individuals and we typically our services have been a third or two third of their daily requirements but in this pilot program we said what happened if we feed 100% of their nutrition needs, a breakfast, lunch and dinner. we designed this program. it lasted about 5 months, 25 people with hiv, 25 people with diabetes and conducted a full extremely diligent study of health outcomes from a qualitative to quantitative fashion. the results are coming in. we are not releasing those numbers yet but to give you an indication on these slides there was a huge increase in food insecurity and the education piece was so critical

and people going from snacking on cookies and chips to soda as to snacking on fruits, vegetables, to salads. just the education component can be so critical. improvement in depression for people with hiv. market improvement in hrt add heerps -- adherence and for the diabetic group reporting fewer glycemia and fewer reported to the emergency room. the last bullet point most importantly is people being keane keen to doing their self monitoring and people being able to do this. that ties very closely and we are very fortunate. an organization manner which is very similar to project open hand another managed care organization where they tracked a number of individuals who were on the manna program and compared to direct cost of

controlled individuals who were not part of the manna program. you can see here. a both short-term and long-term reduction in savings. that grew to about 37% savings over the proceeding 12 months. that hospitalizations were much less and inpatient care was much cheaper for that group of individuals. there is a growing amount of evidence that says if you can provide a healthy nutrition food to everybody, they are going to improve. that's why we look to more innovative programs to providing dollars for housing and why shouldn't they also provide medi-cal dollars for food. it would be a very simple low cost innovative project. we are

advocating for these projects. you asked what you can do which is to support these initiatives and we can affect a fairly significant change if we can convince people to put health care dollars to feed people. wle find great savings in health care. with that, i will open up to any other questions. >> do we have any council members with questions? >> i just have one question and comment. i'm familiar with your pilot study with three meals a day. i had a few clients on that study and their lives improved remarkably. not only were they with better health outcomes but were more alert and better able to take care of daily needs and all sorts of improvement. it was across the board great. we were sad to see it

end. we were working diligently to expand that program. we have an opportunity to start a new program with a much larger population. so stay tuned for a little bit more information on that. >> that was going to be my question. thank you. >> yes, so stay tuned. >> okay. are there questions from staff, comments? >> the connection, i can see the writing on the wall. so here is an idea where i'm wondering if it has been thought of or that typically ask for. we know that federal programs and federal initiatives to demonstrate the connection take a long time. in the meantime people are dying

and we end up spending way more money. what if there was a local initiative that through some legislative action that would advocate 50 $0.50 on the dollar or a minuscule amount of money that would add to a big fund. of all the larger restaurants or a certain amount of money. that would actually come to the non-profits that could actually leverage that and they can work not only in providing the meals, but maybe even cultivating community gardening and sustain our gardening and allow people for exercise and connection and eat what you grow, right? >> right. i don't think any of us would refuse an opportunity to get more funding. so i think what it comes back

to is that while it's obvious to many of us, people still ask for the proof. so, that's where a lot of these programs are really important whether it be the manna program in terms of with a we are doing. i think there is a ground as well of that data now but i think it's a little desperate and what we are trying to do is pull this together. >> there is this brain research about chronic exposure to stress and your body shutting down. that has a strong connection. you can make the argument. you don't have to wait for another 10 years of data coming in. >> that is possible. i was at a meeting in dc last week around the coalition of organizations doing the work. for the first time on the house floor there was a congressman who spoke about this as medicine. finally we are

getting there but we are hoping that not just one is going to do this briefing and we hope to expand the information. we will never refuse opportunities for greater funding. as we said the need is there. we would feed the people if the money was there to do it. we know where those people are. we know how to do this work. nobody does it better than we do it. it's all about accessing the dollars. >> getting to one final question. what is the waiting time for a percent wanting a medically tailored meal? >> all of our clients through our wellness program which is that program that deals with the chronic illness have to be referred by some

sort of medical professional, whether it's an rn, rd, social worker or their physician. as long as we have that form and they qualify, we can get you a meal within 24 hours. >> thank you. >> that's an easy one. >> any other staff questions? i want to thank you very much for your presentation and have a good afternoon. >> thank you. >> we will take a 10-minute break. >> please stand by...>> welcome

to the mayor's disability council >> >> good afternoon council members. today i'm going to do a brief presentation on the capital projects for the city and county's ada transition plan and to talk about the projects in different phases of construction, design and/or in the pipeline. over the last 10 years the city and county have spent over $43

million on ada transition plans and projects to span over 100 projects. the transition planning period is approaching the end of it's 10-year cycle. some projects we'll talk about today m construction and design are at the tail end of the 10-year cycle one of the important projects especially for the eastern part of the neighborhood is the bayview opera house. this is currently in construction. it's scheduled for completion in the early part of 2016. the building itself has historical significance. it's over 100

years old and as one would expect in a 100-year-old building you come across some unforeseen circumstances. so, part of with a we are doing, what the project team is doing with this project is dealing with those circumstances and this project has been developed in coordination and collaboration with the arts commission. mod provided about $600,000 for construction of accessible features within this facility. another arts commission facility, the mission cultural center for latino arts received it's notice to proceed

a couple weeks ago. it's a basic barrier removal project that includes restrooms in the third floor and wheelchair lift to the mezzanine level as well as making the gallery on the second floor accessible. there were prior removal projects conducted at this facility back in 1997 and '91. this project is scheduled for completion in the middle of next year. san francisco city clinic. we are scheduled to have a preconstruction walk through with the contractor. again, getting set for construction at the end of this year. it's a small barrier removal

project focused on the program areas within this clinic. as well as unisex toilet and the reception and waiting areas in the clinic. san francisco general hospital has a bunch of on going projects. some of them you may already be familiar with. building 5 for example has a series of upgrades to the restrooms in building 5. they were done in three phases. currently we have completed roughly 30 sets of restrooms in building 5. in addition to that, we are taking on upgrades to a set of restrooms in building 40 as well.

but the portrero avenue entry ramp will start as well and will provide greater access from portrero avenue on the northwest end of the campus. the project completion is scheduled to be the middle of next year. another ramp project is building three. we are currently struggling with the challenges in terms of parking disruption given all the construction we are working on campus and sf gh is working for parking improvement for people receiving dialysis treatment. next we move on to projects in the design phase for the school

year. and here is another department of public health project. maxine hall project clinic split in two phases. the first phase is for ada upgrades at the restrooms on the second floor and the second phase includes tenant improvements for public health patients for examining rooms and doctors office. it will also include a new elevator and will increase and provide access for the department. we are still working through the design phase and figuring out funding

alternatives for that project as well. the other path of travel elements that will be triggered as part of the tenant improvements of course will include the ramp at the front and sidewalk at the front entrance of the clinic. one 1101 grove street will revenue hand rails. they made sure the handrail details for the ramp for the existing hand rails on the stairs. in addition to that there will be new

handrails for ramps and stairs. the second will add an alternate on the contract and we are waiting for the contractor on that piece. that's again ready to go with the construction. >> we are digging a small barrier removal project at the laguna honda hospital that includes providing new accessible parking as well as connecting those new accessible spaces to an accessible route and entrance to the lhh. the youth guidance center is another one of those projects that will be split into two design packages.

the first phase will address the entrance ramp. and we are currently working with the juvenile probation department on the second phase of the project to upgrade the restrooms on all three floors of the building. we have multiple rec's park projects on advanced design phase. the ones receiving special attention are the golden gate park senior center and looking to upgrading the path of travel to the center and the paths of

travel to the baseball diamond, playground. the zoo primate center viewing area is being upgrade to be accessible as well. those designs are currently being reviewed. another project around the corner from us as far as rpd goes is the civic center plaza second phase. the first phase occurred a couple years ago. moving on to the projects in the pipeline what we will be seeing in the future also in terms of staying on the

recreational park projects. we are currently reviewing the program access requirements vis a vis the 2010 d. ada standards and recreation plan for ada developments included in the new federal accessibility standards. this information will be put into or integrated into geo database so it will allow capital planning staff to search and sort through the barriers and better plan and budget for capital projects in the future. the team will also be coming to the mdc hearing to finalize it's priorities on these recreational ailments to

be finalized in the coming months. another arts commission project here, the som arts center with prior work done in 2001 & 2005. we are looking at opportunities to up great restrooms at the mezzanine level and elevators to the mezzanine level. the next phase as i mentioned earlier, the major transition planning projects are transition planning cycle is coming to an end and the next phase of accessibility improvement and

planning activities as far as is accessibility goes would be focused on the maintenance of is accessibility elements. that is an obligation for all title two entities of the law. and the focus will shift to ada renewels of homeless shelters looking at upgrading to elevators and maintenance of access through elevators as well as maintenance of restrooms in city owned facilities. with that, that brings an end to my brief presentation. if the council has any questions, i will be happy to answer them at this point. >> councilman wong? >> thank you for the update. i

have a question regarding laguna honda hospital. i know the residents at the new building and the path of travel getting to the administrative building at the hospital is very difficult to get through now. is there better access from the old hospital to the new ? >> this project focuses primarily on the point of arrival being by car. if you drive yourself to the administration building and connecting these new accessible spaces to the ramp. there is a ramp that leads to the parking area to the

administration building. there is an new curb ramp installed to the existing ramp. okay, you had they will -- elevator study? where was that? >> this is on the nine existing elevators within the campus. that study is under way. and will be completed shortly. but there is no current plan to upgrade those elevators at this point. >> it's for the old building? >> yes. >> okay. just curious. okay,

it's the old laguna honda elevator. >> that's correct. it's two separate projects and i failed to mention the elevator study. thank you. >> i used to work there and half the time i can't reach the button. >> i have a comment and brief question. my comment is after this presentation it's no wonder your job is full time. this is a lot of work and a lot of projects to juggle. i just want to say i appreciate all the effort. >> thank you. >> my question is on the slide of the som arts center you said they were getting an lula elevator. what is that?

>> a limited use limited access elevator. >> what does that mean, does it carry lighter loads, it's for the disabled in ? >> it's a cat -- categorization. that's a good way to describe it. >> yeah, i think that our other deputy director joanna gave a good comparison. it's much like a wheelchair lift, it's something that's closer to the size of a lift, but it has a lot of proovrments in -- improvements in terms of the control and reliability. the wheelchair lifts, for example it has the automatic doors instead of the manual gates. it's considered an economic alternative to

putting in a fully chapter 31 complying elevator. it's oftentimes used in smaller spaces where we can't fit a brand new complying elevator. at the som arts, specifically that used to have an elevator and shaft so the lulla is designed for the existing space where the old elevator was taken out. thank you. >> are there other questions and comments from staff? >> i have a couple of quick comments and that was about the elevator study. this l councihas really been instrumental over the years at helping us to set priorities and identify future projects and when we look at el -- elevator studies