comfortable in talking about sexual behaviors and that kind of topic. if we are positive and so safe as a city and we are still dealing with these kinds of rising rates of std's, something is missing. i totally agree with

that and it actually might not just be a regular intervention. it might be something deeper and i see that this is where i'm really curious how much have we done around from the social medicine standpoint, you know what other social determinance that contributes to that. you know like i think that's what drove the hiv epidemic many years ago because of the stigma, discrimination, homophobia and the lack of political will to really provide the support it needs. here is a chance for to us change it and i think that's what i'm hearing. dr. chow is saying, what are some of the other angles we can look at this so we can really make a dent. >> commissioner singer? >> i wanted to follow up

thematically a point to what mr. chow is saying. if you look at hiv transmission and you make as an example of a needle exchange and you look at other places in the country that have for their own political issues have had a very hard time adopting those policies. to me there is a lesson in that for this which is that in those communities there are people who are trying to get those policies adopted and the reason they are is because they looked at compare tive data and the transmission of hiv are worse in other cities. who does it better? and they see our examples. so i think we ought to have much more of an ingrained

religious approach when we see our own performance to being very transparent about hey, sure where we are not good versus other people. what are they doing that we are not doing because it's an incredible tool to motivate everyone to understand where there is the challenge and solutions. when we don't show that data and put things into context, we are missing a huge opportunity to get the community behind your efforts. i think in this and everything else we ought to have a sense of who is doing it better than us and what can we learn from them. >> let me ask the director, when would be a reasonable timeframe to have the community and public health continued follow up on this topic so we don't have to wait a year to hear this again? >> i think in six 6 months we can do an

update of where we are and the kinds of issues and i want to acknowledge all the commissioners comments on this. we know how to educate people in this city and we want to work with young people on that area as well an that's where i am concerned with teenage pregnancy. sexual health is important to talk about but we also have to be safe about this in the community. we are looking like we are doing a lot better. i think we can do better. if we are doing the same thing and it's not changing then we have to do something else . i think she's embraced that as well. we are moving the clinic to the hospital. we've been in this field for

many many years we should be doing things and shifting it up to reach out to the communities. have a positive issue and positive direction of sexual health and build a responsibility towards each other and says a lot about the young community who are interacting with each other and working with the adolescent programs and get out of the medical fields and get into the social field and including the violence prevention programs and there are ways for us to spread the information and education and we need to do things differential than thinking we are going to find everybody in a clinic. i think the std clinic has been really on their own before this. as i said we've hat beautiful silos and they have not been asked or welcomed into some of the other dynamic prament -- programs that we have and it is my job and dr. aragon's job. i think that's

the direction you have given us and we'll take that to heart and come up with some action plans as well as your request of increased data is important to really target our communities. thank you, dr. phil ips for all your work. >> yes, thank you dr. phil inps for your work. >> item 9. other business. >> we've added one or two more already. >> i have one thing that i talked to director garcia about briefly that i would like to request for a future agenda item. the department tends to be very data driven. so if you look for example at our discussions about the skilled nursing facility today. we have appropriately done a lot of

analysis on the demands for those services based on data and that data is mostly based on census data that it's aged. we are in a very awkward place in this city that we know for sure because of what's going on that the demographics of the city, it's probably a good question to say are they at a much different trajectory today. or for example the last time we did the survey about the aging in san francisco and what happens to the population because we are setting policies now that we are going to live with for many years to come in setting services. so it's kind of our responsibility to get when we know that this change has happened to get as precise a handle as we can although it will be unprecise. i know the

department has done some work on it and i think it would be worthwhile having the department present to us. here is what the census in 2010 said or here is what the data we are going off of says about different populations in the city and where they live, etc. here is what we are smelling given more recent data that we ought to keep in mind as we are making policy in the next few years until the 2020 census comes out because we no longer have this stable population trajectory that we had in 2010. >> do you have any? >> i'm very happy to try to look at that. i was even thinking real estate data as an example. i think we can find other sources and try to get as much on the ground data as possible. >> and i'm also thinking is there not an interim report from the census

department? >> there is and i will find out what that is. >> one of the things we can do is a presentation in terms of where our current demographics are within some sort of setting. yeah. >> i assume that the city because of tax rolls has some data. there is probably a lot of data we can look at for the interest. >> we can look at the control data for surveys of families for other issues that they have and look at that as much to scour the areas for as much data as we can. >> i think that's very good. up to date context. >> thank you, commissioners, any other topics we would like. i would remind you that we are looking at the planning session in october. we are hoping to get good overview of the population health department and we've already heard some of the interactions with our

delivery system are happening and we are hoping to explore. we saw that very complex boxes. they called what? >> sections. >> we are hoping to have a discussion of how many they are doing and interact with the delivery systems. is there other things that you would like to know from our public health division, let director garcia know so she can work that into the presentation she has or let mark know. >> next topic? public comment, sure. >> sorry, commissioner. i'm

asking for your indulgence, commissioner chow. >> i misread your agenda. i thought your meeting started at 5:00. i'm going to back to the laguna honda gift fund as a new topic if you can bear with me for a moment. >> you have your 3 minutes to make that comment. >> i'm reading my prepared testimony that i would like you to put in perspective as a new item. the city's allocation gift fund in 2010 included finding "laguna honda does not actively manage it's portfolio stock received as request as part of the gift fund" the controller wrote, "as these investments make-up approximately half of the gift

funds total assets there should be actively monitored by experienced personnel to ensure the best possible return is gain". the controller noted lhh should work with the city treasurer to actively manage gift funds and policies and procedures should be established for return or investment criteria along with reports to the health commission. 5 years following that audit l.a. chase wants to sell all of the stock. that is nearly $1.4 million as of last friday may 15. the stocks were gifts to endow the gift fund with an annual income stream. the $1.4 million should be reinvested, not converted to cash. if neither san francisco city treasurer nor

charles swab, an experienced personnel for gift fund you should find an experienced person to locate the stocks and they have been very poorly and passively managed. the health commission should explore only portion of the stock and explore other vehicles to keep generating annual returns on investments. alternatively this commission should amend your resolution with a result, clause, requiring that any cash from sale of the stocks return to the gift fund should be placed in a restricted subaccount for future reinvestment once stock market

conditions and corrections have stabilized. the done or of those gifts of this commission would actively manage the document to revenue in the futures. you have an ethical and fiduciary obligation to do so. i would hope you come back with a future agenda item and address this more properly instead of just selling them. >> thank you, sir. >> the next item 10. joint conference committee reports. >> the laguna honda joint commission met may 12. in open session reviewed and discussed the report and work safety program and dementia services presentations. the committee

approved the wide health policies and in closed session approved the committee credentials reported. >> thank you. any questions? if not we'll go to the next item? you didn't hand in a slip. thank you. we'll recognize you for 3 minutes. >> part of my shock involving the laguna honda gift fund stock sale. it was never discussed at the los l.a.jcc. why not? how does this stuff happen? commissioner chung, you got a clue. director garcia, have you

got a clue? there was supposed to be a funds management and i assume the director was aware of. that management committee appears not to be making quarterly or annual reports back to this committee on the performance of the gift fund investments as the city controller recommended when it slammed l.a. chase with an audit that ordered restitution of $350,000 which should have been higher that had been improperly diverted from patients

despicable. when i heard that i had been munching on that food with an employee when i found out she raided from the people. i was ashamed of taking a bite of that food. on a lighter note, garcia, i hope the award presentation tomorrow goes well. it was my pleasure to work on the poster board. they give me too much opportunity to have a little fun during the day. i hope you enjoy it. and i hope the ems that you serviced continues

it fight. >> thank you, sir. >> any further comments? i have not been given any other public comment request. >> okay. the next item is a committee agenda setting. >> we already spoke about the planning meeting for october. so that's the only announcement i have. if anybody else has any other, we've added items already. so, we'll proceed to the next item. >> i have not received any public comment request for this item. the next item is 12 sand that's a vote for adjournment. >> we'll prepare for a motion on adjournment. >> i will move that. >> i will second that. >> all in favor say, "aye". >> aye. >> any opposed? this meeting is adjourned. adjourn #1yur7b --

gov. the sound producing devices approval of the minutes important may 5. >> motion to approve > all in favor, say i. > i. > thank you communications directors i have no one introduction by board members of new business. >> item 7 director's report. >> good afternoon. director reiskin good afternoon mr. chair and members of the public a couple of things starting with ideally drive not this weekend but starting other than thursday may 27 ideally