>> so the minors are before us for approval a motion for approval is in order. >> so moved is there a second. >> second. >> are there corrections to the minutes if not we're prepared for the >> all in favor, say i. >> i. >> opposed? minutes have been passed unanimously item 3 the director's report. >> good afternoon, commissioners mayor ed lee signed the city's balanced budget for fiscal year 2015-2016 and 2016-2017. in his comments he said that your creating jobs and growing a thriving economy while keeping the city save and compassionate the city and county of san francisco the major employer for the next two fiscal years includes additional employees to staff the new san francisco general hospital implements our

electronic health care records system and the department of public health division as well as implementing the affordable health care act the city budget also vests to support the most vulnerable san franciscans and it includes resources dedicated to help san francisco general hospital adding 5 hundred new supportive housing for people to the navigation center and millions of new fund to support seniors and people with disabilities covered california has a modest rate interest for san francisco for 2016 they recalling reduce the prices in san francisco, california expect an average rate of 4 percentage across all terse this is more than all the regions in northern california we had a great anniversary of

the 50th anniversary of medicare and medi-cal celebration of medicaid on july 30th, 1965, presidents johnson signed the medi-cal and medicare for pregnant women and people with disabilities medal and medicare has protected health and improving the nations economic security on july thursday medi-cal and medicare serves held on event added san francisco general hospital and trauma center to commemorate the 50th anniversary of the medi-cal and medicare our dr. hernandez and ceo of the health care foundation was the distinguished keynote speaker we have started a black african-american health project

there are 3 processes for the projects one of those is the workforce development and that workforce subcommittee has begun in the project chart for the black african-american health initiative was you signed in march and whether the fifth committees that is headed by our colleagues are leading this effort and promoting the interests for the african-american careers and creating black african-american applicants students and volunteers they hope to develop tragedies so retain and show ridicule and support the continued education for the pathway for the existing staff i want to thank them for that work in that area there is an update for san francisco general hospital no new compute u updated other than they're waiting for approval for staff

and i'll let the commissioners know we're still moving forward towards building our new hospital director's report is ended and if there are any questions and commissioners questions of the director on the report i want to point out to the commissioners we had printout from the website the organizers of the 50th anniversary program that was submitted to us a liz of the contents of medi-cal and medicare over the past 50 years i thought would be useful for your information we're having that distributed to you today are there any outlet comments? if not we'll precede thank you and we'll precede oh, actually yeah. just want to comment once again that the mayors budget for our

next two years is really extraordinary for in department and want to thank the department for all the work they've run intoburgburg to advocate for the program and the mayor and board of supervisors for having actually confirmed not just confirmed but added to it and gave us even more robots i think that says well, for the work that our department is doing so thank you, again director >> i'll note no public comment for that item but item 4 is general public comment we have one. >> yes. mr. office of the city administrator to duffey i didn't please and mr. duffey i have a timer for 3 minutes when the buzzer goes off. >> commissioners nice to meet

you i'm on the health center clinic patient advisory committee i have a sister at the age of the internet a 6 degrees of separation but not 3 degrees of separation we know be a lot more people before that i think that is kind of a silver lining to the aging process for example, i heard about rudolph better gary's doing the artwork and i'm looking forward to take a look at that ford was president and hopper and many people responded and i'm looked forward to it look those links i've been in the citizens advisory committee

for some time and tom o'dell won 20 years now we've had some ups and downs and some times we came close to disbanding with the budget part of new to the center was difficult our liaison died we worked through all those things is it appears that the department is putting ay used effort dr. the director she's a apparently going to be at all the health centers i want to thank you for doing that i think there are look good things it come out of that i've been involved and it helps to have reenforcements thank you. >> thank you all right. we'll move on to item 5 report back if

the finance committee. >> chair. >> good afternoon the finance and planning committee met before the commission meeting and we had you know a really robust discussion on the presentation on chirtd care and i think that actually inspired more questions than answer and including you know the goals of charity care like you know in the time of the valuable affordable health care act and charity care was adopted 15 years ago and back then we didn't have the kind of sentiment as we do today those were some of the questions that came up and you know the presentations were actually

coming to the commission and so i want to put on this to thinking how we can actually create a partnership that really serves the buyer city and county of san francisco and including the most important part to reduce you know like health care for those who live in the city we also have some new and old contracts for your approval and it is all on the consent calendar with the contract report there are actually, two items that have been tabled for the next meeting for approval and those two are the medical contracts and services and the network within the contract report the 3 contracts that would be still need your approval will be the

clinic works the data way and the staffing. >> commissioners the reason i've taken off a clerical error the report needs to be clean before it comes to you. >> right there were typos. >> any questions. >> commissioner questions or comments to the report from commissioner chow? no comments all right. great we'll go to the next item >> we'll move on to item six the consent calendar consent calendar is before you you heard the two items that are removed from the consent calendar does anyone wish to extract any items if the calendar otherwise. >> yes. please within the contract report so under the consent calendar it

will be all the items on the consent calendar that we need approval of within the contract report which we have to items removed. >> yeah. it is the 9 approximately 8 millions on the pharmacy agreement; right? >> tip probation officers and 1, 3 and 1, 5 for the pharmacy kind of in the middle of the block of the first folder all contained in the contract report. >> any other questions? if not we should note that the walgreens program extends our 40 b program that required a link to each clinic only to all of the san francisco walgreens clinics under the b program is

that not correct director barbara garcia >> that's correct. >> that's a significant difference an, an added benefit to the program under 9 previously i nodded if you were at chinatown clinic and went down to only one walgreens and couldn't go to another walgreens you had to go to another one like castro that allows all the walgreens in san francisco to participate in this program. >> that was my only clarification we're prepared forever the vote. >> all in favor, say i. >> i. >> opposed? the calendar has been adopted unanimously. >> thank you, commissioners item 7 the dpw policy on the dpw facilities as you recall this was introduced at the last meeting. >> good afternoon, everyone. commissioners colleen i did not

have anything additional as the secretary said the draft of the policy at the last meeting it didn't require our package of the resolution only the affirmation. >> i was wondering if on this is more a technical question on the block that we have which on page 2 if you would get that if so r this this is yet california but for the process in the text and my two questions and which i believe are editorial under the section for dpw non-hospital building and director would review and submit

recommendations and would it seems to me that the commission actually then makes also a review and recommendation; right? to the board of supervisors as it says under item d. >> yeah. >> so the block should clarify that by putting that in and the board recommends. >> so i'll make that change. >> thank you and so the last - the bottom block expelling facility naming in connection with the gift of any amount u amount the director reviews and submits the remedies for final approval and here i believe under our section e it says that the commission will approve the request so the word approve needs to be there also and moves it to the board of supervisors. >> to be consistent with our

text. >> that's right thank you for catching that commissioner. >> so if those are accepted as the editorial correction ann another motion it in order to approve the column. >> so moved. >> there is a motion and a second is there further discussion on the policy? if not, we're prepared vote >> all in favor, say i. >> i. >> opposed? the policy is passed unanimously thank you thank you, commissioner i also note no public comment or questions item 8 is the resolution of the port naming the general clinic and richard a fine clinic. >> i'm not sure who is representing item - ms. >> if you recall a presentation at the last meeting. >> yes would you like to help refresh our minds on the items.

>> there was a proposal on the small video last week of the part of the richard fine to rename the general clinic at san francisco general hospital the richard h fine clinic and the drafts resolution in front of you for your consideration compliant with the - and the draft resolution is before you the motion will be in order. >> so moved. >> is there a second. >> there's a second commissioner sanchez. >> yes. >> yeah. i just like to make a comment pertaining to the naming of that clinic regarding dr. fine initially when it was brought before the jc c to be named by the department and in reference to the hourlong program in general

many of us attended it was an awesome tribute to a outstanding recommendation to the richmond h fine clinic i sort of took the wind out of my sails it was shifted to dr. richard fines people's clinic and i've been trying to get that out of high head why hadn't it bothered me i've known dr. fine when i joined and at 69 all the way through and couldn't think of a more outstanding position to have a clinic named at the san francisco general hospital to have it named that i guess somehow this sort of limitations his focus and maybe

i'm just responding many of us were involved in the 60s and 70s in coming back with the gi bill to berkley and at central nervous system that was part of our effort but dick fine was an extraordinary human being, he played a key roll in working with many of us at the general to form call the urban healthy was a key member it involved every single chief of service at the general from dr. tom surgery to dr. from that he had arctic's and we got them altogether and got the funding, etc. to not only increase the qualities of service based on the philosophy of our faculty and residents the

outcomes in reference to what they're doing and dr. fine played a critical role and continues to play a critical role so the funds many of the folks that served only the committees were some of the old guard the services of retired champions and many at the oil library at the san francisco general you saw all departments one or two some were submitted with replacements and this is a meaningful thought so i got a few comments from dick fine represents the finest of central nervous system so i want to interject that that needs to be said and something else that is important dick fine figure out through the urban health board to insure the minority students in potrero hill be bayview hunters point and the mission

had opportunities through san francisco general hospital did this through the urban health and navigate 4 videotapes we're working with the students and working with other groups to increase access to training and minority positions one the key people involved was francis a mexican-american who become a nurse and got her masters was the director of the urban health project and she was showing so impressed with his service unfortunately after they passed away left a scholarship for the students from the valley to go into nursing and paycheck to the services he provided to the community to me had doesn't say enough about him the reason i'm saying that in other types of awards like the staff like the

julie the honorees for top residency in each of the departments we think about what dr. discretionary review violence did but julie discretionary review violence he supported many the dean and the chancellor but his commitment was the quality of care at general hospital we had the rapid report and talked about who they were and why they're here so as i envision dick fine clinic i imagine their teaching the under graduates and staff what an outstanding position dick machine fine was in the memory of san francisco general hospital that was dedicated to serving i'll regardless of country or people anyway, i just want to share that i think that - he doesn't

like to be so-called - i mean, he marks to a difficult drum but worked within those organizations and programs to insure that access to qualify remains the flagship of excellence and the medication that no other departments in the central nervous system we feel some of us feel quite strongly it would have been great to keep it that way and the curriculum and the training of the future health providers would certainly reflect his philosophy and commitment to people of all walks of life that was what he was through the chair i apologize for getting into that but i'll support it so recommended but i do feel you know it could have been greater had we kept the tradition and

used that as an ongoing teaching this is in my opinion. >> thank you, commissioner because commissioner you can amend the resolution but i think i'd ask director garcia. >> yes. i asked the same question and know it is not just people so i asked the same question that request that went through dr. fine and that way i honestly think it takes away from what you said dr.ations and fine i believe that went through him and he supported that and in fact, he does walk to a different drum i wanted to honor the way he was and i the that through the staffer that presented it i appreciate our

comments and puts the meaning that is the bigger title. >> thank you. >> thank you. >> okay. i think we could note the reason it the name is in and unless commissioner you're entitled to amend the resolution okay. any further comments if not all those in favor of the resolution as presented please say i opposed any public comment no vision zero update. >> item 9. >> good afternoon, commissioners and director barbara garcia and secretary thanks for the opportunity i'm megan wear the

director of the health and sustainability and also co-sponsor of the vision zero task force to present to my colleagues we put together vision zero initiative in may of 2014 the committee passes the resolution in support of vision zero we're here to provide an update. >> so just a give you a little bit of background about preceding vision zero san francisco has been annotate leader respect to transportation safety with the first to install the pedestrians countdowns we're all familiar with now we've been a leader with implementing this to schools in 2010 had a mayoral directive for the collision down by 2021 we played a leadership

role including for the prelims of a number of improvements and publishing a pedestrian strategy in 2014 vision zero was adopted citywide including by the commission and citywide task force was established i co-sponsor you know despite the exchanges around this at the end of 2013 a girl 6 years old was killed in a intersection awhile crossing the 6th death in that december and the city's responses is no more deaths are acceptable and really the only acceptable target is zero we now have san francisco in vision zero that is supportive by a number of city departments the mayor, the board of supervisors we meet on a quarterly basis of the task force towards the ends of coordinating around engineering

and execution and enforcement and activities to fundamentally will eliminate traffic deaths by 2024 it was introduced in 1997 had much success we needed to design a transportation system that protects the most vulnerable people using the transportation system including people walking and biking and seniors and young people i think in many ways that block is consistent with the mission of the department of public health i know this is you guys can you see the map hopefully in our handout i don't know about that slide since vision zero was adapted it is inspiring to see the national limit it growing hopefully, a map that shows the different cities across the country that adopted vision zero

and in 2014 san francisco and the city we've got a number of cities in california adopted last year well including santa fe, san diego and a number of cities in the country including portland and seattle and additional cities are really every week their say new energy around our city and country a vision to do you want that to san francisco is at the forefront of this. >> yeah. >> oh, no. >> i apologize. >> thank you there's the map and really with respect to in san francisco what we've seen despite early declines in the 90s and the 80s starting in the 2000s we've seen the please be advised the ringing of and use of cell phones, to in the death

in our city thirty fatalities a year up to 2 hundred a year injuries and approximately 70 percent are people walking and biking and half the people killed are walking awhile walking are seniors while i'm here to talk about the leadership that the department is providing in that work including on the task force with respect to the data and analysis and evaluation and education engagement in our growing roles as well the task force is co-chaired by mta and dpw we meet as i said on a quarterly basis comprised of city agencies that play a key role no vision zero we've got active community engagement including the neighborhood coalition led and i by walk sf over 40 organized that signed on

that coalition it is really existing to see the continued engagement of the community in this work. >> in 2014 and 2015 we had a number of successes with respect to progress on vision zero it's first year we had 24 projects in 24 months 16 projects are underground they're on track to completing that project delivery showing the city's commitment with respect to education citywide campaigns honest leadership on this she'll talk about and seen an increase or increase on the part of the police department and working on developing more data tools to make sure that the initiatives are day driven and also has

hired a new epidemiologist who is serve for this work as well as advancing with community organizations we have a two year action strategy on our we are talking about that is online that includes more information about the initiatives as well as resolution of the number of departments that joined the hunting in supporting vision zero with respect to the action in 2015-2016 i highlighted in blue when i'm talking about we're going to dive deeper on today including the citywide strategy for education to schools and we're excited in the most recent budget in the seniors program is implemented given the disproportionate fatalities among the seniors and monitoring the resources and continuing the community engagement

slides on reverse is a high-level summary of the resources into vision zero which is appropriate three-quarters by grants and 25 percent from the general fund with respect to the data piece one key contribution that was identifying the high injury network that map identifies the 12 percent of street miles of fatality injuries to vision zero includes people in vehicles and riding bikes and vehicles this is in the contained how to effectively have the preservation initiative at its core of vision zero is the fundamentally addressing the issues of evaluated so in red the high injury corridors in communities of concern that are disproportionately low income communities and communities of

color and community where people are walking and relying on transit and thor percent of the streets in the city 50 percent of part of high injury network dpw is also working with other city departments to develop accountability metrics we know that the goal of zero fatalities is you know the how to be accountability in the short time to have any driven actions and monitoring the impacts on the street a number of metrics we are working to measure in the interim our new epidemiologist we're excited about our collaboration with the san francisco general hospital to work with the trauma sushlgz that treat the patients and working with the polite data to capture 25 percent of

cyclists injuries on the records and we're able to target our initiatives and she's really done precedent work meeting with the police department and the transportation agency all on the same page about the monitoring that is very intuitive and simple i sure it you it not as simple as it seems weren't to having it consistently recorded to the public and there's a screen side of map that is u updated with respect to fatalities we've also development an online interactive injury data with environmental data on a number of factors that are associated with how we predict and look at it patterns this is a screen

shot of map that helps us look at not only the types of injuries but what are the patterns where the aerial streets and fast moving traffic around schools and senior centers and this type of tool has been used for example, with the sfmta capital improvement program for pedestrian safety to analyze the patterns and really target their engineering to the patterns we see in the corridors so have more program improvement measures and now i'm going to turn it over to ann no way that will talk about education. >> good afternoon, everyone. everybody with respect to education related to vision zero we really are working very close with our partners headed by the

mta to create the prosperity citywide strategy to the board of supervisors and the transportation authority outlining all the different educational opportunities welds implement in the next few years for vision zero and we've adopted 37b9 with the information proud about it's the public preservation is not just teaching individuals about how to slow down or cross the streets but we're effecting all the levels we're talking to the providers in various was our health providers the muni operators large vehicle operators we're working with the coalitions i'll talk about in a minute and changing our organizational practices and working with flunking 0 policy and we're going to achieve vision zero we have a citywide strategy that outlines a number of different educational

opportunities i managed save out to school and as megan tubed we've included the streets for pedestrians and the mayor's office has funded it in the city budget for that the next two years because over 50 percent of pedestrian fatalities are seniors and this is a population that needs a lot of save so save outreach we're looking at ways inform coordinate all the information about vision zero and bring that directly to seniors and people with disabilities we focused on creating community-based education this picture is a standard campaign i've worked with supervisor kim's office all over at tenderloin and selma and a had tare highlighting the community residents a professional photo shot that is in the neighborhood we live here please slow down

we offer some grants to selective groups that are working in neighborhoods that are on the high injury network walk sf is the leads for the coalition and groups that serve modeling and non-english communities south of market and chinatown ceda and the economic agency with working with groups in their native languages to deliver the information a national program we founded in 2009 we're interested in promoting walking and biking for obviously for various reasons of promoting health to make it safety in order to do so we work with the school district and a number of city agencies and a number of community-based groups school starts in 2 weeks we're

adding 10 for elementary schools to the program that covers half of the elementary schools i'm proud to say they've passed the vision zero last spring they're one of the lastly partners to join us and as part of changing organizational practices our team worked with the mta to produce intents the schools on the next those are schools that have typically high rates of walking and have a lot of injuries in the buffers of school their prioritized to get the improvements to the streets and sidewalks my prime is gene elementary have r half of the population walking to school and the highest number of pedestrian injuries we have asked mta to produce intents and have gotten

3 grants for the elementary we work with the vision zero coalition it is lead by walk sf and in partnership with the bicycle coalition they help folks to keep the city accountability we again offer many grants and the prime example is actually before vision zero we gave walk sf a little less than $10,000 in 2011 to implement a local option in the subtly was passed to allow the municipalities to implements 15 mile-per-hour school zones we're the only city to fully take advantage of the local option to the city hall's that are eligible other schools in san francisco have done it on a skais basis but walk sf worked

with mta to get if implemented for all the schools it makes all the schools once the speed limit drops it helps with the bumps and the speed limits needs to be reduced first, it was done by walk sf i want to acknowledge one thing barbara co-wrote with her counterpart ed reiskin and acknowledge the hard work with rachel and the communication team for working closed with the mta communication team in helping to profile vision zero in the communication it's been getting a lot of attention and that's the end of the presentation we're open for questions. >> thank you very much questions commissioners commissioner taylor-mcghee. >> a clarification

goith the 15 mile-per-hour they're eligible for the school zone unless they're actually on high-speed aerial so 4 or more lanes not allowed to have that in the state law only 4 schools in san francisco for example, betsey carmichael has it does not have it on one end which is on 7th street but on the surrounding 3 areas the block that are narrower and smaller so but those streets will be getting bigger improvements through other avenues of vision zero and they're a dozen schools that have absolutely no boundaries the mission school is o1 on 16t

street from mission all the way up to church. >> commissioner sanchez. >> this is a think excellent report i'm really glad to see the coordination among the nonprofits this is a good benchmark a number of schools that may not be eligible with the early childhood schools that are part of the school district they're not huge but they're very important and they have families that walked or drive cars and drop off, etc. i know them particularly in the mission that contacted us over the years about trying to get signage that shows kids crossing or especially you have like alleys going between and you get cars or motorcycles and bikes and parents are trying to pick up their can i see and the teachers

it is really traumatic my question is there some unit that could be contacted or we could refer them to get signs posted both in the eel and in the white zones which they have they have for a year and a half to get the signs saying do not park here it's a real question. >> i'll certainly take that back to mta the issue is unfortunately in all of the codes that mta has to operate by the schools are denied by k through 12 we'll brick bring it back. >> it is we're trying to fourth why. >> it comes up repeatedly. >> i'd like to acknowledge tour staff i sat in one of the meetings with the police and

municipal transportation agency with a variety of different agencies they've done an incredible jobs where they have the dollars for the endemocrat lots of so the influence of the health department on the transportation system not only for vision zero but other issues have come up in terms of the growing city of san francisco so i want to acknowledge many years of their companionship around this area they've done a fantastic job thank you. >> very good eric commissioner king. >> congratulations to our ability to get grants that takes a lot of pressure off the city so congratulations i had a request this request in the future when you give us the data on fatalities by injuries that

is what you're aiming for as well and it would be great to track the progress on that. >> it is something having lane in a our epidemiologist that is based out of central nervous system and we are working closely to get not only the severe injuries by the police department. >> defined by the hospital they've got different clarifications at the it is important to understand for the reasons to sharing the preliminary analysis and we looked forward to implementing them. >> that's great whether you look at other cities that are farther along than us on in journey what turn out to be the common iltsz that the work is hard to bring the numbers down to zero. >> i mean, i think you know in other - you know the example of

other international examples is a movement at the core of sweden the engineering so the reality we have a high-level of commitment but you know taking the time to get into the ground is building up the infrastructure so doing with we they've done a great job they have the effective approach of getting things in the ground so you see in the tenderloin removing the parking at the intersections so things go underground and improving the crosswalks or the infrastructure we can do that in the short time and the long term getting things in the ground the 24 projects has been something we're excited about happening but doing that you know there's a vision zero

network that is being kicked off nationally in of the former director of the bicycle coalition is the director of that network she just got back from a fellowship in europe how do we bring that to the united states combining those improvements with data and fundamental focusing on speed we have a goal of fatalities and speed is the strongest predict so, so currently we're not it is not legal to implement something in the state of california but in washington, d.c. they've seen a 50 percent reduction in fatalities so long term with vision zero helping change the culture around how to produce

intents human life rather than how fast we get if from a to b we're loading to address. >> thanks. >> yes commissioner. >> thank you for coming back after you presented to us last year as the day that i present to us as the number of walking kids walking or people walking and biking goes up it is how the data shows that the numbers are not going on is there a way to look at the encouragement of biking and walking. >> in san francisco we had really strong goals with respect to increasing walking and biking that is being tracked by the sfmta so i think you know vision zero is part of that larger mod role

how to see the increases but not seeing the increases in most of the injuries i look at the map of san francisco there are concentrated in the in and of itself quadrant of the city we have the most walking that didn't have to be occupied but walking that is a design problem in the large part we can fix we want more people walking don't have to see the rise a that's what they've been able to accomplish. >> that would be great if that data can be a comparison represented. >> all right. so on the accountability and benchmarks then would we be expecting that in the coming report a year from now obviously you're putting a number of things in place. >> yeah. we are. >> we have this raw data it is

good it is starting to gown again, i think you have some others to try to do this i actually was - i thought the school zones were 15 miles. >> for years. >> (inaudible). >> please accompany to the microphone. >> sorry not before 2011. >> that wasn't part of motor vehicle code. >> prior to that that was 25 mile-per-hour. >> really so it dropped so therefore there is a - there will be signs - there are signs interest. >> there are signs all schools eligible that are signs posted 15 mile-per-hour. >> does that include all schools or only public. >> all parochial and charter and private we have approximately 2 hundred schools in the city and about 2/3rd's is

public but all the schools with eligible. >> then i know that there are yell crosswalks; right? are those also paint at all the schools. >> yes. those are specific the yellow to schools. >> all the 2 hundred schools. >> yep, all crossing guards eligible at all schools. >> it's hard to believe it's been a year since you were all here and you've done a lot is i just by the following year; right? the endemocrat lost and all we should be able to get summer day on what is happening as we move towards it i thought that was great to get international data and see how the other cities are

doing a he how we're staying ahead in no further comments we thank you for your report and look forward to you returning with another positive report. >> great, thank you commissioners no public comment item 10 the dpw proposal to modernize the proposal and the city option and create a new city wellness fund. >> this item was introduced at the last meeting so you'll have a vote. >> good afternoon, commissioners el lien again in response to the commissions discussion at the last meeting we went back with additional analysis in 3 key areas and submitted a follow-up memo to summarize the work we had done so you asks you to do an

economic stress test we performed and asked us for address information to changes to some of the language in the resolution and encouraged us to have an eye it on the developments program for future either further evaluation we discussed it also i'm having the same problem with my - but i'll continue i'm on slide 3 of the - i don't know if you have this slide but essentially for the economic stress test we looked at the trends that emerged during the last recession from 2009 to june sorry 2007 to june 2009 june 2009 was when the recovery began we were not fully out of

low period at this point we ask the uc berkley does the affordability analysis to look at the historical effect of the recession on san franciscans income they told us two major take a ways the first income shifts towards little lower end of the spectrum of the things in your packet between 2008 and 2010 there was a 9 point increase in the number of san franciscans who earned less than 2 hundred and 50 percent of the poverty level those at the lower-income increase and at the same time, a decrease in 5 percent and the incomes shifts peeks in 2010 as incomes grail increase as of the eco report from 2012 at point hadn't reached the

recession levels i'm sorry technical difficulties you can't see the power point the other key findings a recession will present a increase in apartment employment for lower than the 2 hundred and 50 percent of the poverty level and another graph in the packet is apartment to that in 2010 and the shift towards lower incomes is partially explained by people working apartment during the recession in addition to sorry so we look at the effect of the recession in 2008, and 2009 on bridge to coverage and healthy san francisco on the bridge to recovery program we used the income shifts to model the

bridge to coverage in the economic downturn we took the 9 point difference increase in the incomes of people below 2 hundred and 50 percent of poverty and applied that to the projection of the programmers and the 1 point increase in those 0 above 4 percent of income to model our participation overall we anticipate the program is sustainable bus the lower-income flshd the federal participation and decreases the participation on local resources the number of people eligible either they moved the job and didn't quality them for the program in new engrossment increases because the employers will be transcribing on their on behalf of that overall increase is greater than than the

increase in expenditures related to the people if the program because those additional people are eligible for federal subsidies than the people pavrnt in the program we discussed that uc berkley the inflation scenario in the event that health insurance and bridge to coverage rises but in the coverage of the costs is increasing but the employers is tied to the health insurance that also rise at the cost of covered california we believe that is neutral on the program we also did a stress test on healthy santa fe san francisco what does it mean for healthy san francisco and in an economic downturn san francisco will continue to fulfill the 17

thousand ingredient for coordinating the care and continuing to do what it does for us today as previously recorded to the commission a healthy role model the general fund forever the emergency use we the an analysis in our original memo of the 12 hundred individuals we allowed to city in healthy it san francisco as a result of unaffordability of health insurance and we element that will void 2 hundred e.r. i have visits at san francisco general hospital enough to provide preventive care for 2 hundred and 35 families new landscape the modernization proposal mitigates the economic downturn of healthy san francisco in two important ways one it eligibility for medi-cal

for the lowest income more people will be eligible for - more individuals will be eligible for bridge to coverage giving them coverage and not making them ineligible for healthy san francisco second item the health commission asked you us to look at the wellness funds and hesitant on approving the wellness program since the last commission meeting we'll have presented to the small business commission and the health population division we've received valuable feedback from each the presentations small business commission we gave a similar presentation that you got at our last commission meeting no concerns or recommended changes for the

bridge to coverage or healthy san francisco components of the proposal and for the employee wellness program the small business commission oebldz the health commission that the small business in particular are not likely to have the means or on the human resources sign to manage a wellness program they asked you us during the stakeholder process to look at developing a program that smaller employers what participate in collectively rather than having to manage on their own consultation with the population health division identified other opportunities to partner and say they've generally excited about new ways to partner for example, four onsite occupation health and safety training and many clinics for disease testing and they also were excited about the ability to tie those to overall

efforts to increase the health literacy and enrollment insurance and addressing building the employer was a critical xhoenlt of chief financial officer the health in san francisco in response to the health commission feedback and the information from the small business commission we've made modifications to the resolution which you have in your form that requests your approval to composer and among the option that have the hunting restraining order lubricating taking those services suggested that the health commission asks do us for . >> and finally on the evaluation of the new bridge to coverage program we heard clearly preacher from dr.

kateing he wants us to be sure that the impact of the proposal was thought-out and the program design we can do that so we've been in conversation with the san francisco health commission and the bridge to heartache coverage to make sure we can track health updates and citywide health indicators and the health benefits over time that's a summary of memo we presented to you in follow-up to your last meeting a revised resolution rather is available for you for your consideration and polk action today. >> thank you commissioners we did receive before your place a written statement from the san francisco labor council which i believe you have endorses the proposed

bridge program and had some issues considering the wellness we've heard from the people from mr. paulson and he has submitting that in writing commissioner pating who was unable to be here sent a note he'll encourage and personally feels that health care makes sense and hopes that his fellow commissioners b will vote to approve that resolution he also called for us to be mindful of the means for community assistance and contributions from employers employees and all to create a good universal health care program so you have that letter before you are there any - anyone signed up

for public comment. >> not received the public comment i apologize for the glitch not someone to help us out. >> commissioners discussion or a motion on the resolution? >> commissioner - commissioner singer. >> thanks colleen and thanks for being responsive to my comments we're getting used to our thoroughness we're super helpful your team and you spent a lot of time on i just wanted to say that i appreciate the change to the language on the wellness proposal and as we're getting into that understanding the complexity and trying to make trade offs i encourage the department as our studying it to not get completely sold that we should do this as you study is it you shill have still have to

keep in mind the possibility that might not be a good use of funds certainly not arguing those things you've sited in the workplace that are available to itch larger employers are not available and potentially good things to do for the set of san franciscans that work in small employers but i think that one of the goals for studying it ought to be if we're as a city going to devote resources practically speaking where are we going to get as much help if we spend those funds someplace else it is hard to measure we have to have that mindset to maybe we're not going to get the return on the investment the universities or other populations that need it much

more remember much of those people are access to some health insurance there are other places i add we keep that possibility in mind as we go through this. >> thank you commissioner sanchez. >> i would move the resolution i think that staff has done the group did an excellent job they've listened and had meeting with the small groups the recommendations is needed gives us the flexibility to explore all options some of the major functions are interested in funding the links to provide new services those wellness programs are good for preservation in any way to generate that, etc. so you know there's a lot of exploration we could be doing i hope we'll sure we use those

foundation grants to provide a unique model we've been able to do over the years again congratulations and move the resolution this afternoon thank you, thank you there's a motion and second. >> any further discussion on the resolution? commissioner karshmer >> thank you you'll for your thorough review and i'm pleased you linked the public health division work to this resolution i think this helps at least as you study this helps groub what this is as opposed to everything i don't think - but it builds on the strength that was a nice addition. >> thank you. >> thank you further comments commissioner taylor-mcghee. >> no sorry no further comments

then i echo the very fine work and the responses so promptly it is not easy. >> thank you it is what makes it work. >> we're prepared to >> all in favor, say i. >> i. >> opposed? resolution has passed unanimously thank you. >> thank you, commissioners item 11 other business. >> commissioners any others business you'd like to bring to our attention or we'll move on to the next item. >> 12 is a joint conference committee report and you have a july 28th. >> july 28th was the meeting where mr. pickens was serving as is interim ceo and we reviewed the qualities management and regulatory reports and ucsf gave

an excellent destruction briefly on their education and research program i believe we'll have the power points given to the commission it shows that very high percentages of trainees that went through the ucsf educational program actually intrerdz services into the under served population therefore fulfilling that mission at ucsf general noble in the trained positions but have those available for our underserved population so we'll be getting those slides to everyone we also then reviewed the transition program it has been laid out in very greater detail for projecting that aside from the ribbon cutting that is

designated for december that following that we would continue to be - and that's assuming the pods allows us to proceed to be able to stock our building we would then be undergoing a department of public health inspection from the state for licensing and following that which would have approved our policies and procedures to gun to orient people to our hospital projecting a may date at this point for occupancy patients but that a plan will be continued to be monitored by the joint conference over the next several months department of water & power what the timeline we followed through with the building itself and presentations in a know fashion to be maids to the commission to broncos you up to date on where

we are aside from that in closed session the committee also approved the credentials report and i think if there are any questions i'll be happy to answer any questions not hearing any questions any further joint conference report. >> no public comment. >> item 13 is the committee agenda setting. >> okay. so in agenda setting we will remembered i that we have our planning program which will take up the. >> october 6th. >> where is going to be. >> at dwooi van ness and in the public health department division. >> we'll be going to it during our planning commission.

>> please be prepared for that beginning at 2 o'clock i think it is. >> yes. >> do we have any further unanimous. >> item 14 which is adjournment. >> okay commissioners, do we accept the motion for adjournment. >> i move we adjourn. >> okay there being no objections well, no - i >> all in favor, say i. >> i. >> opposed? this meeting is adjourned

>> the aging and adult service commission, could we have the roll call. >> president james. >> present. >> commissioner seriina. >> here. >> loo. >> here. >> commissioner sims. >> here. >> and note that executive director anne hinton is present. >> thank you, could we have

approval of the august 5, 2015 agenda? >> so moved. >> second. >> been moved and second that we approve the agenda for august 5, 2015. all in favor say aye. >> aye. >> opposed? ayes have it, so the motion is carried. could we have approval of the august 5 consent agenda. could i have a motion to approve? >> so moved. >> second. >> moved and seconded that we approve the consent agenda for august 5, 2015. all in favor say aye. >> aye. >> opposed? ayes have it and so the motion is carried. i need a motion to approve the june 24, 2015 meeting minutes, any corrections? >> motion to approve. >> second. >> it's been moved and second that we approve the minutes