work with the white house on some financial support. and it was determined than instead of bringing many, many people to -- so instead of bringing many people to washington, d.c., they would have five regional forums throughout the country. and then they would invite people from surrounding states to attend those. so the folks in california were invited to one in arizona, for example. those were very well attended. i know from hearing reports about what went on in the forums. they were a little different in each one. but again it was gathering information from professionals in the field and older adults themselves about what is important to them. reports were created out of all four of those. and those reports are actually

on the white house conference and aging website. so you can look at what came out of the five forums. l.a. just happened they were doing something similar. so they kind of flipped the event they had planned and turned it into a forum. but it wasn't one of the five that had been proposed by the white house. and then on the day that we went, and then the white house conference was announced, the date was announced just two or three weeks before. and the invitations went out about two weeks before the event. it was all very, very tight. the white house conference itself, though being very different. there were between 160 to 200 of us. really what the white house, what the east room can hold. so it was a very different conference. there wasn't this opportunity on that day to debate big issues of the day. that had actually happened in the regional forums.

but what we did have is a series of panels who focused on, i would say what we would determine to be key issues of the day. so one of the panelists -- one of the first panelists was on care giving. you had alzheimer and dementia on that and work issues. there were members on the panel, there were family members and people that were workers and cabinet secretary. and it was this diverse -- and i believe someone from the business community who works in the world of care giving. or had a national company. so it was really this kind of cross-the-board examination of care giving and what were the important elements you would want to discuss. cabinet secretaries participated throughout the day. and there was someone i believe on each one of the panels. either a secretary or a cabinet

member and an assistant secretary. there was a lot of high-level participation. as there had been in the regional forums and the other discussions. the president spoke right after that panel. and of course to a lot of applause throughout his speech, he talked about and i would just say, although he was relaxed and used humor, he was very focused, and very intentional in his comments about continued support in social security and medicare, issues around workers. issues around understanding that people want to be at home. they want to live their lives in the least restrictive environment that they can, not his words, mine. and then he announced some initiatives that would support that kind of work. so there is going to be dollars

available for training around alzheimer's and dementia for folks in nursing homes, for example. and he also spoke to economic security. and so there will be a pushing out to the states of rules that would allow the states to create retirement funds for workers who don't have access to any kind of retirement. it was one of the themes of the conference, so many people do not have access to any kind of retirement other than social security, and that's not enough in today's world. so initiative there. there will be funding made available related to elder abuse prevention training for district attorneys. so we can see a greater push across the country. anyway, at some point we will make available to you all the many initiatives that came out of the president's speech. and also came out through the day. the president ended on a high

note, i was in the eighth row, i couldn't see that well at that point. i think he was shaking hands with people on the front row. and left the room to a standing ovation. we then had a panel on economic security. and there were people there who really working in the field. helping individuals get out of debt. and trying to sustain that. i think often i was thinking that day of cathy davis and the work she has done and her staff has done in the bayview to get in housing. in order to qualify for certain things you have to have a pretty clean sheet when it comes to debt and those things. there was conversation about that and conversation about worker wages. it was an interesting panel. the afternoon was held, the sessions were all held in the dwight eisenhower building, not

the white house campus but a different space. again it was panels of people who were speaking specifically to various issues. so cathy greenly, the assistant secretary was on a panel related to elder abuse. and people on that panel were both from the business community, government, nonprofits, who talked about experience and what they were doing in this world. she mentioned she had been to california recently and i believe jill you were one of the people that she talked to when she was here. she talked about her experience. she talked about the people she met that had been abused. and used those as stories in her comments. there was a small panel that talked about innovation. another panel that got much more in-depth into technology. but you know as the day getting

to the end of it, everyone was taking a little more time. i have to say that the technology, which one of the things i was most interested in had to be shortened up. because there wasn't the kind of time available. at the end labor secretary perez gave an outstanding speech. i had never heard him before. and he in many ways was like a call-to-action, i think. he talked about the five -- he described it as the five pillars of the middle class. and reminded and talked about what those were. and reminded everyone in the audience, were from the middle class. and a whole lot of folks out there wanting to join that group of people. and what could we do, what would we do to make that possible. it was a speech where you felt kind of much like the president's, where you wanted to be clapping every other word.

but you knew that wasn't going to work. i would say that the day was -- there wasn't a lot of time for questions. although at the end of every panel there was an opportunity for that. and one of the things that i remember very well was in the care-giver panel, the moderator asked, had gotten questions through twitter and the audience. and was reading them. and one of the questions was, what can aaa agencies do related to caregivers. and really the response from all the panelists pretty conclusi conclusively was to help find them. it was conclusive to me because we work in san francisco for a place in the department and venues in the community for people to access for information and assistance and counseling. and the young woman on the

panel, 31 year-old scientists raising a two year-old and has a father with dementia at 90. said that one of the most difficult things for her was finding services. as much work as we all do in this area, it's clear and she didn't come from san francisco, another place. but more work needs to be done. people suffer unduly if they can't get access to good, solid information. and she said, i wished i had known about all the programs that the panelists had talked about in the beginning of my care giving as opposed to this point. i thought that was a meaningful conversation and for us to think about, what are the things that we do. and what are the things we are not doing and where do we want to go with that. for those of you that know, the organization ido, they do space

-- one of you can probably explain better than i. it's all about individuals and space design. and one of their key people in the organization is in her 90s. she was one of the persons that spoke. i have always wanted to, i have read about them and never heard them speak. it was quite an opportunity in that regard. there is a -- is maria still here? the author that has -- she's an author and activist in terms of caregiving was there. and she got up and gave me her seat in the afternoon. i felt very privileged. i got to spend time with fernando torres gills, one of the leading experts in aging in disabilities in the country. i heard him speak but never had a chance to sit and talk. it was this enormous opportunity

for me to think about new things. but also see san francisco in the context of what i heard people talking about from across the country. so i know that much of the press talked about the disappointment, that it wasn't 2,000 people again. i have to wonder if it will ever be that again. if that technology hit the point where we can do things more locally. and still bring that information forward. but we will have to see. there will be another one we hope in 10 years. i guess the other thing i would announce right after that, as soon as we got back from the conference. the senate passed the older's american act, out of the senate and now in the house. we are waiting to see what happens. that was a nice bookend to having the conference and then the white house conference and then to hear that as well. so was really an honor to be

there and it was just a great day. >> are you finished? okay. i had a question, i missed, you talked about the four panels. one was on caregiving and technology and what was the other? >> elder abuse. >> anybody else? so all of this happened in one day? all of these panels? >> yes. >> one day? >> one day. and then you hop on a train and go back to philadelphia, and are very, very tired and like this -- all of this information. going through your head.

i would add there were over 600 watch parties across the country. so they were streaming the event all day. because i got text messages from people who were watching. and commenting on the day. so i think that adds another piece to this, why we may not see a huge group in d.c. >> next document for community living fund. for the year 15-16 annual plan, executive director. >> you have this report in your packets. and i am not going through the whole thing. as a reminder and background. the community living fund was put together and funded about eight years ago. i am thinking, nine years ago now, is that right, linda?

and this fund came about because there was strong community interest in seeing that kind of back to living in the least restrictive environment; right. making sure that people who could live at home, lived at home. and at the same time we had a controller who had a personal -- partner had a personal interest in this subject. they had a family situation and another part of the state had tried to find services and had a hard time doing that. and came back really wanting to look at what was the nature of things in san francisco. so the stars kind of aligned in that sense. initially it was thought that this was also during the time that the rebuild of rio hondo was taking place. and initially a thought that the rebuild won't cost as much money. some money could be set aside. and a large enough fund to draw

on the interest of the fund and help people stay at home or come out of lagunda honda that didn't need to be there. and that idea was soon given up instead under mayor newsom, they decided to create a community living fund. it was $3 million strong. and the money from that fund would rollover, if you didn't spend it all in one year, it would roll forward. for those of you heard this report before, you know that for the first few years money was rolling forward and we had greater dollars to spend. this was a locally designed program. we were able to bring staff on to help us determine what kind of program would be the best for us to implement to achieve the goals that the community living fund language had set out for us. we soon determined that a

program in philadelphia was a model that we liked a lot. it was not so dissimilar from the mmsp and the linkages case management and services program that we had in the state of california. we went with a model that was case managers with small case loads. not 40. but much smaller. because they would be working with people that had either been institutionalized and wanted to come back to community, or at home and had a lot of difficulties. that's what the program was set up to do. it's been enormously successful. and this many years later we have both santa clara modeling programs after this. and due to the care initiative they are able to set up similar funds. we have local people in san francisco, some folks that worked in this area with us are providing that service in those counties as well.

so by-we're required to bring forward to you the annual plan. so what you got in your packet is 2016-17 plan. and i would just say that the big news this year, and it's on page 5 of the report. is that thanks to the long-term care coordinating council and the advocacy provided through them, an additional $1 million is added to the fund. when we thought this might be the case, staff started working on what we thought would be appropriate uses, and gathering information and data. we have a lot of information that we have gathered over the years. and talking to people in the community about where are those needs and what is important. you see on page 5 that what we are really looking at in terms of these new dollars are housing assistance. home care. and home modifications. and we are pretty clear that

that's -- this money will be spent. there has been a need in these areas and we have not had the dollars to do it. we were doing home assistance for a while when we had, as i said when that money was rolling forward and we had greater dollars. we were able to do home assistance. but once back to the base level of $3 million, we had to stop that. this is what we learned from the data review and from the community, these were the areas where we were lacking. and this is what we will be focusing on. and then i would say turning to page 6, you will see that we have added two new performance measures. and we're looking at the percentage of care plan problems resolved, on the average after one year. and we are looking at the percentage of clients with one or few admissions to acute

hospitals within a six month period. so we really -- we have been tracking other measurements as well, but these are the new ones we added in. we think this is important for success. and linda and carry and i are here and we can answer any questions about the report. that's my summary of the highlights. >> commissioner? >> thank you. how do we approach the housing assistance? what strategies do we have? i imagine it's very challenging in today's renting market and housing market in general? >> a number of years ago, not remembering how far back.

after the second lawsuit, the chamber's lawsuit. it was determined that housing would have to be a key component of any work that the city did, just setting aside the community living fund. this was a lawsuit against the city saying fine and good, people are coming out of laguna honda, but you can't come out unless you have somewhere to go. and the service about housing. the city at that point when they settled the lawsuit created a fund, a housing fund. that was specific for this population of people. and at that point a contract was put in place with westbay housing, which has a different name now. brilliant corners. and they have been the organization to find the housing, to lease the housing, to do the work with the clients around making sure that things are going well. on the housing side. i mean these are folks still

receiving case management. so it's a wrap around them. so that's what has been happening. now that requirement has come and gone. because we reached the number of people that the city said in the lawsuit that we would do. but we still have this relationship with brilliant corners. and so we are still working with them but they are the ones that find the housing. and sometimes that housing is in daily city, or sub-city, it's been in my understanding in the past for some population. it's not necessarily going to be housing right here in san francisco. >> thank you. >> but harder and harder to find. >> i have a question. >> commissioner ow. >> for the last four years when the community funding [inaudible] san francisco put in $3 million a year.

and today i see this california, right, money coming from the state, are we talking about this? >> the only other money that comes into this fund is for any of the staff that do time study. and so there could be time study money coming in. but the vast, vast majority of this money is local, general fund money. >> right, and this has nothing to do with the community living. >> i can't see that document -- >> the renewal for the aging. >> no, no, this community living fund report. >> right; right. 100% funded by the city, and spent on behalf of the city. >> pretty much. there a little bit time study money, about $400,000 or $500,000, but the vast majority of the money is local money.

we were able to design it locally and why we have such flexibility to change it when we have seen that the program wasn't reaching the goals we wanted. or maybe we didn't have enough case managers. whatever it be. we were able as time went on to change the program to reflect the needs of the community, which has been great. >> i have a question, i know, i have been keeping record in my community. there about three or four ladies who are talking about getting the wheelchair lift. they have a time trying to get up and down the stairs and to get out. and i am just wondering, i know it's based on need. economic what have you. but is that something that -- how -- what i am thinking of, is that something that can be done in bulk.

like go to the institution that produce this and say, we need five people or do you do it individually? for each person? or is there something like that you can buy in bulk? >> so the -- they have a relationship with the company that manufactures them? >> no, no. i am saying that -- >> the institute on aging with the program has a relationship with the manufacturer -- not the manufacturer but the program that the agency that supplies them. but the first step would be to know if they have made an application for community living fund. and then they would, they would be found eligible or not. depending on the criteria. >> i would say we have -- we raised the eligibility for this program higher than we have for

some of our other programs. but still only 300% of poverty. so there is a lot of people in the community that don't qualify. you can fit the need but still have too much income to qualify for the program. so it is a program that is designed for very low-income people and that does leave a lot of people out. but the thing to do is have people apply. and linda said they will do the resource and investigation and all that and figure it out. >> what i am thinking, if they don't qualify, is there some way that we could get that sort of service to help them in some way to do it in bulk? if they don't qualify with the company that you are doing business with. is there some way we could help them out in terms of going in and asking for a discount?

>> i am not sure. >> let's talk about that. >> i can look into that. >> i think that's not something that we can do in the community living fund. >> no. >> something that we look to do outside of that program. and is there another vehicle for us to do that. >> for us to do that. >> i think one of the things that we talked about a lot and people in the community have talked about forever, how do we provide service for those folks who are just above this; right. so this is i think a really interesting idea to think about what are some of those services that you need the entity to have the contract. but again if you were doing a bulk purchase you might be able to lower the cost. >> lower the cost. >> great idea. >> this is what i am thinking about, could we talk about that? >> sure. >> thank you, i am making a list of people. thank you. any other questions?

okay. >> i have a general question. so this is based on philadelphia model, how does it compare now to that model? >> so i -- philadelphia is a little different. because they're a nonprofit organization and they have some of the same programs that we have. for example, in most states adult protective services is part of the government. but years the state asked this nonprofit to take it on because there was so much corruption in philadelphia. and it's an interesting organization what we think of government programs alongside nonprofits. they are also the entry point for the pace program and nursing homes. which is -- we don't have any of that in california. washington and oregon have similar opportunities there. so they have an area of aging

that in many ways they have a waiver program, and they provide direct service and a policy body and have this interesting mix of programs. so when you come through their doors, you are assessed. and this is the same for us, when people come to us, they are assessed. in our in-taking screening unit. for any program that we are aware of in our program. both things we do in-house and things that are external to us. and that's where we really mirror them. we don't do screening for pace for nursing homes, for example, but we can give people information about that. the folks have a great understand of the programs. it's part of why over the years we really built our in-taking screening unit to what it is today. and now will be introducing, we're not calling it the hub anymore, but in my mind, where

we have veteran services and medi-cal and everybody in the same place. i think we mirror them in many ways. we certainly have kept to the model of case managers having low case loads and this purchase of service. and we have seen great success with that. we have not moved into some of these other arenas because we feel there are people in the community that do that very well. but -- >> thank you. so i came across a couple of patients earlier this year where they were placed in hospice. and two years later they needed to get out. because they were doing actually quite well. >> yes, and as is often the case. >> yeah. >> does this fund also address these people? >> this fund can address anyone as long as they meet the income

eligibility and the assessment giving their health and their ability and who can live in the community. who want to live in the community and are able to live in the community. and again there is almost nothing we can't do, because it's local money. so we have this ability to create the support that the particular person. please feel free to refer people. >> thank you. >> thank you. next, could we have the advisory council report, mr. schmidt. >> good morning, president james, commissioners, and executive director hinton. the advisory council met on july 15, and at that meeting we acknowledged that executive director hinton was one of 200 people invited to the white house conference, and very

pleased that she was able to represent san francisco. >> thank you. >> our reports of our committees, our membership committee is still active recruiting folks for council. we have some vacancies and we are really looking for people to fill those vacancies. we had in terms of our report from the education committee. we had a very successful event at the bethany center in july. it was on aging and h.i.v. and daas staff person, mr. acleby had a great job of identifying speakers and we had a full day. and everyone left with a little more information. and it was the first time that h.i.v. and aging folks had gotten together.

it was a first and we hope to continue those types of presentations. we have -- september will be our next bethany center training, that's on elder abuse. and looking forward to having a good turn-out there also. the membership committee is still actively seeking folks. our site visit, we had two site visits in june. and both went very well. one was at the castro senior center and the other telegraph hill senior association. and report back both are doing really well and continuing to do our site visits. that's my report. any questions? >> yes. >> yes, ma'am. >> how many members are you short on your advisory board?

>> we have -- >> vacancies. >> we have 22, and eligible to put 22, and i believe we have now -- virginia can you help me, we have 15 now. so -- >> so about seven, okay. yes, commissioner. >> thank you for the report. are most of the vacancies because of supervisors haven't appointed representatives? >> yes. >> thank you, anything we can do to get the supervisors to focus on that and submit candidates? >> [inaudible]. >> recommendations?

okay. okay. thank you. hopefully we will have some. >> yes, that's our hope also. >> thank you. >> thank you. >> thank you. joint legislative committee report, is there one? >> commissioners, being that co-chair diane lawrence is absent, there will be no report. she did submit a written report and that will be in the minutes for everyone to read. >> thank you. long-term care coordinator. >> i might add that the legislative committee also voted to not meet in the month of august. so diane's report for the next commission meeting will probably be some detail from our last meeting because there won't be one in august. >> but we do have a co-chair from the commission on aging. to assist her, don't we?

>> we do. >> okay, so that can happen at the next meeting. >> yeah. >> we will look forward to that report, thank you. okay. long-term care coordinating council. >> good morning, commissioners, i am chip savanage, i am a new member of the long-term care coordinating council. i provide advocacy for adults with disabilities. reporting from july 15, the council saw three providers of service that gave council members a three-prong examination of the mental health continuum of older adults with people with disabilities in san francisco. each from a different perspective, micro, and misso

and macro. and first perspective was behavioral services look like for older adults and/or caregivers to access services. two impediments to access care, and first is stigma of mental health issues. and the other is existing gaps in the payment system, including managed care. next the meso-level of service delivery was presented. and that's what the san francisco system of care covers and what it does not, and the safety net role. the council was provided an overview of department of health, and particular emphasis on substance abuse services. and potential to maximize the recovery and meaningful lives in the community.

this includes emergency services and housing and other services. there was several concerns about assistance in san francisco. behavioral services and to have an organized delivery system and to better manage client conditions across levels of care. and finally the micro-manage of affordable care act and service delivery and other policy issues. it was emphasized it's appropriate to view mental health as physical health as there is a direct interaction. the primary challenge is the availability of services. key to ensuring access to necessary services is paramount. which encompasses the development of specialized older adult programs, implementing referral services and

collaborating of providers and screening. in other news the council has an assessment of the council founders of the scan foundation. and the scan event will be friday, october 23, 1-5 p.m. at the main library. there is two parts. one is a forum on san francisco as an aged and disability friendly city. and the second is a reception with a brief program. we invite all of you to attend. and finally we have two new members on the council, voted in july via email. and they are berndette simeon and jeremy [inaudible] for at-large slot. that concludes my report.

any questions? >> thank you. >> thank you, that was very comprehensive. on the mental illness issue, i know there are complicated legal issues regarding many people are diagnosed with particular problems and medication is prescribed. and yet often the side effects of the medication are difficult or the individuals forget or don't take the medication. are there strategies in place to address those issues? >> i believe there are, that is not my area of expertise, i believe there are programs to help people stay on their meds. in the h.i.v. world there are programs to help folks to stay on their meds. i don't know if similar things are done by behavioral health services but simple things like an alarm. >> it's often that the side effects are complicated and the individuals don't feel well when they take the medication.

and consequently their behavior becomes erratic. and it's difficult to compel them to take their medication without a complex legal process. and that accounts for the many people that we often see on the street. clearly disturbed and it's complicated to compel them to take their medication. >> no, there is not any -- [inaudible] this is more in your area than mine. there is no legal authority unless someone is conserved and getting conservativeship is not something that anyone does to do it. it's a serious thing to take away someone's rights. unless someone is conserved, if an adult decides not to take their medication, they have that right. there is a lot of work but a

balance between a person's rights and these other things are difficult to address. it's interesting that one of the studies that someone reported to me recently. there is a larger population of folks in california, an established community that have been there 30 years. and a large group of people that are in their 90s because they moved in, in their 60s. and i was told recently, i can't remember the name of the place, they now have contracts with marijuana growers north of california. because they had a number of folks on medications that were leaving them with such side effects that they didn't want to take them and stopped taking them. and they have been exploring other avenues of medication. it's not quite what you are talking about. but they have seen and are

documenting the outcomes for those people. but i think this is a very big issue. and i think one that we have not solved. seriina, did you want to add to that? >> good morning, deputy director for department of aging and adult services, and i was going to say in california when we conserve someone we don't get blanket authority. and the reason we don't, because in san francisco we believe that people have the right to refuse medications. so they may be placed and opt not to take the medications. but we find that most people do take them and work with their conservator and doctor to get the right medications. but san francisco has a long history of not doing that even

in conservator situations. >> thank you. >> you have another question. >> thank you for that, but that's for people that have been conserved. not individuals who don't have a conservator, is that correct? thank you. >> is there public comment at this time? we don't have -- >> i want to say there is a state law that addresses this. >> okay. >> [inaudible]. >> okay, the only thing that i know in my experience that i haven't gone to court with this. is that unless that patient can become a danger to himself and

others then a 14-day hold for that medication at that time. if they are a danger to themselves and others they are kind of given that medication iv or whatever to control that. but only for 14 days and i think you can extend it to another couple of days and after that, that's it. you know in terms of medication. if they are under control with their behavior. that's the only legal other part of it that i know of. okay. next is the long term -- taac report, cathy russo. >> hello, supervisors, cathy russo from the advisory council

with the taac report. >> you said supervisors, commissioners. >> taac meets quarterly and we have a meeting next week in sacramento. at the last meeting there was a strong recommendation that we all consider joining the california elder justice coalition. and i do have a hand-out on it. i made copies for you. the recommendation was because of the communication, they communicate well with the membership. and they felt that if we belonged, we would have a better idea of what was happening in senior programs and senior issues throughout the state. which is a benefit. also they are very open to bringing in communication from the members. so that if we are a member, and

we want something known or get question out again, we can work through them. so for these reasons they strongly advised us to look into joining. now for a group, the dues are $150. for an individual $100. however, they obviously are for seniors, because if you are retired, the dues are $25. so i am considering joining. seeing if i can find out what is going on. i have a leaflet here that gives a description of the program. and what they do, and there is a membership application on it too. i have given a copy of the original print out to our secretary. because if you want more, she can certainly do a better job than me for making copies. but this is for one for each of you here.

keep us all up on it. but i think we have such an excellent program in san francisco, they need us putting the information in for everybody else. and i just might add that the staff for the state commission on aging is the staff for taac. they set up our programs, meet with us. so for some reason you want something hand carried up to the state commission on aging, when i am going up, which for example i am next week. i will gladly take something up for you and give it to their staff. and that's my report for today. >> thank you. >> any questions?

thank you. >> thank you. >> next we have case report. >> no, old business. >> that was the case report. >> no, that was taac. >> commissioners, executive director hinton, i am the director of the richmond senior center in the richmond district of the city and member of case board. case last february hosted an advocacy meeting. we had 80 people attend, 30 agencies represented and the other 50 were seniors and constituents and people living with disabilities. it was a great brain-storming session and helped form our advocacy season last year. our biggest success, something that we work very hard for and appreciate director hinton's in this area, was to get additional

funds for san francisco senior center. senior centers haven't got additional funding in many years. and what is great about this, it will be open for all senior centers and impact every district of the city. some more consumers than, i don't know what to say, a lot of people. i mention this because on monday we are hosting our annual advocacy planning session. this is going to be open to anyone who can come. it is monday, at 3 p.m. at project open hand. >> thank you. any questions? thank you. old business. none. new business. under the items below, item "a," request authorization to modify the granted with family service agent of san francisco, doing business as felton institute for

provision of senior companion services. during the period of july 1, 2015 through june 30, 2016. in the additional amount of $55,000 plus a 10% contingency for a revised total not to exceed the amount of $86,368. could i have a motion to discuss? >> so moved and i have a question. just about the numbers. it's 55,000 and a 10% contingency, 10% is 5500 that gets us to 6500? >> this is in addition to the underlying part of the contract . >> okay. >> i have a second -- did i have a second? >> second.

>> okay, all right. you are on. >> good morning, commissioners, executive director hinton, this item before you is a modification with the grant of felton institute program, adding $55,000 to that contract. the additional money is to expand the program, and we are increasing to 15 total senior companions in the program. the senior companion program recruits and trains adults and places them in volunteer positions. senior companions are expected to work 16-20 hours per week. in exchange for their service, they are provided a small stipend, what is great, it's tax exempt and excluded from

counting to any means base such as medi-cal and housing. what is great, it's seniors help seniors. it's an opportunity for them to give back, to play a role in their community. and perhaps provide a sense of self-worth through employment. and the work may help them maintain physical and mental alertness. for the agency that is hosting the senior companion. they are able to expand and support services by having this ongoing staffing there. depending on the type of placement, the senior companions work might be social visits to clients. escorting clients to appointments. and helping client participation in organized activities and some life-care needs that they may need during the day.

currently daas senior companions are deployed at a senior center to adult-day health centers and one is case management program. with the new 10 we don't have set locations yet but hope it to be a mix of those types of organizations. with that, any questions? >> is this an expansion of a pilot, why the budget is so small? >> no, it's a program that has been funded at lower levels for a number of years. >> commissioner. >> with the expansion would be have someone at all the senior centers? >> no, so we are going to go -- i think the idea is with these 10 more to spread them as much throughout the community as possible. but off the top of my head, 10 is not enough to meet the needs

of all sites. and typically housed in one center. >> and one concern is the gay/lesbian and transgender persons and if is there any help in that program? >> no, the senior program hasn't had help since these first five. and while deploying the senior companions that is noted and could be factored in. >> thank you. >> any other questions? >> i had something really quickly. commissioner, so one of the things that we are working on is that there is a new funding source for working with isolated

lgbt seniors, we will be working with organizations around developing the scope of service for that. it was something that open house and shaunty came in together on, to the board of supervisors and we have some new funding. we can look at that issue. and in addition to that, marcy adelman, and other folks, rick appleby from our office talked about the lack of appropriate services for lgbt seniors, and had a meeting to talk about the services for lgbt seniors. there is going to be work around that and needs assessment around that, i wanted to say that is being looked at. >> thank you very much, that is encouraging. >> thank you.

any other questions? if not, i will call for the vote. public comment? any public comment? thank you. hearing none, at this time i will call for the vote. all in favor. >> aye. >> opposes? aye's have it and the motion is carried. item "b," requesting authorization to modify the grant agreement with kimochi, inc. for the provision of community services for seniors and adults with disabilities. during the period of july 1, 2015 to june 30, 2016, in the amount of $53,200, plus a 10% contingency for a revised total grant amount not to exceed $609,261. could i have a motion to discuss? >> so moved. >> second. >> okay, you are on.

sorry about that. >> everything okay? >> thank you, yes. go ahead. >> okay. good morning, president james and commissioners, and director hinton, i am with the department of aging, office of the aging. we are here to seek your approval for a kimochi service grant modification. this money will be used to increase service units and as well as boost the program's infrastructure. kimochi services provides services to seniors at three locations. the main office on sutter street. the kimochi lounge on webster

and then 1715 buchanan street, and kimochi is looking to provide stipends for instructors at the various centers. and in addition the money will go to keep the website up-to-date with program activities and to pay for outreach for the program and i.t. support for the system. we urge your approval of this and if you have questions, i will answer them now. >> commissioners loo. >> i am looking at the last page the site [inaudible] page. is there a typo somewhere on the 1580 west room 20. >> is there a typo? >> monday is blank and the other is saturday. is this a typo? >> i can look into and see if

that is a typo. my understanding is that it's not. >> at the bottom -- yeah. >> i can -- hold on one second. steve mccosher will come up and clarify. >> maybe they are open six days. >> good morning, president james and commissioners, commission loo, we are talking about the kimochi lounge, 1581 webster street, that was the original site for the kimochi senior center, when we started 44 years ago, in the old days we used to be open seven days a week, with a lot of volunteerism as well. and we maintained the saturday open as well, because the lounge is located in the japan trade

center and it's tremendous access. and many times on the weekend it's out of town japanese americans that come to the community. they used to come for grocery shopping and didn't have access but still come. and it's one of the best places for international folks that come from outside of the united states. we maintain that balance between the weekday and as well as the saturday. and we have a strong policy any time it's open it has to have a staff person for oversight for the facilities. and it would be nice again if energized by volunteers and open with them. very often the volunteer will accompany the staff person, commissioner, but it's a staff person's responsibility. >> because monday tend to be a slower day, why it's closed on monday? >> yes, and the thinking is if we can balance that scheduling during the week and the month,

we can off balance that. generally the monday are the slower days, but again i have also had many requests to open on sundays as well. but just can't do that at this particular time. >> due to the [inaudible]? >> excuse me? >> because you need volunteer to open? >> right, but we need have to have a staff person responsible. because it's part of our organizational program site. and responsibilities in terms of all kinds of things from information, referral to liabilities and things of that nature. and we want to be sure that folks that come to for contact are properly referred to. if staff services are not there during the weekend, we try to get best efforts and get their names and phone numbers for follow up. >> thank you. >> thank you. >> any other questions?

commissioner. >> i have a general question, not necessarily directed to kimochi, it says number of modifications, three. so i wonder this grant was issued or renewed perhaps in 2013. >> uh-huh. >> for five years? >> uh-huh. >> so from 2013 to date, this is the third modification request? >> correct. >> how regular are modifications gone? and if a grant is approved, how soon can an entity request a modification soon after? >> that's a good question, with my experience to date, what i have seen in particular with this contract, it's a codiby increase and that was cone modification.

and last year kimochi was awarded additional money. and this is for the 53 -- one third. >> i would say to your question, modifications can happen pretty quickly. because one of the things that you will have noticed on the commission, we frequently bring contracts to you in may and june for approval. and then our budget doesn't isn't finalized until july. and in the course of that budget being finalized we could end up with a cost of doing business increase or new dollars. so you could see adjustments coming to you really within months. so it can happen pretty quickly. and as monty said it depends on what is going on in the world. cost of doing business is frequently what you see. and sometimes we have these circumstances like today, where

there is dollars available to put into a program. but it can happen pretty quick. >> thank you. >> any other questions? thank you. >> thank you. >> public comment at this time? any public comment? >> commissioners, we ask for your support, thank you for all your years of support as well. we are ernestly trying to provide the services that we can. >> all in favor. say aye. >> aye. >> opposed? ayes have it, and motion is carried. "c" requesting authorization to renew the grant agreement with next village san francisco for the age and disability friendly community project. utilizing the village med --

model for the term of july 1, 2015-june 30, 2017, in the aim of $20,000 plus a 10% contingency. motion to discuss. >> motion. >> second. >> we have before you the village model service a membership organization that provides an array of services such as organized activities and assistance with transportation. and inhome support with minor repairs. and referrals to recommended businesses and health and wellness opportunities. and a wide gamut of services provided by paid staff, volunteers and the fellow village members themselves. another unique village feature is that specific location is not required. villages utilize public spaces throughout their service area to provide services.

for next village recently examples will be disaster preparededness kit distribution. and a new member event at senior housing in chinatown. or a travel talk at the north beach library branch. and we have partnerships to help provide additional transportation resources to the members. next village has a distinct service area. generally the northeast section of san francisco defined loosely as van ness to the east, van ness to the south and bay as at north and eastward barrier. program monitoring for next village for fiscal year 14-15 was conducted in july. there were no findings and next

village was found to meet all service agreements for the previous year. at the time of monitoring and looking at membership and diversity. next village at the time of monitoring was 113 members. among the membership, approximately 22% was identifying as noncaucasian or lgbt, and next village is taking an interesting approach to expand membership and diversity. and they have a staff member with chinese language capacity. they are increasing each in their monthly newsletter, there is always a chinese language article. and they are targeting events in known chinese speaking sections of their service area. i am told that these out-reach

efforts have paying dividends and they have new chinese speaking members in the past week and that number has gone up quite a bit just recently. with that, i am happy to answer any questions. >> commissioner loo. >> i am looking at the page, appendix page 2. the salary and benefit details. >> yes. >> okay, the employee fringe benefit is 0% and i thought by law you need to give benefit to the employee, how do they -- >> they are paying those costs off the contract. with other funding sources. well, you know this is one thing i have thought about. contractors have raised their own money to pay off some insufficiency of the funds.

and maybe you know, this should really be part of the budget. because otherwise it's not showing you the actual costs. >> so commissioner, i think one of the things that we have -- one of the reasons we have gone to this model is of not asking our contractors to supply us with all the information regarding their budgets. you are right, it leaves us maybe not understanding the full cost for the program. although in our monitoring and our discussions with the contractors, believe me, we do hear from them about what the real costs are. but it's really a matter of administrative support. most of the nonprofit organizations that we fund do not have really enough infrastructure. and support to do the kind of reports that we require. because we have not had

sufficient support and we ask what is only pertinent to the dollars they spend for us. when we get to the point of funding -- we have a lot of requirements our contractors, a lot of data requirements and budget requirements. so that is the case, but we have made a decision to do that given the resources that the contractors have available to them. >> commissioner sims. >> just as a follow on to that, isn't there a requirement that agencies seeking funding from the city provide some minimum standard of non-cash benefits to their employees? >> i believe that the rules are based on how many staff. there is a threshold. so -- clearly our staff knows that this organization is providing benefits. but it has been my understanding

for a number of years, that organizations i am not sure of the number, five or less, do not have to by ordinance. but i would have to check into the rule for you. i am not positive what that threshold is. commissioner, do you know? >> i don't know if it's -- i know that all things are mandatory at 15. >> 15 employees, okay. >> commissioner sims. >> second question, could you repeat the geographic boundaries. >> van ness, broadway and the water. >> van ness and west? >> van ness to the east. >> to the east. >> yes. >> and broadway to the north. >> yes. >> okay, any other questions? if not, i will call for the

vote. all in favor of approving say aye. >> aye. >> opposes? the ayes have it and motion is carried. last item review and approval of the fiscal year 2015-16 hicap and fiscal year 2014-15 mippa budgets. associated with contracts hi-1516 and mi-1415-06. and all subsequent amendments. could i have a motion to discuss? >> so moved. >> second. >> okay. you are on. could you explain. >> yes, so this item before you is actually for the approval of the contract between cda and daas for the funding of our hicap and mippa programs. this contract is just for that

and part requires to go before the commission for review and approval. and with that the contract is finalized and we are able to access the funds in the programs in the city and county of san francisco. we have gone through the solicitation process for the contractor for the hicap and mippa programs, that occurred in the spring and came before the commission and approved. with this it's the final step in the process and gets everything moving and the funding flowing. the contract before you is a standardized agreement, it says standard agreement on it. i can assure you this is the contract used between the california department of aging and the two other aaa's in the state of california. with that said, i am here to answer any questions you might have about this contract.

>> any questions? does this -- does this increase -- i know they have certain communities they go to, does this increase? or do they stay? >> the only change, there is no change in the scope of services of self-help we provide. the only change when the actual state money came in, it was $2,000 lower than we thought it was going to be, hopefully that won't affect any services. >> okay, any other comments? public comment? hearing none. i will call for the vote. all in favor. >> aye. >> opposes?

ayes have it, so the motion is carried. thank you. announcements? hearing none. announcements? hearing none. public comment. yes. >> hi, good morning, cathy spensly, director of the senior division at felton. i appreciate your question, commissioner, regarding medication support. we specialize in mental health in our agency and geriatric mental health. i wanted to let you know it's a very important issue, in all of our contracts we have psychiatry and medication support is tremendously support. and with that said there is a huge deficit of geriatric psychiatrists in san francisco.

that's an issue but we have a lot of support in that area. and the medicare service act is a help and with hiring of peers for folks that are less willing to take medications. and a lot of data of how peers help in this area. and laura's law is a state law that various counties have adopted and san francisco adopted in may. this is compelling serious cases for folks to come to the courts and compelled to take medicat n medications. it was brought forth by family members, [inaudible] and will compel the folks to do it, and almost to the psychological fact of going to the court system.

but at the end of the day, it's a civil rights issue. it's very difficult to force folks on medication, and that's actually a good thing in the long run. and the best news that the newer drugs are better at their efficacy and reduced side effects. thank you very much for the question. >> thank you. >> hi, jessica layman with fsda, and i had two comments on the issue that cathy was speaking about in terms of medications. i want to bring in the room that there is a long history of people with medical health issues and forced to take medications. and some things are disproven.

lobotomies for example is real for a lot of people. and there is a huge movement of people called mental health survivors and consumers and there is a lot of different ways to deal with mental disabilities, and medications is one of them and something to look at as a society. i know that san francisco mental health could speak to how to look at it from a peer perspective and talk about medication. from the white house conference of aging i was so glad to hear that director hinton was able to be a part of it and glad that they held it. i had a lot of concerns about how the community was or wasn't involved. and i understand they talked about including people with technology. but here in san francisco senior access and other groups really

wanted our seniors to be a part of it. and it was very challenging. part of it we didn't have a lot of notice. we tried to set up viewing sessions and they didn't put out the time and agenda but a week ahead. and the white house conference on aging information was not available to community groups. and then they invited people to share messages primarily through the website and twitter. which i found almost amusing. because how many seniors in our community, particularly low-income seniors on twitter. i think -- i hope we as a city can do our part and thanking them for theire efforts. but urging them to do better and really involve low-income seniors in conversations about seniors. >> thank you. any other comment? public comment? okay.

>> good morning. i am linda lou, nutritionist in the office of aging. and want to bring to your attention upcoming diabetes program that the senior center is helping they have always scheduled and we have sent this information out and shared with daas contractors and the network. we wanted to let you know if you want to pass it on and share with your friends and network. i have hard copies on the table and you would like electronic copies, i can share with bridget and share with you. >> hearing no other public comments, can i have a motion to

adjourn. >> so moved. >> second. >> it's moved and second that we adjourn the meeting. thank you. meeting adjourned. [gavel] >> i now call the regular meeting of the health service board city and county of san francisco to order. holy stand and repeat the pledge of allegiance. >>[pleage of allegiance] >> the board secretary will

call the roll. >> rollcall. resident scott-vp lim commissioner breslin, supervisor farrell excused commissioner rigo expected commissioner-omission or sass. we have a quorum. >> item number two, shifted one, i'm sorry jacob thank you. item 1 action item. approval with possible modifications of the minutes of the meeting set forth below. together meeting of june 11, 2015. >> are there any additions or edits to the minutes? >> i move we approve. >> it's been properly moved we approve the minutes is distributed and posts. is there

a second >> second chapter properly moved moved and seconded. approve the minutes as distributed with the regular meeting of approve the minutes as distributed with the regular meeting of june 11, 2015. is there public comment? hearing none, we are now ready to vote. all those in favor say, aye. opposed, nay. the nay had. >>[gavel] >> item 2, >> item to discussion item. general public comment on matters within the board's jurisdiction not appearing on today's agenda. >> is there any public comment? yes, please >> my name is diane perla. i spoken to you before about nine- my dispute with-getting this oral appliance cupboard on the follow is it and i got a phone call from the kaiser represented same that they had

decided they were not going to cover it. i would get a phone call from ms. hill at the health services system explaining why because i asked her to send me a written statement so i would understand what's going on. this was about a month ago and i never heard from anyone at the health service system. i just think i am entitled to get an answer of what was decided and why. >> thank you. before you go accuracy, just remain there. i want to formally request that your request be given to director dodd and that she follow up with you through her staff member. thank you. any other public comment? hearing none, i like to go to item 3 which is the presence report. i do have a few items that i wish to cover. first, i have a privilege under the auspices of the board to participate in an international foundation employee benefits plan trustees

institute, which was conducted here in san francisco on june 15 of this year. this was a very wide range in -presentation. i found a lot of information in some of the sessions. some of it was very, in my humble opinion, very elementary, but i think that you have to take that into account given a person's background and experience in the field of benefits. overall, the program was exceptionally well done. in order to qualify for a certificate of attendance, you had to attend 13 sessions. i did that. i think it's worthy that i go on television and say that i got my certificate in the mail, and

two days ago. saying that i really wasn't there. i know there was some question at least in my office, about where i was. i was at the sessions. there are any number of these items that i think will serve us well as trustees, or in our case, commissioners, as we have a little later in the fall and open forum for this board, which director dodd and i have discussing in terms of items for discussion at that session. not only is it a fiduciary responsibility information that we've asked our good counsel to begin to pull together. it was a very extensive session about. it was another session on various trends, economic and healthcare trends that plan fiduciaries and planned designers and administrators need to be aware of. one of the areas to me also very interesting was the fact that there was a session on specialty drugs and a mystery,

if you will about how indeed they are developed and priced. for us to pay for. this is been a central question for most multiple employer plans across the country and we been experiencing. as well and it's been a big issue at the state. so, i'll be happy to share the content of the sessions with any of the members of the board. i downloaded a number of the presentations and plan to send those over to catherine and her team so they can share them with the rest of the board, and wider as necessary. earlier this week, director dodd sent as a wall street journal article. it summarized a bit of the full report of the academy of actuaries, american academy of actuaries report, which was released on august 5. so delighted to see our actuary out there, neil, i want to tell you i went i read the full report, neil. i'm going to send

electronic version of that to kathryn because i think it's warrant some review by all members of the board. it is in english. it is in english. there's not a lot of formulas in it or anything else. it's really a very excellent summary of trying to find the drivers behind core medical inflation and the cost related to that more broadly across the country. it would be worth our while to kind of have that in our background as a prep piece, if you will, for the november form that were going to be having. so it can serve as a springboard for that get the wall street journal did a fine job in summarizing it, any actuarial report i think will give you a little more detail about how that-how they to some of the summary points, that particular link came from the international employees benefit plans on base. that's how i found. it just was one of those things as part of their daily

updates. we are all members of that group and so you'll be getting an e-mail daily from them. a lot of the stuff does not apply to is that you can skip right there. occasionally, there are these articles that are there. there is also a report that has come across my attention by a consulting firm by the name of deloitte. not a small firm. it is a survey on consumer behavior for people that are participating in exchanges. it's the first such nationwide report on that issue. some of the conclusions might tend to be surprising to some folks well people are going just to go to the exchange to get it insurance covers. every some of the early indicators are that people are trying to make informed choices about various kinds of services, that

they are indeed, trying to inquire about preventative care and how it's to be utilized in their circumstance for themselves or family, and there are other things that we would want to assume that people are doing around how they are using their health benefits. day in and day out. doctors visits, owing to the hospital, whatever happens today. so, this is another piece that i'll send along to catherine for distribution, but i think it's an enlightening starting point because in my mind, the question is, are members doing similar things? we are seeing things in this particular larger arena that might be very useful and the question is, can we learn from that and encourage our members to do likewise. sauce on that along to everybody for your perusal. lastly, as far as my report, it is my great privilege and honor to say that we have a full

health services board. i expect a little pause reaction around the table. with the appointment of dr. stephen elliott-good i'm not going to recite his entire resume, but he's had a very very distinguished medical career here in the bay area. more recently, at kaiser, but also part of the uc system serving at uc san francisco. he has taught in medical schools. he's done very special work in hiv and aids research. he has served as a medical leader in many many dimensions, both here locally, weaselly, and nationally. i am honored that you were willing to take time out of your day to be a part of our group, and i look forward to working with you commissioner falkenstein. do

you have anything you'd like to say? >> college essay is actually a privilege to be asked to join this board. i've been a resident of san francisco since 1977 and in practice here i started my training internal medicine at ucsf at that point, and retired in february of last year. so, 30 some odd years of medical practice. i would say that i practice in essentially every hospital in the city, after which don't exist anymore. it wasn't my fault. partial halo, french i could go on and on. i was cheap that staff at davies. i spent half of my professional career in what we call fee for service. but starting in st. luke's and then in 1998 joined kaiser in the discipline of infection diseases and hiv medicine that i was also president of the dental medical society for agent. i really feel this board

and the medical community that very well into my own passions. i hope to learn a lot from every single person in this room. that's what's fun about this. thanks >> thank you commissioner. we will look forward to working with you. so with that, that concludes the president's record in alaska there's any public comment? >> good after good afternoon commissioners. claire-president of retired employees and a former member of this board. i like first of all to welcome the doctor. it's really wonderful to see a full board again and it sounds like you're the kind of experience that will be helpful and beneficial to all the members and two other members of the board. so welcome. i also want to comment you, commissioner scott, going to and the conference finally. it was something that we did a

lot more when i was on the board in earlier days,, when the city's budget was so bad that all travel and training was removed from most budgets, are board get into the traveling to those conferences anymore, and the staff couldn't even though i think our travel and was to be paid out of the trust. but, it's very important. there's much to be learned in those conferences and i would strongly urge that we really, while there are a number of those presentations that are available electronically, there is something much more valuable in the person to person, the actual conference to beat it. it sounds like you discover that. because you interact with others. you find out who knows what and who doesn't. just that, networking, milling around, when everyone called is extremely valuable. we also previous commissioner went through quite a career in the public domain within-because he

served on our board and is also work for whatever actuaries. so i think the possibilities are there and i'd like to encourage everyone to take advantage of those conference opportunities. the ones that are specific to public-not public health, but our public lands. they are the most beneficial and they're so much to be learned. so, thank you very much. it's very interesting to hear the information that you presented and i look forward to trying to access some of that good i just want to add likely, retirement board yesterday did it five-year demographics report. i think while their populations are not the same, there is some very valuable information available on that report. i can get it electronically or be happy to share it. >> thank you very much. excellent. we look forward to receiving it if we can. thank you. is there any other public comment? hearing none, item for

>> item for discussion item. directors report. director.. >> catherine.director of health services. my report is behind tab for. much like we have a complete health service board we are very close to having a complete hsf staff. we are in the final stages of filling the graphic artist position, which is woefully needed. since we added bonus, rosemary, our communication manager's work has just quadrupled. so we did an initial interview and would do the final interviews on the 21st of this month. and have a graphic artist and an assistant person in place.. it just unfortunate we could not have done it. we the budget was signed into law on i think august 1 and we will have filled this position 21 days. this is record time for the

city and county. but, a lot of the open enrollment work was done. nonetheless, we are also in the final process of hiring the analytics staff person was going to work on the claims database. we have with us to new staff people. marie, murphy. read you want to read your and >> please stand. please stand. >> marie has a phd in sociology. that's not why i hired her. she's a research assistant for the departments. i will credit her with the eloquent testimony that in your book today on the codes on advanced care directives. we also have with us this should all-how to icy alaskan? i was right on. he is working on emerge to image 9.2.

transition. we are delighted to have him. he has years of experience with kaiser. so, >> welcome. >> jeff kleiner, who is not here, after 25 years, we promoted into senior eap and were adding a staff position in eap. this is the first time would increase staff for employee assistance program in 12 years. the operations manager, our new operations member services manager will begin on august 17. he will be at the next board meeting and he comes from usc w has lots of experience. and we will continue to keep two positions empty per the requirement of having attrition savings in the budget. which is kind of ironic. nonetheless, were almost fully staffed. maybe someday we won't have to keep positions empty. in terms of operations, all customer goals

were met. i just want to point out, we stopped 17 people on the holdover list. that's down significantly since i came. for those of you who don't know what the holdover list is, if you are laid off, you get health benefits at the same benefit rate you have for five years. that's for you and your dependents. every year we are required to make them certify that they don't have access to other coverage. so nothing for people actually have other coverage. because they found other work. open enrollment, preparations begin in june and we are in the midst of editing and editing. the changes include the new united healthcare national lapd ppo. they also include the new fsa vendor for

our fsa's. we implement the cobras in july. we are doing what they call six meetings as we convert to peoplesoft 9.2. so there've been several of those trying to make sure that transition goes smoothly. i think it significant to say we enrolled 700 new retirees in the last two months. so, that's a huge amount of work for our benefit staff. i'm going to skip through other than to say among you all approved the budget for the enterprise contract management solution, and that was approved yesterday. now all we have to do is select a vendor and start scanning and it's very exciting. i'm waiting for years for that. the web statistics are in your binder.