up and so we do get those on a probably weekly beltway -- basis so we can debrief on those as they happen >> is there a system wide management team that works in terms of different things coming up >> we have critical responder and those as an example we're broader than just a department commissioners we respond to depths after our housing facility we have guests go out to every team on violence they will come and debrief with staff sometimes we debrief with school with children who are impacted so we have used that same effort we have done externally to the community as large as we reflect

it ininternally as well there is work to do still like some organizations like our two hospitals have a richer system because of their requirements and also because their larger campuses and that's what basil's goal is to work on each of these in terms of any event of the department that impacts the staff member we get this team out they're out there within the hour of any issue >> i'm happy to hear you and mr. price being an employmenty of the health system part of being safe and healthy when things get unsafe it's hard to be healthy i think this is a commitment to our patients and employees >> mr. sanchez >> i think you have done an excellent job of listening and observing and looking at

different path way and subcultures that have operating within the network and laguna honda. i was interested in some of the comments in particular many years ago there used to be a police special team assigned to sfgh to deal with special tra maw psych attic situations available 24 hours a day and between the sheriffs back and forth. the fact of the matter is the sfpd trains with the units and they're critical training in response as you move forward in your planning i know you will you have a unique opportunity to identify with spesht teams whether it's the police or fire department has exceptional teams brought into the hospital given krim cal brace etc. there say network out there, that is above

and beyond the individual klture of the sf police department or f sheriffs or fire department now that we have a director as one person that coordinatings it gives you a unique opportunity -- buys into that model it's not going to fly. so when you do have a crisis if the internal unit doesn't know how or what you will have more of a crisis you name it you can think of it. over the years many years ago there was special training activities both in the public schools r here in the city and in the hospitals pertaining to various crisis that might happen in all coordination is done at that point from some really comprehensive work that goes back many many years all of

these things were laws in prop 613 and everybody cut all of these things the need is there you identified it here are some unique resources we can integrate within our operational model whether it be laguna honda or gang task force whatever with those institutions that are working with paeshlts and where the kid's families are coming from that way it integrates the quality of patient care in community response in that way we haven't had that we did many years ago we had shootings where our physicians were shot that say different world then we're way passed that but there is still navigation problems i was glad to hear you and the director garcia to talk about yeah here's a whole other area we can listen to work with input

and develop an operational model where we know exactly here's path way one here's path way two here's condition one and condition four. we bought into it. and we train we supervisor we train we supervise. real good report i'm glad you are aboard. >> thank you. >> thank you. commissioners if there are not further comments it appears that this is a very important topic to us called into question for our leadership so i thank the memorandum has been in existence for about a month it would be appropriate to have a follow up on some of the questionses we brought up and the issue of expanding your eval indication and reach into other yeahs perhaps a six month report would be appropriate. >> that is fine. >> thank you very much. >> thank you commissioners

>> next item is item 11 other business. >> thank you. under the business i realized as we had accepted the report from mr. wagner of how much support we were getting from the mayor's office that the first comments that the director gave us which i made hope be reflected under the budget statement that the commission is extremely encouraged by the support the mayor has given for the health department and the health of the city and that we encourage and the board of supervisor accept those initiatives as being for the health of the city. so i hope that would be put in there as we complimenting our own staff to work with the mayor's office i know director garcia has looked at different

initiatives that they have had and carry out on behalf of the administration i wanted that on there. the papers recently have an article on the variety soda initiative tell uses on the board of supervisors i wasn't sure if our director was quoted appropriately that would seem to lead the department to be essential essentially not concerned and i may have been miss reading the article -- >> yeah i think that was the intent i did not quote with rachel kagen on our behalf we're waiting for the supervisors to pass it just to let you know our staff is very involved in this effort we're part of several committees in the community about this now we're waiting for legislation for the next step.

>> i think that part was fine and the information we were being very neutral on the subject not on the specific bills i think was the problem which of course is that of an author calling you to just brief us also with the work we're doing with the subject at hand >> certainly good afternoon commissioners we have been working closely with supervisor weiner's office on his particular legislation there are three pieces of legislation introduced as a package on mar coage and weiner that would ban the sell of sugars on city property the other other would ban sugar suite and beverage and the third one a ban on beverage suite and advertisements that

third one had a very broad definition of advertisement it had a couple of challenges to implement it. certainly we have long supports the reduction of consumption of sweets and we have worked with them to create something that is enforceable. anything that had an advertisement needed to have a warning label on it. from a soda can to a bus shelter to the billboard to the shirt of the delivery person so we wanted to work with the supervisor's office to create something that is enforceable they taken the amendmentses on monday. so now the new legislation has other side guidelines and addressed some other concerns we had about ads the previous version said ads that were mraeed before the implementation

date for the warning requirement which made it difficult for inspectors to determine what is older and what is newer so anything is subject to the requirement to say we were not involved is not accurate as the regulating agency this is an instance our health department has several roles to play around something that is sugar sweet and beverage consumption as a health advocate we have been working on this on a language time and we have the ability to enforce it as well. >> thank you. commissioners any other topics you want to bring under this aye snem >> actually chair chow i want to ask a question it would akly be helpful to make a formal acknowledgment to thank the mayor and encourage the supplement whether it adds value

at all personally when you take the items in total they add up to more than the parts i like the emphasis on the volume nar rabble -- vulnerable population if i was to ask nine out of ten people on the street i ask they would be high priority areas they want you to be involved in an i was wondering i will refer to you with a formal recognition or vote or motion without that add any weight to recognizing the budget supplementses >> it would seem that the mayor's proposal is actually moving towards the board we could write a note to the mayor's office thanking him for his initiatives here's putting forth to the board and the support for the department. this would not require any beyond if that was the sense of

the commission we're be doing that >> thank you very much. >> is that the consensus from the commission? then that way formally -- it like we when send over our annual report we write a note to the recipient in this case we received quite a series of initiative along with support of our own departments' own initiative i would think the sense of our commission is to let him know we're grateful for that. >> one other thing i wanted to note is we have public comment last week sometimes we get public comment we're not allowed to respond immediately i'm sure members of the public want to know their comments are being heard i wanted to acknowledge we also had this example of public

bathrooms in front of us that was a source of some energy last time. specifically the availability to use the restrooms in the fire stations. so thank you distributing that it's clear you guys are listening to the public and their concerns. is this something that is new and the person who came and spoke to us didn't know about or were they referring to something else? >> no i think they were aware but i think they needed to seethe it in paper but also this is the beginning of an initiative to get access to public facility and i want thank the chief of pyre who opened up here doors torque do this we also have the pit stop program that is roaming facilities for

individuals and more to come as our city grows public has been a challenge for us as an example in our facility downstairs, we traded a model in the library we have a monitor in there because of behavior downstairs the sheriff asking to close the bather i said no we will have a monotore just like the library. that will help with skaefty concerns and activities happening without supervision in public path room that's why some public bathrooms get closed because of behavior we have a successful program at the library a hot team with peers that are supervisored that work with the facility to make sure they're using them aappropriately >> i know from my specific experience in the men's room on

the first floor i have seen all sorts of crazy stuff in there and never one felt my safety was it. >> that is create. with the -- >> that is great. i have had communities from others who have felt unsafe but i think having bathrooms is important we will do whatever we need to do to make sure people have access. >> thank you for the point that was made. >> commissioner chung? >> speaking of public comment that is a public comment made in the last meeting but the meeting before about the discontinuation of the bus line 33 it's been discontinued so i was wondering if there were conversations we

had with mca >> our policy director lead that effort paul ine will discuss that >> we have a group internally with mta to talk about changes to the bus line. mta says line 33 will be discontinued so the transition can can happen smoothie also we don't have direct information but [inaudible] on my staff and well as megan we're who the director mentioned works on the tran portation has been assessing our data on the patient and staff utilization and what the pact in that change in line will be and she can have a conversation with the mta if necessary. >> thank you. >> any other further comments under this section? if not we can proceed to next

section >> next is joint conference committee reports and commissioner had to leave earlier so we will not hear about the public health foundation but we can hear about the hospital meeting >> okay we can can wait for the commissioner's report next time and fcc looked at regulatory affairs report as well as hospital and services care and medical staff report and human resources vacancy report we followed how the hospital is doing in terms of preparing for the shortages that were occurring within certain departments such as the emergency room and how this is being over come and what plans are being made for the move to the new facility.

these all seemed fairly much in order although there was a question that commissioner singer still had in terms of how we would be able to be prepared for the move into the new facility and we will continue dialogue in coming months. committee approved a number of standardized procedures particularly in the anitinatal testing center and the odablaringology standardized proceediers and rpa's and cp's and we did include it in the minutes and you should all be receiving that report in the coming few days. are there any further? i guess there are not from the

joint conference >> right. >> next item is >> item 13 agenda committee setting >> our next meeting is in october. there is a long list in your calendar of reports to the agenda >> yes the population health division and the san francisco health we're hoping that by july it can be populated out so the topic can be put in i think they're each working on strategies >> fine. commissioners if there are not further committee agenda items to add to our long list we're prepared for a motion for adjournment >> motion to adjourn. >> is there a second all those

in favor, say, "aye." >> (multiple voices): aye. >> all opposed?you. (meeting adjourns at