hall. happy birthday, city hall. [ applause ] >> this year, san francisco's city hall is turn 100. you can join in the celebration by sharing your favorite city hall memories online. whether it's the day of the big game or that magical moment when you said i do. just post your favorite city hall memories with the hashtag sf city hall 100 and you can help to make this year's celebration one to remember. for more information visit sf city hall 100.com. >> okay, thank you. that ends our press conference. [ applause ]

z >> please come to order and secretary call the roll. >> make sure your microphones are purned on. >> pating >> present >> singer >> chow >> present >> chung >> present sanchez >> paren present. >> karshmer >> present. >> the meeting is june 2, 2015 we have one public comment. >> public comment please? >> good afternoon commissioner the minutes he lied too much of what transpyred of may 19th. item seven. page seven omits this commission

has had authority since 1988 to hold prop qharic. it began in 200719 years after prop two passed. as reported in this extract in my new article there is no motion of april 29th. memo documenting the loss of 200 hospital beds between 2002 and 2020 with old two prop two harings with a total of 150 beds how did you lose the other 136 sniff beds without public front q hearing santa monica the minutes under report d hp failed to provide needs analysis that you requested eight years ago

there is no mention of what turned out to be the secret city attorney advice to you gutting prop two by aborting issuing a single finding prop two requires you to issue. the minutes say nothing about the second and third resolve clauses rs and failed to report you have imposed a six month deadline to dph to provide you with eight year passed due sniff needs analysis there is no dph advice you april 29th quote any redugs for sf beds is in san francisco and likely to have a detrimental impact there is nothing about the sniff closure will be detrimental the analysis

warned you twice the minutes failed to warn you of the prop two all among for 27 years the very authority for you to consider community alternative tell us which appears you have never done despite it being clearly written 27 years ago in the voter guide. in your haste to convert prop two hearings to quote positive findings this commission has tramp led our democratic processies i will send to forward it to you. i hope you read every word of it. >> thank you commissioners the minutes are before us. and a motion for approval was in order. >> motion for approval is in order. >> is there a second?

is there a second? >> second >> i heard a second to the minutes. are there corrections to the minutes at this time? hearing none we're prepared for the vote. all those in favor, say, "aye." of may 19. >> >> (multiple voices): aye. >> >> all opposed? minuted approved. next item please >> the director's report >> good afternoon commission mers the mayor proposed his fiscal year for 15-16. creating an educated livable city our department's budget growth by $45.3 million many in 15-16 with a budget of $2.3 million with service epi-hansments and critical

safety net. you will get more from greg wagner our cfo but we're storing 8 million in the reduction this includes a 5% of costs over two years for nonprofits, we're creating 30 additional respite beds to accommodate the current needs of members with homeless with chronic medical conditions in our shelters to reduce to 0 hiv infections also for service enhancementses provides significant funding for technology and infrastructure. with the approval of the board of servers signed by the mayor ed lee.

to ba koe will not be used in san francisco. to prevent youth from a lifetime of nicotine addition. the health department will welcome the mayor's executive fellow in it's marketing effort the mayor's fellowship program is competitive to matches departments to seasoned professionals with more than ten years in the field we're looking forward to having this additional fellow in our network just to let you know the city has developed a process for donations also looking at equipment that is no longer usable in the city for donation and we have a department administrator chief sunka who is the lead on this if you have any -- to donate particularly, this

is due to the issue in nepal and we're trying to organize throughout the city how to get donations and equipment effectively. i will leave the directors report to that and leave for any questions for commissioners >> thank you before the questions we do have one public comment mr. monashaw >> thank you commissioner chow. i will make this under three minutes mr. morewitz. i'm really worried already about this marketing expert director garcia mrs. garcia >> yes i'm listening >> you remember that disastrous branding in laguna remember? they wanted to take out the word hospital. god help you if this marketing

expert tells you to take out the word general or san francisco or -- i don't know -- public health. you need to stop already with the rebranding. patients are either going to choose you for your service like win spauling or they're not. marketing is not going to help it. in fact mark zuckerberg should take his name off that facility. you should market it heavily as a trauma center not as a city guest to ability there.

>> thank you. commissioners questionses to the director on her report please? does anyone have -- i will start with one comment which is in regards to the oral health strategy health employees that the collaborative is going to different neighborhoods that was in china town now it's out in the mission i'm hoping that we will have a report back on what is happening. i forget we agendaed that last time we were >> yes, sir? i believe it was a year it would take that long for the activities of the plan to come to frition. is what the plan is >> at least we're getting the information out to our districts and i would suggest that because it is something that is actually in motion that we try to have a report back at least at the

public health committee within a half year >> yes commissioner we can do that as well in this budget there will be a coordinator for oral health for ncah addition from the mayor's office >> that is excellent it goes along with the number of initiatives we're actually able to look in and supporting our housing and nonprofits which i think we all can thank the mayor and we hope to thank the board when we get the final report on the budget. commission mers any other questions to the director at this point? if not we will move onto the next item please >> item four is general public comment and we have several >> yes we have two general public comments mr. manishaw is our first public commenters >> thank you again commissioner.

this commission should be completely ashamed of itself for trashing or democracy on may 195 of you voted to overturn the well of 129,000 voters who passed prop 720 years ago 1988 how this health commission in 1989 known about prop two the 26 years he served on this commission it was clear may 19th some of you never read prop two so you know what's required of you the handout you were given is an abstract from the 1988 voters guide to pose the question to the voters on their official ballot and legal prop two which requires you to find a single finding of proposed services will or will not end

quote have a detrimental effect rather than ruling on st. mary's closure will not be detrimental because it did x y or z you relied on a secret city attorney opinion exempting from issuing a single finding prop q authorizes you to fish you hiding behind secret city attorney and advice is obscene commissioner chow. it's passed through the ballot box not through you or the city attorney if you want prop q changed go back to the voters and ask them the resend it. how did the five of you who passed his resolution know better than the 129,275 voters

who passed prop 227 years ago concerned about the sudden closier of health care facilities you can't overturn a citizens initiative by passing secret city attorney opinions you who authorized you to so trash our democracy. what you should have done was retain the voter mandated well or will not be detrimental by adding a clause to a finding ruling it might not be detrimental because st. mary's had accomplished xy or z you could have done it that way without relying on a city attorney opinion that is secret. you didn't need to dock our

denominatoric democracy i plan to address the civil grand jury. >> thank you. our next public speaker is dr. tompkins. >> good afternoon commission mers. unfortunately i have to report back on a process that we have been engaged in the clean air health alliance and the situation that took place between the other regulators and the failure of the staff of the san francisco health department to speak out against racism in our discussion for negotiating clean air criteria our president misses more shirley moore who cannot be here due to a death

many her family she's back east who is a retired nurse from the san francisco health department when we were talking lemard and their lead environmental specialist and we were discussing the an nick dotal evidence of dust in homes his response to mrs. moore and julia because they live right above where the stadium the top level is is that mrs. moore can't keep her house clean. she's nasty and dirty what nurse do you know practices that at home? i was hurt i was angry but i maintained and stayed focus on what we were set out to do to provide a clean breath of air. we in our alliance are asking the health department that you cannot sit by and remain silent when you hear ignorance and stupidity being addressed in

these meetings you need to speak up because when you remain silent it plays off the bigotry and ignorance as it's a negro problem you are concerned and discussing it. and passed over. they were found guilty by the air district for failure for asbestos o current they were found guilty again it will come up in due process from the dust on the top level with the ball and chain which we were complaining about we're not crazy every one of us are college graduates performed in different levels throughout this industry and community we're asking the commission and the director which i spoke with prior that our organization is asking that you have -- not sensitivity but affirmative policy and enforcement with the

health department staff and people speak out when ignorance stupidity and racism air is the right for all people just as our children are marching in the streets asking that black and latino's lives and people of color are answered. (buzzer). your staff has our life in your hands >> thank you. dr. tompkins for letting us know about this. any further comment >> i have no received further public comment. >> we will proceed to the next item. >> next five?

finance and planning committee. >> yes we had a report from june 2015 to be included in today's calendar also we approved a new contract of professional service with pp strategies to perform program management and take the lead in capital integration and bond planning for the department and currently we have two bond measures we are working on. one is in 2016 and 1 is 2022 and also we had pretty good discussions about what constitutes those sorts for the departments and that type of sorts contractor also we also had added the nu sole source

list for commissioners to approve under the consent calendar we also had a pretty substantial conversations around our it implementation time line and some of you might remember because of like some of the deadlines change we were concerned it would push it bag significantly -- back significantly that is not going to delay the implementations of the hr because it's a serious matter moving forward we are requesting for an update per quarter so we will have like more information to share and to really look at you know what else we can can do

to make this as smooth process. that concluded my report. >> commissioner chung you want to comment on the report with the commissioners on the sole source actual funding which is summarizes as you recall that is how many sole source actually were -- >> yeah >> so everybody has a copy so those that were not at the meeting might be put into context >> yeah so to put that in context we have the department of public health had approximate fatally $422 million of contracts and of those contracts about 15.5% were sole source contracts and there are three

different administrative courts that constitute sole source it's it wasn't 21.5 that is the regular sole source that means no one else can perform that services except for the organizations or agencyies the second is 21.5 which is propriety software sole source because of licensing the last one is 2142 that is the list of sole source that the health department has to be approved by commission those are the three types it's also the regular board of supervisors designated funding for special projects or sometimes it's part of the [inaudible] process.

so i hope that answer most of those questions what sole source is we're still you know trying to make that more streamlined because we also discovered among the list of sole source we approve there is a huge likelihood that some of those organizations might not even exist today. so we're trying to really you know get a better grasp of that whole process before we approve the next list and hopefully we can clean it up a little bit and make the list more meaningful to us. >> thank you commissioner chung. any request for this item? >> no >> commissioner singer >> we had a reasonably thorough

discussion about the next critical step being after we choose which vendor to go with the contracting with that vendor and put it on the to do list to learn what resources we can bring to bear outside of this typical process to learn what other places have done contracting for this so we go faster and get a better deal for ourselves they will report back to us finance committee on their progress on that. >> thank you. i thought the other interesting thing from the list is the list actually equals 2.6% of our total contracts as such that is for the sole source we're going to be approving today.

any other comments? if not we can proceed to the next item which is the consent calendar. so commissioner chung? >> again the three items for the consent cal eenders for us to vote on is the contract report the new contract with bp strategies and the annual sole source list we approve. it doesn't mean we actually have contracts with every one of the organizations listed it's just the list of like sole source that we actually approve the list of sole source organizations so when there are like contracts to go out it makes it smoother and you know like more efficient process. >> okay so commissioners we have

three items on the consent calendar does anyone wish to extract the items if not prepare for the vote. all those in favor, say, "aye." >> (multiple voices): aye. >> all those opposed? the consent calendar is adopted. next item please? >> next is sfdph fiscal year 2015-16 and fiscal year 2016-17 patient rates >> good afternoon commissioners this is sfdph for fiscal year 2015-16 and 16-17 for public clinics our pair is medicaid and medi-cal that are different from the patient rates in addition many of our patients and clines

have adjustments in their fee schedule that are associated with the sliding scale so typically there are very few patients or clients that pay the full patient charges. if you have any questions. let me go quickly i'm sorry for san francisco general hospital the rates are increased 10% for laguna honda they're 10%. for community mental health these rates vary from 2%-20% the reason they vary is the rates are set so they're above or charges so we maximize reimbursement. fur substance abuse it's a similar type of reimbursement. these range from 0 to 5%. again these are based on our actual cost to maximize our

reimbursement. then the rates for vital records are rates the state sets for birth and death certificates then we have a ewe immunization and clinic fees. >> thank you >> could you tell me what our oshcod ratio is in terms of charges and where that stands in terms of other community hospitals? >> commissioners greg wagner chief financial officer. i was sitting there realizing that you were going to ask for that number. [laughter] because you did last year and i can get you the exact time but we are still a little off. as you know from having heard this in past years the reason

we're increasing our rating particularly for the hospital is we had a consulting engagement a few years back to look at our cost to charge ratio to find out where we were relative to the standard we were behind to the recommendation of that process was to increase our charges over a period of years until we were closer to our cost to charge standard again i don't have the precise number but we're down from where we had been. we had been in the mid 30s when we started this process now i believe we're at around third or just below. so we're still a little bit high. we're in the process now of refreshing that analysis to determine whether we have made significant sufficient progress in terms of our ratios.

that will inform what we do going forward in terms of percentage increase we use. >> commissioners is there any other -- i have more questions it's okay unless somebody has others that was the whole hospital issue and continues to be although i'm sympathetic to the issue i'm not sure we want to get to the sedery level of cost level i don't know if you are close to it. >> correct. i want to emphasize the charges what these adopted rate strive is our commercial commercial insurance reimbursement. that is the vast bulk of what is influenced by these rates so we don't want to be excessive but we do want to make sure for those commercially insured

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