>> >> good evening, ladies and gentlemen, and welcome to the regular meeting of the the meeting will come to order. this is the regular meeting of land use and transportation i'm supervisor cowen the chair of that to my right is supervisor wiener the vice chair and to my left is supervisor peskin he'll be joining us shortly our clerk

is victor young and like to make a moment to thank jesse larson and phil jackson if sfgovtv for broadcasting this meeting today mr. clerk announcements? >> electronic devices. completed speaker cards and documents to be included should be submitted to the clerk. items acted upon today will appear on the may 24, 2016 board of supervisors agenda unless otherwise stated. >> all right. thank you so much well colleagues supervisor farrell supported this item he's here i'm turn the rest of the meeting over to him. >> thank you, madam chair call item one. >> ordinance amending the police code to prohibit anyone from keeping a firearm unless it is disabled with the trigger lock. >> thank you, madam chair so colleagues gun violence a

large irk across the country and here in san francisco one the leading factors continues to be the unsafe storage of firearms during last year the shooting in san francisco did a significant amount of work this is follow-up legislation because call the roll under san francisco law only handguns and rifles and shotgun are to locked i want to thank supervisor cohen and supervisor campos that did a past amount of legislation in the arraign this closes the loophole mandated occupy filers not just handguns have proper trigger locks on the department of justice list a recent study over 1.6 million children's were living with loaded and unlocated firearms and 73 under the age of

10 were in homes with no location felt parents firearms according to the department of justice status a program in the doj posted 90 thousand firearms are arrested in burglars and 15 percent are used in other crimes while this legislation self-was not an incident in the streets of san francisco thankfully i personally don't believe in waiting for a disaster this was a glaring will that we governed last year i'm proud to have it come to committee i want to thank quickly both alison and julie from the law center to protect folks from gun violence over the past years i want to thank and jessie from my office and katherine from previously my office for all but work they put

2, 3, 4 and i look forward to having the fame to be aggressive around gun storage laws colleagues he hope to have your support and i'll be happy to answer any questions you may have. >> thank you supervisor farrell and colleagues anyone in the cue let's go ahead and take public comment any member of the public please be advised hi, i'm al sob an attorney at the law center to prevent gun violence thank you for thereby ordinance to save storage orientals those amendments will require guns in not only the residence of the owner to be safely stored all firearms only handguns and require lost containers to be listed on the california roster of firearm safety devices this legislation

is very important accidental shootings is a significant problem in the country territorial were responsible for one shooting that year on may 1st the post recorded in 2016 the piece of shootings by toddlers accelerated thinking lost cabins in the homes are substantial to gun stoelgz the u.s. department of justice reports 90 thousand firearms are stolenyear during burglaries and unlost guns in home are for people that want to do harm the sandy hook massacre used guns from his mothers arrest natural that makes firearms less likely to get to toddlers and cancel teens

and closes the leadership such as a bayview of a woman to leave them around and theal shooting by children are undocumented and the safe storage law on the roster to insure sympathizer reasonably secure forbes in 2012 recorded a 3-year-old can open guns those amendments lake the safe storage have consistent with the second amendment gun people can carry a loaded gun and assess it in the matter of seconds thank you supervisor mark farrell's and the rest of the board for your consideration for this legislation. >> (inaudible).

>> at this time thank you colleagues is there a motion or discussion i'm sorry. >> apologizes towards the city attorney one clerical error. >> john gibner, deputy city attorney on page 3 line 6 the word handgun is missing so after the committee sought this out we'll submit a clean version with error corrected it's deleted basic in the wrong spot. >> thank you, mr. accept city attorney motion supervisor peskin this is anonymous thank you okay mr. clerk, call item 2.

>> item two resolution for an option agreement for the sale of block the northern one thirds by fulsome by the successor agency to the san francisco redevelopment agency to f four transbay partner, llc for $45 million thank you. i i believe that scott or ms. sally from the occ to present on this item. >> good afternoon, supervisors i have some copies of presentation for the supervisor as well as copies for the public thank you.

>> today to seek approval with the f four, llc for transbay block 4 for a sales privacy eve 45 millions and my that agenda for today is i'll combgd on block 4 and parcel f another within the transbay project area that is related to the matter before you provides some of the terms of the option agreement and discuss the determination before the board a fair market analysis of the sales price of $45 million other considerations we look at during the staff analysis and finally some steps here's the map of the transbay development project area divided two zone one of the state owned parcels

part of development of transbay the portion and block 4 as you can see right kiblgdz other than the right-hand side if you're unanimous familiar with that neighborhood on the transit center bus terminal till taken up blocks 2, 3, 4 parcel f is adjacent to the trans center i'll give you a little bit of background and block 4 in zone one of the project area under the occ land use jurisdiction with the temporary terminal zoned for a tower up to 4 hundred and 50 feet with adjacent mid-rise buildings that the townhomes and skoendz for residential use with the parking and will need to be a mixed income part of the requirements under the transbay

project area the desire project area must insure that 35 percent are available for protecting and moderate based on the projects we're working on now and upcoming pipeline within the district we estimate that 454 percent or approximately half of block 4 will need to be available in order to keep us on track with the 45 percent goal here's an example of massing not a project proposal i'll go into we don't have the specifics we're at option agreement stage based on the mapping residential design guidelines this is the favor what you'll see in the tower with the rise building on the townhomes facing the transbay park this is our block 3 we've developed by at a future date

as i mentioned parcel f is a t.j. tjpa adjacent to the transit center and zoned for seven hundred and 50 feet zone two has land jurisdiction designated to the planning department through the designation as you are familiar with an option process with the tjpa undertook for parcel f for the procedures for the transit center ultimately 9 process was not held but united states tjpa continued to have negotiations with the pre-qualified birds one of the birds was urban pacific they brought on hines development upward with the salesfroce tower and goldman sachs fifth avenue for the tjpa financing so they're familiar

with the transbay area in the project they submitted angle over offer to the tjpa parcel f and block 4 sierra club seeing the two projects work together right now we know about project f as mixed use has has a hotel in the middle and residential at the top the tjpa board approved the purpose agreement with the developer for parcel if for $160 million for march the condition was there was an approval of the option on block 4 from occ so we negotiated that option agreement and which was approved by our commission the purchase price was $45 million it could be load through the negotiation in the wrong direction or if that's the case lower we'll come

back for a fair market determination as i mentioned the site is on the location of the temporary transit center if for some reason the delays it is k9d for but the purpose must be equal or greater than fair market that's why we're here before you the developer whether deposit 5 hundred thousand with occ with the approval that covers the costs with an option for another 100 percent thousands if we need the costs and most importantly the developer agreed to provide for 4 percent affordable housing in the project with no occ subsidy that's a significant friction our commission approved it on april 19th of this year, the

other considerations that lasts until 2018 it gives over two years that's the average timeframe for any of the transbay blocks to move to the discipline process and oats new york city around the development and around that time we'll work to define the project the mass design and the fee and concerns something that includes approval over parcel f residential component assistance not within our purview of zone two goes to the planning department because of the amount of residential units it is important to understand how we meet the 45 requirement we have approve rights over that to know exactly how many units and what kind of housing one thing we anticipate both block four and parcel f they continue to refine to look at

whether that makes sense or make sense to offsite any of the avenue to block 4 we know challenges and including affordable housing at the top of these tower so see if 0 block four is a better site we do know i want to flag about the possibility analyze it that is a proposal made we'll come back to the board with separate approval so you'll be able to make your detectors at this time we're requiring the developer bring on an affordable housing developer with experience and providing affordable housing of 45 percent affordable housing project is a significant amount we want to make sure you'll see expertise we need - one thing that was important for us to flag this is the beginning an option agreement we want to signal we

have a couple of community benefit goals to work on this right now to incorporate the best practices and doing everything we can for the certificate of see corporations and the developers agreed that part of $500,000 deposit community-based organization toward certificate of preference holders to make sure we're learning what we can and providing the service for the housing but we're seeking to develop a robust plan that includes moma the contracting opportunities for small businesses and economically disadvantaged san francisco residents and businesses to make sure the empowering space there is ground floor retail and other xhernld used to make sure those are focused on the communities local nonprofits or small businesses, that would be

provided below-market-rate rates or other terms to help us improve the neighborhood that we can. >> so, now to the meat the fair market determination and so we're required to have a determination made under state law under the health and safety code the property must be the considerations for the property must consist of fair market so we provided to you in our file what we call a section 443 report that includes the option agreement and an analysis in any cost the disprobation officer of lands does this disposition help to eliminate light yes and what the estimated value again since we don't have a specific project before you at this point we used perimeters to

come up what we think a hypothetical development somewhere and did massing and estimate that around 5 hundred and 80 utilities plus for the tower and look at the 100 percent rental scenario all the units are offered at scenario a confined on other transbay blocks the top of the tower might include for sale market-rate homes and we looked at those are described go amongst the tower any subsidy it will be zero and what the revenues for each type of units and came up within an adjusted value and on the fair market of the lot and in the remedy scenario with an estimate of 18 want $6 million and on a reversal and centennial that was higher which assured us the

offer of $45 million did in fact, meet the requirement of the market-rate with a strong requirement from the developer and staff feels confident we are achieving the sate mandate fair market so another consideration is this does facilitate the sale of parcel f that is critical of providing 47 percent of units at their costs which the highest on the transbay this is a significant community benefit, of course, all the other terms of the project with highway, traffic and safety will be worked in the disposition that goes back and forth who the developer and what their design concept and the community benefits and standard d da terms based on that staff's recommendation the option be approved i wanted to highlight we have reached out to the community

this item was heard at the april transbay cac meeting and supportive and endorsed this with a couple of comments to ask us as and move forward with the affordable housing throughout the project there be consideration how transbay block 3 or the park will be programmed that includes high quality chrjz programs and the project there be high quality with exterior and for the unit designs for the residents and so for the next steps the estimated timing from the board approves the option agreement with the tjpa and developer will close on parcel f in june and we'll spends the remainder of 2016 working with the development team to have their dispensary join the team with the concept and framing and get into the meat with the

negotiations in 2017 and as an as i mentioned the terminal needs to be removed by the 2018 scheduled to open early 2018 that concludes my presentation. i have representatives of both the development team and the tjpa are here if you have my questions as well as myself. >> we have a couple of questions in the kind supervisor peskin. >> so relative to the $3 million from the 45, $52 million with the temporary terminal not abandoned by thirty june 2018 what is the timeline for the completion of transbay and the abandonment and demolition of temporary terminal. >> we anticipate the tear terminal will be off by that

point, we have as i mentioned occ blocks on three and four and other timeframes you know for next steps other than to continue to work with to your knowledge but at this point we don't anticipate past that point is a caveat should it in the be a mechanism built into the agreement. >> right i did descents on the vote this body loaned tjpa a quarter of a billion dollars to the extent the project continues to come in late and over budget it just gives me a heart burn to on intersections that might cost us an additional $3 million from 45 to $42 million i mean is there any arrangement arrangement if they fail that tjpa will reimbursement the city that $30 million. >> well, i'll turn to representatives the tjpa that

are here to answer that question supervisor. >> good afternoon, commissioners i'm mark intern executive director with the transbay joint powers authority. >> what's your name. >> mark. >> mark. >> you're the new executive director. >> intern. >> nice to meet you. >> nice to meet you as well your currently schedule to open the transit center in 2017 we saw no reason you'll not dedicate the parcel before 2018 we're confident that land block 4 and 3 as well with the adjusted block that be available by 2018 for - >> you have a 6 month cushion your telling us. >> yes. >> if you fail inform perform.

>> i will not fail to perform. >> perfect that's a good answer, of course, your only the intern director. >> not up to me. >> thank you, supervisor wiener. >> thank you, thank you for the presentation i thank you for this and it is exciting the project will go move forward and i on intersections the 4 percent affordable is terrific one thing i want to just get to classification, of course, nothing is free and so there is a you stated and also stated in the yeah in the presentation that there's no public subsidy to get to that 45 percent and so - the $45 million

purchase price that valuation that led to the purpose price was that 45 percent the or of the units will be below-market-rate. >> that's where we know the pipeline of projects in transbay we know that block 4 has to be 45 percent. >> right in to make that fair market salutation the 45 percent affordability number was baked into that evaluation. >> yeah. the community-based allows for that consideration they call fair reuse a shorthand the fair market to take into account any restrictions. >> i'm going to happy hazard a guess not 45 percent but to the esteem none of us want sold for

market-rate with no or loans 12 percent whatever the minimum under the san francisco law point evaluation of the property will be less than 45 percent. >> yes. it has an impact. >> 42 or 45 percent is a higher evaluation he know that is how you phase it even though it is correct is occ is not cutting a check you're the public subsidy you can build more affordable housing but occ is certainly going to receive less of a lower purchase price because of the higher affordability number than would have received if a lower affordability unable that's correct. all the transbay properties we'll state with a

minimum requirements will be and you know will be based those requirements. >> i'm not chris's that 45 percent is awesome but i'm saying i don't think really necessarily accurate to say no public subsidy there is a public induce in get to the higher inclusionary number of occ and the city is receiving a lower purchase price just like one 60 fulsome the occ basically gave the lands in challenge for the higher affordability there is always there is a publicubsi s here occ is receiving less money than lower inclusionary percentage. >> yes. tjpa will be the one receiving the landfill and like i said the government public entities it is important not

accurate to say no subsidys but a government subsidy in a reduced purchase price pushing the affordability up to 45 percent and some people that like to pretend we're just forcing the developer to do some high percentage and beating up the developer and squeezing it act out of the developer that might be true for a portion of inclusionary but a portion of the inclusion we're - i totally support inclusionary housing but help to increase the percentage that is important to be transparent that there is an actual public subsidy. >> thank you. >> thank you. >> all right. thank you let's if you're done with our presentation go ahead and take

public comment open for item 2 come to the podium if you have questions well. >> thank you, dean with local 2 the hotel and restaurant workers union i appreciate if supervisor peskin and supervisor wiener on the subject focusing on the questions of affordable housing and what we're paying for them obviously a close nexus in many that highlights between hotels development and the needs in the city more affordable housing the question of in circumstances when workers will be able to organize a union and to live in the city is obviously a huge focus of ours i was assured in the hallway prior to the meeting the project sponsors intends to negotiate with the union prior to entitlements and we're looking forward to work working towards that end

obviously this is a huge importance as the city decided whether that is appropriate to have a hotel and parcel the question of the quality of jobs and the impact that those jobs will have on the need more affordable housing is skairl in the jurisdiction of the city and at planning commission and ultimately the board of supervisors under section 303 and so it i look forward to future dialogue. >> thank you for raising the questions. >> thank you. any other member of the public to speak at this time. >> anyone on behalf of the preserve purchase that wants to confirm the comments by the speaker. >> afternoon i'm cameron with times i ask confirm we've. >> speak into the my case or

speak up. >> the tjpa we have an agreement to follow the labor recommendation policy of the tjpa so i this we're covered there with an agreement that any projects that we have applied for parcel we intend to be a mixed use project with a hotel component and that is the plan we haven't submitted yet and this is including a hotel or restaurant with the labor representation policy that are so forth we comply that includes that check neutrality we agreed from the psa to take that. >> thank you for your very important comment anyone else public comment is closed. at this time. >> colleagues if you note this item is agendize as the committee report the motion will need to specify that

is there another motion supervisor peskin? >> so moved without objection. >> a motion by supervisor wiener and without objection that item passes and the motion to move this out of committee as a committee report. >> yes. supervisor made the motion. >> supervisor wiener made the motion. >> sorry supervisor wiener made the motion to recommend this matter as a committee report to the tomorrows board of supervisors meeting. >> that's correct mr. clerk item 3. >> item number 3 ordinance designating 35 through 45 avenue a.k.a. emergency health center for blocks as the landmark under

the planning code article 10. >> excellent supervisor avalos is the author of this item he's right here and supervisor alavos we're ready. >> great, thank you supervisor cowen and thank you for scheduling that landmark designation ordinance i appreciate the discussion we'll have today on this is granting the historic landmark designations the brick building. >>was a former emergency hospital in 1933 part of san francisco emergency hospital that was in existence until 1978 after that the emergency hospital was used for other purposes adult health care was one of the last resources that

was used in through the mid 2000s the odds was the health center on over and over dog an example of that charles sawyer's project with two significant murals by bernard that had painted murals in first come in coit tower one called community spirit we have in district 11 and because those are significant murals and time for the work for the coit tower we want to make sure we provide landmark designation for this sight as well as they're significant because of the architecture and the aesthetic value of the earth and have a

huge community interest in making sure we can landmark those buildings in particular, the mission paris improvements association has filed an application that was done by alicia for moving forward with that application the landmark designation commission has voted unanimously i on intersections that was unanimous to grant the designation of two buildings it is really carrying forward with the community spirit to make sure we make that designation from the board of supervisors and we have a gentleman from the planning commission who is here to talk more about the project >> thank you good afternoon chair cohen and i'm tim frye from the planning department i wanted to add a couple of comments to supervisor avalos presentation at the may of last year the historic preservation commission added 35 to 45 to the land program bans

the community application filed with the department in february of this year the commission reviewed that historic landmark designation and this year it was unanimously approved a recommendation to the board of supervisors for local landmark designation and as supervisor avalos mentions the building is significant not only as part of the citywide health system of emergency hospitals that became one of the most comprehensive public health centers in the united states it was constructed in 193 that it was a final piece of the system supervisor avalos also mentioned the building was designed by city architect charles sawyer that includes murals by designers and you'll see the interior characteristic

dedefining features and communities members are in support of this and supervisor avalos is in support the department planning department supports the designation as it meets the eligibility reminder i'll be happy to answer any questions you may have. >> that you may have rewarding the hpc comments that concludes my remarks. >> that's okay. if i may add another thing i like about the - this designation which is not related to the building itself again i am excited there is a part of san francisco that is named after the likes of new york (calling names) they're all in this general region of the district 11 and that has a significant high school designation for you for our country that it is a

designation a founder body for the constitution based on the packs at the coordination to form their confederacy want to throw that in there. >> supervisor peskin. >> thank you, madam chair i want to thank supervisor avalos for supporting this and the planning department and historic preservation commission for their work it is a great case report to read i enjoyed residential design this this weekend and happy to be a co-sponsor this ordinance. >> any members of the public that want to speak on this item please come up and speak, sir. >> overhead please. my name is richard rothman and i sort of rediscovered those

those were really lost in the city whatever was listed in 1950 when the arts commission did a survey was forgotten about i found out about that when the real estate was going to sell a building and happened to be talking with barry in regards daughter that told me about those those are the two murals this one on the bottom well, first bernard at this point was burn if poland and came to the united states and studied under diego rivera's the most famous was the one on coit tower and the other famous was with the usf and if you've not seen those you should this one here see if

you can see the two growth in communities spirit this one was painted over white washed who knows why and this one is the community spirit and these are really you beautiful murals and they should be opened to the public so the public can enjoy them and here's another mural here i'm showing those beautiful murals and we'll hope that making that a landmark will keep it in the city ownership so the arts commission will have ownership of mural and that will be attentively and be enjoyed by everyone thank you. >> thank you, mr. rothman anyone wish to comment on this item. >> supervisors i'd like to my name is david hooper get to serve the

president of the new mission terrace that the jewel and the crown 6 excelsior thank you to supervisor avalos and richard rothman for having supported in effort richard because of his enthusiasm initially for the mural another members of the public have precedent his interests the potential for these buildings and terms of serving the communities in the future as they have in the past sits about the idea of communities health from the emergency health system that was opportunity and voted on before the great depression and this is a significant effort the last major use those buildings was for senior health services both services are necessary all the more necessary in the communities this gives the neighborhood and

community a chance to focus on improving mission street and the adjacent areas i'm not going to take the two full minutes this is a great idea thank you for teresa for leading the effort. >> thank you for your comments. >> next speaker. >> good afternoon, supervisors i'm linda i live in mission terrace and represent face a group called friends and advocates in the excelsior we celebrate an advocate for the rich currently heritage and rich cultures of our neighborhood that is a good work our communities is rich with artists for us to discover unknown murals and be able to say the historic building is particularly sixth our community

will rally around restoration community projects to make the buildings all they can be thank you very much. >> thank you. next speaker, please. >> all right. seeing none, public comment is closed. at this time supervisor avalos is there anything else you want to share. >> thank you. the members of the public for coming out and mr. roth marijuana for our great work to preserve the murals and the community spirit murals was accidently found they were doing work on the walls and removed paint and saw the work blow the surface spent a couple of months pelosi that off so it is just great we can actually weigh in and provide the landmark designations. >> supervisor cohen's. >> bernards daughter ruth

alive and well and sons and grandson of california contacted me last week to say they are very pleased and excited about the landmarking of this edifice and bernards work inside of it so good thing all around. >> this is a great thing on that ground supervisor avalos my claimants to you and agree with the public commenter that described i believe this project is a jewel in the crown if no further comments from my colleagues public comment is closed. and i'll entertain a motion. >> so moved. >> by supervisor peskin and without objection that that item passes unanimously that most with a workers' >> yes. >> okay madam clerk, is there

any additional business to come before this body? >> that completes the agenda for today. >> thank you very much this meeting is good morning. i'm be joined by city attorney jessie smith also here are tom [inaudible] evan [inaudible] kristin jen son and victoria, all working diligently on the action we filed in san francisco superior court this morning. i'm joined by supervisor aaron peskin and

soon scott wiener both of whom are working on isues related to this defend for many years. today, i'm announcing i filed suit against the silties largest property owners and land lob lords acad amof arts that detailed [inaudible] purchase and lease properties for use city wide. again and again aa [inaudible] use thrf property acquired was unauthorized, unpermed or prohibited by local law. again and again aau [inaudible] at planning and building code requirements which every other san francisco property owners is expected to follow. again and again aau flouted basic requirements involving signage, historic preservation and environmental review and more. most seriously of all, again and again aau

acquired residential and xhrjs properties to convert to student dorms and facilities. in doing so aau derived san franciscan of 300 residential developing we need in the misof affordable housing crisis as well as critly needed office space. infact, the stale of aau's defiance is breath taking. according to a planning department memo last month, the 40 properties aau operates in san francisco shown on the map to my right, 33 failed to xum ply with permit entitlement or authorization requirements. academy of arts is a agregious land use scauth law and defiance per cysts at the worst possible time for our residential. for as long as aau has been breaking the law, city officials have been working to get them to comply the law

and i'll confez i was sometimes less patient than some of my client departments about those efforts. make no mistake, for more than a decade our city worked with aau to resolve the violationment we extended aerfck professional courtesy and no one can doubt the good faith san francisco showed work wg aau and yet again and again aau met our good faith with bad faith and again and again sought to fix existing violations and scheming to commit new violations. aau set deadlynns it missed and made promises it broke. with a lawsuit today the again and again's end. sue toog end the wrong doing we ask to adjudicate 23

aau properties in violation. another 10 properties on the map remain under review by my office and may be added in a complaint in a later date. our litigation make certain san franciscos rights are protected and seeks objective no environmental r view process alone can accomplish. we seek to restore [inaudible] residential units. san franciscos right to have a voice shaping their neighborhoods. to end unfair business practices which disadvantage competitors who play by the rule jz penalties that are commensurate and sufficient to detrer would be laws in the future.

i'm conclude saying how thankful i am with the lawyers. i'm grateful the effort and patient of zoning administrator scott sanchez, to the planning department and to our planning commission. i'm grateful to aaron peskin who includes many san franciscos properties where aau is flout thg law for leadership and hard work over the years and to to scott wiener who pushed legislation to design to limit the aau's ability to flout san francisco's zonejug land use laws. before i take any questions i like supervisor peskin and when supervisor wiener can join us to say a few words. >> thank you city attorney, i'm here to commend the city attorney and staff for finally bringing this action. we have been waiting patiently perhaps two patiently for over a decades.

this is disproportioninately impacted the northeast corner othe city where hundreds of units of affordable housing are removed during the height the crisis. the academy played san francisco for a fool but that is coming to a end today so let me thank city attorney her aa and deputy city attorneys. >> thank you supervisor peskin. i'll let supervisor wiener say a few words when we gets here but in the interim happy to take questions or refer to my staff. >> [inaudible] >> took so long for? >> all this to come to a head. [inaudible] for a long time. >> it has been no secret i have been less patient than others. there has been i think a process of [inaudible] and dlie by academy of art leading people to believe they were

going engage in a good faith effort to remedy the issues and to our clieants credit they gave them every opportunity. they bent over backwards to give them every opportunity and despite that the academy of art did not engage in good faith. there is no secret that they are economically politically powerful and have a lot of resources at their disposeal and used every one to kick the can down the road. this has toened and that is why seeing the planning department issue their round of notice of violation and think everyones patients has run out. >> [inaudible] >> it can not alone. you probably heard or may hear from aquadomy of art we are so far along in the eir

process why in the world would you drop the law suit now? this has nothing to do with slowing down anything. the eir alone doesn't remedy past wrong doing ortake care of violations that are currently there. it doesn't slow down the eir process at all and the fact of the matter is this process has been going on for more than 5 years which is unheard of and that is because of their delay. >> the academy is iis aing they had a generous settlement proposal on the table and you turned it down. >> i say that is groussly over states the facts. settlement discussions the particulars i can't go into because they are conficial but nothing is further from the truth a generous offer was put forth. there was

numerous settlement discussions but it became clear to me they were going no where because the aau wasn't taking this as serious as they needed to. i wouldn't have fall filed the suit if i didn't think i needed to. before i take questions i want supervisor wiener to say few words. happy to have supervisor wiener here and he has been pushing legislation and working for years to limit the aau's ability to flaut the law and make sure we have even handed enforcement with educational institutions and mast r planning. jerk >> thank you dennis i want to thank the city attorneys office to moveic forward to enforce the law. it is a basic concept that everyone needs to fall ow the law. when we passed zoning

limitations, when we passed housing measures to try to protect our scrarserantal housing stock, it is important those laws mean something and it means something when the board of supervisors passes a law that says universities need to build their own housing but can't buy rent controlled apartments and convert to dorms. it means something when we have restrictions in the planning code limiting how you can use properties, there is a reason why we do that and everyone needs to follow the law. in 2012 i authored student housing legislation to do that, give incentives for universities to build student housing, we don't want student housing at the expense of the general

population cannibalizing the housing stock. just a couple months ago we passed a legislation and thank to supervisor peskin to support it, to beef up our coud enforcement efts to make it easier and more efficient for our department to enforce the law and to empower the city attorney to step in when thingerize not moving quickly enough. thank you to the city attorneys office to moving forward to make sure everyone follows the law. >> thank you. ileler continue taking questions to the extents people have them. >> you seem fired up >> i am fired up. this is embarrassing, we are sitting here and fighting this for 10 years and i'm angry about it. i know these two supervisors are angry about it. i'm angry about it because the vast majority of people in san francisco know what they have to do to play by the rules and if you had a issue at your house or small business you know

the standard and the process you have to go through with the planning department. here we have a entity that didn't just ignore the rules, they actively flouted them and it is infearating. i think this go tooz had heart of what either inspires or detracts from the publics confident in the integry of government. when they see a large and powerful entity flouting rules that the ordinary san franciscan has to abide by, it creates a confidence in their perception of the integtry of government and that denigrates all our residential and what we do, so i am. >> [inaudible] greed. >> they are one of the largest property owners in san francisco and

this is a highly lucrative run by the institution and it is very profitable. >> is there evidence at all or investigation as to whether or not the corruption at city hall that allowed the academy to [inaudible] violating the laws over a decade? >> we are focused on remedying the problem and can tell you that i do know that while i may have differed with the timeline that my clients over the planning department were taking, i know they were doing the best they can and were motivated in good faith. i look forward work wg them, their patience has run out and they have had it because they know how much time and effort they put into it. we are just moving forward with that and cofds we

will be successful working together. >> [inaudible] as i recall where the academy appeared [inaudible] >> that is the timeline and the path that it is on to be--now, there are other timelines that haven't been met, so it may be met, it may not be met, but i think the planning department planning commissions is clear about their expectations so like i said, that in and of itself doesn't remedy any of this. they are still a lot of work that needs to be done. there is lot of host of buildings probably more than a 3rd of what we identified to get the use authorized they have to go before the board of supervisors to get legislative changes so there is a fair amount of work that needs to be

done. >> [inaudible] economic and political power to [inaudible] >> they know it was tremendous money and resources. we have been through probably 7 or 8 law firms they have been through that made various promises, different promises, different representations to property the boferd supervisor jz planning department and planning commission. a great deal of advocacy use that makes use of their economic power and use of political process. that is what i think has enable #d this to gee on for as long as it has. so, i think everybody has come to the ends of their rope. >> okay. thank you very much.

. >> good afternoon, the commission will please come to order and the secretary will call the roll. commissioner pating, here. commissioner singer, here. commissioner chow, present. commissioner sanchez and commissioner karshmer, present. commissioners, i'm looking at your screens. are your monitors not on? i'm sorry, it person usually does that. on the bottom right corner if you press the button it should pop on. second agenda item is approval of the minutes of april 19, 2016. >> approval of the minutes are before you, a motion is in order. >> second. >> are there any corrections

to the minutes? hearing none or seeing none, all those in favor of the minutes please say aye. the minutes have been approved unanimously. >> thank you, commissioners, item 3 is the director's report. >> good afternoon, commissioners. >> yes, please. >> we're so happy to announce that san francisco general hospital and trauma center has officially been licensed and is ready to receive patients. we want to thank all of the people who worked so hard to make this historic mile stoeb possible. i know our ceo is in the audience and just want to let her know how lucky she is to move into a brand new hospital this weekend and i know she will be working hard along with many. also, just to let you know, we have have 24/7 it teams ready to support the new hospital. they will be on call for a whole week and then of course

they will stand down if things look good in terms of any issues. so i think that is one of the best news. also mayor lee did announce his department of homelessness and housing. the new department is expected to have about 110 staff members, many of them transferring from the department of human health and service agency, we will have a budget of about 165 million, jeff costofsky will be leaving the department as he has been the recent director of hamilton family services, which is serving homeless families. so we really want to welcome him and i'll be working very closely with him in terms of our job, which is to provide the clinical services for all of the homeless, housing as well as the needs. homeless individuals that they serve. also just want to recognize

our deputy director, coleen chala, who worked closely with me in the development of our able project. we are partnering with the san francisco police department, bart police, public defender to launch a program that would allow police officers to divert drug offenders to treatment rather than arrest. this is modeled after a successful seattle program and basically under the program officers who have probable cause to arrest someone possessing drugs will take them directly to the public health intake site where they can be connected with treatment services. we have had similar programs like this and we can tell you at least 50 percent of the individuals do take us up on the pee tension of being able to access services. this is also one of our initiatives to ensure that people get opportunities and every opportunity when they engage with the police in terms of seeking treatment. want to acknowledge the fact that alice chen is to be honored by the san francisco

clinic consortium event and she will be honored for strengthening the city's safety net and improvements she has made to access to high quality health care for all san franciscoans. i will stop there and any questions the commissioners may have regarding the report. >> commissioners, questions to the director? i could ask the first one, which is related to your report on the climate and health program of 2016 i'm wondering if we could have that reported also. >> absolutely, we can do that. >> i was wondering whether you can expand on the issues of sentinel? we have talked about it here at some length, it just seems like happening. >> absolutely. we have a whole group of individuals in our department working with all of the other providers to ensure that our provider

network knows the issues. also this is a different community that could be using these, it looked like narcan, it looked like xanex or narcan. >> good afternoon, commissioners, so we have first of all i think what's interesting is that we often hear from our providers in the community first when these things are out and we have a great communication with our syringe access providers. we have a process that's not unlike our emergency response system so we develop a health alert when it's up for review and core provider review and we get it out to all of our providers that would be engaging with drug users of any

kind, people on the street. they have photos of the drugs that are safe, for lack of a better term. >> to follow-up, what about with sfusp >> we have our mailing list, we have the pio's at all of the (inaudible) and, yeah, we actually work directly with the school districts because the initial information a few months ago was in marin county or i forget which county it was in the high schools. yes, actually it was it was east bay. >> further questions? >> we'll keep you updated on some of the activities.

>> thank you, i think also the commission would like to welcome dr. alick, it's nice she got such a nice gift as the license so she has a hospital to operate. we're pleased you are on board and to thank dr. alice chen for her work, nice that the consortium recognized that. further comments from the commission at this point? >> i'd like to take a moment to again thank everyone who has been involved with getting us to this point. really acknowledge that on the 21st we will move our first patient into the new hospital, is that the intention? >> that's right, they start at 7:00 am and they anticipate being done by 2:00 pm >> it is such a big deal as both a city and as a health system and even commission giving kheers, this is just a really wonderful moment for all

of us to actually move the first patient who will get the, i hope, the penthouse suite to the new hospital is really a major accomplishment. so i would like to take a moment to thank everybody for your hard efforts and the wonderful success of this moment. >> that's very nice of you. i do want to also acknowledge we have everybody from it to outfit the whole system and (inaudible) done an incezible job. >> i assume there will be cameras there? >> yes, there is a media vepbtd and when we hear about the branding and marketing raifrp he will can talk a little bit about that, she has a whole plan with them as well. we had to do a couple little changes this week, we had ambulances that were practicing, there was a little bit of curb issue and this weekend they fixed that and i'm

sure there will be little things that come up, any time you move into a new home or anything else there's always things they have to fix as they use them so we anticipate that and i know staff is ready to respond to those in good fashion. so we'll bring you an update as well from our next meeting as to how well that went down. >> good luck and good sailing. >> commissioner sanchez. >> i would just add, pertaining to the opening for patients on the 21st, this is really a unique challenge not only for our hospital, for the entire department. and i think what has impressed me the most, having been there when the other hospitals opened a number of years in the 80's is the fact that there was a whole network involved. it isn't just our core staff, rowan had

to do multiple things, barbara led a whole different intervention, we have people from our different institutions, it, you name it, we were involved. it was a real, real commitment to not only the department of public health and the city of san francisco, to the health department and sfgh will continue to be a flagship of excellence in patient care but getting involved in the funding because we've already talked about the foundation and others who have given major major dollars that no other public hospital in the nation has ever got. when the rubber hits the road on saturday and on-going, we've been through some clinical trials and underway with reference to all these advise itds from csn, from the state, from the feds, whatever, that will continue. but we know that we have the confidence and the excellent staff and the collaboration and the network that we never had when we had the other, quote, hospital bill, we know that for a fact

and i really think that we're setting a whole new pattern of involvement and leadership pertaining to public health, county hospitals, and excellence that no one that hopefully other cities will be able to duplicate if they have the resources to generate it and more importantly to maintain it. that's our real commitment, to sustain it and to ensure that due diligence and leadership is in facting there as we continue to focus on our unique needs of sf general. well done for everybody but again it was a really unique pathway i've never seen before and i've heard many, many excellents from so many people from industry, from the community, from other academic science centers saying, wow, this is unbelievable. yes it is and we as a department, and the city, it's a commitment we have as a city and the leadership we had the last years to make sure that it

is a flagship of excellence and it will be a flagship of excellence. thank you. >> i might just note for information that the completion of the rest of our campus in terms of being able to use our new, the vacated buildings, five in all, is on the ballot for people's consideration. further comments? >> no, but in the spirit of commissioner singer who asks how we celebrate things, can we applaud the staff of the staff at the general for all their efforts and wishing them well. (applause). >> thank you. item 4 is general public comment and i have not received any requests. are there any at this time? all right, we can move on to item 5, which is report back from the community public health committee. >> commissioner. >> i was joined by

commissioner chow today on the public health committee. we heard two reports, one is a technical report in order to prepare us to present to the full commission. this was on san francisco health network primary care implementation as a medical waiver or the 1115 waiver. it has two parts. first of all the waiver was implemented beginning january 2016 and we are already into may. the specifications for the waiver are dribbling out, so this is a process in which we are kind of catching up with the bus, running, and this waiver will run to 2020 and will probably be the last of the 5 year waivers that we receive. this was the prime waiver that replaced the waiver that we had for hospital integration over the last 5 years. i'm just going to give you a quick outline of what we heard. it's both a funding and quality set ever mandates under

prime, which is public hospital redesign and incentive in medical, and it also includes global payments and program reform. the best way to think about it is moving us through pay for performance to become an accountable care organization. it's money, about $200,000 that will be at risk through medical with the goal of meeting certain outpatient performance standards and the department has picked three areas in three domains they will be targeting as their primary initiative. one is the million hearts initiative, reduce hypertension and cardiovascular disease. another is the chronic malignant pain management initiative and a third one is resource stewardship involving high cost of pharmaceuticals. so these are initiatives that will drive towards performance

and based on how we meet them, certain medical dollars will be at risk. there's also a second performance, that's the prime component i just described called global payment reforms. these are new rules by medical that will allow flexible funding for services, for example telephone visit nursing appointments and other kinds of non-traditional visits that previously we know effectively improve service but may not have been able to be billable. so these are really good things. implementing them will be a large challenge and the department has given us an outline and will come back over the next couple years with a more detailed timeline of the plan, how many dollars are at risk and this will all be hopefully presented to the health commission consortium. we heard the overview of that and we're just kind of getting

a summary. the second core report we heard was on the food safety program and is our annual review of the environmental health division. we had director stephanie christian present. the environmental health division, as you know, oversees everything from air quality, waste management, housing, health, sewer protection, hazardous waste and our all-important food safety. they have a total of 143 inspectors which, interestingly, are highly cross trained. you can start out as a food safety inspector and get on the job training as a toxic waste inspector and then go and inspect massage parlors and it's a very fluid and multi-talented staff, but it's one of the efficiencies and strengths of the department is that by being flex i will and moving their staff around they've been very efficient, very nimble, and very employee

friendly workplace. one of the other highlights of this position is that environmental health is embedded in our population health and public health department. this allows for collaboration, for example, around food safety or even massage parlor safety to link up services, for example, when we were looking for trafficking issues and some of the illegal massage parlors and making inspections. this is actually unique to our county. not all counties have the joint units. but we got the impression that the environmental health unit is meeting its needs and meeting expectations and then we heard specifically on food safety. we have 35 inspectors looking at food safety, 7500 restaurants and food trucks and hot dog stands that they go and

inspect a year, giving all the ratings and very high satisfaction rates from both the community as well as the restaurants. and i think the most important thing is they go out in a multi cultural way in chinatown and then the mission and give detailed training on how to provide safe food. and it's really building capacity which goes beyond and helps with prevention rather than being strictly a licensing or permitting division, which really makes our food safety program really unique. so these are two things that we lerd. i think that we (inaudible) do what they do and part of our annual review of environmental health. >> thank you, commissioners, questions to commissioner pating? seeing none, was there any public comment? >> there is no public comment request feir this item.

>> item 6 is a resolution in support of vision zero and automated speed enforcement. the resolution was introduced at the april 5, 2006 meeting. >> thank you, commissioners for having us back. my name is ana validzic and i am with the community health equity and promotion branch. as you remember we gave a presentation on april 5 on the status of vision zero in general and with the specific request for the health commission to support a resolution for a technology called automated speed enforcement because this is currently not legal in the california motor vehicle code and we are asking for local support to urge sacramento to make a change in that law in order for us to pilot this. and your request was it strengthen the resolution because you thought this was so great, thank you so much. so i believe you got a marked copy

in your packet, i just wanted to highlight that wae made some 4 major areas of change. we added a lot of language on the more data on the general traffic injuries here in the city. we added more language on the exact problem of speeding here in san francisco, we added more language specifically on automated speed enforcement, including a lot of reference to the controller's report that was issued about six months ago on automated speed enforcement and how effective it is, and those are all in the whereas clauses. and then we added a clause in the resolve section to address the privacy issues that some people bring up, saying that we really only support these, the data that is collected from the cameras can only be used for this purpose of this program and not for any other purpose. so that should address a number of the privacy issues. so i'm happy to give more

detail or answer any questions if you have them. >> commissioners, we have the revised resolution before us. was there any public comment on this? >> there are no public comment requests on this item. >> so we can have discussion, further discussion, on this and/or a motion for the resolution. >> can i just clarify? there's no sponsored legislation either locally or in the state at this point, this resolution would move forward to recommend to our government affairs for the city to sponsor legislation by the state? >> there are two local resolutions on record here in san francisco. one is passed actually by the board of supervisors urging our representatives in sacramento to take this on and make that change in the motor vehicle code, and there's also the commissions for the san francisco county transportation authority have also passed a resolution. so we have two

local resolutions. we did not get a sponsor for this legislative season, but we are, the city is laying the ground work to reach out to the people, the organizations that have initiated concern this summer so that we would be able to address those and go to our policy makers, assembly man ting, assembly man chiu and whoever wins the senate race and ask them to introduce a bill in the next cycle, which that groundwork starts in the late fall. so this resolution would be in support of that effort. >> thank you very much. >> thank you. commissioner singer. >> i just want to express appreciation for strengthening this and rewriting it and as this unfolds in the fall, keep us posted.

>> absolutely. >> any further comments? a motion for acceptance of the resolution is in order. >> so moved. >> and is there a second? >> second. >> is there further discussion of the resolution? if not, all those in favor of the resolution before us, please say aye. all those opposed? the resolution has been adopted unanimously. thank you very much for your work on this. >> thank you, commissioners, item 7 is a resolution in support of the 2016 community health assessment. again, this resolution was introduced it at the april 5, 2016 meeting. >> thank you. >> good afternoon, commissioners, my name is michelle kirian and i'm an epidemiologist with the community health assessment impact unit with the population health division. i'm here today to provide a brief update on the 2016 community health assessment.

as discussed on april 5th, the community health assessment was completed in collaboration with the san francisco health ement partnership and the assessment not only fulfills the health department's accreditation requirements but also the nonprofit hospital's irs requirements. to more fully align with the hospital's needs we changed the name of the assessment from the 2015 community health assessment to the 2016 community health needs assessment and this change is reflected throughout the rest of this presentation. in april, commissioner chung voiced concern another -- on the lack of data describing health trend in residents. while due to data availability and quality we were unable to provide better statistics for this population, we did add information regarding our limitations and our work to

reduce those limitations in a new appendix titled using this report. to this appendix we also added language clarifying how data are presented for different racial and ethnic groups. for both the section -- sex and gender we referred to the respective guidelines published by the department of health for guidance. commissioner chow noted that use of data might be complicated and how the overlap with the zip codes. again we were not able to put both the zip codes and neighborhood data on one map and maintain readability in one report so

instead we added a zip code map to the main report. additionally in the using this report appendix we added boat the zip code map, the neighborhood map as well as two tables cross referenced between the two and a link to an online interactive map of san francisco's geographies. over the past month there were various errors that were corrected and while the majority of them were sifrp typographical, grammar, spelling, formating errors, i'm not going to present all of those. i will just mention two. among the errors was a mislabeling error of the asian and pacific islanders on page 14 of the report and in the demographics section and that was corrected. we also replaced the annual amllosis and pertussis with

more data. both form a basis for the collaborationings with the nonprofit hospitals and other san francisco health improvement partnership member organizations. an additional whereas statement was added to the resolution to better place the community needs health assessment in this context. and during the april presentation the commissioners voiced a number of thoughts and concerns for the community health improvement plan process which follows the assessment. these concerns including commissioner ping's presentation to the health commission on how the goals and outcomes are going to change

with the update and commissioner chung's concerns that diverse language needs be addressed were both passed on to the san francisco health improvement plan partnership backbone who are working on the plan. this concludes my summary of the changes to the 2016 community health needs assessment. and i thank you for having me present today and ask if you have any questions. >> is there any public comment? >> there have been no requests. >> commissioners, questions? commissioner singer. >> thank you for this pretty important work because it lays the foundation for a lot of the work the rest of the department does in allocation of resources. so my question is really to director garcia. give us a sense of how you think about

using this information to inform kind of how we decide our priorities back at the department and allocation of resources and how you check to see, you know, did daily activity and urgent matters kind of take us off course from the fundamental plan of the needs assessment and how do we get back, give us some insight into how things operate. >> we really, this is a new process for us for this, particularly as we brought all the parties together and so i think this is a very comprehensive report. and we do recognize and it's a long-established where our issues of equity are and the need for equity in the department. i think as you look at the annual report you can see how we've really tried to focus in, as an example, on our black african american

health initiative. so we will use this as part of our strategic planning for the future and nepb look at it again as it comes to be again because this, again, is a relatively new document as we move together in terms of the groups and use it as our richter scale and use it in terms of our promotion, but this is how we're trying to look at population health data and its delivery. as you saw in my director's report, we hired dr. anya bennet, we can manage our delivery system and then influence the rest of the delivery system as well. there document is great and provides us some real informed information particularly in the direction we need to go. it's not just the department but how we move the entire city system of care in a new direction. so

i think, looking back, we can definitely use this and look at 2017 and then give you a report how well we're doing. we think that would be an excellent exercise for us to do. >> commissioner karshmer. >> thank you for this. it is really quite comprehensive. i do think it helps conceptualize the scope of the work of the department and as you were saying next year a report, a comparison of what this shows and what that shows, but it also strikes me that this is a way that might help organize our work in the commission, that it could be sort of a check -- i don't have this fully formed, but the idea it could be a way for us to make sure we are addressing each of these in some way over the course of the rhythm of our year. so perhaps we can think through how this could be a road map for us in terms of

looking at the work of the commission, the work of the department and the updates that they want. >> just to give an example in data, if we don't have the data for a particular population, how are we going to identify their needs? so we have a tricounty pacific islander community that has really been concerned about not the data doesn't target its needs because we put it under the api area. to really take that and use pacific islander as specific requirements for us to check on our data information will give us a better health status for that population. i thought commissioner chung's information about transgender needs and, as you know, we are about ready to look at a transgender business plan and that kind of information to really inform the direction we are going. i think it's a

great idea to look at how the commission can also look at their work and i'm sure planning director and our secretary can really think about how we can structure that. >> commissioner pating. >> first of all i want to thank you very much for including my comments, to me that's really the link, saying how this assessment impacts what we're doing going forward. i think what happened is like a plan to act cycle, last year's plan and based on our assessment influences next year's plan. i'm looking forward to when next year's plans will come out and presentation how you will link those two. i want to thank you for including. my second question or comment is when is that plan going to happen, when should we xegt, now that you've been through the assessment when will you come up with what the next steps will be? that's actually

what i think the commission is following is implementation of the plan, not necessarily assessment, although assessment is an important part of it. >> i'm not actually on the group working on the plan but i do know they are actively working on it now with a due date around the milds -- middle of this year. >> okay, great. with regard to assessment the data is so valuable not only to the commissioners and the department but i actually think it has such public relevance as we try to build community collaborative that it would be wonderful, maybe not this year but next year to get this data realtime and on the web where people can go, see it in there and have a solution and the data gets them there, that would be really wonderful. i don't know what the cost of that would be, but that would be -- realtime web based date

ta reflecting the complexity and the thoroughness done in that assessment report. as i told you, i keep a copy by my bedside and literally i delve into it every night, which part of the city has trees and which part of the city has no stoplights, i should avoid those corners, it's all there. i didn't know salmonella, i learned how to correctly spell it as well. >> i do believe it's also in pdf format. >> yes. >> you could actually read it through your i pad. >> okay. >> before we go further, i did want to follow-up on the question on the community health improvement plan because i believe that's also what commissioner karshmer was asking about. i think does anyone, can anyone today tell us what the

time frame is because it says here on your last presentation, next was going to be, and i appreciate that you put in the community health improvement plan within our whereas, it says. this is the assessment and then we're going to have our proven plan. i'm just trying to get a time frame so we can be sure we aren't going to lose track. >> colleen cappa as michelle stated the summary there is the plan's deadline. as you might remember, the community health needs assessment or community health assessment is really the compilation of many efforts. as dr. pating said, the foundation of a lot of work that's being done not just in the health department but across the county. so this needs assessment is really the foundation for hospital and community benefits plan and the community health improvement plan will inform the community plan, it will also inform the strategic plan for the

population health division, as well as the health care services master plan. so we're all working from the same foundation of data to make the same conclusions to move toward health city-wide. >> you're saying by the end of the summer. >> that's the expectation. it's being moved largely through the san francisco health (inaudible). >> commissioner sanchez. >> i would just say this is, it's an exceptional comprehensive report. the first time we have a comprehensive base line to look at the parameters and the subsets, as you reported here, outcomes, findings, et cetera, limitations, all the challenges coming up. it's really an exceptional document and it

keeps getting better and better for the documents our department is producing. astounding. could be published. >> a motion is in order. >> so moved. >> and is there a second? further discussion? if not we are prepared for the vote. all those in favor of the resolution for supporting the community health needs assessment report please say aye. all those opposed? it has been adopted unanimously, thank you. >> thank you, commissioners. item 8 is the san francisco health network update and just to note there is no action on this item, this is just a presentation.

>> please silence all phones in the audience. >> good afternoon, xhirs, roland pickens, director of the san francisco health network. it is my pleasure to share with you an update on the network and in today's presentation we'll focus on providing you first an update on the development of the strategic plan for the network. next, a description of our youth of a toyota production system lean management system in developing and monitoring and reporting on the status of our strategic plan, and then finally to provide to you an update on the development and implementation of a strategic outreach and communication

activities of the network and that presentation will be done jointly by rachel kagen and patty verbiglia who has joined us in the last year as a mayor's fellow, recruited to bring us her expertise in the area of marketing and communications. you will recall that when i last presented to you in october we had just completed a two-day strategic visioning session in september. that session lay the groundwork for the development of the strategic plan that we're going to review today. during that two-day strategic visioning session we developed consensus on our vision, mission and true north for the network. armed with the mission, vision and true north we were ready to use the tools

to guide development of our strategic plan. in march we did that, facilitated by consultants greg cruz and vera romy, who you met at your last planning says, they helped facilitate what you see in this picture which is one of many breakout sessions in march of this year during a two-day process of strategic planning, also known as ocean connery. we discussed what it means and what it would take for us to meet our mission, vision and true north. so in sum the product of our two day strategic visioning session, followed by our two-day strategic planning session, is summarized in the document you see before you

known as an x matrix. the x matrix is designed to provide a visual description of our high level strategic initiative, including our mission and vision, and our accountability mechanism anticipated outcomes and how it all ties to our true north. our current version of the x matrix is still in draft but approaching final format as it will continue to be refined throughout the month of may in what is referred to as a3 clinic, in lean terminology. we'll talk more about the a3 clinic in a minute. i'd like to spend a few moments just reorienting you to the x matrix document. first, on the far left are 6 true north, which we've

previously presented, which are safety, quality, work force, care experience, equity and financial stewardship, represent what we blaefrb to be the long-term goals of the network. as i mentioned this visual was previously shared with the commission and when you look at the box for each one of those, it provides more detail of what each of these true north means at the network level. for example, safety, the goal is to eliminate harm in all forms to both patients and staff. the next portion of x mate trex is the strategic initiative portion. that session that i mentioned was a process where we looked at all the various initiatives throughout the network and there were almost a hundred different activities that were being worked on across the divisions of the network. going through the lean process, we narrowed that almost hundred

list of projects down to initially 8 but really 9 strategic initiatives that you see presented and they are presented in rank order. no. 1, titled right information every time, everywhere, that was originally entitled implemented network wide ehr, but through our iterative process the group determined a better title was right information every time, everywhere. the top left corner depicts how these measures align with our true north measure. green in the color indicates a high coloration, yellow a moderate correlation, and white either very little or no correlation. the performance measure section of the x matrix

obviously will provide information on how we are doing meeting our initiatives. as background these were developed and first recommended in our two-day session and as we are going through the a3 two day process, we started in april and will end and will end in may. and the key leader section reflects those who are important in achieving these key initiatives. it's important to note we formerly formed five a3 teams for the first five priority rate projects because that's where we will be focusing our efforts over the next year, on the first five of those nine.

the next section. x matrix is the true north outcomes. typically in a health care delivery system, the organization's x matrixes have financial and other operational metrics for the outcomes and we've identified some of those in our network. however since, as you know, our network encompasses a wide range of clinical services, everything from outpatient to inpatient, acute rehab, home health, mental health substance abuse, it was important that we identify measures at the network level that offered the greatest amount of flexibility across this wide range of clinical services so as to account for the fact that a metric chosen for one type of care delivery system wouldn't necessarily apply to another. so, for example, in the

skilled nursing facility arena, hospital tracked pressure ulcers is a great metric and is being used there, but obviously that wouldn't apply, necessarily, in an outpatient substance abuse center. so again we've therefore gone to electing to use a composite of the true north from all the various divisions of the network. the network goal is to have 70 percent of our divisions meet their true north goals. for example, if we have 10 total metrics for safety, our goal is for 7 out of the 10 metrics to be met. again, this allows divisions to select the metrics that are relevant to them and their specific clinical offering. the use of a network level composite allows for alignment across all our divisions by setting up minimum standard metric to which each division

is expected to achieve. it's important to note the only metric that is not a composite roll up is the financial stewardship metric in true north, which, in consultation with greg wagner and jenny lue we decided to express as less reliance on the general fund. since the march session the development of the a3's for each of these initiatives has been happening throughout the department. this a3 development represents a significant contribution of work from the leaders of the network and across the network to really build consensus around the improvement activities that will be necessary for each of the strategic initiatives by defining the target and milestones and establishing

accountability mechanisms. and finally, this slide shows lean work is happening across the network and at different levels. some division are further in their laepb journey than others, but they are all coming on board. we know sfhg was an early entrant and honda has also initiated lean methodology. we implement, develop and monitor our strategic plan. that concludes my part of the presentation and i defer to you if you'd like to ask questions or make comments on my part before going on to the outreach communications part or go forward. >> commissioners, any questions at this point? no,

then we will --. >> the first thing i'd like to do is say congratulations to you for the move to the new hospital. you were thrust into additional responsibilities in the milds of the project, it was late and you got us back on track and i think we're all super appreciative. >> group effort. thank you. >> yes, but you would have been in front of us if you hadn't met it so we should give you the credit. so i want to ask you some questions that have more to do with outcomes than process. and i realize that you've described in detail how we're doing on many processes so that we get the outcomes we desire, and that's kind of a precondition to do that, but i also think it's worth sort of touching on a couple of those. so i guess the first is what is the key performance metrics of the network that you are

obsessed by? i know you have hundreds of them and you look at them carefully, but what are the ones that you kind of use in your head as, okay, this tells me how we're doing. >> obviously the most readily available ones are the financial ones. are we meeting our budget, are we performing within budget and if not is that appropriate? if we have an issue with fuller costs to network it may be appropriate that we are out of budget in terms of lower level of care placements. so finances is one important measure i monitor. the other is appropriate measure of care, how many patients particularly at laguna and as csfg how does that impact level of care. >> i know we're talking a lot about the details of that. my next question was managed care is 14 percent instead of

153,000 or so of the patients in the network. is that number going to increase, that percentage going to increase and what's 14 percent of the 156, is that going to increase and what implications does that have? >> the expectation is certainly that it will increase. the question becomes by how much more. i think we're over the hump in terms of the medical expansion adding new members to our network. we'll continue to see, i think, some more of that particularly as we come to conclusion on the covered california contract that will again allow us to have a few additional patients but again we expect most of those to be going back and forth between covered california and medical. the expectation is that it will increase but, frankly, we've already gt a little over a hundred thousand patients

within our network and in terms of our current capacity we don't have capacity to really add a whole lot of additional ones. so i think our goal really is to make sure we're optimizing access to the patients that we currently have already in our system, including the ones that are assigned to us and have still not yet even come in to receive care. but we can only expect capitation to grow, that's the real purpose of prime to expect us to survive with alternative methods of payment with capitation being the backbone of that. >> do you expect 20 percent in 5 years or 50 percent, what should be our expectation? >> i would say probably 20

percent, i would say, would be the most we might expect. again, we are staying true to our core mission of being that underserved medical managed care provider, that's our bread and butter. but we're also exploring ventures into targeted commercial contracts that make sense for our capacity and for the stability of our trauma center. so we have to balance all those things as we look forward to our future plans. >> and you said in your discussion that your goal was to reduce the amount of money from the general fund. and i'm curious by how much by when is your goal. >> so we -- one of our 9

initiatives is financial stewardship and we're actually developing those goals right now. so greg wagner is the team leader for that one, that group is actually meeting now to set what the ending of the general funds would look like. by the end of this month we will have a more final document with goals and targets identified. >> just to level that, what is the draw from the general fund for the network today? >> i'll have to let greg --. >> commissioners, greg wagner, chief financial officer. i don't have the exact figure off the top of my head, but it's around 550, 575 million dollars. so we have our public health general fund is a

portion of it, the bulk of it is in the network and i can give you the exact figure as soon as i go to a file. also in response to your earlier question, the targets and what we're doing for our true north and our response to it is one of the things we'll be talking about at the retreat, the planning session we have scheduled this fall. we're trying to develop the strategy and the goals and then tie that into both our lean process and the city's 5 year financial plan so that's one of the things that we'll be looking at is some of the variables and some of the options for how we bend that cost curve and what realistic targets are over 5 years. >> thank you. would you like to proceed, then, with the

remaining --. >> going the wrong way? there we go. hello, thank you, rowan, thank you very much for this opportunity. my name is rachel cagen, director of communications at the health department. i'd like to present my co-presentor, patty verbiglia she comes to us with a wealth in expertise in marketing, in change management and in working with organizations on strategy internally how to create capabilities for organizations so they can meet their strategic and business goals. she's going to give the bulk of the presentation because she's really been leading us in this work and already dived in and is doing a fantastic job, but i did want to start with a bit of

a vocabulary item. as you can see we're calling this the patient communications update. previously you had asked for marketing update and branding update and certainly those activities are within patient communications, but we have learned as we have delved into our organization to see what our capabilities are that this is a patient communication function and we need to build so we are talk to go patients we currently have, in reach, as well as outreach it attract new patients. a lot of this work has to do with looking at our own systems and how our staff understands the network and how our staff speaks with patients so it's broader than sort of a narrower market-driven marketing branding project so we have named it to reflect that. before we talk about what we're doing now and where we are going i wanted to remind you of some of where we've been and ou