be able to retire those systems and our contracts and so that is our hospital, and inpatient and billing system, it is our ambulatory care and our primary care and ehr that is in the primary care and other supporting products that we are purchasing and so both the new cost. >> and so that i think my point, really is, right now you have a net total cost of 181 million. i am just thinking, that what you have not incorporated in through the city is not really a savings, but you would have to come up with it a new system that is going to cost you money. so, it is not truly, 181 million that you have to spend the

extra. because you would have to spend the money to have the new system. >> absolutely. >> and that the cost of that new system is on the cost side, so you will see that there is added cost of 340 million and partially offset and so it is a net cost to us that we have been working on applying for. thank you. >> supervisor, tang? >> thank you very much for the explanation and i think that again, it is very clear the need for a new system, and one that is clearly a lot more integrated. since the item before us is about waving a competitive so listation process, i was wondering that there have been concerns about not going forward with the rfp process and could you talk about why dph decided or is bringing north this item. >> sure. >> thank you for the question. and i do want to say, we understand that and we get the benefits of an rfp and i have never asked for this type of

permission before i don't expect to, again. but it really is because of the unique nature of this situation that we are in. so i think that the way that we are really thinking about it is, this is not a situation where you have vendors that can provide you a product that all can kind of do it and you are going out, and looking for the best cost for a similar product or the best quality. that is part of what is out there. and that could be where we end up at some point. but what we are really doing proposing here, and the way that we are looking at this, is this is kind of a different route, instead of just buying a product from a vendor, we are proposing to say, let's take a different approach and go with a government to government agreement where we are leveraging both their system and their operations. and the reason that we are doing that, is because we have kind of come to realize, that by virtue

of that partnership, and not by virtue of what the software is or what the system is, it is the partnership itself, that we can do something good for our patient and that we can contribute to the medical research, and the popular, health management of the city and since it is by virtue of the partnership itself, there is by definition, not really another path that we can take to achieve those benefits for a patient population, so you kind of have an apples to oranges situation where there is really only one path that we can take that gets us all of those things that we see that are available to us. and so, seeing that, in front of us, if you are doing an rfp process where you are comparing apples to oranges, you kind of have a strange situation where you are either focusing our rfp just to capture those things and you can only get in one place, or you are putting yourself at

risk for getting something that will be less than opt mal for your patients. and so seeing that situation, we determined that we wanted to come bring this to the board. and say here is what we see, we think that there is a unique opportunity to do things in a different way that will have real benefitsor health system, and seek your support to pursue that alternative. if we did not, or if we were not able to achieve what we opened that we will be able to achieve with the ucsf whether for the financial reasons or the technical reasons or whatever it will be, i think that we will be back in a more standard place, where we will be building our own system and it will be more of a scenario where we are saying, that we need our system, which is the best product for us to go out and purchase. >> so i think that i get that, distinction and so, what if, and let's just say that you were to do an rfp, would that also be the process or the place for you to explore, whether this

partnership, would work out? >> well, it is a good question. and i think that there are a couple of concerns that we have about that route. we did think about this. and evaluate it. the first is, that we are again, proposing to negotiate with ucsf, they have a system that they have bought from a vendor, but our negotiations and ultimately our agreement would be with ucsf and not a vendor, so there is not a precedent that i am aware of for the governmental entity to bid and compete through an rfp process of this nature, ucsf bids on the patient, community care contracts with us, but those are service contracts.

this is unchartered territory of how the government to government, partnership will work, the second issue is if we were to go through a process of your standard rfp process, what does that look like? we want a vendor that will, be or provider of care and especially services for the population that trains our figureses. and if we did, and there will really only be one respondent and cap able. and meeting those criteria, if we don't include those and then we don't capture those benefits in our evaluation. and so that was our logic and our thinking on why, because this is such a unique, situation, it does not lend itself to the normal process

that is -- >> thank you. >> okay. if no other questions fl rose could we go to your report, please? >> yes, mr. chairman. the members of the committee, on page 17 of our report we note that the actual projected expenditures from july, first 2010, to june, 30, under the existing contract, the electronic healthcare system, between dph, is 52.3 million, and that is shown on table one, and again, on page, 176 our report. and the board of supervisors has appropriate ated the general fund moneys for the existing contract. we also know that as shown in table two on page 17, of our report, dph estimates that the contract with ucsf will cost estimated $341,919,891, over the nine to ten years and dph and

anticipates the savings of 160 million. and from the discontinuation of the existing systems, and reduced to the growth in the cost for the services which will result in the total net cost of $181 million. and for the contract. and again that is shown in the table two. on page, 19, of our report, we do know that a competitive request for the proposals and process will insure that all eligible vendors are able to apply and strengthen the city's after ability to secure the most qualified price for the needed services. and our recommendations on page 20, recommend that you amend the proposal that dph, issue a request for the proposals. if dph is unable to attain the sufficient assurances that ucsf

will be able to meet the criteria, and we consider it as amended to be the policy matter for the board of supervisors. >> thank you, there rose. >> no other questions, we will open it up to public comment. i have a number of speaker cards. sue car lyle and jim marks, and cluade and kneel, and hedie and dr. church well. >> good morning, supervisors. good morning. >> i am the vice dean for the school of medicine. and today, i strongly urge you to support director cer garcia' request to allow the negotiation to begin, for an net cost expansion of the epic system to include, dph. there have been extensive as you

have heard, internal and external evaluations of this, and a con ses sense has been achieved. and the ucsf, city and county of san francisco, partnership, has spanned nearly, 150 years, and together as we prepare to go into the opening of our magnificent, new and mark zuckerberg san francisco, trauma center, i urge you to exercise the necessity of the timely, implementation of technologies that will insure the best care for our patients, the adoption of the epic system for the did. ph will not only benefit, our patients but also enhance our practice environment for the 1,000 physicians and 900 trainees, many of which are already, trained to use the system.

as you have heard there is also, significant opportunities for increased revenue through improved efficiencies and better documentation. so again, i strongly urge you to consider this proposal. thank you. >> next speaker, please? >> good afternoon, supervisors my name is jim marks and i am the chief of 1,000 plus, medical staff. at san francisco, general and with my colleagues i am here in support for the ordinance to acquire an emr with the unique features that best serve our patients and providers. you have heard that we use paper electronic, and records as well as over 60 different records. and fk, when i care for the critically ill patients i cannot see the care or the medications that they have received in the

emergency department. and we are making and the regulatory challenges in the environment in which we practice and, we now have the opportunity to solve these challenges by negotiating the acquisition of apex and ucsf, implementation of epic and going this route, offers the substantial benefits to the patients and staff, compared to the other alternatives. and as you have heard, half of our physicians work at ucsf, and regularly use apex and this reduces the training costs and more importantly, increases safety because the physicians do not have to know and use two different emrs. and simply, all of our resident and fellow trainees know and use it with the same advantages, i cannot over emphasize the importance of this and insuring the patient safety with a workforce that moves back and

forth between the two -- >> thank you very much. >> appreciate it, next speaker please? >> good afternoon. i am the chief of neurology and the director at san francisco general. integrated electronic health record is a required tool of the trade for the doctors and nurses to get the care for the inpatients and outpatients when i announced at our faculty meeting that the director garcia was seeking to bring it to the hospital, the faculty actually

applauded and the residents say thank you, and i am inspired on a daily basis for the dedication of the providers on behalf of the patients across the care, continuum from the emergency, fair treatment, and implementation of the ehr is a major undertaking and having the enthusiasm and the engagement in the medical staff is critical to success and we have it for director garcia's proposal. >> they need to spend the time not learning a no. uhr and it is a safety, issue, when the provider, works in the hospitals as most of the doctors do is treating a stroke, patient in the emergency, department and when the minutes mean brain cells, any delay, brought by the infa familiarity is unacceptable, and when the doctor follows a patient in the outpatient, clinic it is at a different hospital that day and they need to be able to seamlessly, access the patient's medical record from off site.

and it is a mission, issue. the it is a special place and the link, will insure that the patients are at the center of our commitments to the patient care, and medical education and, research. on behalf of the service, and medical staff, i urge you to support this ordinance. thank you. >> thank you. >> next speaker. >> good morning. i am neil and a physician and a chief of medicine. and we are the largest department and we take care of people in this city, with heart attacks and diabetes and high blood pressure and hiv. if you have an iphone, imagine if you were forced to use an android this month and an ifor enin april and android in april and iphone in june and android in july. you would become, quickly

frustrated. you might make a mistake, dialling or texting the wrong phone number because you are not familiar with the software features that is what it is like for the 1,000, ucsf physicians at san francisco general who provide, primary and specialty care to 123,000 san francisco residents. and they have to toggle between the two different electronic health records. systems. one at ucsf and a totally different one at san francisco general as they go back and forth boetween the institutions losing your bearing in the electronic health record is not as trivia as texting the wrong phone and saying excuse me, it could mean the delays in care and patient harm and death for a patient treated by a physician, having to use, two widely different information systems. imagine ordering the wrong medication because of unfamiliar arty with two systems. and not only a human cost for

the adults. or the children, like the ones that were just in this chamber, but there is also, the grief for providers and unnecessary cofor tax payers and you have the power to prevent this. and behalf of the chiefs of service i ask you to support this non-competitive process. to advance the health and well-being of san francisco residents. >> thank you. >> next speaker, please. >> hello, heidi collins and iment the vice president of ucfhealth for the health record and the systems, at 5 hospitals and over 160 hospital and community based clinics. and i wanted to give the historical background on ucsf road to the successful implementation. and prior to epic, it undertook

a nine year journey to implement the functionality, this project had multiple stops and starts.

>> thanks, the next speaker, please? >> good afternoon, i am scott kene senior director and general manager with the health services a division of the corporation, required. the services february of 2015, it has been the electronic health and partner for dph for

20 plus years and we value our relationship. i am here today, in support of the letter flanagan shared with the board of supervisors regarding the waving of the competitive process requirements. for the selection of a new ehr and naming ucsf as the preferred contractor. we believe that it is not in the public's best interest to wave the competitive process and allow the sole source of the complex and high risk, 342 million dollar, information technology contract. we are asking that the competitive process remain in place, the competitive process, provides, dph the opportunity to fairly evaluate the key factors which include, an integrated system that meets the unique needs of the dph across the full care. and in addition to the exchange of information, with

non-affiliated epic partners, service level agreements for out time, warranty and support levels and a fixed fee implementation and the total cost of ownership. there are no examples of two organizations as large as ucsf and dph with different service lines and government structures coming together in a shared system. this is a very important long term project and we urge the board of supervisors to reject the wave request and follow the normal competitive process, that will allow dph to select a supplier that can meet their unique needs. thank you. >> next speaker, please? >> good afternoon, supervisors, my name is eloise and i am a san francisco resident and i do not have a slew of initials behind my name as t the ladies and

gentlemen before me. it is a great need and it needs to happen and no one has the passion of the members of the san francisco community more than i do. this goes far beyond the project. the concern is that we are being asked to wave administrative code 21.1, which actually is a protection for business? san francisco, and dph even stated this is for the business of health. well the business and small business of san francisco, have not had the opportunity to engage with anyone. to partner with anyone. and to move forward to be able to be included in this process. this sets a dangerous precedent. and as we move forward, this is a significant amount of money to the sole source of individuals and not to mention that the data that ucsf is going to be able to accrue and going to be of a great value to them and provide, more dollars into the network as

we move forward and we begin to negotiate and negate 21.1, then all of the other contracts that are other larger constitutional contracts that are coming down the way will get much more scrutiny than this one is appears is getting right now. so, i absolutely urge you to reject this as and provide a waiver, and absolutely encourage you to move forward do a competitive process as this administrative code was desiepd to do. thank you. >> thank you. >> next speaker. >> ♪ >> if you are searching for your health records i am sure that you will find the information there. if you are searching for health

records systems. i am sure you will find it helpful safe in there. >> thank you. any other members of the public wish to comment? >> okay. seeing none, public comment is closed. >> i will just say from my point of view, i never, we don't like doing these, and or it is not of the preference to do these type of source things but from the process perspective that is why we have the ability to wave it if we need to. and i am, very conscious of the economics here and i will say from my perspective. the integration, here from the doctors and the health department and i will just say that a personal experience and my folks over the last few years, the integrated system at ucsf and it is, critical. and i cannot imagine and i would not be in conscious not voting

for it. knowing how critical that it has been to their personal healthcare. and not being able to give everybody else the opportunity to do that. so, i understand all of the other kernshz i get it. but from my perspective, when it comes to it all, it trumps it all, i am prepared to approve this right now, and we are going to have the full contract before us and we can evaluate it at that time. that is why we have this procedure in place right now. and i would be happy to support it. tang? >> thank you, i do echo, sperp farrell's comments and also i will make a motion now then to accept the budget analyst's recommendation that if there not an agreement, reached in six months, that the department will go forthwith the rfp process. so, with that, then, i would make that motion for amendment and then, send forward to the full board with the positive recommendation as amended. >> okay. we have a motion by supervisor tang. >> and we can take that without

objection. >> mr. clerk, do we have any other business in front of us? >> on the previous, item, i believe that dph was wanted to propose an amendment that was different from the recommendation of the budget analyst. and i am happy to read that into the record, i don't know if --. >> sure, >> the only difference is if you look at the budget and legislative analyst report, the recommendation is phrased slightly different from the body of the report, than it is in the bullet point at the end. one version says if we are unable to conclude negotiations, in six months, we go to rfp, and the body of the report it says if the director of health is unable to obtain substantial assurances under subsection b of the ordinance, that we will go to an rfp. and we would prefer significant

assurances language, because it does not lock us into that hard deadline. >> and we agree with that. with he discussed that with the department and the wording that i read to you, today, is consistent with that. so we are in agreement with the department. >> thank you. mr. rose. >> do we need a different vote at this point? >> i think that your vote is okay. if it is consistent with the regular dagss. but just one point of clarification, in the write up to the clerk, we will not say that the department has to go with an rfp, if the negotiations break down, but that it has to go with a competitive sola solicitation process, which could be a range of options. >> no other vote needed? in no. >> any other business in front of us. >> i would like to request that the department provide the am d amended ordinance to me by 9:00 m a, tomorrow morning at the late. e >> okay. >> with that, we are adjourned.

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>> good morning everybody. and welcome to the hamilton family residents and emergency center. thank you jeff for hosting us today. i can't think of a better place to do the signic ceremony for our voter, but i want to say thank you to your and your staff for working with us to end homelessness for a lot of families and continue to doing that work. today we are here with a number of departments that includes our obviously public health and fire department and emergency services, city administrator that helps me oversee the 10 year capital plan making sure our bonds are affordable, focused and do not raise property taxes as well as public works deapartment who

helps oversee that very same goal and to a resident who lives right here who will talk about her experiences and the need for more healthcare and also more facilities in the city. as i said earlier, this today is a opportunity to sign legislation that the board has successfully passed with my support to place before the voters this june a $350,000,000 public health and safety bond for consideration. it is huge win for our residents because this bond seeks to protect-to make sure we have necessary improvements to our infrastructure and healthcare and emergency medical services, it protects and expand melthal health suvs for those in need and particularly

thoest on the streets. i will continue emphasizeing that we do this in a very responsible way. in all our bond and particularly the last decade we have been successful and made sure they do not raise property taxes while we do this and the reason we are able to do this is because we havetony year capital plan staff and assurance that we have sth facilities that we work together with the 10 year capital planning staff, that makes sure we only present bonds that reflect room in the bond capacity that don't raise property tax squz fit into that. that st. the magic, but it isn't magic for finance people, it is magic we can present new thing for people to embrace in like the voter jz not have to raise property tax to get those new things mptd in this case i want to make sure people

understand while we talk about the zuckerbering sf general facility we know we vanew facility that reflects the larger bond in the history of the city but we are also moving all those operations into the hospital as we speak, we are leaving a building that is not seismically safe and we are snot interested ichb demaunshing the bity. we are interested making sure the needs the public are reflected in the ongoing use of the 1970's era building we have ajaistant to the new hospital and how do we do nat? we need to make it seismically safe, we need to invite the services that we don't have in a new hospital as much as we have and reflect the ongoing needs that we have while ongoing with the leadership of

ourpublic health department has been the conversation we need more mental health facilities. this is where the judges are asking for more beds, the community asks us to take care of more of our mental health needs in the community and we want to use the facility we have and expand those services. at the same time, there is incredible need to make sure we work with our fire department because they are and continue to be the emergency response team that we have when ever something happens in the city. they have also informed us in addition to supporting more mental health facilities in the city, we need a ambulance response facility to meet the demands we have. we find in the community based fire station squz the stations that house the

ambulances not to have the facilities safe enough for the operation to expand and want you to know they are enthuse astic because more and more as our fire department and all of us are having a experience where knock on wood, we have less fires, we increase the calls for medical services and this is where i enjoyed work with our fire department to increase every facility that we have particularly the ambulance response and particularly the emt staffing that we increased over the last few years to respond to the ambulance calls and make sure we have that capacity. it just so happens that many the fire stations we actually have over all most a $600,000,000 need to increase and make sure we have seismically safe fire hours and can't do tin just one bond and keep the promise of having

the bond not increase property taxes so we do it in a way in which we can identify what is the most critical and respond tothat and this is what this particular $350,000,000 bond will do is help a number of critical fire stations particularly where we house ambulance squz make sure they are safe. we also want to make sure we respond to the ongoing need and i know media is here to talk about our ongoing efforts to house more homeless and make sure we have facilities that are transitional in nature as we struggle to rebuild and rehabilitation permanent house frg the homeless. while we do that the navigation centers are very success ful and people want more of that and this is where we will take the opportunity to place another $20,000,000 of support effort here and know the voters

get it when they see and have a opportunity to see our navigation centers that we know these are more than just shelters. they are gathering of all the support services we need to allow people to go back to their homes if that is their wishes so get the best service to transition them into permanent housing that we are building and we have places like hamilton and other places we are building but it takes time and a lot of money and we are do that bond after bond and done that with the $350 mill ,000,000 bond to find the land and make sure we build in an affordable way. we have many more ideas but these are the at buttes of the $350,000,000

bond we place before the voters this june. we don't have a bond for november so this is critical to have it to the voter squz educate them on the bond. i'm happy to work with general hospital and public health department because they have #250i78 time and time again shown wrathe need is respond to need and authenthuse astic about the ways we built the navigation centers because pier 80 and 16th and mission are the examples of what woe can do more with public private partnerships we engage in into help the navigation centers become more than [inaudible] they are life savingsenters for people who shouldn't be living on our streerts and shouldn't be in tent encampments. we want to take them out but want to do it the right way. we dont want to take people moving from corner to

corner, we want to make sure they are taken care of and have long term solutions to them. even those that resist ourerts when they get into the the navigation centers they realize the humanity we do there is more than inviting in the long term. this is and will continue to say, this is the city of saint francis and never turn our backs in those in need. people come to our city or end up here for many different reasons without the social safetyinate net we are used to. we have the robustness in the neighborhood clinics and response and navigation centers and want to make sure you know our neighborhood health clinics are touched strongly, all most

$50,000,000 bond because the clinics need the capacity to help with mental illness as well and this is a theme that we are increasingly hearing and respawning effectively by talking with all the partners within the justice system or health system, the [inaudible] needs more facilities for this to happen, more beds and treatment centers and more professional care that our public health providers can provide, so i want to say thank you to the all the airjs that are here reflective of the bond program including the mayors office of disability too because they are out there helping us figure out not only facilities but services that we need along with public health. i have a special guest speaker today, someone who is living here at the hamilton family residence, her name is

precious sharia, she a single mother of 3 children 8 years old, 5 years old and 2 years old and the sureara family stayed at the hamilton famry residences for the past 4 muchckt months and needed the service of the emergency care. the good example of the kind of families we want to help but not just help. i know at some point in time when she knows her family is being taken care of, i know mrs. sharia will want to be part of that work force, the incredible workforce we are training people to get into the new economy on. let me introduce to you mrs. precious sharia. [applause] >> yes, sir. i lived here about 4 months. the shelter took me in when i was on the street and called every day to get in the emergency beds.

i finally got in and then once i reached my room up stairs it gave me to about june. my kids live in the shelter but they don't realize it is a shelter because they have good programs such as the children program, helping with the homework, they give a dj party on the roof and make it so fun by kids dont know they are homeless sometimes. i like the-they feed us 3 times a day so don't have to worry about that. the shelter has ups and downs, but most of all it is a plus because if it want fl the shelter i would be on the stroostreet and worry where my kids will eat or sleep or give them up. if i'm in the shelter my kids can stay with me. in the streets i wouldn't permit them to live on the streets so probably would have gave them

up. i'm thankful and grateful. people have their different opinions about the shelters. some complain all day but at the end of the day you have a place to stay and sleep and it helps you. i'm starbting chef school tuesday so i'm doing something with my life. trying to make something better and the situation. this is my first time being homeless and from the experience it will be my last because this helped me but i am glad i was homeless because it showed a different side of me i didn't know, the strengths and dpoles goals and think it helped me a lot. sorry. it had so many opportunities. they constantly post jobs or injrj you to do. you can only do so much. hamilton can only do so much if you dont want to do for yourself. me, i'm taking a stand and doing for myself so i won't be here and hopefully i will be

a chef so i can cook for the shelter or homeless program. i will give back to the community as much as i can, i voluntary also. i don't have much to say, i thank god and the thank the people that donate and make this place possible because i see the ups and very grateful and thank you. >> [applause] >> thank you precious and thank you for everything you are doing to improve your life and also take care of the children that you have. as i said for this particular bond, i want to make sure you know if i can simplify it it is 3 words, it about access to good care, it is about emergency response, and about navigating and 33 word i thipgs are reflective in this. i just 79 to say our public health department

is incredible partner reponding to everything that happens in the city and next for tim episteen who is director of sf children youth and families community behavioral health at our public health department to say a few words about how important the bod is to the care we want and access that we want people to have to our healthcare facilities. ken. [applause] >> first i want to say before i start speaking precious told us her cheern use san francisco general hospital mayor all 3 children use the hospital so the connections are clear between what we are doing today and our future and i want to thank the mayor and city for your support for this incredibly important bod for the residence of san francisco. today this bond will improve and expand access to

services and medical care and mental hemth care in the community and community clinic squz san francisco general hospital. it will prurfb or 24 hour psychiatric care that is so critical to the citizens of the san francisco to have a place to go 24 hours a day, 7 days a week. 14 community clinics will be able to build access to behavioral and minuteal health and substance abuse services in the clinics so when you see your doctor in the same place you can get the mental health and substance abuse. the funding will improve access and amountimately help us renovate and build a better and stronger system of care for the children, youth, families, adults and other adults in san francisco. we know that there is a tremendous need for healthal

health and substance abuse care and the mayor mentioned. we also know folks will better utilize the services when it is isn't stigmatized where they have to go to a different place for it. we hope public helths can partner with the cities to build integrated care and using the bond to expand the services. thank the mayor again and the city for your support and public health department is ready to move forward this with initiative. thank you. >> [applause] >> okay, well like i usually said it is time to go to work everybody and by signing this document it sigal ins we ready to talk to the public and got on with it. let's sign this so we can start work on it. everybody come on over. [applause]

>> >> >>

>> you know i've always wanted to do this job that drives my parents crazy we want to help people i wasn't i did not think twice about that. >> i currently work as cadet inform the san francisco sheriff's department i've been surprised 0 work within criminal justice system field i had an opportunity to grow within that career path. >> as i got into the department and through the years of problems and everything else that means a lot i can represent women and in order to make that change how people view us as a very important part of the vice president you have topanga you

have to the first foot chase through the fight are you cable of getting that person whether large or small into captivity that is the test at times. >> as an agent worked undercover and prevent external and internal loss to the company it was basically like detective work but through the company from that experience and the people that i worked around law enforcement that gave me an action when i came to be a cadet i saw i was exploded to more people and the security he was able to build on that. >> unfortunately, we have a lot of women retire to recruiting right now is critical for us we gotten too low faster the percentage of women in the

department and us connecting with the community trying to get people to realize this job is definitely for them our community relations group is out attempt all the time. >> in other words, to grow in the fields he capitalized any education and got my bachelors degree so i can current work at city hall i provide security for the front of the building and people are entering entering but within any security or control within the building and checking personal bags is having a awareness of the surrounded. >> there is so month people the brunet of breaking into this career that was every for easier for me had an on the with an before he cleared the path for laugh us. >> my people he actually

looking at lucid up to poem like he joe and kim and merit made they're on the streets working redondo hard their cable of doing this job and textbook took the time to bring us along. >> women have going after their goals and departments line the san francisco sheriff's department provide a lot of training tools and inspiring you to go into the department. >> they gave me any work ethics she spider me to do whatever he wanted to do and work hard at the intersection. >> if you're going to make change you have to be part of change and becoming law enforcement i wanted to show women could do this job it is hard not easy. >> finds something our compassion about and follow roll

models and the gets the necessary skeletals to get to that goal with education and sprirmz whatever gets you there. >> if this is what you want to do dream big and actually do what you desire to do and you can go vertebrae far it is a fast job i wouldn't do anything else. >> ♪ ♪ ♪ ♪

the city of san francisco sfgtv meeting of the budget and finance committee